Psycho-Babble Medication Thread 96446

Shown: posts 1 to 9 of 9. This is the beginning of the thread.

 

Medication Treatment of Bipolar Disorder 2000

Posted by Cam W. on March 5, 2002, at 1:21:18

The following URL is from the "Expert Consensus Guideline Series". It is good, but it does have its drawbacks. It might be fun to critique the Guidelines. There are some heavy hitters in the field of bipolar disorder research on the Consensus Panel (p.2).

Also, I like this line: "The recommendations in the guidline reflect the aggregate opinions of the experts and do not necessarily reflect the opinion of each individual one each question."

The Guidelines are very good, but they have to be interpreted with caution. Anyone wanna critique it's short comings and praise it's strong points?

It can be downloaded free at:

http://www.psychguides.com/gl-treatment_of_bp2000.html

And, if it is within your price range of 104 pages of paper (I use to backside of memos) and the ink that the paper sucks up. The only other thing it will cost you is a thin three-ringed binder and hole-punch. It is a good reference book (once again, when read properly).

Have fun - Cam

 

Re: Medication Treatment of Bipolar Disorder 2000 » Cam W.

Posted by JohnX2 on March 5, 2002, at 1:35:38

In reply to Medication Treatment of Bipolar Disorder 2000, posted by Cam W. on March 5, 2002, at 1:21:18


> And, if it is within your price range of 104 pages of paper (I use to backside of memos) and the ink that the paper sucks up. The only other thing it will cost you is a thin three-ringed binder and hole-punch. It is a good reference book (once again, when read properly).
>
> Have fun - Cam

Gee 104 pages!
I hope someday this thing can be condensed to a
sentence of 1 or 2 medicines.

-John

 

Re: Medication Treatment of Bipolar Disorder 2000 » Cam W.

Posted by Krazy Kat on March 5, 2002, at 8:08:11

In reply to Medication Treatment of Bipolar Disorder 2000, posted by Cam W. on March 5, 2002, at 1:21:18

thanks!

 

Re: Medication Treatment of Bipolar Disorder 2000 » Cam W.

Posted by Ritch on March 5, 2002, at 10:21:49

In reply to Medication Treatment of Bipolar Disorder 2000, posted by Cam W. on March 5, 2002, at 1:21:18

> The Guidelines are very good, but they have to be interpreted with caution. Anyone wanna critique it's short comings and praise it's strong points?
> Have fun - Cam

Hi Cam, Thanks for that one. The strong points? Well, it is consistent with my experience especially with regard to antidepressants and their effect on aggravating hypomania (generally).

The weak points? It is a consensus of opinions. It is very generalized. When it comes to BPII you will see a lot of variance with some treatment option scenarios. It doesn't address treatment intolerance effectively. The bizarro thing is how they seem to rate bupropion so high for not triggering hypomania, yet stimulants are rated down with TCA's for being very likely to trigger hypomania. Bupropion was worse in my case. You get the feeling that *all* symptoms are directly springing from the bipolar disorder. They seem to look at comorbidities as some sort of mirage (mistakenly in my opinion).

Mitch

 

Re: Medication Treatment of Bipolar Disorder 2000 » Ritch

Posted by JohnX2 on March 5, 2002, at 16:59:05

In reply to Re: Medication Treatment of Bipolar Disorder 2000 » Cam W., posted by Ritch on March 5, 2002, at 10:21:49


Off a mood stabilizer, bupropion by far produced
the worst mania. I think there is some "mass psychology"
history to this that maybe isnt all that well understood given
how old the medication is.

-John

> > The Guidelines are very good, but they have to be interpreted with caution. Anyone wanna critique it's short comings and praise it's strong points?
> > Have fun - Cam
>
> Hi Cam, Thanks for that one. The strong points? Well, it is consistent with my experience especially with regard to antidepressants and their effect on aggravating hypomania (generally).
>
> The weak points? It is a consensus of opinions. It is very generalized. When it comes to BPII you will see a lot of variance with some treatment option scenarios. It doesn't address treatment intolerance effectively. The bizarro thing is how they seem to rate bupropion so high for not triggering hypomania, yet stimulants are rated down with TCA's for being very likely to trigger hypomania. Bupropion was worse in my case. You get the feeling that *all* symptoms are directly springing from the bipolar disorder. They seem to look at comorbidities as some sort of mirage (mistakenly in my opinion).
>
> Mitch

 

Re: Medication Treatment of Bipolar Disorder 2000 » JohnX2

Posted by Ritch on March 6, 2002, at 0:11:31

In reply to Re: Medication Treatment of Bipolar Disorder 2000 » Ritch, posted by JohnX2 on March 5, 2002, at 16:59:05

>
> Off a mood stabilizer, bupropion by far produced
> the worst mania. I think there is some "mass psychology"
> history to this that maybe isnt all that well understood given
> how old the medication is.
>
> -John


John,

That is akin to a title of a book I heard mentioned in an English class called "The Anxiety of Influence". It was about how all of the major themes in lit had already been written about-and how was a writer to approach a truly novel subject?

Philosophically, this phenomenon of "me-tooism" has to do with pdocs (often unwitting)prejudice towards patients in the limited amount of time they have to do any evaluation. I understand that all sorts of human *institutions* are frought with "contemporary establishment mullahs" that compose all of the guidelines for the bright newbies and to advise relative incompetents (who happened to have decent finances from parents, but who lack originality), etc., on how to do their stuff.

I just think that too many people "run" with ideas of others without looking at fresh empirical data of their own and forming their own ideas. The idea being-wouldn't it be better to read Marx than to read a book by someone who wrote *about* Marx??

I was very impressed with a philosophy prof. that liked Herman Hesse a lot. Perhaps a good idea for the bookclub would be "The Glass Bead Game".

Ok. There is your *mass psychology* elaboration. I think most meds are trial and error on an individual basis.

Mitch

 

Re: Medication Treatment of Bipolar Disorder 2000 » Ritch

Posted by JohnX2 on March 6, 2002, at 0:54:39

In reply to Re: Medication Treatment of Bipolar Disorder 2000 » JohnX2, posted by Ritch on March 6, 2002, at 0:11:31

Very well written Mitch!

-John


> >
> > Off a mood stabilizer, bupropion by far produced
> > the worst mania. I think there is some "mass psychology"
> > history to this that maybe isnt all that well understood given
> > how old the medication is.
> >
> > -John
>
>
> John,
>
> That is akin to a title of a book I heard mentioned in an English class called "The Anxiety of Influence". It was about how all of the major themes in lit had already been written about-and how was a writer to approach a truly novel subject?
>
> Philosophically, this phenomenon of "me-tooism" has to do with pdocs (often unwitting)prejudice towards patients in the limited amount of time they have to do any evaluation. I understand that all sorts of human *institutions* are frought with "contemporary establishment mullahs" that compose all of the guidelines for the bright newbies and to advise relative incompetents (who happened to have decent finances from parents, but who lack originality), etc., on how to do their stuff.
>
> I just think that too many people "run" with ideas of others without looking at fresh empirical data of their own and forming their own ideas. The idea being-wouldn't it be better to read Marx than to read a book by someone who wrote *about* Marx??
>
> I was very impressed with a philosophy prof. that liked Herman Hesse a lot. Perhaps a good idea for the bookclub would be "The Glass Bead Game".
>
> Ok. There is your *mass psychology* elaboration. I think most meds are trial and error on an individual basis.
>
> Mitch

 

Re: Medication Treatment of Bipolar Disorder 2000 » Ritch

Posted by Blue Cheer 1 on March 6, 2002, at 1:08:44

In reply to Re: Medication Treatment of Bipolar Disorder 2000 » JohnX2, posted by Ritch on March 6, 2002, at 0:11:31

> >
> > Off a mood stabilizer, bupropion by far produced
> > the worst mania. I think there is some "mass psychology"
> > history to this that maybe isnt all that well understood given
> > how old the medication is.
> >
> > -John
>
>
> John,
>
> That is akin to a title of a book I heard mentioned in an English class called "The Anxiety of Influence". It was about how all of the major themes in lit had already been written about-and how was a writer to approach a truly novel subject?
>
> Philosophically, this phenomenon of "me-tooism" has to do with pdocs (often unwitting)prejudice towards patients in the limited amount of time they have to do any evaluation. I understand that all sorts of human *institutions* are frought with "contemporary establishment mullahs" that compose all of the guidelines for the bright newbies and to advise relative incompetents (who happened to have decent finances from parents, but who lack originality), etc., on how to do their stuff.
>
> I just think that too many people "run" with ideas of others without looking at fresh empirical data of their own and forming their own ideas. The idea being-wouldn't it be better to read Marx than to read a book by someone who wrote *about* Marx??
>
> I was very impressed with a philosophy prof. that liked Herman Hesse a lot. Perhaps a good idea for the bookclub would be "The Glass Bead Game".
>
> Ok. There is your *mass psychology* elaboration. I think most meds are trial and error on an individual basis.
>
> Mitch


Excellent insights, Mitch. I am so sick of hearing psychiatrists tell me about the successes they've had using various drugs with *other* patients I can't tolerate 0.5 mg. of Risperdal/day - it causes dyskinesias and makes me feel dead. In fact, I'd rather be dead than use this drug again, but *knowing* this, a psychiatrist just asked me to try it for a week at 2.5 mg/day (if I get randomized to it in a study). It's crazy, and I've been hearing this for years. Sixty drugs or more since 1967, and only three have ever helped long-term (lithium, Lamictal and Valium). Thorazine and high-dose Zoloft were helpful for a short time during acute episodes.
The guidelines seem to be written for medical students. It make me wonder when I see the Consensus Series compared to the Texas Algorithms or the VA Guidelines, *or the APA's Best Practice Guidelines. There must be better things to do. :)

Blue

 

Re: Medication Treatment of Bipolar Disorder 2000

Posted by JohnX2 on March 6, 2002, at 1:27:17

In reply to Re: Medication Treatment of Bipolar Disorder 2000 » Ritch, posted by Blue Cheer 1 on March 6, 2002, at 1:08:44


Its funny because my experience is that the GOOD DOCTORS
all WELL intuned with the "behind-the-scene" trends that
may be useful for patients. I've noticed that a lot of those themes pop up
early as atypical success stories on this news group. Lamictal is a really
good example. Sadly a number of doctors I had would not prescribe
it because of the rash issue, because it wasn't in the
international playbook of mood stabilizers, or they would
not prescribe it appropriately. I haven't read the
latest book on Bipolar, so don't know what the international
handbook flowchart computer dealy says what to do with Lamictal.

I also had a really crappy doctor (my 1st), that would
just rattle off medicines and tell me to pick. For that experience
I would have preferred he just started me with a flowchart answer
to help my confidence a little and get a good starting
dx. It would have been a no brainer to diagnosis me bipolar
if he followed the simple flowchart and taken the time to
ask the right questions. Sorry if i'm rambling off topic...
typical me.

-John


>
> Excellent insights, Mitch. I am so sick of hearing psychiatrists tell me about the successes they've had using various drugs with *other* patients I can't tolerate 0.5 mg. of Risperdal/day - it causes dyskinesias and makes me feel dead. In fact, I'd rather be dead than use this drug again, but *knowing* this, a psychiatrist just asked me to try it for a week at 2.5 mg/day (if I get randomized to it in a study). It's crazy, and I've been hearing this for years. Sixty drugs or more since 1967, and only three have ever helped long-term (lithium, Lamictal and Valium). Thorazine and high-dose Zoloft were helpful for a short time during acute episodes.
> The guidelines seem to be written for medical students. It make me wonder when I see the Consensus Series compared to the Texas Algorithms or the VA Guidelines, *or the APA's Best Practice Guidelines. There must be better things to do. :)
>
> Blue


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