B.K. Eakman (“Anything That Ails You,” Views, August) laments the use of psychotropic medications; as is so often the case, however, she is not the one who deals with the suffering patient.  Though the patient might have erroneously bought into the notion that she can and should be happy, this is irrelevant: The patient still suffers, and it is the doctor who is called upon to relieve that suffering.

The prescription pad is usually not what the physician turns to first.  What most often happens is that the patient has presented the doctor with symptoms; a thorough work-up has been done to exclude other disorders, and the diagnosis of depression, anxiety, a combination of both (or another psychiatric diagnosis) is ultimately made.  It is also true that many people just have tough lives: a woman divorced with two children, a poor education, and a husband who is a deadbeat; a woman who has just lost her job; a woman who has a son in Iraq and cannot sleep at night from worrying about his safety.  It is the physician who deals with these problems, and, believe me, to tell the patient just to suck it up is cruel and stupid—because most people cannot just suck it up.  So when that referral to a sleep clinic does not bring sleep, and when biofeedback and all those other New Age wonders fail, the patient must be medicated—not because the doctor is lazy but because the patient is still in anguish.

It would be better if Mrs. Eakman had some answers to offer, instead of useless criticisms.  Perhaps she should spend a few months seeing patients before blessing us with her observations.

        —John Dente, M.D.
Wilmington DE

Mrs. Eakman Replies:

It is not so much a question of women (or men, for that matter) “buying into” the notion that they should be happy but doctors buying into the notion that they can actually do something about depression, among other mental problems.  For starters, I refer you to a recent Glaxo (Pharmaceutical Company) release regarding studies of the effects of Paxil on youth.

Reuters News Service reports that: “GlaxoSmithKline Plc, responding to a lawsuit claiming it suppressed negative data about its antidepressant Paxil, published results of trials showing the drug is broadly ineffective in children and adolescents and could increase risks of suicidal behavior.

“The British drug-maker released data from nine pediatric trials on its Web Site after New York Attorney General Eliot Spitzer filed suit two weeks ago accusing Glaxo of fraudulently suppressing the information.”

According to thememoryhole.org, “The results in a nutshell: Paxil had as much effect on depression as a sugar pill.  Though no one committed suicide during the trials, actions related to suicide showed up significantly more often in patients taking Paxil than in those taking a placebo.

“All nine studies (complete except for the appendixes) have been posted on Glaxo’s site.”

And, according to an August 25 article in the Wall Street Journal, the antidepressant Effexor has the highest association of suicidal thoughts or actions, suggesting an already-admitted finding by British researchers that other antidepressants (notably Paxil and Prozac) have similar side effects.

As a matter of fact, I am quite familiar with patients suffering from depression as well as other mental illnesses.  My conclusion is that the medical and psychiatric professions are nowhere near advanced enough to solve, or even to alleviate, most of these problems.  Every compassionate person wishes it were different, of course.  At present, however, the “cure” is often worse than the “illness”—if, indeed, mental conditions such as depression can even be classified as “illnesses” rather than phenomena.  There simply is no pill or medication for life’s trials, tribulations, and even outright horrors—all of which can get even the best of us down.  At present, we are still left with such mundane responses as character and fortitude.