Do we understand brain chem enuff to hand out AD's and other meds?

In My Humble Opinion (IMHO)
#1

Just wanted to get some input from some folks.

I notice docs handing out products like lexapro, prozac, etc like candy these days.
I had one pushing it on me.

Also, benzodiazepines seem to be common place for all stress related issues.

Antipsychotics are getting used commonly.

I am not one to talk as I have used some of these products and used them successfully to treat issues on a one off basis.

It seems though at times products are pushed through the FDA machine just for us to find out later there are a lot more issues with these drugs than previously thought.

I also notice many drugs mention some nomenclature about “We do not fully understand the exact mechanisms” by how this drug works. Well are we opening up a dangerous wormhole here?

I realize some meds are very necessary for some folks but I get the feeling we hand out quick solutions without knowing long term consequences.

Thoughts?

#2

No, we don’t understand brain chemistry, or how these drugs are affecting it, very well. It is very complicated.

On the other hand, they are extensively tested on both animals and humans before being released for public use, and if they don’t seem to work (at least sometimes), or if they have serious side effects (commonly) they will not be released.

#3

Facinating topic, I started a thread a few days ago about our body being it’s own pharmacy. I can’t tell you how many lives I have seen turned upside down by thse drugs you are talking about. In many cases they do help but often they just put the patient into a state where they stop complaining. I wish more work would be done on behavioral tecniques that could stimulate healthy amounts of our own brain chemicals. Teach us how to recognise when we are out of kilter and train us to use rituals or excersizes that may get us back into kilter

#4

That has not been the case historically and I have no reason to believe it is true now.

Antipsychotics in particular have and are being used that are known to have some truly horrendous permanent side effects.

Almost all psychiatric medications change brain chemistry, which then, apparently, tends to be compensated for, thus causing at least semi-permanent changes in how the brain works, and generally resulting in dependence on the drug without the initial benefits that manifested themselves short-term.

In short, the pharmaceutical folks and the psychiatrists who prescribe are guilty of making claims for these meds that are not supported in the research. (I agree with njtt’s first paragraph quoted above).

On the other hand, as long as they are taken voluntarily, I think they should remain available. But their long and widely-promulgated advertising had done damage and an equally well-publicized retraction should be required.

#5

Thanks, good take on that.

As for anti-psychotics, can you comment on some of the permanent effects? What about seroquel? Anything on that one? I use that off label at a low dose (25mg) at times for mid insomnia.
Thx

#6

When benzodiazepines first became common (late 1960’s or so?) they were the wonder drug that replaced barbiturates (“Mother’s little helper”) which were implicated in many OD deaths. From then until rather recently, benzos were handed out like candy, and maybe many doctors still do. Lately, however, it’s become better understood how hideously addictive benzos are, and doctors are cutting back. I believe that benzos are no longer covered by Medicare in the US.

#7

Not sure about all benzos and medicare, but some docs are still handing them out like pez. Well at least in my experience. YMMV

#8

Another obvious problem, which I think is well known and widely discussed, is the take-over of the medical profession by the insurance companies in recent decades. One result has been the near demise of anything like genuine psychiatric treatment.

Psychiatric treatment has historically been a time-consuming, long-term, very time intensive specialty, consisting largely of various styles of talk-therapy.

Today, instead, shrinks are squeezed like other docs by the insurance companies, and they are strongly steered towards just making quickie knee-jerk diagnoses of their patients and then handing out the brain-pill prescriptions. Especially in institutional or semi-institutional settings (like HMO’s), psychiatrists have been largely reduced to being just brain-pill vending machines.

So you get a 15-minute intake interview, followed by a superficial broad-brush diagnosis. Then they just start throwing pills at you. If one doesn’t float your boat (after some six weeks of trying it), they try something else. The strategy is to just throw one toxic brain potion at you after another, until one either cures you or kills you (whichever happens first).

#9

The most debilitating permanent side effect from antipsychotics is still tardive diskinesia. The so-called “atypicals”, which includes seroquel, have a lower incidence of that than older drugs like thorazine, haldol, and prolixin, but it’s still a risk. With a low dose for off-label use for insomnia, it may be even more reduced.

Some deaths, development of diabetes, and severe/significant weight gain, and heart disease have occurred as side effects of Seroquel and the manufacturers were sued over it.

As with pretty much all the psych drugs, Seroquel modifies neurotransmitter activity and then the brain compensates for that, which constitutes a permanent (or semi-permanent at least) change resulting in dependency. In the case of Seroquel, it works by blocking the receptors in the brain that dopamine acts on and the brain reacts, over time, by increasing the density of their receptors to compensate for that. (Whitaker) This would be the case regardless of whether you were taking the medication as a sleep aid or taking it because you were diagnosed schizophrenic. In short, if you take it regularly your brain adjusts in such a way that in the absence of Seroquel your brain is prone to the types of neurological behaviors that are manifested as schizophrenic episodes. This may or may not be a permanent change (i.e., it may or may not fully reverse itself gradually in the absence of Seroquel). In the name of full disclosure, I myself take Ambien as a sleep aid (as needed basis) and it also breeds physiological dependency in the brain, although not quite in the same receptor sites.

#10

The Whitaker article is interesting.