I love Midwestern Doc. He has done some amazing research on SSRI’s and the role they play in violent teenager incidents/shootings/etc. It was one of his articles I linked in my post actually! The points I listed in my post were the teenage shooting article written by Midwestern Doc, I agree with what his research has shown, there were a …
I love Midwestern Doc. He has done some amazing research on SSRI’s and the role they play in violent teenager incidents/shootings/etc. It was one of his articles I linked in my post actually! The points I listed in my post were the teenage shooting article written by Midwestern Doc, I agree with what his research has shown, there were a few points that I have not seen in that high of number which I addressed. Speaking of Columbine, I highly recommend reading the book by Sue Klebold, the mother of shooter Dylan Klebold. She discusses mental health a lot in her book, it is a great read! I couldn’t put it down when I started reading it. It is called “A Mother’s Reckoning”. Fun fact, I lived in Denver shortly after Columbine, and had a class with a youth pastor who lost one of her youth group members in the shooting. There is a fantastic video made about her called “She Said Yes”, and it was the story of the brave young woman who was asked if she believed in God with a gun in her face and she said yes, and one of the Columbine shooters shot her. I think that video is available on YouTube.
I am sorry you were the victim of “pharma guinea pig”. Throughout my training, we were taught that SSRI’s were the “gold standard” to treat depression and anxiety. I fully discovered SSRI’s were not great about 2 years into my practice. By that point, I had seen enough patients for a long enough period of time to have a large enough sample size of my own to see exactly what you mentioned above: trialed 3-4-5 SSRI’s, throw on Abilify (because it is FDA approved 🤮 for treatment resistant depression), and keep throwing more meds at it. I have been in the field so long that when I started out, abilify was still brand only and Trintellix had not even been invented yet lol. Several antipsychotics have gotten the FDA to approve them for “depression adjunct” treatment, namely Abilify, Rexulti, and Vraylar. The new drug Caplyta is going for FDA indication for depression as well. The only difference is that SSRI targets serotonin only, whereas antipsychotics target Serotonin and blockade Dopamine. That narrative to use those drugs is sold by pharma reps with FDA approval. The drug hound prescribers will throw them at any patient they choose to. :(
I do have some patients that have been successful on a low dose antidepressant. Those individuals probably do have a serotonin reuptake deficiency. But that number is low. When I see a patient who has been through numerous meds with no success, that is all you need to know as a provider to DO NOT “throw a med and hope it sticks”. More often than not, we have a significant trauma event, life and work stressors, etc. Things that we can tackle with a great therapist instead of a med. We have always been too quick to throw a med at something that alternative treatment can fix.
Patients come see me and I give them options, and one of the option is always a no medication option. I had one patient recently that did not need a med, and I sent them to therapy. They refused to pay their bill because “I didn’t do what I was supposed to and give them pills”.
Another path that has not been discussed is what is truly depression? We are so quick to slap a depression diagnosis on someone without assessing for what is behind it. Most people experience depression at one point or another for various reasons. But we have been quick to just throw an SSRI on without assessing why someone is depressed, how long does a depressive episode go on for, what triggered it, what symptoms do they associate as being depressed, etc.
So to answer your original question, I changed how I prescribed SSRI’s about 9-10 years ago, but after the study in 2022 came out with that kind of data, I have prescribed even less than I did before. So at this point, I don’t use them much at all. Prior to that study release in 2022, maybe 15% of my patients were on an SSRI, and now it is probably in the 5-10% range. And most of them on an SSRI came to me on that med already and do not want to stop taking it, which I respect. ❤️. If anyone wants to come off an SSRI, I 100% help them get off of it as comfortably as possible.
Thank you for your extended comment. I truly appreciate the time you took to respond to me. The doctor i saw wasn’t aware that I had taken antidepressants before nor did he ask much of my history, but just decided that I should try one of the newest drugs on the market. I’m guessing that a drug rep recently visited him and sung its praises. I saw that happen a lot through my years of being in medical practices.
This:
"Another path that has not been discussed is what is truly depression? We are so quick to slap a depression diagnosis on someone without assessing for what is behind it. …
and keep throwing more meds at them."
No pill can resolve people’s life problems without talk therapy being included. I was lucky to find 2 excellent therapists who worked with me on mine and I will always be grateful for them. And I ‘recovered' without any meds after taking myself off them. I don’t recommend the way I did it though.
Weren’t the problems with SSRIs known to Pfizer before the FDA approved them, but they kept it hidden from doctors and especially the people who got prescribed them? And even after the FDA found out about it they have done nothing to inform us?
Kudos.
"So at this point, I don’t use them much at all."
I will look into the book and video. Yes that young lady was very courageous in answering the question.
I love Midwestern Doc. He has done some amazing research on SSRI’s and the role they play in violent teenager incidents/shootings/etc. It was one of his articles I linked in my post actually! The points I listed in my post were the teenage shooting article written by Midwestern Doc, I agree with what his research has shown, there were a few points that I have not seen in that high of number which I addressed. Speaking of Columbine, I highly recommend reading the book by Sue Klebold, the mother of shooter Dylan Klebold. She discusses mental health a lot in her book, it is a great read! I couldn’t put it down when I started reading it. It is called “A Mother’s Reckoning”. Fun fact, I lived in Denver shortly after Columbine, and had a class with a youth pastor who lost one of her youth group members in the shooting. There is a fantastic video made about her called “She Said Yes”, and it was the story of the brave young woman who was asked if she believed in God with a gun in her face and she said yes, and one of the Columbine shooters shot her. I think that video is available on YouTube.
I am sorry you were the victim of “pharma guinea pig”. Throughout my training, we were taught that SSRI’s were the “gold standard” to treat depression and anxiety. I fully discovered SSRI’s were not great about 2 years into my practice. By that point, I had seen enough patients for a long enough period of time to have a large enough sample size of my own to see exactly what you mentioned above: trialed 3-4-5 SSRI’s, throw on Abilify (because it is FDA approved 🤮 for treatment resistant depression), and keep throwing more meds at it. I have been in the field so long that when I started out, abilify was still brand only and Trintellix had not even been invented yet lol. Several antipsychotics have gotten the FDA to approve them for “depression adjunct” treatment, namely Abilify, Rexulti, and Vraylar. The new drug Caplyta is going for FDA indication for depression as well. The only difference is that SSRI targets serotonin only, whereas antipsychotics target Serotonin and blockade Dopamine. That narrative to use those drugs is sold by pharma reps with FDA approval. The drug hound prescribers will throw them at any patient they choose to. :(
I do have some patients that have been successful on a low dose antidepressant. Those individuals probably do have a serotonin reuptake deficiency. But that number is low. When I see a patient who has been through numerous meds with no success, that is all you need to know as a provider to DO NOT “throw a med and hope it sticks”. More often than not, we have a significant trauma event, life and work stressors, etc. Things that we can tackle with a great therapist instead of a med. We have always been too quick to throw a med at something that alternative treatment can fix.
Patients come see me and I give them options, and one of the option is always a no medication option. I had one patient recently that did not need a med, and I sent them to therapy. They refused to pay their bill because “I didn’t do what I was supposed to and give them pills”.
Another path that has not been discussed is what is truly depression? We are so quick to slap a depression diagnosis on someone without assessing for what is behind it. Most people experience depression at one point or another for various reasons. But we have been quick to just throw an SSRI on without assessing why someone is depressed, how long does a depressive episode go on for, what triggered it, what symptoms do they associate as being depressed, etc.
So to answer your original question, I changed how I prescribed SSRI’s about 9-10 years ago, but after the study in 2022 came out with that kind of data, I have prescribed even less than I did before. So at this point, I don’t use them much at all. Prior to that study release in 2022, maybe 15% of my patients were on an SSRI, and now it is probably in the 5-10% range. And most of them on an SSRI came to me on that med already and do not want to stop taking it, which I respect. ❤️. If anyone wants to come off an SSRI, I 100% help them get off of it as comfortably as possible.
Thank you for your extended comment. I truly appreciate the time you took to respond to me. The doctor i saw wasn’t aware that I had taken antidepressants before nor did he ask much of my history, but just decided that I should try one of the newest drugs on the market. I’m guessing that a drug rep recently visited him and sung its praises. I saw that happen a lot through my years of being in medical practices.
This:
"Another path that has not been discussed is what is truly depression? We are so quick to slap a depression diagnosis on someone without assessing for what is behind it. …
and keep throwing more meds at them."
No pill can resolve people’s life problems without talk therapy being included. I was lucky to find 2 excellent therapists who worked with me on mine and I will always be grateful for them. And I ‘recovered' without any meds after taking myself off them. I don’t recommend the way I did it though.
Weren’t the problems with SSRIs known to Pfizer before the FDA approved them, but they kept it hidden from doctors and especially the people who got prescribed them? And even after the FDA found out about it they have done nothing to inform us?
Kudos.
"So at this point, I don’t use them much at all."
I will look into the book and video. Yes that young lady was very courageous in answering the question.
Thanks again.