Posted by linkadge on July 1, 2005, at 17:17:48
In reply to Re: Trileptal is pooping-out on me. » linkadge, posted by SLS on July 1, 2005, at 9:00:53
>It will be interesting to see where Trileptal >takes me. If I respond robustly to it, I think >it might give you another clue as to how the >pieces of the puzzle fit together. The subgenual >cingulate region (Brodmann area 25) is >metabolically overactive in treatment-resistant >depression. Perhaps the white matter in this >adjoining region becomes hyperactive for lack of >information processing in the hypofunctional >subgenual gyrus gray matter. Sodium channel >antagonists like Tegretol and Trileptal might >reduce the activity in the cingulate white >matter in depression. That sounds pretty stupid, >actually. Never mind. I was just trying to bring >into the equation the successes seen in the use >of DBS for severe depression, but that might be >something that is applicable only to unipolar >depressives who experience sadness. Maybe DBS >doesn't work for bipolar depression.Maybe a simple pet scan could guide treatment for you?? It is known that different AD's and different mood stabalizers have effects on different areas of the brain.
I failed to see the logic in the DBS though. If the subgenual cingulate is overactive in depression, what good is done by electrically stimulating it ???
>Linkadge, I think for future visits, and prior >to seeing a doctor for the first time, you send >them a letter laying out your history, symptom >profile, previous treatments, and your most >immediate treatment ideas. Keep your comments >organized and focused rather than rambling and >thinking out loud. Give the practicioner a >little time to digest your case and develop a >respect for your knowledge and intellect before >they ever meet you. He will also need time to >engage his humility circuits.
Things are extrordinarily tight here in canada. I waited 8 months for *any* opening for *any* psychiatrist in the area. They know they have the upper hand since they are in so much demand. I feel that if I ventured to write a letter like that, chances are good I'd never hear from them again. It's almost like an "accept what you get" type of situation. It's pretty bleak unfortunately.
Linkadge
poster:linkadge
thread:520955
URL: http://www.dr-bob.org/babble/20050627/msgs/522078.html