{"id":48232,"date":"2014-07-20T22:27:24","date_gmt":"2014-07-21T02:27:24","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=48232"},"modified":"2014-07-21T03:26:06","modified_gmt":"2014-07-21T07:26:06","slug":"our-own-eyes","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2014\/07\/20\/our-own-eyes\/","title":{"rendered":"our own eyes…"},"content":{"rendered":"
In the first post about the Lu et al<\/a> study, I mentioned the CDC 1979-2007 suicide data [see a madness to our method…<\/a>]. But in its origin…<\/a>, my post had a broken link to the CDC YRBS<\/a> [Youth Risk Behavior Study] in the Rapid Response by Barber et al<\/a>. That was an unfortunate omission as it’s a center ring piece of information. First, here’s the CDC Suicide data [1979-2007]:<\/div>\n
<\/div>\n
Here’s my graphing of the YRBS<\/a> data [1991-2011]:<\/div>\n
<\/div>\n
The Youth Risk Behavior Surveillance System<\/a> [YRBSS] was  actually new for me. It’s an every other year survey querying dangerous behaviors in kids 16-19. It looks pretty solid to me and I was glad to find it. Take a look. It certainly doesn’t confirm the findings of Lu et al<\/a> [in fact, most things don’t].<\/div>\n

I honestly don’t believe that the black box warnings lead to an increase in either suicides or suicide attempts based on scientific grounds, some of which are shown here. But that’s not what fuels my writing about this. What keeps me writing is what I do believe, not what I don’t believe. I’ve seen two completed suicides from SSRIs that I’m sure about. Thankfully, neither was a patient of mine, but I was privy to enough information to be unquestioning about what happened. I may fill this blog with graphs and population statistics, but as a clinician, I’m a one-person-at-a-time doctor. And people like me are at a loss because I can’t or won’t report why I can say that with such conviction. I also believe in Akathisia of the kind that’s described in patient reports, books, on RxISK, in blogs etc. I believe it because I’ve seen it personally in its very loud forms. I can’t or won’t report the stories that lead to that conviction either, so I can only say that I have no doubts. I think the black box warning is correct – the truth:<\/p>\n

 <\/p>\n

If someone actually did a non-jury rigged study that said that the black box warning is wrong, I wouldn’t change a single thing in the way I personally do things. David Healy says why best when he talks about getting doctors to "doubt our own eyes." See Akathisia once, a dramatic change in personality and the aggression that comes with the drug, that then disappears when the drug is withdrawn, and you’re on alert. See it the second time and that’s enough for this old man. It might as well be an epidemic. And given the fact that I’m an infrequent prescriber, that I’ve seen it often enough makes it real for me. I would bet it’s even under-reported because the patients stop that drug<\/em> and don’t go back to see that doctor<\/em>. I’ve prescribed SSRIs to adolescents and young adults infrequently, and only when I’ve said my spiel and am comfortable that I and competent others can keep close tabs. I can’t imagine anything ever changing that. There have been some successes, some failures, and much indifference. So I’m glad the black box warning slowed down the accelerating rate of prescribing – even in an HMO. And what I’ve seen with my eyes trumps epidemiology on large datasets.<\/div>\n","protected":false},"excerpt":{"rendered":"

In the first post about the Lu et al study, I mentioned the CDC 1979-2007 suicide data [see a madness to our method…]. But in its origin…, my post had a broken link to the CDC YRBS [Youth Risk Behavior Study] in the Rapid Response by Barber et al. That was an unfortunate omission as […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[2],"tags":[],"class_list":["post-48232","post","type-post","status-publish","format-standard","hentry","category-politics"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/48232","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/comments?post=48232"}],"version-history":[{"count":15,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/48232\/revisions"}],"predecessor-version":[{"id":48249,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/48232\/revisions\/48249"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=48232"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=48232"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=48232"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}