Those Big Pharma ads used to be illegal and now they’re not. Doctors have told me they gum up health care needlessly.
I work with young adults, and I would say 10-15% of my work is supporting them in making sensible decisions about crap meds. This is almost, though not quite, as dangerous a problem as substance abuse. While I am prohibited by law from discouraging the use of patent medicines (SSRIs & SNRIsa) I am allowed to provide education about them. I can also encourage them to report side effects promptly.
Fortunately, I'm working with college students, so I can just point them to some of the studies that claim the drugs work, as well as the studies that prove they are no better than placebo-- as well as stuff like RIAT's work on the reanalysis of Paxil Study #329, and encouraging them to do their own research (not on Reddit or TikTock.) The hard science and pre-med kids are usually outraged, as most folks are who have any background in research and writing.
Many of the psychiatrists are caught in a bind. Their job has been reduced to simply prescribing medication, and the good ones don't like it any more than I do. In the past few years, I've had the vague impression that they
are relieved when I send them back to be re-evaluated and often tapered off the meds. For the moment, they are shielded from liability because these 'medications' are still considered part of the standard of care. Hope to see that change in my lifetime.
The most extreme situations are in hospital; I had one client have their Xanax removed with no taper, and Abilify dose was quadrupled. Again, I can't legally suggest changing medication. But there is no law against going to the nurse's station, noting the change in medications, and saying, "My client is now trembling uncontrollably and showing symptoms of tardive dyskinesia. What's the plan here?" Uh, I don't know, the psychiatrist isn't here right now.
"That's okay. I can wait."
And then I stand there with my arms folded. Might not work again, but at least it worked once. Client got off all medication, had a complete recovery, aced all their exams, and called me from southeast Asia to brag about their new job and learning to drive. Great kid.
Nothing was wrong with them except the medication. To be fair, I have seen SSRIs work well about two or three times in seven years of practice. I had one kid with severe TBI who did really well on Prozac, another now who might be benefiting, but with severe headaches, so there may be rare situations where they're helpful.