According to a study in the Journal of Clinical Psychiatry (1), 69 percent of patients that were prescribed antidepressant medications never met the diagnostic criteria for major depressive disorder (MDD). An additional 38 percent also didn't meet the criteria for obsessive-compulsive disorder, panic disorder, social phobia, or generalized anxiety disorder which are sometimes treated with antidepressant medications.
According to psychiatrist Julie Holland (2): At least one in four women in America now takes a psychiatric medication, compared with one in seven men. Women are nearly twice as likely to receive a diagnosis of depression or anxiety disorder than men are. For many women, these drugs greatly improve their lives. But for others they aren’t necessary. The increase in prescriptions for psychiatric medications, often by doctors in other specialties, is creating a new normal, encouraging more women to seek chemical assistance. Whether a woman needs these drugs should be a medical decision, not a response to peer pressure and consumerism. If you are dealing with anxiety or depression-like symptoms I think it is important to consider all your options. Sometimes jumping to a medication may be easier but it may not always be the right choice and all medications have side effects. In many cases cognitive behavioral therapy from a competent psychologist can be as effective as medications and may help patients make lasting changes in their lives. Of course, each individual case is different and the advice in this post should not substitute for getting a consultation with your doctor. Let me know what you think in the comments below. Visit the home page for more information on Murdock Health and our services. References: 1. Yoichiro Takayanagi, MD, PhD; Adam P. Spira, PhD, et. al. Antidepressant Use and Lifetime History of Mental Disorders in a Community Sample: Results From the Baltimore Epidemiologic Catchment Area Study. J Clin Psychiatry 2015;76(1):40–44 10.4088/JCP.13m08824. 2. Holland, Julie. Medicating Women's Feelings. New York Times. http://www.nytimes.com/2015/03/01/opinion/sunday/medicating-womens-feelings.html?_r=0. Published Feb. 28, 2015. Accessed 10/26/2015.
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"Doc, I think I have a sinus infection and need an antibiotic."
This is an example of one of the most common comments that I encounter when I go into a patient room. The truth is that this patient scenario is also one of the most frustrating types of visits that I have as a physician. I want to do the right thing for the patient but often their mind is already made up about what they have and what treatment they need before I enter the room. What does the current evidence tell us about sinus infections? First of all I find that there tends to be a lot of confusion about what a sinus infection is. Many patients equate sinus pressure with being synonymous with a sinus infection. Sinus pressure or inflammation of the sinuses (Sinusitis) can actually be caused by many things. These include viruses, allergies, and bacteria. The most common cause is a viral infection associated with the common cold. Bacterial sinusitis, which is treated with antibiotics, complicates viral sinusitis in only about 0.5 to 2 percent of cases. (1) This means that the vast majority of patients that present with a "sinus infection" should not be treated with antibiotics. So how do we determine if someone has bacterial sinusitis which can be treated with antibiotics. The Infectious Disease Society of America suggests the following three criteria (2):
The bottom line is that a sinus infection doesn't necessarily mean antibiotics. Of course, each individual case is different and the advice in this post should not substitute for getting a consultation with your doctor. Let me know what you think in the comments below. To learn more about Murdock Health and what we can do for you visit our Benefits or Services page. References: 1. Fokkens W, Lund V, Mullol J, European Position Paper on Rhinosinusitis and Nasal Polyps Group. EP3OS 2007: European position paper on rhinosinusitis and nasal polyps 2007. A summary for otorhinolaryngologists. Rhinology 2007; 45:97. 2. Chow AW, Benninger MS, Brook I, et al. IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clin Infect Dis 2012; 54:e72. |
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