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View Diary: Was Bowe Bergdahl "going Galt"? (Cue Teapublican heads exploding.) (188 comments)

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  •  I don't consider myself a rogue. (0+ / 0-)

    I prescribe medications because I'm a physician, and because that's what I'm paid to do. I do primarily outpatient work, so the vast majority of my patients come to me requesting medication treatment, with no coercion whatsoever. They tell me that they benefit from the medications, they go to the pharmacy and get their medications filled, and take them on a daily basis. I'm not about to tell them that the medications don't help them. However, I am wary about the use of medications to address dysphoria that appears to be situational, or due to maladaptive personality factors. I go to the trouble to explain that medications are of little to no benefit in such circumstances, and try to redirect them to a therapist and/or address these issues myself.

    I don't think that psychiatric medications are any better or worse that other medications, all of which have the potential for negative effects. I don't do work for pharmaceutical companies anymore, although I did in the past until my ethical concerns became more crystallized. I think that pharmaceutical companies are created to make money, by creating products that are useful to health care consumers and providers, and in that manner are no more evil than a company that, say, makes tires. They have to maintain product safety, and fairly represent their product, but are not ethically responsible for their medical application.

    Providers are of course responsible, but are given guidance regarding their use from practice standards and research that is generated by academic medical centers. Such research has been generously funded by pharmaceutical companies. I don't blame pharmaceutical companies for promoting their products in this manner--but I do blame academic psychiatrists for taking this money, and especially for compromising psychiatric science because of this undue influence. I believe (idealistically) that academic centers are the stewards of science (i.e., truth), and it is their duty to maintain high standards of fidelity to the scientific process. The biological model of psychiatry that currently prevails, and justifies the obsession with medications as a solution for all psychiatric problems, is a simplistic pseudoscientific myth, buttressed with a ton of data--but no rigorous application of the scientific method for analysis of that data. In short, I see pharmaceutical companies as a bunch of johns--and I see the academic psychiatrists who collude with them as a bunch of whores.

    I share these impressions with my patients, telling them that the TV ads for psychiatric medications are no more realistic than commercials for Axxe, or any other product. I accept the ambiguities of my work, and frankly love doing it. And I don't pretend to be any more than what I am.

    Battling psychiatric myths with sensible skepticism at www.makingsenseofpsychiatry.com

    by candid psychiatrist on Fri Jun 13, 2014 at 09:30:37 AM PDT

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