Readers: I just took down a comment posted by "James" in response to the recent posting on the Whitaker book. James was asking for assistance in coming off a psychiatric drug that he has been taking for many years.
I wish James all the best for his future health. But I must remind all readers that this blog is about ethics and health policy. It is not designed to offer anyone personal medical advice and it would be highly irresponsible to interpret anything said on this blog as personal medical advice. You must consult the appropriate health professional to get personal medical advice. Everything discussed on this blog is general background information and cannot be applied to any specific individual's care without expert interpretation.
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3 comments:
Some blogs include very legalistic disclaimers. Mine doesn't. I don't 'take these comments' down, but I never offer even a whisper of advice, for self-evident reasons. I have given very sterile advice, such as 'talk with your doctor'. The public may not realize it, but if we were to offer any advice, even a simple routine suggestion, this would be enough to establish a duty between the physician blogger and the inquiring patient. This puts the physician and the patient at risk.
Dr. Brody, I understand your position. But I also understand where James is coming from as I was in his position before finding the wonderful supportive site of Paxil Progress, http://www.paxilprogress.org.
As an aside, I don't mean any disrespect but most doctors are clueless about tapering patients off of psych meds. Many will taper way too fast and then falsely attribute it to a relapse which is discussed in an Anatomy of an Epidemic. That is how many people end up at the Paxil Progress Boards which supports anyone tapering off of all psych meds and not just Paxil.
The site suggests a tapering schedule of 10% of current dose every 3 to 6 weeks.
So while usually saying, "talk to your doctor" is great advice, sadly, that falls way short regarding the issue tapering off of psych meds. Many people have found that doing this actually puts them in greater danger.
Of course, I understand that you can't make exceptions and have to stick to standard procedures. Would you be putting yourself at risk legally to suggest that people like James visit the site with all the standard disclaimers?
Thanks for all the great work you do.
AA
To Anonymous: Thanks a lot for your understanding of the difficult position we are in as physicians trying to give the general public useful scientific background, on the one hand, while taking as much care as possible not to give anyone the impression they are getting personalized medical advice, on the other. You are also correct that we're in a bind on the issue of discontinuing SSRI's and other psychotropic drugs. I have no doubt that all too often, "ask your doctor" is simply not useful advice about such matters. I mention (I think in HOOKED) how embarrassing it is that the college students on many campuses who act as the informal advisors to their fellow students on going on and off prescription psychotropic drugs that the students freely (if very unwisely) trade amongst themselves, seem to have known a good deal more, and many years earlier, about withdrawal syndromes from Paxil and other SSRI drugs than most physicians. This is a sad commentary on the way that the drug marketers, and those psychiatrists in their pay, managed to pull the wool over our eyes regarding the downside of these medications.
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