Healing, and not just prescribing

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Fri, 29 Feb 2008 15:51:44 GMT

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re: Healing, and not just prescribing

Tiiu-Imbi Miller (Mrs. PhyD in psychology) — Tue, 04 Mar 2008 17:17:49 GMT

The report showing that antidepressants may not be as effective as some may have thought is not the last word. Ffirstly, don't assume that a talking treatment is always safe. The amount of damage that a less than skilled doctor/psychiatrist can do by verbal means can be very substantial. Secondly, some drugs work for some patients, others for other patients, while some patients do not benefit at all. A good doctor wil experiment with several. but when that is not done, as in a drug trial, it is not surprising if the result is not good. Rather like alternative medicine really. A long time back I read a study which had the overall result that psychotherapy made no difference. But closer analyses revealed that 5% of therapitsis made their patients better, 5% made them worse, and the rest made no difference. Very different than saying it doesn't work. I personally know several people who have suffered from serious depression and who have benefitted greatly from drugs, but not always the first drug that was tried. But once the effective drug, or drug combination, was found it was likely to work for that patient later too.

re: Healing, and not just prescribing

Phil Chave — Tue, 04 Mar 2008 17:50:06 GMT

Hi Bryan,

having been working in the field of bi-polar and clinical depression as a counsellor and talk therapist (or perhaps I should say tapping therapist, as I often use EFT) for 4 years now, I can say that I am not in the least bit surprised at this news that antidepressants don't work.

Actually, I think they do in a lot of cases, and a lot of peoples lives have been greatly improved by their use, but it is because they are dished out like sweeties, to anyone that askes for them, that they stop being effective, as this study demonstrates they are being prescribed when they are not needed.

Pressure from patients to be given them? Could be.

Pressure from drug companies and to comply with DSM-IV? Quite likely.

To facilitate rapid surgery turnover? Most certainly.

Because there is the perception there are no alternatives? Now we're getting there!

My practice is leaning towards, and tends to specialize in the long term, non responsive or 'stuck' types of depression, and many of these patients start, having been on antidepressants for as long as 15 years.

Following a quick check of my practice records I can also confirm that not one of them has remained on their antidepressants longer than 10 months after starting talk therapy, with many asking to come off within a few months of starting. Obviously I refer the patient to their own GP for that, and it is not without some humour how often they are congratulated for their 'spontaneous recovery' as those good old meds have kicked in after all this time. Hmmm.

There will be lots of you who know all about this scenario, I'm sure.

I hope this report will, a.) as you suggest, make doctors look at alternatives like counselling and then recommend it to their patients as an adjunct to medication.

And b.) encourage the depressed, or more likely the partners of the depressed, to seek another way forward, by talking and learning the tools that can help combat a lifetime of depression.

All the best to WDDTY.

Phil