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When I see new patients, I do not prescribe medication for them. Patients who come to me know that I plan to help them understand “why” they are experiencing “what” they are going through.

Once I have tapered patients off of medication, we use alternatives if symptoms crop up again.

Knowing my basic orientation around the issue of psychiatric prescribing doesn’t seem to stop some patients from asking for what they believe will be a quick fix in an antidepressant pill.  Where did they learn to make these treatment requests of providers?

Perhaps they are a reflection of the 49% of requests for drugs prompted by “direct-to-consumer” (DCA) advertising by pharmaceutical companies.1 Fully 7 out of 10 times, doctors prescribe based on these requests made by patients who learned from advertising that they have an “imbalance” that must be fixed with a pill.

In a 10-year period from 1999 to 2008, DCA tripled from 1.3 to 4.8 billion dollars devoted to educating patients about their need for psychiatric medication. The “mass provision” of SSRIs to the public is not a reflection of their well-understood mechanism, of their efficacy, or of their safety. In fact, it flies in the face of all three.