#pharmaceutical drug (medical treatment)

[senselessalchemist]

CW: blood and medical stuff

It is just over 7 years now since my diagnosis with an autoimmune* disease (~10 years since symptoms started) and I don't really have anything profound or useful to say, but A) don't let people tell you it's just stress without any further testing if you have unexplained internal bleeding and B) if you literally can't stay awake because you've been bleeding for a few months straight, don't listen to the PCP who tells you not to go to the hospital because your hands are too pink and rosy for you to actually be anemic and there's not much the hospital will be able to do for you anyway

Two-ish days after that appointment I was in the hospital and almost immediately getting a transfusion because I was so anemic. (I would end up getting a 2nd as well because continued bleeding + already low on blood = first one not enough.) Stayed there for almost a month until they got the bleeding under control.

This could have happened to anyone but it's hard not to think that being afab probably had something to do with the downplaying and dismissal of symptoms for 3ish years before being diagnosed. They did the classic "it's probably just stress" because I was a senior in college (and possibly because afab). I don't want to make this a never trust medical professionals kind of thing, because there are many good ones and some of them probably saved my life and/or prevented me from having major surgery (which turned out not to be necessary at the time b/c the med they tried started to work)... but also when things are obviously wrong and especially if they recur (like unexplained bleeding cropping up again and again over years) maybe don't take "it's just stress" as an explanation. Also fuck the doctor who thought he could diagnose anemia or lack thereof by hand color and who advised against further treatment ("just wait until your specialist appointment in a month!")

*there does seem to be some debate about whether my particular condition should be classified as autoimmune or not, but enough people do at this moment I'm just gonna go with it because it's treated like many autoimmune diseases are, with various immunosuppressants or immune system modulating medications

[thiefnessman]

i’m not gonna get too worked up about it but like. idk today some of us were talking with our instructors about our future internships and careers and how a lot of the areas we’re passionate about are things we’re unlikely to get stable positions in because scientific progress only gets rewarded if it can be profitable or in someone’s business interests. the fucking song and dance of bowing down to the interests of investors and the almighty nebulous idea of Profit is fucking screwing everything over

[familythings]

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[fidicusautism]

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[thoughtportal]

Opinion Here’s how to get free Paxlovid as many times as you need it

When the public health emergency around covid-19 ended, vaccines and treatments became commercial products, meaning companies could charge for them as they do other pharmaceuticals. Paxlovid, the highly effective antiviral pill that can prevent covid from becoming severe, now has a list price of nearly $1,400 for a five-day treatment course.

Thanks to an innovative agreement between the Biden administration and the drug’s manufacturer, Pfizer, Americans can still access the medication free or at very low cost through a program called Paxcess. The problem is that too few people — including pharmacists — are aware of it.

I learned of Paxcess only after readers wrote that pharmacies were charging them hundreds of dollars — or even the full list price — to fill their Paxlovid prescription. This shouldn’t be happening. A representative from Pfizer, which runs the program, explained to me that patients on Medicare and Medicaid or who are uninsured should get free Paxlovid. They need to sign up by going to paxlovid.iassist.com or by calling 877-219-7225. “We wanted to make enrollment as easy and as quick as possible,” the representative said.

Indeed, the process is straightforward. I clicked through the web form myself, and there are only three sets of information required. Patients first enter their name, date of birth and address. They then input their prescriber’s name and address and select their insurance type.

All this should take less than five minutes and can be done at home or at the pharmacy. A physician or pharmacist can fill it out on behalf of the patient, too. Importantly, this form does not ask for medical history, proof of a positive coronavirus test, income verification, citizenship status or other potentially sensitive and time-consuming information.

But there is one key requirement people need to be aware of: Patients must have a prescription for Paxlovid to start the enrollment process. It is not possible to pre-enroll. (Though, in a sense, people on Medicare or Medicaid are already pre-enrolled.)

Once the questionnaire is complete, the website generates a voucher within seconds. People can print it or email it themselves, and then they can exchange it for a free course of Paxlovid at most pharmacies.

Pfizer’s representative tells me that more than 57,000 pharmacies are contracted to participate in this program, including major chain drugstores such as CVS and Walgreens and large retail chains such as Walmart, Kroger and Costco. For those unable to go in person, a mail-order option is available, too.

The program works a little differently for patients with commercial insurance. Some insurance plans already cover Paxlovid without a co-pay. Anyone who is told there will be a charge should sign up for Paxcess, which would further bring down their co-pay and might even cover the entire cost.

Several readers have attested that Paxcess’s process was fast and seamless. I was also glad to learn that there is basically no limit to the number of times someone could use it. A person who contracts the coronavirus three times in a year could access Paxlovid free or at low cost each time.

Unfortunately, readers informed me of one major glitch: Though the Paxcess voucher is honored when presented, some pharmacies are not offering the program proactively. As a result, many patients are still being charged high co-pays even if they could have gotten the medication at no cost.

This is incredibly frustrating. However, after interviewing multiple people involved in the process, including representatives of major pharmacy chains and Biden administration officials, I believe everyone is sincere in trying to make things right. As we saw in the early days of the coronavirus vaccine rollout, it’s hard to get a new program off the ground. Policies that look good on paper run into multiple barriers during implementation.

Those involved are actively identifying and addressing these problems. For instance, a Walgreens representative explained to me that in addition to educating pharmacists and pharmacy techs about the program, the company learned it also had to make system changes to account for a different workflow. Normally, when pharmacists process a prescription, they inform patients of the co-pay and dispense the medication. But with Paxlovid, the system needs to stop them if there is a co-pay, so they can prompt patients to sign up for Paxcess.

Here is where patients and consumers must take a proactive role. That might not feel fair; after all, if someone is ill, people expect that the system will work to help them. But that’s not our reality. While pharmacies work to fix their system glitches, patients need to be their own best advocates. That means signing up for Paxcess as soon as they receive a Paxlovid prescription and helping spread the word so that others can get the antiviral at little or no cost, too.

{source}

[xtruss]

Prescription drugs accumulate in a box at the Back Cove Trail parking lot in Portland, Maine, during a take-back event. Photograph By Ben McCanna, Portland Portland Press Herald/Getty Images

How You Should Dispose of Unused or Expired Medications

Flushing or throwing away leftover drugs can contaminate waterways, threatening people and wildlife. Here are some safer solutions.

— By Priyanka Runwal | Published July 22, 2022 | Sunday August 6, 2023

If you have a stash of unwanted, unused, or expired medicines in a cabinet or drawer somewhere in your home and you don’t know the best way to get rid of them, you’re not alone.

A 2021 survey conducted on behalf of Covanta, a New Jersey-based waste management company, found that 53 percent of the 2,000 Americans polled had no idea what to do with their old medications. Pill hoarding is a common outcome, and many people eventually toss these drugs into household trash or flush them down the toilet or sink—none of which may be a good idea.

Unused or expired medicines lying around at home can get into the wrong hands, leading to accidental poisoning or drug overdose. One study found that between 2000 and 2015, U.S. Poison Control Centers received roughly 32 calls a day about children accidently ingesting opioids that had either been stored or disposed of incorrectly.

When drugs are flushed or sent to landfill, the pharmaceuticals can contaminate our groundwater, lakes, rivers, and streams, threatening human and aquatic life, although our urine and feces that contain remnants of consumed medication are bigger sources of pollution. Wastewater treatment plants aren’t designed to remove these pharmaceuticals, Tim Carroll, a spokesperson for the U.S. Environmental Protection Agency, says in an email. “EPA’s first message to everyone is do NOT put leftover, unused drugs down the drain.”

So how does one dispose of unneeded over-the-counter and prescription medications accumulating in our homes? There are a few options.

Drug Take-back Programs

In an effort to find a solution to drugs languishing in medicine cabinets or lurking in waterways, the U.S. Drug Enforcement Administration launched its first National Take-Back Day in September 2010. More than 4,000 sites across 50 states collected nearly 250,000 pounds of pharmaceuticals that people returned. Since then, DEA has hosted this single-day event biannually; in April this year, more than 5,000 sites collected about 721,000 pounds of pharmaceuticals.

People can also use mail-back envelopes or drop off their unwanted medications year-round at DEA-registered collection kiosks in police stations, pharmacies, community health centers, and hospitals. These returned drugs are then sent to medical waste incinerators.

Drug Enforcement Administration agents and Soldiers from the New Jersey National Guard's Counter Drug Task Force dumped prescription drugs to be incinerated at the Covanta Essex Resource Recovery Facility during Operation Take Back New Jersey in Newark, N.J., Oct. 31, 2017. Operation Take Back New Jersey is a DEA program that provides a safe and legal method for the citizens of New Jersey to dispose their unwanted, unused, and expired medicines. The New Jersey National Guard assisted with the collection and disposal of the medications. (U.S. Air National Guard photo by Master Sgt. Matt Hecht) Photograph By Master Sgt. Matt Hecht, AB Forces News Collection/Alamy Stock Photo

In 2021 Stericycle, the largest medical waste incinerator company in the U.S., burned 40 million pounds of unused and expired pharmaceuticals, says Jim Anderson, the company’s vice president for product management and innovation. Incineration produces an inert ash that’s sent to landfills. However, one downside of this disposal method is that transporting and burning such waste and its packaging can release greenhouse gas emissions that can be potentially greater than those generated if the drugs were dumped in landfill, according to one study estimate.

But take-back programs are preferred as they reduce the risk of drug misuse and the incineration “effectively eliminates the entrance of these pharmaceuticals into our nation’s waters,” Carroll says.

However, Steve Skerlos, a mechanical, civil, and environmental engineer at the University of Michigan argues that take-back programs could still result in medicines piling up in homes—a problem such programs were designed to address in the first place. “The question is, if I have extra, unused medication, am I going to leave my house in the next day, or week, even a month, to return that,” he says, especially in rural settings where take-back sites may not be as easily accessible. “A reasonable person may consider landfill to get it out of the house fast.”

In such cases, the DEA suggests mixing medicinal tablets and capsules with undesirable substances like coffee grounds or kitty litter and tossing the mixture into the trash inside a sealed bag or container. (Don’t crush the drugs though.)

And while the EPA advises against flushing pharmaceuticals down the drain, the U.S. Food and Drug Administration maintains a list of limited medications that have the potential to be misused or result in death if taken inappropriately and so can be flushed when safer disposal alternatives are lacking.

Pharmacies also sell drug destroyers such as DisposeRx that can work with pills, tablets, capsules, liquids, and powders. “It’s about the size of a packet of sugar,” says Thomas Menighan, former CEO of the American Pharmacists Association. “You open it, put it in a bottle of unused opioids, or any medicine, for example, you pour a little water in and shake it up, it turns into a white slurry,” which can then be tossed into the trash.

But it’s unclear if these products permanently bind or inactivate the medicinal compounds so that they don’t end up in the landfill liquid, which is released into wastewater treatment plants, and can eventually contaminate our waterways.

Recycling Pharmaceuticals

Perhaps surprisingly, not all unused medications need to be thrown away.

Every year five billion dollars’ worth of unexpired medicine ends up being discarded in the U.S. That could happen because a patient dies, their condition improves and they no longer need their prescribed medication, there’s a dose change, or they experience side effects and are put on new drugs. In such cases these unexpired medications—worth an estimated $700 million—can be recycled.

“We’re wasting a lot of medication which is already paid for,” says Anandi Law, a patient engagement specialist at the Western University of Health Sciences in California. “We could have somebody else who needs it have it.”

Millions of U.S. adults skip or delay getting their prescriptions filled due to high costs. Hence, at least 40 states have passed legislation to establish medication repository programs that allow pharmacies, drug manufactures, medical and long-term care facilities, and sometimes individuals to donate their unused drugs in original sealed containers or tamper-evident packaging.

A licensed pharmacist then inspects the donated medication to check the expiry date and look for signs of tampering, misbranding, or any indication that the drug could be compromised. Once approved, the drugs can be dispensed to uninsured or underinsured individuals via state-approved pharmacies, hospitals, charitable clinics, or community health centers.

Since its inception in 2007, Iowa’s drug donation program, SafeNetRx, has served more than 117,000 patients and redistributed nearly $54-million worth of medication and supplies. Georgia’s program formally launched in 2018, and it has already filled prescriptions worth over $50 million.

“Even though over 40 states have these drug donation laws, a lot of people don’t know that they exist,” says Kiah Williams, co-founder of SIRUM, a nonprofit organization that works with pharmacies and health facilities across the country to assist with drug donation.

Donating unused medications or using take-back programs are voluntary for households, but experts hope more people will use these options instead of disposing of their leftover drugs in the trash or down the drain, which tends to be more convenient.

“All of these efforts are still relatively new,” Carroll says. “We expect we have a long way to go until households change their habits.”

[copperbadge]

I'm researching second-line medications for ADHD, because the Adderall works well for the executive function but non-pharmaceutical solutions are simply not effective for the emotional dysregulation, which I think the Adderall might be making worse, apparently that can happen.

But what's wild to me is that it seems as though the most effective treatments for ADHD, first or second line, almost all come in one of two flavors:

-- High potential for addiction

-- Used outside of ADHD as a treatment for addiction

There are definitely some treatments that fall somewhere in the middle, but it's hilarious how often my notes read stuff like "Second-line treatment for ADHD, can be used with stimulants, also used for smoking cessation/substance use disorder/individuals with history of alcohol misuse". It's almost like addiction frequently has biological causes related to emotional regulation and impulsivity and can be treated medically. Fancy that.

I've also found fascinating anecdotes by people with ADHD who prior to their diagnosis were struggling with addiction to opiates and were able to stop when they got on stimulant medication -- which "shouldn't be a thing" because opiates are depressants, not stimulants, and shouldn't impact ADHD. I've seen the theory floated that it's not stimulant/depressant that matters so much as impact on dopamine production and reception, but who the hell knows honestly.

It is interesting to me, though, because despite the jokes I've made in the past I've always watched myself very closely when it comes to opiates. I became well aware fairly early on that "oh, this is the drug that I could get in trouble over", but part of that was always that if I took a Vicodin, I would actually go do stuff like the dishes or the laundry or my essays for grad school, and that felt really good.

Anyway, I don't think it's often discussed that medication which increases your ability to do stuff can also overblow your ability to feel stuff, and also medication for emotional regulation may also boost you onto the wagon. So there you have it.

[gothhabiba]

hi i just saw some of ur posts on anti-psychiatry and then kept reading more on ur blog about what it is. for the most part i agree with what you've said about how capitalism uses psychiatry to designate people who are bad/abnormal and how it aligns itself w/ misogyny, racism, and so on. with that said i think i have some similar concerns/questions as another asker about what this means for those who do/would suffer even in a non-capitalist society, even if we didn't ascribe a specific label to X symptoms. if we are opposed to psychiatry, what are the options for people today who are suffering and want help? are you opposed to psychopharmaceuticals and therapy? i dont mean to ask this in a confrontational/accusatory way, i'm just new to this and genuinely curious

There are a few different parts to your question & so there are a few different angles to approach it from—

are you opposed to psychopharmaceuticals and therapy?

If this means "are anti-psych writers and activists opposed to individuals seeking treatment that they personally find helpful," then, no—a couple posts in my psychiatry tag do clarify this.

If it means "are there anti-psych critiques of psychopharmaceuticals and therapy," then, yes. Keep in mind that I'm not a neurobiologist or otherwise an expert on medications marketed as treatments for mental illnesses, but:

The evidence for the effectiveness of SSRIs in particular is sort of non-existent—even many psychiatrists who promote the biomedical model of mental illness doubt their efficacy, and refer to the "chemical imbalance" theory that enforces their usage as "an outmoded way of thinking" or "a kind of urban legend—never a theory seriously propounded by well-informed psychiatrists." But promoting SSRIs (and corresponding "serotonin deficiency" theory of depression, despite the fact that no solid evidence links depression to low serotonin) is very profitable for pharmaceutical companies. Despite the fact that direct-to-consumer advertisements are nominally regulated in the U.S., the FDA doesn't challenge these claims.

Other psychotropic drugs, such as "antipsychotics" or "antianxiety" medication, shouldn't really be called e.g. "antipsychotics" as if they specifically targeted the biological source of psychosis. No biological cause of any specific psychiatric diagnosis has been found (p. 851, section 5.1). In fact, rather than "act[ing] against neurochemical substrates of disorders or symptoms," these medications "produc[e] altered, drug induced states"—but despite the fact that they "produce global alterations in brain functioning," they are marketed as if they had "specific efficacy in reducing psychotic symptoms." Reactions to these medications that don't have to do with psychosis or anxiety (blunted affect, akathisia) are dismissed as "side effects," as though they don't arise from the same global alteration in brain function that produces the "desirable" antianxiety/antipsychotic effect. This doesn't mean "psychiatric medication turns you into a zombie so you shouldn't take it"—it means that these medications should be marketed honestly, as things that alter brain function as a whole, rather than marketed as if they target specific symptoms in a way that they cannot do, in accordance with a biomedical model of mental illness the accuracy of which has never been substantiated.

Psychiatrised people also point out that meds are used as a tool for furthering and maintaining psychiatrists' control: meds that patients are hesitant about or do not want are pushed on them, while patients who desire medication are "drug-seeking" or trying to take on the role of clinician or something and will routinely be denied care. Psychiatrised people who refuse medications are "noncompliant" and prone to psychiatric incarceration, re-incarceration, or continued/lengthened incarceration.

As for therapy: there are critiques of certain therapies (e.g. CBT, DBT) as unhelpful, status-quo-enforcing, forcing compliance, retraumatising &c. There are also critiques of therapy as representing a capitalist outsourcing of emotional closeness and emotional work away from community systems that people largely don't have in place; therapy as existing within a psychiatric system that constrains how therapists, however well-intentioned, are able to behave (e.g. mandatory reporting laws); psychotherapy forced on psychiatrised people as a matter of state control; therapists as being in a dangerous amount of power over psychiatrised people and being hailed as neutral despite the fact that their emotions and politics can and do get in the way of them being helpful. The wealth divide in terms of access to therapy is also commonly talked about; insurance (in the U.S.) or the NHS (in England) may only pay for pre-formulated group workbook types of therapy such as DBT, while more long-form, free-form, relationship-focused talk therapy may only be accessible to those who can pay 100-something an hour for it.

None of these critiques make it unethical or something for someone to get treatment that they find helpful. It's also worth noting that some of these critiques may be coming from "anti-psych" people who criticise the sources of psychiatric power, and some of them may come from people who think of themselves as advocating for reform of some of the most egregious effects of psychiatric power.

if we are opposed to psychiatry, what are the options for people today who are suffering and want help?

This looks like a few different things at a few different levels. At its most narrow and individual, it involves opting out of and resisting calls for psychiatrisation and involuntary institutionalisation of individuals—not calling the cops on people who are acting strange in public, breaking mandatory reporting laws and guidelines where we think them likely to cause harm. It involves sharing information—information about antipsychiatry critiques of psychiatric institutions, advice about how to manage therapists' and psychiatrists' egos, advice about which psychiatrists to avoid—so that people do not blame themselves if they find their encounters with psychiatry unhelpful or traumatising.

At the most broad, it's the same question as the question of how to build dual power and resist the power of capitalism writ large—building communal structures that present meaningful alternatives to psychiatry as an institution. I think there's much to be learned here from prison abolitionists and from popular movements that seek to protect people from deportation. You might also look into R. D. Laing's Kingsley Hall experiment.

what does this mean for those who would suffer even in a non-capitalist society, even if we didn't ascribe a specific label to X symptoms?

It means that people need access to honest, reliable information about what psychotropic medications do, and the right to chuse whether or not to take these medications without the threat of a psychiatrist pulling a lever that immediately restricts or removes their autonomy. It means that people need to be connected to each other in communities with planned, free resources that ensure that everyone, including severely disabled people whom no one particularly likes as individuals, has access to basic resources. It means that people need to be free to make their own choices regarding their minds and their health, even if other people may view those decisions as disastrous. There is simply no defensible way to revoke people's basic autonomy on the basis of "mental illness" (here I'm not talking about e.g. prison abolitionist rehabilitative justice types of things, which must restrict autonomy to be effective).

Also, I've mostly left the idea of who this would actually be untouched, since my central argument ("psychiatry as it currently exists is part of the biomedical arm of capitalism and the state, and the epistemologies it produces and employs and the power it exerts are thus in the service of capitalism and the state") doesn't really rest on delineating who would and wouldn't suffer from whatever mental differences they have regardless of what society they're in. But it's worth mentioning that the category of "people who are going to suffer (to whatever degree) no matter what" may be narrower than some would think—psychosis, for instance, is sometimes experienced very differently by people in societies that don't stigmatise it. I see people objecting to (their interpretations of) antipsych arguments with things along the lines of "well maybe depression and anxiety are caused by capitalism, but I'm schizophrenic so this doesn't apply to me"—as though hallucinations are perforce more physically "real," more "biological," more "extra-cultural" in nature than something like depression. But the point is that positing a specific neurobiological etiology for any psychiatric diagnosis is unsubstantiated, and that capitalist society affects how every "mental illness" is read and experienced (though no one is arguing that e.g. hallucinations wouldn't always exist in some form).

[weirdly-specific-but-ok]

WebMD Page for Aziraphale

As promised to you all, inspired by that video of Aziraphale as an antidepressant. The WebMD drug format, from your clearly deranged mascot, Asmi. This took way too much effort. For legal purposes, even though this blog is a lawless hellscape, this is a spoof. If you did like it, reblog it, maggoty loves of mine, because likes don't help visibility on tumblr, and I want everyone to be traumatised with my own specific brand of unhinged. No pressure though, be rebels muaha. That being said:

MENU > DRUGS & MEDICATIONS > AZIRAPHALE

COMMON BRAND(S): Guardian of the East Gate, Angel GENERIC NAME(S): Aziraphale

USES This medication is used to treat mood-related disorders ranging from depression to chronic loneliness and anxiety. It has also been proven effective in treatment of Compulsive Demonic Behavioural Disorder (CDBD) and Post Fall Stress Disorder (PFSD). The medication results in an overall improvement in mood (see Side Effects), morals, and lifestyle choices. This medication is sometimes described as a 'miracle-worker'. It is advisable to ensure that the correct dosage is taken at regular intervals. The doctor/God/Forces That Be may prescribe a lower dose at the start, gradually increasing frequency and amount over the course of millennia.

SIDE EFFECTS Documented side-effects include pining behaviour, severe withdrawal symptoms in case of suddenly stopping the medication, heart palpitations, stuttering or stammering, mood swings including irrational lashing out or defensive behaviour when faced with highly emotional situations, break-ups, misunderstands, obliviousness, amongst others. Despite the studies being limited to a single subject (see Crowley et. al. updated 2023) these effects are typically harmless in the long term. Life-altering effects may also be noted, including irretrievably falling in love, marriage, a positive character arc, tendencies to put oneself at risk to ensure continuation of medication, lifelong friendship, fate-defying romance and severe allergy to the idea of discontinuation of medication.

WARNINGS Casual or reckless consumption can be too fast for the medication, which will lessen its effects, leading to withdrawal symptoms. Withdrawal symptoms range from repeated indulging in CDBD and PFSD induced behaviours to alcoholism, depressive episodes, recklessness, listlessness, and prolonged car rides with no purpose. While the medication should not be consumed too fast, regularity is also advised. This is a long-term medication and not a short-term fix. Rare, short-term exposures will only worsen the side effects, withdrawal symptoms and may even reverse the drug effects.

PRECAUTIONS Ensure immortality so that the medication may be able to work its effect through the full course. Pre-existing trauma and heart conditions may require regular consultations with a therapist.

INTERACTIONS Drug interactions may change how the medication works or increase severity of side effects. This document does not include a comprehensive list of all drug interactions, please do adequate research and check instructions on the medication before proceeding with additional drugs. Aziraphale is known to have highly negative interactions with the toxin hellfire as well as the drugs Gabriel (only when sold as Supreme Archangel), Satan and Metatron (known toxin). Negative interference may occur due to most drugs from the class Heaven and Hell. Vague interference may occur with the drug class Homo sapiens.

OVERDOSE While less dangerous than withdrawal symptoms, overdose may lead to lack of personal space, miscommunication, and decrease in mood stability. Increased irritability is also common. Use with caution.

IMAGE

REVIEWS (1) Effectiveness: 5 stars Ease of use: 4 stars Satisfaction: 100000000000000000000e stars

It must be noted that in the country where I live (India), advertisements for pharmaceutical drugs are legally prohibited on television and other media. Which is why I was very bewildered at the initial video. But WebMD is a universal phenomenon so this shall by my contribution to the fandom. Thank you @neil-gaiman, Good Omens has given me a lot of opportunities to exercise my brain in all the weirdest ways.

[transmutationisms]

do you feel like SSRIs are mostly pseudoscience? I'm not sure if I should be open to trying them or avoid them at all costs since I'm not sure if they even work or if they will mess me up permanently

a preliminary note that i don't find the category 'pseudoscience' to be useful & would classify SSRI research more as 'methodologically shoddy science' or 'ideologically slanted' or 'part of a centuries-long effort on the part of psychiatrists to secure themselves professional prestige by claiming neurobiological etiologies where none are shown to exist' &c &c. imo the notion of 'pseudoscience' is itself pretty positivistic, ahistorical, and ideologically noxious (particularly apparent in any analysis of epistemological imperialism).

that aside: you raise two major issues with SSRIs, namely whether they work and whether they will cause you harm.

efficacy of SSRIs is contested. a 2010 meta-analysis found that in patients with mild or moderate depressive symptoms, the efficacy of SSRIs "may be minimal or nonexistent", whilst "for patients with very severe depression, the benefit of medications over placebo is substantial". a 2008 meta-analysis found a similar distinction between mildly vs severely depressed patients, but noted that even in the latter population, drug–placebo differences were "relatively small" and argued that the differences between drug and placebo in severely depressed patients "seems to result from a poorer response to placebo amongst more depressed patients" rather than from a greater efficacy of SSRIs. a 2012 meta-analysis found some SSRIs consistently effective over placebo treatments, but several authors disclosed major relationships with pharmaceutical companies. a 2017 meta-analysis concluded that "SSRIs might have statistically significant effects on depressive symptoms, but all trials were at high risk of bias and the clinical significance seems questionable" (emphasis added) and that "potential small beneficial effects seem to be outweighed by harmful effects".

when evaluating any of this evidence, it is crucial to keep in mind that studies on antidepressant trials are selectively published—that is, they are less likely to be published if they show negative results!

A total of 37 studies viewed by the FDA as having positive results were published; 1 study viewed as positive was not published. Studies viewed by the FDA as having negative or questionable results were, with 3 exceptions, either not published (22 studies) or published in a way that, in our opinion, conveyed a positive outcome (11 studies). According to the published literature, it appeared that 94% of the trials conducted were positive. By contrast, the FDA analysis showed that 51% were positive.

meta-analyses are not immune to this issue, either. in addition to the problem that a meta-analysis of a bunch of bad studies cannot magically 'cancel out' the effects of poor study design, the authors of meta-analyses can and do also have financial interests and ties to pharmaceutical companies, and this affects their results just as it does the results of the studies they are studying. according to a 2016 analysis of antidepressant meta-analyses,

Fifty-four meta-analyses (29%) had authors who were employees of the assessed drug manufacturer, and 147 (79%) had some industry link (sponsorship or authors who were industry employees and/or had conflicts of interest). Only 58 meta-analyses (31%) had negative statements in the concluding statement of the abstract. Meta-analyses including an author who were employees of the manufacturer of the assessed drug were 22-fold less likely to have negative statements about the drug than other meta-analyses [1/54 (2%) vs. 57/131 (44%); P < 0.001]. [...] There is a massive production of meta-analyses of antidepressants for depression authored by or linked to the industry, and they almost never report any caveats about antidepressants in their abstracts. Our findings add a note of caution for meta-analyses with ties to the manufacturers of the assessed products.

so, do SSRIs work? they are certainly psychoactive substances, which is to say, they do something. whether that something reduces depressive symptoms is simply not known at this point, though it is always worth keeping in mind that the 'chemical imbalance' narrative of SSRIs (the idea that they work by 'curing' a 'serotonin deficiency' in the brain) has always been a profitable myth. look, any medical treatment throughout history has been vouched for by SOME patients who report that it helped them—no matter how wacky it sounds or how little evidence there was to support it. this can be for a lot of reasons: placebo effect, the remedy accidentally treating a different problem than it was intended for, the symptoms coincidentally resolving on their own. sometimes the human body is just weird and unpredictable. sometimes remedies work. i'm sorry i can't give you a more definitive answer about whether SSRIs would help you.

as to potential risks: these are significant. SSRIs can precipitate suicidal ideation, a risk that has been consistently downplayed by pharmaceutical companies and studies. SSRIs are also known to contribute to sexual dysfunction and dissatisfaction, again a risk that is minimised and downplayed in much of the literature and in physician communication with patients. further (known) side effects range through emotional blunting, glaucoma, QT interval prolongation, abnormal bleeding & interaction with anti-coagulents, platelet dysfunction, decreases in bone mineral density leading to increased risk of osteopenia and osteoporosis, jaw clenching / TMJ pain, risk of serotonin syndrome when used in conjunction with other serotonergic substances, dizziness, insomnia, headaches, the list goes on.

i don't mean to sound alarmist; all drugs have side effects, some of the ones above occur rarely, and you may very well decide the risk is acceptable to you to take on. i would, though, always encourage you to do thorough research into potential side effects before starting any drug, including an SSRI. more on SSRI side effects in david healy's books 'pharmageddon', 'let them eat prozac', 'the antidepressant era', and 'the creation of psychopharmacology'; 'pillaged' by ronald w maris; and 'the myth of the chemical cure' by joanna moncrieff.

in addition to the above, SSRIs are known to come with a risk of 'discontinuation syndrome'—that is, chemical withdrawal when stopping the drug. this, too, is often downplayed by physicians; many still deny that it can even happen. some patients don't experience it at all, though i can tell you purely anecdotally that SSRI withdrawal was so miserable for me i simply gave up on quitting for over a year, despite the fact that at that point i was already thoroughly experienced with chemical withdrawals from other, 'harder' drugs. again, i am not telling you not to go on SSRIs if you decide these risks are worth it to you! i simply think this is a decision that should always be made with full knowledge (indeed, this is a core, though routinely violated, principle of medical 'informed consent').

ultimately this is not a decision anyone should make for you; it's your body and mind that are at stake here. as always i think that anyone considering any kind of medical treatment should have full knowledge about it and should be making all decisions freely and autonomously. i am genuinely not pushing any agenda 'for' or 'against' SSRIs, only against prescription of them that is done carelessly, coercively, or without fully informing patients of what risks they're taking on and what benefits they can hope to see.

[spooniestrong]

[Text id:

"“Do I want to take pain medications? The simple answer is no. Just like I don’t want to take any of the medications I am prescribed. But equally I know that those same drugs keep me functioning. That without them I would not be able to write this post, or stand, or walk the few steps to my toilet. Similarly, adequate pain control gives me the ability to drive 3 hours to the city for my medical appointments and to sit on the couch with my family without tears. But access is complex. And there is a pervasive idea of the drug-seeker, seen in every patient who has chronic pain. That those who simply don’t get over pain and require ongoing pharmaceutical management are weak. Friends who have used pain clinics tell stories of dismissal and blame. That they are not trying hard enough when they don’t recover, when I know the lengths they have gone to to try and alleviate their pain. And compassionate pain doctors who become the exception not the rule.”

- "When ‘Suck it Up’ Becomes the Only Pain Treatment You Are Offered" (via chronic-illness-support ) ]

[beguines]

Most commonly, critical scholars focus on one major reason for the current expansion in the numbers and categories of mental illness in western society—namely, the influence of pharmaceutical corporations (colloquially referred to as "big pharma") on the construction of new categories of disorder and the promotion of drug solutions for those disorders. The institution of psychiatry is the ultimate authority responsible for defining and treating mental pathologies, yet commentators argue that the profession has been steadily compromised by forming close relationships with big pharma, who are now effectively setting the mental health agenda. For example, critics point to the 69 per cent of psychiatrists responsible for the development of the latest edition of the DSM who have financial ties to the pharmaceutical industry. Research has also demonstrated the close involvement of big pharma in the development of current mental illness categories including social anxiety disorder and premenstrual dysphoric disorder. The more behaviour and experience that can be successfully medicalised—that is, reconceptualised as in need of medical intervention—through this medico-industrial partnership, the more drugs can be potentially sold to the public. Thus it is argued that the expansion of the mental illness discourse is the result of a market takeover of health care; corporations rather than medical practitioners are now designating what mental pathology is and, as a result, dictating treatment. The obvious solution to this situation involves the de-coupling of mental health services from the influence of big business. Tighter government regulation and oversight of pharmaceutical corporations is required, as is transparency within the relevant professional organisations.

While this critique of big pharma's intervention in the production and promotion of the contemporary psychiatric discourse is relevant, it is perhaps the least surprising aspect of the operation of the mental health system within capitalist society. Scholars of medical history such as Andrew Scull, for example, have profiled a continuing "trade in lunacy" which can be traced back to the beginnings of industrial society and witnessed throughout the development of modern mental health work. That the market is part of the workings of psychiatry and related professions should be self-evident to any scholar aware of the history of the mental health system in western society. Such critics would also acknowledge that while psychiatry legitimates the products of big pharma, pushing psychopharmaceuticals in turn helps legitimate the psychiatric profession. The prescribing of drugs is a key symbol of modern doctoring which serves to align psychiatric practice with other branches of medicine through a shared biomedical understanding of health and illness.

Bruce M.Z. Cohen, Psychiatric Hegemony: A Marxist Theory of Mental Illness

[self-loving-vampire]

I feel like people fundamentally misunderstand the way pharmaceutical companies can be unethical.

Like, they treat it as being basically a scam, acting as if medical drugs and treatments are ineffective or even making people worse. You can most clearly see this in anti-vax or anti-trans conspiracy theories.

But in reality the actual issue is that the medicines do work and are just inaccessibly priced or made insufficiently available, often via IP law.

So for example if you are diabetic your concern probably should not be "insulin is a big pharma scam meant to sell me medicine forever", because insulin does work and you need it. The actual issue you're facing is that it's far more difficult to acquire than it should be.

Profit incentives also work against public health in impoverished countries, where the battle is against pharmaceutical companies extending their patents on things like tuberculosis drugs to monopolize the market and keep prices high.

The issue is not whether the medicine works or not. It clearly does. It's a matter of access.

[crossdreamers]

Donald Trump's horrific plan for transgender people

Warning: The content of this article may be traumatizing for trans people living in the US.

Now that Trump as won the US presidential election as well as the Senate, LGBTQ people around the country need to prepare for a long and painful battle.

During the campaign Trump made it perfectly clear what he wants to as far as transgender protections and health services are concerned.

The following summary is based on a presentation made by the Trump Vance campaign. We have rewritten the most offensive language.

The new Trump administration will:

Revoke current policies that support gender-affirming treatments for minors, including puberty blockers and surgeries.

Issue an executive order to end federal agency support for programs that promote the concept of sex and gender transition at any age.

Prohibit the use of federal funds to promote or cover the cost of gender-affirming procedures.

Introduce legislation to ban gender affirming procedures on children nationwide.

Penalize healthcare providers involved in these procedures by removing them from Medicaid and Medicare compliance.

Support legal avenues for individuals to sue medical professionals who have performed gender-affirming procedures on minors.

Mandate investigations into pharmaceutical companies and hospital networks for potentially concealing negative side effects and marketing unapproved drugs.

Direct the Department of Education to ensure school personnel do not encourage discussions about gender identity without repercussions, and punish those that do.

Promote education that emphasizes traditional gender roles and the nuclear family.

Request a law to formally recognize only male and female genders assigned at birth.

Ban transgender women from taking part in women's sport.

Uphold parental rights concerning their children's gender identity decisions.

Will they do all of this?

There is no reason to believe that Trump will not follow up on this. To what extent the new administration will be able to implement these policies, will depend on several factors, including:

The outcome of legal processes in courts.

Public outrage.

Whether the Republicans take the House of Representatives.

To change federal legislation in this area, the Republicans need to control both houses of Congress.

A war on transgender people

This list proves that the Republican Party has now declared war on transgender people. This is a policy aimed at erasing trans people from society.

It is true that some of the proposals are aimed at children only, but we will not be surprised if that approach is extended to adults as well later on. In any case the message that gender incongruence in children is "not real" carries the message that this applies to adult identities too.

Note that the Republicans want to scare and numb people and institutions from supporting trans people. Out of fear of legal action individuals, companies and institutions may avoid giving trans people any support, even if it is legal on paper.

The public policy of the Trump administration will also encourage transphobes to attack trans people both in public and in private spaces.

Trans people and their allies inside and outside the US will have to plan for the worst. We have to do everything we can to unmask the cruelty of Trump and his Fascists. We need to make sure that the Republicans are not able to normalize this kind of cruelty.

See our article "Trump and the transphobes won in the US. But there are still ways trans people can win" for more on what we can do.

Free hotlines for gender & sexual identity, LGBTQ+ in the United States.

Photo: Boogich

[dcdreamblog]

As someone who works in American health insurance (boo hiss) customer service, one call that I get frequently, about once every two months is "why doesn't my plan cover Miraclo (tm)?" And then I have to explain that there's no such thing as "generic Miraclo" and don't even get me started on so-called "herbal Miraclo."

So may I ask you to write a bit about the history of Hourman and why Miraclo (tm) isn't covered by most health plans?

Ok, I agree with you but I should warn you, if you are a person familiar with the medical field this explanation is going to make you cringe yourself sideways. Here goes. 1. Rex Tyler AKA Hourman, was not a pharmaceutical scientist by trade. He was a biochemist. His job was not to invent medicine specifically and he invented Miraclo on accident. The only three subjects it was ever tested on were

A. Tyler himself B. Rats C. An owl (if certain stories are to be believed)

2. Miraclo was never released to the public and we still don't know what's in it. As with any drug or chemical agent that grants superhuman abilities it is HEAVILY controlled and the only reason it hasn't joined the likes of Venom on the most wanted list is because it never leaked to the drug trade in the first place.

3. SPEAKING of Venom, Miraclo is how that drug got started when only PART of Tyler's notes ended up in the wrong hands.

And finally,

4. Miraclo is not safe for human consumption over any extended period.

It makes the muscles stronger, but not as strong as it makes them FEEL. Making it super easy to deeply injure yourself.

It only lasts for an hour (at MOST, for anyone other than Tyler its effectiveness can be measured in minutes if not less), meaning it would be useless for the treatment of basically any medical issue.

As you can expect from such a potent rush, the come down is worse. It leaves the subject weak, shaky, disoriented and aggravated.

It's addictive

It can only be taken once every 24 hours between doses without instant, violent overdose reactions.

If it IS taken "safely" over extended periods it strains the involuntary muscles, most specifically those around and within the heart. Placing the user at increased risk of random heart attacks.

It also sharply spikes your risk of developing virulent and aggressive leukemia

And, over time The debilitating effects after each dose become more and more permanent, meaning it makes the muscles it empowers weaker without it over time.

Before anyone even THINKS the words "but what about Hourman's son Rick" Rick Tyler is A. a metahuman B. using a form of Miraclo that makes it "nonaddictive" but doesn't get rid of any other side effects. C. Had cancer and D. spent several years retired under the assumption that the Miraclo rush had helped him kill a man.

I respect the Tyler men, deeply. We would not be living in this world we have, maybe even a world at all, without Hourman. Miraclo is a closely guarded secret for a lot of really good reasons and even their teammates have interceded multiple times with the worry that while it might make them for effective heroes it is almost certainly shortening their lifespans. (The original Hourman and Doctor Midnite infamously butted heads over it constantly)

The only difference between Miraclo and Kobra Venom is that nobody with a profit motive knows how to make Miraclo.

[librarycards]

Is there a word for like, the phenomena of many people in academia positions calling themselves "anti psychiatry" but having a really shallow take on it that is openly reactionary and hostile to disabled people. Like they'll say "adhd isn't real" not in a "the way mad people critique and reformulate concepts of adhd takes precedence over the way the medical establishment does" way but in a "stop whining addict you are not medically corrupt but morally corrupt" way that is really obviously hostile to the self-actualization of the disabled. Or they have tunnel vision on deligitimizing all pharmaceuticals. Which seems like a very unthorough and flawed way to critique the medical industrial complex. Companies are lying about drugs, mis-prescribing them, AND with-holding them. You can't just ignore the last one. Entire countries are held hostage by threat of pharmaceutical copyright embargo, and these types could care less. Anyway what's their deal. They seem like fash wellness types in "anti psychiatry" clothing.

this is a dangerous pov that has been embedded in the antipsych movement for a very long time, and continues to be perpetuated by people whose antipsych scholarship doesn't have a strong disability studies conceptual framework. the most (in)famous figure representative of these views is Thomas Szasz, who believed, in short, that "mental illness" was an abdication of patient "personal responsibility" and an excuse for "malingering." He correctly identified mental illness as a sociocultural + medico-legal construct, but chose to blame persons experiencing psychosocial distress/difference for the insufficiency and danger of pathologizing labels, rather than the structural violence that undergirds both discourses and material realities of what is understood as "mental illness."

Personally, I think that this genealogy of antipsychiatry is libertarian in origin, distinct, though not disconnected, to bodymind fascism / wellness-reductionism. Szasz and his ilk are notable in that they believe/d in absolute bodily autonomy and self-determination, with the caveat that such autonomy is predicated upon the absence of social supports for people experiencing distress, and on the absence of compassion for those using violent language in an attempt to make sense of their lived experiences. The reason that I make this distinction is that Szasz is Jewish, and fled Hungary for the US in the 30s. He made the (correct) connection between the Nazi genocide of "undesirables" (including psychiatric patients) and state classification, incarceration, and "slow" genocide of Madppl globally and transtemporally.

But to return to your question: with this, as with pharmaceuticals, there is a fundamental discomfort at all levels of scholarship and discourse with identifying neoliberal capitalism as the enemy of self-determination, joy, community, and, like, an actual future for all life on this planet and beyond. The claim that pharmaceuticals are uniformly evil is a hackneyed way of attacking capitalism for those not yet ready or willing to acknowledge that, even absent a given pill or brand name, the structural violence that we associate with them would remain and simply morph. The fundamental danger of any and all medical "treatment," particularly that which involves significant alteration to an individual's bodymind and/or potential incapacitation, is that medico-psychiatric institutions function as zones of exception for many of the "rights" we are taught that we enjoy. Under the sign of patient, typical assumptions around autonomy, dignity, and equality –– while never fully existent in the first place –– completely vanish. Of course, it is far easier to blame individual people, companies, etc. than understand that disabled/Mad liberation will never exist without total abolition.

Equally, however, it's important to understand that "academics" discussing the abuses of big pharma or questioning the ontology of mental illness, as it were, are not somehow magically separated from psychiatric survivors. The academics dismissed as being unaware of the "real" struggles of psychiatrized people are oftentimes psychiatrized themselves, and their perspectives, writings, and movements are grounded in lived experience. People with academic degrees are not immune from emotional reactions rooted in trauma and anxiety, and in fact, to try to separate "emotion" from academic "reason" is a dangerous eurocolonial practice. In short: many who write, correctly, of the dangers of pharmaceutical companies and practitioner pocket-lining are and have been subjected to these abuses firsthand. This doesn't mean that a wholesale rejection of all medication is, like, "good." But it means that scholars are people –– people with more specialized knowledge in a given area than your average random person, but people nonetheless.

So, to conclude: there are a bunch of things going on that lead to the pervasiveness of reactionary antipsych perspectives. Sometimes, in the case of libertarian or fash (to say nothing of religiously-specific fascism) approaches, there is a willful refusal to distinguish pathologization from material need/suffering, and the assumption that eliminating diagnostic markers will simply neutralize the problem of mental illness-qua-human vulnerability. Other times, conscious objection to myriad genres of oppression under the (neoliberal capitalist) Med/Psy industrial complexes are shoehorned in with these reactionary approaches.

Overall, there are longstanding movements designed to oppress/abandon/eliminate disabled / Madppl in which scholars, wittingly and unwittingly, participate, and given the average joe's utter ignorance of any kind of antipsych thought, it is very difficult to address these issues with rigor and honesty.

Lastly –– I highly recommend doing more reading in critical Mad studies if you're interested in well-thought-out perspectives on Madness, antipsychiatry, and disability justice! Scholars like Liat Ben-Moshe, Jijian Voronka, Margaret Price, La Mar Jurelle Bruce, J. Logan Smilges, sarah madoka currie, Bren LeFrançois, Alexandre Baril, Cameron Awkward-Rich, Eric Stanley, Therí Alyce Pickens, Erica Hua Fletcher, and many others do incredible Mad work explicitly informed by disability and abolitionst frameworks! (and so do I –– at least, I'm trying!)