The doctor who gave up drugs

[Itscurtainsforyou]

Did anyone watch this tonight?
I caught the last 40 mins (at the gym ) except for the closing minutes.

Basically saying that antibiotics, painkillers, antidepressants (among other things) are over-prescribed, do they work and what alternatives there might be.

Bolding failure there

Re the ADs, the Dr really did give the impression that he didn't agree with her having them in first place.
He said something along the lines of "she could have been learning a life lesson, rather than being given Ads".
I remember this as my DD, aged 17 at the time, was in a very similar situation and had tried for a year to live with her best friend being killed, she was very, very depressed. God knows what that poor girl in the programme was like, having lost her dad and then her brother.
ADs DO work for many people, yet that Dr seemed to dismiss them. Maybe the programme was badly edited but I worry that people watching, would come out with the message-- Ads aren't necessary.

Yes that was the message i took from it. It's not only dangerous but also insulting to those of us whose lives (or whose family members' lives) have been transformed by ADs. There was the implication that if only you'd developed coping skills appropriately, you'd have avoided depression entirely. On what evidence is this based?? Two family members that have died of MH diseases suggests either a very dysfunctional environment or a strong genetic propensity to depression. Or both. Neither of which are likely to be cured by long walks and cold baths.

Even if it later transpires that the patient's story/ withdrawal is more complicated

I waited 14 months for CBT. The citalopram and the propranolol stopped me being suicidal over the huge panic attacks I was having, but the CBT helped massively

I tend to try to refuse antibiotics but the doctors always say I need them so it's a catch 22... I get horrendous thrush the minute I take the first few tablets and it takes me 3-4 treatments to get rid of it which is why I want to avoid them. I reckon I have probably had over 100 courses of antibiotics

ADs perform no better than placebos for most people. Yet doctors hand them out freely. Im tired of people raving on about how great the supposedly are - great if it works for you but you are in the statistical minority and frankly we don't need people endorsing ADs when the problem we have is too much focus on them/faith in them working, from both medics and the general public. I've had some shocking things said to me about ADs by professionals, including a refusal to believe they don't work for me, despite the actual scientific evidence showing that is quite likely!

Cold baths etc just ridiculous though. It's kindness, care, companionship and acceptance, not to mention some kind of in depth therapy to help with the underlying issues/trauma, that's needed. I find it astounding the way people suffering because of stuff thay've experienced is so massively glossed over in mental health services. Unfortunatey it seems like the general public, whilst becoming more "mental health aware" increasingly prefer to label things as "mental health issues" in a vague, often medication endorsing way at the expense of the human experience (whereas some years ago the tendency seemed more towards "armchair psychology" at the expense of recognising serious issues).

And there is plenty of evidence to suggest psychosis can be recovered from/just be a one-off episode without medication. Like the fact that the developed world, with access to these meds, has some of the worst recovery rates. It's not a case of simply just stopping the meds once someone's been taking them years though! And I don't know if it can be done once the problem's become entrenched. Psychiatric meds have some really bad side effects - some permanent. As this programme seems to suggest (I'm halfway though!) part of the problem is the time limits and resources. Plus the isolation and traumatic exeriences that are so often inherant in being mentally ill (getting bundled off by the police and sectioned for eg.), basically society dehumanises the mentally ill in various ways and that fucks you up even if you're fine to begin with.

Anyway the actual reason I came searching for a thread about this show is the husband of the painkiller lady. OMG! He's so annoying, the way he's lecturing her giving her that know-it-all look, yet he admitted he didn't even know how many pills she was taking (and I bet he'd do the same if in pain). I bet he does that look loads and mansplains a lot. Whereas she seems quite up for the experiment.

Also my GP has a bizarre attitude on the reducing medication front - he seems to promote ADs and hormonal contraceptives (both of which I choose not to take; the pill makes my MH worse yet he suddenly forgets his holistic approach when I point that out ) whilst refusing pain relief for the one day a month I'm in wrenching pain (with associated fever and sickness) with my period/endometriosis. Although reducing medication in general seems like a good idea in many cases, I do worry that women in particular in extreme pain will be the first to be fobbed off when they actually might benefit.

As someone who suffers from depression I agree that ADs are dispensed way too freely. And it's true that most major studies have shown that placebos work just as well, and that there is no such thing as a chemical imbalance in the brains of those who are depressed.

I'm not sure whether cold water swimming j itself can 'cure' depression, but in an ideal
world, other options would be explored, rather than repeat prescriptions going on for years and years because doctors are short on time and answers.

Remember the patient herself said she was unhappy on ADs, feeling numb and emotionless. Looking at her, and the state of her house, it was clear that meds had hardly been a dream solution.

This bears repeating.

look at the effort he has to put in to help each individual person - house visits, personalised investigation and treatment plans, in-person support and skype calls to keep them motivated. Theres no way we have the resources to do that for every person now we havent been doing it for so long, theres just too many people.

It's HUGELY irresponsible to give a blanket "People can manage without drugs!" message.

Are drugs used as a crutch in place of proper support? Absolutely! And on the other hand, sometimes they are desperately needed and no level of support would make any difference. But you can't just take that away and not replace it with anything, not monitor people, not look for alternatives.

I would be truly ecstatic if the NHS had the resources to do the kinds of investigation and support for every patient as it sounds like the programme makers are advocating, but of course they don't.

The flip side to it is why are people unwell? Why have I needed over 100 courses of antibiotics? I kept going in and asking why was I always ill, they kept taking bloods and 8 years no answer
I'm neutropenic. And have been since 2008, it even says in 2008 on my records that I was. Nobody picked it up until last year which was a GP that thought I was peri menopausal as I was having night sweats. She actually opened my white blood cell count results rather than looking at the overall count, fracked all my previous results and then sent an emergency haematology referral. I need bone marrow stimulant weekly
Quite angry that virtually all the antibiotics wouldn't have been needed if they had spotted it
I get that's not the case for everyone but... Makes you think

So I have been on a reasonably unusual anti depressant on and off for 16 years. Before this i was in loads of different ones which 'didnt work'. I had a very rubbish childhood and lots of problems and I guess the doctors just assumed they were the causes. Counselling on and off didn't seem to help as I couldn't admit anything or just couldn't deal with the reality of my life. 3 years ago I finally admitted I had a massive alcohol problem and haven't had a drink since. With clarity and hindsight I know now that this was the problem. The medics never really looked I to my alcohol use - although really it should have been obvious - admittedly I didn't want ti accept it either. Anyway. I am now finally down to the lowest dose possible every three days - virtually useless really and I am, not fine, but able to manage !y mental health. It was a massive crutch and not the solution. Exercise is for me the answer - well one of them - life is terribly hard at the moment, I am facing redundancy and the potential loss of our home through this but no tablet will solve that. What I am clumsily saying I think is that over 35 odd years of me being not right at all tablets were the solution offered and not the right one.

Apologies for grammar and spelling -poorly little girl next to me!

It is upsetting to see the scientific evidence on antidepressant efficacy mangled again and again and again. It is categorically not true that they don't work for most people. Cochrane has shown they work better than placebo for those with moderate to severe depression. Not for people with mild depression certainly but to trot out the old line that they don't work is bollocks.

Not saying they don't work but I think for me it was most thn likely alcohol! Obvious looking back of course but it was easier for the doctors to give me them than for me to work it out.

Excerpt from the Cochrane findings:
Through extensive searches of the literature we found 14 studies conducted in adults (not the elderly) in primary care setting, in which tricyclic antidepressants (TCAs) or selective serotonin reuptake inhibitors (SSRIs) were compared against a placebo control group in the treatment of depression. The results showed that both TCAs and SSRIs were effective for depression.
Most of the studies were supported by funds from pharmaceutical companies and were of short duration. There appeared to be more adverse effects with TCAs than with SSRIs, however rates of withdrawal from study medication due to adverse effects were very similar between the two antidepressant classes. Adverse effects not leading to medication cessation seemed to be more common with TCAs than SSRIs.

And Reimherr:
Performed a double-blind, placebo- and amitriptyline-controlled comparison study to evaluate the antidepressant efficacy of sertraline, a specific serotonin (5-hydroxytryptamine [5-HT]) uptake inhibitor. Patients (18–65 yrs old) with Diagnostic and Statistical Manual of Mental Disorders-III—Revised (DSM-III—R)-defined major depression randomly received either sertraline (N = 149), amitriptyline (N = 149), or placebo (N = 150) once daily for an 8-wk period. The mean final daily medication dose for the all-patient group was 145 mg and 104 mg for the sertraline- and amitriptyline-treatment groups, respectively. As measured by the Hamilton Rating Scale for Depression and the Clinical Global Impressions Scale, both the sertraline and amitriptyline treatment groups showed a significantly greater improvement from baseline (p ≤ .001) than the placebo group. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

I'm sorry to hear about your situation, Str4ngedays.

What really surprised/concerned me was that when I first entered the mental health system, I was seeking counselling because it seemed that was obviously the answer, because my problems appeared as a result of stuff happening. It wasn't random, which would suit their chemical imbalance theory. Yet I was coerced into taking ADs (on pain of being refused counselling if I didn't.)

Also the chemical imbalance theory is repeated all over the place as if it were fact. So you end up with ignorant people trying to convince you to take ADs because in their mind it's truly a "happy pill" and think you're being difficult saying they don't work for you (alternatively they are the complete opposite and go all homeopath on you - the concept of slowly sorting through and dealing with your issues doesn't seem to feature anywhere). And GPs say stuff like "these pills work by slowly lifting your mood". Er, no they don't. They don't even claim to work like that! And the classic disbelief that you are actually depressed if they don't work. Oh, and when the nightmares and memories get really strong and I end up speaking to the MH crisis team stressing I need some help to work on the longterm issues, because they are making me so depressed I can't function, they tell me ADs are for that.

There seems to be a false dichotomy, in practice, between having a "chemical imbalance" requring medication to "correct" it, and a sort of mind-over-matter, go for a run every day, stop making a fuss about nothing, type attitude. Serious = drugs, not serious = ODFOD.

In defence of the doctor on this show, at least he did the cold water thing himself. Psychiatrists would balk at the idea of taking some of the meds they dole out. But his view about resilience, and not appearing to understand what being depressed actually feels like, is ridiculous.

Whe she got into the water and started swimming it made me feel better! But there is something very nice about doing something invigorating and unusual with a bunch of encouraging strangers (not dogging! ). Dragging yourself to your local pool is completely different. I wonder about how we used to live - presumably we'd be working on the land/hunting/childcare together? Physically arduous but mentally very much connected to each other, surviving becase we survive together. It's how we evolved.

Another thing I thought was interesting was the messiness of the woman's own room compared to the tidiness of her daughters room, and the effect findnig out she was pregnant had on her. It just seem to point so strongly to this being an emotional problem, and a starting point to begin to explore in therapy.

WRT the cost and time involved, I think the money goes in the wrong places. The NHS, Police, Social Services, DWP etc end up picking up the pieces down the line.

Erm I appear to be writing an essay so will stop now!

It was kind of my own fault though. I let myself take the tablets hoping they would be the answer and wipe out all the past but until I realised I was making myself mentally much more unwell through alcohol i couldn't do anything. It's a tricky one. I lied to the doctors and they didn't push!

Once at dogging

Arf at dogging. Who knows? Maybe it's the answer. "In episode 2, Barry stops taking his statins and takes up dogging...."

Thd chemical imbalance theory used to peddle SSRIs is now widely recognised for what it was: a marketing strategy.

There are serious studies showing that ADs are only very slightly better than placebos for even moderate-severe depression. I will dig them up when I get a chance. And as you quoted yourself (but didn't bold) from the Cochrane study, much supportive research is at least partly-funded by drugs companies. And then there is the question of side effects.

The placebo effect is astonishingly powerful and if the pills (and chemical imbalance theory) serve that purpose for some then I guess that's all for the good.

Well blimey I have been educated! Just read some chemical imbalance theories. Fascinating.

I don't (luckily) have any experience of depression or ADs - but the thing that totally shocked me was the number of patients going in asking for antibiotics and the doctors giving in to them.

It would never occur to me to request ABs, I've gone in twice in the last ten years and been prescribed them for cystitis / kidney infection and in my mind they are a last resort if your body isn't managing to fight off an infection, not a first line of defence. So I only went to the GP for cystitis when treating it via over the counter meds hadn't worked. Am I totally out of step with how other people think? Looks like it

I think that taking medicine has become the "easy option" for some people and they expect to be given a tablet that will work like waving a magic wand rather than trying to improve health for themselves. I also think the NHS being free at the point of delivery perpetuates this as they might be more likely to adopt other measures if there was a charge

That is not to say that medicines are not needed, for many people they improve or save their lives, but there is a huge number that could and should be withdrawn in my opinion.

Paracetamol is often used as an example as it is so cheap to buy but the problem for many people is that the quantities allowed over the counter are not sufficient for many. If you have arthritis and need 8 a day, it is not practical to buy the number of tablets needed

P

I think that taking medicine has become the "easy option" for some people and they expect to be given a tablet that will work like waving a magic wand rather than trying to improve health for themselves. I also think the NHS being free at the point of delivery perpetuates this as they might be more likely to adopt other measures if there was a charge

I disagree with having a charge as I think it will hit the wrong people. Why can't they market lifestyle and other things as a fantastic new cure backed by the latest scientific research?

It also concerns me, as mentioned upthread, that it will hit the "soft targets" when it comes to medication that may be necessary. It can be hard enough in the current climate to get menstrual pain taken seriously, for example.

The "quick fix" thing comes from both sides. GPs don't have time. I went to the GP with a flu-like illness; I wouldn't normally have gone but it kept happening when I got my period so I figured there was a link that needed investigating, especially as I had severe period pain too. The GP dismissed any link whatsoever and wrote me a prescription for something to make my throat feel better. I explained I wasn't after medicine and had only come in due to the period link but she pressed the script on me. I looked it up later; it was an antibiotic throat spray. I didn't get the prescription, but did buy some throat lozengers!

ahahaaaar, taking medicine the quick and easy answer?!?!?!

Six weeks to efficacy, complete deadening of libido (possibly long term), inability to drink alcohol, potential for increased risk of osteoporosis, two weeks of horrible commencement effects.... and for my other one, weight gain, increased risk of T2 diabetes, QT interval prolongation, raised trigylcerides... oh I could go on. It's really not the easy option.