In a new book, a local psychiatrist calls doctors in his own field "pill pushers" and says not enough is being done to treat patients with more than a prescription.
"The meds don't go far enough and people need more than just a pill," said Newburyport psychiatrist Dan Carlat.
"You automatically felt limited to 10 to 15 minutes. So you get your medication and you run out," said Claudia, who went through nearly a half dozen psychiatrists in five years.
"They would push it on me and I wouldn't want to be on it," she said.
Claudia said she wanted more from her doctor, and found it in Carlat.
In his new book "Unhinged", Carlat argues most doctors in his profession have given up talk therapy in favor of the more lucrative drug therapy.
"We're pill pushers," Carlat said. "Insurance companies reimburse us more for pyscho-pharmacology visits than for therapy visits. So if I can fit 3 or 4 patients in an hour for psycho-pharm or med visits I'm going to make twice as much as I would make if I were seeing them for therapy."
In his controversial blog, Carlat has long criticized the influence big drug companies have over what psychiatrists prescribe.
"Drug reps will come in and give you your favorite latte. They'll give staff sandwiches. It's not like they're bribing us to give that medication. It just causes that particular brand to be uppermost in our mind," said Carlat.
Carlat said most psychiatrists don't know nearly enough about the medications they prescribe.
"We don't really know what the medications do," said Carlat. "We often talk about neuro-transmitters like serotonin and noroepharin. But that really ends up being neurobabble. It sounds impressive to patients and it makes them think we know what we're doing when we're prescribing the medications. But we don't really know how these meds work."
Side effects, said Carlat, can be serious or in some cases, unknown.
"We don't know enough about the side effects to know how many people we're putting at risk."
Carlat said he's also concerned about over-diagnosis, particularly with children. He pointed to the case of Rebecca Riley, the Southshore girl who was diagnosed with bipolar disorder before the age of 4.
"Ten years ago versus now, the rates of bipolar disorder diagnosis in children hasn't just doubled or tripled. It's gone up 40 fold, 8,000 percent."
But many in the psychiatry field take issue with Carlat's claims.
"Many people go without meds who could benefit from them," said Dr. Don Condie, of the Massachusetts Psychiatric Society.
"I think that's a bigger problem than people getting too many medications," he said.
Carlat said patients need well-trained psychiatrists who offer a range of support, and need to get to know their patients more
"I hope we're getting away from the idea that we can solve complex life problems purely with medications because obviously we can't. Patients need more than that," Carlat said.
http://www.thebostonchannel.com/health/23557552/detail.html
