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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by stargazer on May 2, 2005, at 23:06:23
I don't know if I'm the only one who feels this way but I'm having trouble reading through all the postings and getting a handle on the meds, due to the number of choices, how to know what meds might be effective for me, how to sort through the side effects vs symptoms, etc.
I have been reading this site for a few years now and I find it more confusing than helpful.
One one hand it's a great source for support and advice, but on the other hand I don't know how anyone can sort out what might work for them.
I am baffled and confused most of the time after I read a few postings between the various classes of drugs, dosages, combinations, etc. I think too many drugs can mess someone up pretty good too.
Frankly, since I am so drug phobic(sensitive) the thought of being on more than a couple of meds makes me nervous. How do you know that the combination of meds isn't causing you to feel like sh*t rather than the depression or whatever dignosis you are treating.
Help me see how all of this information can be useful rather than overwhelming.
SG
Posted by Declan on May 3, 2005, at 4:19:42
In reply to Overwhelmed by # of Meds Prescribed/Combos, posted by stargazer on May 2, 2005, at 23:06:23
I know, I bought Stahl's book (essential psysopharmacology?) after coming here, and boy....I need to concentrate.
Posted by Racer on May 3, 2005, at 14:07:35
In reply to Overwhelmed by # of Meds Prescribed/Combos, posted by stargazer on May 2, 2005, at 23:06:23
> I don't know if I'm the only one who feels this way but I'm having trouble reading through all the postings and getting a handle on the meds, due to the number of choices, how to know what meds might be effective for me, how to sort through the side effects vs symptoms, etc.
>
>
> Frankly, since I am so drug phobic(sensitive) the thought of being on more than a couple of meds makes me nervous. How do you know that the combination of meds isn't causing you to feel like sh*t rather than the depression or whatever dignosis you are treating.
>
> Help me see how all of this information can be useful rather than overwhelming.
>
> SGWell, it can be helpful in a lot of ways, just like the drugs themselves. For me, what was initially most helpful was just the idea of educating myself about what the meds did. You know, all those things like "this med affects this neurotransmitter, that neurotransmitter is associated with those side effects," etc. Just the idea of looking into that information, rather than just taking what the doctor prescribed without question was worth all the confusion involved in trying to learn about it. For that alone, I am very grateful to the people here.
As for the multi-drug combinations, that's a bit harder, and much more individual. For one thing, there are almost as many ways of dealing with drug cocktails as there are doctors prescribing them. My current Dr CattleProd, for example, won't change more than one thing at a time, and wants to wait at least four to six weeks between changes, so that there's rarely any question about what drug is causing what effect. My prior doctor, Dr EyeCandy (who recently changed his name to Dr SomeoneHasToGraduateAtTheBottomOfTheClass, which is so hard to type I'll still refer to him by his original name), on the other hand, had a habit of stopping everything and starting a bunch of other meds, all at the same time -- bad science, since you've got so many uncontrolled variables.
Of course you're absolutely correct that too many drugs can mess someone up -- too much of anything can, just ask me about the time I drank too much water on a hot day. The key, I think, is to make changes slowly, and consider what effects each med has at every dose. While many meds will behave differently at different dosages, they will rarely change from, say, overly sedating to wickedly agitating in one small increase. There are generally indications from the getgo that something like that might happen, so you can usually avoid those things.
As for the bottom line, if there is one that generally applies, I guess it would be to be able to trust the doctor prescribing the meds, and to be able to communicate with that doctor. Everyone will react differently to the various meds out there, so there's no way to say what will work for any one person without trying. Or, at least, there's no way to advise someone about what med *will* work without a lot of qualifications. We can tell others about how something has affected us, and we can tell each other what we think *might* help based on symptoms.
I also keep in mind that most of us here have proven difficult to treat over time, so a lot of the very negative things that I see written here about a specific med I take with a grain of salt. If it didn't work for someone, even if it caused severe side effects, that doesn't mean that it won't be great for me. I'll only know if I try it.
Hope that helps, at least by offering you another perspective on it all.
Posted by Phillipa on May 3, 2005, at 17:20:04
In reply to Re: Overwhelmed by # of Meds Prescribed/Combos, posted by Racer on May 3, 2005, at 14:07:35
As usual your answer was all inclusive. But, I'm still having an awful hard time trying to understand all the neurotransmitters. I think I do know three things though. l. Dopamine is energizing, 2. Serotonin is good for a lot of people with just depression[some say for anxiety too],3. Norepinephrine is i think stimulating and combined with Serotonin in Effecor and Cymbalta. Is this correct? Fondly, Phillipa
Posted by Dr. Bob on May 4, 2005, at 10:28:01
In reply to Re: Overwhelmed by # of Meds Prescribed/Combos, posted by Declan on May 3, 2005, at 4:19:42
> I know, I bought Stahl's book (essential psysopharmacology?) after coming here
I'd just like to plug the double double quotes feature at this site:
http://www.dr-bob.org/babble/faq.html#amazon
The first time anyone refers to a book, movie, or music without using this option, I post this to try to make sure he or she at least knows about it. It's just an option, though, and doesn't *have* to be used. If people *choose* not to use it, I'd be interested why not, but I'd like that redirected to Psycho-Babble Administration:
http://www.dr-bob.org/babble/admin/20020918/msgs/7717.html
Thanks!
Bob
Posted by Chairman_MAO on May 5, 2005, at 20:54:29
In reply to Re: Overwhelmed by # of Meds Prescribed/Combos » Racer, posted by Phillipa on May 3, 2005, at 17:20:04
If you want the best introduction to psychoactive drugs on the planet, order an out-of-print copy of "Drugs and Human Behavior" by Tibor Palfai. He was my psychopharmacology professor at Syracuse University, and by all accounts one of the most interesting, kind, insightful, and hysterical people I've ever met. Oh, yeah, and he also knew a helluva lot about psychoactive drugs. ;)
The book is co-authored by him, who is of Hungarian decent and a senior citizen (English not first language) and Henry Jankiewicz, a writing professor at Syracuse University who studies drugs in culture, literature, etc. It is by far the most interesting textbook I ahve ever read and also is a great read in general. About 1/4 of what I know about psychoactive drugs and the brain comes from that book, and the rest was self-taught because I was inspired by the man and the book.
Posted by stargazer on May 5, 2005, at 21:53:49
In reply to Re: Overwhelmed by # of Meds Prescribed/Combos, posted by Chairman_MAO on May 5, 2005, at 20:54:29
I guess in the last few years everyone on these meds have gotten more and more sophisticated about how these meds work, at times, the patients seem to know more than the docs. I haven't kept up with the technology so it looks like I will have to do my homework to understand the workings of all of the neurotransmittors, etc.
I think it will still be too complicated for me to understand all of the chemical interactions occuring in the brain and which drug affect which
symptoms. Between agonists, GABA, dopamine, 5HT1A (what the hell is that?)I feel totally baffled.Thanks for all who responded to my post. We are fortunate to have such intelligent and caring people amongst us.
Stargazer
Posted by Racer on May 5, 2005, at 22:52:45
In reply to Re: Overwhelmed by # of Meds Prescribed/Combos, posted by stargazer on May 5, 2005, at 21:53:49
> I think it will still be too complicated for me to understand all of the chemical interactions occuring in the brain and which drug affect which
> symptoms. Between agonists, GABA, dopamine, 5HT1A (what the hell is that?)I feel totally baffled.
>The ONLY thing I can answer here is that 5HT1A refers to serotonin:
5HT -- sorry, not gonna look up what the HT means, it's a chemical description -- is serontonin. There are numerous serotonin receptors. This one is serotonin 1 sub A. Just like, oh, French vanilla rather than plain vanilla. A little different, but basically the same flavor.
And an agonist basically means that something holds the ion channel open on a cell, rather than having it close and open. The channels are ligand gated, which means that each channel is a little like a tiny sphincter, which can be propped open for neurochemicals to move into the cell. Or out of the cell, I suppose, but we usually worry more about getting stuff in...
I hope this helps. I find it fascinating, but don't understand it much myself...
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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