Guest Column: Rebuttal to Gatekeepers to Pharmaceuticals

Jane H. Feldman, MD

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In This Article

Objectivity and Judgment

The last point gets to the issue of decision-making and judgment, and who is able to do those adequately. Once again, headaches or secondary symptoms of an upper respiratory infection may make someone cranky, slightly irritable, and less than happy but, generally speaking, do not impair judgment to any extent. Depression and anxiety, however, often have a great deal of impact on judgment. Decision-making regarding staying on a medication long enough and giving yourself an adequate dose requires a great deal of objective thinking. It can be very difficult to be objective when you are in a pathologic mood or anxiety state. It is likely that patients without some form of ongoing contact with a professional will become prematurely discouraged after starting a medication trial and will falsely believe that nothing can help them or that things are going worse than they really are. It has often been noted by clinicians that the first symptoms of depression to resolve are the physical ones such as the sleep and eating disturbance, and the last thing to resolve is the subjective sense of depression. This could have a profound negative impact on the possibilities of success for a self-administered medication trial.

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