Why do doctors over prescribe drugs?

Why? I responded to a different post in which you posted an accusation of not reading an abstract about work by Kirsch, drawing the conclusion that anti-depressants did not work. I have noted that your claim is an erroneous recapitulation of the work cited, one that addressed only SSRIs–indicating that you are the one who did not read it.

And you are now back into the “cure” nonsense. You clearly claimed that posters had made claims that they were cured by anti-depressants. Your sole citation was to a poster who claims to have been cured by therapy, not anti-depressants, but for whom the anti-depressants were necessary to get to a point where the therapy could work. No one claims to have been cured by anti-depressants and your assertion that anyone had made that claim was in error.

Does hospice care include deaths from:

Table II Page 216

A relevant comparison would be the suicide rate of people with depression who weren’t treated with antidepressants. There should be such a study, since there were no antidepressants approved by the FDA before 1985, but it might be on dead trees as Rat Avatar calls it. I would like to see the rates for untreated depression, psychotherapy, antidepressants and psychotherapy + antidepressants.

You missed the point.
You made a claim that antidepressants were dangerous because the morbidity of people on antidepressants was highger than the rate among the general population. (Ignoring for a moment that even your numbers have been challenged as imaginary), I noted that if we compared morbidity in hospitals with and without hospice units, those with hospice showed higher morbidity. Since hospice is employed for terminal diseases, it should be clear that hospitals with hospice units would have higher morbidity. In the same way, people who are depressed are more likely to be suicidal and the rates of people being treated for depression will always be higher than the general population, regardless of the efficacy of the treatment.

It was not really a difficult point to understand.

(And, given that the “8.5” number has an unknown provenance, your whole claim begins to fall apart.)

You may want to search MAOI and TCAs were found in the 50’s.

Why would the suicide rate be going down as my one cite listed if use has gone up but they cause suicide?

They use some funny punctuation for the decimal point. It probably threw your search off.
On Page 218

Here is one, look at the end of the paper they link to other studies too.

http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0447.2009.01344.x/pdf

I should note though what you ask for is pretty hard to prove, suicide is a very complex subject.

But please explain with the increased use, why has the suicide rate not gone way up?

If it is over prescribed, and causes suicide why are the suicide rates not going way up.

I said on post 166

My reaction was from reading the article you cited. Since you introduced the article into the discussion, it seems like the onus is on you to either explain why my interpretation of the article is incorrect or the article is wrong. I was perfectly happy with the idea that antidepressants don’t have a significant impact on suicide until I read it.

I’ll try to get to the other articles after I get up.

Ah, I see what happened. You quoted rat avatar’s reference to: Jick, H, Kaye, J A, and Jick, S S, (2004), ‘Antidepressants and the Risk of Suicidal Behaviours’, Journal of the American Medical Association, 292, (3), 338, and said you downloaded “this” study.

You then described another study (Jick, Dean & Jick, 1995), which you linked to at the end.

So, my comments were in regards to the Jick, Kaye & Jick (2004) paper. I’ll go take a look at Jick et al., 1995.

Crap You are right. I did a Google scholar search for Jick and my first hit was on her paper Antidepressants and Suicide. I’ll see if It can find JKJ online.

Well, right off the bat, the first problem is that “person-years” is not the same as “people.” The 8.5 per 10,000 is not a population rate. It’s an index of the total time of exposure to risk in the sample population.

So, in order to do what you’re trying to do, you would need data on the rate of suicide for years of exposure to the risk factor of depression among people who are not prescribed antidpressants, and you would seem to want to compare that against a control group of people not exposed to the risk factor of depression, or to the general population.

You certainly cannot take the figure in the Jick et al, 1995 paper and force it into some relationship with the general population frequency of suicide. That’s just ignorance about what you’re talking about.

JoelUpchurch, regarding your interpretation of the Jick et al., 1995 paper, didn’t it cross your mind that it was a little odd that you noticed the evidence from the paper that using antidepressants increases your risk of suicide by a million-billion, BUT THE AUTHORS OF THE STUDY THEMSELVES MISSED THIS REMARKABLE FINDING?

In fact, the only thing they have to say about a causal relationship of the type you’re talking about is on page 218, where they say: “Though the suggestion has been made that fluoxetine may trigger an emotional state which itself increases the risk of suicide, this suggestion has not been supported by formal evidence.”

So, you thought that you had found a stunning, earthshattering bit of evidence in this paper that the authors, the peer reviewers, the editors and all the readers of this article in the British Medical Journal had missed in the nearly two decades that it has been in print?

You certainly don’t want for self-confidence, friend, but in this case it has served you false.

I looked the person-year.
Definitions:

  1. The product of the number of years times the number of members of a population who have been affected by a certain condition (years of treatment with a given drug).

If the study says that 143 people committed suicide during 167,819 person-years of the study (which it does), why that number isn’t remotely comparable to the suicide rate of 167,819 people for one year.

As for paragraph 2, I already said at 2:19 this morning:
A

I said a factor of 7, not million-billion. BTW, since this is a British study, I looked the UK suicide rate for 1995 it would be 9, not 7.

Can anyone agree that eating a healthier diet than most of us American’s do and exercise is helpful in preventing many diseases? And if we could all follow this healthier life style, people would not be going to the doctor all the time for a crutch for whatever ales them.

Now I do agree some medicine is medically necessary. For example I have hypothyroidism and require a synthetic thyroid hormone. And this is really what caused me to post this topic. I went to the doctor for heart palpitations and she almost dismissed that my thyroid was acting up and wanted to change my antidepressant and put me on a beta blocker. I insisted she order new blood work, she was hesitant…A day later they called and said my thyroid level was too high and wanted me to come back for more blood work. In the mean time I research hypothyroidism and the majority of people that have it is caused from an autoimmune disease called Hoshimotos. I called back to see if they could also test to see if that’s what I have, they wanted to know why…I said number one I would like to know what the cause of this is and two I can go on a gluten free diet to help my thyroid issues. What I learned is most doctors do not test for that because they would treat it with the same type of medication as if it wasn’t caused from Hoshimotos. What bothers me is they did not mention anything about Hoshimotos or a gluten free diet. It seems like I have to do a lot of research on the internet since doctors are not very good at educating.

I have also been on antidepressants for 6 years due to anxiety. Which I also recently learned it was due to my thyroid. And I have been to 4 different doctors in this 6 year period and I am just now discovering this. I have tried to get off the antidepressants but it threw me for a loop emotionally and my anxiety was 10 times worse than it had ever been. And yes I slowly came off of them. I hate taking medicine and would love to find a healthier and natural way to cure my anxiety and depression. God gave of this wonderful planet, I would like to believe he left us a cure in all living life forms. Look at antibiotics!

Posting a few links I found interesting… Like I said I do not have a strong specific belief system on this topic. I am just trying to educate myself and I always keep and open mind. This debate has been great and you all have a lot of good helpful information. Just a lot of back and forth. Not sure what to believe!

http://crazysexylife.com/?s=raw+food+cancer

Yes, eating healthy and exercising regularly is a good idea, and it does reduce the risk of certain diseases. But again, it’s not a cure all. And again, completely healthy people can get fatal illnesses and die young, and people who live a totally shitty life just keep on keepin’ on. (How do we explain Keith Richards?)
And finally, would you kindly stop using the word “crutch”? I suffer from OCD, and my meds aren’t a choice. Do you have OCD? Then please stop referring to my meds as a “crutch”, as if I’m somehow weak and should just tough it out, or get over it. Would you seize a crutch away from a man with a broken leg? No, you would not.

The whole “raw food and detox” bullshit is just that: bullshit. First, we don’t need to “detox”. Second, as of now, there is now no proof that these methods work, and plenty that they can be hazardous. Third, I think we’d ALL love to find a “cure” for depression, anxiety, etc. But right now, we’re doing the best we have.
No, they’re not perfect – but you work with the tools you have, and keep working to find better ones, not go with the whole, “doctors don’t want you to know this!” So keep trying to live a healthy lifestyle – that IS important. But there is no instant cure-all.

(Remember another thing – family history also plays a part when it comes to cancer)

I’ve been trying to discern if there was a question of some kind in this post, and if so, whether there was any utility to answering. Just in case there is, I’ve decided to go ahead.

Yes. As I said before, it’s an index of the total time of exposure to risk in the sample. And…

Are people with depression at greater risk for suicide than those without? Are people with depression those who get prescribed antidepressants? Then it’s largely people with depression who both get prescribed antidepressants and are at risk for suicide.

If you believe that the general population and the population of people with depression are equally at risk for suicide, then your comparison makes sense. See how many people you can get to agree with your belief.

Why, in your opinion, did the authors not draw the conclusion that you have from their study?

YES I have OCD along with anxiety and some depression. I am in no way making you feel anyway, we have a choice to feel the feelings we feel! Life is all about making choices! Taking medicine is a choice and in fact it’s easier and cheaper to pop a pill then to go to a psychiatrist twice a week to get the the root of what is causing the OCD in the first place. There are all kinds of alternatives to help with OCD. And I admit I take medication for my anxiety because it’s easier and cheaper than going to see a psychiatrist. I also know from experience that Yoga, deep breathing, eating healthy and exercise is also a great tool and probably healthier and more effective than taking an antidepressant. I would love to get be able to come off my antidepressants and use these alternative methods!

Back years ago before antidepressants came along I wonder what people did back than, guess they didn’t have any other CHOICE then to take care of it naturally by talking it out?? I believe the drug companies pray on the weaker and lazier people of this society and most Doctors allow is to continue because they all profit from prescribing drugs for medical issues that can be cured by alternative means.

Oh, they had lots of choices: beat their wives/husbands/children, lynch “darkies” for fun and profit, drink themselves to death, develop opium/heroin/cocaine addictions, have “accidents” involving farm implements or shotguns, get sent to institutions where they were tortured into submission, break laws and go to jail…

Most of those choices are still available today, come to think of it, for those who chose not to take or are scared/humiliated away from taking medication for their mental illness.

Before modern medicine, many people suffered and some died from things that are treatable and curable today.

Early in my career, when tricyclic antidepressants were becoming more generally prescribed, I had a patient in her 70’s who tried them, responded positively to them, and lamented they’d not been available 50 years earlier, to spare her a half century of suffering.

And I don’t get a dime from drug companies for prescribing medications. Never have. Got some free pens, but not in the last decade. Got some free pizza when I was a resident back in the 1980’s, but not since. And that was for listening to their spiel, not for prescribing things.

And it is very tedious and tiresome to hear ignorant people prate on and on about how the drug companies are giving me money.