tag:blogger.com,1999:blog-7772182113499451603.post2722387151505401261..comments2024-03-27T10:50:53.692-05:00Comments on Real Psychiatry: Clozapine As A Fictional Murder Weapon On The Walking DeadGeorge Dawson, MD, DFAPAhttp://www.blogger.com/profile/03474899831557543486noreply@blogger.comBlogger12125tag:blogger.com,1999:blog-7772182113499451603.post-58035675529726130532016-03-27T18:50:31.030-05:002016-03-27T18:50:31.030-05:00Lol. Watching this episode in 2016. Immediately ...Lol. Watching this episode in 2016. Immediately googled 75 mg clonazepam - I was trained as a pharmacist, and have a PhD in pharmacology, and this seemed suspect. Apparently in present day there is no benzo being prescribed in 75 mg doses.Anonymoushttps://www.blogger.com/profile/10414060625682813973noreply@blogger.comtag:blogger.com,1999:blog-7772182113499451603.post-83083476416731687532016-03-27T18:47:25.685-05:002016-03-27T18:47:25.685-05:00Lol. Watching this episode in 2016 (I was trained...Lol. Watching this episode in 2016 (I was trained as a pharmacist, with a PhD in pharmacology), and I had the same questions. 75 mg of a benzo is generally beyond the pale, regardless of the indication.Anonymoushttps://www.blogger.com/profile/10414060625682813973noreply@blogger.comtag:blogger.com,1999:blog-7772182113499451603.post-5270781770975431642014-11-23T22:03:54.564-06:002014-11-23T22:03:54.564-06:00That was my concern as well.
Can you say more a...That was my concern as well. <br /><br />Can you say more about how clozapine is used in Homeland? I am not a subscriber and see the episodes 2 or 3 years later. <br /><br />A friend of mine who used to run a clozapine clinic reminded me of research that shows that despite the potential side effects can be used with fewer problems than other atypicals. Overall use is declining and that is probably not a good trend.George Dawson, MD, DFAPAhttps://www.blogger.com/profile/03474899831557543486noreply@blogger.comtag:blogger.com,1999:blog-7772182113499451603.post-42285430582494744212014-11-23T17:57:41.258-06:002014-11-23T17:57:41.258-06:00Thank you for your post. I was baffled by the sudd...Thank you for your post. I was baffled by the sudden death in Walking Dead and googled to find out if this could happen. Clozapine is used in a bizarre way in Homeland as well - it seems in American dramas it is shorthand for Scary Drug. I know someone who takes clozapine and if he watched these programmes he would definitely take it personally! Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7772182113499451603.post-22500231434083423302014-11-10T12:42:53.715-06:002014-11-10T12:42:53.715-06:00Agree with you mostly - especially about the lack ...Agree with you mostly - especially about the lack of expertise. I have seen maybe 1 or 2 films where somebody seemed to be practicing psychiatry.<br /><br />Disagree about Side Effects. It was more than just dramatic license. All of the psychiatrists were problematic in major ways. In the Verdict, I seem to recall that Paul Newman rose to the occasion, won the case and redeemed himself. There was really nothing redeeming about the Jude Law character and the Zeta-Jones character was sociopathic.<br /><br />My favorite is Still of the Night starring Roy Scheider and Jessica Tandy as a son-mother combination of psychiatrists. It would be good for me to see it again because that was when I was a PGY-1 and still naive about the profession so my opinion is probably based on how I imagined psychiatrists should behave.George Dawson, MD, DFAPAhttps://www.blogger.com/profile/03474899831557543486noreply@blogger.comtag:blogger.com,1999:blog-7772182113499451603.post-17025723503428298482014-11-10T11:32:29.249-06:002014-11-10T11:32:29.249-06:00I thought SLP was propsychiatry too. Maybe the In...I thought SLP was propsychiatry too. Maybe the Indian psychiatrist as war painted Eagles fanboy was over the top but it endeared him to the audience. At a more subtle level I think it revealed the current trend of treating Axis 2 problems as Axis 1 problems.<br /><br />Side effects was a problem for me mostly because I never believed Jude Law and Catherine Zeta Jones in their roles. I can't label it antipsychiatry because it gave the audience the false impression that psychiatrists are that good looking! I didn't see it is totally antipsychiatry because the twist debunked some of the more hysterical claims made about medications.<br /><br />I give screenwriters a lot of latitude to make characters unethical or deeply flawed if it advances the plot. Even if only 1/1000 psychiatrists are criminally unethical, that character would probably be more interesting in a dramatic context than an ethical psychiatrist. I think saying that SE is antipsychiatry is like saying The Verdict is antilawyer or A Few Good Men is antiMarine. If that was the only representation, you'd be absolutely right. They're not trying to make a general point about a profession, they are trying to create a dramatic situation.<br /><br />One very underrated movie is "The President's Analyst" with James Coburn. In it's absurdism, it hits a lot of high notes.<br /><br />This whole subject is interesting to me. The Sopranos is often cited as propsychiatry and for some good reasons. However, I always found Melfi to be amazingly incompetent and lacking self-awareness.James O'Brien, M.D.https://www.blogger.com/profile/14994350319492582321noreply@blogger.comtag:blogger.com,1999:blog-7772182113499451603.post-52370417936863004322014-11-10T06:36:53.653-06:002014-11-10T06:36:53.653-06:00Thanks for your viewpoint Dr. Puri. My view has be...Thanks for your viewpoint Dr. Puri. My view has been evolving based on past posts on this blog. For example, I didn't have a problem with Silver Lining Playbook after someone suggested it was a "pro-psychiatry" movie despite an unrealistic depiction of psychiatry (there have not been many realistic depictions):<br /><br />http://real-psychiatry.blogspot.com/2013/02/silver-lining-playbook-propsychiatry.html<br /><br />On the other hand I could not apply that loose standard to the heavy handed portrayal of psychiatrists as commonly unethical and unconcerned about patients in Side Effects: <br /><br />http://real-psychiatry.blogspot.com/2013/02/the-ultimate-antipsychiatry-movie.html<br /><br />As far as portrayals of psychiatrists go I guess I have my limits and I certainly don't agree with what at least some people see as a "good" psychiatrist in the movies.<br /><br />Agree with the purpose behind the medicine here - and you are correct I am concerned about public perception especially where the person might benefit from the medication and where the idea for the medication comes from in the first place. Maybe the writers went down the list.<br />George Dawson, MD, DFAPAhttps://www.blogger.com/profile/03474899831557543486noreply@blogger.comtag:blogger.com,1999:blog-7772182113499451603.post-74731241398994717312014-11-09T23:39:32.876-06:002014-11-09T23:39:32.876-06:00I guess I just assumed if you can lie about the me...I guess I just assumed if you can lie about the medication order, you can also lie about the dose, but I don't recall any statement made about the clonazepam dose.George Dawson, MD, DFAPAhttps://www.blogger.com/profile/03474899831557543486noreply@blogger.comtag:blogger.com,1999:blog-7772182113499451603.post-43062899118376948952014-11-09T23:37:20.501-06:002014-11-09T23:37:20.501-06:00This comment has been removed by the author.George Dawson, MD, DFAPAhttps://www.blogger.com/profile/03474899831557543486noreply@blogger.comtag:blogger.com,1999:blog-7772182113499451603.post-12843388736001754252014-11-09T21:51:48.609-06:002014-11-09T21:51:48.609-06:00I agree Dr. Dawson, that it doesn't fully make...I agree Dr. Dawson, that it doesn't fully make sense. As a writer and a psychiatrist, I do recognize the need of times to sacrifice accuracy for the purpose of story or drama. I wouldn't go so far as to say that this is inaccurate, however. There are few medications that have an more sounding names which would be used to keep a patient sedated. It seems to me, without knowing the writers, that there are several story points that medication was intended to serve.<br />1. Beth was intended to be framed for making a medical error and causing the death of the patient<br />2. the error was intended to be through the use of the medication, mainly through two medications that sound similar<br />3. one medication would be expected to be therapeutic, the other harmful.<br />Therefore there are few options, and clozapine/clonazepam does work.<br /><br />In this respect, the story purposes were fulfilled. Your point is well taken, though, that any commentary in the media on mental health issues, Including the use of psychotropics, inherently has an effect on the public perception. Use of these concepts then should be used conscientiously.<br /><br />It might have been better, to simply use a single medication where the error was dose related. Such as 5 mg of Klonopin, instead of 0.5 mg.Paul R. Puri, MDhttp://paulrpurimd.comnoreply@blogger.comtag:blogger.com,1999:blog-7772182113499451603.post-55384493635335882102014-11-09T20:34:12.751-06:002014-11-09T20:34:12.751-06:00Apparently not.
@ URL Warning Strong Language an...Apparently not. <br /><br />@ URL Warning Strong Language and kind of a dated article.<br /><br />http://thechive.com/2013/04/03/a-few-things-that-make-no-sense-about-the-walking-dead-33-photos/RBnoreply@blogger.comtag:blogger.com,1999:blog-7772182113499451603.post-62653721144454040042014-11-09T16:23:16.058-06:002014-11-09T16:23:16.058-06:00Giving 75 mg of clonazepam doesn't make sense ...Giving 75 mg of clonazepam doesn't make sense either. Not to mention injecting ground up tablets. I assume everything else about the zombie apocalypse is accurate, though.Steven Reidbord MDhttp://blog.stevenreidbordmd.comnoreply@blogger.com