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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by shar on August 15, 2000, at 20:12:57
I've been wondering if there isn't a way to determine what meds might work with whom? That is, some sort of map or matrix that shows if you have trouble with x, and insomnia with y (in an xy combo), and had no effect from a previous try on z, the next step would be to try...a, or a combo of abc.
It seems that there should be some underlying pattern that says that success with x probably means success with y; or success with x probably means trouble with y. Because, even though there is individual variation, the drugs do act on specific chemicals in our bodies (serotonin, others I can't spell). And, depending on how we do on certain ones, shouldn't we be able to approximate a "next step" if we are not being helped?
For example, I used an SSRI that started out great but pooped out really quickly. So, my doc said we wouldn't try any more SSRIs. I thought that was sort of premature, but what do I know?
I did find a site that was designed to help docs figure out what types of meds (SSRI, tricyclic, MAOI) would be of probably benefit based on diagnosis and symptoms. It had you answer questions and depending on answers, would lead you to more questions, ending up (I assume) with recommendations. However, it was too technical for me to get through, had some DSM questions (if I remember) and other diagnostic criteria that I couldn't answer.
I guess it just seems like we end up rolling the dice or something, or choosing meds based on really gross distinctions, and I find it harder to research combos especially if it is 2 ADs, vs. 1 AD plus Ritalin or something.
I anybody knows of some sort of tracking system, or matrix, I would appreciate the info.
Thanks!
Shar
Posted by ChrisK on August 16, 2000, at 8:15:20
In reply to Depression and/or Meds Profiling?, posted by shar on August 15, 2000, at 20:12:57
Shar,
I hope John L answers this post because he has had experience with your question. There is a Dr. Jensen who has a website and speciallizes in this area. He uses a protocol of combining many meds in short trials to determine which meds are most likely to work for any individual. I believe the website is www.drjensen.com but if it's not it should show up on most search engines. The site doesn't go into specifics but does give you an opportunity to purchase his book on the subject.
If you decide to give it a try you will probably have to convince your doctor about the methods as they aren''t the standard month long trials.
John, if you are out there please add to my limited knowledge of this method,
ChrisK
Posted by Rhainy on August 16, 2000, at 9:04:09
In reply to John L: Help with Meds Profiling?, posted by ChrisK on August 16, 2000, at 8:15:20
ChrisK,
Thank You So Much for the Info on Dr Jensen, the site addy you gave is correct adn I am going to order his book.
Maybe it will help to find a doctor who can treat me...if I can hand over the book and ask the doc if they are familiar with his findings.
Blessings,
Rhainy
Posted by JaneST on August 16, 2000, at 12:25:16
In reply to Depression and/or Meds Profiling?, posted by shar on August 15, 2000, at 20:12:57
> I've been wondering if there isn't a way to determine what meds might work with whom? That is, some sort of map or matrix that shows if you have trouble with x, and insomnia with y (in an xy combo), and had no effect from a previous try on z, the next step would be to try...a, or a combo of abc.
>
> It seems that there should be some underlying pattern that says that success with x probably means success with y; or success with x probably means trouble with y. Because, even though there is individual variation, the drugs do act on specific chemicals in our bodies (serotonin, others I can't spell). And, depending on how we do on certain ones, shouldn't we be able to approximate a "next step" if we are not being helped?
>
> For example, I used an SSRI that started out great but pooped out really quickly. So, my doc said we wouldn't try any more SSRIs. I thought that was sort of premature, but what do I know?
>
> I did find a site that was designed to help docs figure out what types of meds (SSRI, tricyclic, MAOI) would be of probably benefit based on diagnosis and symptoms. It had you answer questions and depending on answers, would lead you to more questions, ending up (I assume) with recommendations. However, it was too technical for me to get through, had some DSM questions (if I remember) and other diagnostic criteria that I couldn't answer.
>
> I guess it just seems like we end up rolling the dice or something, or choosing meds based on really gross distinctions, and I find it harder to research combos especially if it is 2 ADs, vs. 1 AD plus Ritalin or something.
>
> I anybody knows of some sort of tracking system, or matrix, I would appreciate the info.
>
> Thanks!
> SharHey Shar:
This not the sophisticated approch you were looking for but my pdoc and I are currently doing this sort of thing with my trial and error history. She got her Ph.D in Chemistry then became a pdoc...we are working some more on Friday along these lines...it's been very enlightening...last time we added Wellbutrin to augment my Remeron...so I will let you know how it goes. Her Guru of choice is Dr. Stahl.
Looks like with all of the money poured in to research we would, by now, have an equation to work with.
Just thoughts,
Jane
Posted by Cam W. on August 17, 2000, at 0:51:24
In reply to Re: Depression and/or Meds Profiling? » shar, posted by JaneST on August 16, 2000, at 12:25:16
>Her Guru of choice is Dr. Stahl.
Jane - Stephen Stahl is a silver-tongued (& penned) devil and editor of the only psych journal to which I subscribe (Journal of Clinical Psychiatry). He is puts a slightly different slant on psychopharmacology and is quite knowledgeable (but who wouldn't be with all the access to research that he has). I'd love to hear him speak, or better yet, have a couple of beers with him. He ranks right up there with my other idols like Stan Kutcher, Charles Nemeroff, Ming Tsang, Joseph Calabrese, Florian Holsboer, and Nancy Andreasen (although Dr.Andreasen chastised me for asking a philosopical question at the Schizophrenia '99 Conference in Edmonton - I still think the question was valid. I wondered whether thought was just a higher form of motor functioning).
God, talk about babbling. I think I need to go to bed. - Cam
Posted by JaneST on August 17, 2000, at 13:45:05
In reply to Re: Depression and/or Meds Profiling? » JaneST, posted by Cam W. on August 17, 2000, at 0:51:24
> >Her Guru of choice is Dr. Stahl.
>
> Jane - Stephen Stahl is a silver-tongued (& penned) devil and editor of the only psych journal to which I subscribe (Journal of Clinical Psychiatry). He is puts a slightly different slant on psychopharmacology and is quite knowledgeable (but who wouldn't be with all the access to research that he has). I'd love to hear him speak, or better yet, have a couple of beers with him. He ranks right up there with my other idols like Stan Kutcher, Charles Nemeroff, Ming Tsang, Joseph Calabrese, Florian Holsboer, and Nancy Andreasen (although Dr.Andreasen chastised me for asking a philosopical question at the Schizophrenia '99 Conference in Edmonton - I still think the question was valid. I wondered whether thought was just a higher form of motor functioning).
>
> God, talk about babbling. I think I need to go to bed. - CamCam:
I have always read most of your posts here and hold you in high esteem as well, so I would add your name to the above list. Your description of the how's and why's of AD's is printed and I will be taking that with me tomorrow am to my pdoc.
She, actually, is one of the lucky ones to have shared a few beers with Dr. Stahl...so we are working within his premises (did I say that right?) as well.
Ditto your humor...we could use more of that here!
Thanks and best thoughts,
Jane
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