Posted by Alex Findlay on July 2, 2009, at 0:40:00
Response to patient seeking Ritalin.
There are a number of doctors, who for some reason or another hate Ritalin and there is no point in wasting time, as they have access to studies that support the use of stimulants.
My recommendation is to change doctors as there are just about the same number of doctors who support the use of it.
I recently had to meet with a doctor because I was on an out of State assignment and out of Ritalin, which I have been taking continuously since 1989. He asked me if I had ever had effexor and I said yes but I changed to Pristiq, and he said what is that?
The doctor, Dr. Mills MD in West Plains Missouri, was a young doctor who was unfamiliar with Haldol and even asked what MMPI stood for and out of the blue said I was manic depressive(bi-polar). I had medical records that were up to date, but he refused to look at them or even call my doctor when I handed him my doctors card and told him he was awaiting a call.Ritalin is often used off label successfully and made the difference of Night and Day to Me. I was out Ritalin and he turned me away knowing that abrupt withdrawal is life threatening.
I was very upset and found a number of people who have to drive 150 miles for treatment.Closed minded doctors are similar to pro and anti abortion advocates, cannot see logic and in my opinion are in need of Cognitive Behavioral therapy.
Supporting Doc.
An open study of methylphenidate
in bipolar depression
by
El-Mallakh RS.
Department of Psychiatry and Behavioral Sciences,
University of Louisville School of Medicine,
KY 40292, USA.
rselma01@athena.louisville.edu
Bipolar Disord 2000 Mar; 2(1):56-9ABSTRACT
BACKGROUND: The treatment of bipolar depression is problematic. Mood stabilizing agents are often inadequate, while antidepressants may induce mania or mood destabilization. Methylphenidate has been advocated as an effective antidepressant agent in unipolar depression, and depression secondary to medical illness. Amphetamine administration has been shown to reduce manic behavior. These independent observations suggest that methylphenidate may be a safe and effective agent in bipolar depression. METHODS: Fourteen depressed subjects with DSM-IV bipolar illness and a Hamilton-depression (HAM-D) scale score of at least 15 had methylphenidate added to a stable mood stabilizer regiment. Patients were followed weekly for 4 weeks and then biweekly for an additional 8 weeks. RESULTS: HAM-D scores dropped from 16.9 +/- 1.79 SD at baseline to 9.4 +/- 9.73 on week 12 (p = 0.12, t = 1.84, df= 6) and 9.8 +/- 7.56 on last observation carried forward (LOCF) (p = 0.019, t = 2.8, df = 10). Psychiatric symptom assessment scale (PSAS) scores dropped from 17.9 +/- 5.63 at baseline to 4.8 +/- 7.47 at week 12 (p = 0.016, t = 4.02, df= 4) and 6.3 +/- 6.75 on LOCF (p = 0.007, t = 3.74, df = 7). Three individuals stopped secondary to anxiety, agitation, and hypomania, respectively. CONCLUSION: In this brief, open study, methylphenidate was effective and relatively safe in depressed bipolar subjects.
Alex Findlay
poster:Alex Findlay
thread:904411
URL: http://www.dr-bob.org/babble/20090630/msgs/904411.html