Monthly Archives: July 2016

Medicine side effects vs the illness itself – Which is worse?

Clinical Case Studies, Issues & Debates, Treatment Approaches

The illness itself, or the medication side effects – which is worse? Perhaps people who are taking medication can share their experience?

I’d always thought it’s the illness. Of course, it’s something that you don’t get to choose and can’t control. To many people, it just happened, then their lives changed.

So whenever people complained about side effects of medication (e.g. many anti-psychotics cause so much drowsiness that patient can sleep all day; or some antidepressants cause dry mouth, constipation etc), I’d tell them the gains are much greater than the losses, or that you get more advantages than disadvantages out of it. So tolerate with it, and it’s going to fade away anyway  (when patient gets better the dosage can be reduced, or maybe when their body get used to the drug then the side effects diminish!)

Till this morning when I saw this young girl. She was completely disorientated, perplexed, restless, with limited response, almost zero eye contacts and tremor hands when I held her. It’s not possible to hold a brief conversation with her, leave alone doing psychotherapy. I knew it’s a psychosis case, but in my mind i kept wondering why her presentation was like that. It’s hard to believe she was once a happy and easy going girl, doing well in the schools, despite her kind of difficult family background.

Then I recalled what her auntie told me in the emails – the medicine she was taking from the hospital following the first onset and admission couple of weeks ago. Suddenly it became much clearer. I have seen this quite many times, most of them are patients who were already taking medicine when they first came to us. It’s not the presentation of the illness itself. It is the side effects of the medication (you can perhaps email me to ask what drug it is; I think to many people, the answer is obvious) given by the GH.

If this were one of my family members, I wouldn’t want it. I’d rather to have her having difficulty sleeping, some hallucinations and being a bit paranoid – ok, this might be equally bad I can’t deny it. But It’s really difficult. Isn’t it?

What would you choose? Do you have any experience tolerating side effects of medicine that you take?

N.B. Don’t get me wrong, I’m not asking everyone to stop their medication due to the side effects. Most of the time I still think that medication would be beneficial and helpful despite the side effects. However, if you suffer from intolerable side effects (another common one from anti-depressants – sexual dysfunction, ranging from changes in drive, arousal, erectile/orgasm problems, satisfaction), do speak to your consultant, quite often there are substitutes.

Introducing “The monk who sold his Ferrari”

Review - books movies series

This is my second Robin Sharma’s book, following “The Leader who had no title.”

monkferraribook

I bought it with RM 34.90 (before 10% membership discount) at Popular bookstore. And guess what, I just happened to find its pdf file here, for free?!

Firstly, I have to say this is a very well-titled book. It doesn’t just tell you what the book is about, it also attracts people to pick it up, wanting to read the content. I’ve taken quite some time to read it, though it’s such a small book. I wanted to slowly digest it, and practise what it says whenever possible.

So the book is written in the form of a story, saying to…

  • master your mind
  • follow your purpose
  • practice kaizen
  • live with discipline
  • respect your time
  • selflessly serve others
  • embrace present

It’s practical, it is practicable. I don’t like so much of theories and meaning and quotes, when they tell you this and that, without telling you how to do it, achieve it, without giving you the application tools. But Robin does tell you what to do. So the only problem is – whether you do it.

I think every house should have a copy of it. It might not help everyone all the time (though a friend told me Robin’s books have been with her through ups and downs), it should still be worthwhile to go back to it once in a while.

It’s not what you will get out of the books that’s so enriching – it’s what the books will get out of you that will ultimately change your life

-Robin Sharma

Introducing “Listening to Prozac”

Depression, Issues & Debates, Review - books movies series, Treatment Approaches
By Peter D. Kramer
By Peter D. Kramer MD

Last year I bought this book for RM5 from the Popular RM5 book fiesta (by now you probably have realized that I bought a lot of books there, and yes you’re right, I do spend time to go through those non-fictions and try to pick some treasure!). It is written by an American psychiatrist.

This is really a book that I’d strongly recommend, to … certain people, like me – who know quite a bit about psychopharmacology, but not enough, not much about their history – who have seen how all those drugs are used practically and in day to day life, but not read much about the facts and dark stories behind them. It is an old book I have to say, but I learnt so much about the older generation anti-depressants (tricyclic like Imipramine, Monoamine Oxidase Inhibitors which is not so common these days) and those that I’m so familiar with, i.e. the SSRIs (e.g. Prozac (Fluoxetine)!).

It made me think a lot about how those so-called legal drugs are prescribed, used and misused, how it can change a person from the inside (personality! how they see themselves all their lives simply changed after they started the medicine!), how vague the definitions of psychiatric diagnosis are, how tiny the difference between well and unwell could be etc etc. It may not be a book for everyone, I’m sure some might fall asleep reading it, but it’s probably the first time I’m reading such old book (published in 1993 -before I attended elementary school :P, some updates in early 21st centuries at the back) but still get so astonished and learnt so much!