I have been working most of the night. I think it is funny how when you open your eyes to something, then you begin to see it all the time.
A great example is the Fed Ex logo. I dare you to find the hidden symbol....I'll even tell you the symbol....It's an arrow.
Keep trying.......
Didn't get it? Think a White Arrow....
Ah Ha!!! You got it. Now everytime you see the logo you will be looking for the Arrow!!
Tonight I admitted a great patient who attempted suicide. Interestingly, the patient had just started citalopram (Celexa) therapy. I almost feel as if the blogpost and literature review had me attuned to what was going on.
I spoke with the family and with the physicians. I am amazed as to how often these occurences are. I know that we will soon have an FDA approved test for this risk. I just feel bad that it had to be too late for this patient.
We are giving people too many medications without evaluating them. We are giving too many medications without knowing exactly what the risks are. Frankly, I am surprised this push for drug safety and pharmacogenomics has not started sooner.
I think it is because as physicians we too easily blow something off as idiosyncratic. There is not enough intellectual curiosity going on in medicine. Primarily because we are all overworked, secondarily because most don't have the proper molecular background to evaluate and understand the issues which we see. This is not the fault of physicians primarily. I blame their teachers........
The Sherpa Says: For a public who thinks everything is genetics and a set of healthcare providers who think it is not genetic in adults we have a disconnect. Even worse, we have a failure to communicate. Which is why companies like Navigenics et.al. come to be. They want a scalable solution to our education problem. By cutting out those who are "educated" How does that play out? We will soon see. The good news is, the physicians who I educated tonight asked if we could send the test. The bad news is "I think it's too late" at least for her. She does have a sister though.
3 comments:
I read this after sending you my email! :-) I had never seen the arrow before but I think you are right the universe, if you want to call it that, has away of helping us move forward.
That said, I don't think we should look to blame because blame will fall at all levels I think it is more productive to change the system - the whole system.
but this is happening - the science has advanced, the ability to handle large amounts of data is there, and the drug companies are having to change the way they bring drugs to market because the current system is broken. What is needed is not blame but ways to find cohesiveness between disciplines but I think that is happening too.
I hope we can.
-Steve
My name is Daniel Wilson and i would like to show you my personal experience with Celexa.
I am 27 years old. I took this drug on and off for 3 years (2 years on, 1 off). It definetely helped my anxiety. The major side effect was the weight gain. Trying the new version (Lexapro) now. I'm hoping it will have better side effects.
I have experienced some of these side effects-
Weight Gain, diarrhea.
I hope this information will be useful to others,
Daniel Wilson
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