Medics on Antidepressants

[BVESBC]

Virginia NPP

Thank you, I stand corrected!

[Virginia NPP]

Hi,

Glad you found it helpful.

For all,

I try to answer Psych questions, I can't keep up on posts on the site so feel free to PM me if there is a question you think I may be able to help with.

Virginia

[firedoc5]

This is a long thread and I have a long, somewhat long drawn out answer. But I'm going to be short with it.

Be evaluated, twice. I agree with a previous post that profilactically is absurd. If subscribed, start at very low dose. And if anything, at least for me Prozac was a nightmare.

On a short note. I can look back now and see how during many periods of my career I might have handled something differently, maybe even been easier on me, maybe not. But what you feel, what you experience, and how you handle it makes up part of you and what kind of medic you can be.

[terr0154]

"many should be on some form of antidepressant to mellow them out and prevent burnout. "

Its just a job! It's not your livelihood or your life. Get a hobby!!! If your job is making you this emotional, it's probably time to check out a different field.

[tniuqs]

I am a true believer in aerial spraying of prozac, just think, if all medivac aircraft sprayed before they landed it would be preventative EMS medicine !

:twisted:

j/k

[tniuqs]

Antidepressants of various kinds are proven to help the clinical manifestations of depression. Despite what the Law Offices of Dewey Cheatem and Howe would have you believe, the risk of suicide with antidepressants is overstated. The media hype over them and subsequent black box warning and giant jury awards have resulted in fewer candidates taking SSRIs, and a resulting increase in suicides among at-risk groups.

Antidepressants in appropriate doses are very well tolerated and have side effects that are rarely anything but annoying. That includes SSRIs, TCPs, other cyclics, and MAOIs. Professionals of all types take them for treating diseases that move far past just depression and anxiety. Chronic pain, muscle spasm, smoking, and irritable bowel syndrome to name a few.

I don't think that they should be taken to "prevent burnout". They are medications to treat a disease, and nobody should be taking them if they don't manifest the symptoms of the disease.

'zilla

Don't mean to be too adversarial here zilla and in your post and I make note: You are not commenting on bicyclic type drugs as Effexor/Venlafaxine, which in my personal opinion is a lemon, many documented cases of extreme difficulties in discontunuation of this drug.

Wendy T try google please, you may need a support group.

I have asked many exactly the mechanism of action other than just reuptake and some very informed individuals can not explain how exactly this or other rx works, point being do we actually know enough enough about the human brain as far as the very complex chemical/ pharmo reactions that take place?

I do not believe that we do quite yet.

Absolutely there are treatable organic causes but it is a sad commentary on our North American Culture when "meds for your head" are prescribed in such huge numbers. Just take this pill and troubles will be tolerated, sadly more often true than not, I believe that there is a lack of funding for mental health councilors and this could partially be to blame in some cases.

Perhaps even a reflection on our fast paced, chase the buck society, could be a direct result of media and marketing and that hollywood movie ideal, dictating what success in life is really is supposed to be. This instant society, with instant food, instant communications, instant gratification, instant fixes, and instant whatevers.

It always floors me when an "ex" father in law goes to hospital for his "ticker" and looking for the instant fix of a pill, despite a heavy smoker, hard boozer, overweight, saturated fat eating and depressed fellow and somehow the MD is supposed to instantly solve his problems... ?

cheers

ps I could not agree more with asytole in 2 leads !

[firedoc5]

I am a true believer in aerial spraying of prozac, just think, if all medivac aircraft sprayed before they landed it would be preventative EMS medicine !

:twisted:

j/k

zoloft or Cymbalta's better man

Like I said before for me Prozac was a nightmare... :tongue9:

[Asysin2leads]

I would like to think that psychopharmacology would be a last resort and major sign that you need to make some changes in your life. I believe that as a society we are to quick to look for that magic pill before looking for the true problem. I have said it before we as a group are not at the top of the list of healthy people. For most of the providers that I know sleep deprivation, large quanities of caffeine and poor diet in general, are the rountine. I think that our lifestyle choices have a huge impact on us and our families, both physically and psychologically. There is no doubt that these medications, "Antidepressants" (Tricyclic compounds, Monoamine oxidase inhibitors, Lithium carbonate, SSRI's) can have benefits but correct me if I'm wrong in saying they dont treat the cause of the problem.

BVESC, I agree and disagree with you. On one hand I am quick to agree that American society wants everything in pill, injection, and spray form, from medication to food to deodorant.

On the other hand, I also think we make too much out of "talking out our problems." I call this the Dr. Phil effect. We like to think that people with problems "just need someone to reach out to" when many, if not most times, its not the case. Sure, some people, and hopefully they are professional counselors, can offer insight into someone's suffering and give them some tips on getting better, but really, this has no more actual effect on someone then a physical therapist's advice on how to exercise in the morning.

Most people can't change their lives, and if they could, they would, without help.

People are the way they are for a reason. People do the things they do to cope, and the reason they are coping is because usually, they can't get out of the situation they are in, either for financial, cultural, or emotional reasons.

The way I liken mental problems is to that of diabetes. Some people have type II diabetes, and it can be controlled with diet and exercise, just like people some people could probably get rid of their mental problems if they made lifestyle changes. But guess what? A lot of people go on pills for type II diabetes because they either can't or they won't make the lifestyle changes necessary. The same goes for mental illness. Many people simply cannot, or will not make the changes necessary to get better. That's where medication comes in.

To further this analogy, just like some people have Type I diabetes, and their body actually physically does not make enough of a vital chemical, the ONLY treatment is to use a medication to regulate it. This is true for major mental illness as well, such as clinical depression. If someone comes into the ER out of it because their body is not making enough insulin, then the appropriate medication needs to be given for them to survive and function. The same goes with major mental illness, you can't get rid of it by talking anymore than you can get someone's pancreas to start secreting insulin by trying to talk them into it. Mental illness is just that, an illness, and the sooner we start looking at it that way the better and happier we will all be.

[emtannie]

I have been watching this thread for a few days... and thinking about the varied responses.

I think all agree that prescribing meds as the OP was referring to is inappropriate.

Prescribing to "prevent burnout" is absurd.

I find some of the other posts thought-provoking. I don't agree with some, and one caused me to consider the ripple effect...

If someone is currently taking a potentially altering medication, then they should not be performing front line work in EMS. Put them in dispatch, put them in education, or put them behind a desk...........

This comment bothers me... put them in dispatch?????? And you worry about EMS people taking a potentially altering medication, and yet you are willing to have those same people be in dispatch? I disagree.. If your argument is that you don't want them in EMS because the medication may cloud their judgment, you blew the argument with this comment. Dispatch is also about judgment calls.

But when you attempt to play with brain chemistry, then you have too high of a potential to not make sound judgement calls.

So where do we draw the line? Anything that alters brain chemistry makes someone unfit for EMS? Just consider... a partner who was at a wedding or a bachelor party yesterday and shows up today hung over/dehydrated/ill.... probably has altered his/her brain chemistry.. do we send them home? A female on birth control pills... or at "that time of the month".. all PMS jokes aside... quite possibly has a different emotional level than before... do we refuse to employ females? The guy who has decided to quit smoking... and is more than a bit edgy because of it... is that altered brain chemistry? Do we refuse to let them treat a patient?

The ripple effect, although you could say that is absurd, is possible... and possibly heading back into the dark ages.

A truly personal opinion... I would far prefer the partner who has recognized that they have depression, have sought out professional help, and are working towards solutions, including medications, and are aware of their own limitations, over the partner who parties constantly, shows up hung over, and is generally far less responsible for his or her own health and the health of the rest of the crew and patient by showing up to work at less than 100%.

Just my two cents...

[celticcare]

For those who know me, know I am on SSRI anti depressants, and it seems there isnt such a stigma about them here in kiwiland as there is over in the USA. People take them if they need them and the docs here that I have had dealings with, will try the counselling and psycotherapy line before anti d's are given.

I have no shame saying I am on them, I have PTSD *non EMS related* and the medication have helped, I will prob come off them in a couple years, but at this stage in my life, they help and anyone that is prejudiced for needing them or seeking help rather than drugs or alcohol is unfairly prejudiced then.

Scotty