Pinned Tweet
This video illustrates how too-fast psychotropic withdrawal has a domino effect throughout the nervous system and, consequently, many body systems: youtube.com/watch?v=7Nn7NZ… It can take a while for all the dominoes to fall, explaining delayed withdrawal symptoms.
29
93
213
Kindly #deprescribe -- taper psychiatric drugs retweeted
When i started psychiatry 60 yrs ago, "patient's rights" was a new & thrilling concept- returning to them the dignity as citizens they deserved.
It instead became society's excuse for cruel neglect- patients die/are homeless/in jail "with their rights on".
It instead became society's excuse for cruel neglect- patients die/are homeless/in jail "with their rights on".
“I can’t help but wonder what her life could look like if we cared as much about her suffering as we do about her right to be left alone.”
open.substack.com/pub/deborahgee…
9
16
59
2,910
Kindly #deprescribe -- taper psychiatric drugs retweeted
Post partum is not a disease, it's a time period.
Post means after, partum means birth. After birth.
Post partum depression is depression after childbirth.
Post partum psychosis means psychosis after childbirth.
Hope that's helpful.
Post means after, partum means birth. After birth.
Post partum depression is depression after childbirth.
Post partum psychosis means psychosis after childbirth.
Hope that's helpful.
1
3
11
858
Kindly #deprescribe -- taper psychiatric drugs retweeted
"This study found that from 2012 to 2022, children and adolescents diagnosed with ADHD or ASD became increasingly similar to peers without these diagnoses."
Changes in Characteristics Associated With ADHD and ASD Diagnoses Over Time jamanetwork.com/journals/jamap…
Changes in Characteristics Associated With ADHD and ASD Diagnoses Over Time jamanetwork.com/journals/jamap…
0
6
15
833
Both psychiaty & neuroscience need some additional bond to make psychiatric neuroscience work, because what it's come up with so far for a biological basis of thoughts & emotions is ludicrous (but expensive).
November issue of Brain Journal now out with an Editorial by @belin_david and myself on The return of neuropsychiatry: why clinical neuroscience needs neurology and psychiatry reunited
academic.oup.com/brain/article/…
0
0
0
120
New diagnosis," complex persistent opioid dependence (CPOD)", for patients reluctant to go off opioids prescribed for chronic pain. Physiologically dependent, but not, you know, addicted.....
Opioid Tapering in Psychiatric Care: Risks and Best Practices hmpgloballearningnetwork.com/site/pcn/qa/op…
Opioid Tapering in Psychiatric Care: Risks and Best Practices hmpgloballearningnetwork.com/site/pcn/qa/op…
0
0
1
195
Kindly #deprescribe -- taper psychiatric drugs retweeted
‼️ The same rules apply in outpatient setting and chronic illness management. 🩺
✔️ Believe the patient! (Yes, they really DO have 30 symptoms. Yes, they really DO have fatigue that severe. Yes, they really DO have brain fog that impairs work/school.)
✔️ You may not understand what's going on with your patient as a physician and a fellow human, but you should avoid judging your patient as "crazy," "anxious," "not right in the head."
✔️ Practice compassion and hopeful-realistic attitude. You should avoid making promises for a cure, but also avoid hopeless statements like, "There is nothing we can do for you," OR "Only a good psychiatrist/psychologist can cure you."
✔️ Believe the patient! (Yes, they really DO have 30 symptoms. Yes, they really DO have fatigue that severe. Yes, they really DO have brain fog that impairs work/school.)
✔️ You may not understand what's going on with your patient as a physician and a fellow human, but you should avoid judging your patient as "crazy," "anxious," "not right in the head."
✔️ Practice compassion and hopeful-realistic attitude. You should avoid making promises for a cure, but also avoid hopeless statements like, "There is nothing we can do for you," OR "Only a good psychiatrist/psychologist can cure you."
"Acts of compassion during a period of trauma may last a lifetime in a person’s memory."
Brian Kulp describes the lasting effects of compassion and humour from healthcare professionals during a medical emergency
bmj.com/content/395/bm…
19
64
298
9,751
A long list of citations can be quite impressive. But over the last 30 years, the quality of articles published in medical journals has declined as pharmaceutical companies & supplement sellers game the journal system with advertorials for their products.
In case anyone wants to check the research Dr. Aiken cites, here's all the 1,796 citations organized by topic and treatment area: thecarlatreport.com/CAMresource
He tackles the research the way you'd expect from someone who started out as a research assistant at NIMH.
0
0
2
165
Kindly #deprescribe -- taper psychiatric drugs retweeted
DSM has been oversold & overbought. It is not:
1)applicable to most people in general population
2)meant to be used in self diagnosis
3)a golden path toward self understanding
4)a self help manual
5)an encyclopedia of human behaviors
It is a:
1)valuable, but fallible, way to sort psychiatric symptoms
2)vehicle of clinical communication
3)necessary guide to treatment planning
4)tool for clinical & epidemiological research
I agree completrly with:
1)applicable to most people in general population
2)meant to be used in self diagnosis
3)a golden path toward self understanding
4)a self help manual
5)an encyclopedia of human behaviors
It is a:
1)valuable, but fallible, way to sort psychiatric symptoms
2)vehicle of clinical communication
3)necessary guide to treatment planning
4)tool for clinical & epidemiological research
I agree completrly with:
When a diagnosis like autism or ADHD becomes a way to understand yourself, we have a problem.
Psychiatry was not created as a tool for self-development or self-knowledge. It applies the medical model to human behaviour and experiences and in doing so, frequently pathologises them. It categorises but it does not explain.
If you look to psychiatry to provide the answers as to why you are the way you are, you are inevitably going to be frustrated. That just isn’t what psychiatry can do.
10
30
157
8,302
Kindly #deprescribe -- taper psychiatric drugs retweeted
Learning to say no to patient requests
bmj.com/content/395/bm… via @HelenRSalisbury
bmj.com/content/395/bm… via @HelenRSalisbury
2
1
3
1,073
This comment is news only because it goes against psychiatry's prevailing conceptual paradigm, which is that you feel bad because there's something wrong with your brain, which can be fixed with psychiatric drugs.
It's important not to get so focused on what's happening in someone's brain that we forget to ask what's happening in their life.
1
1
11
425
Kindly #deprescribe -- taper psychiatric drugs retweeted
Another large study finds ADHD meds don't improve school performance, at least for kids on the margin of treatment.
I remain unsure what ADHD is. I was taught it was a delay in maturation that resolved. Later, a lifelong disorder of attention. More recently, a problem of thways more than attention.
Either way, parents and teachers often push medication hoping to improve grades.
This study looked at all children aged 5 to 15 in Norway. It used differences in how clinics prescribe as a natural experiment. Using this analysis academic benefits of medication disappeared.
"For children and adolescents on the margin of pharmacological treatment for ADHD, we found no causal effect of pharmacological treatment on any of our measures of academic performance."
DOI: 10.1192/bjp.2026.10754
Picture: Figure 2(b) showing that GPA doesn’t significantly increase with meds using the instrumental variable analysis.
I remain unsure what ADHD is. I was taught it was a delay in maturation that resolved. Later, a lifelong disorder of attention. More recently, a problem of thways more than attention.
Either way, parents and teachers often push medication hoping to improve grades.
This study looked at all children aged 5 to 15 in Norway. It used differences in how clinics prescribe as a natural experiment. Using this analysis academic benefits of medication disappeared.
"For children and adolescents on the margin of pharmacological treatment for ADHD, we found no causal effect of pharmacological treatment on any of our measures of academic performance."
DOI: 10.1192/bjp.2026.10754
Picture: Figure 2(b) showing that GPA doesn’t significantly increase with meds using the instrumental variable analysis.
40
44
203
20,415
"Bipolar disorder" is rather promiscuously distributed. What are the chances that any woman has a purportedly bipolar relative? Probably about 100%.
Simple family history remains a much more powerful/useful predictor of psych diagnosis & treatment response than all the fancy genetic studies constantly being published. Too often neglected in assessment.
0
0
2
212
Kindly #deprescribe -- taper psychiatric drugs retweeted
Reminder: "findings do not support the use of antipsychotic augmentation in patients with treatment-resistant depression."
A 2025 study followed almost 40,000 patients with treatment-resistant depression given an antipsychotic and compared them with matched patients given
Antipsychotics did not reduce suicide outcomes, though suicide death showed a concerning signal (HR 1.22, 0.91–1.71). All-cause mortality was higher on antipsychotics (HR 1.21, 1.07–1.33).
Ref: 10.1192/bjp.2024.283
A 2025 study followed almost 40,000 patients with treatment-resistant depression given an antipsychotic and compared them with matched patients given
Antipsychotics did not reduce suicide outcomes, though suicide death showed a concerning signal (HR 1.22, 0.91–1.71). All-cause mortality was higher on antipsychotics (HR 1.21, 1.07–1.33).
Ref: 10.1192/bjp.2024.283
Aripiprazole or bupropion for antidepressant augmentation?
Similar in new trial of anxious #depression.
Learn why bupropion causes less anxiety than often thought:
psych-partners.com/aripiprazole-v…
15
16
79
4,629
Kindly #deprescribe -- taper psychiatric drugs retweeted
We learned nothing from the disastrous #OxyContin tragedy.
Big Pharma/Venture Capital/Biotech startups are pouring billions prematurely hyping ketamine/psilocybin/MDMA.
Long term efficacy unclear & safe only in highly controlled/very expensive settings.
Result will surely be massive increase in very dangerous street use.
Big Pharma/Venture Capital/Biotech startups are pouring billions prematurely hyping ketamine/psilocybin/MDMA.
Long term efficacy unclear & safe only in highly controlled/very expensive settings.
Result will surely be massive increase in very dangerous street use.
Researchers are optimistic about psychedelic drugs as potential treatments for depression and mood disorders, despite pushback having stalled the field
go.nature.com/4e1WDEM
18
21
84
6,546
How much did they spend on this nothingburger?
Biological psychiatry is still wasting research resources, now in the guise of neuroscience. Attitudes don't have neural signatures, y'all.
Biological psychiatry is still wasting research resources, now in the guise of neuroscience. Attitudes don't have neural signatures, y'all.
Nature research paper: Emotion regulation capacity lacks a shared neural signature
go.nature.com/4itfBFL
1
0
1
216
Kindly #deprescribe -- taper psychiatric drugs retweeted
Somethings I learned recovering from years of psychiatric drug harm.
Get out of your own head. Engage with the physical world. Go outside. Breathe, meditate learn to observe your thoughts.
The harsh reality is I had to learn I was the only one that could fix my life. I stopped being a victim and took back control. None of this is easy. Healing is a lot more involved than just getting off the drugs.
I'm so grateful for my recovery.
Get out of your own head. Engage with the physical world. Go outside. Breathe, meditate learn to observe your thoughts.
The harsh reality is I had to learn I was the only one that could fix my life. I stopped being a victim and took back control. None of this is easy. Healing is a lot more involved than just getting off the drugs.
I'm so grateful for my recovery.
8
16
79
3,220
Kindly #deprescribe -- taper psychiatric drugs retweeted
Top 10 Lessons Medical School Doesn’t Teach You
The patient is not the disease. – Treat the human being, not just the diagnosis.
Listening is a clinical skill. – Sometimes the most important clue comes when you stop talking.
Confidence is not competence. – The most dangerous doctor may be the one who never doubts.
A normal report doesn’t mean a healthy patient. – Clinical judgment matters more than isolated numbers.
Knowing when to ask for help saves lives. – Medicine is teamwork, not a competition.
Patients remember kindness. – They may forget your name but remember how you treated them.
Good documentation protects patients. – What isn’t communicated can become a medical error.
Not every patient needs another prescription. – Sometimes reassurance, education or observation is better medicine.
You cannot save everyone. – But you can offer every patient dignity, honesty and compassion.
Doctors are human too. – Rest, mental health and personal relationships matter.
Medical school teaches you how to become a doctor.
Real patients teach you what it means to be one.
Which lesson did you learn the hard way?
The patient is not the disease. – Treat the human being, not just the diagnosis.
Listening is a clinical skill. – Sometimes the most important clue comes when you stop talking.
Confidence is not competence. – The most dangerous doctor may be the one who never doubts.
A normal report doesn’t mean a healthy patient. – Clinical judgment matters more than isolated numbers.
Knowing when to ask for help saves lives. – Medicine is teamwork, not a competition.
Patients remember kindness. – They may forget your name but remember how you treated them.
Good documentation protects patients. – What isn’t communicated can become a medical error.
Not every patient needs another prescription. – Sometimes reassurance, education or observation is better medicine.
You cannot save everyone. – But you can offer every patient dignity, honesty and compassion.
Doctors are human too. – Rest, mental health and personal relationships matter.
Medical school teaches you how to become a doctor.
Real patients teach you what it means to be one.
Which lesson did you learn the hard way?
3
5
16
1,608