I would like to extend my thanks to Dr. Andrew Farah for taking the time to provide me with this interview. Dr. Farah is a clinical psychiatrist who lectures about psychiatry and family medicine at Wake Forest University. He is also the Medical Director at High Point Regional Hospital in High Point, North Carolina.
Q. What role do you feel the Internet can play in becoming an educated healthcare consumer?
A. The Internet can be a double-edged sword. It is great on one hand to see so many resources, yet the huge volume of information can be overwhelming for the consumer. Learn to rely on a few trusted sources. Don't feel the need to examine all sites and articles in a search. Also, make your search as specific as possible. For example, if you are concerned about weight gain on an antidepressant, your doctor may tell you abut Celexa, which has been proven in clinical studies to have a low side effect of weight gain. After speaking with your doctor, you should return to the Internet to research this drug further at both at Celexa.com, or credible third-party Web sites.
Q. Do you feel Internet resources provide good quality information?
A. Know your source! Just because it is "on the net" does not mean it is reliable. Avoid chat rooms for direct advice- stick with your doctor for instruction- even if there is a doctor in the chat room. Patients visiting chat rooms tend to discuss extreme responses - not always typical examples. Many doctors on these sites are good, but they don't know YOU and how your specific body may react to medications and changes. Using Medline, an online medical search engine, searches can be interesting, but these are research-oriented, and many patients are left confused by abstracts and articles that don't answer their specific questions. Take Medline searches to your doctor. Don't try to interpret them for any meanings specific to your case without a professionals input.
Q. What specific Internet resources do you personally feel are helpful? Are there specific sites that you can recommend?
A. Third-party informational site, like WebMD are easy to use. This site offers a helpful selection with a quick search option. Organizational sites dedicated to mental health, like the National Institute of Mental Healths (NIMH) site, at www.nimh.nih.gov, offer a large database of data and resources. Finally, drug manufacturers sites like Celexa.com are helpful, providing links/sections for educational information. These are well written sites, usually updated daily.
Q. What sorts of questions should the patient be asking his/her doctor?
A. In a recent survey, I found that a majority of physicians use the Internet for specific patient care information. For example, if they have a patient with Parkinson's disease, and are interested in a new drug, they will search that information in a specific way, but will not routinely visit patient education sites. So your doctor is probably more familiar with those sites than others. You should ask your doctor about areas of interest specific to your illness. For example, I recently had a patient interested in breast-feeding on antidepressants, and she asked me about the data, and I told her where I'd researched it. She would have had a hard time finding it just searching for antidepressants.
Q. What sort of information is helpful to bring to the doctor during an initial evaluation for depression?
A. We want to know if this change in your behavior and emotions has undergone an acute change or if the change has been a gradual onset and will ask you about how you are functioning. For example, how is your sleep, appetite, energy level, and concentration? Have you had any past response, or lack of response to a drug? Any family history? Any drug or alcohol use? Medical problems? Any history of mania? And of course we want to know if you have suicidal thoughts. Answers to these questions are essential to most effectively diagnosis and treat the patient.