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  • BDD Moderators: Keif’ Richards

How much do psychiatrists really know about how drugs work?

sacsky

Bluelighter
Joined
Jan 20, 2015
Messages
131
I really wonder how much does the ordinary psychiatrist really know about how a certain drug works.
I mean do they really understand the theory behind it and what's going on at the receptors and all that or do they basically only know that
for depression you use this drug and for anxiety you use that drug and for bipolar you use another drug and so on?
I often feel like that nerds who are all about nootropics and stuff like that often have more specific knowledge about certain drugs
than doctors, is this possible?
For example should a psychiatrist be able to answer instantly wether you can mix DXM cough syrup with a SSRI? What if he doesn't know what DXM is?
I'd really like to put my psychiatrist to the test sometimes simply to find out how much he really knows but I can't just start asking all kinds of
questions without coming across suspicious.

There are doctors who come across like they know everything and I think it's always a good feeling when you find out that they don't know everything. It makes
them appear less "godlike". For example when I watch Dr House then it always depresses me cause it gives me the impression that he simply knows everything.
I wonder how can a person really have such a broad medical knowledge? I really wonder how realistic this is and how many real doctors exist which are like House.
 
They know "a lot", however, they do not specialize in drug-use that is aimed for rec. use... like this forum and ALMOST ALL users.

Say someone goes to a psych for anxiety, you, yourself will have more insight of what drug you should use because you are focusing on anti-anxiety meds... and your psych is focused on all types of disorders and medications... so your psych might say "Well, most of my patients with anxiety do well with buspirone" ... which, all the people that came to him with anxiety were full of shit, lol.
 
Haha, you hit the nail on the head xanax xr. Which I actually just got a script for, 1 MG extended release, how do the's differ from regular xanax?
 
They appear to be mild as they should last almost a day. It´s not as intense a short acting medication. But it does meet the same requirements.
 
Psychiatrists are retarded because the first thing they do is test you for depression and anxiety and then look to put you on pills. They over diagnose a fuckload of questionable diseases such as anxiety disorders, depressive disorders and adhd. Whereas all those emotions are simply natural and experienced by every single human on the planet and there's absolutely no need to put people on pills which creates more problems IMO such as they start using those fucking pills as crutches.

Psychs are fools IMO and do not deserve the amount of money for the kind of advice I hear from my fucking parents. I do not care how long they spent in school. Psychiatry should be terminated or they should ONLY deal with people in psych wards where they are TRULY useful.

The next time I encounter one I'd have them shitting bricks. If they truly understood how those drugs work they wouldn't be putting 75% of their patients on them.
 
I have a great psychiatrist. Very open minded, listens to me and takes me seriously, doesn't push anything I don't want to do. He's improved my life dramatically.

Some people need medication. Some people kill themselves or others without it. Over-prescription sucks but there's bad people in every profession. It's childish to look at a problem and want to burn down the entire field.
 
The chemists who invent drugs don't know how they work for real for real. Sometimes they have a good link, especially in health conditions. In terms of neurotransmitters, there isn't much known except dopamine serotonin etc etc. These are just words and they mean nothing regarding the brain. They cannot measure happiness by tracking the excitatory cohort in low anterior region of nucleus accumbens " psychobabble. As for psychiatrists, they have good training to know signs people are loose cannons their job is to manage people and prevent crisis type scenarios...
 
First off, doctors will never be Gods. They are as flawed as everyone else on earth. They have problems, addictions, marital problems and every other issue we all go through. With that said, specialists usually know their shit on their professional specialty but as far as GP's and any other doctor that may be in a position to prescribe pain meds (less some PM places, mine is good, for instance) got very little training in pain management in school and generally, dealing with chronic pain patients. Most jump to conclusions, look down their noses and say, no one needs pain meds like that. That's too much etc., but between docs being pinched by the DEA and their general lack of knowledge on the subject, they're probably the last people to be going to but what are you going to do?

As for head docs, I say, if they're prescribing meds for depression and the like, they better damn well know how it reacts to other meds I may be on! We all need them to have that knowledge for our well-being. Personally, I take it upon myself to know as much as I can about the meds I take. I go to the docs and ask very specific questions about certain meds. Many docs are not too comfortable with what I call "informed patients". I actually had a recent PM doc give me the raised eyebrows when I talked about what I knew about some of the meds I was on and what may be an alternative to what I'm currently taking (btw, not said in a "to sound like a smart ass" manner but as someone who really cares about what's in their body). It just proved the point to me that many docs want patients who come in, tell them their problems, take the script, and the whole time shaking their head up and down. I say, it's your job to know about what you take and you're doing no one any favors by being a dumb shit at the doctor's office.
 
Psychiatrists are retarded because the first thing they do is test you for depression and anxiety and then look to put you on pills. They over diagnose a fuckload of questionable diseases such as anxiety disorders, depressive disorders and adhd. Whereas all those emotions are simply natural and experienced by every single human on the planet and there's absolutely no need to put people on pills which creates more problems IMO such as they start using those fucking pills as crutches.

Psychs are fools IMO and do not deserve the amount of money for the kind of advice I hear from my fucking parents. I do not care how long they spent in school. Psychiatry should be terminated or they should ONLY deal with people in psych wards where they are TRULY useful.

The next time I encounter one I'd have them shitting bricks. If they truly understood how those drugs work they wouldn't be putting 75% of their patients on them.

Great post. I once watched a mini documentary about this awful culture of over diagnosing diseases and over prescribing drugs for a variety of mental health conditions in the USA. He basically went in there with the mindset that his symptoms would just reflect that of the average American holding down a high paid stressful job and was behind on his rent. Before he did the undercover filming, he was thoroughly examined by an independent Psychiatrist who confirmed that he had no 'disorder or disease' and was simply just stressed. Yoga, meditation, exercise, a change of diet and negotiating a better work life balance were the real solutions.

He under cover recorded about 5 Psych appointments and was diagnosed an array of conditions between ADD, ADHD, MDD, GAD, and Panic attacks. He was effectively told that the only way to get better was to start a course of varying drugs such as SSRIs/SNRIs/TCAs/Anti-Psychotics/Benzodiazepines/Z-drugs and Lithium.

I wish I could find the video as I'm sure you'd be as shocked as I was when I first saw it. I'll keep rummaging around YouTube for it, but it highlights the horrible nature of psych's making you fill in a questionnaire, deciding what disease or disorder you have and then pushing a whole host of pills your way and telling you that these will cure your disease/disorder.

It's truly sickening.

Not too long ago, the prescribing and administering of Thorazine to chemically lobotomise patients, as well as insulin therapy to comatose them was seen as cutting edge medicine with regards to Psychiatry. Now we've learned a bit more, we can obvious tell how disgustingly misguided such abhorrent treatments were. And I honestly mean this, but I don't think it'll be too long until we're looking back on the most common of drugs like SNRIs/SSRIs/TCAs/Antipsychotics etc... thinking exactly the same thing.



I have a great psychiatrist. Very open minded, listens to me and takes me seriously, doesn't push anything I don't want to do. He's improved my life dramatically.

Some people need medication. Some people kill themselves or others without it. Over-prescription sucks but there's bad people in every profession. It's childish to look at a problem and want to burn down the entire field.

Doldrugs, I totally agree with you.

I saw two psychiatrists on the National Health Service here in England, the first of which patronised me by saying that my depression was only caused 'by a simple chemical imbalance of serotonin in the brain, which Prozac would naturally restore and rebalance'. The thing is, he said it in such a way that I could tell he actually believe what he was saying. He was well into his 50's, early 60's so probably had a fair amount of clinical knowledge. I couldn't believe what I was hearing. It actually wound me up and thinking I had nothing to lose I actually called bullshit on the nonsense he was feeding me and he sat back in his chair and said 'Well yes, you're right, that's not the whole truth to the story. The real truth is, we know very little why they do work and more often than not, a placebo proves just as affective in clinical trials. Still, it's here if you want it'.

The second Psychiatrist on the NHS (6 months later?) told me that drugs they were all addictive and the best thing for me was to go and have a kick about (play some football/soccer) with some friends.

I'd lost faith in Psychiatrist until I paid to see a private consultant. He was fresh, honest, transparent, open to ideas and firmly believed in patient autonomy. He always said that I could tell him how I felt, but he could never feel how I felt. He'd describe what medications may be helpful, the benefits and drawbacks of all and then let me choose. If it didn't go well, we'd try a different plan. As part of my depression I suffered from huge lethargy and fatigue and SSRIs/SNRIs/TCAs just didn't help, they made me even more tired and made it even more hard to drag my sorry arse out of bed. In every single doctor/psychiatrist appointment I had attended with regards to my depression, I was shot down and scorned for even suggesting that I felt a low dose of a mild stimulant (Ritalin) may really help to perk me up, and provide me with a little more energy to try and break out of that depressive cycle.

The only Psychiatrist open to trialling it was the private consultant psychiatrist that I paid for. In England, the NHS is governed by a lot of red tape an bureaucracy with strict government prescribing guidelines - so to some degree I understand they have limited power. Though they should admit that this is the case and tell patients that they may receive better care if they went private as it would open up more options to them.

He was the only person to allow me to take Quetiapine for sleep, I was laughed out of the room by several doctors when I suggested it.

All I can say is just keep on trying, knocking on door after door. Eventually, you'll find the professional help you're entitled to.


As for head docs, I say, if they're prescribing meds for depression and the like, they better damn well know how it reacts to other meds I may be on! We all need them to have that knowledge for our well-being. Personally, I take it upon myself to know as much as I can about the meds I take. I go to the docs and ask very specific questions about certain meds. Many docs are not too comfortable with what I call "informed patients". I actually had a recent PM doc give me the raised eyebrows when I talked about what I knew about some of the meds I was on and what may be an alternative to what I'm currently taking (btw, not said in a "to sound like a smart ass" manner but as someone who really cares about what's in their body). It just proved the point to me that many docs want patients who come in, tell them their problems, take the script, and the whole time shaking their head up and down. I say, it's your job to know about what you take and you're doing no one any favors by being a dumb shit at the doctor's office.

That's excellent advice, and in the 21st century there is absolutely no reason to read up about different medications before you visit your doctor to gain a better understanding of your condition and the treatments available. I always do this and in honesty, it pisses off a lot of doctors because they think I'm being cocky or undermining their opinion. Truth is, I have 5 chronic conditions that I need to manage as well as possible and I have to take responsibility for that to some degree. Last year I was rushed to hospital with kidney stones and I was on Agomelatine and Tapentadol, none of the doctors in A&E had heard of them and didn't want to administer me any medications because they were fearful of interactions, despite me being in crippling pain. Fortunately, I know the mechanisms of both Agomelatine and Tapentadol to a basic degree and explained what drugs I knew should be avoided and what ones were fine. My knowledge wasn't faultless but it certainly hurried up that IV Oxycodone that I was screaming out for. If I hadn't have known, they'd have either had to gone away to seek advice from somebody who did know, or sit down for a while and thoroughly research them on the internet - Wikipedia no doubt.

Unfortunately, when I did this at one my latest pain management consultations I was red flagged on the computer as a drug seeker because I was 'suggesting and seeking specific drugs to attain via prescription' - Ridiculous. That red flag is still on my file and it causes me a lot of trouble, my 5 year long monthly prescription for a few Diazepam tablets to help control my GAD was cut off instantly. It's a shame really, I've lost faith in my doctor's service.
 
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SSRIs are not "as effective as placebo." That's an oversimplification of multiple conflicting studies. For more severe depression, they are absolutely better than placebo for most people. The trick is finding the one that works for you and has the least side effects. And it's important to keep in mind that for some people they just don't work at all, so a good doctor will try a variety of options besides that class of drug.
 
The human mind is a very difficult terrain to navigate so I don't blame psychiatrists for fumbling around, I also don't blame patients for being frustrated.
 
'How much do psychiatrists really know that much about how drugs work?'

About as much as we do.
 
Now I know psychiatry is one tricky field to work in - Freud dubbed it the 'fence-less field'- but I've been trying to gain access to a Psychiatrist on the NHS for five years.

stone walled at very turn. gps refused to go any further than chucking a box of citalopram at me, which only made my mania worse.

it took 4 intentional OD's and vertically slitting my wrists to get to get a five minute consultation with one before i was passed off to a psychiatric nurse with nothing more than 'lets try some busiprone on this one'. i didn't know whether to laugh or cry, so i did both, and they sedated me with temazepam.

this isn't One Flew Over the Cuck-Coo's Nest, this is England, 2015, in the home counties. i'm at my wits end. i just want a decent psych, who do i have to murder to get one?
 
Your psych is not the one you go to for advice. He's paid to not to know the medicines and know just the disorders. And believe me I'm a senior pysch major and i discuss this stuff with therapist who I had to research for evdebilitating k me ten yrs to find a good place. They are in two separate towns and i drive far and I that's justce a week. Thats how fucking awesome myt therapust. I've been trying to find a good one since I was 17 and moved out. I have some ocd but it only gets to me 8 I'm really stressed and i have ptsd they do cognitive therapy using your eyes and retraining your brain ( but you so knowledge on this fucking subject I'm sure you know what cognitive means. My anxiety is through the roof strange stresses repossession can come out of your body I didnt even know about. that's been really hard for me from my earliest memory at 4 I was tortured mentally and physically until I went away to college. Bit i do agree way to many ppl go for petty shit. It pisses me off I never got that fucking chance no one can comprehend what that's like unless u lived it. But they don't even know why i go or who i am or anything.
I never got a chance to "just deal with my problems" like I believe u too many ppl are medicated said and I've had that chance u don't have those skills at 4 or even know what's going on ur every waking moment is in fear. I don't let m
ppl get to me and Ive certainly never argued on a forum.t his i my first day on here or any for that matter. I'm sorry but your ignorant with a few other ppl in here you know nothing about mental health. i cant sit back at this time 8n my life and keep my mouth cloaed anymore i did that for way to long. Im a pysch major I just learned that 8n psychopsyiology word for word cuz it was an essay question.
im a senior right now. I know exactly how the brain cimmunicates with the entire body. All we are is little electrical firings. They just don'tknow why tthat makes you not depressed. They didn't know why we sleep either they've got an idea now. But ur taking about to fields very different. They guy doing pysch research had a whole diff glad school experience then the pyschiatrist. i cant stand ignorance and a lack of empathy. And it's always the dumb ones who got spout their beliefs. I just hope u 5 gin about me next time u feel like getting on the fucking Internet ir wow er you go maybe u go no where else maybe that's ir problem. I just want you to think about me next 5 i me ur talking some heavy shit you dont know anything about. Remember that if your ignorant belief don't try to have convo about it like you do knpw. Just do us all a favor and keep that garbage to yourself.
 
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