![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by ace on March 9, 2003, at 3:39:30
OK THIS IS MY OCD....PLEASE, PLEASE, PLEASE READ ALL AND OFFER OPINION MED SUGGESTION, I BEG OF YOU GUYS!
I essenetially have two aspects to it. MD's and myself have diagnosed it as atypical OCD. Myself - I don't believe in labels but this d/o is closed to OCD symptoms without a doubt.
Before I start I must say...
1. Reality Testing ALWAYS intact (I know this is crazy!)2. All thoughts are ego-dystonic (I don't like or want them, they hurt real bad)
3. I NEVER hav psychotic phenomena about the thoughts (At worst they turn into Ovrvalued ideas- I'm very attached but a part can see it's crazy)
OK
OCD #1
'YES PROCESS'
This ocd is wierd and a pain in the a-hole. First, usually when I feel good or excited about something, a thought comes to counter that happiness. It say's 'It's bad if you do that and thsis thought (ie it's bad) will forever be in your mind stifling the fun of the activity, product or whatever. Then this other thought comes into play - It's pushes into my consciousness and trie's to say 'yes' to the 'ba' thought, tries to affirm it in spite of the fact that the 'real' me doesn't want it. The 'real' me of course say's 'no' to the thought wwhich trys to affirm the 'bad' thought. Over the top I have to think a 'good' thought (the ritual, compulsion) In therapy I was told to accept the 'bad' thoughts but it didn't work. I EVEN FLOODED MYSELF WITH 'BAD' thoughts and in some ways it made me worse ie even now I occassionaly think of the 'bad' thoughts i flooded myself with! This above goes on frequently all day and is fluid - ie it coves all activities and comes wherever I am.OCD #2
this is more straight foward. basically it is rumination. if a 'bad' thought get's 'in' (i don't cover the ''yes' thought which affirms the 'bad' thought' i start ruminating on the bad thought , sometimes for hours. this kills - whenever i think of the activity/product etc that has been stained by the 'bad' thought i get a bad gut feeling which stifles the happiness about the enjoyable activity.
Other ruminations - infinity, obsessing i don't have ocd, obsessing whether my condition is the only one in the world like this, obsessing on body parts (when younger ie Body Dysmorphic Disorder).OK that's enough.
I beg of you guys to offer any med suggestions.
My Nardil has dfinately mad the 'yes' process more in the background and stopped a lot of rumination. But only by 40-60%. Of course, IT HAS BEEN A LIVESAVER FOR MY OTHER MULTITUDE OF ANXIETY D/O's. BUT NOW THIS CRAZY STUPID OCD CRAP IS ON THE HIT LIST. I BELIEVER IN 90-95% reduction, none of this partial help crap.
SPECIFICALLY WHAT MED DO YOU THINK SUITS THIS BEST?
WITH THE NARDIL?
WITHOUT THE NARDIL (OF COURSE I AM EXTREMELY RELUCTANT TO STOP NARDIL) BUT SUGGESTIONS ARE WELCOME.
PLEASE GUYS AS MUCH INFO AS POSS.I LOVE YOU ALL
ACE (ANDREW)
Posted by ace on March 9, 2003, at 18:35:02
In reply to Atypical OCD - URGENT med suggestions needed NOW!!, posted by ace on March 9, 2003, at 3:39:30
Posted by KrissyP on March 9, 2003, at 21:15:22
In reply to Atypical OCD - URGENT med suggestions needed NOW!!, posted by ace on March 9, 2003, at 3:39:30
Hey ACE, I posted to you a little on this but IMHO, and I am not a doc nor claim to be one,
START LUVOX OR/AND PROZAC-those 2 have been proven to conquer OCD in MANY people.
I don't know what else to say except that I would talk to your doc, if you haven't already, about EXACTLY what you just posted here:-)
Most definately he/she can help you with the dosages of the meds. Hang in there, and remember, YMMV and it may be a case of trial and error- Also, I have seen you so much in these postings regarding the positiveness and success with your NARDIL-Stay on it, IMHO, but see if there aren't any contraindications with Luvox first-obviously-but with your doc, there has to be something you and your doc can agree on to add to.
Keep me posted. Did this help at all?
Kristen:-)
==================================================================================================
Before I start I must say...
1. Reality Testing ALWAYS intact (I know this is crazy!)
2. All thoughts are ego-dystonic (I don't like or want them, they hurt real bad)
3. I NEVER hav psychotic phenomena about the thoughts (At worst they turn into Ovrvalued ideas- I'm very attached but a part can see it's crazy)
OCD #1
'YES PROCESS'
This ocd is wierd and a pain in the a-hole. First, usually when I feel good or excited about something, a thought comes to counter that happiness. It say's 'It's bad if you do that and thsis thought (ie it's bad) will forever be in your mind stifling the fun of the activity, product or whatever. Then this other thought comes into play - It's pushes into my consciousness and trie's to say 'yes' to the 'ba' thought, tries to affirm it in spite of the fact that the 'real' me doesn't want it. The 'real' me of course say's 'no' to the thought wwhich trys to affirm the 'bad' thought. Over the top I have to think a 'good' thought (the ritual, compulsion) In therapy I was told to accept the 'bad' thoughts but it didn't work. I EVEN FLOODED MYSELF WITH 'BAD' thoughts and in some ways it made me worse ie even now I occassionaly think of the 'bad' thoughts i flooded myself with! This above goes on frequently all day and is fluid - ie it coves all activities and comes wherever I am. OCD #2 this is more straight foward. basically it is rumination. if a 'bad' thought get's 'in' (i don't cover the ''yes' thought which affirms the 'bad' thought' i start ruminating on the bad thought , sometimes for hours. this kills - whenever i think of the activity/product etc that has been stained by the 'bad' thought i get a bad gut feeling which stifles the happiness about the enjoyable activity.
Other ruminations - infinity, obsessing i don't have ocd, obsessing whether my condition is the only one in the world like this, obsessing on body parts (when younger ie Body Dysmorphic Disorder).
My Nardil has dfinately mad the 'yes' process more in the background and stopped a lot of rumination. But only by 40-60%. Of course, IT HAS BEEN A LIVESAVER FOR MY OTHER MULTITUDE OF ANXIETY D/O's. BUT NOW THIS CRAZY STUPID OCD CRAP IS ON THE HIT LIST. I BELIEVER IN 90-95% reduction, none of this partial help crap.
SPECIFICALLY WHAT MED DO YOU THINK SUITS THIS BEST?WITH THE NARDIL?
WITHOUT THE NARDIL (OF COURSE I AM EXTREMELY RELUCTANT TO STOP NARDIL) BUT SUGGESTIONS ARE WELCOME.
>
>
> PLEASE GUYS AS MUCH INFO AS POSS.
>
> I LOVE YOU ALL
>
> ACE (ANDREW)
Posted by KrissyP on March 9, 2003, at 21:17:07
In reply to Atypical OCD - URGENT med suggestions needed NOW!!, posted by ace on March 9, 2003, at 3:39:30
Ace-ALSO, as jay said BE CAREFUL-What about adding the Anafranil we spoke of?
just a thought....
Kristen
Posted by mattdds on March 10, 2003, at 0:48:57
In reply to Atypical OCD - URGENT med suggestions needed NOW!!, posted by ace on March 9, 2003, at 3:39:30
Ace,
All I can say is WOW, great description of the *exact* mental dynamic that plagued the first 25 years of my life! You did an excellent job of describing this, better than I ever could have! I loved how you explained the intrusive thoughts that "contaminate" your experience, almost like they're saying "as long as I'm here you won't be able to enjoy X activity". This can be very difficult to shake, not to mention depressing!
I, like you, dislike labels, and prefer to work with specific problems. It is more meaningful to me to describe in detail the dynamics of an experience (when, where, time, how I felt, what I was thinking) as you did perfectly, than to vaguely say "oh, it's OCD". But anyway, I had never thought of myself as "OCD", because I lacked the compulsions, but you make a great argument here. But the cognitive component of my problem was was exactly as you described.
I'm sorry, but I can't say that I have any med solutions for this. I can say that I did try ALL the SSRI's, including Luvox, but they all worsened my condition. I have become very skeptical of SSRI's, and wonder if they are much more than placebos with (really bad) side effects.
This type of problem that you describe, being "atypical", is not something most CBT therapists could solve. But I'm quite confident it's amenable to CBT. Really, most clinicians use a watered down and very outdated version of CBT, and I wonder if most people really get an adequate trial of it. I had to read some seriously advanced theoretical stuff that most practitioners don't even know about yet (BTW, the scientist-practitioner gap in CBT theory is HUGE). Adrian Wells over in the UK is doing some beautiful and very groundbreaking work on the CBT treatment of OCD and GAD. I'd say 99% of CBT practitioners don't even know about this, really cutting edge!
I know your feelings on CBT, so I won't push it. But if you are interested in chatting more about this, the offer is there, over at psychological babble. I have some great book suggestions and personal experiences. I too had BDD when I was younger, and tended to get "stuck" in repetetive, bizarre thought cycles. But also, never had any psychotic component to the whole thing.
FWIW, it seems like some people are having some luck treating the cognitive portion of obsessions with atypical neuroleptics. Although they have some pretty severe possible SE's which you'll have to do a cost-benefit analysis on.
I hope you get some relief from your more persistent symptoms, in whatever way you can!
Best of luck, friend.
Matt
Posted by ace on March 10, 2003, at 2:12:16
In reply to Ace - You just described ME!, posted by mattdds on March 10, 2003, at 0:48:57
> Ace,
>
> All I can say is WOW, great description of the *exact* mental dynamic that plagued the first 25 years of my life! You did an excellent job of describing this, better than I ever could have! I loved how you explained the intrusive thoughts that "contaminate" your experience, almost like they're saying "as long as I'm here you won't be able to enjoy X activity". This can be very difficult to shake, not to mention depressing!Matt. God Bless you! I really feel like I've found a brother! The thoughts really stifle the happiness don't they? They are so wierd.
> I, like you, dislike labels, and prefer to work with specific problems. It is more meaningful to me to describe in detail the dynamics of an experience (when, where, time, how I felt, what I was thinking) as you did perfectly, than to vaguely say "oh, it's OCD". But anyway, I had never thought of myself as "OCD", because I lacked the compulsions, but you make a great argument here. But the cognitive component of my problem was was exactly as you described.This is EXTREMELY well put, Matt. Do you have to 'cover' a 'bad' thought with a 'goog thought' - This is the cognitive compulsion or ritual.
> I'm sorry, but I can't say that I have any med solutions for this. I can say that I did try ALL the SSRI's, including Luvox, but they all worsened my condition. I have become very skeptical of SSRI's, and wonder if they are much more than placebos with (really bad) side effects.
Matt are you REALLY my lost brother!!!??? I agree 100% abot the SSRIs. BUT PLEASE DON'T LOSE FAITH IN MEDICATIONS!. For instance there is many NON-SSRI medicines which have done MAJOR things for some people....
1. Nardil
2. Parnate
3. Remeron
4. Trazodone
5. Tramadol
6.zyprexa
7. risperidone
8. AnafranilMost of these (except the first two) can be used in combo. Please Matt don't give up on medications!
> This type of problem that you describe, being "atypical", is not something most CBT therapists could solve. But I'm quite confident it's amenable to CBT. Really, most clinicians use a watered down and very outdated version of CBT, and I wonder if most people really get an adequate trial of it. I had to read some seriously advanced theoretical stuff that most practitioners don't even know about yet (BTW, the scientist-practitioner gap in CBT theory is HUGE). Adrian Wells over in the UK is doing some beautiful and very groundbreaking work on the CBT treatment of OCD and GAD. I'd say 99% of CBT practitioners don't even know about this, really cutting edge!I must say although you know my feelings on CBT there's a guy named dr. phillipson (i think) who's done some great stuff. BUT AS SOON AS I START DOING CBT FOR 'OCD' THE OBSESSION BEGINS - 'MAYBE I DON'T HAVE OCD'!
> I know your feelings on CBT, so I won't push it. But if you are interested in chatting more about this, the offer is there, over at psychological babble. I have some great book suggestions and personal experiences. I too had BDD when I was younger, and tended to get "stuck" in repetetive, bizarre thought cycles. But also, never had any psychotic component to the whole thing.
These lines fit me to a tee, Matty "get "stuck" in repetitive, bizarre thought cycles.'
You were right on with that.> FWIW, it seems like some people are having some luck treating the cognitive portion of obsessions with atypical neuroleptics. Although they have some pretty severe possible SE's which you'll have to do a cost-benefit analysis on.
"cost-benifit analysis" - have you read David D. Burns?
> I hope you get some relief from your more persistent symptoms, in whatever way you can!
>
> Best of luck, friend.
>
> Matt
>Thankyou SO MUCH Matt! Please post me EVERYTHING about your experiences and therapy. Tell me the book titles, even though I might be a bit sour on them.
WE MUST KEEP IN TOUCH,
WISHING YOU MUCH HAPPINESS,
Ace (Andrew)
Posted by Ritch on March 10, 2003, at 10:15:26
In reply to Atypical OCD - URGENT med suggestions needed NOW!!, posted by ace on March 9, 2003, at 3:39:30
Ace, did you ever try out the Neurontin add-on idea?
Posted by Jack Smith on March 10, 2003, at 12:34:22
In reply to Ace - You just described ME!, posted by mattdds on March 10, 2003, at 0:48:57
> I can say that I did try ALL the SSRI's, including Luvox, but they all worsened my condition. I have become very skeptical of SSRI's, and wonder if they are much more than placebos with (really bad) side effects.
>I have a problem with this statement. The SSRI's are revolutionary drugs that have done wonderful things for SOME people and the effects were clearly not placebos. They do have side effects but their S/E profile is not worse, and usually better, than most drugs.
Matt, as someone with a medical background, I think you know better than to make such blanket statements. I am sorry that you did not benefit from SSRI's. BUT there are plenty who have and will. Statements about them being no more than placebos will discourage some who could greatly benefit from them to try them. In fact, I know that you have no connection to this, but the Paxil Class Action in LA is alleging that Paxil and all SSRI's are just placebos. We all know that such frivolous allegations are bad for those of us suffering from mental disorders because they will discourage drug companies from continuing to develop new drugs. I urge you to rethink your statements. Celexa (an SSRI) saved my life. Too bad it pooped out. BUT, I am still greatful that it was invented. AND I CAN ASSURE YOU IT WAS NO PLACEBO. I tried enough other things first to know.
JACK
Posted by mattdds on March 10, 2003, at 14:51:41
In reply to SSRI's » mattdds, posted by Jack Smith on March 10, 2003, at 12:34:22
Hi Jack,
Thanks for your comments! I appreciate a good challenge to my thinking. Not everything I say is well thought out, I'm certainly very human (obviously). And I don't think I have any special knowledge above anyone else.
Perhaps I should restate what I said, because I probably gave the wrong impression. You are quite right that we should avoid globalizations and the last thing I wanted to do was spoil someone's medication experience. I really do think the right meds can play a huge part in recovery.
First off, if you reread what I said, it was that I **wonder** if SSRI's are much more effective than placebo. I still do have these doubts....*doubts*. Is this okay? I am not being dogmatic here and I am not married to any ideas that I have. I have no hidden agendas, and no motive to convince you. But my opinion right now is that there are some major problems with antidepressant efficacy studies, particularly the SSRI's. I'd be happy to provide some references that seem to support that opinion.
I am not of the "Breggin" mentality that SSRI's are demonic or harmful. I just **wonder** if they work as well as most people think. But I'm not pushing that idea on anyone else. I'm for what ever works, as long as it works!
You seemed to be saying I "should" think a certain way because I have a medical background. I politely disagree with you. Medical training should not be indoctrination, and sometimes people in the medical field do things that are not even evidence based.
Let's just assume for a moment that SSRI's and antidepressants really aren't any more effective than placebos. Would you want to know this? I sure would. You say it would prevent the drug companies from making more effective drugs. My opionion is the opposite; it would put the pressure on them to make drugs that are MORE effective.
You're right, I am a little bitter about SSRI's not working, and perhaps my bias is too strong. If Celexa works for you, GREAT! Keep taking it as long as it works. I don't think that is a blanket statement, do you?
Best of luck,
Matt
Posted by ace on March 10, 2003, at 20:48:05
In reply to Re: Atypical OCD - URGENT med suggestions needed NOW!! » ace, posted by Ritch on March 10, 2003, at 10:15:26
> Ace, did you ever try out the Neurontin add-on idea?
I am considering and researching this, cause as the time goes closer to atypical ap time I feel somewhat worried.
Can you tell me about it please esp for OCD?
Thanks Ace.
Posted by Ritch on March 10, 2003, at 23:13:36
In reply to Re: Atypical OCD - URGENT med suggestions needed NOW!! » Ritch, posted by ace on March 10, 2003, at 20:48:05
> > Ace, did you ever try out the Neurontin add-on idea?
>
> I am considering and researching this, cause as the time goes closer to atypical ap time I feel somewhat worried.
>
> Can you tell me about it please esp for OCD?
>
> Thanks Ace.
I brought it up mainly because it *isn't* an SSRI and you can take it with the Nardil you already take-and it won't affect the level of Nardil in your blood. It doesn't interact with other drugs. It might not work for you-don't know. Figured it would be worth a trial to see before you add AP's or switch from Nardil to SSRI. You shouldn't porkout on it like an AP.
Posted by Questionmark on March 11, 2003, at 0:53:03
In reply to Re: Atypical OCD - URGENT med suggestions needed NOW!! » ace, posted by Ritch on March 10, 2003, at 23:13:36
i agree that a AP trial would be better before getting off Nardil and switching to smthing else, but i'm sure you probably agree w/ that anyway.
But if you do try an AP, i really suggest you start out with a very low dose, especially since you are not psychotic or anything. i really believe that AP doses are so often too high for people and then they can turn you into little less than a zombie.
Also, i wanted to mention something to you. Not to be condescending, anxiety-provoking, or discouraging at all, but... i'm convinced that psychiatric drugs can VERY often lose their efficacy after awhile (though it varies widely of course). So make sure you don't waste too much time in your present nardil happiness-- use it to accomplish things that you'd like to and better your life while you can. Not that you aren't of course, but i just wanted to tell you that. Also, i'm not saying you haven't already-- but just in case-- take some time to evaluate whether further med tinkering is really necessary or worth it. i really don't know, cuz i dont know how troublesome your remaining obssv-cmplsv stuff is. But if it's not too bad, i suggest just sticking with what youve got. -Just something to think about.
Question: you said youre studying psychopharm. or would like to become a psychopharmacologist eventually-- do you know, does this require taking a buttload of chemistry courses (or being a chem major), or can one go another route? You think one could get an undergraduate psychology degree (w/ some chem and bio courses) and then go into grad school on a psychopharm path?
Posted by KrissyP on March 11, 2003, at 1:03:57
In reply to Re: Atypical OCD - URGENT med suggestions needed NOW!!, posted by Questionmark on March 11, 2003, at 0:53:03
Just wanted to share. I said this before but I agree with this>>>"i really believe that AP doses are so often too high for people and then they can turn you into little less than a zombie".
Sroquel did that to me I was on 300mg at one time and now take 100mg-much much better!
Ace, I suggest this too:-)
Hang in there!
Kristen ** Also I can maybe help withthis>>>> Question: you said youre studying psychopharm. or would like to become a psychopharmacologist eventually-- do you know, does this require taking a buttload of chemistry courses (or being a chem major), or can one go another route? You think one could get an undergraduate psychology degree (w/ some chem and bio courses) and then go into grad school on a psychopharm path?
Yes. hope to hear back on that one:-)
==================================================================================================
> i agree that a AP trial would be better before getting off Nardil and switching to smthing else, but i'm sure you probably agree w/ that anyway.
> But if you do try an AP, i really suggest you start out with a very low dose, especially since you are not psychotic or anything. i really believe that AP doses are so often too high for people and then they can turn you into little less than a zombie.
> Also, i wanted to mention something to you. Not to be condescending, anxiety-provoking, or discouraging at all, but... i'm convinced that psychiatric drugs can VERY often lose their efficacy after awhile (though it varies widely of course). So make sure you don't waste too much time in your present nardil happiness-- use it to accomplish things that you'd like to and better your life while you can. Not that you aren't of course, but i just wanted to tell you that. Also, i'm not saying you haven't already-- but just in case-- take some time to evaluate whether further med tinkering is really necessary or worth it. i really don't know, cuz i dont know how troublesome your remaining obssv-cmplsv stuff is. But if it's not too bad, i suggest just sticking with what youve got. -Just something to think about.
> Question: you said youre studying psychopharm. or would like to become a psychopharmacologist eventually-- do you know, does this require taking a buttload of chemistry courses (or being a chem major), or can one go another route? You think one could get an undergraduate psychology degree (w/ some chem and bio courses) and then go into grad school on a psychopharm path?
Posted by ace on March 11, 2003, at 1:08:38
In reply to Re: Atypical OCD - URGENT med suggestions needed NOW!!, posted by Questionmark on March 11, 2003, at 0:53:03
> i agree that a AP trial would be better before getting off Nardil and switching to smthing else, but i'm sure you probably agree w/ that anyway.
> But if you do try an AP, i really suggest you start out with a very low dose, especially since you are not psychotic or anything. i really believe that AP doses are so often too high for people and then they can turn you into little less than a zombie.
> Also, i wanted to mention something to you. Not to be condescending, anxiety-provoking, or discouraging at all, but... i'm convinced that psychiatric drugs can VERY often lose their efficacy after awhile (though it varies widely of course). So make sure you don't waste too much time in your present nardil happiness-- use it to accomplish things that you'd like to and better your life while you can. Not that you aren't of course, but i just wanted to tell you that. Also, i'm not saying you haven't already-- but just in case-- take some time to evaluate whether further med tinkering is really necessary or worth it. i really don't know, cuz i dont know how troublesome your remaining obssv-cmplsv stuff is. But if it's not too bad, i suggest just sticking with what youve got. -Just something to think about.
> Question: you said youre studying psychopharm. or would like to become a psychopharmacologist eventually-- do you know, does this require taking a buttload of chemistry courses (or being a chem major), or can one go another route? You think one could get an undergraduate psychology degree (w/ some chem and bio courses) and then go into grad school on a psychopharm path?I'm in a real hrry so i have only read your question.
Yes, I do indeed wish to become a psychopharmacologist. Now, remember I am in Australia so it could be different. But could be similiar too.
In my time I HAVE studied a LOT of chemistry.
At the moment I am almost about to complete my undergraduate degree (Arts/Science) I have studied Philosophy as part of my Arts section. Next year, provided I get an average mark of credit (I have actually got average Distiction thus far) I will sit a test called the GAMSAT. This test goes for a couple of days, and when you pass you are then allowed to begin a postgraduated medical degree. This is my plan.I should note that you do NOT need any science courses for the test. You just need a credit average in ANY degree. But of course going into med without any knowledge on physics/chemistry/maths/biology is implausible.
But, for instance, you could do an arts degree and study all the science stuff at home. But I chose to study a combo of Arts and science (which of course included chemistry)I actually have studied a fair bit of psychopharmacology at home because of my illness. But the psychopharmacology course I'm doing now at uni is very thorough. When finished I will know the actions of every psychiatric drug down to a tee. I know a bit now, but this course is really exciting me.
Tell me where you are from, your education, and anything else. If you need any help with chemistry/physics we can do it over email.
Take Care, dude
Ace.
Posted by Questionmark on March 11, 2003, at 20:17:15
In reply to Re: Atypical OCD - URGENT med suggestions needed NOW!! » Questionmark, posted by ace on March 11, 2003, at 1:08:38
Ace, Interesting, thanks.
i'm in the U.S. The semester after this and i should have a B.S. in psychology and minors in philosophy and biology-- unless i screw something up. i was a bio major for awhile but then all the labs and math and everything was driving me absolutely mad, so i switched to psychology (i'd like to do research eventually, if i continue this). From the looks of things now, pursuing psychopharmacology would not be a good idea for me. Whatyou think? Ah i dont even know what i want anyway. Ah well. Thanks for the info man.
Posted by ace on March 12, 2003, at 0:28:54
In reply to Re: Atypical OCD - URGENT med suggestions needed NOW!!, posted by Questionmark on March 11, 2003, at 0:53:03
> Also, i wanted to mention something to you. Not to be condescending, anxiety-provoking, or discouraging at all, but... i'm convinced that psychiatric drugs can VERY often lose their efficacy after awhile (though it varies widely of course).
I disagree with this statement. I do not really believe psychiatric medications poop-out much at all. Most MDs I have spoke to never even have heard of it! I believe poop-out represents many variant things but not the actual medication ceasing to act in a therapeutic way. Of course I'm not sure, but it seems as if this phenomenon is specific to people. For example, ANY drug will 'apparently cease' to work with them. But others can take any drug for a life time with no probs. Are these specific poop-out people just getting used to the phenomenological change in themselves and seeing it as 'now' normal, and then (as all humans do) wishing to reach a greater level of happiness? Does poop-out represent latent/undiagnosed Bipolar D/O.
Is poop-out the result of the ceasing of an initial placebo response?I'm not sure, but I can tell you I'm not worried about any med pooping-out on me, and I am sceptical of the whole phenomenon.
Ace.
Posted by Questionmark on March 12, 2003, at 18:49:17
In reply to Re: Atypical OCD - URGENT med suggestions needed NOW!! » Questionmark, posted by ace on March 12, 2003, at 0:28:54
> > Also, i wanted to mention something to you. Not to be condescending, anxiety-provoking, or discouraging at all, but... i'm convinced that psychiatric drugs can VERY often lose their efficacy after awhile (though it varies widely of course).
>
> I disagree with this statement. I do not really believe psychiatric medications poop-out much at all. Most MDs I have spoke to never even have heard of it! I believe poop-out represents many variant things but not the actual medication ceasing to act in a therapeutic way. Of course I'm not sure, but it seems as if this phenomenon is specific to people. For example, ANY drug will 'apparently cease' to work with them. But others can take any drug for a life time with no probs. Are these specific poop-out people just getting used to the phenomenological change in themselves and seeing it as 'now' normal, and then (as all humans do) wishing to reach a greater level of happiness? Does poop-out represent latent/undiagnosed Bipolar D/O.
> Is poop-out the result of the ceasing of an initial placebo response?
>
> I'm not sure, but I can tell you I'm not worried about any med pooping-out on me, and I am sceptical of the whole phenomenon.
>
> Ace.
>
>Ace, you brought up some really good points and questions. Made me think. But i am still a firm believer in poop-out (at least for most people, for most drugs). i'd like to try to explain why, below. You or anyone else, please tell me what you think so we can get try to get a better understanding of this-- because i think this is an extremely important matter and has a lot of ramifications to treatment and what not.
First i just wanted to comment on your one statement. You said "Most MDs i have spoke to never even have heard of it!"
True, but most MDs are ignorant about many things and too arrogant or overconfident to realize or admit it.Secondly, again i thought your other points were really good and, after thinking about it, do think that they (the reasons you gave for why you thought poop-out occurs) can be the actual causes in a good number of cases. But i still think that poop-out does often occur, and can occur with any psychoactive drug or substance. i have experienced tolerance with every single psychoative substance (legal or illegal) that i have used, i believe. And tolerance is just the process of poop-out, right? So it seems that every drug can eventually, gradually, lose its effectiveness, at least to some extent especially. Plus on a neurophysiological (woah) level, it would seem to make sense, too. The receptors and what not eventually adapt to the change in neurotransmitter (and whatever else) functioning (e.g., with recptor up- or down- regulation). This might take awhile and might not return to completely normal functioning, but still.
Fortunately from what ive heard/read it does seem that MAOIs can take years and years for full tolerance (poop-out) to occur. But it's still something to think about.
So sorry this was so freaking long. My brain doesnt work anymore.
This is the end of the thread.
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