of a lot about. This is my reply to my mate who's currently working in
America. He's a little older than me, was a GP by 30, has worked for the
UN or the World Health Organisation in Iraq, did a business degree (in a
year) in Russia during his medical degree and has just completed a
Masters in Public Health at Harvard where he was also the President of
their photo club. I've know him since I lived in Sri Lanka. And yes, in
comparison I'm a total loser. Here's my reply to his reply on Facebook.
/The 1,800 figure if from the Royal College of Psychiatry. The RCPsych
did the report after the research that came out showing antipsychotics
in dementia patients reduced life expectancy by 50%. Here's the NHS
coverage of the research. Link to the paper at the bottom.
http://www.nhs.uk/news/2009/01January/Pages/Dementiadrugdanger.aspx
The paper prompted the government to get the RCPsych to write the
report, the report was then used to prompt a significant change in the
UK's dementia strategy which is currently being put into place. One of
the measure's they're using is how few antipyschotics GPs prescribe to
the elderly - that's right, in primary care (think I read that in Pulse
or GP magazine recently). Don't worry. I'm not quoting the Zyprexa kills
1 in 125 because even though that figure was in the research looked into
by Robert Whitaker the figure and the evidence wasn't published in a
peer-reviewed journal so is about as useful as a chocolate teapot when
it comes to lobbying for change.
I'm not totally Szaszian (critical psychiatrist who wrote The Myth of
Mental Illness). There's a biological problem with dementia. That wasn't
treated by antipsychotics. Antipsychotics were used for their
behavioural modification 'quality' because doctors and society couldn't
be arsed to put up with crazy old people. You've justified it well but
it's just convenience. Yes, people are too busy with their own lives to
look after the elderly. Society is that dysfunctional. There's lots of
ways to could justify the cost saving. Certainly killing them off
quicker saves a lot of money. According to the research above the
savings from using antipsychotics are at least 50%. (sorry. It's a cheap
shot there, but cheap stuff's better! ;~) )
I'm against the prophylatic use of antispychotic medication. I don't
have a health economics rationale. Alternative paradimgs of psychiatric
care cost more. Doctors are totally biomedical in this area and sadly
this doesn't give the best outcomes. Here's another bit of research you
might not have heard about. The World Health Organisation did a massive
study in the 70s. Think it's the International Pilot Study of
Schizophrenia but there may be others. It showed something surprising.
People with sz do better in the developing world. Why? Honestly I have
no idea. People have guessed though. The local cultures are more
accepting o the experience. A person is "with the spirits" rather than
has a brain illness, and this interpretation leads to better results.
The are countries with no formal mental healthcare system and no money
to buy antipsychptics.
This acceptability of the local culture element is little observed by
doctors but it's pretty significant, especially when it comes to
diagnosis. In the UK black men are diagnosed with sz 9x more than their
white counterparts (AESOP study cited in the New Horizons consultation
document), 7x in the US (can't remember how I know that) and equally in
the Caribbean (New Horizons consultation). Make whatever conclusions you
want from that evidence.
A psychosocial approach is rarely taught to doctors but it's totally
vital if they're to understand what they're doing, Basically I don't
care who commissions social control but they'd better know it's social
control. GPs were prescribing antipsychotics for demenita for the
purpose of social control. Then I can get on with stopping them using
the medical profession as a tool of social regulation.
/
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