Friday, January 25, 2013
Antidepressants prescribed 'too easily' says GP
Denying truly depressed patients medication would be very risky. Death (suicide) could readily ensue.
I agree however that improvements in taxononmy are needed. To be a bit radical, not all suicidal ideation should be classed as depression. So called "anxious" depression should be regarded at least initially as an anxiety state only and NOT treated with depression drugs. It should be treated with anxiolytics. Getting the two mixed up could worsen the problem and such confusion may explain the "paradoxical" results anti-depressants sometime produce. Wrong taxonomy could kill
Doctors are prescribing antidepressants “too easily” according to a GP who says the current medical definition of depression is “too loose and is causing widespread medicalisation”.
Dr Des Spence, who practises in Glasgow, said a recent review of studies “suggests that only one in seven people actually benefits” from antidepressants.
“Millions of people are enduring at least six months of ineffective treatment” with the drugs, he argued in an opinion piece published in the online edition of the British Medical Journal.
He said the updated version of a widely used psychiatrists’ handbook, the Diagnostic and Statistical Manual of Mental Disorders, “suggests defining two weeks of low mood as ‘clinical depression’, irrespective of circumstance”.
He continued: “It even proposes that being low two weeks after bereavement should be considered depression.”
He claimed that 75 per cent of those who wrote such definitions had “links to drug companies” and argued: “Mental illness is the drug industry’s golden goose: incurable, common, long term, and involving multiple medications.”
But Ian Reid, professor of psychiatry at Aberdeen University, defended antidepressant use in a response on bmj.com.
He said studies claiming to show that antidepressants were no better than sugar pills for mild and moderate depression were riddled with “methodological flaws and selective reporting” of data.
He wrote: “Antidepressants are but one element available in the treatment of depression, not a panacea.
“Like 'talking treatments' (with which antidepressants are entirely compatible), they can have harmful side effects, and they certainly don’t help everyone with the disorder. But they are not overprescribed.
“Careless reportage has demonised them in the public eye, adding to the stigmatisation of mental illness, and erecting unnecessary barriers to effective care.”
Homeopathy is 'rubbish' and shouldn't be available on the NHS, says Britain's top doctor
This needs to be said more often
Homeopathy was condemned as ‘rubbish’ by Britain’s chief medical officer yesterday, who admitted she is ‘perpetually surprised’ it is available on the NHS.
Professor Dame Sally Davies also described homeopaths as ‘peddlers’ and spoke of her concern that they can prescribe pills and potions to treat malaria and other illnesses.
Giving evidence to an influential committee of MPs, Dame Sally said that homeopathy doesn’t work past the placebo effect. In other words, any benefits patients perceive are simply caused by them receiving attention and simply expecting to feel better.
Her outspoken views are in conflict with the policy of the Health Service, which spends around £4million a year on funding homeopathic hospitals and on prescriptions and referrals.
Homeopathy, which has the backing of Prince Charles, claims to prevent and treat diseases using diluted forms of plants, herbs and minerals.
It is based on the principle that an illness can be treated by substances that produce similar symptoms. For example, it is claimed onions, which make eyes itchy and tearful, can be used to relieve the symptoms of hay fever.
Other treatments include anti-malaria tablets made from African swamp water, rotting plants and mosquito eggs and larvae. But scientists argue the ‘cures’ are so diluted they are unlikely to contain any of the original substance.
Asked about her views on homeopathy by the Commons science and technology committee, Dame Sally – a consultant haematologist, or specialist in blood diseases, at the Central Middlesex Hospital from 1985 until 2011 – said: ‘I’m very concerned when homeopathic practitioners try to peddle this way of life to prevent malaria or other infectious diseases.’
The exact amount of NHS spending on the discipline is unclear but various homeopathic associations say it is as high as £4million a year.
The Department of Health said it is up to local NHS organisations to decide whether to fund it.
Posted by jonjayray at 12:44 AM