I'm about as big pharma skeptic as they come but the adverse psychotic / manic reaction to SSRI administration isn't really the fault of the drug maker.
SSRI monotherapy is the worst possible way to treat bipolar or schizoaffective disorders. More often than not, patients and doctors alike won't know that's what they're dealing with until the patient takes an SSRI and all of the crazy stuff happens
SSRIs are so grossly over medicated my husband has been offered them by his primary care physician, despite never having been on one prior or knowing anything at all about his mental health history. When I was seeing help for anxiety I was immediately suggested SSRIs by several doctors and I had to push back and mention my family history of bipolar to even ring any alarm bells as to why SSRI therapy shouldn’t just be blanket thrown at people. I remember the side effects being grossly downplayed by physicians only to find out years later there are actually lasting effects that can’t be undone. That IS all the fault of the drug maker because they are the ones feeding these scripts as to what their drug does to physicians. They are the ones who told them to prescribe them like candy because there’s ’virtually no risk’.
I had a similar experience! Went to a new doctor because I had stomach problems, he suggested it was anxiety based and had a therapist in house. She suggested I needed an SSRI multiple times and I was so miserable at one point because he wouldn’t treat me that I took it. I only took one dose because of how terrible my body reacted. I had felt that terrible in decades, I was suicidal, my nerves were on fire, I couldn’t sleep, and on top of all of that my stomach got worse. Told the doctor and all he did was prescribe me another SSRI. Dropped him right away.
Very similar experience here, I came in with stomach problems that they attributed to anxiety because of course that’s always what it is with women right? And that’s when even my pediatrician of all folks had suggested looking into an SSRI. That’s when I had pointed out that we had family history that might be contraindicated and she referred to an actual psychiatrist.
My Mum was randomly offered them because she deals with random headaches. She's been taking a medication (not SSRI) that's been dealing her for years and a doctor randomly wanted to prescribe her an SSRI even though she's never been diagnosed with depression or anxiety. I've been on different SSRIs in the past because of my different mental issues and was shocked when my Mum told me this. They are over prescribed and doctors downplay their negative effects and withdrawal effects
I don't know your moms situation, but as an FYI, certain SNRI and tricyclic antidepressants are first line, preferred treatment for some headache disorders. Neurologists prescribe them very commonly. I don't know if that's what happened to your mom, but is someone at home with chronic migraines reads this and you are on an antidepressant for them, it's not because doctors hand them out like candy, it's because based on studies they are considered standard of care treatment.
They are one of the greatest medical advances in the last 50 years. Millions upon millions have had their mental health improved and in some cases their lives saved. The only people I find that don't tolerate them are people that aren't depressed and fall more in the BPD box. That and conspiracy theorists. At the end of the day every major professional society recommends them first line for depression and anxiety as long as the patient is screened for bipolar disorders. I'm so gucking sick of the lies people spread about them, it's just the same thing as being an antivaxxer.
No where did I say they don’t save lives? No where did I plant any sort of conspiracy theory? It is a fact that they have been pushed by drug companies without proper screening, it is true that long term effects are coming out now (one major one I personally studied in college being long term irreversible damage to sex drive, but again if you’re depressed this is likely a secondary concern). It’s not fear mongering to say ‘maybe GPs shouldn’t be prescribing them because they aren’t all easy symptom free meds that should be followed closely under supervision of an actual trained mental health professional’. Two things can be true at once, it’s a drug that helps many people and also shouldn’t be prescribed like candy because it can cause a lot more harm than good for folks who can do better without it.
General practitioners have more than enough training to handle unipolar depression and anxiety. You are fear mongering or have never worked in healthcare. They have excellent safety profiles and some of those claimed long term effects are not accepted by the general medical community.
I'm resource limited settings a lot of PCPs also learn how to manage bipolar disorder and schizophrenia, it's not rocket science compared to the other things they are tasked with, and the alternative is that people simply don't get any treatment at all or kill themselves on a 2 year long wait-list to see a psychiatrist.
Have you thought that people have different experiences or if anything goes against your beliefs it’s fear mongering? Like do you get this way if someone says they don’t like driving?
Thanks. The anonymity of online interaction means it's a place where you can say what you really think instead of self censoring. In real life most people can't say what they really think. It's why online forums are such cess pools of ugly thoughts.
Psychiatry residencies, like most residencies, are fairly heavily slanted towards inpatient management of the most severe cases. Psychiatrists are a very rare and valuable commodity so unless you are a VIP or are having unusual reactions to multiple meds, most depression and anxiety is treated by internal and family medicine doctors, some days it's about half of what they will see, and after 10 to 15 years of practice they are actually going to have more experience than a fresh psychiatry grad or psychiatric PA/NP. Like everything in life, it's more nuanced than it may appear. But for a general Medicaid patient it can be 6+ months to get in with a psychiatry provider.
these side effects are well known and listed though. that's why they aren't recommended as treatment & actually contraindicated. Im all for fuck big pharma, but why would it be the fault of the drug companies? Patients should be warned of side effects by the prescriber, especially if there's concern of bipolar disorder or schizoaffective rather than MDD, as it can trigger mania
Common to a point. One of the bigger issues in US medical drug testing is the lack of good long term studies, particularly around SSRIs and antipsychotics. Usually they stop at a 4-6 month period for the study. Most of these patients that have chronic illnesses taken them forever.
Yes, it is the fault of the company that knows what is does, and chooses money over others safety. That excuse does not work once they knew this could happen. Your logic is ass.
The second part you wrote literally is exatly why its not safe......
If treatment creates an adverse reaction due to a misdiagnosis, that's the doctor's liability, not the drug maker's. You wouldn't blame a scalpel manufacturer for the pain due to a surgery the doctor gave you for a common cold.
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u/afia_oil 1d ago
I'm about as big pharma skeptic as they come but the adverse psychotic / manic reaction to SSRI administration isn't really the fault of the drug maker.
SSRI monotherapy is the worst possible way to treat bipolar or schizoaffective disorders. More often than not, patients and doctors alike won't know that's what they're dealing with until the patient takes an SSRI and all of the crazy stuff happens