Tuesday, May 07, 2019
People made dependent on psychotropic medication have not abused or misused the drugs
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Twitter conversation this morning (see thread leading to my tweet) has made me realise that it may be misleading to say that people who have experienced antidepressant discontinuation problems have become addicted to antidepressants. I'm certainly not wanting to imply that people made dependent on antidepressants have abused or misused the drugs. There is confusion in the nomenclature (see eg. previous post and my Antidepressant Discontinuation Reactions webpage) and I don't want to add to it.
Moving from an outdated physical disease model of mental illness to a more relational mental health practice
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8 comments:
You can be addicted to a substance without having abused or misused the substance.
That happens for example with opioids. No a priori reason that it doesn't happen with antidepressants.
Duncan - may I ask please how much leeway psychiatrists have to prescribe or inform people when opinions differ for example about the adverse effects of prescription drugs. susanne stevens
Not quite sure what’s behind your question, Susanne. Can you explain a bit more?
I do understand what you mean F68.10, but several people who have had discontinuation problems do not see themselves as addicts. In fact, they find the term misleading, even stigmatising
"In fact, they find the term misleading, even stigmatising"
Yes. But that applies all the same to schizophrenic patients. And everyone tells them to "shut the fuck up".
I'm against double standards.
Duncan I meant that psychiatrists have different views about treatments and different philosophies about mental health issues. If they are in positions of teaching students how much can individuals convey their own views or are they obliged to stick to a prescribedcurriculum, Would somebody like you inform students that you are a critical psychiatrist for example ,Would you refer people who consult you to the literature? Individuals as you know can have a very different experience depending on who they consult. thanks susanne
Obviously there is uncertainty in medicine in general, Susanne, and psychiatrists as much as any doctors should base their advice on evidence. As far as treatment is concerned, although NICE, for example, provides guidelines for doctors, it does admit that its evidence is not necessarily as strong as it would like, even basing some recommendations just on clinical opinion.
I think your latest blog shows just how unreliable the 'evidence' is Duncan. Psychiatrists don't all use the same 'evidence' to base their treatments on - people can be referred to one and get a totally different experience than if they see another eg one whose own personal views are based more in favour of psychoanalysis and another who heavily supports drug treatment. The point I was trying to make is as I said - how much leeway do individual psychiatrists have to provide different treatments based on their own views. They don't all follow NICE and shouldn't if the guideline are unreliable. would you point individuals to critical psychiatry literature to provide wider information - it can take years for people to find there are alternative views if they are not happy with what they are being told.Are students actually taught about critical psychiatry ? thanks susanne
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