Lack of physician confidence in tapering plays a large role. Their patients don't trust their knowledge, either, & rightly so. This is a subject nobody wants to unpack.
@benzosarebad@wendyburn@_eleven13_@BubblesTapering@rcpsych Scholten, W., Batelaan, N., & Van Balkom, A. (2020). Barriers to discontinuing antidepressants in patients with depressive and anxiety disorders: A review of the literature .... Therapeutic Advances in Psychopharmacology, 10, 2045125320933404. doi.org/10.1177/204512…
@benzosarebad@wendyburn@_eleven13_@BubblesTapering@rcpsych Chevance, et al. (2020). Identifying outcomes for depression that matter to patients, informal caregivers, and health-care professionals: Qualitative content analysis of a large international online survey. The Lancet Psychiatry, 7(8), 692–702. doi.org/10.1016/S2215-…
@benzosarebad@wendyburn@_eleven13_@BubblesTapering@rcpsych Guy, et al. (2018). The Patient Voice: An analysis of personal accounts of prescribed drug dependence and withdrawal....All-Party Parliamentary Group for Prescribed Drug Dependence. prescribeddrug.org/wp- content/uploads/2018/10/Voice-of-the-Patient-Petition-Analysis-Report.pdf
@benzosarebad@wendyburn@_eleven13_@BubblesTapering@rcpsych Berzins, et al. (2018). A cross-sectional survey of mental health service users’, carers’ and professionals’ priorities for patient safety in the United Kingdom. International Journal of Public Participation in Health Care and Health Policy. doi.org/10.1111/hex.12…
@benzosarebad@wendyburn@_eleven13_@BubblesTapering@rcpsych Mc Gillicuddy, et al. (2017). The knowledge, attitudes & beliefs of patients and their healthcare professionals around oral dosage form modification: A systematic review of the qualitative literature. Research in Social and Administrative Pharmacy. doi.org/10.1016/j.saph…
Basically, nobody knows what they're doing, patients are demoralized and stuck on #antidepressants because they keep getting told they have a life-long condition no matter the reason for initial prescription.
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@DrFulli@lapsyrevoltee I do agree, Dr. Fulli. Response to the drug most certainly is not a diagnosis, & those physicians who conclude an adverse reaction to an #antidepressant is diagnostic of bipolar disorder not only have poor pharmacology knowledge but poor logical skills as well. /1
Conversely, any psychotropic might relieve "depression" in someone, eg. amphetamines or opiates. This is another law of psychotropics. /2
@DrFulli@lapsyrevoltee For what it's worth, I have a collection of case studies where people had immediate severe adverse reactions to #antidepressants & even though they quit within a handful of doses, suffered symptoms identical to post-acute withdrawal syndrome #PAWS for months or years. /3
"Professionalism in any field requires keeping pace with change, & nowhere is it more true than medicine....valid knowledge may come from the patient as well as from clinician resources: a sociological change driven by technological change." #psychiatry /1 journals.sagepub.com/doi/10.1177/00…
"Case after case is presented showing that patients today have generated undeniable value, violating the expectations and assumed best practices of the old model." doi.org/10.1177/009121… /2
"standards of professionalism & appropriate care must be updated, lest we fail to achieve best possible care....new standard must be to teach clinicians to recognize, welcome, & work with empowered #epatients in the new model of participatory medicine." doi.org/10.1177/009121…
"As the meaning of the term has expanded, some #ePatients have developed a high level of expertise & in turn have taken a leadership role within the ePatient movement. @StanfordMedX has coined the term ePatient scholar to describe these leaders...." /1
Nelson, R., (September 13, 2016) "Informatics: Empowering ePatients to Drive Health Care Reform - Part I" OJIN: The Online Journal of Issues in Nursing Vol. 21, No. 3.
"The leaders introduced below demonstrate what equipped, enabled, empowered, & engaged patients can and will do to gain a proactive role in managing their healthcare. They demand ‘Give me my own damn data’ & even point out that the data are often dirty." /3
UK woman tapering paroxetine: "After 18 years of stupor—of emotionless head fog, of sleeping 14 hours a day, of apathy—I’m succeeding in getting off the #antidepressant Seroxat." /1
After reducing to 7mg paroxetine: "I spent the first half of 2019 in continual, breathless, agitated terror.
....
I couldn’t sit still, and my constant squirming made my partner cry. I suspect I had something I’ve since found out is called #akathisia." linkedin.com/pulse/learning…
"Within days of that first panic attack in January [2109], I decided to stop tapering the Seroxat and stay on the same 7mg dose. I got in touch with my GP to tell her what had happened.
@psychunseen: "...if the goal of anti-psychiatry is to get #psychiatrists to listen...this is better done within a therapeutic relationship, not in a picket line at the American Psychiatric Association annual meeting or on social media" apparently refers to me personally. /1
"They considered their findings generalisable across healthcare....” bmj.com/content/370/bm… /1
"Perhaps most striking was the testimony from 100s of patients reporting lack of informed consent for...initial treatment, followed by years of dismissal by clinicians & regulators who did not want to associate life altering symptoms or injured children with their [products]" /2
"The review panel found that healthcare providers’ dismissive attitude toward patients was underpinned by a reluctance in all parts of the system to collect evidence on potential harms...." /3