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Post by Admin on Mar 19, 2019 17:08:43 GMT -4
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Post by Arsalan Shah on Mar 19, 2019 20:50:32 GMT -4
As I progressed through the articles, I kept thinking about what Dr. Antin said this morning during our orientation. To be mindful of "the triple threat." More specifically to think about how an interaction benefits the patient. That point seems to have been overlooked in the NY Times article when it comes to discontinuing medication and dealing with a patient’s experience of withdrawal, especially if it persists years after discontinuing the medication. I can understand how it would make it difficult for clinicians to consolidate their medical knowledge, obtained through academia, with a patient's personal experience of medication if the two contradict. Interestingly enough it took a physician's own experiences with withdrawal to challenge the standard practice of an antidepressant withdrawal regimen. Given the chemical complexity and variation of the human body, it makes sense to adjust medication to better fit the patients’ needs which would also apply when discontinuing the medicine.
I found the article titled "Head Meds" to be an interesting insight into a patients prospective of Antidepressants. I found it helpful in the sense that it gives me tools to better deal with patients who might be hesitant to try antidepressants due to a preconceived notion surrounding the medications. The practice of deconstructing some of those notions set by society and media is something that I plan to put into practice when appropriate. I also like the analogy of rain-boots in reference to antidepressants and plan to use that in my discussions with patients.
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Post by ericgarza on Mar 20, 2019 9:37:59 GMT -4
The first article describes one of the biggest challenges that doctors face in medicine. Finding that perfect dosage to maximize benefits and minimize side effects is not easy . When these patients do,however, taper off the meds , the difficulties of withdrawal and unwanted symptoms is something that we as physicians have to work against to ensure the well being of our patients .
From the second article , I was reminded of personal stories of family members hesitant to start medication for their illnesses . There is always that feeling of embarrassment and apprehension to starting medication because , to many , it may feel like they couldn’t fight off or heal themselves from their illness on their own. I agree with the article that building a great relationship with our patients and building a bond can help ease them into taking medications by showing the patients that you are going to be right there with them monitoring their progress in collective that will ultimately benefit them in the long run .
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Alison Burkett (MS4)
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Post by Alison Burkett (MS4) on Mar 20, 2019 10:37:08 GMT -4
I liked how the article addresses the common but unfortunate situation in which doctors, by presuming that their training and/or judgment is more founded, disregard a patient’s experience. As a clinician (even at a student level) there is a high level of frustration when we expect a medication or treatment to have a desired effect and the patient reports something completely different. This really resonated with me, having experienced this as a patient myself several times. This article serves as a good reminder that we need to be aware of our own biases and expectations, and approach each patient as a complex individual who may or may not respond as the textbook or academia says they should.
The second article Head Med was spot on about the portrayal off antidepressants in the media, and the perpetuation of this idea that taking these meds is shameful, or makes a person weak. It really shows you how important perception can be, as a patient’s perception of treatment is critical in establishing a beneficial therapeutic relationship; however, if their views regarding medication or therapy is skewed from the get go, it becomes even more difficult. Much like the first article, this also reminds us to address each patient individually, and establishes that maintaining an open dialogue between the patient and the provider is essential.
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Post by Benjamin Hunter on Mar 20, 2019 10:59:07 GMT -4
I found the article to be important in terms of looking into patient variability and the importance of treating the individual. This brings up an important approach to medicine that includes personal responsibility, whereas much of today's medicine is focused around algorithms and numerical cutoffs in terms of decision making. I believe that this is a more holistic approach to the patient and should be adopted in all realms of medicine to make sure we are treating the patient and not just the disease. I also find it interesting that there may be other factors at play here, such as the individuals ability to deal with stress, or the subjective manner in which an individual may experience a side effect. Perhaps four weeks feels to a certain person as though the withdrawal is complete, even though they may be experiencing some symptoms of withdrawal and are simply handling it better than another patient.
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Post by Bassem H on Mar 20, 2019 11:22:30 GMT -4
The New York Times article raises an interesting point of discussion regarding the established tapering methods for psychiatric drugs. There has not been very much research conducted on different tapering schedules but it it seems to be an area with lots of research potential. Considering our priority as healthcare professionals is the safety and well-being of patients, it’s surprising that longer term tapering methods have not yet been further explored. Based on what the article is saying, there seems to be sizable patient population that is negatively impacted by withdrawal symptoms due to psychiatrists tapering them off of their meds too quickly. I found it interesting how patients learned to experiment with their own tapering regiments by reducing their daily medication dose by as little as one microbead of the drug. It seems extreme but it’s understandable that patients would go to such lengths in order to avoid unpleasant withdrawal symptoms from being tapered off too quickly.
The second article discusses the stigma of psychotropic drugs that is sometimes demonstrated in modern media. I think over the recent years, this stigma is becoming less and less prevalent overall and that it is mainly due to a lack of understanding about how the drugs work. Neurotransmitters have a profound effect on our state of mind and it’s easier to sell entertaining media portraying psychotropic drugs as “mind control” pills than to show how they work scientifically.
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Post by Mary Didden on Mar 20, 2019 11:22:51 GMT -4
As I read the first article I found myself thinking, “how can they classify what these people are experiencing as withdrawal?” How can they be certain that these symptoms simply aren’t due to the patients underlying mood disorder? However, as I continued to read the article presented some very compelling evidence. One study noticed a symptom reduction of 72%! Then I began to think about it logically and the idea of tapering antidepressants made sense. Much like a patient on chronic corticosteroids cannot simply come off them. The antidepressants alter your brain chemistry, so of course a tapered regimen seems easier on the body.
In terms of the second article it is true that there is still a large stigma surrounding mental illness. People who suffer with mental illness are thought to be weak minded, when in fact they have a real disease. We are trying to change the way people view it, but change is hard to accomplish. I also understand the stigma regarding antidepressants and it being a form of “ mind control”. I can’t help but think of the dystopian novel Brave New World where everyone is prescribed daily Soma, just like vitamins.
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Post by Shivani Sharma on Mar 21, 2019 15:25:48 GMT -4
I remember this one incident where I was talking to my friends in undergrad about Anti-depressant and they mentioned that Anti-depressant can ‘mess up’ your neurotransmitters balance and once you are on them, you will never go back to your normal self. Having experienced a conversation like this first hand, I definitely agree that there is a lot of misunderstanding about anti depressants and how they work, among the general population. Not only does it keep people from accepting the help they really need but also, it stigmatizes people who are taking them. Because mental illnesses are very subjective in nature a lot of the times, it becomes very difficult to discard these misconceptions among people. As a result, pt population with mental illnesses suffer a great deal. However, there is a lot of objective data available on how imbalanced neurotransmitters are associated with depressive symptoms and that antidepressants just attempt to bring them up to normal baseline where pt can feel well enough to function. I have noticed that lots of medical care providers at PACT Atlanta try to explain this to patients who are unsure of how to proceed with their treatment. This not only validates pts’ concerns but also helps in clarifying the misconceptions they may have about Anti-depressants.
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