tag:blogger.com,1999:blog-33960805.post4548146728050043764..comments2023-10-30T02:03:47.513-07:00Comments on Clinical Psychology and Psychiatry: A Closer Look: Atypical Antipsychotics for the Elderly: A Booming BusinessCL Psychhttp://www.blogger.com/profile/13990549972520745769noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-33960805.post-53615376507424083702007-12-01T04:02:00.000-08:002007-12-01T04:02:00.000-08:00My name is Kathy, and I am the primary caregiver f...My name is Kathy, and I am the primary caregiver for my 79 year old Dad who has Alzheimer's disease and lives with me in North Carolina.<BR/><BR/>I am writing a daily blog on my Alzheimer's caregiver website that shows the lighter side of caring for someone with dementia.<BR/><BR/>Please pass this link along to anyone you feel would enjoy it.<BR/><BR/>www.KnowItAlz.com<BR/><BR/>Thanks,<BR/><BR/>KathyKathy NChttps://www.blogger.com/profile/09658200834717816823noreply@blogger.comtag:blogger.com,1999:blog-33960805.post-10241431413058091122007-11-29T07:45:00.000-08:002007-11-29T07:45:00.000-08:00Steve,Superb comment. I may have to post your com...Steve,<BR/><BR/>Superb comment. I may have to post your comment as its own post. <BR/><BR/>Mark,<BR/><BR/>In short-term studies on schizophrenia and bipolar, the evidence favoring reduction of symptoms with antipsychotics seems reasonably strong to me. The longer term evidence, however, casts doubts, especially for bipolar. And, of course, there really are few long-term studies despite their frequent long-term use. Long-term treatment with antipsychotics for bipolar (among many other conditions) is all a gigantic experiment, really. And the long-term data on schizophrenia treatment is certainly not a completely positive story.<BR/><BR/>The safety data is also often overlooked, which has led to an untold number of heinous events.CL Psychhttps://www.blogger.com/profile/13990549972520745769noreply@blogger.comtag:blogger.com,1999:blog-33960805.post-65445337859493555962007-11-19T17:21:00.000-08:002007-11-19T17:21:00.000-08:00Great post. I've seen reports of "cultural change"...Great post. I've seen reports of "cultural change" similar to that at Cobble Hill, and with comparable results: less agitation, increased cooperation between staff and patients, less cost (over the long run). It would be interesting to study the mortality/QOL benefits, too.<BR/><BR/>But even if these facilities <I>still</I> choose to use "chemical restraint" (god, I hate that phrase), they can do better than the extremely expensive atypicals. Older antipsychotics work just as well, although would have to be used judiciously with their greater potential for EPS.<BR/><BR/>Regarding your comment that "<I>...it takes time, effort, and using one's training in mental health</I>," that just speaks to how the mental health profession (particularly psychiatry), despite its stated interest in improving the lives of patients, is too focused on the immediate effect on a patient's behavior than in long-term outcomes. As a psychiatrist, I am sometimes appalled at how my colleagues focus on the short-term benefit afforded by an unproven medication and ignore any consideration of the long-term side effects or, more importantly, <I>other</I> ways that the patient may learn to <I>change</I> his/her behavior for the better.<BR/><BR/>We have indeed been hijacked by drugs. I wouldn't <I>entirely</I> blame the drug companies, though, because psychiatrists have every right <I>not</I> to use meds in this way. It's just that our profession's knee-jerk reaction to a psychiatric symptom is to medicate, and not to help a person through his/her struggle in a more compassionate and productive way.SteveBMDhttps://www.blogger.com/profile/11937264509253612864noreply@blogger.comtag:blogger.com,1999:blog-33960805.post-1731314133721160212007-11-19T09:08:00.000-08:002007-11-19T09:08:00.000-08:00"There is indeed some evidence for the efficacy of..."There is indeed some evidence for the efficacy of these medications in the short-term treatment of schizophrenia and bipolar disorder"<BR/>Are the patients voluntarty or involuntary in the studies? Does this get accounted for? No.<BR/>Does "efficacy" mean kissing the ass of doctor who is determining success of the treatment ? If so , maybe the medication does not treat schizophrenia or bipolar, but instead motivates/allows the patients to be better ass kissers,<BR/>as there is no lab test to measure mental illness.Mark p.s.2https://www.blogger.com/profile/10529811159862096782noreply@blogger.com