Posted by linkadge on August 1, 2007, at 14:45:52
In reply to Re: My Experience Mirrors Yours, posted by dewdropinn on July 31, 2007, at 18:04:14
>I watched my mother go through a similar >breakdown over the course of year -- on the >downside, I think I inherented the whole genetic >schmorgasborg from her -- on the upside, it's >made me very proactive about finding solutions >and trying every possible option available.
I too was fairly proactive myself. That has given me a bad record however. Some doctors consider this a sign of drug seeking, some doctors just don't like the fact that they can't take the same approach with me, ie telling me that drugs do things they don't or that they don't do things they do.
>At a certain point, the diagnosis becomes >largely irrelevant -- the diagnosis determines >the treatment, and if the treatment isn't >effective, then the diagnosis doesn't mean a >great deal. IWell thats the thing. I could list about 5 drugs which I think would help, but my doctor simply *will not* do anything I suggest. He doesn't like me playing doctor, and will go to the extent of almost prescribing the opposite to what I suggest.
I don't know how it works in the States. I don't know if you pay for any of the psychiatrist appointment out of your pocket. All the doctors I have seen have been absolutely adament on the fact that I will not be making any decisions.
>1) there are very few drugs that have been >around as long as Dilantin and Tegretol, and >they are among the very few drugs that people >have sucessfully taken for entire lifetimes at >heroic doses -- no one can truly say what the >ramification of taking SSRIs for 30 years areTrue, but that doesn't necessarily make the drugs any safer. My main concern is that strict compliance will send me down the same road as my mother. She is mentally 20 years older than she is. She is the only one in our distant family that has treated the disease as agressivly and as long term as she has. Even the episodes of mild lithium toxicity have left cognative scars that nobody in the family can deny.
>In many respects, some of the older anti->convulsants are among the only psychiatric meds
>(excepting the benzos) that you can feel some >degree of comfort taking for 10, 20, 30 years >because tens of millions of people have done >exactly that. This isn't to say that people >haven't suffered side effects associated with >long-term administration of Dilantin or >Tegretol -- it's just that the track record for >long-term use is very well defined.I agree that the record is well defined.
>Epileptics usually take these drugs at much >higher doses than those suffering from mood >disorders, which just makes the long term >picture look rosier.
Why? Epileptics have notorious histories of depression, cognative dysfunction and all sorts of crazy things that may be a result of treatment.
>and there's a neuro-degenerative component to >mood disorders, so there's still probably a net >gain associated with taking anti-convulsants.
I would still argue that this is an unknown.
It may depend on the type of mood disorder.
We only really have evidence that these treatments supress symptoms. We don't know if they are supressing the underlying pathology or not. Dr. Manjii, a molecular biologist who is a head researcher for the NIMH in bipolar says that of the mood stabilizers, only lithium and valproate show any ability to upregulate markers of neuronal placticity. Lamictal, tegretol, trileptal, gabapentin, topomax, had no ability to modify targets such as PKC, BCL-2, GSK-3b, BDNF etc. Sometimes anticonvulsants actually lower such markers. The benzodiazapines, for instance, lower BDNF, FGF-2, NGF, and other growth factors, which is probably a cause of some of induction of depression.>Jack Dreyfuss, phenytoin's single greatest >promoter, attributed his sanity and longevity to >his low dose Dilantin protocol, and he lived >well into his 90's. So, I think there's many >reasons why you need not be overly concerned >with the implications of long-term use of anti->convulsants
Yeah, and old Uncle Dwayne smoked 5 packs a day and lived to 120! Doesn't mean smoking is good for you, or that good ol' Dwayne might not have lived that long anyway.
>Your dilemma also begs the old quality of life >question -- is it better to live a long and >miserable life, or a less lengthy but happy and >productive one?But thats the thing. I would need to find a treatment that works before I could make that comparison acurately. Most medication regiments I have taken have made me significantly less productive. My mother, for instance, had to quit as a teacher as lithium made keeping up with the students too difficult.
>If you die of a heart attack 30 years from now >because of cardiotoxicity issues associated with >long-term use of a tricyclic, will you have >lived a happier and more productive life
Perhaps, but the end would sure suck, and at that point, I'd probably wish I hadn't taken the meds. I might wish, at that point that I'd rather be alive and miserable.
>With treatment resistant mood disorders, I >personally think that you have to be willing to >assume some risks, because the consequences of >not exploring options with potential long-term >side effects can be absolutely tragic
Somtimes such disorders resolve without treatment more completely than they do with treatment. Although I feel like crap, for the most part I feel better off meds than I do on them.
Linkadge
poster:linkadge
thread:772375
URL: http://www.dr-bob.org/babble/20070730/msgs/773341.html