Re: Anti-depressants
Thanks for your reply Brashbrother.
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My personal take on anxiety disorder is that it should be treated with a 2-pronged attack: meds plus cognitive therapy (ie counseling). Both of these are shown to be effective when used in combination over time, but both take several weeks of use to be effective.
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In my practice, I never prescribe refills for xanax when treating anxiety, and I only give someone enough for 2-3 weeks use. I also will start them on another, longer-acting med, such as lexapro, celexa, prozac, wellbutrin, etc., and I refer them to some form of cognitive therapy, such a counselor or maybe their pastor, if available. I do all of this at the first or second visit, once I make the diagnosis. I tell them the goal is to use the xanax rarely, and only as a sedative once they are home from a stressful day or if they actually have a panic attack. I let them know it will not be refilled, and that the other med and the counseling will soon take the place of the xanax completely.
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I respect this approach. It's really nice to hear that you stress counseling in addition to drug therapy. My personal opinion is that counseling should be a requirement for all people on these anti depressant and anxiety drugs. It disappoints me that not more doctors take this position.
You sound like a very conscientious doctor and I can't tell you how much I appreciate it. You might think it sounds weird but it's refreshing to find a doctor who actually takes time to thoroughly go over the side effects of a drug and warns his patients of their addictive nature. Not a lot of doctors spend time counseling patients about this issue.
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Many of these folks, believe it or not, have insurance and real jobs, and they keep their appointments every 2-3 months like clockwork. (wonder why?)
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I believe it. Drug addiction cuts across all socio-economic and age barriers. Thank you so much for taking the time to answer my questions.
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