Comments and Controversies
Busting my own myth
I enjoyed the article “From Persephone to psychiatry: Busting psychopharmacology myths” (Pearls, Current Psychiatry, September 2010, p. 40-41) because I think we all have biases, and I wanted to look at my practices. After learning about the use of multiple antipsychotics for schizophrenia despite little evidence it helps, and the fact that most panic disorder patients are not taking a selective serotonin reuptake inhibitor, I began to change what I do.
I recall a recent trial where I tried to follow algorithms until the patient reached remission. In my opinion, these types of algorithms, which are used routinely in the United Kingdom and other government-run health care systems such as the VA, take the guesswork out of our profession and allow us to trust the evidence and give our patients realistic and positive expectations for full remission or recovery regardless of the extent of their disorder. When enacted on a large scale, I also believe that following algorithms and taking out your personal biases leads to improved results by simply making people make almost automated decisions. I also agree that checking evidence and recent articles doesn’t take a lot of time.
Corey Yilmaz, MD
Adult and Child Psychiatrist