Depression Meds

[skcin]

Originally Posted by HejiraNYC

A side effect of more DTC pharm ads is that there is a heightened sense of awareness about personal health. It can only be a good thing IMO. Sure, there are hypochondriacs. But they were around long before DTC ads came into existence.

See, I don' t think it's only a good thing. I'm sure something like this has happened to you? The following happened at a recent appt. with a young adult patient:

"I need Chantix. I want to quit smoking"
"OK, well there are other drugs that I recommend you try."
"I saw the commercial for Chantix, so I want that."
"There can be severe side effects for some people taking Chatix, so you should really try another med first."
"My uncle took Chantix & he quit. I want it."
"I'm not comfortable prescribing Chantix for you right now. It's honestly not the best drug for your situation - your age, the length of time you have smoked..."
"I don't understand why you won't help me. I want to quit smoking, and I've heard that Chantix is the best med around."

And on & on & on. Not a hypochondriac by any means, but heavily influenced by the ads on TV. Patient ended up agreeing to try another med first, btw. But only after more than 20 minutes of patient education. Docs don't usually have the time for that, nor do their nurses. I fear the only education patients are getting is from TV - it's not exactly unbiased information.

[HejiraNYC]

Originally Posted by skcin

See, I don' t think it's only a good thing. I'm sure something like this has happened to you? The following happened at a recent appt. with a young adult patient:

"I need Chantix. I want to quit smoking"
"OK, well there are other drugs that I recommend you try."
"I saw the commercial for Chantix, so I want that."
"There can be severe side effects for some people taking Chatix, so you should really try another med first."
"My uncle took Chantix & he quit. I want it."
"I'm not comfortable prescribing Chantix for you right now. It's honestly not the best drug for your situation - your age, the length of time you have smoked..."
"I don't understand why you won't help me. I want to quit smoking, and I've heard that Chantix is the best med around."

And on & on & on. Not a hypochondriac by any means, but heavily influenced by the ads on TV. Patient ended up agreeing to try another med first, btw. But only after more than 20 minutes of patient education. Docs don't usually have the time for that, nor do their nurses. I fear the only education patients are getting is from TV - it's not exactly unbiased information.

Thanks for the anecdote. But the positive takeaway here is that the patient came in to start on the path to smoking cessation after being inspired by the TV commercial. Admittedly he/she sounds like a stubborn, irrational a-hole, but that's beside the point. It's better to deal with the patient now than to spend the oodles of time and money later on when the patient develops end-stage lung cancer.

True, TV ads are not perfectly unbiased, but they are highly, highly regulated. There is a warm and fuzziness to these ads that you don't get from the prescribing information alone. I wouldn't exactly call that misleading.

[WildHeart69]

Originally Posted by skcin

Too f*cking bad. This isn't a takeout restaurant.

*snort* HA!

[WildHeart69]

Originally Posted by HejiraNYC

A side effect of more DTC pharm ads is that there is a heightened sense of awareness about personal health.

Agreed. Some cynics, however, would call this "creating the disease" - ie "restless leg syndrome" or "erectile dysfunction"... I do not consider myself one of these people though.

[David]

Originally Posted by skcin

Absolutely, Remy! Eating right & exercising is a HUGE part in keeeping healthy mentally AND physically. I'm not saying you have to do an hour of cardio every day or lift heavy weights or eat only vegetables. But a daily walk around the block does wonders.

It certainly does do wonders. Depression has such a strong component of inwardness, of obsessing on the self, that any activity which focuses the mind's attention (however weak that attention is) on something else can do wonders. I go back to my Swiss ball! Not a joke. You must inflate your Swiss ball to its fullest, & then lie down on your back across the ball -- do this very carefully the first few times, until you stretch & get the hang of it. Feel your spine bend convexly (or concavely?) across the curvature of the ball, & let your head hang backward, upside-down.

Stay in this position for 10 minutes, moving slightly -- roll the ball forward & backward, bounce up & down a bit. Let your whole body stretch & move. Let the blood flow into regions it usually reaches only weakly. Let gravity elongate you.

Great treatment for an anxiety attack, too!

[ragrsrocalot]

Originally Posted by David

It certainly does do wonders. Depression has such a strong component of inwardness, of obsessing on the self, that any activity which focuses the mind's attention (however weak that attention is) on something else can do wonders. I go back to my Swiss ball! Not a joke. You must inflate your Swiss ball to its fullest, & then lie down on your back across the ball -- do this very carefully the first few times, until you stretch & get the hang of it. Feel your spine bend convexly (or concavely?) across the curvature of the ball, & let your head hang backward, upside-down.

Stay in this position for 10 minutes, moving slightly -- roll the ball forward & backward, bounce up & down a bit. Let your whole body stretch & move. Let the blood flow into regions it usually reaches only weakly. Let gravity elongate you.

Great treatment for an anxiety attack, too!

Yes. It totally works, I've done this with " Steve " ( red evercise ball ) a time or two, and definitely feel 3 inches taller when I get back up. Magic I tell you.

[skcin]

Originally Posted by HejiraNYC

Thanks for the anecdote. But the positive takeaway here is that the patient came in to start on the path to smoking cessation after being inspired by the TV commercial. Admittedly he/she sounds like a stubborn, irrational a-hole, but that's beside the point. It's better to deal with the patient now than to spend the oodles of time and money later on when the patient develops end-stage lung cancer.

True, TV ads are not perfectly unbiased, but they are highly, highly regulated. There is a warm and fuzziness to these ads that you don't get from the prescribing information alone. I wouldn't exactly call that misleading.

Actually, he came in to start on that path after seeing one of our posters telling him that 40% of the LGBTQ population smoke & that we can help people quit. But I get your point.

[HejiraNYC]

Originally Posted by skcin

Actually, he came in to start on that path after seeing one of our posters telling him that 40% of the LGBTQ population smoke & that we can help people quit. But I get your point.

That number sounds high to me, but at the same it would not surprise me. Walking outside around the gayborhood yesterday I could not escape the persistent stench of secondhand cigarette smoke wafting through the air. Despite the known health hazards, tons of warning ads and $10/pack for cigs, you'd think people would finally give it up. I know I must be getting old when it distresses me to see these pretty young kids carrying lit cigs around. I just feel like grabbing them by the shoulders and scolding them- "Not only is this **** gonna kill you; you're gonna look busted up and wore out by the time you're 30!"

[skcin]

Originally Posted by HejiraNYC

That number sounds high to me, but at the same it would not surprise me. Walking outside around the gayborhood yesterday I could not escape the persistent stench of secondhand cigarette smoke wafting through the air. Despite the known health hazards, tons of warning ads and $10/pack for cigs, you'd think people would finally give it up. I know I must be getting old when it distresses me to see these pretty young kids carrying lit cigs around. I just feel like grabbing them by the shoulders and scolding them- "Not only is this **** gonna kill you; you're gonna look busted up and wore out by the time you're 30!"

OK, I had to go & look at the poster & make sure. The LGBTQ community is 40-200% more likely to smoke than straight people. Not sure how they came up with that wide range of numbers. But according to 1 website, about 40% of young (18-24) LGBTQ people are smokers. So there ya go.

[Ghost_Tracker]

Hopefully it won't seem like I'm being "superficial," I mean, I've already posted my thoughts about meds, therapy, etc. - - -

But have you guys tried watching funny movies and tv shows?
Finding jokes on the Internet to share? Taking nice walks and
enjoying nature? Being around a lot of light? (Including the types
of lights that people affected by S.A.D. use during the winter.)
Just seems like those are things that "can't exactly hurt."

A lot of the times when I'm missing my Mom I put on the the "Boomerang" channel, which has cartoons 24/7. Surprisingly, the one that cheers me up the most seems to be "The Banana Splits" show - - - that has a very upbeat tone and the theme song is very cheery. ALL the cartoons seem to help, though - - very "innocent" and nostalgic and cheerful.

Anyway, don't these seem like things that "couldn't hurt?"

[jannieC]

As a mental health therapist, I tend to be very pro meds, but within reason, of course. I cannot tell you how many clients I see that are so OVER medicated. They will come to me with their own diagnoses..."I am SO Bipolar", etc. I have even seen children diagnosed with Bipolar D/O which is wrong on so many levels, but that's a rant for another day.

I also work with clients whose lives have literally been saved by anti-depressants. When prescribed correctly, psychiatric meds can help certain clients gain just enough of what they need to even care to take part in therapy.

Eating right, taking walks, drinking water, watching funny movies, etc etc, are all things folks can do to help with depressive symptoms. But what works for one will not always work for someone else. And talking to a therapist is always a step in the right direction. I don't say that because I am one. I say it because I see that it works and I believe it.

All that being said, I am going to go lie on my Steve Ball exactly the way David described. This is going to take time and effort on my part, as I have a neck/shoulder injury that is making me want to hurt people. And the next time I feel anxious, I am going to remind myself of the word "gayborhood" because that absolutely cracked me up.

[sara1998]

Originally Posted by WildHeart69

^This is not the case... detailing drugs to physicians is completely legal and is always done. The "promotion" you are speaking of is that in the form of pens, clocks, mugs, etc that display the name of the drug, and promotional spend for lunches for nurses and office staff... and even in this case, there is no "legislation" that bars this practice; there are "guidelines" that have been put in place that outline the desired practices for drug companies as far as how they can promote their products in this manner, but these guideline are not really laws. Drug companies follow them, however, because they all kind of keep each other in check and nobody wants to be the one to "break code" because it will look bad for the company...

And as far as direct to consumer ads, I would sort of agree for the most part... but the main reason they do it is because of the type of system we have in place and simply because this is the only country in which they CAN air them (besides New Zealand...but thats another story). You can hear one group of doctors that DO like DTC, one that doesnt, one that says that they aren't influenced by what their patients come in asking about, and some that say they are.... but I think the bottom line is if these ads WEREN'T boosting sales, then they wouldn't be airing them (or printing them in magazines, etc...).

Thanks for sticking up for big pharma. I work for big pharma. No one - EVER - sticks up for us.

With that being said, DTC ads, in my opinion, give the public just a little more information about what's available to them. Then again, it also makes a society of hypochondriacs We shouldn't just blindly follow the doctors. We need to be informed, but it's up to us to take the time to look up the information. In the end, if you trust your doctor, then you should let them make the decisions. They are the professionals.

[David]

Originally Posted by jannieC

All that being said, I am going to go lie on my Steve Ball exactly the way David described. This is going to take time and effort on my part, as I have a neck/shoulder injury that is making me want to hurt people.

BUT BE VERY CAREFUL the first several times you try this!! DON'T OVERDO IT!!

I have a slipped disc in my neck, so I took a round of corticosteroids & then learned a whole bunch of good exercises in physical therapy. The Super-Dave Ball is great for stretching my mandibular lumbar interclavicostal hexadecimal bone away from my mopar-maxillary vestigial oompa-loompa bone.

DO THIS CAREFULLY.

[carrie721]

Originally Posted by David

BUT BE VERY CAREFUL the first several times you try this!! DON'T OVERDO IT!!

I have a slipped disc in my neck, so I took a round of corticosteroids & then learned a whole bunch of good exercises in physical therapy. The Super-Dave Ball is great for stretching my mandibular lumbar interclavicostal hexadecimal bone away from my mopar-maxillary vestigial oompa-loompa bone.

DO THIS CAREFULLY.

speaking of psychotropic drugs ...

[jannieC]

Originally Posted by David

BUT BE VERY CAREFUL the first several times you try this!! DON'T OVERDO IT!!

I have a slipped disc in my neck, so I took a round of corticosteroids & then learned a whole bunch of good exercises in physical therapy. The Super-Dave Ball is great for stretching my mandibular lumbar interclavicostal hexadecimal bone away from my mopar-maxillary vestigial oompa-loompa bone.

DO THIS CAREFULLY.

I have a ruptured disc and bone spurs. Just did a round of prednisone and it worked...until I stopped taking it. I am putting off the inevitable until my daughter is older. I've had the surgery before (10 years ago) and I'm scared of the recovery. PT does help, but I seem to be in a bit of a bind this time. Super Dave Ball tomorrow night. I'm lying on an ice pack right now and thinking! good! thoughts!