I’ve been on Lexapro, an anti-anxiety medication, for at least a decade. It was prescribed by a psychiatrist, but then just became part of my relationship with my general practitioner. I just get it renewed. And I’ve not really been asked to think about how long I should be on it. And now suddenly having this conversation with you is making me ask that question. How long am I supposed to be on it? What would happen if I stopped taking it? Would all the white noise of anxiety that made me want to go on Lexapro, would that return? Or 10 years later, have I outgrown that and I just don’t it because I’ve never tried to taper myself off this to find out who I would be if I weren’t me on Lexapro?...
The guest on the episode, Ellen Barry, asks Barbaro, "what did you conclude about stopping?"
Michael Barbaro: "Me? I don’t that I’ve ever gotten far enough along in the conversation with myself to stop.... It was just an accepted fact in my conversation with the doctor that I was on it, and then I’d probably still be on it for as long as I’m going to be on it.... But now I’m asking myself the question of, are we all infantilizing ourselves in the face of medicine? Should I be asking this question myself? Why should I be waiting for a doctor to ask it? It’s getting a little existential now."
If Michael Barbaro, a man whose whole career is about being thoughtful about miscellaneous things, is only thinking of these questions as he's in the middle of doing his podcast on the subject, what hope is there for the millions of Americans who take these medications as a matter of endless routine?
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40 टिप्पणियां:
Leftists should be dumping anti-depressants down their throats.
Full-on Socialist Fists- full. Go on - this is what you leftist do. The opposite of anything that might be healthy.
What’s the one that everyone’s on that gives them outsized and misplaced confidence? That’s the one that everyone needs to get off…
"..medication, for at least a decade.."
sounds like the 'medication' is REALLY WORKING..
at least working for the medical company that's selling it.
but Wait! Just like the BS forced Fauci Jabs - you need more!
There is a new pill to help stop your shaking from all the other anti-depressant pills our leftwing culture/ Big Pharma(D) push and pimp.
You will take your pills! You will take your jabs!
I’m standing in line to vote back when people in Boston stood in line to vote and this little group of people in their forties all together chattering away, clearly on adderall and something like xanax, maybe some kind of uppers. They’re all shitting on so and so’s husband, someone who I later met and figured out he’s the one they were shitting on. Clearly normal this guy was, no meds. The drugs make life like the party you show up at late and everyone’s drunk except you…
keys mic…Medication Time…
Always do your own homework, and never just go with what the MD has to say. Follow your doctor's advice, but question him or her on things. Ask questions. Make sure you have a doc who listens and welcomes the back and forth, who is willing to look at other information.
They are busy. And they are all schooled the same way with the same way of looking at things. There are exceptions, but not many. And in today's world, most docs are so overwhelmed with patients and computer time, some barely even know you're in there with them. They see your name on the computer, but you? The person?
No...just keep taking Lexipro and a dozen other meds forever.
We are the most medicated society in the history of the world. It should not be this way.
Thankfully, there are a couple of AI companies working to help free doctors up to face their patients again and have more timely information at their fingertips (see Abridge.com). But too many are just not there.
What was the question?
Psychotropic drugs don't "work" in the conventional sense of most medical interventions. If you have an infection and you take an antibiotic, the infection goes away and you are cured. According to the data, most of the effect of psychotropic drugs is the placebo effect. Not working is indicated by the fact that they don't work for everyone and frequently stop working. Amelioration of symptoms is just a side effect (for some people) of throwing a chemical hand grenade into your brain. The idea that mental illness is the result of a chemical imbalance in the brain is the white whale of psychiatry that has never been proved.
My old urologist once told me that Americans have the most expensive urine in the world.
Reducing the amount of medication one is taking should be a very simple thing to "study". If you cut the blank med by 25% and nothing happens then go to 50% and if nothing happens odds are zero will be just fine too. But like most things in life testing is the best form or trial and error.
The internet informs me that the Catholic Church "holds a position of tender mercy and compassion toward those suffering from mental health conditions, recognizing the medical usefulness of psychiatry and the role of psychiatric medications when prescribed and used under the supervision of a competent psychiatrist."
Life has never been easier or safer for humans. What's all the anxiety about?
I suspect that a lot of the unhinged social anger is medication induced. The divisiveness of our current culture arose with the widespread adoption of mood altering medications. Coincidence?
sounds like the 'medication' is REALLY WORKING..
at least working for the medical company that's selling it.
Do you have the same attitude about blood pressure medications or insulin for diabetes?
The Subscription Model is killing America. When pharmaceutical companies in concert with healthcare providers started developing “maintenance” therapies instead of providing doctors with a way to cure ailments they realized a lot of ailments could be moved to that model. But every therapy in theory should have a goal, and if possible the goal should include a metric that moves the patient from reliance on a therapy. But an endless prescription model creates several revenue streams (office visits, testing, test results consults, drugs, rinse and repeat) and is just too tempting for Big Med to resist.
They even attempted to turn the COVID crisis into subscription with drugs that had never been proven “safe and effective.” THAT’s how tempting the New Model is to the world’s second oldest profession.
Now do statins and blood pressure medications. Since my diagnosis of borderline hypertension, I'm wondering whether I will need to take these pills forever. There's no offramp.
"...are we all infantilizing ourselves in the face of medicine? Should I be asking this question myself? Why should I be waiting for a doctor to ask it? It’s getting a little existential now."
In this instance, the meds are causing some anxiety.
Take your soma all will be well
Freder - what do those meds have to do with the subject?
Anti-depressants.
Freder, meet ChrisC:
"The idea that mental illness is the result of a chemical imbalance in the brain is the white whale of psychiatry that has never been proved."
Whereas the connection between insulin and diabetes is well established.
The corrupt D-hack Soviet media completely ignore the COVID lies.
But that reflecting pool is really important to them.
Freder - what do those meds have to do with the subject?
Chronic depression is a long-term, often life-long condition just like hypertension or diabetes. They are indeed over-prescribed, but for a significant portion of the population, anti-depressants save lives.
" But now I’m asking myself the question of, are we all infantilizing ourselves in the face of medicine? Should I be asking this question myself? Why should I be waiting for a doctor to ask it? It’s getting a little existential now."
I agree with Althouse's last paragraph. Is he really that clueless and trusting? Is his doctor? I have asked that question about every medication since baby aspirin since I was very young. Surely there has been a brief period in the last decade when he missed taking the Lexapro. What happened?
(I am not condemning Lexapro--I am fairly certain there are many people--possibly including Barbaro--whose life would be a living hell without it. But RFK Jr's basic premise is correct--anti-depressants are grossly over-prescribed).
"But RFK Jr's basic premise is correct--anti-depressants are grossly over-prescribed)."
Maybe if RFK Jr. took some anti-depressants he wouldn't have needed to self-medicate himself, and consequently get addicted to, heroin.
Perpetual medical monopoly.
This might be the most important policy RFK Jr. implements: changing the perception that psychological drugs have no end date.
When did we start seeing ads for drugs that can only be prescribed by a physician?
Beware statins, Amp. British Med Journal and others have been covering pretty well lately:
https://bmjgroup.com/new-study-sheds-light-on-long-term-effectiveness-and-safety-of-two-widely-used-statins/
Blogger no longer allows hypertext links?
Humperdink asked: "When did we start seeing ads for drugs that can only be prescribed by a physician?"
In the late 1990's. It changed the way physicians prescribed. I can't tell you how many times people would come in and start a sentence with "I don't believe ads I see on TV, but what about trying this drug?" Then when given pushback, they would always follow up with "They say I should find a doctor I can trust to prescribe what I need" or some such thing but it always included the word "trust." It seemed they had been coached, or maybe the word is "influenced." And that was before social media!
In addition to the placebo effect, there is also something called the nocebo effect. That's when the patient doesn't believe a therapy will help so it doesn't. If a doctor recommends a better alternative to the requested drug, it doesn't work because of the nocebo effect. That's especially true of drugs for the mind.
The other thing it's true of are non-medical interventions that are known to be better alternatives to drugs - diet changes for indigestion, physical therapy for pain, etc. The prescription arc for powerful antacids follows the same as the anti-depressants. They, too, were meant to be used for short durations but people end up being on them for a lifetime because they say they can't live without them. I think they could, if they tried, or wanted to try.
Blogger sucks.
"Ask your doctor if Lexapro is NOT right for you!"
There's are at least two verbs missing in that post.
A.I. can't take over medicine fast enough.
Dependency on SSRIs (and their variants) for depression and anxiety is a result of a failure to change attitudes and behaviors that cause the dysphoria. People and therapists are too lazy to work on these things, so they medicate.
'Reducing the amount of medication one is taking should be a very simple thing to "study".'
Indeed, antidepressants have been heavily studied and consistently shown to improve symptoms of depression significantly better than placebos. They don't work for everyone, but neither does chemotherapy.
There are simply a lot of people who believe that mental illness is essentially moral; if you're suffering, it's because somehow you deserve to. Taking medicine to reduce the suffering is thus offensive.
Everything youi put in your body is a drug of sorts. What we spend a fortune for at the pharmacy is simply something that isolates and mimics certain properties in convenient-to-deliver form and amout.
Not all drugs have the same effect on all people. Valium, for me, has either NO effect or makes me a bit hyper. Xanax is almost instantly sleep-inducing, even at low dosage. Epinephrine will cause a panic attack and urge to do violence to nearby people. Cocaine without adulteration is something too wonderful to describe. Morphine does what morphine does but its 'clones' vary. I need a LOT when there's a need to put me all the way 'out' for some surgical procedure - "Start saying the alphabet...". "OK, now what?..."
Addiction is bad but inevitable for some people. That problem won't go away with government dictating how doctors treat their patients. Establishing a personal relationship with your doctor is just as important as his/her medical knowledge.
The 'why' example is too long for the telling here but I would have died three or four times in the last seven years if my docs of many years didn't know ME and treat ME in ways that did not confrom to protocols of their practice, admitting hospitals, professional associations, licensing boards and the U.S.-fucking-Government.
Doing this puts the doctors at significant personal risk. Because they trust me as much as I trust them, they do what's best for me.
There was a time when the doctor/patient relationship was everything. Then, doctors had to hire lawyers, insurance advisors, record-keepers, bean-counters and myriad experts to keep them up-to-date and in complicance with countless regulations governing the endless aspects of doctoring.
There were so many of these support functions, they morphed into umbrella organizations that provided more efficient one-stop solutions for ALL THAT STUFF THAT HAD NOTHING TO DO WITH DOCTORS AND PATIENTS.
Then, people running these support businesses said, "Hey, there's a hell of a lot of money in medicine. There's a way WE can get more of it". So they hired some doctors to work for THEM (tail wagging the dog).
So here we are. Inform yourself. Tell your doctor the whole truth. Take care of yourself.
Anti-depressants are one reason why people aren't dating and mating as much as in the past. Maybe not the main reason, but a factor that can't be ignored.
As for blood pressure, it has a lot to do with diet. Cut out salty foods and your blood pressure will go down. Maybe you'll still have to take the pills, but maybe you'll be lucky.
If I understand correctly, drugs you see advertised on television are the expensive ones with a high profit margin and perhaps not the ones you should ask your doctor for
Barbaro doesn't seem to know that he is in charge of his own life.
I'd be anxious about taking an SSRI without knowing the side effects, interactions with other medications and issues related to long-term use. I'd ask my doctor, the pharmacist and do online research.
Maybe taking anti-anxiety medication makes the patient less concerned about taking a pill to alter your brain chemistry.
Antidepressants, pshaw! Try statins next. Lifetime prescriptions are a desired outcome of modern pharmacology!
Give me my soma, or give me something generic or equivalent.
Before the 1960s schizophrenia was treated by institutionalization, electroshock, and insulin coma treatment. Nothing worked, mothers were blamed for making kids schizophrenic. With Thorazine and haldol behavior was changed, no commands from the tv, no spooky visions, they went home. This led to the imbalance theory, the pill works, you lack something, but it made people dull and passive, they stopped taking the drug and went wild again.
So it’s control, not a cure, we still have witch doctors with different more effective rattles and bones. So, is the pill better? You have to decide. In most cases, yes, but it may make you sick as you age, no easy answer. Just make sure you really do have a problem and not an imaginary problem.
Unlike an infection you are probably not going to be cured, so make your plan and follow it.
Regarding statins, they absolutely work on reducing coronary artery disease and stroke. The diet reduces cholesterol is mostly happy talk, blame the guy with bad genes. If you have naturally low numbers ok, if not, take the drug. It’s generic now anyway.
I half way believe that the glp weight loss drugs may some day be used for depression.
It comes down to the two stories. Either you are taking the drug and damaging your health in some way chemically and wasting money and 1. You really don’t need it at all. Or 2. you do need it and the quality improvement is worth the risk to health and the cost.
The factors may change over time so why not work with your doc periodically and see if tapering off helps. But I understand that you should not go cold turkey on most drugs either.
"Maynard said...
Dependency on SSRIs (and their variants) for depression and anxiety is a result of a failure to change attitudes and behaviors that cause the dysphoria. People and therapists are too lazy to work on these things, so they medicate."
You want to see change of attitude and behavior, watch what happens when the legitimate crazy stop taking their drugs.
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