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29th August 2016, 03:11 PM | #241 |
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29th August 2016, 03:17 PM | #242 |
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I'm glad that you're not the person giving medical advice to my sister
Your information is extraordinarily biased - both by that ax that you're grinding as well as by ignorance. It is well-known that some prescription treatments for depression may cause suicidal thoughts in some people uncommonly. Did you know that some treatments for migraine can cause increased aggressive tendencies in some people uncommonly? Or that statins may cause diabetes in some people? Or liver damage? Clearly there's a crisis in the medical community, what with all of these side effects of drugs! |
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29th August 2016, 03:29 PM | #243 |
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We know that there can exist very challenging situations for parents in dealing with serious behavioral problems. At the age of three, it would seem to me that drugs would a very last and exceptional resort for serious problems. Certainly, desructiveness would be one of those serious problems to consider. Nevertheless, I would ask, is the drug being administered for the convenience of the parents or for the welfare of the child?
We have had this discussion before. Your personal experiences are quite compelling regarding the efficacy of psychiatric medication -- but at not so young an age as three, as far as I can recall. My major concerns are the unknown long term effects on a developing brain and I maintain that it is irresponsible (and even criminal) to administer such drugs without extraordinary need. As I have already said on another thread, I dealt with some serious behavioral problems of my own (I was expelled from four high schools and dropped out of college twice), but was never given psychiatric drugs. I have experienced a normal and fulfilling life, professionally, personally, family, marriage (six wonderful grandchildren) -- all without psychiatric drugs. I simply got older and gained control of my compulsive behavior. I shutter at the thought that drugs might have changed my brain (had they been administered as a young teen) in some unknown way. Perhaps I would still be in need o drugs or have other behavioral problems that might have been created. The problem is that we do not know with any confidence based on scientific studies. |
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29th August 2016, 03:40 PM | #244 |
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Yes, long term studies (beyond 15 years) are rare. An adult can factor this into his/her decision making process regarding drugs. But a child is not making a choice; it is being made for him/her. And it is being made in a situation (regarding psychiatric drugs), where there could very well be long term harm -- by long term in this context we are speaking of the rest of the remaining years for this person and his/her sense of self and consciousness. Were I a psychiatrist, I would not want to bear that burden.
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29th August 2016, 04:55 PM | #245 |
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It's kind of nice when I skip 6 pages of a discussion, to find that it's pretty much exactly where it was at the end of page 1. At least I haven't really missed much of anything.
In regard to psychoactive compounds being prescribed to young children... It certainly seems that there should be a lot of hesitancy for this. It shouldn't be common practice. Drugs specifically designed to act on the brain should be treated as a definite risk when being given to a developing brain. That said, I'm not about to say "never". There may very well be children for whom that last resort is better than nothing - particularly those prone to violence and aggression toward themselves or others. Now... THAT said, I still don't see that non-psychiatrists prescribing psychoactive drugs is in any fashion a black mark against the psychiatric field of endeavor. Sure, I skipped a few pages of this back-and-forth... but I haven't seen much of anything that seems to indicate a widespread tendency for actual psychiatrists to prescribe psychiatric drugs to very young children. |
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29th August 2016, 05:00 PM | #246 |
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To recap:
Psychiatric medicine has made some pretty substantial advances in the last 50 years, and is continuing to search for ways to control and treat mental illness. Comparing treatment efficacy for mental illness (a persistent condition) to treatment efficacy of cancer (an acute condition) is not a good comparison; a better comparison would be to CHF, COPD, Asthma, or Diabetes. Exercise is not better than drugs; exercise and drugs together is better than drugs alone; drugs alone is better than exercise alone. The poor conditions of a specific facility does not represent a failing of an entire field of medicine. Poor prescription decisions by non-psychiatric primary care doctors does not represent a failing of psychiatric medicine. |
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29th August 2016, 05:53 PM | #247 |
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A good summary, Emily's Cat.
One more point: Non-psychiatric primary care doctors sometimes prescribing psychiatric drugs without first determining if there is a psychiatric condition does not represent a failing of psychiatric medicine. |
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29th August 2016, 06:14 PM | #248 |
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I agree.
I agree. However I disagree with "arrogant, negligent, irresponsible and criminal". Technically doctors can legally prescribe any drug though there is an expectation that they will not prescribe specialized medicine. Unfortunately drugs such as Prozac seem to become mainstream rather than specialized. Not treating patients is definitely negligent. There is no arrogance in assuming that adult drugs will work safely on children. I agree with "irresponsible". The doctors have given in to a pill pushing culture with other aspects that have not been emphasized as much
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29th August 2016, 06:28 PM | #249 |
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Irrelevant insults do not make a reasonable debate, The Atheist. Misleading people about a Wiki article is bad because people can read it: The term infant is typically applied to young children between the ages of 1 month and 12 months; however, definitions may vary between birth and 1 year of age, or even between birth and 2 years of age. (my emphasis added).
For example the article you cited does not just say "babies". The reporter makes it clear that it is the non-typical use of below 2 years old. I suspect that "babies" is used for shock value to sell the article - the New York Times article that is the basis of the first half of that article uses "children 2 and younger". |
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29th August 2016, 06:45 PM | #250 |
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That leads to a catch-22 situation - how can children be prescribed any drug until after it has been tested by prescribing it to children for decades if we do not allow prescriptions to children until it has been tested for decades on children ?
There are indirect exposures such as mothers breastfeeding while on psychiatric drugs. The ideal situation would be long term animal trials with their known limitations. However at some point someone needs to make at least an educated guess about whether the risks of a drug on a developing child (mind and body) are less than other drugs or no treatment. That is another problem with the use of psychiatric drugs for childhood problems. The decision seems to be too much up to individual doctors with various degrees of expertise. |
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29th August 2016, 09:42 PM | #251 |
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It depends entirely on what other steps have been taken first.
Sure, but with something as hideously addictive as valium, it should be avoided where possible. That wasn't my argument. You're holding a mentally ill person as the best resource for mental illness? Whoa. Damn good idea - multiply the subjectivity of a patient by getting the subjective uninformed opinion of their family. Gotcha. Or even better, follow the evidence that shows time and time again that the best results at treating depression are exercise-based programs. 1 2 3 4 |
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29th August 2016, 10:45 PM | #252 |
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Or even better, read your sources, The Atheist.
Exercise Treatment for Major Depression: Maintenance of Therapeutic Benefit at 10 Months (PDF)
Quote:
Bigger nitpick: A 16 year old paper hints of cherry picking. Where are the follow-up papers confirming (or not) these results? Effects of Exercise Training on Older Patients With Major Depression
Quote:
The Benefits of Exercise for the Clinically Depressed
Quote:
Quote:
Quote:
What you have cited is evidence that exercise is comparable to (not better than) existing treatments, especially for older patients. |
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29th August 2016, 11:57 PM | #253 |
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No, I picked the first four results at random and didn't look at any of them, because the evidence has been posted throughout the thread and I see no need to repeat it all again.
Those who care will find, those who don't, or who are operating to some other agenda, shall remain ignorant. Ignorance is Strength. Livin' the dream - I love your handle. |
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30th August 2016, 07:20 AM | #254 |
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Good points. Nevertheless, my guess is that there are many cases where doing nothing might be the best medicine.
I have mentioned before on another thread that I have a close friend whose son committed suicide at the age of twenty. He was started on drugs at a very early age for what seemed to me to be a relatively minor problem with attention and overall behavior. (His behavior did not seem to be very different than mine at the same age.) It can never be known if the drugs were a contributing cause, but I personally suspect they were. |
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30th August 2016, 08:22 AM | #255 |
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So apparently you don't understand psychosis, the child is hallucinating, fearful and unhappy most of the time. They eat very little and forcing them to eat creates more problems, they do not attend to reality very well, they respond to internal stimuli with anger and lashing out.
Is treatment just for the benefit of the parent's? Do you really think the child is going to thrive in this situation? |
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30th August 2016, 09:04 AM | #256 |
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30th August 2016, 09:36 AM | #257 |
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Should we also avoid all opiates and opioids, regardless of efficacy? What about all the other mental health drugs that are habit forming? What about all the other NON-mental health drugs that are habit forming? Why are you singling out valium?
Most importantly, on what clinical basis are you determining that it should be avoided, and on what clinical expertise are you basing your personal assessment of what constitutes allowable prescriptions? Wow. Way to miss the point and exacerbate it by being condescending. Let me try this again: Perhaps you should actually learns omething about mental illness, the impacts it has on people's lives and loved ones, and the challenges inherent in it before you make sweeping assertions about what's best for other people. Especially before going on a rampage implying that people with depression shouldn't take drugs, they should just exercise, because it's "better". You who have clearly NEVER actually had to deal with depression, even second-hand. |
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30th August 2016, 09:41 AM | #258 |
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Is there a specific patient you're describing in the above? Or is this a description of a generic case that would be appropriate for prescribing?
My concern based on the studies exploring pediatric prescribing is that we don't know the validity. In fact: the authors seem to be unsure about the diagnoses that led to prescribing. There is such a thing as childhood onset schizophrenia, but it's incidence is something like one in 30,000 children. 74 million children in the USA (0 - 17 years old), that would mean there's possibly 2500 children with schizophrenia in the USA during this study; whereas, the antipsychotic prescribing volumes appear to be in the twenty thousand range. That's almost an order of magnitude of misdiagnosis and misprescribing in my opinion. So, just to clarify my position on this... I don't think it's inherently wrong to diagnose schizophrenia to an infant and prescribe antipsychotics in cases where the child's safety is at risk. What I'm concerned about a possible trend toward overdiagnosis to include misbehavior, for which antipsychotics are not indicated. However, at least one of the articles brings up a good point: antidepressants appear much more overprescribed, and there's the distinct possibility that they're intended for the parents' use, but prescribed in this way to be eligible for insurance. So, it's still bad news, because it would mean conventional healthfraud instead of malpractice, which does not cast them in much of a better light. |
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30th August 2016, 09:46 AM | #259 |
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We could; childhood onset schizophrenia is rare but satisfactorily verified (eg: with MRI in addition to age-adapted clinical diagnostic exercises).
I would expect the number of severe (child at risk of harm) cases in the US at any given moment to not exceed a thousand. |
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30th August 2016, 10:22 AM | #260 |
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The problem with not reading what you're posting as evidence is that it's not always evidence of what you think it is. This is one of those cases. You have asserted that exercise is better than drugs for MDD... and yet none of the evidence you've provided supports your assertion. They say that:
Exercise + Drugs > Drugs Alone Exercise > No Treatment Exercise ~ Drugs for older patients Can you see that what you've claimed is not supported by your evidence? |
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30th August 2016, 10:56 AM | #261 |
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Yes, regardless of the cause there are very small children who have full blown mania and psychosis, it does not seem to be a 'behavioral' issue. Fortunately the incidence is low.
I had a client, as an adult, whose first psychotic break happened when she was six. |
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30th August 2016, 10:58 AM | #262 |
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30th August 2016, 01:15 PM | #263 |
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31st August 2016, 02:24 AM | #265 |
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Or, instead of reading some pseudo-shillery posted some bloke on the internet, people could just check with Harvard.
Since you struggle so much with formatting writing and understanding why exercise is so helpful, I'll go easy on you, because I think I know what your mistake is: you're confusing severe depression with all depression. Maybe this Depression 101 from HuffPo might help you. For Zarquon's sake, even bloody the Kirwan touted Depression.Org site lists exercise as the very first thing people can do to try to help themselves. You do know who Sir John Kirwan is? Keep 'em coming - you never know, someone who is actually depressed might see the sense in putting down the prescription and giving it a go. Your continued feeble and ill-informed attempts to deny the obvious are breathtaking enough that you'll do a far better job of convincing people than me. Oh, did you note where Harvard concluded the positive effects lasted longer as well? |
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31st August 2016, 03:29 AM | #266 |
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Well. A "certified personal trainer" citing a single study, and concluding you should hire a certified personal trainer, in the ever-reliable Huffington Post. Don't know about you, but I'm convinced.
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31st August 2016, 09:06 AM | #267 |
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You really need to actually read the things you're posting as evidence, The Atheist. REad them critically, and with full understanding. From your Harvard article (emphasis mine):
Quote:
If you would like to take the opportunity to refine your position, I would fully support that. I suggest something along the lines of: Exercise should be a component of treatment whenever possible; long-term effects on mild depression seem to be better when exercise is involved. That I would get behind completely. |
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31st August 2016, 09:17 AM | #268 |
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31st August 2016, 09:53 AM | #269 |
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31st August 2016, 10:20 AM | #270 |
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Yep. The "the Kirwan touted Depression.Org" website also advocates for massage therapy, pastoral support, herbal preparations, and dietary supplements.
I'd say it's a typical government site, aiming to please the voters, but not a reliable medical information resource. |
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31st August 2016, 11:02 AM | #271 |
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31st August 2016, 12:39 PM | #272 |
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31st August 2016, 01:50 PM | #273 |
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The Atheist: Shoots himself in the foot with more exercise/depression sources
Providing evidence of a lie in this post is not "blether", The Atheist. It is a lie that any evidence that exercise is better than any other treatment for depression was in this thread before your 30 August 2016 post.
10 June 2016 The Atheist: Can you understand that this paper ("The Benefits of Exercise for the Clinically Depressed" ) does not state that exercise is better than drugs? It is true that you wasted our time with 4 random exercise/depression papers:
Your assertion is about depression in general - not low, moderate or severe depression:
You, The Atheist (who is not me) started with an invalid citation about major (severe) depression. You, The Atheist (who is not me) continued with 2 more invalid citations about major (severe) depression. You cite Exercise and Depression that destroys your assertion for anyone who understands English
Quote:
Supporting role in treating severe depression is not "better than drugs" ! 1 September 2016 The Atheist: "Exercise and Depression" destroys your assertion. Depression 101 from HuffPo is down at the moment but I suspect that it does not support you either. Sir John James Patrick Kirwan is an example against your assertion. He was a great athlete (I watched most of the games he played) and yet this person who exercised extensively needed drugs to control his depression ! You can take the first step to enjoying life again
Quote:
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31st August 2016, 02:49 PM | #274 |
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31st August 2016, 07:15 PM | #275 |
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1st September 2016, 10:27 AM | #276 |
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2nd September 2016, 07:06 AM | #277 |
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2nd September 2016, 08:23 AM | #278 |
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2nd September 2016, 09:15 AM | #279 |
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I actually think it's a marketing problem. Therapy makes people think of fru-fru hippie **** or long conversations about subconscious mother lust; whereas, drugs make people think of eggheads in lab coats solving your problem scientifically. The latter seems more like it's a modern proven solution.
Not to mention, nobody sees ads on television for group therapy. "Group therapy may be right for you. Talk to your therapist today." |
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2nd September 2016, 09:53 AM | #280 |
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well, I was not even thinking of GROUP therapy. I was think of psychoanalysis.
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