December 6, 2004

SOCIAL PRESCRIPTION:

GPs giving Prozac to thousands who don't need it (Sam Lister, 12/07/04, Times of London)

THOUSANDS of patients suffering from mild depression have been given excessive and potentially harmful quantities of antidepressants, experts said yesterday.

The largest review of the class of antidepressants known as selective serotonin reuptake inhibitors, or SSRIs, has found that the drugs are often overprescribed and should not be given as the first treatment for patients suffering from mild depression.

The possibility of side-effects, including suicidal thoughts and self-harm, prompted the review of the drugs, which are used by 3.5 million people in England.


Like the old habit of passing students to the next grade just because that was the path of least resistance, so too with drug prescriptions in modern medicine.

Posted by Orrin Judd at December 6, 2004 11:49 PM
Comments

They should give them cigarettes instead.

Posted by: carter at December 6, 2004 11:59 PM

Exactly.

A lot of peeople go to the doctor with some imagined or minor ailment and the doctor gives them something, anything, just to get rid of them.

Posted by: Bart at December 7, 2004 6:32 AM

This raises an interesting point. The sunny futurists, backed generally by the medical profession and drug companies, who promise increased longevity in good health rely heavily on anticipated pharmacological developments. Now, as some drugs and medical procedures are making the promise come true from the perspective of physical health, the complementary wonders that were supposed to keep everyone in good spirits suddenly look dicey. Depression is, and always has been, an incident of age for many. Are doctors going to be able to maintain their absolute veto on who gets them, and how can they justify refusing them to an individual on the grounds that "too many" other people are getting them unnecessarily? Should they, when everyone knows the science on this is in a constant state of flux?

You see this a bit with antibiotics, where young, progressive doctors will refuse them for social or collective reasons and encourage natural remedies. The trouble is that our world is not built around accommodating the extended rest and convalesence those remedies require. We have a much lower tolerance for other peoples' ailments in our "up and at 'em" world. That is one of the reasons patients expect and demand drugs, and it is a good one.

I must say, I can hardly wait for the reaction when the inevitable second-guessing on Viagra arrives and doctors start trying to prescribe it more selectively.

Posted by: Peter B at December 7, 2004 7:20 AM

Some people have always lived long lives in good health. My wife has a great aunt who is 104. Most of my relatives live into their 80's and many into the 90's.

Trouble is that their lifestyle and beliefs would be considered uncool by the sunny futurists.

Posted by: Randall Voth at December 7, 2004 8:21 AM

In the 16th century or so, we quit building homes with vertical logs. We discovered that horizontal logs not only provided more sturdy construction, but offered better insulation and protection from the elements, helping keep us warmer in winter, cooler in the summer, and safer from phenomena such as high winds.

It was something we call "progress." It was a step in the ongoing quest to improve the human condition in the face of nature another step onto the path of least resistance.

There's absolutely no difference between building a structure that provides more comfort, and building a set of molecules that provides more comfort. You can rail against Prozac all you want, but so long as humans are humans, they will always seek ways to better their lives by overcoming the threats posed by nature.

You can also be assured that plenty of 16th-century cabin dwellers would have welcomed genuine antidotes to pyschological pain. I can't even imagine the pain borne by someone who suffered depression or OCD during that time.

Posted by: Semolina Pilchard at December 7, 2004 2:55 PM

Semolina

If that is as true and straightforward as you say, why do so many middle-aged and older folks react negatively or with foreboding to so many of the new developments and inventions that "better our lives". Why is the sense of the "good old days" so stong in so many? (and I hope you won't say petty jealousy.)

Posted by: Peter B at December 7, 2004 5:37 PM

I second Semolina. I would be curious to understand how they decided who was misprescribed the drug. Was it based on the response of the patient or on comparing the medical records of the patients to some standard protocol? If the protocol says that they don't need it, but the patient reports good results, was it misprescribed?

I take antidepressants myself. It has done wonders for me, I wish that they were available earlier in my life. I have an anxiety prone personality, always have. In the ancient world, I would have been diagnosed with the "melancholic humour". I find that I function at a higher level, at work and in my family life. I imagine that there a lot of people in my same boat. So why are so many people all upset over the amount of drugs that are being prescribed nowadays?

Peter, all I can say is that at a certain age people's idea about how the world should work becomes fixed, and they are no longer receptive to change.

Posted by: Robert Duquette at December 9, 2004 2:02 AM

I second Semolina. I would be curious to understand how they decided who was misprescribed the drug. Was it based on the response of the patient or on comparing the medical records of the patients to some standard protocol? If the protocol says that they don't need it, but the patient reports good results, was it misprescribed?

I take antidepressants myself. It has done wonders for me, I wish that they were available earlier in my life. I have an anxiety prone personality, always have. In the ancient world, I would have been diagnosed with the "melancholic humour". I find that I function at a higher level, at work and in my family life. I imagine that there a lot of people in my same boat. So why are so many people all upset over the amount of drugs that are being prescribed nowadays?

Peter, all I can say is that at a certain age people's idea about how the world should work becomes fixed, and they are no longer receptive to change.

Posted by: Robert Duquette at December 9, 2004 2:04 AM
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