I’ve written about this before — the expanded use of antipsychotic medication for indications other than psychosis. These run the gamut from acute mania, where a solid rationale exists, all the way to simple insomnia, for which there is no good rationale. Somewhere in between, but closer to the insomnia end of the scale, is […]
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A recent Rolling Stone article on the over-prescribing of Eli Lilly’s anti-psychotic Zyprexa (olanzapine) started me thinking in a general way about the psychology of choosing what to prescribe. I’ve written before about the effects of pharmaceutical marketing, how billions are spent to influence doctors’ prescribing habits at both rational and non-rational levels. The Zyprexa […] The following is my article originally published in Ethical Times (No. 16, Fall 2008), the bulletin of the Program in Medicine and Human Values at California Pacific Medical Center. Since this piece appeared, PhRMA has voluntarily suspended the distribution of branded items and certain food gifts to doctors (see my post). The ethical argument still […] Happy 2009! As promised, I’ll start adding photos to brighten up the page, and maybe illustrate a point at times. This one is a mid-winter tribute to spring. As you might surmise from past posts, I have long-standing concerns about commercial influence on the practice of medicine generally, and psychiatry in particular. I have two […] I often remind psychiatry residents that while a patient’s treatment preference is important, it does not take the place of their own evaluation. It is a bittersweet irony that many of us are mistaken about, or repelled by, what would most help us. Some patients, with depression for example, only consider medications, and have tried […] A psychiatric revolution began in the late 1950s with the marketing of Thorazine, the first neuroleptic (antipsychotic) medication. Thorazine and similar drugs quelled psychotic agitation and quieted auditory hallucinations (voices). This allowed large numbers of state-hospital patients to be “de-institutionalized,” i.e., released to the community. While the ultimate promise of this revolution was broken in […] In my last post, I wrote about the use of placebos in clinical practice — or more accurately, about giving medical treatments based on psychological comfort, not physiological effect. However, the area where placebos are most used and accepted is human research, not clinical practice. Psychiatric research in particular introduces some interesting conceptual issues regarding […] |
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