{"id":48671,"date":"2014-08-13T21:25:47","date_gmt":"2014-08-14T01:25:47","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=48671"},"modified":"2014-08-13T21:28:50","modified_gmt":"2014-08-14T01:28:50","slug":"a-more-legitimate-science","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2014\/08\/13\/a-more-legitimate-science\/","title":{"rendered":"a more legitimate science…"},"content":{"rendered":"
You’ll never know more about a disease than with those first cases in medical school. The first autopsy, the first case in the clinic, the first hospitalized patient. It’s all so new and things fall on a mind eager to see the things learned in the basic sciences manifested in a real patient. In those days, one believes everything you read in journals, textbooks, hear from valued teachers. It’s a time where one is desperate for anchors. This article is by a second year medical student, however it unfortunately veers off the track. <\/div>\n
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Perpetuating Schizophrenia’s Stigma<\/a><\/div>\n
New York Times: Opinion <\/font><\/strong><\/div>\n
By EDWARD LARKIN and IRENE HURFORD<\/a><\/div>\n
AUG 12, 2014 <\/div>\n

Edward Larkin is a second-year medical student at the University of Pennsylvania, where Irene Hurford<\/a> is an assistant professor in the department of psychiatry. <\/em>  <\/p>\n

A few months ago, a patient came to our hospital, seeking help. One of us, Edward, was on the team that treated him. He was pleasant, if slightly withdrawn, and cogent. He was a college graduate in his 20s and had recently been fired from his job as a high school math teacher, because of unexpected absences. He had come to believe that government agents were conspiring against him, and he had taken to living out of a truck and sleeping in different parking lots. By the time he came to us, he was exhausted. A diagnosis became clear: he had schizophrenia<\/span>. We admitted him to the hospital, and after a few days, with his symptoms under control, we released him. Unfortunately, we prescribed a medication for him that could cause significant, permanent harm, instead of an equally effective drug with milder side effects — all because he was uninsured. <\/p>\n

Schizophrenia, which affects 1 percent of the population and emerges in the late teens to early 20s, is deeply misunderstood. People who suffer from it are often suspected of being dangerous, but this is not usually the case, and antipsychotic drugs are very effective. Our patient was exactly the kind of person who, with the right treatment, could have weakened the stigma surrounding schizophrenia. Antipsychotic drugs fall into two classes: the older ones, like Haldol, and newer ones, like Abilify and Latuda. Both classes are equally effective at treating some of the worst symptoms of schizophrenia, specifically the hallucinations<\/span>, delusions and paranoia that cause social alienation. [They’re not effective for treating “negative symptoms,” like low motivation].<\/p>\n

But the older drugs can cause a multitude of serious side effects, including a potentially devastating one called tardive dyskinesia<\/span>. This condition involves unsettling, animalistic smacking and wagging of the lips and tongue. At its extreme, it can affect the entire body. It occurs in 20 percent or more of patients who take the drugs long-term, and it tends to start so mildly that patients can’t identify it in time to stop taking the drugs. It is often irreversible. <\/p>\n

The newer drugs have lower rates of tardive dyskinesia [estimates vary, but most likely less than half or one-third the risk], although they can cause weight gain and predisposition to diabetes<\/span>, among other side effects. The newest among them, however, have decreased these risks, too. And a 2006 study<\/a> showed that patients were more likely to keep taking the new drugs than the older ones. <\/div>\n
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