Re:I'm a shrink and I can tell you why this is... (Score 2)

Some words on this:

I think that it's important to acknowledge that ALL antipsychotics are basically just fancy sedatives. Don't let you anyone tell you otherwise (i.e., that the newer antipsychotics "pinpoint symptoms" like auditory or visual hallucinations, etc). They serve one purpose, and one purpose only and that is to dull the brain down (which in turn may or may not have an efficacious effect on symptoms of psychosis and subsequent behavior). We have not really come all that far since Thorazine except to have improved (some) of the side effects (if an MD wants to argue this, I'll be happy to substantiate my point on every level, including molecular). Sometimes the meds help people, sometimes not.

So while I appreciate what Pickens reports, I also think it's important to understand that these drugs are used to serve many purposes; however, I think that the reason why they are being prescribed in such vast quantities is more emblematic of the times than anything else. Nobody really wants to work with out-of-control behavior when one can simply dispense a pill. I recently worked with a patient who served some time at Riker's last year for trafficking, and he told me that "EVERYONE is given Seroquel (an antipsychotic known for its sedating effects, particularly in a non-psychotic population) at night to keep them calm". This man was a credible source of information, and I was pretty shocked at his report. There used to be a real stigma attached to these drugs (obviously I'm not saying that's a good thing), but now they're becoming household names in certain populations.

The whole notion of giving antispychotics to kids scares the hell out of me on a lot of levels, especially when it comes to brain plasticity at a young age. It can really fuck them up, and they often learn nothing about their own behavior (unless by some stroke of luck they have a talented and caring counselor or therapist). I've assessed 12 to 15 year-old girls who do quite well in school and have friends, but who come from very hard family or otherwise challenging backgrounds whom are prescribed alarmingly high doses of antipsychotics (as well as antidepressants), when in fact they have NO psychotic symptoms whatsoever but merely conduct and behavioral issues.

In addition to this, their families are sometimes eager to have them hospitalized so that they can get a little "vacation" away from the kid. Once the child is on a psychiatric inpatient unit, they are going to damn well get pretty serious meds 99% of the time, because that's how it's done. So now you have a child who is an identified patient and whom is usually misdiagnosed, so that insurance will pay for the treatment and meds (this is the same reason why the elderly earn these diagnoses; nursing homes need to get paid for the meds that they use to keep them calm). The diagnoses "Schizophrenia" and particularly "Bipolar Disorder" are tossed around like they were the common cold, and when I ask these patients (young and older alike) if they know what it means to have these disorders, at least 75 % of them have absolutely no idea. I once had a young woman break down in tears in the Psychiatric ER, because I said to her, "you're not Bipolar and the sooner you can think of yourself as being an extremely emotional person and not a sick one, the better you might start to feel." She's in individual therapy and has been doing pretty well for over 3 years. She used to thank me every time I'd run into her in the hospital.

I also worry about and hate the fact that these extremely powerful meds are being dispensed by (often well-meaning) health professionals who have very little psych training, and applaud clinicians that have the wherewithal and resources (sadly a lucky few) to continue to experiment with alternatives to psych meds, or at least administer them as a last resort rather than a first line of defense.

At any rate, just wanted to weigh in.