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Re: various bipolar meds » 49er

Posted by SLS on October 27, 2010, at 21:46:05

In reply to Re: various bipolar meds » SLS, posted by 49er on October 27, 2010, at 18:24:07

> > > I don't mean to sound like a smart alleck but if polypharmacy is as wonderful as you say it is, why haven't you found the right combination?
> >
> > That is a horrendous question to ask me.
> >
> > It is a cheap shot against me, the doctors whom have treated me, and the efforts of medical science to cure me. I don't understand your need to invalidate psychiatry as it is currently practiced, despite the limitations imposed upon it by a fundamental lack of understanding in a field that is still in its infancy. Neuroscience is working feverishly to gain knowledge and understanding so as to cure mental illness.
> >
> > What does the validation of the rest of psychiatry have to do with me or the difficulties medical science has had in treating me? Do you think that all of the cases of cancer are responsive to the polypharmacy administered? Does one failed attempt to treat in this manner indicate a condemnation of the use polypharmacy in oncology? Of course not.
> >
> > I don't think it serves well that you should use your own experience with psychiatry as a standard by which all other cases are to be compared. Mental illnesses are extremely variable in their presentations and treatment responses. What are the odds that all cases of mental illness should mirror your own? You didn't relapse when you discontinued antidepressant treatment? You are fortunate, but not unique. It happens. I think it depends upon the individual's endophenotype. It happens quite often that the discontinuation of psychiatric drugs allows for relapse. Greater chronicity and recurrency in the presentation of an affective disorder seems to indicate long-term treatment.
> >
> > How is it that I never responded to monotherapy, yet reached remission with polypharmacy? The doctor discontinued my medication after only 9 months. I relapsed within 2 months. To treat this relapse, the doctor elected to use only one of the two drugs that got me well previously. By the time I had tried and failed to respond to a bunch of other drugs as monotherapy, I was no longer responsive to the previously successful combination treatment when it was reintroduced. There is more to my case history that leads me to believe that my chances of remitting spontaneously are nil. After 33 years of unrelenting chronic depression without spontaneous remissions, I think it would be irresponsible of me to neglect polypharmacy as an alterative treatment just because the idea is unpallatable to some authors who fail to demonstrate any science behind their conclusions.
> >
> >
> > - Scott
>
> Scott,
>
> To be honest, I find your assumptions about me just as offensive.

I doubt it, but I would be curious to know just what you think my assumptions are about you.

> I have worked darned hard at my recovery

Recovery from what?

> which has happened in spite of a parent's death and dealing with job instability, and severe insomnia. It wasn't just good fortune.

Yes it was. It was your good fortune not to have the type of depression that never goes away, regardless of how much "work" one does. You are fortunate that you do not yet have terminal cancer. I guess fortune is a matter of perspective.

> And just so everyone is clear on this board, I am not saying that if you relapse, you're not working hard.

Thanks for clearing that up. How about if I do work hard, yet remain ill? I hope you are not intimating that I don't work hard.

> Speaking of oncology, I think chemotherapy has a very low success rate if we're really honest about it.

What are the alternatives you would prefer oncology to adopt during the time between now and when cures are developed? Would you elect to reject chemotherapy now because it is not a panacea?

> I still can't honestly say I would refuse it if god forbid, I was struck with cancer. But I did want to mention that.

Here, your mentioning it really serves to support the use of treatments that have a "very low success rate". How do you justify not treating mental illness with the same desperation? Perhaps your personal experience with depression wasn't desperate enough.

> We have already discussed relapse vs, withdrawal issues so I won't rehash that.

You confuse my often stated belief in the existence of withdrawal rebound depression with your resistance to believe in the existence of post-discontinuation relapse. Hey, if you believe in both, then how would you tell the difference between one and the other? This is a critical question that you have never answered, despite my asking it of you several times. So, how would you?

> > Everyone uses their experience when offering opinions including you.

Not everyone.

> That is human nature.

Is it inhuman to follow the scientific method? Scientists are often perpetual students of objectivity. It must be practiced, but not before it is first internalized.

> By the way, please explain how the links I offered are unscientific. One of them was provided by a psychiatrist who is definitely not anti meds.


Link 1: Here is the conclusion of all of the authors' work:

"12. Conclusion

We are not advancing that antipsychotic combination therapy should be banished from clinical practice. Indeed, a good clinical practice implies taking into account multiple complex variables while determining the best clinical algorithm that should be followed for a given patient. However, it could be argued that, in light of a relative lack of research-supported proof of efficacy, a treatment using the combination of antipsychotics represents polypharmacy, i.e. the prescription of toomany medicines from an EBM perspective."


Link 2: It's a blog of unsubstantiated opinions. A blog.

> I am sorry if I offended you.
>
> My reasoning for asking the question was if I was on a remedy that wasn't working for many years be it drugs or natural remedies, I would be trying something else.

You are clueless as to what I have exposed and subjected myself to in an effort to pursue sufficient improvement to feel alive and rejoin human society.

Clueless.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

 

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poster:SLS thread:966733
URL: http://www.dr-bob.org/babble/20101020/msgs/967181.html