Several years ago, actor Tom Cruise denounced psychiatrists' use of antidepressants and methylphenidate in children and adults. I took his comments as innocent expressions of ignorance about a specialty that takes years of study to understand.
Recently, however, Cruise criticized actress Brooke Shields for taking antidepressants for her postpartum depression. He then verbally attacked NBC television's Today show host Matt Lauer, who said he knows people who have benefited from using methylphenidate.
I think Cruise is venting his psychological issues in public but using the wrong venue. A well known country music singer interviewed by CNN's Anderson Cooper also suggested that Cruise discuss his own emotional issues instead of chastising the people who could help him. The singer told Cooper how antidepressants saved her career and possibly her life.
If your patients won't try medication after Cruise's diatribes, I offer these two examples:
A 76-year-old woman refused to eat for fear of being poisoned by her relatives. She spent all day in bed and demanded to see her lawyer to change her power of attorney. I started her on olanzapine, 5 mgld, which increases appetite as a side effect. Three days later, she was eating and sleeping normally and attending physical therapy sesswns.
An 8-year-old boy with obsessive-compulsive disorder was using three or four rolls of toilet paper per day and taking 1-hour showers to make sure he didn't smell. After 2 weeks of sertraline, 50 mg/d, and behavior modification by a psychotherapist, his behavior improved dramatically.
I would love to hear how Cruise and others who stigmatize psychotropic use dispute how the medications improved these patients' quality of life. Shields offered this testimony: "To suggest that I was wrong to take drugs to deal with my depression, and that instead I should have taken vitamins and exercised, shows an utter lack of understanding about postpartum depression and childbirth in general," Shields wrote in The New York Times. "If any good can come of (Cruise's comments), let's hope (they call) much-needed attention to a serious disease."