Posted by bleauberry on December 9, 2009, at 17:21:52
In reply to Adolescent Readmission Rate Linked To Polypharmacy, posted by Phillipa on December 8, 2009, at 21:21:02
Well, not popular or even thought of by many, but I happen to believe the adolescent brain is not all that different than the adult brain. Different yes, but not that different. Not enough different to have a black box warning only for adolescents but not for adults.
It's a pharmaceutical industry political thing that has spun the story the way it is. Reality is, it happens across all age groups. It's not as if the brain magically changes stature at age 18 or whatever. For some, it might be age 8, for others, age 12, for others, age 21, for others age 35, and so on. To try to say that all people's brains follow a definable pattern on a reliable timeframe is ludicracy as I see it.
Just thinking back on the people in the worst condition here at pbabble over the last 12 or 15 years I've been hanging out here, they all had pretty much one thing in common...out-of-control polypharmacy of at least 3 drugs but sometimes more, sometimes up to 7. The ones that seemed to get people in deep water that was hard to get out of were the mood stabilizers, antipsychotics, and designer off-label drugs. That said, an antipsychotic was pretty good to me for a number of years...though I regret it now. Generally speaking of course.
Likewise, the longterm sufferers who ended up with happy endings did so usually with 1 to 3 med combos, usually just 2. The STAR*D program also achieved high remission rates with just 2 meds.
When I see people pile one new med on top of several that already are not working, if you could see my face, you would see a grimace and a worry.
My realistic logic says polypharmacy for anyone should be approached with respect, and a continual weeding process that removes the underperformers or the ones that cause deterioration before the situation gets bad enough for a so-called readmission.
The readmission in my opinion is not the patient's fault, not the disease's fault, and not the medicine's fault. It is the fault of poor medication choice and poor medication management combined for a knockout punch. It was the doctor's fault. They were the ones in charge of the whole mess, from beginning to readmission.
poster:bleauberry
thread:928572
URL: http://www.dr-bob.org/babble/20091206/msgs/928666.html