Hi guys

Just trying to get some anecdotal snap shots of how psychiatrists treat mental illness in Thailand.

Is it usual to hand out prescriptions for lexapro and prozac without any in depth assessment?

Moved to the Health, Body and Medicine forum.

Well GPs in the west hand out Lexapro and Prozac without much in terms of assessment.

What is precisely your question, and I'll try to answer it.

If it's about how easy is it to obtain, wel yes very easy. If it's about standards of Psychiatry, very poor in general, although there are a few decent ones around, the majority are pill pushers IMO. That may change in the coming years, with some of the younger Psychiatrists, who seem much more modern in thinking, assessing and prescribing.

My usual advice, unless it is a case of frank psychosis, is to go into counselling with a Western therapist and let him/her refer you to someone for a script if, once they have a handle on what is going on with you, they think meds are indicated.

Reasons being:

(1) A therapist who is spending say an hour a week with you will be in a much better position than even a conscientious psychiatrist to assess (i) if you need meds and (ii) if so, what exactly for i.e. depression alone, anxiety alone or depression with anxiety (makes a big difference in terms of best med). They will in turn convey their assessment to the psychiatrist. They all have MDs they refer to for this purpose. So better chance of getting the right medication from the very start, which can save a lot of problems.

(2) Therapy plus meds works better than meds alone.

I had been suffering terrible panic attacks and went to BKK Pattaya Hosp. The psychiatrist had no interest in anything I had to say just wrote an rx for Lexapro, told there are no side effects and I was out in under 10 mins. I took Sheryl's advice and sought help from a western psycholigist and found out I had situational panic and slight pstsd. 2 months later, I'm back to my old sel again. Glad I sought the advice of a western dr. Just my experience with the Thai mental health system.

Once heard an eminent psychiatrist say that the best treatment for mental illness is never given in todays hospitals....when asked what that was he replied.....ordinary everyday ....time for chatting...compassion and above all........LOVE.

psychiatrists, anywhere, are just representatives of the legal drug companies, aka drug pushers

if they can earn a nice bundle of cash on commissions, that everybody is mentally ill, read DSM-V manual

Hi, it is not just Thai doctors pushing legal drugs, try Europe, Australia, USA. anywhere!

The inducements can be pretty good.

The only thing that these "doctors" can do is help you become a drugged zombie...

No problem to get prozac, or what you want in Thailand, sleeping pills, no problem.

As a Clinical Psychologist, may I comment on the professionalism of Thai trained/educated psychiatrists. Their background of training is similar to those in the west, but their medical and ethical standards are not as high. Having said that, the Thais doctors whom I meet have a similar educational and medical background as most found in the west. My impression is that when a doctor enters the residential phase of training they are taught to rely too heavily on just prescribing medication and diagnosing from the DSM Manual. The same happens in the west but there the psychiatrists at least make an attempt to assist by having the client undergo some clinical intervention and many do refer to a Clinical Psychologist. I cannot prescribe medication but I am able to inform the MD concerned and the psychiatrist of the type of medication that should be prescribed. One problem that most psychiatrists do not recognise is that their background in psychology is nowhere as extensive as that of a psychologist. I often get very frustrated when in a medical team, and psychiatrists are always the leader as they are M.D.s but do not have the insight into the causes or development of the type of problems we handle. I have sometimes been asked how I was able to solve and help overcome some behaviours that they could not resolve.