quote: IT'S ABOUT TIME: L.I. MOM Tue Mar 23, 5:05 AM ET Add Op/Ed - New York By DOUGLAS MONTERO
Joanne Schillinger didn't get any warnings about the antidepressant drug prescribed to her then-12-year-old daughter - except that she might gain a few pounds.
It wasn't until her daughter's suicide attempt a year ago that the Long Island mother began blaming the drug Paxil for the girl's violent and irrational behavior.
Yesterday, the 44-year-old mother said the Food and Drug Administration (news - web sites)'s decision to ask the makers of 10 antidepressants to put a stronger warning about suicide on its labels is a little too late.
"I don't know why it took them so long," Schillinger said.
"If I had known [about the risk], I would've never let my daughter take the drug . . . I didn't have a [medical] degree. I took the word of the doctors because they know better."
Weaned off the drug nearly a year ago, Jaime, now 15, is still suffering from flashbacks.
She does not remember mutilating herself with scissors, knives and paper clips, or the tantrums, or the day she jumped out of her father's moving car.
" 'I can't believe I did that,' " Schillinger recalled her daughter saying as memories begin to enter her life.
"We used to walk around on eggshells because we never knew what was going to trigger her."
Every time Schillinger complained about her daughter's behavior the Paxil dose was increased from 10 milligrams to 20, and eventually to 30.
By March 11, 2003, Schillinger wanted Jaime off Paxil but the doctor persuaded her otherwise - and upped the dosage to 40 milligrams.
Sixteen days later, Jaime used black lipstick to write obscenities all over her bedroom wall, swallowed a fistful of Tylenol and slit her wrist, the mother said.
"I should've followed by motherly instinct and taken her off the drug - that's what makes me so mad," said Schillinger, who learned through the Internet that for years many other families across the nation have complained about possible links between antidepressants and their loved ones' suicides.
"The FDA should've made [its] decision years ago."
I absolutely believe that pharmaceutical therapy works for people who are treated correctly, but Paxil scares me.
posted
Yeah, I had a neighbor who shot his toddler, his infant, and himself. I'm not sure what he was taking, but sometimes it's better for a person to be depressed and ineffectual than depressed and enabled.
I've never taken reuptake inhibitors for precisely this reason. P.S. I've not heard of folks being unable to remember things they do on the meds, though...
posted
They put my friend on Paxil---it's a long story which invovles me wanted to throw things at the school counselor.
One day in lunch, she turned white (she's of mixed decent, so this was odd) and her veins popped out of her arms like a weightlifter's and she started shaking all over. I thought she was going to have a seizure.
That week, her boyfriend made her stop taking it because a woman in central Jersey who was taking it tried to kill her husband and herself.
I hate stuff like that. It does more harm than good.
Posts: 463 | Registered: Oct 2003
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posted
I think the main problem is the idea that drugs are a less expensive alternative to therapy. Folks should be closely monitored by a professional while they are tapering up on psych meds and periodically monitored while they are on it.
Trouble is, right now you can get a prescription from your General Practicioner (sp?) and never see anyone with mental health experience.
And I really think it's wrong for kids to be put on it at school without parental informed consent. I don't know how common that is, but I am definitely against it.
I think both of these scenarios are made worse by social bias against the mentally ill.
Posts: 383 | Registered: Nov 2003
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posted
Drugs are scary even in environments under the control of medical professionals.
When I was about 9 I broke my right arm rollerblading on a hill after a particularly nasty winter (lots of gravel and sand does NOT mix well with wheels). It had to be set 4 times since they botched it up so much at first but anyway...
About the third time I went in, they couldn't give me any more anesthesia or I would have died so, instead, they put me on a hallucinogen. I had to be watched by two whole teams of both doctors and nurses - one in the room and the other watching outside on monitors. I'll tell you one thing, those things are scary. Yeah, you get the nice hallucinations but the scary or bad ones are REALLY bad. And they don't make any sense either. For instance, when I came out my mum asked me why the poptarts were so scary. It turns out I'd screamed out the word "poptarts!!!" in absolute terror. Why were they frightening? I don't know and THAT is a scary thought.
Anyway, my point is that drugs are NEVER cool, whether perscribed or not. I told my mum right afterwards that I would NEVER take drugs and I've kept my word - once was frightening enough: as in, imagine being utterly helpless with no distinction between reality and the hallucinations whatsoever.
...I know this is a bit of a derailing so I hope you'll pardon that. Just wanted to share.
Posts: 1548 | Registered: Aug 2002
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posted
OH CT (and other Hatrack docs)! Please tell these people that not all SSRIs are evil!! These drugs have helped so many people, including myself. Yes, I had to go through a few, but I finally found one that helped me through some very tough times in my life.
That article, and many more just like it, are going to scare sooooo many people away, people that maybe could've been helped by them.
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posted
I know. But I just don't know how to explain it so that people will hear what I have to say. Hence banging my head against the wall.
Posts: 14745 | Registered: Dec 1999
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posted
I figured that was why you were doing that. Maybe we should try and find some articles from a couple of journals for them. Posts: 2064 | Registered: Dec 2003
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posted
I've tried that many times--it goes ignored. Sensationalized reports and hearsay seem to have more effect.
I mean, I study this stuff. Brain chemistry and such.
People who doubt or discount these medications...do they really look to see how they work? Percentages of side effects? Patient rights? Patient advocacy? Checking other articles and resources that advocate for patients, such as the National Alliance for the Mentally Ill?
Posts: 14745 | Registered: Dec 1999
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posted
I apologize for posting this without giving more of my opinion on the article. I should have realized that it would make persons who need Paxil (and other pharmaceuticals) and professionals who prescribe them have to explain that not all drugs are bad. It wasn't really my intention to do this, but rather to induce a dialogue about misprescribed/overly prescribed drugs and their effects. Especially if the follow up care misses signs of ineffectiveness/bad side effects.
So I officially apologize to mack, Theca and CT; and to the others who might be adversely effected by this article. But I'm not going to stop this discussion.
One thing I did want to discuss about this article, that is fairly tangential, is the bias inherent in reporting. Granted, this is The New York Post we're talking here, but it is clear that the drug is being demonized. There's no quote from the doctor or the medical establishment, either.
And I'm thinking about the use of drugs with juveniles, too. There've been some news stories about the uncertainty of dosage for youths and the different chemical make-up they have.
All my thoughts are unravelling. I'm grumpy and tired tonight. Maybe someone else will be able to address these incoherent issues for me.
posted
jexx, no, I think it's a good question to raise.
Unfortunately, the sensationalist bias of many such stories leaves out the more accurate assessment of the numbers.
A very small number may have bad side effects (and even then, whether these are attributable to the medication is a big question, because you don't really have a control group of non-mood-disordered persons to compare to). But there can be a vastly greater group of people who are enormously helped. The ratio of these groups is very important.
It's like anti-seizure medications, all of which have causing seizures as a known potential side effect. Weird, huh? And if you just listened to one bad account, you may not have an accurate and helpful picture of whether to use these medications for your child. But thorough and accurate information helps make sense of this apparent paradox of "why would these evil doctors give my child with epilepsy a medicine that could make him seize more? Arrrrgh!"
I should write more, but I am currently watching the expanding scotoma of an oncoming migraine. (I'm not saying it was triggered by seeing mack's head banging against a wall, but I'm not ruling it out, either. ) My trusty Imitrex awaits. By the way, the known side effects of this medication includes headache. Oddly enough, for me and millions of other people, this is not a problem.
[PS: But there have been important other topics raised here, too: informed consent, overmedication of kids, reliance solely on medication without appropriate non-pharmaceutical therapy, and the like, are all well worth discussing. So is the main issue, but I'm out for now. I loves me Imitrex. ]
Posts: 14017 | Registered: May 2000
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Correct me if I'm wrong, but didn't Abbott's Depakote get a black box warning on it due to a patient death. If I remember right, a trial subject died in a car accident while he was on the drug and because of that fact, it had to be listed in the PDR as a possible "side effect".
Edit: At least I think that was what the rep told me...
posted
The hard part about dosing for the pediatric population is how fast they are growing and developing. Neurons and neurotransmitters are continuously being refined and organized up through adolescence. In fact, the most major mental illnesses (schizophrenia and bipolar disorder) form in early adulthood--after this biochemical organization is finished.
But...kids can become depressed. Drug therapy alone IS effective--as is talk therapy alone. However, the greatest effective treatment is both together.
Any psychiatric medication must be administered with care.
Different medications work in different ways.
SSRIs: Selective Serotonin Reuptake Inhibitors (zoloft, paxil, prozac, celexa, lexapro) create higher levels of serotonin in the body by inhibiting the reuptake of serotonin into the synapse.
Serotonin is formed by the neuron and sent out across the synapse into a receptor, where it transmits its information. It's released by the receptor and then taken back up into the neuron. SSRIs inhibit this action--so the serotonin stays in the synapse longer and can create better functioning (if the level was low).
But serotonin isn't the only neurotransmitter. There's dopamine, ephinephrine, norepinephrine...and many, many others.
Atypical antipsychotics (risperdal, geodon, abilify, seroquel, zyprexa) work in many different ways. Many act as agonists or antagonists for neurotransmitter receptors, either creating more of less available neurotransmitters. But that's a very simplified explanation.
See, the thing is..while these medications DO act on receptors and synapses and such on a selective level...they also have low or high levels of affectation on OTHER receptors--which is what causes side effects.
Which sucks.
But, there's a cost of living analysis. Is it better to suffer with the illness? Or suffer the side effects of the medication?
Tough call.
But in treatment of mental illnesses, it's a responsibility to treat the biochemical aspect as well as the behavioral cognitive aspect.
Posts: 14745 | Registered: Dec 1999
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quote:But the FDA stopped short of recommending people discontinue taking their antidepressants.
"We specifically decided not to tell people not to use these drugs," said Katz. "We don't think that is necessary at this point."
Hear that? I know what some of you might be thinking: DO NOT stop taking your meds without first discussing it with your doctor!
Posts: 2064 | Registered: Dec 2003
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posted
Yes, this is exactly what I wanted to know (mack)! And a little of what I was trying to say, as far as the growth of brainy bits in younger persons. Thank you, mack.
It's incredibly complicated, drug therapy. But important, I realize that. And I can't imagine that drug therapy alone can be very effective, unless the patient is regularly (like monthly) seeing a doctor to keep tabs on the meds. Wouldn't that constitute *some* kind of therapy, anyway? Hurumph. I need to read more about this.
CT, I hope the Imitrex works like a dream (so to speak) for you. I have several friends with migraine problems, and Imitrex works for a couple of them, and one takes Midrin with good result. Thank goodness for pharmaceuticals, yes. Thank you for making me feel less guilty about posting this article, and for bringing up more questions to ponder. Posts: 1545 | Registered: May 2002
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posted
there was an article somewhere a while ago, that listed ten drugs for treating anti depressants that were being perscribed legally to children in the US. only one of those ten is allowed to be given to children in the UK.
quote: This kind of stuff pisses me off. This is why I don't like doctors.
O_o That seems kinda extreme. Are there bad doctors? Surely. Was the one involved in this story one? Not enough information to tell. Even if so, would this be a reason to dislike all doctors? Um . . .
quote: I'm not sure what he was taking, but sometimes it's better for a person to be depressed and ineffectual than depressed and enabled.
*blink* Wha? For the vast majority of people who take these drugs, depression is reduced or alleviated -- and what the heck does ineffectual v. enabled have to do with anything?
quote: I hate stuff like that. It does more harm than good.
Blatantly false. These medications SAVE LIVES. And even more often, make life worth living.
Repeat after me: The plural of anecdote is NOT data! Do some people have bad side effects? Yes, sometimes very bad. Should there be warnings about them, and should doctors and patients be on the lookout. Definitely.
Are these side effects common? No. Should they stop people who need these drugs from taking them? Not in my opinion!
quote: I think the main problem is the idea that drugs are a less expensive alternative to therapy. Folks should be closely monitored by a professional while they are tapering up on psych meds and periodically monitored while they are on it.
Trouble is, right now you can get a prescription from your General Practitioner and never see anyone with mental health experience.
This I do agree with 100%.
quote: And I really think it's wrong for kids to be put on it at school without parental informed consent. I don't know how common that is, but I am definitely against it.
Is that legal??
I have never (yet, anyway) been on SSRIs. However, I have been on narcotics (post appendectomy and while in labor). While I cannot understand the appeal of taking them for non-medical reasons -- I really didn't like not making sense and the wooziness -- they sure as heck beat post-surgical pain!
Posts: 32919 | Registered: Mar 2003
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posted
Hell. I'm the poster child for tried/failed meds.
Celexa: no effect Depakote: malaise, constant hunger Zyprexa: slept for 32 hours straight Topamax: malaise, severe loss of appetite Trileptal: dizziness, headache, loss of coordination Seroquel: slept for 20 hours straight Risperdal: slept for 16 hours straight Geodone: slept for 14 hours straight Lithium: severe nausea, malaise Abilify: fainting, heart palpitation
...this was over the course of about a year and a half.
Successes:
Lamictal: completely alleviated atypical major depressive episodes. have not had one since starting it last June. side effects--severe headache for the first month. worth it now? absolutely.
Lexapro: alleviated abdominal pain. side effect--headache for first week. worth it? yes. no pain.
Ritalin LA: controls symptoms of ADHD and allows me to focus, relax, concentrate. side effects--appetite supression, tiredness when dose runs out. worth it? absoeffinglutely.
Better living through chemistry.
Posts: 14745 | Registered: Dec 1999
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quote: I'm not sure what he was taking, but sometimes it's better for a person to be depressed and ineffectual than depressed and enabled.
Well, in mental health, that IS a concern, but in a different way.
When a person is SO deeply depressed that they have no energy or will to do anything, they're fairly safe, because they just won't DO it..they'll just contemplate it.
The most dangerous part of recovering from depression is that lift from listless, deep depression to the active irritable depression. That's where action can occur from a mind not in its right place.
But to not treat because of this possibility is unethical. But you have to be well educated and well versed and MONITORING it.
Posts: 14745 | Registered: Dec 1999
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posted
Wow, mack, that is quite a list. Some heavy duty ones there.
Diagnosis #1: Depression
1. Paxil: nothing. Did NOTHING! 2. Zoloft: Sex? What's that? 3. Celexa: first 20, 40, then, yes, 60mg. Serious side effect: my short term memory is GONE. It is really sad, actually, I can barely remember the details of yesterday...(I'm serious)
Diagnosis #2: Anxiety
1. Risperdal: Sleepy time 2. Paxil XR: (gimme a break) 3. Effexor XR: 37.5, 75, 150mg....getting closer
Diagnosis #3: Sleep Disorder
1. Seroquel: DEAR GOD! WTF are you trying to do to me!! 2. Sonata: Nada 3. Ambien 10-20mg: Works like a dream....
Posts: 2064 | Registered: Dec 2003
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Val, if you're on 60mg of celexa with side effects, have you talked to your prescriber about switching to lexapro? It's a more potent form of the active ingredient of celexa, so has less side effects and you take less OF it.
quote:Seroquel: DEAR GOD! WTF are you trying to do to me!!
posted
About people forgetting things they do while on pills: I don't remember most of high school.
But I don't think they're all bad. I think they're overused, but honestly...they have helped me a lot, when I haven't been able to handle things on my own. I think they need to be studied more carefully, though.
EDIT: Lexapro?! I remember that stuff. I took it last year; I spent most of the week curled up in bed wishing for death from the sheer physical discomfort of it.
posted
You know what, mack, come to think of it, I probably tried Lexapro too. See, it's kind of hard to REMEMBER! Posts: 2064 | Registered: Dec 2003
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posted
No one made the connection between my memory loss and Celexa until much later...so, yes, I do realize Lexapro just came out not that long ago.
Posts: 2064 | Registered: Dec 2003
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posted
I wasn't allowed to be on Ritalin due to drug abuse and alcoholism in my family (almost everysinglepersoni'mrelatedto). I'm on Stratterra right now, and it's AMAZING.
I'm on the beginning dose (or...whatever it's called), so I'm only on 25mg, but I'm supposed to have it upped within the next couple of days. It's so wonderful being able to lay down and not have to wait three or four hours for my mind to unwind; to sit and now start shaking because I need to MOVE ... so much more. I can recognized and stop being obnoxious when it happens ... well, most of the time; sometimes, I can only recognize, and I get this insane feel that "Hey, I should stop!" but I can't.
Stratterra has done so much for my family. My brother Christopher, just now 16, who lives with my mother, is on it, and he's doing so much better than he's ever done before. He now reminds my mother to refill his prescription! This is the child that smoked pot on a school bus when he KNEW that there was a video camera on it! His teachers say that there has been a huge improvement.
Tony, 9, is on 50mg, and he's doing so well in school! He was never the problem child that Chris was, but he's even better now. His reading level has gone up from sixth grade to seventh in just a few months. This from a fourth grader! I'm so pleased for him.
So, yes, I luff Stratterra.
Posts: 45 | Registered: Mar 2004
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posted
I can definitely see a difference in mack (and anyone who has had a passing acquaintanceship with her can, too, I bet) once she and her doctor figured out which med was most effective.
When I first 'met' mack online, I was often afraid to sign off of AIM with her because she was ideating (imagining suicide), sometimes actively (planning suicide). Once, I called her so she could hear the sound of someone's voice. What scared me most about this was primarily my ignorance. Secondly, mack knew exactly what the terms were for her suicidal thoughts, and why suicide was wrong (technically), and could explain to me what was going on, but felt powerless to stop it. That was/is totally alien to me. Through different drug therapies and whaddyacallit "talk" therapies, mack gradually made it out of her fog. When she visited me this past weekend, I was astounded by how fully *alive* she is now.
So yes, there IS better living through chemistry. Of course. I just hope that there are people working on how to do effective drug trials and development and yaddayadda.
Also: I have never heard of drugs being administered in schools (by school nurses, presumably) without parental consent. Would anyone have a link?
Posts: 1545 | Registered: May 2002
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posted
I've been thinking about trying adderall....apparently, in some rare cases, it'll fix ocd right up. And SSRI-type medications definitely do not agree with me, as evidenced by my happy Lexapro time, among other adventures.
Posts: 9057 | Registered: Nov 2000
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posted
I have been hearing such wonderful things about Strattera. People have been raving about it. Sure is nice to not have to have a written script for every time to the pharmacy too, like it is for Ritalin, Adderall, and Concerta.
Posts: 2064 | Registered: Dec 2003
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posted
I have very little knowledge of this subject, so feel free to laugh at me.
I feel that everyone wants the "quick fix", so they come up with these personality disorders, then prescribe behavior changing drugs. Now, in extreme cases, this could definitely be the right course. However, I believe that way too often, someone says "I have a problem, someone else should make it go away." Taking these medications seems very similar to drinking or taking narcotics in order to get rid of problems, which really doesn't work. I also thought it was hilarious when I saw an ad for one of these drugs that claims "people can finally get to know the real you." Well that's just wonderful, but if you're hopped up on behavior changing drugs, then how are they getting to know the real you?
Posts: 7 | Registered: Mar 2004
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posted
Okay, Eljin, think of it this way: if you had a vitamin deficiency, you would change your diet. If you had diabetes (a deficit of insulin, right? A naturally occurring element in your body) you would take insulin shots. Similar thing.
Posts: 1545 | Registered: May 2002
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posted
Eljin, except you're missing one rather important fact. These drugs work by fixing something that is wrong. Would you tell someone who had an infected appendix not to have surgery, because that would not be the "real them"?
Being on psychoactive drugs is NOT like being on narcotics or alcohol -- they don't mask the problem. They adjust the brain chemistry back to normal.
Posts: 32919 | Registered: Mar 2003
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posted
According to the website for Strattera, trials have only been done on Child and Adult ADHD. But that doesn't mean a doctor can't prescribe it for you for that diagnosis if they think it is right for you.
posted
I think that the real me was finally allowed to emerge when I started taking antidepressants. I have days where I'm still pretty down, so I doubt my mood is being artificially elevated.
I am taking drugs to get rid of my problem, yes. The problem being a neurochemical imbalance which I can't fix on my own.
quote:I feel that everyone wants the "quick fix", so they come up with these personality disorders, then prescribe behavior changing drugs
Disorders are diagnosed using the DSM-IV by licensed professionals. A diagnosis cannot be ethically made if said symptoms of said diagnosis are not moderately to severely affecting life functions.
The DSM-IV-TR has a five axis diagnostic system.
Axis I: Clinical Disorders (mood disorders, schizophrenia, disorders most often found in childhood) Axis II: Personality Disorders, Mental Retardation Axis III: General Medical Conditions Axis IV: Environmental concerns Axis V: Global Assessment Functioning
Medications prescribed actually aren't going to change behaviors. They may alleviate symptoms...but behavior change is brought about using behavioral cognitive therapy.
quote:someone says "I have a problem, someone else should make it go away
Most of the time, people have been trying to solve the problem themselves for quite some time and are unable to. Why? It's biochemistry. And you can wish all you want but it won't fix it.
quote:Taking these medications seems very similar to drinking or taking narcotics in order to get rid of problems, which really doesn't work.
*scratches head*
I'm just going to have to disagree with that. Yup.
I'm not even sure how to address that.
And yeah. If the real you is suffering from a mental illness and all your friends see are SYMPTOMS...they aren't seeing the real you. A person is NOT their illness.
Posts: 14745 | Registered: Dec 1999
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quote:I feel that everyone wants the "quick fix", so they come up with these personality disorders, then prescribe behavior changing drugs.
I understand that you feel this way, but I'm curious as to the thought process which lead you there. Why do you believe this? Specifially, what are your reasons for believing this to be more than just a possibility, but rather an established fact?
(Thanks. Honest questions, I promise -- I'm interested. )
posted
oh, and be very careful buying drugs from other countries. I've heard ten thousand instances of people who have done that and had various horrible things happen to them.
Posts: 3493 | Registered: Jul 2001
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quote: Well that's just wonderful, but if you're hopped up on behavior changing drugs, then how are they getting to know the real you?
This reflects a bias that is behind much mental-illness discrimination and also pharmaceutical non-compliance. As soon as some folks start feeling good they want to stop taking their meds. They think they aren't authentic if they have to take a pill. Strangely folks don't feel this way about nitro-glycerin or viagra.
Then there's exercise\ . Of course no one should try to replace meds with exercise on their own.
Posts: 383 | Registered: Nov 2003
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This type of thing really really saddens me. That's awful.
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) My trusty Imitrex awaits. By the way, the known side effects of this medication includes headache. Oddly enough, for me and millions of other people, this is not a problem. ![[Big Grin]](biggrin.gif)
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Is that legal??![[Sleep]](graemlins/sleep.gif)
Works like a dream....
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I remember that stuff. I took it last year; I spent most of the week curled up in bed wishing for death from the sheer physical discomfort of it.![[Grumble]](graemlins/grumble.gif)
