tag:blogger.com,1999:blog-8693444065893424281.post1513406975764389932..comments2022-03-27T22:43:22.984-04:00Comments on David Behar, M.D., E.J.D.: NYT Article Bashes Modern Emphasis on PsychopharmacilogyDavid Behar, M.D., E.J.D.http://www.blogger.com/profile/01190471881953566960noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-8693444065893424281.post-4256532060292470992011-05-09T00:17:52.481-04:002011-05-09T00:17:52.481-04:00Assume your seven year average is correct. Take tw...Assume your seven year average is correct. Take two breast tumors. One is the size of a pinhead, barely noticeable on a mammogram. The other is 7 years older, adn the size of an orange. What outcomes can you expect? <br /><br />Allowing psychiatric symptoms to go untreated seems to result in some permanent burning in, with more frequent episodes, harder to put into remission, and progressively more intense, disabling, and dangerous.David Behar, M.D., E.J.D.https://www.blogger.com/profile/01190471881953566960noreply@blogger.comtag:blogger.com,1999:blog-8693444065893424281.post-53305609288869463942011-05-07T11:08:20.889-04:002011-05-07T11:08:20.889-04:00Most of those years are spent either avoiding trea...Most of those years are spent either avoiding treatment or being treated for the wrong condition due to a different set of symptoms, such as those of an anxiety disorder. Years later, the patient become manic and the diagnosis is evident.David Behar, M.D., E.J.D.https://www.blogger.com/profile/01190471881953566960noreply@blogger.comtag:blogger.com,1999:blog-8693444065893424281.post-38512161143741417472011-03-13T14:50:58.686-04:002011-03-13T14:50:58.686-04:00Pj: Academic medicine is the medicine of 7 years a...Pj: Academic medicine is the medicine of 7 years ago. So most data lag, at best verify, effective treatments that have spread around the world years before. <br /><br />The evidence. People often forget to give it. There are numerous, and immediate on-off-on-off single case design experiments that are highly reliable, and motivate patients to stay on medication. <br /><br />Skip a day, the proof is there in spades. Take the medication late. Symptoms abate in 2 hours. There is no better proof than individualized effects, repeated, and confirmed many times. Plus, there is a tradition of trying to take kids off medication for the summer. In about half the cases, that idea lasts about a day.David Behar, M.D., E.J.D.https://www.blogger.com/profile/01190471881953566960noreply@blogger.comtag:blogger.com,1999:blog-8693444065893424281.post-42425724009242672222011-03-13T14:11:01.496-04:002011-03-13T14:11:01.496-04:00"Your Abilify will reduce your impulsivity an..."Your Abilify will reduce your impulsivity and will solely give you 5 seconds to think before acting.... A year later, patients say, I have been doing it for months. Abilify taught me to think first. I can do it on my own."<br /><br />Can you give some evidence that this "five seconds" business is accurate? I've heard the same thing said about Depakote, SSRIs, lithium, Tegretol, even Buspar. I've seen nothing in the clinical trials or psychopharm literature to back it up.<br /><br />I'm not saying it doesn't work. In fact, I've told patients the same thing. And they've responded the same way ("Abilify helped me to pause before acting" or something like that). But I have absolutely no proof this is anything more than a placebo effect-- an "expectancy" of the patient established by their trust in me and in the pill.SteveBMDhttps://www.blogger.com/profile/11937264509253612864noreply@blogger.com