Melissa Raven

38.8K posts

Melissa Raven

Melissa Raven

@psychepi

Psychiatric epidemiologist policy analyst Critic of dodgy claims/bandwagons/propaganda/conflicts of interest. JSBachtragic Klavierschülerin Ambulophile Aviphile

Beigetreten Eylül 2011
5K Folgt2.4K Follower
Melissa Raven retweetet
Medicating Normal
Medicating Normal@MedicatingNorm1·
Overdiagnosing allows for Rx-ing of antipsychotics which makes the dementia patients "easier to manage." As even more incentive to overdiagnose, residents on antipsychotics w/ a schizophrenia diagnosis are not counted toward the CMS quality measure which can improve the facility's star rating. medpagetoday.com/geriatrics/dem…
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Justin Garson
Justin Garson@justin_garson·
This is sad but unsurprising. Antipsychotic drugs were created in the 1950s not to heal, but to manage unruly patients. They were called a “chemical lobotomy”. That logic persists today.
The Washington Post@washingtonpost

U.S. nursing homes are fabricating schizophrenia diagnoses to hide their use of dangerous antipsychotic drugs to subdue dementia patients, a government watchdog report found. The drugs increase risk of falls, strokes and death. wapo.st/4tfSUsr

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Nicolas Badre
Nicolas Badre@BadreNicolas·
Psychiatrists should be more transparent that antipsychotics are frequently used for behavioral management rather than to treat or cure an underlying disease. By implying that an antipsychotic fundamentally “treats” psychosis rather than acknowledging that it bluntly blocks dopamine receptors, we have created a catch-22. It is not surprising that individuals are rightfully upset when these medications are prescribed in what appear to be alternative or off-label ways. I suspect that if the field had been more honest, it wouldn’t seem like such a leap to use antipsychotics to address agitation in other situations. This means acknowledging that a significant reason we use them in schizophrenia is to manage the severe agitation that often accompanies the condition, rather than to “cure” it. This transparency, however, does not negate the very real problems associated with their use. Antipsychotics are at times inappropriately prescribed merely for the convenience of overburdened staff in inadequate facilities. Yet this is not always the case. Even in well-run facilities or homes with particularly caring family members, all involved often reach the difficult conclusion that antipsychotics genuinely improve the patient’s living conditions. When accompanied by thorough informed consent, these medications can sometimes be a tool that allows a patient to safely remain at home longer. How, then, does one differentiate the well-intended use of antipsychotics as a compassionate last resort from their lazy use for convenience? Not easily. Failures such as lack of informed consent, erroneous diagnoses, chronic understaffing, and poor clinical evaluation make inappropriate use easier to identify. The WSJ is right to point out these failings. However, the broader public conversation about the role of these medications needs to be more honest and nuanced. For context, people should revisit the landmark case of Clites v. Iowa (1982). Timothy Clites, an 18-year-old with developmental delays, was committed to a state hospital. There, he was prescribed antipsychotics specifically to manage behavioral disturbances stemming from his developmental delay, rather than for psychosis. His medical care was particularly poor, exemplified by the fact that he was not seen by a physician for three entire years. After Clites developed severe and permanent side effects from the antipsychotics (tardive dyskinesia), his father sued the state. The court ultimately found that the hospital failed to meet the standard of care because it used the medications not for the patient’s benefit, but for institutional convenience.
The Washington Post@washingtonpost

U.S. nursing homes are fabricating schizophrenia diagnoses to hide their use of dangerous antipsychotic drugs to subdue dementia patients, a government watchdog report found. The drugs increase risk of falls, strokes and death. wapo.st/4tfSUsr

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Kim Witczak 💜
Kim Witczak 💜@woodymatters·
Antipsychotics carry a black box warning for increased death in elderly dementia patients. Yet they are still widely used in nursing homes, often for staff convenience, not patient care. The government tried to curb this use. CMS quality measures exclude residents labeled with schizophrenia. Now suddenly schizophrenia diagnoses are rising in this population. Coincidence? 🤔
The Washington Post@washingtonpost

U.S. nursing homes are fabricating schizophrenia diagnoses to hide their use of dangerous antipsychotic drugs to subdue dementia patients, a government watchdog report found. The drugs increase risk of falls, strokes and death. wapo.st/4tfSUsr

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Cooper Davis
Cooper Davis@Cooperdavis·
There’s no possible way anyone would ever be motivated to diagnose someone with something just because they are motivated to medicate someone with something, is there?
The Washington Post@washingtonpost

U.S. nursing homes are fabricating schizophrenia diagnoses to hide their use of dangerous antipsychotic drugs to subdue dementia patients, a government watchdog report found. The drugs increase risk of falls, strokes and death. wapo.st/4tfSUsr

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Nick Taber
Nick Taber@NickTaber·
The dangers of antipsychotics aren't a priority because they're largely used for populations that have little voice and society wants to control and forget about: the elderly, foster children, the poor, scapegoat children in toxic families, etc.
Dr. Anna MD “In My Opinion”@drannamedical

@NickTaber I don’t believe the general public understands the dangers of these drugs

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The Washington Post
The Washington Post@washingtonpost·
U.S. nursing homes are fabricating schizophrenia diagnoses to hide their use of dangerous antipsychotic drugs to subdue dementia patients, a government watchdog report found. The drugs increase risk of falls, strokes and death. wapo.st/4tfSUsr
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Adam Urato, MD
Adam Urato, MD@AdamUrato1·
New Study: SSRI/SNRIs linked to ⬆️ hemorrhage & blood transfusion with shoulder surgery. Risks were more than doubled. These drugs significantly increase a patient's hemorrhage risk. "[SSRI/SNRIs] have been associated with significant adverse reactions, the most pertinent of which are adverse bleeding events." link.springer.com/article/10.100…
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Benjamin Ryan
Benjamin Ryan@benryanwriter·
News study finds that for all their hype, psychedelics don't beat antidepressants "These results argue against highly optimistic narratives surrounding [psychedelic-assisted therapy] and highlight the importance of blinding integrity."
Benjamin Ryan tweet media
Benjamin Ryan@benryanwriter

Are psychedelics better than antidepressants? New study says no eurekalert.org/news-releases/… jamanetwork.com/journals/jamap… With an innovative approach, scientists try to get around the problem of participant expectation in tests of psychedelics. Psychedelic-assisted therapy may be no more effective than traditional antidepressants when patients know what drugs they are actually taking, according to a first-of-its kind analysis that compared how well each type of drug worked for major depression. Psychedelic-assisted therapy has resisted placebo-controlled testing methods — the gold standard in clinical trial design. Due to their powerful subjective effects, nearly everyone in the trial knows whether they received a psychedelic or the placebo even if they are not told. But in trials of antidepressants, participants may not figure out whether they have received the drug or a placebo, which makes it hard to compare them with psychedelics. To get around this problem, researchers from UC San Francisco, UCLA, and Imperial College, London tried a different approach. They compared the results from psychedelic therapy trials to the results from so-called open-label trials of traditional antidepressants, in which the participants all knew they were getting an antidepressant. That way, both treatments benefitted equally from the positive effect of patients knowing that they were being given a drug instead of a placebo. The findings both surprised and disappointed them: there was virtually no difference. “Unblinding is the defining methodological problem of psychedelic trials. What I wanted to show is that even if you compare psychedelics to open-label antidepressants, psychedelics are still much better,” said Balázs Szigeti, PhD, a clinical data scientist at UCSF’s Translational Psychedelic Research Program, who led the study. “Unfortunately, what we got is the opposite result — that they are the same, which is very surprising given the enthusiasm around psychedelics and mental health.” Szigeti is the co-first author of the paper with Zachary J. Williams, MD, PhD, of UCLA; Hannah Barnett, MSc, of Imperial College, London is also an author. The study appeared March 18 in JAMA Psychiatry.

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Emediong TG
Emediong TG@EmediongTG·
@omgsidewalks Financial stability is the cheapest therapy. When you take away the fear of not paying rent, 80% of the anxiety usually vanishes.
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‏ً
‏ً@omgsidewalks·
A lot of "mental health issues" disappear when bills are paid, rent is secure, and the fridge is full. Peace is expensive. And pretending money doesn't affect mental health is privilege.
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Melissa Raven
Melissa Raven@psychepi·
@ClinicalReality That attitude is a major reason why so many people are seriously harmed by antidepressants etc. - psychiatrists not only not listening to patients, but also saying that people shouldn't listen to patients. #SSRIs #gaslighting
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Clinical Reality
Clinical Reality@ClinicalReality·
I don’t know who needs to hear this, but the only person you should listen to about SSRIs or any other psychiatric medication is a psychiatrist. Seeing far too much misinformation being shared on X by psychologists, therapists, and other randoms with no knowledge of psychopharmacology.
GIF
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Prof. Peter C Gøtzsche
There is no serious danger of leaving depression in pregnant women untreated with antidepressants. Absolutely none. The clinical effect is far below what is clinically relevant and the drugs double suicides and have many other serious harms. It is naive to think that clinicians can weigh benefits and harms. If they did, no one would use antidepressants.
Clinical Reality@ClinicalReality

@PGtzsche1 Medication decisions in pregnancy are rarely simple—untreated severe depression or suicidality in a mother carries real risks too, which is why clinicians usually weigh the potential medication risks against the dangers of leaving serious illness untreated.

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Prof. Peter C Gøtzsche
Adverse drug events are a major killer but the US has no national strategy. American Society of Pharmacovigilance convenes national leaders for Medication Safety Policy Roundtable in Washington, D.C. on March 24. See press release: bit.ly/4cT8jdd. Members of the public may register to watch the livestream at: thirdcause.eventbrite.com
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PSSD Institute
PSSD Institute@PSSDInstitute·
In a letter published in Innovations in Clinical Neuroscience (@Innov_Clin_Neur), neurologist Dr Rocco Salvatore Calabrò (@IrccsMe) discusses reports of enduring sexual difficulties and the severe impact on relationships and quality of life for people with #PSSD. Calabrò emphasises the need for healthcare providers to recognize PSSD, and calls for further research to support treatments that could alleviate the burden of this debilitating condition. Read the letter: innovationscns.com/letters-to-the…
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Daniel Owens
Daniel Owens@dsowens17·
Overmedication is part of the business model. It’s striking to see the difference between how GLP-1 drugs are discussed by medical professionals and how they are described in the financial press. They are talking about the same drugs, but they sound like two completely different realities.
Daniel Owens tweet media
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Daniel Owens
Daniel Owens@dsowens17·
If you have PSSD please consider responding to this post.
PSSD Institute@PSSDInstitute

First realising you have #PSSD can be really tough. Due to limited recognition, many are left to navigate their symptoms in isolation. People with PSSD often learn about their symptoms online, eventually finding support through virtual communities. If you could give one piece of advice to someone discovering PSSD for the first time, what would it be? What do you wish you had been told when you first discovered it? Share your thoughts ⬇️

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Daniel Owens
Daniel Owens@dsowens17·
Anyone who smugly repeats “the plural of anecdotes is not data” misunderstands how drug safety monitoring actually works. A large number of similar reports is observational data. In pharmacovigilance these patterns create safety signals that trigger further investigation. If you dismiss patient reports as “just anecdotes”, you eliminate the very signals that are supposed to prompt formal research into causality. This is scientifcally illiterate.
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Dr James Davies (PhD) 💭
Dr James Davies (PhD) 💭@JDaviesPhD·
In case you didn't know, GSK withheld data linking its antidepressant, Paxil, to baby heart defects during early pregnancy. The company only added label warnings after lawsuits forced such disclosure. GSK later paid over $1B to settle birth defect claims. schmidtlaw.com/paxil-class-ac…
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