Wednesday, October 13, 2004

What do patients think...

about Brownlee's article, accusing psychiatrists of ignoring damaging evidence about antidepressants? I'm bracing myself for their questions. Curiously, there is little reaction so far. But I am full of questions for them. What is your opinion of your treatment? What do you think about your meds? Have you felt comfortable asking questions about your treatment?
So far, there is more interest in talking about current issues, and about what's going on in their lives. There seems to be some acceptance of the ambiguities and unknowns of psychiatry. (If they weren't accepting it, they might not be making appointments.) One said, I know what happens to me if I don't take the meds, and I don't want that to happen again.
That is where we often find ourselves in psychiatry. I've been asked, why can't medicine be based on science? We think we are as scientific as we can be, but to one reader, that's not enough. How can we ask even one patient to take a drug that still has unknown physiologic mechanisms? All we are left with is current research (it will help when we are allowed to see negative studies). We're always trying to interpret the research, with all its limitations, and communicate the results to patients.
And yes, to another e-mailer, I wish that we psychiatrists knew more about what we are doing. No one will be happier when we have better understanding of the mind, and when current treatments have been replaced by more effective, less risky options...

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