Rob Purssey

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Rob Purssey

Rob Purssey

@RPurssey

Psychiatrist, ACT therapist, psychopharm expert. Brisbane ACT Centre. Co-author Learning ACT: Essential Guide Mindful Psychiatry. Am Psychiatric Assoc Pub. 2020

Milton, Brisbane, Queensland Katılım Temmuz 2014
612 Takip Edilen816 Takipçiler
Rob Purssey retweetledi
Dr Joanna Moncrieff
Dr Joanna Moncrieff@joannamoncrieff·
The psychiatric establishment is reluctantly and belatedly acknowledging the overprescribing of psychiatric medications and need to help people get off them in order to salvage its reputation.
Laura Delano@LauraDelano

The @nytimes ran a piece this morning on the psychiatric profession’s effort to take control of the conversation around “deprescribing” as attention grows under Secretary Kennedy and MAHA. On its surface, the new ASCP guidance reflects the work of psychiatrists who, I have no doubt, care deeply about their patients and are genuinely trying to improve practice. But it’s also a long overdue acknowledgment of something patients themselves forced into the open years ago, after being told their withdrawal was “relapse” and kept on medications without meaningful review. So many of us were cycling through prescriptions without anyone seriously asking whether we still needed them, or how to safely come off. Now the field is stepping in to define deprescribing for itself, at the same moment political pressure is forcing the issue into the mainstream. I keep coming back to the way that slow tapering is framed as “unscientific” in this article, and the dangerous suggestion that some long half-life drugs like Prozac can be stopped abruptly because they “auto-taper.” That view does not reflect what many patients have lived through. It’s also not what’s reflected in the hyperbolic tapering methods patients developed on their own, after being left without clinical guidance and finding each other instead

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Moral Medicine
Moral Medicine@MoralMedicine·
One of the key points I emphasized during my presentation at the PSSD, PFS, and PAS World Congress was the overlooked physical dimension of these conditions. Much of the conversation has historically focused on sexual and neurological symptoms, but many patients report significant structural and systemic changes, including facial changes, muscle loss, lipoatrophy, joint issues, gastrointestinal problems, the development of osteoporosis, etc. In some cases, these presentations resemble a profound disruption of endocrine function. Whether or not we fully understand the mechanisms yet, the consistency of these reports across independent patients makes this a critical area that deserves far more attention. This perspective seemed to resonate with those in attendance, which is encouraging, because this symptom profile is not only under-discussed, it can be among the most physically and psychologically devastating aspects of these conditions.
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Laura Delano
Laura Delano@LauraDelano·
We current and former patients have long figured out the safest psychiatric drug tapering methods that enable most people, most often, to have the greatest chances at successfully getting off their meds when that's what they want. The psychiatric profession may no longer be able to ignore the topic of deprescribing, but that doesn't change who the world's leading experts on the matter are. My hope is that those prescribers feeling threatened by layperson expertise recognize that we are actually here to help you help your patients better. The door is open to collaboration and partnership. We welcome you to come learn from us 🕊️
Inner Compass Initiative@_innercompass

🧵We read today’s New York Times article and we are glad to be mentioned alongside Surviving Antidepressants as one of the patient-led groups that have long supported people through tapering psychiatric drugs. 1/

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MISSD
MISSD@MISSDFoundation·
Akathisia is often misdiagnosed—and patients aren’t clearly warned. The consequences can be severe. Healthcare consumers deserve better drug risk disclosure. Clinicians need greater awareness. einpresswire.com/article/909351…
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Outro Health
Outro Health@outrohealth·
The psychiatric system is finally catching up. The New York Times reports that top US psychiatrists are now developing formal guidance for safely coming off antidepressants, something Outro has been doing all along. Read the full article via the link in our bio! @markhoro
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Mark Horowitz @markhoro.bsky.social
The consensus statement this @nytimes article is based on is full of minimisation+denial and psychiatrists continue to insist withdrawal does not undermine evidence for l-t medication (when it clearly does) but at least this topic is being talked about.
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Mikhaila Peterson
Mikhaila Peterson@MikhailaFuller·
This is why I’m going to be jumping up and down about akathisia. It isn’t just my dad. It wasn’t just me. It’s going to impact an unbelievable number of people if tapering guidelines aren’t changed. It already is. They just have no voice, they’re too hurt.
Brandon's Health Journey@BrandonJourney2

Listen, I'm bad at math, didn't look at all the studies to come to a complete conclusion because I'm still struggling with my health, but know some publications stTe roughly 30%+ people that take SSRIs will develop Akathisia. If Gemini is right about this Akathisia data... Then we Americans are indeed looking at a national emergency. I'm going to ask Grok next in the comments below 👇.

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Mikhaila Peterson
Mikhaila Peterson@MikhailaFuller·
There are a ton of extremely well written stories like this on prescribed-harm.com now. I’m uploading another bunch today. People who took meds as prescribed who eventually got much much much worse. These aren’t rare side effects.
Sam Hall@samhall404

1/ Thanks to @MikhailaFuller for allowing me to share my story. 🧵 My experience sits in the uncomfortable space between what patients are routinely told about antidepressants and what can, in many cases, actually unfold over time. It is not simply a story of adverse effects, it is a story about the consequences of incomplete information, overconfidence in simplified narratives and a medical culture that too often defaults to explanation rather than investigation when things go wrong. I was prescribed the antidepressant Sertraline for situational panic attacks following a house fire when I was younger and remained on it for approximately 13 years. During that time, I was never meaningfully informed about the possibility of physiological dependence, nor about the potential difficulty of stopping the drug after long term use. The phrase “safe and effective” was presented as if it were a stable, universal truth, rather than a context dependent conclusion drawn from limited and biased data. There was no discussion of what happens when the brain adapts to a drug over more than a decade. No acknowledgement that removing that drug might not be a neutral act. No mention of protracted withdrawal or that stopping could result in a severe and prolonged destabilisation of the nervous system. Informed consent, in any meaningful sense, was absent. When I eventually came off the SSRI, it was done through a rapid doctor led taper that bore no relation to the duration of my use. What followed was not a return of my original symptoms, but the onset of something far more severe, complex, disabling and life changing. Almost immediately, I began to experience intense and persistent surges of physiological anxiety and panic. These were not thoughts or worries in the conventional sense. They were full body events; overwhelming waves of adrenaline that arose without psychological trigger, accompanied by a profound sense of internal threat. They were not responsive to reasoning, reassurance or standard psychological strategies because they were not primarily psychological in origin. Alongside this, I developed widespread neurological and sensory disturbances. I experienced constant “electric” sensations throughout my body, moving unpredictably through my arms, legs, hands and across my head and face. These were often painful, presenting as burning, tingling or sharp nerve like sensations. My muscles began to twitch involuntarily, with fasciculations and spasms becoming a daily occurrence. At times, my facial muscles would contract and twitch without warning. One of the most severe and distressing symptoms I experienced was akathisia. It is often described clinically as restlessness, but that description is profoundly inadequate. What I experienced was an intense, unrelenting inner agitation combined with a powerful urge to escape my own body, alongside a compulsion to move that made stillness feel intolerable. At its worst, it generated intense suicidal urges, not from hopelessness, but from a desperate need to escape the sensation itself. It was not psychological distress in any conventional sense, it was a physical state that overrode any attempt at control. It is difficult to overstate how severe and destabilising this symptom has been for three years. Sleep became almost impossible at times. I went through prolonged periods of insomnia, sometimes sleeping only three hours across several days. When I did manage to fall asleep, I was frequently jolted awake by hypnic jerks; sudden, violent awakenings accompanied by adrenaline surges. The cumulative effect of this sleep deprivation was profound, amplifying every other symptom and eroding my ability to cope. Cognitively, I experienced significant impairment. I developed … prescribed-harm.com/stories/story-…

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Sam Hall
Sam Hall@samhall404·
1/ Thanks to @MikhailaFuller for allowing me to share my story. 🧵 My experience sits in the uncomfortable space between what patients are routinely told about antidepressants and what can, in many cases, actually unfold over time. It is not simply a story of adverse effects, it is a story about the consequences of incomplete information, overconfidence in simplified narratives and a medical culture that too often defaults to explanation rather than investigation when things go wrong. I was prescribed the antidepressant Sertraline for situational panic attacks following a house fire when I was younger and remained on it for approximately 13 years. During that time, I was never meaningfully informed about the possibility of physiological dependence, nor about the potential difficulty of stopping the drug after long term use. The phrase “safe and effective” was presented as if it were a stable, universal truth, rather than a context dependent conclusion drawn from limited and biased data. There was no discussion of what happens when the brain adapts to a drug over more than a decade. No acknowledgement that removing that drug might not be a neutral act. No mention of protracted withdrawal or that stopping could result in a severe and prolonged destabilisation of the nervous system. Informed consent, in any meaningful sense, was absent. When I eventually came off the SSRI, it was done through a rapid doctor led taper that bore no relation to the duration of my use. What followed was not a return of my original symptoms, but the onset of something far more severe, complex, disabling and life changing. Almost immediately, I began to experience intense and persistent surges of physiological anxiety and panic. These were not thoughts or worries in the conventional sense. They were full body events; overwhelming waves of adrenaline that arose without psychological trigger, accompanied by a profound sense of internal threat. They were not responsive to reasoning, reassurance or standard psychological strategies because they were not primarily psychological in origin. Alongside this, I developed widespread neurological and sensory disturbances. I experienced constant “electric” sensations throughout my body, moving unpredictably through my arms, legs, hands and across my head and face. These were often painful, presenting as burning, tingling or sharp nerve like sensations. My muscles began to twitch involuntarily, with fasciculations and spasms becoming a daily occurrence. At times, my facial muscles would contract and twitch without warning. One of the most severe and distressing symptoms I experienced was akathisia. It is often described clinically as restlessness, but that description is profoundly inadequate. What I experienced was an intense, unrelenting inner agitation combined with a powerful urge to escape my own body, alongside a compulsion to move that made stillness feel intolerable. At its worst, it generated intense suicidal urges, not from hopelessness, but from a desperate need to escape the sensation itself. It was not psychological distress in any conventional sense, it was a physical state that overrode any attempt at control. It is difficult to overstate how severe and destabilising this symptom has been for three years. Sleep became almost impossible at times. I went through prolonged periods of insomnia, sometimes sleeping only three hours across several days. When I did manage to fall asleep, I was frequently jolted awake by hypnic jerks; sudden, violent awakenings accompanied by adrenaline surges. The cumulative effect of this sleep deprivation was profound, amplifying every other symptom and eroding my ability to cope. Cognitively, I experienced significant impairment. I developed … prescribed-harm.com/stories/story-…
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Adam Urato, MD
Adam Urato, MD@AdamUrato1·
SSRIs are clearly associated with postpartum hemorrhage & other types of bleeding. SSRIs have a profound chemical impact on platelets - reducing platelet serotonin levels by 14-fold in this study: journals.sagepub.com/doi/10.1177/00…
Steve Garthwaite@stevegarthwaite

@TheSalonDon FWIW, my cousin was on Zoloft and had excessive bleeding post delivery that almost killed her. It was a known risk and she didn’t know.

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Cato Institute
Cato Institute@CatoInstitute·
Rising psychiatric diagnoses may say more about a broken incentive system than about Americans' actual mental health. When clinicians are rewarded for diagnosing more, not diagnosing well, the result is runaway spending with no way to measure real outcomes, argues Cato’s Adam Omary. Learn more: ow.ly/c5mc50YRJHP
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FICEBO
FICEBO@ficebo·
The final 10-year results of the FIDELITY trial are now out, published in @NEJM You can find the full article through the link in the comments. #FIDELITY #NEJM #MedicalResearch
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Antidepressant Risks
Antidepressant Risks@antideprisks·
Fifty percent of 15-19 year olds in the UK have been diagnosed with a ‘mental illness’. The number is set to rise to two thirds by 2030. We are pathologising normal human experience, and burdening our young people with diagnostic identities that erode their sense of autonomy and resilience. telegraph.co.uk/business/2026/…
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Inner Compass Initiative
Inner Compass Initiative@_innercompass·
“Nobody told me that these drugs can cause serious physical health problems.” “Disable sexual function.” “Worsen emotional distress and cognition.” “And in some cases, increase suicidal thoughts.” This shocking testimony will change your entire perspective on the “mental health crisis.” Laura Delano was diagnosed with bipolar disorder at age 13. She was told she would need meds for the rest of her life. From that point on, her list of diagnoses grew longer and longer. “2 meds became 3, 4, 5.” But her life didn’t improve. In fact, the exact opposite happened. “My life unraveled.” “I gained 70 pounds.” “Developed chronic health issues.” “Was constantly exhausted.” “And became increasingly anxious and suicidal.” “Nobody told me that the medications I’d been on for years were approved by the FDA based on clinical trials lasting, on average, 6-12 weeks.” “Or that the safety and efficacy of taking multiple psychiatric drugs at once has never been properly established.” “Nobody told me that what I experienced whenever I missed a dose or tried to stop a med was withdrawal symptoms—not a return of an underlying condition.” Her terrible experience with the mental health industry drove her to a suicide attempt. Then, she questioned everything she thought she knew about the “mental health crisis” in America. “23.4% of American adults, 61.5 million people, have a psychiatric diagnosis, including 1 in 3 young adults.” “Suicide rates in adults increased 35% from 1999 to 2018.” “From 2007 to 2021, the suicide rate among youth aged 10 to 24 increased by 62%.” “The suicide rate among children ages 10 to 14, more than tripled from 2007 to 2018.” “In 2023, nearly 50,000 Americans died by suicide, the highest number ever recorded.” “At the same time… more Americans than ever are receiving mental health treatment.” “Approximately 61 million adults and 4 million adolescents are now taking psychiatric medications.” “The financial costs are staggering.” “In 2023 alone, Medicare and Medicaid combined spent $36.6 billion on psychiatric drugs.” “That’s $335 billion over the past decade—with no measurable population-level improvement in mental health.” “What if our nation’s mental health crisis is in significant part a crisis of unintended consequences of treatment-caused harm misread as illness, generating more treatment, more disability, and more despair?” Now, countless victims of this crisis of over-medicalization are coming forward to reveal that nobody told them about the harms of psychiatric medication. And if you have your own experience dealing with this crisis, we want to hear your story, too. You are not alone. Follow @_innercompass
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@samizdathealth
@samizdathealth@DrDavidHealy·
Last week in Detroit a meeting was held aimed at tackling & solving the enduring sexual problems linked to Isotretinoin, SSRIs & Finasteride. We need your help- volunteers for a genome screening that could help shed light on our sexualities & identities. davidhealy.org/calling-isotre…
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Joe Tudor
Joe Tudor@JoeTudor_·
My podcast is finally out (only took me 4 years). I've tried to create epsiodes that would have helped me at my lowest point. Episode 1 and 2 are out with James Scurry and @_AndersSorensen ! Available on YouTube, Apple Podcasts & Spotify: linktr.ee/joetudor
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Toby Rogers
Toby Rogers@uTobian·
Croen et al. (2011) ‘found a two-fold increased risk of ASD associated with treatment with SSRIs by the mother during the year before delivery (adjusted odds ratio = 2.2; CI: 1.2, 4.3)’ (p. 1104). They also found a more than three-fold increased risk of ASD with treatment with SSRIs during the first trimester (aOR = 3.8; CI: 1.8, 7.8) (Croen et al., 2011, p. 1104). ‘No increase in risk was found for mothers with a history of mental health treatment in the absence of prenatal exposure to SSRIs’ (Croen et al., 2011, p. 1104).
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