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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by emmanuel98 on August 16, 2010, at 21:15:55
Has anybody read Unhinged by Daniel Carlat. It's a new book and is a scathing critique of the links between psychiatry and the drug industry.
Posted by Phillipa on August 17, 2010, at 0:01:16
In reply to Unhinged, posted by emmanuel98 on August 16, 2010, at 21:15:55
No what's it say. Is it good or bad? Phillipa
Posted by 10derHeart on August 17, 2010, at 1:48:00
In reply to Unhinged, posted by emmanuel98 on August 16, 2010, at 21:15:55
Here's a link:
"Unhinged"
Posted by europerep on August 17, 2010, at 13:56:42
In reply to Unhinged, posted by emmanuel98 on August 16, 2010, at 21:15:55
hmm, I only read the amazon product description, but it sounds interesting..
knowing that I might be naive, I do think though that the general forum population here is slightly (!) less affected by the things that dr. carlat attacks.. it does not seem to be all against the drug industry only, but also against individual psychiatrists who prefer giving out meds and don't give a damn about talk therapy and stuff (of course there the drug industry is playing a role too, but it's still individuals who do nothing but prescribe drugs).. and about the problematic relation between DSM and science.. I say that some people here might be a little less affected by some of these problems here, is, for example, because most do know that a successful approach to treatment should be multi-disciplinary (i.e. involving psychologists).. also, it's because people here have an idea what drugs are there, which ones have a good reputation and which do not (although that can well lead the refusal of a drug that would help, so it's a little difficult).. I think people who are the most affected by this are the ones who go to ONE psychiatrist, having perfect faith and confidence and him, and do not (or aren't able to because of age, illness, ...) do some researching on their own.. a doc will never say "well there are MAOIs but I don't prescribe them, because, well, I don't know.. I don't know too much about 'em, you know?" if one isn't inquiring into these kinds of things, because one doesn't have a clue of which drugs are there, then one cannot see if a psychiatrist is absolutely incompetent.. I really feel bad for the people who are treated by the psychiatrist at the university clinic that I used to go to.. she was not just dumb and a bitch, she also didn't know stuff.. "what about phenelzine?" -"hmm, phenel... hmm" -"it's an MAOI" "oh, well, we hardly use those anymore.. we've had a patient two years ago who took it, but... well, I could look into whether we can do this in outpatient treatment" -"there's a two week washout period" "yeah I think so too, right..yeah..we'll see about that next time you're here ok?"...grrr..
oh well, I notice I digressed.. but it's similar, if one doesn't know about the sometimes superior efficacy of psychotherapy, then one won't have the idea and ask for it.. one *shouldn't* have to, but unfortunately one has..
Posted by Phillipa on August 17, 2010, at 19:35:21
In reply to Re: Unhinged, posted by 10derHeart on August 17, 2010, at 1:48:00
It really sounds good to me. I'd like to see if the library has it. Phillipa
Posted by emmanuel98 on August 18, 2010, at 20:30:51
In reply to Re: Unhinged, posted by Phillipa on August 17, 2010, at 19:35:21
He is very critical of SSRIs, saying, essentially, that they are all the same and doctors mostly choose which to prescribe based on which drug rep gave them a gift or a meal or a fee for a speaking engagement.
Posted by violette on August 24, 2010, at 10:45:39
In reply to Re: Unhinged, posted by emmanuel98 on August 18, 2010, at 20:30:51
I agree that does happen..but I personally think some SSRIs are cleaner than others and that some may have unique properties...maybe they are negligible, I wouldn't know..
But I do know drug reps pay for market research and can get a tally of which doctors prescribed which medications at what quantities at specific pharmacies. Then sometimes the drug reps give up and don't come around to those doctors who take the freebies--but at the same time, who are immune to the influence of the drug co. incentives as opposed to their research knowledge and patients' experiences.
I've noticed a difference with psychiatrist who have a steady stream of drug reps with those who did not. Of course someone who needs free samples might feel the opposite.
Prior to my current psychiatrist-I was having problems with side effects from a Zoloft trial. The Pristiq rep just left before I entered his office, and he had a pile of samples. He prescribed me Pristiq. This was after telling him I had a really bad reaction with Effexor. He is no longer my psychiatrist. That was good timing as I am so lucky to have found my current psychiatrist. :)
Posted by ed_uk2010 on August 24, 2010, at 15:30:06
In reply to Re: Unhinged » emmanuel98, posted by violette on August 24, 2010, at 10:45:39
>The Pristiq rep just left before I entered his office, and he had a pile of samples. He prescribed me Pristiq. This was after telling him I had a really bad reaction with Effexor.
Just goes to show how ludicrously susceptible some doctors are to drug rep's influence. Given that Pristiq is very similar to Effexor (and offers no clear advantages), what sort of doctor would initiate Pristiq in a patient who had just described their bad reaction to Effexor?
Pristiq isn't even available here. I don't think it would be very popular if it was. Our health system is less susceptible to drug company hype.
Posted by sigismund on August 27, 2010, at 0:14:51
In reply to Re: Unhinged » emmanuel98, posted by violette on August 24, 2010, at 10:45:39
>I've noticed a difference with psychiatrist who have a steady stream of drug reps with those who did not.
Me too
This is the end of the thread.
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