tag:blogger.com,1999:blog-7772182113499451603.post924190245739001985..comments2024-03-27T10:50:53.692-05:00Comments on Real Psychiatry: The Antidepressant Black Box Warning - A Better SolutionGeorge Dawson, MD, DFAPAhttp://www.blogger.com/profile/03474899831557543486noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-7772182113499451603.post-7759039126951512622014-10-30T10:21:42.862-05:002014-10-30T10:21:42.862-05:00The issue of side effects is extremely germane he...The issue of side effects is extremely germane here, and in even more ways than you mention in your excellent post. The question is not whether antidepressants may increase suicidal ideation, but if they do, WHY is that? Answering this question requires a detailed history not available from the use of treatment outcome measures/symptom checklists, but from other clinical details. It also requires close follow up when these meds are prescribed with an awareness of some common clinical issues - again issues that don't show up on a Hamilton rating scale. See http://davidmallenmd.blogspot.com/2010/07/do-antidepressants-cause-suicide_19.html for the issues I think are most important in this debate.David M. Allen M.D.https://www.blogger.com/profile/06280912088483192599noreply@blogger.comtag:blogger.com,1999:blog-7772182113499451603.post-2847153468370586912014-10-30T06:42:56.046-05:002014-10-30T06:42:56.046-05:00I think that is a common problem and your experien...I think that is a common problem and your experience points out that there is some focus on Black Box warnings. I have seen the blanket statement: "Do you have any questions about the medication?" used by both physicians and pharmacists alike. There has to be a commitment beyond that to discuss adverse effects and what to do if they occur. As an example, I also tell everyone that I do not expect them to tolerate or "get used to" medication side effects and tell them about my rationale for that approach. I also advise people who will be on a medication not to take it for granted if they develop what appears to be a physical illness and consider that it may be a problem with the medication that needs to be checked out sooner rather than later. A focus on Black Box warnings is too low of a standard.George Dawson, MD, DFAPAhttps://www.blogger.com/profile/03474899831557543486noreply@blogger.comtag:blogger.com,1999:blog-7772182113499451603.post-59808930739363879102014-10-30T04:18:32.932-05:002014-10-30T04:18:32.932-05:00This would be great if it happened. I've only ...This would be great if it happened. I've only been counseled once and that on a relatively rare, potentially fatal condition of Stevens–Johnson syndrome.<br /><br />I think that pharmacy counseling was supposed to cover most of your talking points but I can't say that is anything like what I used to see years ago.<br />RBnoreply@blogger.com