Friday, June 26, 2009

Rx Drugs

I started taking wellbutrin SR last week to help me quit smoking, as it worked 6 years ago. (I started again after beginning my career in outside sales.)

I've had the side effects that I remember from last time - can't sleep for shit during the first week of taking it twice a day, my left hand shakes if I hold it a certain way, I feel jittery and jumpy, and have the occasional dizzy spell. Last time I was on it, all of these were gone by the end of the first month. 

Anyway, because a new side effect has started up (severe night sweats), I wanted to look up the patient info to verify that this was in fact a side effect of the wellbutrin. So I googled it. One of the sites I decided to look at has firsthand experiences of people taking particular medications. I was bored, so I said what the hell, I'll read through some of these. 

OMG. The first whole page is people who are taking wellbutrin and prozac at the same time. The second page is people who are like "Yeah, my doctor gave me atavan (sp?) to help with the sleeplessness, but now he's taken it away permanently :-(" and "I've been on wellbutrin for 7 months, and at night I take it with 10mg of valium, and now my doctor wants me to try seroquel in addition, even though it's an antipsychotic and I'm not psychotic."

It contains advice such as "If you're getting the jitters, you should ask your doctor for klonipan, because it worked for me while I was on the wellbutrin." Or "I recommend taking a Xanax at night if the jitters keep you up." Or "The prozac + wellbutrin killed my sex life, so my doctor gave me an Rx for Viagra." One person said "I like getting the jitters and the energy on wellbutrin - it has taken away my daily desire for cocaine which I quit 7 years ago."

OMG, the PILL POPPING in this country!!!!! Taking medications to treat the side effects of medications!! 

I have never met a doctor in my LIFE that would give someone who was on wellbutrin for depression a prescription for valium. Talk about begging for an addiction!

Now I personally have never gone to a doctor to ask for a medication to treat a side effect of a medication. I HAVE gone to the doctor and said, "I hate the side effects of this medication. Is there something else we can try instead?" I'm not judging the people who ask for it, but at the same time I wonder if we just walk around with the expectation that we should never feel uncomfortable for any reason. 

We as a society seem to believe that there is a pill to solve every problem we have in life. People no longer balance priorities and make decisions that way - they think they are entitled to have everything and shouldn't have to decide. 

For example, wellbutrin is known as the "sex-friendly" antidepressant, whereas the SSRIs tend to kill your sex drive or ability to perform. But wellbutrin has the side effect of increasing anxiety, something that Prozac can fix.

I look at it this way: what's more important, sex life or experiencing anxiety? I'd take the anxiety, hands-down. But the men on this thread chose to take both wellbutrin and prozac, plus viagra, while the women who are taking both wellbutrin and prozac are complaining that there IS NO viagra for women! They're bitching about not having that third option! STOP TAKING THE PROZAC AND DO SOME GODDAMN YOGA!!!!!!!

I feel sorry for these people. It makes me wonder about the psychiatrists. I personally chose not to take that career path because I have always thought of them as primarily drug dealers. Which I get - they are trained in medicine (diagnose and treat), and since psychologists can't prescribe medication, most patients of psychiatrists are there for only one reason - to get the Rx for the meds. They get their therapy elsewhere. 

I just resent this social climate of "Oh, you have a problem? We have a pill for that! Oh, taking that pill makes you nauseous? We have a pill for that too!"

I am never going to message boards to find out about experiences with medication again. It's too depressing. And I'm already on a pill for that.

16 comments:

Becca said...

This might sound harsh, but your post is really dramatic and it's irking me.
Don't go into clinical work at all if STOP TAKING THE PROZAC AND DO SOME GODDAMN YOGA!!!!!!! is your attitude.

There's nothing wrong with pills. There's nothing noble, natural or admirable about suffering.
Mind you, there's nothing wrong with opting *not* to take pills either, assuming you don't have a problem that results in you hurting others (I have known depressed parents who could not take care of their children as effectively without medication, but refused to take it.
And not because of any side effects, or because there was something informative about the depression, but simply because of 'pills aren't natural' hippiethink).

But psychologists that believe that psychiatrists are drug pushers, and that their patients on medications are taking the easy way out, are among the worst psychologists.

JLK said...

@Becca - First of all, no I have no and never had any intention of going into clinical work. Understand that I don't have any issues at all with anyone taking medication for depression or any other reason. What I take issue with is a society that develops pills for everything. I mean, doesn't it seem kind of dangerous to you to be taking wellbutrin, prozac, valium and seroquel at the same time? Talk about fucking with your brain chemistry! And given what we know about these medications in terms of side effects, withdrawal symptoms, and addictive qualities, it seems to me that it may end up doing more harm than good.

What I was trying to convey with this post (obviously failing) is that drugs shouldn't be the first thing we turn to, and I DO think there's something wrong with taking 3 medications to treat the side effects of 1 medication. ESPECIALLY when we're talking about medications that fuck with your brain chemistry.

And here's the thing: GOOD psychologists believe that medications are a TOOL, not a CURE, to be used in conjunction with some sort of therapy. If you are depressed, wellbutrin might make you feel better, but it's not going to solve the underlying reason for the depression.

Becca said...

I'm by nature somewhat more cautious then average about what I put in my body, and the thought of taking wellbutrin, prozac, valium and seroquel at once would give me pause (to say the least!). However, I'd never judge someone else's motivations for taking them (particularly from very limited contact with them). People taking drugs for side effects does not imply they are necessarily turning to drugs first thing.
But more importantly, even if they are turning to drugs first thing, why is that wrong? You gotta try something first! A society that develops pills for everything is a society that recognizes the reality of consciousness being influenced by physical biochemistry.

What do you do if there truly appears to be no underlying reason for depression? Or what if you can't do anything about the underlying reason?
Insulin isn't going to solve your autoimmune reaction to your beta cells, but knowing that your body attacked your beta cells doesn't bring them back either.

JLK said...

I see your points, Becca. What worries me about this societal mentality is that drugs get rushed into the market and we don't find out that they're dangerous until after the fact. Remember that Pfizer medication that was giving people heart attacks or something? Or this nasal spray thing that's making people lose their sense of smell, sometimes permanently?

The fact that we have a tendency to turn to drugs first is what fuels much of these issues, because Pharma is in a hurry to get them out on the shelves so they can make money off it. And that brings up a whole other issue - why not work on making the drug not have those side effects instead of making a whole other drug (that needs to be paid for) that treats them?

I think you're taking my argument as focusing on an individual level, which is not what it's meant to be. Healthcare has been on my mind a lot lately because of the reform issues being talked about, particularly in reference to wasteful costs. I think paying for 3 or 4 medications to solve what was originally a single problem is wasteful. Profitable for Pharma, but wasteful for the rest of us.

And if you want to take the discussion another step further and force me to show my bleeding-heart liberal side - then I would say that it pisses me off that people can take thousands of dollars worth of medication (most of it going to problems they didn't have initially) in a single year, but we can't seem to get HIV and AIDS medications to countries that desperately need them.

So in that sense, yes, on some level I do judge people who go online and talk about how they need to take valium so that they don't feel jumpy because of the antidepressant they're taking.

PhizzleDizzle said...

I hear you JLK. I know that I am lucky to have extremely stable brain chemistry, but at the same time, I find the world to be fucked up if at a party someone says, "And then like, I was like, sooo stressed and I thought, I sooooo need a Xanax!" wtf? That's fucked up. Everyone's taking a pill for everything. To the point that my OB/GYN, when I saw her for the first time and I told her I was 20-some years old and not on any drugs except the pill, was really surprised. She was like, "really, wow! so healthy! that's wonderful?" and i was like, wtf drugs do you think i should be on, in the prime of my life? is it that unusual that i should not be on anything?

I hear Becca's point that suffering sucks and judgning someone for being on medication can be wrong.

But man, something is wrong with the world if a doctor is surprised by a young person not being on any prespcription meds. seriously. wtf. drugs are for people who are suffering, not the occasional "ooohhh, woe is me, give me a pill."

Becca said...

JLK- It seems like you're conflating two issues- superfluous drug use in general, and taking one medication to treat another's side effects. The first is of concern to me, but I don't think the second is itself a real issue (Or would you have a problem with e.g. anti-nausea drugs that allow higher and more effective doses of chemotherapy to be used?)
In the case of celecoxib (I think this is the Pfizer drug you heard about); it's a COX2 specific NSAID. Basically, like aspirin without the gastrointestional effects.
Is that a necessary drug?
Now, you could argue this kind of drug is superfluous, and was developed for whiny consumers who can't deal with a tummyache from aspirin. ('ya know, if they were really in pain, then the tummy upsetness wouldn't phase them!').
OR you could argue that for patients for whom aspirin is counterindicated, who are going to bleed out their stomachs in a way that is riskier than having a heart attack, this class of drugs is urgently needed.
Both types of patients exist, it's just a case of what you focus on.

If the science were easy, there are ample markets for drugs that would relieve massive suffering.
The trouble is, Pharma companies are companies, and want to get to the most profitable products in from the least amount of research time and expense. Even if everyone somehow only wanted drugs for things you think are needful, the priorities for drug development are still going to sometimes be wasteful in the sense of more resources thrown at less important problems (I'm a malaria researcher; it's not enough to treat the disease, the goal is to cure the disease on <$1/day and as few days of treatment as possible).

PhizzleDizzle- have we developed a "suffering meter"? I can imagine one like the fuel gauge on my car, smack in the middle of everyone's foreheads. Until we install those, I personally try to avoid trying to figure out who is "woe is me!" and who is "legitimately suffering".

JLK said...

Becca - we are not in disagreement over the fact that people are suffering. I would NEVER begrudge a cancer patient any form of treatment or any combination that may save their life or at least increase the quality of it.

Maybe if I put this stuff in a different perspective for you, you might understand what I'm trying to get at. The death of Heath Ledger. Possibly the death of Michael Jackson as well, and numerous others who have died from combinations of prescription drugs.

I commented on this over at DrugMonkey I think. The combos of shit that people put in their bodies now is just not right. Did Heath Ledger kill himself? Probably not. I believe it was ruled an accidental overdose because of the amount and combination of drugs that were in his system.

I wondered how someone could even think for a second that combining those drugs together WOULDN'T kill them. But then I figured it out. (I think)

Let's take painkillers for example. You start taking them and they work. But eventually you start to build a tolerance and you have to take more. Most doctors at this point would switch you to a different pain med if possible.

But if you're taking something else at the same time, say an anti-nausea because the vicodin you're taking makes you sick. Now you have a second drug in your system. And then you start having difficulty sleeping, so you get an Rx for Ambien or something similar.

You are now at risk for becoming addicted to the Ambien, which you wouldn't have needed if you weren't on the anti-nausea medication, which you wouldn't have needed if you weren't on the vicodin, which you are also now addicted to.

Imagine being a teenager with all that shit in your mom's medicine cabinet. We know that's what kids are doing these days instead of ecstasy or LSD.

(Oh, and the drug you mentioned was not the one I was thinking of.)

PhizzleDizzle said...

Becca, as I said in my original comment, I hear you point that judging someone for whether they on medication can be wrong. I personally don't have the expertise (I'm not a doctor) to decide if someone is legitimately suffering or not. Nor do I think it's my place to do so, though I do feel safe in thinking that the NY society girl who is stressed because her hair appt. got pushed back does NOT need a Xanax. I have friends on Prozac, lithium, whatever and I understand that it helps them. That's fine and I'm glad they're getting the help they need.

However, I stand by my statement, which was the point of my whole last comment and I think it was pretty clear, that we as a society take too many drugs. Is it up to me to decide who should take drugs and who shouldn't? Hell to the no. But can I legitimately feel like something is wrong with society when drugs are taken so lightly? When college kids can get their hands on whatever prescriptions they want? When my sister gets advice on how to fake this disease or that to get this drug or that, if she wanted? When doctors are surprised that young people aren't on multiple prescriptions? When it's not unusual for people to have >5 prescriptions to their name?

I believe that answer is yes. Just because I think at a societal level we take too many drugs doesn't mean I want to personally go around judging people that I run across as whether they are legitimately suffering or not.

leigh said...

whoa.

i've been meaning to write out a sizable reply to your post, JLK, but i've been pretty swamped with minor revisions. i'm down to my last benchmark for the night, which i can probably knock out in an hour or so (provided teh pubmed godz are on my side), so let me take a few minutes to talk about a neuropharmacologist's perspective on this.

you've probably read sci's excellent series on depression. in that case you already know that we really have no fucking clue about what's going on to cause depression, and the best medicines we have are really derived from a glorified case of circular logic, and aren't always particularly great, and vary widely by individual. side effects of pissing around with neurotransmitter concentrations vary because we all have different baselines for what could be up to about a million reasons.

so different drugs work for different people. and sometimes the only drug that works for a certain individual also produces some pretty intolerable side effects. so someone goes from maybe being depressed and sleeping all the time, being unable to function because of that- to having a more even mood but being totally unable to sleep, and being unable to function at their daily life because they can't sleep. the net effect is still not good for this person's daily life. that's when you'd probably start looking at secondary treatments.

you can't pick based on the side effect profile. you pick based upon what works and then handle the side effects.

on one hand, yes, it's convenient to handle some problems with a simple pill. when it's medically indicated, withholding such treatment is just lording one's opinion over another.

however, people are far too casual about pills. the fact that people are going around on internet groups and recommending drugs x, y, and z for different conditions kind of disturbs me. while people seem to grasp that you take a drug to produce an effect (ie, sleep, or mood regulation, or just to get it up), in general, the population is grossly undereducated in what harm pills can do- if not immediately, over time. swallowing a convenient little capsule seems easy and harmless, but that's not always the case.

i partially blame our culture for this. look at that happy couple on the tv commercial, about to go have teh awesome sex because of this little convenient pill, when before it wasn't working right for them. (ohanddontforgettheselittleinsignficantsideeffecskthx)

on the other hand, if there is something available to handle an unneeded temporary nausea or insomnia or whatever, why not take advantage of it to get over a temporary hump? the key word being temporary.

now when it comes to the mixing of massive different numbers of drugs- that's usually a different issue. these people tend to have either multiple doctors who are maybe not aware of the other doctors or the other drugs this patient is taking, maybe the patient is getting drugs from friends, saving them from months ago and doesn't have a current rx, or maybe the doctor is careless or who knows what. there are lots of ways this can happen.


alright... i just totally lost my train of thought... got a phone call. at any rate, take that for what it's worth.

JLK said...

@Phizzle - You always manage to say what I'm trying to say but so much more clearly and concisely! I don't know how you do it, because I always end up elaborating even more. lol

@Leigh - I think we're on the same page. Rx drugs are good when they help people who need it. But we have a huge bunch of pill poppers out there who don't really need it. I'm sorry, but one week of not being able to sleep does not constitute a "need" for valium.

Your point about depression and its neurochemistry is a huge part of what I was hoping to get at. If we don't really know how it works, then we can't really know what things could possibly go wrong.

I am not anti drugs in the least. I am just extremely wary and concerned about this pill-popping culture we've created.

If you've watched the Colbert Report, you've probably seen his bits on Prescott Pharmaceuticals. There's a reason they're so funny.

Becca said...

I certainly appreciate that no one here is trying to be judgmental of any actual individual (just hypothetical strawman individuals like "the NY society girl"). I still believe that saying things like "STOP TAKING THE PROZAC AND DO SOME GODDAMN YOGA!!!!!!! " is utterly counterproductive if minimizing suffering is accepted as a valid aim. Whether you are targeting individuals or not, you are perpetuating a very destructive and judgmental atmosphere- an atmosphere that surrounds mental health issues radically more than physical health issues; an atmosphere that discourages people from seeking help. You aren't complaining about diabetics or cancer patients. You aren't even going after what I'd term vanity pill users (that I've seen most commonly in people trying to loose weight, and some 'natural supplement' enthusiasts). You are going after people with depression and anxiety.

Even aside from that, I'm immensely skeptical of this notion of a "pill popping culture we've created". Pill popping compared to what? When people died before antibiotics? I'd say bring on the pill-popping.
Now, if you've got some cross-cultural data here (e.g. an average American is on X more prescriptions than an average Canadian or German or other Western culture), then I'll be happy to reconsider my position on this (particularly if the data break it down by type of medication use- more obesity leading to more cholesterol lowering drugs is more complicated than just a lax attitude toward drug risks).
Certainly some individuals aren't nearly as concerned about various biological effects of drugs as I am, and there are potentially some very dangerous consequences of ignoring the myriad biological effects possible with even very common or 'simple' drugs.
But I simply don't see the culture the way you do. RIOT-Is (random idiots on the internets) really don't convince me very much as evidence that Important Cultural Phenomena exist.

JLK said...

@Becca - If you reread the paragraph in question that contains the yoga comment, you'll see that I'm referring to a very specific situation. In this situation a woman is taking wellbutrin for depression. But one of the side effects of wellbutrin is anxiety (drug-induced, in other words - not mental illness), so she is taking prozac to help with that anxiety (which, by her own description was merely the "jitters," not panic attacks). But prozac takes away her sex drive and ability to orgasm, so she's complaining that there is no viagra for women.

You can repeat my own words back to me as many times as you like - drug-induced anxiety is NOT the same thing as suffering from an anxiety disorder. Someone who is diagnosed as having both depression and an anxiety disorder should most definitely be taking at least prozac, if not in combination with another medication.

But I stand by my original opinion. If sex is the most important thing, then stop taking the prozac and find another way to relieve the DRUG-INDUCED anxiety - like yoga, for example. If not getting the jitters is more important, then find some new ways to invigorate your sex life. But don't sit there waiting for a drug company to make you another magic pill.

And you're absolutely right - we're not talking about diabetes or cancer. Because most people respect the medications for conditions such as those AS medications. I've never met anyone who said "I'm feeling down. I wonder if grandpa's heart medication will make me feel better." We KNOW that most "real" drugs are dangerous, but the drugs for mental illness and pain meds are not treated the same way.

And I've been guilty of it too. If a friend comes over and is in some sort of extreme pain and nothing is helping, I'll offer a vicodin if I have some in the medicine cabinet.

But I would never give someone an Rx antibiotic or anything else I have a prescription for. I think that's weird.

You're right that I don't have cross-cultural data or any of that to back me up. I'm not even so sure that we're disagreeing, just talking about 2 different things because the tone of my post left a bad taste in your mouth from the get-go.

My point is this: Drugs that act on the brain (stimulants, depressants, anti-depressants, painkillers, etc.) are generally viewed as the latest and greatest designer drugs to hit the market. We do not have the same level of respect and caution when it comes to these drugs as we do to others. (For example, morphine and other opiates are not nearly as feared as heroin.)

I won't get into a discussion about the mind-body philosophy or any of that in this post, though I think it might play a huge part in what I'm talking about.

I just think the casual attitudes we have about these types of drugs is very dangerous.

rogny said...

Some of the striking informative tidbits associated with the anti-anxiety medication valium make it apparent that valium is a prescription-based drug for treating anxiety, it belongs to the medicine group termed as benzodiazepines and is duly approved by the FDA (Food and Drugs Administration) for treating anxiety disorders.

JLK said...

Hi Rogny, thanks for stopping by. I am aware that valium is approved for treating anxiety - heaven knows it WORKS.

But it is still one of the most highly addictive prescription drugs on the market and shouldn't be prescribed willy-nilly to anyone with a case of the jitters.

I don't know, maybe it's a New England thing as opposed to other areas of the country, but around here the only way a doctor is going to prescribe valium for long-term use is if you're under in-patient care at a mental health facility.

Clerk said...

If you are encountering consistent problems in falling asleep at night and are unable to cure your insomnia in spite of putting in your best efforts, you should soon pay a visit to the doctor. After evaluating you as a victim of the sleep disorder insomnia, the physician may prescribe sleep aid pills such as Ambien, Lunesta et al for you but to extract maximum benefits from the sleep aid pill, it is to be taken as per the instructions of the doctor. However, before you move ahead to treat your insomnia with Ambien, it would be considerably beneficial for you to obtain first hand information on Ambien from the website http://www.sleep-aid-pills.com/.

ellisbriony said...

RX drugs, also considered as prescription drugs do can put a harm over the body, if intake in an inadequate quantity. For that reason, one cannot buy these drugs without a medical prescription. Seeing the expensive prices of these drugs, some online pharmacy stores have introduced these drugs at their place at genuine prices.

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