This is very interesting! However, there are a couple of assumptions
here:
1. The depression and anxiety symptomalogies were the results of lack
of money/worries about lack of money, or sudden deprivation of money.
2. There are unlimited funding to provide money as therapy instead of
drug treatment.
3. It is more cost effective (probably) to just give patient money
than drugs.
4. Money is the original of all happiness. Hmmm.....
But I see plenty of rich people that are depressed and have substance
abuse problems. Just count all the Hollywood celebrities.
>>> GRETA DOUCET <[log in to unmask]> 10/02/07 6:20 AM >>>
Just give them more money! Wouldn't you give them more medication?
Greta
Ana Natale-Pereira <[log in to unmask]> wrote: what happens when the
money runs out??
Ana Natale-Pereira, MD, MPH
Assistant Professor of Medicine
Division of Academic Medicine, Geriatrics, and Community Programs
Director---Community Based Networks
30 Bergen Street ADMC-6-614
Newark, New Jersey 07102
Office: 973-972-8994 or 1744
Fax: 973-972-8799
[log in to unmask]
"We the willing, led by the unknowing, are doing the impossible for the
ungrateful. We have done so much, with so little, for so long, we are
now qualified to do anything, with nothing."
~ Mother Teresa ~
>>> [log in to unmask] 10/02/07 1:40 AM >>>
I can't resist posting this article from the Bonkers Institute.
Socioeconomic disadvantage is well established as a risk factor for
depression and other psychiatric disorders, but psychiatry and its pal
the
pharmaceutical industry monotonously emphasise chemical imbalances (for
which the evidence is very shaky - see Lacasse & Leo 2005
http://medicine.plosjournals.org/perlserv?request=get-document&doi=10.1371/journal.pmed.0020392),
not socioeconomic imbalances.
Of course even better than individual treatment of poverty would be
population-level prevention of poverty!
Melissa
Therapeutic Efficacy of Cash in the Treatment of Anxiety and Depressive
Disorders: Two Case Studies
Methodius Isaac Bonkers, M.D., Principal Investigator
Bonkers Institute for Nearly Genuine Research
bonkersinstitute.org
Depression and anxiety are the most common mental disorders in America,
affecting more than 60 million patients every year. Pharmacological
interventions dominate the medical management of these disorders and
may
include selective serotonin reuptake inhibitors (Prozac),
norepinephrine
reuptake inhibitors (Strattera), monoamine oxidase inhibitors (Emsam),
benzodiazepines (Valium), azaspirodecanediones (BuSpar), and any number
of
similarly efficacious drugs or drug combinations prescribed in
accordance
with strict FDA guidelines, or not, based on the treating physician's
better
judgment.
Since mental illness is a lifelong condition with no known cure, the
successful psychopharmacological management of a mental disorder such
as
depression or anxiety is challenging. Treatment with medication almost
inevitably results in side effects requiring additional medications
leading
to additional side effects necessitating still more medications, in a
self-perpetuating cycle that finally ends when the patient dies or the
insurance runs out.
This report discusses two cases in which complete symptomatic relief
was
achieved following the administration of large sums of money to the
patients. The comparative safety, efficacy, and tolerability of cash is
assessed. Based on our findings, the clinical utility of monetary
incentives
in the form of cash deposits or lump sum payments directly to patients
should be reappraised as a viable alternative therapeutic modality for
the
treatment of mild, moderate or severe cases of anxiety with or without
co-occurring depression. Cash payment should also be considered the
treatment of choice for all major depressive disorders including mild,
moderate and severe clinical or sub-clinical depression, depressed
moods, or
any and all dysthymic, cyclothymic or depressive symptoms appearing
with or
without comorbid anxiety disorders.
Case report 1:
The patient is a 52-year old male with a history of depression. He
reported
feeling sad at various times throughout his life but did not seek
treatment
until age 51, when the factory where he had worked for 23 years was
permanently shut down, costing him his pension and health insurance the
same
year his wife was diagnosed with terminal cancer. The patient was
initially
prescribed Paxil 20 mg, but after complaining of sleeplessness and
expressing suicidal ideation, the dosage was increased to Paxil 40mg
and
Ambien 10mg was prescribed for insomnia. Depressive symptoms improved
somewhat, but constant diarrhea, headache and nausea grew intolerable,
so a
switch from Paxil to Zoloft 50mg was tried. Within 5 weeks the
therapeutic
effects of Zoloft became readily apparent: the patient stopped worrying
about the future and no longer seemed concerned about his wife's
failing
health. Numerous treatment-emergent side effects were observed but the
patient was reassured by his physician that chest pain, skin rash,
constipation, tremor, dry mouth, hypertension and palpitations were not
life
threatening. One month later, pharmacotherapy was discontinued because
the
patient refused further treatment, claiming to be cured after winning
$200,000 in the Illinois State Lottery. A computed tomographic brain
scan
confirmed the patient had indeed fully recovered (see images below).
Brain scan of depressed patient.
Case report 2:
The patient is a 27-year old female diagnosed with generalized anxiety
disorder. She reported feeling nervous and fearful most of the time,
constantly worried about one thing or another, and doubted her fitness
as a
single mother of four children aged 1-4. The patient responded well to
Xanax
0.25mg with only minor side effects including dizziness, impaired
coordination, and blurred vision. One month into treatment, the
positive
therapeutic effects of Xanax 0.25mg diminished noticeably, but symptoms
again improved when the dosage was doubled to 0.5mg. Two weeks later,
following a traffic accident for which she was ticketed, the patient
reported feeling more anxious than ever, complained of nausea and
vomiting
in addition to increased dizziness and blurred vision, and now
exhibited
signs of depression as well. After several difficult weeks the patient
was
weaned off Xanax, and combination therapy with Lexapro 10mg and
Cymbalta
60mg was initiated. At the regularly scheduled 3-month follow-up
examination, all symptoms of anxiety and nervousness had completely
disappeared. The patient reported zero medication side effects,
explaining
that she had discarded the unopened packages of Lexapro and Cymbalta
upon
learning she had inherited $250,000 from a distant relative. Laboratory
tests were unable to verify any causal link between the inheritance of
a
quarter of a million dollars and the patient's subsequent recovery, but
ongoing clinical evaluation and comprehensive reassessment confirmed
significant improvement from baseline. Positive outcome was
corroborated by
visual examination of a mood ring worn by the patient (see images
below).
Suffering from chronic anxiety, patient's mood ring appears green,
indicating tension.After inheriting $250,000, patient's mood ring
appears
blue, indicating tranquility.
Analysis and Conclusions
The brain chemistry of depression and anxiety is not fully understood.
However, a growing body of evidence supports the view that people with
these
disorders have an imbalance of the brain's neurotransmitters. (Lexapro
Product Brochure, Forest Pharmaceuticals, 2007.)
Psychiatric medications relieve symptoms of depression and anxiety by
restoring chemical balance within the brain, but exactly how these
drugs
restore the brain's chemical balance while simultaneously wreaking
havoc on
every other organ in the body remains a mystery. Equally mysterious is
the
mechanism by which cash payments provide therapeutic benefit to
depressed
and anxious patients. The receipt of a large sum of money may somehow
stimulate, increase, block, adjust or otherwise act upon the level,
supply,
transmission, inhibition, secretion or excretion of dopamine,
serotonin,
norepinephrine, gamma aminobutyric acid or some other chemical yet to
be
discovered.
Elation and euphoria are the most common side effects associated with
cash.
The favorable side effect profile and high response rate compared to
placebo
are the main advantages of cash over standard pharmaceutical treatment,
while the major disadvantage of cash would appear to be its prohibitive
cost. However, retrospective analysis supports the hypothesis that over
the
long haul cash is not only safer but also more cost-effective than any
medication currently on the market.
A depressed and/or anxious patient is typically maintained for an
indefinite
period of time on two or more psychiatric drugs simultaneously, in
addition
to numerous other medications prescribed to control side effects
ranging
from diabetes to high blood pressure to urinary incontinence to
insomnia to
everything in between. The cost of maintaining a patient on a standard
treatment regimen of half a dozen or more prescription drugs might
easily
surpass $1,200 per month, amounting to roughly $150,000 over the course
of
ten years, or nearly $300,000 after 20 years. Seen in this light, a
lump sum
payment of $100,000 or even $200,000 would be a genuine bargain by
comparison. Cash-strapped state Medicaid programs, squeezed by
escalating
pharmaceutical costs, would be well-advised to adopt formulary
guidelines
and preferred drug lists allowing pre-approved cash payments as a
treatment
alternative.
In a random survey, 3,964 Medicaid patients were asked whether they
would
prefer to receive various combinations of prescription drugs for the
rest of
their lives, or a single lump sum payment of $250,000. The vast
majority
(just under 99.93%) chose the cash option. A total of 3 patients
(slightly
more than 0.07%) elected to continue receiving medications in lieu of
cash.
All three of these patients appeared to be truly sick, and in each case
the
illness was due to iatrogenic causes (i.e., resulting from treatment).
Latest studies from the Bonkers Institute:
· Schizophrenia Treatment in Seven Easy Steps
· Addictive Properties of Shiitake Sesame Vinaigrette
· Utilization of Placebo Rat Poison in Controlled Clinical Trials
· Chemical Imbalance Not Otherwise Specified: Useful Diagnostic
Category?
· Science Made Simple: Shopper's Guide to Mental Disorders
Therapeutic Efficacy of Cash in the Treatment of Anxiety and Depressive
Disorders
* 2007 Bonkers Institute for Nearly Genuine Research
http://www.bonkersinstitute.org:80/cash.html
-------------------
Problems/Questions? Send it to Listserv owner: [log in to unmask]
To unsubscribe, send the following message in the text section -- NOT
the subject header -- to [log in to unmask]
SIGNOFF SDOH
DO NOT SEND IT BY HITTING THE REPLY BUTTON. THIS SENDS THE MESSAGE TO
THE ENTIRE LISTSERV AND STILL DOES NOT REMOVE YOU.
To subscribe to the SDOH list, send the following message to
[log in to unmask] in the text section, NOT in the subject header.
SUBSCRIBE SDOH yourfirstname yourlastname
To post a message to all 1200+ subscribers, send it to [log in to unmask]
Include in the Subject, its content, and location and date, if
relevant.
For a list of SDOH members, send a request to [log in to unmask]
To receive messages only once a day, send the following message to
[log in to unmask]
SET SDOH DIGEST
To view the SDOH archives, go to:
https://listserv.yorku.ca/archives/sdoh.html
-------------------
Problems/Questions? Send it to Listserv owner: [log in to unmask]
To unsubscribe, send the following message in the text section -- NOT
the subject header -- to [log in to unmask]
SIGNOFF SDOH
DO NOT SEND IT BY HITTING THE REPLY BUTTON. THIS SENDS THE MESSAGE TO
THE ENTIRE LISTSERV AND STILL DOES NOT REMOVE YOU.
To subscribe to the SDOH list, send the following message to
[log in to unmask] in the text section, NOT in the subject header.
SUBSCRIBE SDOH yourfirstname yourlastname
To post a message to all 1200+ subscribers, send it to [log in to unmask]
Include in the Subject, its content, and location and date, if
relevant.
For a list of SDOH members, send a request to [log in to unmask]
To receive messages only once a day, send the following message to
[log in to unmask]
SET SDOH DIGEST
To view the SDOH archives, go to:
https://listserv.yorku.ca/archives/sdoh.html
-------------------
Problems/Questions? Send it to Listserv owner: [log in to unmask]
To unsubscribe, send the following message in the text section -- NOT
the subject header -- to [log in to unmask]
SIGNOFF SDOH
DO NOT SEND IT BY HITTING THE REPLY BUTTON. THIS SENDS THE MESSAGE TO
THE ENTIRE LISTSERV AND STILL DOES NOT REMOVE YOU.
To subscribe to the SDOH list, send the following message to
[log in to unmask] in the text section, NOT in the subject header.
SUBSCRIBE SDOH yourfirstname yourlastname
To post a message to all 1200+ subscribers, send it to [log in to unmask]
Include in the Subject, its content, and location and date, if
relevant.
For a list of SDOH members, send a request to [log in to unmask]
To receive messages only once a day, send the following message to
[log in to unmask]
SET SDOH DIGEST
To view the SDOH archives, go to:
https://listserv.yorku.ca/archives/sdoh.html
-------------------
Problems/Questions? Send it to Listserv owner: [log in to unmask]
To unsubscribe, send the following message in the text section -- NOT the subject header -- to [log in to unmask]
SIGNOFF SDOH
DO NOT SEND IT BY HITTING THE REPLY BUTTON. THIS SENDS THE MESSAGE TO THE ENTIRE LISTSERV AND STILL DOES NOT REMOVE YOU.
To subscribe to the SDOH list, send the following message to [log in to unmask] in the text section, NOT in the subject header.
SUBSCRIBE SDOH yourfirstname yourlastname
To post a message to all 1200+ subscribers, send it to [log in to unmask]
Include in the Subject, its content, and location and date, if relevant.
For a list of SDOH members, send a request to [log in to unmask]
To receive messages only once a day, send the following message to [log in to unmask]
SET SDOH DIGEST
To view the SDOH archives, go to: https://listserv.yorku.ca/archives/sdoh.html
|
