BTW:
- Thread starter Daniel E.
- Start date
David Baxter PhD
Late Founder
Daniel,
Many thanks for your post. I am reminded again and again how complicated the whole area of meds and side-effects are. Your post brings up many issues of prescribing patterns, how common the side effects can be with psychiatric meds and issues with terminology.
Your post reminds me of how (in my opinion / experience), terminology use and medication prescribing patterns can be geographically determined. That is, what term gets used and recommendations for particular meds can depend, in part, on where someone is living. I know that this might sound bizarre, but it happens in part because of "clustering" of professionals after their training and what determines whether or not a provider will really keep up to date with the advancements in pharmacology. Part of the push behind the treatment guidelines that are being put together by The American Psychiatric Association is to minimize this phenomenon with respect to treatment.
Whether bruxism is akathesia or dystonia is still actually being debated in the peer-reviewed literature. In part because akathesia implies invol. movement, or the feeling of needing to move - which bruxism is. But when it is a side-effect from meds (and not simply teeth grinding) it is also spasm of the cheek (masseter) muscles. Hence, the ongoing debate.
but when you do a lit search, I don't think that there are lots of current articles on the issue because what matters to many clinicians is that the individual is uncomfortable (or in frank pain) and they weren't that way before they started the med.
so, then the issue becomes one of what to do about it. That is kinda a style-thing. Certainly many would add another med to counter the first side-effect (although have to be clear that it would never have occurred to me to use Buspar in this context. Very creative approach). Others might suggest changing drug classes to minimize the likelihood that the side-effect happens again - while keeping the total number of prescription meds down. but lots of people have trouble with this - particularly if it took a long time and they were significantly distressed before the "right" med was found.
When I am being prescribed a medication, it is crucial that I can actually work with the person prescribing the meds. For me, this is someone who doesn't assume that I have knowledge about what they are recommending, nor do they treat me as though I am completely ignorant. They are someone who considers affordability and accessibility (usually for me has to do with the number of times a day I would have to remember to take the med). Finally, for me they are someone who will take my complaints of side-effects seriously and can offer me several pathways of treatment from that point - particularly if it is a med that I am going to have to be on for a longer time than, say, a week or 10 days.
When I am working with a client / consumer / patient with their medications, I find it easier to work with people who are interested in working with me on the issues that are important to them - but I am very respectful of the fact that at that point, it isn't about me and what is easier for me. It becomes a matter of, the best that I can, honouring that person and their medication needs to the very best of my abilities.
Hope this helps to clarify where I was and do come from.
df
Many thanks for your post. I am reminded again and again how complicated the whole area of meds and side-effects are. Your post brings up many issues of prescribing patterns, how common the side effects can be with psychiatric meds and issues with terminology.
Your post reminds me of how (in my opinion / experience), terminology use and medication prescribing patterns can be geographically determined. That is, what term gets used and recommendations for particular meds can depend, in part, on where someone is living. I know that this might sound bizarre, but it happens in part because of "clustering" of professionals after their training and what determines whether or not a provider will really keep up to date with the advancements in pharmacology. Part of the push behind the treatment guidelines that are being put together by The American Psychiatric Association is to minimize this phenomenon with respect to treatment.
Whether bruxism is akathesia or dystonia is still actually being debated in the peer-reviewed literature. In part because akathesia implies invol. movement, or the feeling of needing to move - which bruxism is. But when it is a side-effect from meds (and not simply teeth grinding) it is also spasm of the cheek (masseter) muscles. Hence, the ongoing debate.
but when you do a lit search, I don't think that there are lots of current articles on the issue because what matters to many clinicians is that the individual is uncomfortable (or in frank pain) and they weren't that way before they started the med.
so, then the issue becomes one of what to do about it. That is kinda a style-thing. Certainly many would add another med to counter the first side-effect (although have to be clear that it would never have occurred to me to use Buspar in this context. Very creative approach). Others might suggest changing drug classes to minimize the likelihood that the side-effect happens again - while keeping the total number of prescription meds down. but lots of people have trouble with this - particularly if it took a long time and they were significantly distressed before the "right" med was found.
When I am being prescribed a medication, it is crucial that I can actually work with the person prescribing the meds. For me, this is someone who doesn't assume that I have knowledge about what they are recommending, nor do they treat me as though I am completely ignorant. They are someone who considers affordability and accessibility (usually for me has to do with the number of times a day I would have to remember to take the med). Finally, for me they are someone who will take my complaints of side-effects seriously and can offer me several pathways of treatment from that point - particularly if it is a med that I am going to have to be on for a longer time than, say, a week or 10 days.
When I am working with a client / consumer / patient with their medications, I find it easier to work with people who are interested in working with me on the issues that are important to them - but I am very respectful of the fact that at that point, it isn't about me and what is easier for me. It becomes a matter of, the best that I can, honouring that person and their medication needs to the very best of my abilities.
Hope this helps to clarify where I was and do come from.
df
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