re: Interesting Article About SSRI's. HHS Director Kennedy vs Congress

Yeah, I don’t think most psychiatrists would say meds alone are the whole answer. Sometimes they help enough to get somebody sleeping again, functioning again, able to exercise/work/go to therapy/reconnect with people. But if nothing else changes, the underlying problems are often still there.

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We actually know exactly what what SSRIs do...

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Yeah, but that's not what he said.

He said, "how exactly any of the prescribed psychiatric drugs “work” as “treatment” for any psychiatric diagnosis."

How does selective serotonin reuptake inhibition cure depression, OCD, anxiety, PTSD, eating disorders, and PMS, all of which are diagnoses that they are commonly prescribed for?

That's the question.

Do we know the answer to that question?

Note, I am not of the opinion that we have to know exactly how something works for it to be clinically warranted. As you pointed out, we don't always know the answer to that question when we discover that some treatment or another is effective. As long as the potential side effects have been vetted and the risk-reward analysis indicates that it's worth trying, sure.

Just being clear on the actual question.

I think there’s definitely truth to that criticism. Part of the problem is modern medicine is very compressed/time-limited and patients are often coming in exhausted, overwhelmed, not sleeping, anxious, wanting relief ASAP and with a model for what's going to give it. A prescription is sometimes the fastest thing available even when everybody knows it’s not the whole answer. I think doctors are most helpful when they treat meds as one tool instead of THE tool and also push basics hard: sleep, exercise, substance use, relationships, purpose, routines, social connection, etc. You're right about the relationship. That's what ultimately helps good docs convince people to tackle the more complicated stuff when they realize a med isn't the whole solution.

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the FDA doesn't have a clue how any of th SSRI's work" is mind boggling.....

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As a person who has been on them, unfortunately, for 25 years, I can answer it. They don’t.

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Let’s review the possible side effects associated with Prozac, the first SSRI antidepressant. Anxiety, confusion, difficulty with concentration, mood or behavior changes, amnesia, hyperkinesia, sensory disturbances, depression, dyskinesia, memory impairment, abnormal dreams, agitation, emotional lability, hostility, hypomania, mania, personality disorder, thinking abnormal, depersonalization, paranoid reaction, aggression, suicidal thoughts, and behavior and suicide attempt to name a few.

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This is mine and the only one that I could tolerate that did anything at all. After all these years, I think that what I felt like it did was simply placebo effect. I’ve been weaning myself off for awhile now, but I have concerns about the possible permanent alteration to my brain chemistry and how being off completely might affect me.

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There must be a hell of a kickback scheme in place.

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Yep. Just like autism. It’s more an excuse now days and every bastard has it. Gotta get that IEP to counter the kid being a bad student and also the school gets more funding just like doctors.

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I’m actually pretty firm against therapy as well.

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Same. Seems like a crutch for weak people, that does nothing but they can claim they are trying.

I just don't buy into the idea that if experts don’t possess complete mechanistic understanding, then the product is illegitimate/corrupt. We saved a gazillion soldiers' lives with penicillin before we had a clue about how it was killing bacteria. It would've been better to have had the explanation, but it was defensible to give the treatment because research showed that it worked even though they didn't know how.

You’re basing the word “experts” as someone who did homework and passed tests. They may be subject matter experts but at the end of the day they are humans with their own problems as well. I bet you as a doctor have strong feelings about things you’re not certified in but since you’re a doctor you’re smarter than everyone else. Again this may not apply to you but you can’t tell me that’s not how it is. Just like teachers thinking they know everything because they’re a teacher but have never left a classroom and all they do is repeat lesson plans.

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otta get that IEP to counter the kid being a bad student

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Like I noted before, it creates an excuse to cover for shitty parenting, so anxious white women (don't see a lot of African, Chinese or Indian kids with issues) have a documented excuse.