Interesting info on anti depressants

[DrDavid]

Agree 100%. For every great psychiatrist, there are about 100 terrible ones who will see you for a few minutes, prescribe random things, and follow up in 3 months. It's partly an artifact of managed care on cutting re-imbursement so that seeing folks for 30-45 minutes is not sustainable financially, but also laziness and unethical practice on the docs' parts.

The sad fact is that SOME of these extremely heinous crimes are simply not preventable. We can take measures to reduce risk, but every single one of us is capable of horrific things. In terms of neurobiology, it's a complicated issue that will likely bore most folks to tears, but suffice it to say, we humans are not nearly as civilized as we think ourselves to be. If it weren't for our frontal lobes, we would be looking up at chimpanzee's for education on how to behave.

DRDavid -

While I agree with your statement "when used appropriately" - can you not agree, as I've seen as an EMT, that when not used appropriately or when not constantly monitored by a doctor, that a disasterous result may ensue?

I ask with all due respect because I suspect some in your profession, like all professions, lack the ability or desire to follow up on treatment regimens as to their success for each individual patient.

 

[DrDavid]

The question is: what was the original problem in those killers? Was it an actual psychosis (which, BTW, is treated with anti-psychotics, not anti-depressants)? Was it an actual clinical depression? Was it a bipolar disorder? Or was it a standard popular complaint of feeling blue and being over stressed, which does not necessarily means a psychiatric condition?

Most violent acts are in the immediate moment a result of impuslivity. Risk factors for that involve genetics, ADHD, Bipolar Disorder, substance abuse, and certain personality disorders. I often would ask myself who is more mentally ill? A person suffering from schizophrenia qith fixed delusions who kills a person because he thinks they are trying to read their thoughts and sell them to the devil, or someone like the Iceman: a mafia hitman who killed over 40 people yet would go tuck his children in at night and get in bed with his wife.

My point is that the human condition is more vast than most of us can fathom. Our brains have evolved over millions of years and everything is there for a reason. Certain abberations can and do happen in nature. We have sadly seen the results of these recently. If it wasn't with firearms, it would be with other means.

 

[M1911]

Most violent acts are in the immediate moment a result of impuslivity.

Most of these mass murders were not impulsive acts. Klebold and Harris planned their attack for a year. The Aurora shooter booby-trapped his apartment with more than 30 home-made explosive devices. In the Virginia Tech shooting, the shooter chained shut doors to the building so that his victims would be unable to escape.

These mass murderers aren't sane people who just snap. They plan their attacks, maybe for days, weeks, months, or even more than a year.

I'm sorry but I don't believe the suggestion that a sane person, not suffering from depression, is turned into a homicidal maniac when prescribed anti-depressants. And these killers were not described by their peers as sane. People who knew them knew that they were several bottles short of a six-pack.

 

[Garys]

The ironic thing about anti depressants is that often when people start taking them they are so depressed that they can't function at all. Which is what causes them to go to the doctor. After they get on the medications their depression starts to lift and they get some amount of ambition. Unfortunately sometimes they get enough ambition to kill themselves or possibly others. Which is why people on anti depressants need to be watched closely by the prescribing physician. As someone else said in this thread, correlation does not necessarily equal causation.

 

[DrDavid]

The ironic thing about anti depressants is that often when people start taking them they are so depressed that they can't function at all. Which is what causes them to go to the doctor. After they get on the medications their depression starts to lift and they get some amount of ambition. Unfortunately sometimes they get enough ambition to kill themselves or possibly others. Which is why people on anti depressants need to be watched closely by the prescribing physician. As someone else said in this thread, correlation does not necessarily equal causation.

This is absolutely correct. Close monitoring is needed with all medicines and the fact that the majority of antidepressant prescriptions are provided by non-psychiatrists lends to less than ideal follow up.

 

[DrDavid]

Most of these mass murders were not impulsive acts. Klebold and Harris planned their attack for a year. The Aurora shooter booby-trapped his apartment with more than 30 home-made explosive devices. In the Virginia Tech shooting, the shooter chained shut doors to the building so that his victims would be unable to escape.

These mass murderers aren't sane people who just snap. They plan their attacks, maybe for days, weeks, months, or even more than a year.

I'm sorry but I don't believe the suggestion that a sane person, not suffering from depression, is turned into a homicidal maniac when prescribed anti-depressants. And these killers were not described by their peers as sane. People who knew them knew that they were several bottles short of a six-pack.

My wording was less than ideal. What I meant by "most violent acts" excluded these horrific mass murders. I meant simple assaults, single homicides and suicides. You are absolutely correct that the incidents you referred to were pre-meditated by insane individuals. I'm not a forensic specialist, but there is literature that is very accessible describing what psychopathology is involved in murderers like this.

I do believe that in general, society has become too complacent and "accepting" of people who clearly appear to be straight up crazy. Of all the killers you mentioned, to the best of my recollection nobody seemed surprised when they found out these people were involved. In terms of not blaming gun violence, the aurora shooter was a phd candidate and clearly had knowledge of bomb making etc. Had he wanted to he likely could have planned far worse carnage with explosives at the theater instead of firearms. As unspeakable as these killings all were, they could have been infinitely worse if the assailants chose to use explosives rather than firearms.

 

[M1911]

I do believe that in general, society has become too complacent and "accepting" of people who clearly appear to be straight up crazy. Of all the killers you mentioned, to the best of my recollection nobody seemed surprised when they found out these people were involved.

No argument there. We completely dismantled our mental health system and as a result, people who need long-term (possibly lifelong) confinement and treatment don't get any. 72-hour "observation" and then they are diagnosed as not having insurance, so they are kicked out the door with a scrip.

 

[atilla]

I do believe that in general, society has become too complacent and "accepting" of people who clearly appear to be straight up crazy. Of all the killers you mentioned, to the best of my recollection nobody seemed surprised when they found out these people were involved.

being a professional in your field and knowing how to deal with these folks, what do you offer as a solution?

also this amounts to a "see something, say something", if based on a personal opinion one finds another "crazy" what do they do? call the local police to get the ball rolling on a no-knock raid?

No argument there. We completely dismantled our mental health system and as a result, people who need long-term (possibly lifelong) confinement and treatment don't get any. 72-hour "observation" and then they are diagnosed as not having insurance, so they are kicked out the door with a scrip.

point. i do want to see what his solution is though. i personally don't trust the medication.

 

[TayNinh_66]

A low dose of amitrytiline is quite successful in relieving cronic pain associated with nerve damage. The main problem is that it takes two weeks for the body to get used to it. During that two week period, the patient feels tired and lethargic, especially first thing in the morning. On day 15, life is good again.
Many medications when used properly can help a patient return to a pain reduced state. The key words are: "when used properly."
It would be a complete injustice to link everybody's use of RX to "Gun Mental Health Checks." The average person will think an anti-depressent is only used by the clinically depressed or mentally ill. And that is just not true.
Best regards.

I was prescibed nortriptyline for neuropathic pain. It substantially reduced the pain for the first two weeks, (along with eliminating the ability to sleep.)
It was prescribed by a neurologist, who didn't seem to have a lot of knowlege of side effects. It's an off-label usage. After three weeks it scrambled my brain chemistry to the point where the pain was preferable. I did not attack anyone using sumarai swords, guns, salt shakers, etc. I've switched back to Tylenol, which also scrambles brain chemistry, and will trash my liver to boot.

If anyone is going to assert that there is a correlation between drugs and aberrant behavior, then they should add aspirin, tylenol, etc to the list of mind altering substances to be considered automatic disqualifiers.

 

[DrDavid]

being a professional in your field and knowing how to deal with these folks, what do you offer as a solution?

also this amounts to a "see something, say something", if based on a personal opinion one finds another "crazy" what do they do? call the local police to get the ball rolling on a no-knock raid?

I certainly don't have all the answers. And we can't simply violate our neighbors' civil liberties. I think there's a balance needed. When I think back on how many times I've been hassled and treated like a criminal for simple traffic stops, my bleeding heart for everyone's civil liberties takes a back seat to common sense. Aurora and VA Tech killers were actively receiving mental health treatment. Some shrinks are gun shy (pun intended) about being more aggressive with civil commitments. It's not something to be taken lightly, and each case is different. I will say that if either of these killers were ever hospitalized psychiatrically under involuntary status, they would never have been able to legally purchase firearms.

 

[DrDavid]

No argument there. We completely dismantled our mental health system and as a result, people who need long-term (possibly lifelong) confinement and treatment don't get any. 72-hour "observation" and then they are diagnosed as not having insurance, so they are kicked out the door with a scrip.

Yes the dismantling of "asylums" has been one of the worst things to happen to mental health care for those with chronic mental illness. It's sad, but there are folks who belong in hospitals for extended periods of time. The era of managed care and "community psychiatry" has led to a revolving door and very poor overall trajectory for these folks. The disparity between the haves and have nots has grown (the mentally ill Kennedy's get top notch private care, your local homeless schizophrenic gets bounced around from ER to ER).

Those of us in the field have been advocating for better services for many years. It saddens me that it takes heinous acts of violence to draw the general public's attention to the issues of mental health.

 

[Rockrivr1]

My only comment to this is that the new to be Mental Health laws will keep gun owners who are suffer from seeking help. They will continue to suffer. Damned if you seek treatment, damned if you don't......

 

[atilla]

My only comment to this is that the new to be Mental Health laws will keep gun owners who are suffer from seeking help. They will continue to suffer. Damned if you seek treatment, damned if you don't......

by far this is one of the worst things about the mental health system, there are gun owners who just won't seek help even if they need it.

 

[M1911]

by far this is one of the worst things about the mental health system, there are gun owners who just won't seek help even if they need it.

Yup

 

[TayNinh_66]

I will say that if either of these killers were ever hospitalized psychiatrically under involuntary status, they would never have been able to legally purchase firearms.

Due to hipaa regs, MA does NOT share info regarding involuntary commitments or info regarding court declarations of incompetentcy to any databases used to check qualifications. Felonies will disqualify you. Section 12 youre good to go.

 

[M1911]

Those of us in the field have been advocating for better services for many years. It saddens me that it takes heinous acts of violence to draw the general public's attention to the issues of mental health.

It has some attention now, but that doesn't mean it will get fixed. Fixing the system (reopening public psychiatric hospitals) would cost money. Big money. Passing gun control costs no money. Guess which alternative a politician will choose?

 

[DrDavid]

Due to hipaa regs, MA does NOT share info regarding involuntary commitments or info regarding court declarations of incompetentcy to any databases used to check qualifications. Felonies will disqualify you. Section 12 youre good to go.

I'd have to double check that. I did my training elsewhere and in that state a commitment disqualified you from gun ownership. I do believe it varies from state to state. I seem to remember that if you were placed under section 12 you needed a psychiatrist to vouch for your mental fitness prior to getting an LTC. wouldn't quote me on that though.

 

[Garden12]

Due to hipaa regs, MA does NOT share info regarding involuntary commitments or info regarding court declarations of incompetentcy to any databases used to check qualifications. Felonies will disqualify you. Section 12 youre good to go.

I thought the licensing authority check with the Department of mental health. I know MA doesn't share it on the Federal level, but to get and F.I.D/LTC, they check.

 

[TayNinh_66]

I'd have to double check that. I did my training elsewhere and in that state a commitment disqualified you from gun ownership. I do believe it varies from state to state. I seem to remember that if you were placed under section 12 you needed a psychiatrist to vouch for your mental fitness prior to getting an LTC. wouldn't quote me on that though.

It varies from state to state.

 

[TayNinh_66]

I thought the licensing authority check with the Department of mental health. I know MA doesn't share it on the Federal level, but to get and F.I.D/LTC, they check.

Not that I am aware of. DMH would only have info on commitments to public state hospitals. DMH has no involvement in private admissions. Nor does DMH have any knowledge of court declaring people incompetent.

 

[marleythefish]

deleted, trying to help

 

[Garden12]

Not that I am aware of. DMH would only have info on commitments to public state hospitals. DMH has no involvement in private admissions. Nor does DMH have any knowledge of court declaring people incompetent.

Didn't know these, thanks.

 

[Garden12]

.

 

[Fixxah]

I know a woman who has been prescribed many diffrent SSI drugs over her lifetime and wouldn't be able to function without them. Brains are not wired the same between individuals. To each their own.

-tapatalk and Devin McCourty blow chunks-

 

[Garys]

Yes the dismantling of "asylums" has been one of the worst things to happen to mental health care for those with chronic mental illness. It's sad, but there are folks who belong in hospitals for extended periods of time. The era of managed care and "community psychiatry" has led to a revolving door and very poor overall trajectory for these folks. The disparity between the haves and have nots has grown (the mentally ill Kennedy's get top notch private care, your local homeless schizophrenic gets bounced around from ER to ER).

Those of us in the field have been advocating for better services for many years. It saddens me that it takes heinous acts of violence to draw the general public's attention to the issues of mental health.

The problem was not dismantling the system of state hospitals per se. The problem was not replacing it with a system that insured that people who needed treatment actually get it even if they aren't doing so voluntarily. MA doesn't seem to have any laws regarding Assisted Outpatient Treatment and some states that do have it on paper don't enforce it. Mental health treatment is a disgrace in this country and we pay for "saving" all that money with a larger population of homeless people, many of whom are mentally ill. We also pay for it with more crime, a lot of it committed by the mentally ill. Of course, as someone else noted, it's easier to pass laws that penalize and criminalize people who are prone to neither crimes or be mentally ill.

by far this is one of the worst things about the mental health system, there are gun owners who just won't seek help even if they need it.

The worst thing is that politicians are going to politicize this issue and neither reduce crimes nor improve mental health care. We really do have the worst political class ever in this country.

Due to hipaa regs, MA does NOT share info regarding involuntary commitments or info regarding court declarations of incompetentcy to any databases used to check qualifications. Felonies will disqualify you. Section 12 youre good to go.

Section 12's are incredibly over used and used inappropriately. Denying someone their 2A rights merely because of a Section 12 would be a travesty. There should be a process, requiring judicial oversight, before a person's mental health history can be used against them. A lot of people who are not violent need "mental health" services on occasion. That should not be a bar to exercising their rights under the Constitution any more than writing an angry letter to the editor should be a bar to exercising ones rights under the First Amendment.