Mental Nurse

The clamouring in the live chat box must mean it’s Saturday and time for This Week in Mentalists.

To nominate a blog for future editions e-mail zarathustra at mentalnurse dot org dot uk

First off, Furious Seasons is getting hate mail from anti-psychiatrists.

Because I don’t bow down to the intellectual power of Michel Foucault and Thomas Szasz (and for all I know, L. Ron himself), then I am a “motherfucker,” a “cocksucker,” a “fence sitter,” a “fraud” and a “greed filled pig.” Those are just some of the highlights of unapproved comments in recent days and of emails that have been sent my way. One longtime reader sent me an email yesterday noting that I must have very tough skin–I’d argue it’s a thick head–to put up with that kind of abuse and still pump out the prose on this site. The reality is I have been harshed by the anti-psychiatry crowd before–just as I’ve been smacked up by the psychiatry worshipping crowd of fools who call me a “murderer” for pointing out that research shows anti-depressant are a weak technology, a “Scientologist” for pointing out that there are clearly softer forms of mental disorders being diagnosed and treated as the worst thing this side of John Hinkley, and an “anti-psychiatrist” for daring to question the wisdom of psychiatrists.

The Shrink discusses the anti-dementia medication memantine.

I’ve a few patients on memantine, for good reasons. Well, I think they’re good reasons. Anyway, the outcome is that the patients have stable cognitive function now, so there’s been no progression of symptoms of dementia on memantine (but before memantine they were getting worse month on month). So, I continue to use it, a bit, because for a small number of folk it makes a meaningful difference.

It’s just a small number of folk, partly because it’s not funded (so I can never pass them back to the GP, so our hospital has to bear the cost of the drugs forever). The costs are not trivial. If I’ve a dozen patients on memantine then that’ll cost as much as a secretary. Two dozen would pay for a nurse. Since we’ve no money for it, that’s what it really means . . . if I want 24 folk on memantine, which nurse post do we lose to fund that?

But the other reason I’ve very few on memantine is, does it really work that well? I’m biased since over the years I’ve not used it on squillions of folk, but of those I have prescribed it form, for the vast majority it’s done nothing. I’m sure it’s not snake oil linement to cure all ills but it really does seem striking less efficacious than donepezil, galantamine and rivastigmine. Or is it just me?

Life With Aspergers has decided to try his son’s Ritalin, to see what effect it has.

During my time under the influence of Ritalin, we had a meeting. I’m normally a bit talkative at these things but this time I found myself being even more “with it” - as a result, I talked even more. We were reviewing a development specification and I stopped the meeting at several points to question decisions. I felt much more in control of the situation and much more focussed. Towards the end of the meeting I started to feel as if I was annoying my colleagues by pointing out things (which they’d missed) and I attempted, not terribly successfully, to quieten down. I can see this being a double-edged sword for my son in class.

(As a registered clinician, I think I have to add a disclaimer here: we at Mental Nurse would strongly advise against taking a medication that has not been prescribed for you, as such we do not encourage any readers to follow Life With Aspergers’ example.)

Mental Patient about Town considers Labour’s track record on mental health issues.

* The Mental Health Act. Farcically draconian powers have been introduced to compel people to have treatment in their own home and to detain people even if they are a) untreatable and b) haven’t committed any crime. The debate, such as it was, has increased the idea that there are dangerous mental patients living in the community and so increased the stigma for us unfortunate souls who are diagnosed with serious mental illness. In seeking to forcibly treat more people resources are being taken anyway from the vast majority of people who seek treatment voluntarily - and are often denied it.
* The NHS. As reported in yesterday’s post, Labour are seeking to find ways of undermining the NHS in order to open it up as a market for private companies - the polyclinics wheeze is just the latest example. Consequently - and absurdly - the Tories are ahead of Labour in the opinion polls for who people trust to run the NHS. How can this be happening?
* Welfare reform. For years first Conservative and then Labour governments encouraged the signing off of the long-term unemployed onto incapacity benefit. They did this to keep the unemployment figures down. They could also avoid having to invest money into unemployment black-spots to stimulate the local economy in order to create jobs. “Welfare reform” has become another opportunity to create a market for private companies to exploit. It has nothing to do with the needs of disabled people and reducing the numbers on incapacity benefit will be just a byproduct of profiteering. While it’s true there may be some people who shouldn’t be on a sickness benefit, is it worth terrorizing legitimate claimants with an ongoing media campaign screaming “scrounging benefits scum” in the tabloids on a daily basis?

Serotonin is undergoing a change in medication.

Well have been on 50 mg Sertraline almost a week now & due to reduce Venlafaxine to 75 mg again Fri.Had headache for nearly all of this first week.Even with some Ibuprofen it just doesn’t go.Have noticed a few aches & pains, which initially I put down to wearing flat canvas pumps & or monthly period.However I have since found out that Sertraline can (though this might not be the case with me) have side effects involving joint pain.Mind you it could also be down to reducing the Venlafaxine or a combination of all these things