Your opinion of Freud and Psychoanalysis

[IvanPavlov]

This has been a very interesting thread and I appreciate your responses. I think what bothers me the most is the prescribing of atypical antipsychotics to children, which I understand is quite prevalent for children on Medicaid. It also bothers me that these drugs are routinely prescribed to patients in nursing homes.

Back in 1970 my grandfather was a resident in a nursing home. When I visited one day, he was like a zombie. A nurse brought him a pill and I asked what it was and she told me that it was Mellaril. After I looked it up, I was furious and asked to see the nursing home director who told me that it was a common Rx for patients and was prescribed to "keep them calm". I called his physician and demanded that he take him off the drug at once and in a few weeks my grandfather was back to his old self, yes he had dementia but he was no longer a zombie. To me it was and still is unconscionable to prescribe such drugs to patients in nursing homes, simply to to control the patients and make the administration of the homes easier.

As you know antipsychotics are very dangerous drugs with a myriad of side effects. To prescribe such drugs to children is to me, just beyond the pale and is very upsetting to even contemplate. Would any psychiatrist prescribe such drugs to their own children? I think not. I am a very moral and ethical individual and I know that the vast majority of physicians are the same however it is personally very upsetting to me when I read of what I consider to be unethical prescribing of antipsychotics.

It is the same with a drug such as Xanax, what possible purpose exists for this drug? At least Valium has a clear medical purpose.

It was reported on Friday -

"A Food and Drug Administration panel Friday rejected a proposed Jazz Pharmaceuticals Inc. drug to treat the pain disorder fibromyalgia partly on concerns that the drug could be misused and abused.

The drug, Xyrem, is currently sold to a limited patient population as a narcolepsy treatment. The drug is known generically as sodium oxybate and in an illegal form is similar to the street drug GHB. The product is currently sold under a restricted distribution system to treat narcolepsy, a condition marked by excessive daytime sleepiness."

After Googling GHB I quickly learned that GHB is a date rate drug. Good for the FDA!

In addition it is my understanding from speaking to physician friends that fibromyalgia is a not a real disease but is rather a psychosomatic illness. If this is correct, then the FDA deserves another gold star for rejecting this drug.

I have excellent health care and I trust my physician and his medical group, I only wish that everyone could enjoy the same.

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[Manicsleep]

This has been a very interesting thread and I appreciate your responses. I think what bothers me the most is the prescribing of atypical antipsychotics to children, which I understand is quite prevalent for children on Medicaid. It also bothers me that these drugs are routinely prescribed to patients in nursing homes.

Back in 1970 my grandfather was a resident in a nursing home. When I visited one day, he was like a zombie. A nurse brought him a pill and I asked what it was and she told me that it was Mellaril. After I looked it up, I was furious and asked to see the nursing home director who told me that it was a common Rx for patients and was prescribed to "keep them calm". I called his physician and demanded that he take him off the drug at once and in a few weeks my grandfather was back to his old self, yes he had dementia but he was no longer a zombie. To me it was and still is unconscionable to prescribe such drugs to patients in nursing homes, simply to to control the patients and make the administration of the homes easier.

As you know antipsychotics are very dangerous drugs with a myriad of side effects. To prescribe such drugs to children is to me, just beyond the pale and is very upsetting to even contemplate. Would any psychiatrist prescribe such drugs to their own children? I think not. I am a very moral and ethical individual and I know that the vast majority of physicians are the same however it is personally very upsetting to me when I read of what I consider to be unethical prescribing of antipsychotics.

It is the same with a drug such as Xanax, what possible purpose exists for this drug? At least Valium has a clear medical purpose.

It was reported on Friday -

"A Food and Drug Administration panel Friday rejected a proposed Jazz Pharmaceuticals Inc. drug to treat the pain disorder fibromyalgia partly on concerns that the drug could be misused and abused.

The drug, Xyrem, is currently sold to a limited patient population as a narcolepsy treatment. The drug is known generically as sodium oxybate and in an illegal form is similar to the street drug GHB. The product is currently sold under a restricted distribution system to treat narcolepsy, a condition marked by excessive daytime sleepiness."

After Googling GHB I quickly learned that GHB is a date rate drug. Good for the FDA!

In addition it is my understanding from speaking to physician friends that fibromyalgia is a not a real disease but is rather a psychosomatic illness. If this is correct, then the FDA deserves another gold star for rejecting this drug.

I have excellent health care and I trust my physician and his medical group, I only wish that everyone could enjoy the same.

Are you against GHB, fibromyalgia or specifically the use of GHB in Fibromyalgia?

BTW, nice job of not responding to HMS and changing the subject. Gold star!

 

[michaelrack]

"A Food and Drug Administration panel Friday rejected a proposed Jazz Pharmaceuticals Inc. drug to treat the pain disorder fibromyalgia partly on concerns that the drug could be misused and abused.

The drug, Xyrem, is currently sold to a limited patient population as a narcolepsy treatment. The drug is known generically as sodium oxybate and in an illegal form is similar to the street drug GHB. The product is currently sold under a restricted distribution system to treat narcolepsy, a condition marked by excessive daytime sleepiness."

After Googling GHB I quickly learned that GHB is a date rate drug. Good for the FDA!

.

I have several patients on xyrem for narcolepsy, and have used it once in the past for a patient with insomnia.

Xyrem is very salty and there have been no reports of date rape with xyrem

 

[Evidence Based]

Between this thread and the Mental illness and Society thread, my respect for psychiatrists (and other mental health professionals) as a whole has doubled about five-fold. If responding to bizarre and head scratching statements is what you do for fun, I can't imagine what it must be like for you guys at work...

 

[Giemsa]

. . . my respect for psychiatrists (and other mental health professionals) as a whole has doubled about five-fold.

Ditto.

I'm a pathologist who clicked the wrong forum, but thanks for the reminder:

I love my patients my job is great

 

[IvanPavlov]

Are you against GHB, fibromyalgia or specifically the use of GHB in Fibromyalgia?

BTW, nice job of not responding to HMS and changing the subject. Gold star!

Gee, I don't know, are you for GHB? Apparently the U.S. Drug Enforcement Administration considers GHB to be a predatory drug.

http://www.justice.gov/dea/concern/ghb.html

As far as fibromyalgia is concerned I was told by a physician friend in the early 2000's, during a casual conversation in which he brought up the subject, that it is not a real disease but a psychosomatic illness. Maybe things have changed and it is now considered a real disease. What does fibromyalgia tell us about the state of medical science as well as big pharma? First doctors diagnose the symtoms as psychosomatic and the person is labeled a hypochondriac and referred to a psychiatrist and now big pharma recognizes a new market and it is labeled as a disease. Do you march to the beat of big pharma's drum and just bend like a reed in the wind? Thank god ice-pick lobotomy no longer exists. http://en.wikipedia.org/wiki/Psychosurgery



Obviously, many are uncomfortable in the fact that I have brought up subjects that they would prefer be swept under the table. I am surprised by the emotional response.

 

[kugel]

I am not qualified to state an opinion

That hasn't deterred you one bit.

 

[kugel]

All I am saying is that in my opinion, psychiatrists, who are real doctors, could benefit society if more of them practiced traditional psychoanalysis.

Great. You said it.
Now can we be done?

 

[IvanPavlov]

Between this thread and the Mental illness and Society thread, my respect for psychiatrists (and other mental health professionals) as a whole has doubled about five-fold. If responding to bizarre and head scratching statements is what you do for fun, I can't imagine what it must be like for you guys at work...

Welcome to the business of healthcare, you are on the right road to success.

Hear no evil, see no evil, speak no evil.

 

[kugel]

I am going to bow out of the discussion and let others discuss the post.

??!!

 

[kugel]

I have read the psychiatry thread on and off for years, therefore I understand of the zeitgeist of the profession

Well, then please proceed to provide psychiatric care for all those you believe we are failing to treat. We would welcome the vacation.

And from reading the business section of the newspaper, I understand the zeitgeist of investment bankers. So I will go on to espouse what I think investment bankers SHOULD think....

Oh, yeah. I forgot. I don't actually know anything about investment banking.
Small problem.

 

[Evidence Based]

Ditto.

I'm a pathologist who clicked the wrong forum, but thanks for the reminder:

I love my patients my job is great

And we wonder why the pathology forum doesn't get trolled as much as the psychiatry forum...

Although it's just a matter of time before the zombie outbreak, and all your autopsy patients and tissue samples will come back to haunt your forums.

 

[IvanPavlov]

Well, then please proceed to provide psychiatric care for all those you believe we are failing to treat. We would welcome the vacation.

And from reading the business section of the newspaper, I understand the zeitgeist of investment bankers. So I will go on to espouse what I think investment bankers SHOULD think....

Oh, yeah. I forgot. I don't actually know anything about investment banking.
Small problem.

Investment bankers are the complete opposites of physicians. I am convinced that most physicians truly wish to practice good medicine, they are just in general a little naive and susceptible to the influence of authority.

Investment bankers on the other hand are generally very selfish, independent, shrewd left brained individuals many of which, while obscenely wealthy could be considered pathological in their quest for money and power. They are always looking for an edge. I have found that the best edge is simply the truth. See, The money motive a study of an Obsession by Thomas Wiseman 1974. http://www.amazon.com/Money-Motive-Study-Obsession-Coronet/dp/0340199148/ref=ntt_at_ep_dpt_1

At least OldPsychDoc has a sense of humor, lighten up, take a Xanax and call me in the morning.

 

[erg923]

I think the emotional responding you are getting is due to:

1.) Your obvious hiding of an agenda/topic with a question that you have now abandoned and provided no evidence for in the first place.

2). Your need to provide opinions that are outside your area of experience/knowledge and that are only supported by annoying anecdotal stories such as "Well I talked to the guy this one time who said" and "My dad said X..."

3.) Similar to number 2, your failure (refusal) to cite empirical evidence/data for any of your statements regarding psychoanalysis, "real doctors" being better at psychoanalysis/psychotherapy, and psychopharm practices.

 

[IvanPavlov]

I think the emotional responding you are getting is due to:

1.) Your obvious hiding of an agenda/topic with a question that you have now abandoned and provided no evidence for in the first place.

2). Your need to provide opinions that are outside your area of experience/knowledge and that are only supported by annoying anecdotal stories such as "Well I talked to the guy this one time who said" and "My dad said X..."

3.) Similar to number 2, your failure (refusal) to cite empirical evidence/data for any of your statements regarding psychoanalysis, "real doctors" being better at psychoanalysis/psychotherapy, and psychopharm practices.

"You might very well think that; I couldn't possibly comment" - Francis Urquhart, House of Cards.

http://en.wikipedia.org/wiki/House_of_Cards

 

[Giemsa]

And we wonder why the pathology forum doesn't get trolled as much as the psychiatry forum...

Although it's just a matter of time before the zombie outbreak, and all your autopsy patients and tissue samples will come back to haunt your forums.

 

[IvanPavlov]

Actually, you never know. My dad was a funeral director and one time I was in the embalming room with him together with the maid who was having her morning cup of "Coffee Royal", a shot of whisky in her coffee.

A body laying on the slab moved up to a 45 degree angle and made an ohh like sound. My dad explained that it was some type of after death reflex however the maid almost fainted. On another occasion another funeral director who was a ventriloquist was with my dad at the cemetery when a pair of grave diggers were lowering a body into the grave. The other funeral director projected his voice and said, "let me down easy boys". The two grave diggers dropped the casket and ran away, never to be seen again.

 

[Ibid]

Ivan Pavlov

I started out in the square mile. You can not leave medicine to doctors any more than you can leave banking to bankers. Try explaining the difference between a proprietary trading desk and retail banking to the man in the street and all you get is a denial that banks regulators and the public are all to blame.

The analogy extends to psychiatry. Yes, psychiatrists come in for a lot of ill informed and misjudged criticism but just like bankers some of it is legitimate and some not.

I suppose the patients of psychiatrists are mostly fond of them even if they disagree with them sometimes. Not something one could say of bankers. Also when pharma produces a new product it at least goes through a vigorous process before it gets to market. Any one fancy a CDO or Swap? See what I mean. Any old crap gets out and does real damage. Real damage to peoples lives and who picks up the mess?

 

[snarfer]

This has been a very interesting thread and I appreciate your responses. I think what bothers me the most is the prescribing of atypical antipsychotics to children, which I understand is quite prevalent for children on Medicaid.

It also bothers me that these drugs are routinely prescribed to patients in nursing homes.

We use these medicines to treat kids with autism, genetic abnormalities and other developmental disabilities. This is in addition to severe mood disorders, ptsd, ODD/CD, eating disorders, anoxic /traumatic brain injury resistant to other treatment. Clinically, these kids bang their heads repeatedly against the wall, throw themselves from buildings, run out onto cars, refuse food, and are extremely violent toward themselves and others. I can go on and on. As another poster wrote, a lot of thoughts regarding risks vs. benefits are considered before we prescribe these medicines.
The link between poverty, Medicaid and use of neuroleptics is not a simple one. Severe mental illnesses can be financially devastating to families just as cardiorenal anomalies, oncologic diseases or blood dyscrasias can. The illness often precedes poverty. If poverty is indeed a factor, we know that children born into impoverished families may have been exposed to alcohol, infections, malnutrition and other toxicity in utero predisposing them to respiratory illness, learning disabilities and mental illnesses. Adults with untreated or undertreated mental illnesses are often impoverished. And we know mental illnesses run in families and these kids are at high risks.
I am sure parental abuse and neglect are contributing factors but these are not always the main factors. And we sure like to blame parents, doctors and poverty but this may or may not always be the case.

I wanted to work in geriatric as a medical student and now take 1-2 shifts at a nursing home per month. Elderly patients can become physically/sexually assaultive requiring neuroleptics. The alternatives of using longterm 4 point restraints or isolation which can cause rhabdo, infections, cardioresp distress are inhumane and unacceptable.

 

[IvanPavlov]

I would be willing to bet - wealthy parents with excellent legal counsel = no neuroleptics. Just a hunch.

 

[snarfer]

I would be willing to bet - wealthy parents with excellent legal counsel = no neuroleptics. Just a hunch.

Probably not. Not with the symptoms I described. There maybe some delays as parents try multiple therapists, perhaps 1-2 of those $30,000 per month therapeutic camps, visits with multiple doctors in every specialty including psychiatry. You know, the million dollar workup. During this time there will be emergencies requiring SGAs. If all fails, then long term SGAs.

I would not make this bet.

Also have known a few psychiatrists, neurologists, pulmonologists, internists with children on SGAs.

 

[Manicsleep]

I would be willing to bet - wealthy parents with excellent legal counsel = no neuroleptics. Just a hunch.

There would be a significant number of cases where you would lose that bet. But yes, the legal counsel and the money can keep the child away from treatment they may require.

Then again, money and good lawyers can do a lot of evil in many different ways. Look at the banking crisis. A lot of those bankers should go to prison and some should just be lined up and shot. They won't though because they have money and good lawyers.

 

[michaelrack]

I would be willing to bet - wealthy parents with excellent legal counsel = no neuroleptics. Just a hunch.

I don't think legal counsel has much to do with it.

I would revise your statement to:

wealthy parents= less neuroleptics

 

[zenman]

Deleted

 

[zenman]

I was weeded out early and ended up as an investment banker.

So what do you think about tele-a-therapy for you rich business types so you don't have to leave your office...say at $500 an hour?

Or is that too low?

 

[ClinPsycMasters]

Ivan you're all over the place. Pick a very specific criticism and expand on it. I was trying to reply but I'm not quite sure what it is that we're discussing here. Do you like to focus on Freud, psychoanalysis, psychiatry as a profession, medication, CBT...?

 

[billypilgrim37]

Ivan has become the sort of character that, if he didn't exist, we would have had to create him!

I would like to see somebody take this thread and turn it into one of the text-to-voice cartoon youtube videos.

 

[erg923]

Ivan you're all over the place. Pick a very specific criticism and expand on it. I was trying to reply but I'm not quite sure what it is that we're discussing here. Do you like to focus on Freud, psychoanalysis, psychiatry as a profession, medication, CBT...?

It should be obvious by now that he doesnt really care too much about any one topic, cause he doesnt know enough about the profession to debate back or support his arguments empirically. He just switches to the next "thought provoking" controversey that noone has ever thought of except him. He's what us southerners call, a "Rabble Rouser"...