Thread by @Altostrata

@sash_andy @samwoolfe @lisa63artist @jonathanstea @bmj_latest @hrw @C4Dispatches @gmcuk Sam, please note 3 Blind Psychs whining that there are real, serious flaws that need attention in #psychiatry but they are prevented from addressing them because dings from "anti-psychiatry" patients (on Twitter, no less) hurt their feelings. What does this say about the doctors?

@sash_andy @samwoolfe @lisa63artist @jonathanstea @bmj_latest @hrw @C4Dispatches @gmcuk The epithet "anti-psychiatry" directed at patients is nothing but ad hominem from clinicians who have no intention of bringing patients into the discussions of improving clinical care. (This is #psychiatry we're talking about, the science of human emotion.)

@sash_andy @samwoolfe @lisa63artist @jonathanstea @bmj_latest @hrw @C4Dispatches @gmcuk The argument that people are dissuaded from necessary #psychiatric treatment by purported "anti-psychiatry" is intellectually dishonest on so many levels.

1) #Psychiatric prescribers report being swamped by demand for their services; they plead for additional prescribers. /1

@sash_andy @samwoolfe @lisa63artist @jonathanstea @bmj_latest @hrw @C4Dispatches @gmcuk They cannot have it both ways, claiming business is down because of "anti-psychiatry" AND they are overburdened with demand from patients. /2

@sash_andy @samwoolfe @lisa63artist @jonathanstea @bmj_latest @hrw @C4Dispatches @gmcuk 2) If a big chunk of the adult population is already taking #antidepressants -- maybe 15%-20% -- plus more taking other #psychiatric drug, how can they claim not enough people are seeking treatment? What is their target, 50%? 90%? Does that make sense? /3

@sash_andy @samwoolfe @lisa63artist @jonathanstea @bmj_latest @hrw @C4Dispatches @gmcuk 3) Not even the well-known adverse effect of sexual dysfunction (affecting >50%) has dissuaded millions of people from asking for #antidepressants, which prescribers readily provide without adequate informed consent. /4

@sash_andy @samwoolfe @lisa63artist @jonathanstea @bmj_latest @hrw @C4Dispatches @gmcuk Apparently either people are willing to sacrifice their sex lives for a miracle pill's promise, or clinicians make the decision for them that their sex lives are superfluous.

(Some people are outraged when they experience this adverse effect absent informed consent.) /5

@sash_andy @samwoolfe @lisa63artist @jonathanstea @bmj_latest @hrw @C4Dispatches @gmcuk 4) Exposure by the public of adverse effects of #antidepressants & other psych drugs was inevitable due to their vast overprescription. If you prescribe to 10 million people, an adverse effect rate of only 1% is going to produce a lot of injured people. /6

@sash_andy @samwoolfe @lisa63artist @jonathanstea @bmj_latest @hrw @C4Dispatches @gmcuk In reality, over the last 25 years of new-era #psychiatric drugs, they have been prescribed to hundreds of millions of people.

Do the math: Many, many injured people, some in high places. /7

@sash_andy @samwoolfe @lisa63artist @jonathanstea @bmj_latest @hrw @C4Dispatches @gmcuk 5) With the rise of social media, those many injured patients have the opportunity to expose their testimonies of injury, for which they cannot find any treatment.

These are adverse effects that #psychiatry has been shrugging off for 25 years.... /8

@sash_andy @samwoolfe @lisa63artist @jonathanstea @bmj_latest @hrw @C4Dispatches @gmcuk There are decades of literature about psychotropic withdrawal syndromes, for example, but to this day, many #psychiatrists claim it's negligible in importance. /9

@sash_andy @samwoolfe @lisa63artist @jonathanstea @bmj_latest @hrw @C4Dispatches @gmcuk You might say the overprescribing has reached a tipping point, injured patients are not buying that their iatrogenic conditions are "relapse" of a #psychiatric disorder, and psychotropic chickens are coming home to roost in #psychiatry's back yard. /10

@sash_andy @samwoolfe @lisa63artist @jonathanstea @bmj_latest @hrw @C4Dispatches @gmcuk 6) If people are being dissuaded from seeking #psychiatric drug treatment because injured patients expose the adverse effects -- well, those adverse effects should have been covered in informed consent anyway. Which clinicians have not been doing. /11

@sash_andy @samwoolfe @lisa63artist @jonathanstea @bmj_latest @hrw @C4Dispatches @gmcuk Fact is, testimony of injured patients on social media shows adverse effects are real, not just tiny print in gray ink on a pill packet insert. Adverse effects are real, & they may happen to you. If prescribers find this complicates their sales pitch, maybe vary the pitch? /12

@sash_andy @samwoolfe @lisa63artist @jonathanstea @bmj_latest @hrw @C4Dispatches @gmcuk What we really, really want them to do is pay attention to adverse effects from #psychiatric drugs & incorporate minimization of risk into clinical practices.

You would think this would be written into their job descriptions, right? Yet they are offended by these pleas. /13

@sash_andy @samwoolfe @lisa63artist @jonathanstea @bmj_latest @hrw @C4Dispatches @gmcuk But nooooo, we have pipsqueak dinosaurs like Joe Pierre, Tyler Black, & Jonathan Stea flapping their hands & complaining that patients are rude to them on Twitter!

The responsible medical response would be "omg, we have to fix this so more people aren't harmed". /14

@sash_andy @samwoolfe @lisa63artist @jonathanstea @bmj_latest @hrw @C4Dispatches @gmcuk Not these ex cathedra pronouncements that patients with complaints about #psychiatric treatment must be suffering from a #psychiatric disorder NOS. How very banal of a physician, to claim a patient with complaints must be crazy. Hallmark of a mediocre doctor. /15

@sash_andy @samwoolfe @lisa63artist @jonathanstea @bmj_latest @hrw @C4Dispatches @gmcuk But that's the state of #psychiatry for you. Mass marketing of #psychiatric drugs has degraded the specialty. Iterating: It's up to #psychiatry to decide its own future. If it wants to ignore patient injury, it makes itself look bad, it's not anti-psychiatry doing it. /16