![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 2 to 26 of 26. Go back in thread:
Posted by JohnL on January 7, 2000, at 15:42:09
In reply to Lamictal for depression?, posted by Peter on January 7, 2000, at 13:10:11
> I would like to hear of anyone who has used Lamictal for depression. Effctiveness? Side effects? Dosage? I'm considering this as my last resort. Thanks!
I've taken lamictal up to 150mg. It had no side effects. It didn't have a huge impact on my melancholic anhedonic dyshtymia, but I can see how it might work well for other types of depression. It did however smooth my days out so I had no fear of any real bad days. And it relaxed me in social settings where I would normally be uncomfortable. It did have benefits which are hard to put in words, but it did not treat my primary symptom of anhedonia.
But I'm curious. Why is this a last resort? What is your history? If you don't mind, could you share your previous medications, reasons for discontinuation, etc. ? A lot of sharp minds at this board might be able to figure something out.
In the meantime, Lamictal is certainly working for some people. There was a poster here a few months ago that said it was the only thing in a long list of drugs that helped his depression. It's worth a try. The one drawback I can think of is that it has to be titrated slowly, like 25mg a week, up to a range of 100mg to 500mg. Any faster greatly increases the risk of a dangerous rash requiring immediate discontinuation. So it takes a while to get up in dose. Whether you try Lamictal or not, I'm convinced there is always reason for hope and always something else to try.
JohnL
Posted by To John on January 7, 2000, at 18:42:21
In reply to Re: Lamictal for depression?, posted by JohnL on January 7, 2000, at 15:42:09
> > I would like to hear of anyone who has used Lamictal for depression. Effctiveness? Side effects? Dosage? I'm considering this as my last resort. Thanks!
>
> I've taken lamictal up to 150mg. It had no side effects. It didn't have a huge impact on my melancholic anhedonic dyshtymia, but I can see how it might work well for other types of depression. It did however smooth my days out so I had no fear of any real bad days. And it relaxed me in social settings where I would normally be uncomfortable. It did have benefits which are hard to put in words, but it did not treat my primary symptom of anhedonia.
>
> But I'm curious. Why is this a last resort? What is your history? If you don't mind, could you share your previous medications, reasons for discontinuation, etc. ? A lot of sharp minds at this board might be able to figure something out.
>
> In the meantime, Lamictal is certainly working for some people. There was a poster here a few months ago that said it was the only thing in a long list of drugs that helped his depression. It's worth a try. The one drawback I can think of is that it has to be titrated slowly, like 25mg a week, up to a range of 100mg to 500mg. Any faster greatly increases the risk of a dangerous rash requiring immediate discontinuation. So it takes a while to get up in dose. Whether you try Lamictal or not, I'm convinced there is always reason for hope and always something else to try.
>
> JohnLJohn, Have you found anything for the Anhedonia?
Posted by Peter on January 7, 2000, at 20:29:07
In reply to Re: Lamictal for depression?, posted by To John on January 7, 2000, at 18:42:21
Hey John L
Thanks for your offer of consultation but I think I'm played out as far as meds go. The following is a list of meds I've taken, many of which I've taken at therapeutic doses for many weeks (Prozac, Parnate, Effexor, Remeron, Celexa, Zyprexa). Others I couldn't tolerate because of the side effects (Reboxetine). If you have any ideas I would be happy to listen!Prozac
Zoloft
Wellbutrin
Zoloft
Prozac
+ Lithium
+ Buspar
Prozac
+ Trazodone
Trazodone
+ Cytomel
Effexor
Parnate
Parnate
+ Lithium
+ 5HTP
Paxil
+ Depakote
+Nortriptylin
Nortriptyline
+Lithium
Serzone
Moclobemide
Prozac
St. Johns Wort
+ Naltrexone
+ Lithium
+ Pindolol
Prozac
+ Pindolol
Remeron
+Cytomel
+Lithium
+Pindolol
+Zyprexa
+Prozac
Zyprexa
+Prozac
+Celexa
+Naltrexone
+Celexa
+SAMe
+Celexa
Celexa
Effexor XR
+Welbutrin
+Risperdal
Amisulpride
Reboxetine
Clomipramine
Posted by judy on January 7, 2000, at 21:55:49
In reply to Lamictal for depression?, posted by Peter on January 7, 2000, at 13:10:11
Dear Peter,
Your list is similar to mine. I took lamicatal along with depakote because I would cycle up on AD's (I'm dxd bipolar). Because I seem to be treatment resistant, I don't know if the lamictal helped my depression or I simply cycled out. I do remember that it had no side effects (which was a real plus for me). I wish I had some advice to offer, other than totally understanding how frustrated you must feel. I have decided to taper off my meds, I have a very kind psychologist who is supportive. I hope you find some relief.
Take care.
Posted by JohnL on January 8, 2000, at 3:43:04
In reply to Re: To John L, posted by Peter on January 7, 2000, at 20:29:07
Yikes Peter. I see what you mean. I didn't mean to imply consultation here, but in the past other posters have brought up good ideas when I thought I was running out of options. Here are some options.
ECT. You were a candidate for ECT before half that list of drugs was tried.
The dopamine connection. SSRI or TCA augmentation with Methylphenidate, Desoxyn, Adderall, Bromocriptine, Amantadine. None of the drugs you've tried were in the dopamine agonist class. That is an angle that has been totally unexplored with you so far.
The borna virus connection. Amantadine, with or without SSRI or TCA. Some refractory depressive patients discovered by accident their depressions finally lifted after multiple failures when they took Amantadine for influenza. If your depression is virus related, nothing else will work. At this point, this is an option to look at seriously.
Check DHEA levels. I don't know your age, but DHEA supplementation to bring levels up to those of a young 20 year old or teenager is worth considering. Doses of 90mg have worked wonders, even when DHEA levels were normal to begin with. There are prostate risks with this. But regular medical checkups can monitor any problems early.
Other supplements that have worked in refractory depression are Chromium, Acetyl-L-Carnitine, high doses of precursor loading of DL Phenylalanine+Tyrosine, Phosphatidylserene, Pycnogenol.
High doses of vitamin B12 are sometimes used in combination with an AD. I know a lady who had horrible refractory depression who finally got it under control when her doctor had her start a program of taking B12 megadose injections 3 times a week with high dose oral supplements of folate. Matter of fact, high doses of folate can spark mania.
My pdoc tells me in the old days it wasn't uncommon to use MAOI+TCA+stimulant.
And of course, Lamictal, Neurontin, or any combination of two or three of the mood stabilizers WITHOUT an antidepressant. Sometimes the AD makes things worse, where a mood stabilizer or two alone would have worked.
So just when you thought choices were limited, there are actually a lot of things to try. Personally in your shoes I would first try Amantadine, then ECT. Then the dopamine connection. All the while working with the supplements as well.
I'm praying you'll catch a second wind and approach something here with renewed vigor. Wishing you well. Wishing you better days. JohnL
Posted by Scott L. Schofield on January 8, 2000, at 17:01:21
In reply to Re: To John L, posted by Peter on January 7, 2000, at 20:29:07
> Hey John L
> Thanks for your offer of consultation but I think I'm played out as far as meds go. The following is a list of meds I've taken, many of which I've taken at therapeutic doses for many weeks (Prozac, Parnate, Effexor, Remeron, Celexa, Zyprexa). Others I couldn't tolerate because of the side effects (Reboxetine). If you have any ideas I would be happy to listen!
>
> Prozac
> Zoloft
> Wellbutrin
> Zoloft
> Prozac
> + Lithium
> + Buspar
> Prozac
> + Trazodone
> Trazodone
> + Cytomel
> Effexor
> Parnate
> Parnate
> + Lithium
> + 5HTP
> Paxil
> + Depakote
> +Nortriptylin
> Nortriptyline
> +Lithium
> Serzone
> Moclobemide
> Prozac
> St. Johns Wort
> + Naltrexone
> + Lithium
> + Pindolol
> Prozac
> + Pindolol
> Remeron
> +Cytomel
> +Lithium
> +Pindolol
> +Zyprexa
> +Prozac
> Zyprexa
> +Prozac
> +Celexa
> +Naltrexone
> +Celexa
> +SAMe
> +Celexa
> Celexa
> Effexor XR
> +Welbutrin
> +Risperdal
> Amisulpride
> Reboxetine
> Clomipramine
It’s a close one, but I may have you beat!
- Scott
Posted by Scott L. Schofield on January 8, 2000, at 17:19:23
In reply to Re: Lamictal Peter, posted by JohnL on January 8, 2000, at 3:43:04
> The dopamine connection. SSRI or TCA augmentation with Methylphenidate, Desoxyn, Adderall, Bromocriptine, Amantadine. None of the drugs you've tried were in the dopamine agonist class. That is an angle that has been totally unexplored with you so far.
Bromocriptine is a direct dopamine agonist (ligand for the DA receptor). Others would include pergolide and pramipexole.
Just a quick little note…Lamictal has consistently shown itself to be effective it treating bipolar depression (the depressive phase of bipolar disorder). Many people, myself included, are “stuck” in this depression and rarely, if ever, have a manic episode. Most of the studies investigating the effective dosages of Lamictal for bipolar disorder seem to indicate that 200 mg/day is about average. There are also some clinical investigators who feel that Lamictal is also useful in treating rapid-cycling presentations. I am not sure how useful it is for unipolar depression.
The dosage of Lamictal *must* be cut in half when used in combination with Depakote.
- Scott
Posted by judy on January 9, 2000, at 11:36:35
In reply to Lamictal for depression?, posted by Peter on January 7, 2000, at 13:10:11
Dear Peter,
I don't want to start another debate about meds, but I'm just curious about your treating psychiatrist. Is he/she a good therapist? Are you seeing a good therapist aside from the prescribing doc? I posted a while back about my complete frustration with meds and psychiatrists and my decision to taper off. ECT was not an option for me, despite these really nice videotapes provided by two different pdocs, mine to keep. Anyway, I don't know if it's a placebo thing, but I'm really starting to feel better slowly getting off the 5 meds I'm on, maybe it's just the compassionate psychologist. Something to think about. Take care.
Posted by anita on January 9, 2000, at 19:59:18
In reply to Re: Lamictal Peter, posted by JohnL on January 8, 2000, at 3:43:04
For me, Lamictal helps stabilize my moods, and in that way it helps with depresssion, but I can't say it generally speaking has a strong antidepressant effect for me. I do highly recommend Lamictal to those who have fluctuating moods, especially since it seems to work at a low dose and has low side effects.
The interesting thing about amantadine is that it increases dopamine (D1 & D2). So the reason it works for some depressions may be not because it is a viral depression, but because the dopamine helps the depression and other dopaminergic meds hadn't been tried with this population. I believe there is a test for the borna virus, but I could be just thinking of an experimental one that's in the works.
I second the suggestion to try dopaminergic meds -- I think some depressions are really helped by them that do not respond to serotonergic/noradrenergic meds.
anita
> The dopamine connection. SSRI or TCA augmentation with Methylphenidate, Desoxyn, Adderall, Bromocriptine, Amantadine. None of the drugs you've tried were in the dopamine agonist class. That is an angle that has been totally unexplored with you so far.
>
> The borna virus connection. Amantadine, with or without SSRI or TCA. Some refractory depressive patients discovered by accident their depressions finally lifted after multiple failures when they took Amantadine for influenza. If your depression is virus related, nothing else will work. At this point, this is an option to look at seriously.
>
Posted by Zeke on January 10, 2000, at 4:14:16
In reply to Lamictal for depression?, posted by Peter on January 7, 2000, at 13:10:11
Peter --
The Merck Manual reports that Lamictal, "may provoke suicidal behavior." (see: http://merck.com/pubs/mmanual/tables/189tb6.htm) Of course, that claim is clouded by the fact that suicidal behavior is not uncommon with depression itself.
You might get some other ideas from the Treatment section for depression there also: http://merck.com/pubs/mmanual/section15/chapter189/189b.htm
I agree with others that stimulants and other pro-dopaminergic drugs might be helpful. The stimulants in particular (Ritalin, Dexedrine, Desoxyn, Adderall) should specifically considered since they have an antidepressant effect in themselves, as compared to simply augmenting an antidepressant. MAO inhibitors also seem absent from the list you posted and (most) also effect dopamine -- increase dopamine levels.
The theories about Borna Virus and depression (and other psychiatric disorders and chronic fatigue syndrome) are relatively new. They may or may not be significant. None the less, amandadine has multiple effects -- including but not limited to dopamine. It also effects serotonin and norepinephrine for example. (for more re amantadine and depression see: http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=10333162&form=6&db=m&Dopt=b) So Borna virus or not, it could be helpful.
The other item that seemed missing was use of thyroid hormones to potentiate ADs. JohnL is right -- you have many other options unexplored. Your frustration is understandable and something I've felt. But options abound.
Judy -- I'm curious why ECT was not an option for you. I assume you're speaking of a personal decision, not for medical reasons. I've not had ECT but had epilepsy in my childhood and don't feel I have the gross brain pathology that some of the antipsychiatry (anti ECT) sites aspouse. Despite what Dr. Breggin and others say, the method is relative harmless and the effect of an ECT seizure vs. an 'epileptic' seizure are the same. I'm curious how these antiscience people rationalize that there are many epileptics without the destructive mental effects they claim of this procedure, especially as used currently (unilateral not bilateral, limited course of treatments). Love and compassion are desirable and beneficial but usually not effective in themselves in serious mood disorders. And most psychanalysis and pop psychology hasn't prooven itself in scientific study. But I can see how you would feel somewhat better now as you were concurently on 5 meds before. That's a pretty hefty mix and can certainly leave you feeling zonked. But good luck to you. (And use critical thinking re Dr. Breggin's notions, since he dosen't.)
Posted by judy on January 10, 2000, at 17:03:14
In reply to Re: Lamictal for depression? Peter & Judy, posted by Zeke on January 10, 2000, at 4:14:16
Hi,
I knew I would stir up trouble. Would you believe I was a highly functioning scientist up until 2-3 years ago? (Although to be honest, I changed jobs often and abused drugs pre- psychiatrists). Anyway, alot of Dr. Breggin's points are actually based on evidence, and while he puts a positive or negative spin on things- I'm still comfortable with his theories. Which when it comes to the brain and it's intricacies, most stuff is. I, personally will not have ECT because I'm afraid of further injury to my brain, I have years of drug abuse, 2 head injuries that caused seizures, and these last almost 2 and 1/2 years on psychotropic meds. You're absolutely right that there's no proven evidence that compassion "cures" mental disorders, but then again what does? In my case support has been a hell of a lot more helpful then the list of drugs Peter presented; but I also accept that drugs help an awful lot of people. Because of my bipolar label, unfortunately nobody was giving me any options- it was my way or the highway. Thanks for your views and take care.
Posted by Ruth on January 10, 2000, at 20:35:51
In reply to Lamictal for depression?, posted by Peter on January 7, 2000, at 13:10:11
I've been taking lamictal for a unipolar depression for the past two years at dossages up to 500. I became toxic at that dossage and started to have double vision so we dropped the dose back to 300. Other than that I've had no problems with side effects.
Has it been effective? When I first began taking it it seemed to have a significant impact on the intensity of the hopeless feelings. That is less true now so it is unclear whether that is related to its losing effectiveness or a change in my reaction to other meds.I feel for you and the long combo of meds you've tried. I have had a similarly frustrating time. I've been taking lamictal, respirdal and celexa and up until recently that combo seemed to work for about a year. Most recently I added aricept to try to impact the concentration and memory problems I've had, but it is too soon to tell what that will do.
Good luck and keep us posted.> I would like to hear of anyone who has used Lamictal for depression. Effctiveness? Side effects? Dosage? I'm considering this as my last resort. Thanks!
Posted by Zeke on January 10, 2000, at 22:55:01
In reply to To Zeke, posted by judy on January 10, 2000, at 17:03:14
> Hi,
> I knew I would stir up trouble. Would you believe I was a highly functioning scientist up until 2-3 years ago? (Although to be honest, I changed jobs often and abused drugs pre- psychiatrists).It sounds like highly functioning scientists are also human beings with human limitations and human problems. And it sounds like your life has changed a great deal in that time.
> Anyway, alot of Dr. Breggin's points are actually based on evidence, and while he puts a positive or negative spin on things- I'm still comfortable with his theories.
First, I don't mean to attack you by attacking Breggin.
But here's the beef--
1. Breggin picks out evidence that supports his notions and discards the rest.
2. Further, much of his 'hard' evidence is anecdotal and testimonial. (Others -- scientists -- use phenomenology to illustrate findings and generate hypotheses, not in place of emperical research. When they do, their ideas are always conveyed as tentative & hypothetical.)
Judy, you could go to the NIMH site and look at Breggin's presentation to the ADD conference in Nov. 98. He rants and raves and pulls every piece of evidence about the evils of psychostimulants. One in particular is that stimulants simply make people obsessive. Now do a PubMed search on stimulants and OCD. He never mentions that amphetamine also has antiobsessive effects. There is abundant research about safty and effectiveness of stimulants in ADD but he mentions none of this while scraping up only research that supports his thesis. Spin is quite an understatement.
Ironically, Breggin takes these gross liberties, but nit picks about views that differ from his own. He does not apply these standard to what he supports. Nor do I see him -- or his 'center' -- doing research. At least I don't see it in crediable science & medical journals.
Lastly, reports I heard of Breggin and his followers' behavior at the conference -- dominating the Q/A period of other presenters -- make me believe that he will probably never be invited back
> I, personally will not have ECT because I'm afraid of further injury to my brain, I have years of drug abuse, 2 head injuries that caused seizures, and these last almost 2 and 1/2 years on psychotropic meds.
I can feel where you're coming from. Even without your hx, ECT can be freightening.
And since you are bipolar, ECT might not be as appropriate unless you are deeply depressed. (With the head injuries and resultant seizures, I wonder if you were rapidly cycling.)
I'm curious though, what specific brain injury would result from ECT?
> You're absolutely right that there's no proven evidence that compassion "cures" mental disorders, but then again what does?
I've found that Dexedrine has relieved many symptoms of my ADD. I had found that Tegretol controlled my seizures -- I no longer have them so I guess that could be called a cure.
Compassion should not be discounted, but RE my ADD, without medication, others' compassion usually turned to frustration, anger and blame.
The compassion notion leaves me with the idea that mental disorders are therefore caused by a lack of compassion. The idea soon becomes very muddy.
> In my case support has been a hell of a lot more helpful then the list of drugs Peter presented;Don't you mean "than the list of drugs *YOU* were on"?
> but I also accept that drugs help an awful lot of people. Because of my bipolar label, unfortunately nobody was giving me any options- it was my way or the highway.
I feel sad for you and the way you were treated. Being treated with kindness and humanity should be part of any physicians manner -- especially psychiatrists. Yet I fear that kindness without medical care will leave you at least as frustrated and wanting as the reverse.
The "my way or the highway" attitude must make you terribly angry at the medical approach. To be fair, it is the 'my way' doctor who are the ones to be angry at.
What I'm trying to say is, don't force yourself to one side or the other. Give consideration to the benifits of both.
> Thanks for your views and take care.
Ditto
Posted by Noa on January 11, 2000, at 6:43:37
In reply to To Judy, posted by Zeke on January 10, 2000, at 22:55:01
Hi, Zeke. I was at the ADD conference. As much as I don't like Breggin's views and question his science, I don't remember him behaving inappropriately there. He does present himself as provocative, but that is just part of who he is. This conference was a "consensus conference", and the panel was purposely diverse. Breggin was in the extreme position at one end, but there were others who questioned the validity of the diagnosis, or prevalence, or costumary treatment practices. The difference is that they presented more credible data. But I don't remember him behaving badly perse.
Posted by Noa on January 11, 2000, at 6:46:30
In reply to Re: To Judy, posted by Noa on January 11, 2000, at 6:43:37
The difference is that they presented more credible data--I should have added that another major difference is that other doctors who expressed doubts about the validity of the diagnosis, etc., were less extreme in their views, in that they conceded a lower prevalence of some of the aspects of ADHD, and that there were some kids for whom they would prescribe ritalin.
Posted by Noa on January 11, 2000, at 6:49:10
In reply to Oops, left something out..., posted by Noa on January 11, 2000, at 6:46:30
BTW, there were also conflicting reports about the addictiveness of ritalin. Some animal studies showing repeated use actually sensitizes the brain to amphetamine. A large study of hyperactive boys over many years, showing no significant difference in drug abuse between those on ritalin and controls.
Posted by Zeke on January 11, 2000, at 10:37:21
In reply to Re: To Judy, posted by Noa on January 11, 2000, at 6:43:37
> Hi, Zeke. I was at the ADD conference. ... I don't remember him behaving inappropriately there.
Hi Noa --
I didn't mean Breggin per se, but the band of folks associated with him and the antipsychiatry movement. My info is that they dominated the question periods following other presenters. My impression is that these same people pressed to have Breggin included as a presenter; he was invited later than most others. So between this display by the antipsych folk, and the bad science from Breggin himself, I feel he likely 'played out his hand' at NIMH conferences. Perhaps I'm wrong about this. And you are right about it being a consensus conference.
I appreciate your two addl. (oops) comments too. Certainly there is much legitimate contraversy re ADD, such as the diagnostic limits. I tend to agree with Wender's approach: That the potenmtial benefits from stimulants are so great in those with ADD, and the side effects / dangers of a limited trial so minimal to one without, that if one reasonable fits the diagnosis, that ethically, stimulants should be tried.
My take on the stimulant/sensitization issue is that at the moderate doses used in ADD are basically benign. (As you comment on also.)
I think that "neurogenesis" -- absolutely contrary to old wisdom about the brain -- makes some of these issues of sensetization and brain changes, a bit more relative too.
Posted by judy on January 11, 2000, at 11:18:41
In reply to Oops, left something out..., posted by Noa on January 11, 2000, at 6:46:30
Thank you for your views of Dr. Breggin's behavior. I just read something interesting about the disparity in diagnosing ADHD in Britain vs the U.S. In Dr. Sutherlands book, Breakdown, which was originally written in 1976 and later ammended in 1998, he notes that ADHD is dxed 10x more often in America as Britain and feels it is likely to be caused by the differences between the countries psychiatrists rather than children. I feel the same sort of disparity exists with bipolar disorder, once the DSM1V was published with it's 40 something? categories of bipolar disorder this conditon became more dxed. The positive was the distinction between schizophrenia and manic depression; the negative more people being drugged unnecessarily. As a former scientist, I see the role of pharmaceutical companies in all of this, the desire to push a drug that shows any efficacy in animal trials to make a few more bucks. I've seen the "massaging" of data, some scientists are not immune from questionable ethical practice just as some psychiatrists are not. Just me evolving here, from total faith in the medical system to a lot of questions about it. I am open to any and all views. Take care.
Posted by judy on January 11, 2000, at 11:29:58
In reply to To Noa, posted by judy on January 11, 2000, at 11:18:41
I also see Dr. Breggin's actions as commitment rather than over zealous behavior; and I also like the fact that he took time to e-mail me with suggestions of where I could find help. (When I posted a few weeks ago about my dilemma, someone suggested I e-mail Dr. Ivan Goldberg, which I did but got no response. Perhaps he is busier than Dr. Breggin) Take care.
Posted by Peter on January 11, 2000, at 11:48:16
In reply to Re: Lamictal Peter, posted by JohnL on January 8, 2000, at 3:43:04
Thanks to all of you for your support/advice.
John L: the Borna virus is an interesting theory but I have a hard time believing there wouldn't be other symptoms besides some form of mental illness.
I have tried Ritalin and Cylert, both of which give temporary relief and then I rapidly develop tolerance.
Anyway for right now I have started the Lamictal and I would be very happy if it would make just a little difference.
BTW I have gone the psychotherapeutic route for many years and it has helped to a slight degree but I find the depression/dysthymia to be just as strongly rooted as it has been most of my life.
Good luck to all!
Peter> Yikes Peter. I see what you mean. I didn't mean to imply consultation here, but in the past other posters have brought up good ideas when I thought I was running out of options. Here are some options.
>
> ECT. You were a candidate for ECT before half that list of drugs was tried.
>
> The dopamine connection. SSRI or TCA augmentation with Methylphenidate, Desoxyn, Adderall, Bromocriptine, Amantadine. None of the drugs you've tried were in the dopamine agonist class. That is an angle that has been totally unexplored with you so far.
>
> The borna virus connection. Amantadine, with or without SSRI or TCA. Some refractory depressive patients discovered by accident their depressions finally lifted after multiple failures when they took Amantadine for influenza. If your depression is virus related, nothing else will work. At this point, this is an option to look at seriously.
>
Posted by Noa on January 11, 2000, at 12:12:12
In reply to Re: Lamictal Peter, posted by Peter on January 11, 2000, at 11:48:16
While there might be a great deal of cases in the US of very "liberal" diagnosis, and certainly I know of inadequate evaluation before prescribing stimulants, there is also a great deal of underdiagnosis, people whose problems go unnoticed. This came up again and again at the NIH conference last year. Not that this evens out happily for all. Hardly. We need the pediatricians to be better trained about getting independent observations from teachers and others besides the parents. We need HMOs, etc. to allow pediatricians to refer kids to pediatric psychiatrists and neurologists. We need the HMOs to all pediatricians to refer to therapists for non-pharmocological treatment, either instead of or in conjunction with, medication (depending on the individual needs of the patient). We need school professionals to be better trained, and for parents to have access to more guidance on how to decipher what is going on with their kids and how to develop more effective parenting skills.
Posted by judy on January 11, 2000, at 12:36:15
In reply to Re: Lamictal Peter, posted by Peter on January 11, 2000, at 11:48:16
Dear Peter,
Did your therapist try cognitive therapy? It's really been proven to work except with the most severe of depressions. (It has really helped me) JohnL wrote a while back to me about doing a "wash" from meds; once someone has been on as many as you, do you even know what your "baseline" is? I sure don't, but I'm finding out. I hope whatever you decide, that you feel better soon. Take care.
Posted by Zeke (with horns pitchfork) on January 11, 2000, at 23:20:41
In reply to To Noa, posted by judy on January 11, 2000, at 11:18:41
JUDY> more people being DRUGGED unnecessarily
Where'd I hear this terminology before? The term 'drugged' implies coercion and control -- I mean, do we say some people are 'appropriately drugged'? It's clearly pejorative.
JUDY> ADHD is dxed 10x more often in America as Britain and feels it is likely to be caused by the differences between the countries psychiatrists rather than childrenDoes this mean American psychiatrists overdiagnose or British psychiatrists underdiagnose ADD? I would venture to say that 50 years ago, 10 times as many depressed people were treated with psychoanalysis. So? (This approaches what Patricia Churchland calls 'Arguments of Ignorance'.)
Am I being unfair to Breggin? Prior to the November 98 ADD Conference, he wrote a piece (still on his site) that goes:To Protest The Make Up Of the Conference
To demand the modification of this conference to include a broader diversity of opinion about “ADHD” and psychostimulants:
...Write to the Director ... at NIH who oversees consensus conferences AND DEMAND THAT HE STOP THE CONFERENCE.Some don't see this as 'over zealous':
ZEAL: eagerness and ardent interest in pursuit of something
How does that shoe fit Noa?
The whole Breggin matter has the flavor of something Bertrnd Russell writes about in 'An Outline of Intellectual Rubbish':When Benjamin Franklin invented the lightning rod, the clergy, both in England and America, with the enthusiastic support of George III, condemned it as an impious attempt to defeat the will of God. For, as all right-thinking people were aware, lightning is sent by God to punish impiety or some other grave sin-the virtuous are never struck by lightning. Therefore if God wants to strike any one, Benjamin Franklin ought not to defeat His design; indeed, to do so is helping criminals to escape. But God was equal to the occasion, if we are to believe the eminent Dr. Price, one of the leading divines of Boston. Lightning having been rendered ineffectual by the "iron points invented by the sagacious Dr. Franklin," Massachusetts was shaken by earthquakes, which Dr. Price perceived to be due to God's wrath at the "iron points." In a sermon on the subject he said, "In Boston are more erected than elsewhere in New England, and Boston seems to be more dreadfully shaken. Oh! there is no getting out of the mighty hand of God." Apparently, however, Providence gave up all hope of curing Boston of its wickedness, for, though lightning rods became more and more common, earthquakes in Massachusetts have remained rare.
Interestingly, Russell adds later:
Belief in "nature" and what is "natural" is a source of many errors. It used to be, and to some extent still is, powerfully operative in medicine. ... Every advance in civilization has been denounced as unnatural while it was recent.
Perhaps the world would lose some of its interest and variety if such beliefs were wholly replaced by cold science. ... A wise man will enjoy the goods of which there is a plentiful supply, and of intellectual rubbish he will find an abundant diet, in our own age as in every other.
Or as Churchland says, "Given that neuroscience is still very much in its early stages, it is actually not a very interseting fact that someone or other cannot imagine a certain kind of explanation of some brain phenomenon." But later says, "Learn the science, do the science, and see what happens."
Alas, I seem to sense old intellectual recipes cooking.
PS It's unfortunate that Ivan Goldberg didn't respond to Judy's query, but I doubt she's tried contacting the National Depressive and Manic-Depressive Association
Posted by Noa on January 12, 2000, at 6:30:14
In reply to To Noa: Breggin the Point!, posted by Zeke (with horns pitchfork) on January 11, 2000, at 23:20:41
Believe me, I am certainly no defender/supporter of Breggin! I was simplysharing my observation that I didn't see any bad BEHAVIOR on his part at the conference. I agree, he is more of a missionary than a scientist, and therefore it is hard to take him seriously.
I agree that it is unfortunate that Judy didn't get a response from Dr. Goldberg. And she has described unsatisfactory treatment from doctors. But the fact that a doctor responds speaks only to his personal "bedside manner" and not to his clinical skills in general or his approach. I understand the wish to be free of meds. They have been both a life saver and a royal pain in the neck for me, and there have been years of frustrating adjustment and readjustment and trading side effects. For me, it seems worth it because life without meds wouldn't last long. With meds I can function and use my therapy to try to take more control of my life. I also worry about Judy's wholesale abandonment of meds for Breggin's questionable philosophy. But I guess she got fed up with the medquest.
Posted by Scott L. Schofield on January 12, 2000, at 15:23:11
In reply to Re: To Noa: Breggin the Point!, posted by Noa on January 12, 2000, at 6:30:14
> Believe me, I am certainly no defender/supporter of Breggin! I was simply sharing my observation that I didn't see any bad BEHAVIOR on his part at the conference. I agree, he is more of a missionary than a scientist, and therefore it is hard to take him seriously.
I’ve seen a whole lot of posts regarding the controversial perspectives of Dr. Breggin. I submitted only one of my own, and didn’t feel like reading the rest. I have pretty much made my mind up about his contentions anyway.I had one interesting thought, though. It might be a cool (constructive) idea for opponents of the Breggin camp to list those things they agree with. There may be a few things that he has been right about, and it would be a shame if any of them were overlooked.
It’s pretty hard work to be wrong about everything.
I guess that’s why I feel fatigued all day long.
- Scott
This is the end of the thread.
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