I give up, I will never be able to work for any clinic for a prolonged period ever again in my life. Nope, these places just want providers to be eager to prescribe and willing to conform to agendas that don’t practice by a biopsychosocial model.
Every damn psychiatrist I have followed in the past 2 years as a Locum doc, and now this current job I hoped to take on as a permanent doc, were just a bunch of nice, compliant prescription sources who couldn’t say no to a script demand, never annoy an administrator eager to maintain the business model, and truly believed that quantity trumped quality every freakin’ moment of the day.
Anyway, after yet another draining week, I come home and find this sample issue of The Brown University Psychopharmacology Update (August 2015 issue), and what is in there to just piss me off? First, the lower cover story of “Extended-release mixed Amphetamine salts effective for Comorbid ADHD & cocaine use”. Really?! Let me advise readers here, that is such a joke and profound lie at the same time, ADD patients do not use cocaine for two reasons over 90% of the time: they don’t get a high from it as cocaine is a stimulant so the effect is therapeutic, and, if they really want to push the odds then they have to use a lot of it, so cost ends up making use fairly much prohibitive within a few months at most. That’s if the large quantity to use doesn’t have serious morbidity or mortality, a nice way of saying if it doesn’t hurt or kill them, then they are lucky.
So, there really is not a sizeable cohort of ADD patients who are coke users, thus the frank ridiculousness of this article in the first place.
The second loser in the issue was this, on page 3: “SSRIs and Venlafaxine show no Major risk of Cardiac birth defects”, umm, this study was based on live births in five Nordic countries between 1996 and 2010, so did they either avoid Paxil or just ignored the truth plainly out there?
You can google “Is paxil safe to use in pregnancy” and find whatever articles you want, I think this one sums it up fine for me, and was updated this month:
In there this: “There is one SSRI that the FDA and its manufacturer warn women not to take during pregnancy— paroxetine (Paxil), which carries a grade D. Drugs that are labeled as D have been shown to be a risk to a human fetus.”
And yet, at the end of the article is this little gem: “a growing body of evidence from animal studies has suggested that the neurotransmitter serotonin is important as a signaling molecule in a variety of cells and tissues during embryogenesis, including heart development. Disruption of the serotonin signaling cause by exposure to SSRIs may thus result in disturbances of cardiac development….”
Huh? The title says there are no major risks of cardiac birth defects, yet this ending seems to contradict that very premise. WTF am I missing here?!?!
So, once again this lame publication that is trying to sell meds are safe in pregnancy, well, when can a lawyer use this to drag Brown’s Psychopharmacology Update into court as a complicit co-conspirator in a lawsuit by a damaged child?
Remember, if you are pregnant and feeling depressed and end up in a psychiatrist’s office being offered meds, just ask the doc this question: “would you as a woman, or if a man and married, take or advise your wife this medication you are offering me now?” Watch the stammering or frank denial blossom before you!
Just incredible what I have to endure these last several years…
“Prescriptions for all, come and get ’em!!!”