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Comment by Theodores | Hacker News Reader

For those down voters: I am British, we have the NHS.

Over here healthcare is not just another business, it is a public service. We grumble about the NHS but we love it too. With the NHS you don't have to second guess whether that doctor is after your wallet, or even think about it, he/she isn't.

By comparison the American healthcare system is something that, with a British perspective, appears to have something tantamount to 'Münchausen syndrome by proxy'. With the British NHS you can end up on pills all your life but there is not a business case for it. Meanwhile, in America, if you can be signed up for a smorgasbord of uppers, downers and a few off-label side orders for the rest of your days then Big Pharma is happy.

Here is one of my favourite books that describes what goes on:

http://www.amazon.com/Blood-Medicine-Blowing-Deadliest-Presc...

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I've been through the wringer with depression in the American system, this has not been my experience.

I've heard this particular chestnut often. In so far as I understand, if your doctor does this, they're committing malpractice. I'm not saying doctors don't do this, or someone's doctor doesn't, but this is not the norm. Not by a long shot.

Ditto. In fact, my psychiatrists have loved generics, they don't want cost to get in the way of treatment.

(Caveat: generic mood stabilizers (used for treating bipolar disorder) that are also anticonvulsants have I've heard a bad history of not working like the brand name, First World manufactured originals.)

The fact that Wil was prescribed Effexor (venlafaxine) instead of the almost identical but more expensive Pristiq (desvenlafaxine) is a pretty good indicator that this wasn't just an attempt to get more money out of him.

I was put on literally dozens of medications from age 10-18 to try to treat depression and anxiety. None of it responded the way psychiatrists or doctors claimed it was supposed to, for me. I only started to alleviate symptoms once I forcibly and against my parents' wishes took myself off of them. It was rough at first, but slowly I started to gain the social skills that I had lost over time due to being completely out of whack during the time I was on medication.

I've gone back and tried a few, but the only things that seem to have any positive effect are short-acting anxiety medications which I take maybe once every 2 weeks to help with a flare-up. The long-term depression is nearly gone.

I still would recommend that anyone that is in a deep depression that hasn't tried medication before try them, because it works well for most people. But if you are one of the unlucky ones that it does not work for, keep trying, as coming out the other side is definitely worth all the pain and suffering. You also get a wonderfully nice perspective and can empathize with others who are going through it, something a lot of people can't say.

(1) The NHS still has to buy the drugs, so there is still significant incentive to market them. (2) While British doctors are not paid by their patients, they can be(and are) paid by pharmaceutical manufacturers to run trials, speak at conferences, advocate to other doctors, etc. (A notable, and infamous, example is Wakefield's MMR study, which was performed while he was receiving money for drug company litigants and trying to develop a competing product)Better than the US, but not perfect.

A book I recommended elsewhere in this thread, http://www.amazon.com/Anatomy-Epidemic-Bullets-Psychiatric-A..., does an admirable job of researching the history and results (medical, scholarly, social and financial) of psychological drugs in the US.

There's not a business case for it? Are you implying the NHS gets the drugs for free?

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