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FDA-Approved Drugs Are Not Always Effective: The Benefits Of Alternative Medicine


On Saturday, while thousands of Boston Bruins fans gathered at Government Center to celebrate the team’s recent Stanley Cup victory, a hundred or so true die-hards met a few blocks away at a Massachusetts General Hospital conference to talk about complementary and alternative medicine for psychiatric disorders. While I hated to miss the Bruins parade, I’m glad I attended the MGH conference.

I’ve always been a bit of a skeptic about so-called natural therapies for one simple reason: they don’t have to go through the same rigorous testing in clinical trials that medications do. At the same time, I realize that FDA-approved drugs don’t work for everyone. One in three adults with major depression, for example, can’t completely improve their mood and other symptoms even after trying multiple antidepressants.

Clearly, we need better options for treating mental health disorders. The MGH conference convinced me that some types of complementary and alternative medicine—or CAM, for short—might be worth trying. The presenters, all psychiatrists who treat patients at MGH, backed up their recommendations with scientific evidence. Several of them also contributed to the American Psychiatric Association’s recent report on CAM therapies.

We’ll be doing a story on CAM therapies for psychiatric disorders in an upcoming issue of the Harvard Mental Health Letter. For now, here are some things I learned on Saturday: Read more »

*This blog post was originally published at Harvard Health Blog*

Psychiatric Diagnosis And The DSM-5 Controversy

I’ve followed in bits and pieces — sometimes for Shrink Rap, sometimes because the issues fill my email inbox, sometimes because there’s no escape. Oh, and lots of the players have familiar names.

In the December 27th issue of Wired magazine, Gary Greenberg writes a comprehensive article on the debates around the revision of the American Psychiatric Association’s (APA) upcoming revision of the Diagnostic and Statistical Manual (DSM) entitled “Inside the Battle to Define Mental Illness.” Do read it. Here’s an excerpt:

I recently asked a former president of the APA how he used the DSM in his daily work. He told me his secretary had just asked him for a diagnosis on a patient he’d been seeing for a couple of months so that she could bill the insurance company. “I hadn’t really formulated it,” he told me. He consulted the DSM-IV and concluded that the patient had obsessive-compulsive disorder.

“Did it change the way you treated her?” I asked, noting that he’d worked with her for quite a while without naming what she had.


“So what would you say was the value of the diagnosis?”

“I got paid.” Read more »

*This blog post was originally published at Shrink Rap*

Prison Overcrowding: Does It Affect Mental Health?

In California, the U.S. district court has ordered that tens of thousands of prisoners be released to reduce overcrowding. The case, Schwarzenegger v. Plata, was argued this past Tuesday and the transcript is online.

This is relevant to a psychiatry blog because one of the arguments used in support of the releases is the contention that overcrowded facilities reduce access to mental health and medical services and that overcrowding causes mental deterioration and breakdown. The APA filed an amicus brief in the case, but the brief isn’t available online yet. (Keep an eye out for it here.)

The challenge with this case is that there is no (or extremely little) actual research to support the link between overcrowding and psychological problems. Correctional systems have spent a lot of time litigating issues — and experts make a fair amount of money working on these cases — without actual data. Read more »

*This blog post was originally published at Shrink Rap*

Single-Session Psychotherapy: The Cab Driver Story

Here’s a story that came out of the American Psychological Association (APA) conference:

I was in a cab going to dinner. The cab driver found out I was a psychiatrist so he told me about his life-changing experience with therapy.

At one time he was having an incredible problem with his life. He was using cocaine, couldn’t keep a job, and his relationships were going down the tubes. Therapy helped him quit cocaine and change all that. (Which was good, since he was the driver of my cab. I really wanted him not to be high or in distress.) This kind of turn-around story isn’t unusual for me — parolees will often come back and tell me about things they’ve done in free society that they’re proud of. The unusual part of this story is the fact that he made all of these changes after a single one-hour session. Read more »

*This blog post was originally published at Shrink Rap*

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