![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 14 to 38 of 38. Go back in thread:
Posted by linkadge on September 23, 2005, at 16:15:55
In reply to Re: My opinion on antipsychotics » Chairman_MAO, posted by Declan on September 23, 2005, at 14:45:41
I totally agree with what med empowered has said.
Linkadge
Posted by linkadge on September 23, 2005, at 16:25:13
In reply to Re: My opinion on antipsychotics, posted by linkadge on September 23, 2005, at 16:15:55
It's the same thing with depression. We say to ourselves, I'm so glad we have antidepressants, I wonder what they would have done in the olden days.
They got better is what they did. Three generations back in our family has suffered depressive episodes. But none has lasted more than 6-8 months, and then they got better. Better, as in, were no longer depressed.
I thought, well, we live in an age where I don't have to go through this, I can get better with pills.
So I take the AD's. Sure, I initally felt good, but soon enough that effect pooped out. I've been medicating for like 6 years now. That is more time than the cumulative depressions of my whole family. We think we can fool the brain, but we cannot.
And now, not only am I still depressed, but my brain is fried by the meds, I have permanent neurological defects.
So it comes down to how you want to take your pain, fast and get it over with, or slow and lingering.
Linkadge
Posted by crazy teresa on September 23, 2005, at 21:10:23
In reply to NEUROLEPTICS, posted by med_empowered on September 23, 2005, at 5:18:42
You wrote: Depressed? Take this mind-numbing drug that costs lots of $$$, may cause TD and/or diabetes/weight gain, may cause akathisia, and will in general do little more than calm you down and make you more placid. Treatment? That isn't treatment. For too long, psychiatric "treatment" has meant subtracting from the personality, from the soul of the very person ostensibly being "saved" or "treated".
What would you suggest as treatment for depression?crazy t
Posted by crazy teresa on September 23, 2005, at 21:13:29
In reply to Re: My opinion on antipsychotics, posted by linkadge on September 23, 2005, at 16:25:13
Wait it out instead of meds?
crazy teresa
Posted by Guy on September 23, 2005, at 21:44:30
In reply to WARNING GEODON 50% TARDIVE DYSKINESIA RISK, posted by Jeroen on September 22, 2005, at 11:35:41
Zyprexa has recently helped me claw my way out of a suicidal cesspit. All summer long I struggled with crippling anxiety and suicidal thoughts (but no psychosis). Nevertheless, I was proud of myself for "getting by" without resorting to anti-psychotics. Finally, this fall, I was so suicidal, I started again (after a four month hiatus) on 5 mg Zyprexa combined with 1.5 mg clonazepam. The change for the better has been nothing short of miraculous. I know I can slide back down into the hole again at any moment, but for now I am just happy to have the knife removed from my throat. Deep down I suspect my brain has been severely damaged by all the meds I have tried over the past nine years...if I had to do it all over again, I wouldn't touch a pharmaceutical with a barge pole. But that's all water under the bridge and now I have to make the best of a bad situation--both for myself and for the people I live with. You really have to have walked a mile in my shoes to know what I'm talking about.
Posted by crazy teresa on September 23, 2005, at 22:35:00
In reply to Re: WARNING GEODON 50% TARDIVE DYSKINESIA RISK, posted by Guy on September 23, 2005, at 21:44:30
Posted by linkadge on September 24, 2005, at 10:01:57
In reply to linkadge what would you suggest for depression? » linkadge, posted by crazy teresa on September 23, 2005, at 21:13:29
I don't know what I'd recommend.
Therapy, vaccation, exercise, religion, stress management techniques, nutritional approaches, major lifestyle changes, smoking ...
I know that many have tried all of the above without sucess. But even if one can lessen the symptoms and wait it out, I think the course of illness would be much better.
I know that some people do get better on pills (or so I've been told) but know dozens of people on meds, and I know that once they start the picture just gets more and more complex.
I found out my older brother had some depressive episodes (suicidal), but he refused to medicate for them, and instead got counselling through the church. It lasted a typical 6 months. It may have been harder for him to go through, but we both know that the toll the depression took was not as bad as the toll the meds took on me.
Linkadge
Posted by Declan on September 24, 2005, at 15:25:54
In reply to NEUROLEPTICS, posted by med_empowered on September 23, 2005, at 5:18:42
Med_empowered, that was a great post. Thankyou.
I thought, or read, but maybe dreamt it, that phenothiazine was a disinfectant or something, which was used to clean the excrement off the walls of mental hospitals. The patients calmed down and......maybe I read it in Laing or Cooper.
Declan
Posted by med_empowered on September 24, 2005, at 17:05:51
In reply to Re: NEUROLEPTICS, posted by Declan on September 24, 2005, at 15:25:54
hey! Yeah, from what I understand, phenothiazines were used first in industrial type applications (for some reason, I seem to recall reading about phenothiazine-type pesticides/insecticides that preceeded Thorazine) and then were later used in medicine, ending up primarily as psychiatric drugs.
Posted by Declan on September 24, 2005, at 17:39:10
In reply to to DECLAN..., posted by med_empowered on September 24, 2005, at 17:05:51
Posted by crazy teresa on September 24, 2005, at 17:53:01
In reply to Re: linkadge what would you suggest for depression?, posted by linkadge on September 24, 2005, at 10:01:57
> Therapy, vaccation, exercise, religion, stress management techniques, nutritional approaches, major lifestyle changes, smoking ...Hmmm. What kind of major lifestyle changes? Killing my husband and kids? LOL!!! Are you implying Tom Cruise is on the right track? :~} I would LOVE to be in the country where there is peace and quiet. I'm sooo much less agitated there.
> I know that many have tried all of the above without sucess. But even if one can lessen the symptoms and wait it out, I think the course of illness would be much better.
>
> I know that some people do get better on pills (or so I've been told) but know dozens of people on meds, and I know that once they start the picture just gets more and more complex.
>
I've been thinking that way. It started out for just a few months until the depression subsided. Now it's been years. Once they've gotten us hooked, it's a bitch to get off.> I found out my older brother had some depressive episodes (suicidal), but he refused to medicate for them, and instead got counselling through the church. It lasted a typical 6 months. It may have been harder for him to go through, but we both know that the toll the depression took was not as bad as the toll the meds took on me.
Good for your brother! He must have an amazing church.
Posted by linkadge on September 24, 2005, at 19:54:20
In reply to Re: linkadge what would you suggest for depression? » linkadge, posted by crazy teresa on September 24, 2005, at 17:53:01
Tom Cruise came across as sounding like he thought depression was not a real illness, that it was made up.
I fully believe that depression can be a serious illness. I don't undermine it's potential to ruin life. But in some ways I do agree with Tom in that the science behind the treatments is simply not too sound.
I know the drugs have an ability to destroy life.
I have seen quite a few lives destroyed by psychiatric drugs. Primarily my mother's life has been destroyed by tricyclic antidepressants, and antipscyhotics.
You need to find your own path, but I would be lying If I sat here and told you that I thought they were safe and effective.
When you're happy on the drugs, it is hard to imagine what kinds of things they could be doing to the underlying brain.
I heard a recording of myself playing a mozart piano sonata, when I was 16 yrs old. I was studying for a piano exam.
I have not stopped playing the piano since then, but I suspected that I was getting worse. When I heard the recording I wept bitterly for days, because I knew that there was no way on earth that I could make my hands move like they did back then. I knew in the back of my mind that I could not play like I did, but when I heard the recording it hit home hard.
My brain is dammaged. I know that doctors don't give a crap when I tell them this, but at this stage of the game I am not looking for somebody to tell me that they didn't dammage my brain. I know dammage has been done, I just wish somebody would believe me. I know Jaroen would believe me.
I am not trying to minimalize the depressive illness, but I cannot sit here and defend the drugs used to treat it.
Linkadge
Posted by yxibow on September 24, 2005, at 21:02:26
In reply to NEUROLEPTICS, posted by med_empowered on September 23, 2005, at 5:18:42
>The idea that antipsychotics "correct" some sort of "chemical imbalance" is not only weak, its not even an "idea" or "theory" in the truest sense of the word; its based on the observation that the damaging, much-despised drugs given to those with schizophrenia (often against their will) dampen dopamine.
Actually direct dopamine blockade function is only one of the components of antipsychotics, especially current neuroleptics. 5HT blockade shows additional aspects of neuroleptic treatment.
>So..basically, we don't *know* that dopamine malfunction causes schizophrenia, but we do know that if you dampen dopamine enough you can make a patient shut up and quit making trouble.And possibly prevent suicide, which is one of the leading causes of death among people who are afflicted with severe schizophrenia.
>Drug companies, of course, can now charge outrageous prices for drugs that are only marginally better than the old meds and still claim that they are "on the cutting edge of schizophrenia treatment." Please. They may well be on the "cutting edge" of false advertising and price gouging, but their reformulated Haldols don't represent all that much of an advance in improving the lives of those with schizophrenia.
They represent a significant advance in improving the lives of those affected by schizophrenia who otherwise would discontinue old line medications because of severe EPS. Not every drug is tailored to the entire schizophreniform disorder population. Agreed, the industry is a very expensive one -- at least 1% of the population of this country suffers from some spectrum of the neurobiological disorder. But tell the person suffering on thioridiazine or fluphenazine with severe EPS that the relief they get from Zyprexa from these debilitating side effects that they're not on the "cutting edge" and I think one would get a different story. Its all a matter of the patient, and I agree the patient's needs and wants should be closely listened to.
>Then there are the psychiatrists, who are now RXing these expensive, side-effect ridden pills for everything from florid psychosis to mild insomnia.
Very low dosage Seroquel may in fact help some people with severe insomnia where other treatments havent, but I agree that neuroleptics should be considered a last line of medication in those who are otherwise not suffering a psychotic form of illness. On the other hand, psychotic depression is just that, psychotic depression. It may not be something that can necessarily always be dealt with purely through behaviour and psychodynamic counseling.
>Talking to yourself? Seeing things? How about we throw you in an asylum, isolated from the rest of humanity, for the next 10-15 years, all the while preventing you from escaping or even trying to live a life outside? Is that *treatment*? Is that *respect* ? Of course not.Agreed -- current, at least current western medication, here in the United States, does not follow the 1950s idea of "throwing people into asylums". Rather, when schizophrenia is discovered early (and this is the best time, it is debatable how degenerative it is over a lifetime without treatment, but thats another argument), a patient may be in a psychiatric ward for 4 to 6 weeks to stabilize and monitor the patient, prevent suicide, provide counseling, in addition to possible medication use, for that individual. To leave the patient wandering the streets of a major American city is simply just as callous as treating the patient as a number. Again, here is the point that while the CATIE study may have proved that old and new line neuroleptics have similar functions, they dont always have the same side effect profile for the individual patient.
Tidings
Posted by Declan on September 24, 2005, at 22:28:36
In reply to Re: linkadge what would you suggest for depression?, posted by linkadge on September 24, 2005, at 19:54:20
Linkadge, tons of people here would believe you (I think).
What's so weird about the fact that these drugs can damage your brain?
It's common sense.
Declan
Posted by yxibow on September 25, 2005, at 1:08:35
In reply to Re: linkadge what would you suggest for depression?, posted by Declan on September 24, 2005, at 22:28:36
> Linkadge, tons of people here would believe you (I think).
> What's so weird about the fact that these drugs can damage your brain?
> It's common sense.
> DeclanI know this starts the drugs vs. psychotherapy debate, but one has to remember medications take around 7 to 10 years to market unless they're fast-tracked things like vaccines and HIV medication. Damage I do believe is a bit of a harsh statement, and I am not any way connected to any drug company, but yes, there is the bad and the good. That's why we have the FDA, and yes, there have been some black marks like the COX-2 inhibitors which previously were thought to be the panacea for arthritis and other pain disorders. Even older medications like Mellaril have been black boxed for their QT interval issues while Geodon has been re-evaluated extensively with nearly no danger in that realm.
It's what is called informed consent. You have to weigh over time the effects of depression (or any neurochemical disorder), which untreated can also alter your brain. Not to mention suicide.
If the will is strong and the depression is relatively on the milder end of the spectrum, psychotherapy is a perfectly good alternative to depression and other disorders. Its been shown clearly that medication and CBT (cognitive behavioural therapy) affect the outcome of OCD in the same way. And of course the combination of the two in some cases are even better.
Neurons are neurons and untreated neuropsychiatric disorders can also "destroy" the brain in the same way as medication can. Conversion disorders can occur. People can even have seizures with severe anxiety, conversion disorders, and OCD -- and that can lead to a loss of oxygen to the brain. Its a matter of choice -- as I've said before, its what we have in 2005. And that's alot better than 1955.
My aunt would still be alive today if modern medication controlled her bipolar illness and didn't result in suicide.
But that's the choice I choose, at least at the moment, because I have a fairly complicated and severe anxiety disorder which requires a combination of medication and psychodynamic therapy.
In the end, it is one's choice -- there is no perfect solution. It's not like the diptheria or smallpox vaccines which are carefully targeted at a precice point.
Some medications are shotguns and should only be used in dire cases -- some are tapered life savers and have fewer side effects. I guess I believe in better living through chemistry -- up to a point. Others are in their right to choose.
Posted by Declan on September 25, 2005, at 1:23:58
In reply to Re: linkadge what would you suggest for depression » Declan, posted by yxibow on September 25, 2005, at 1:08:35
Hey, I do want to make it very clear that I am not against meds. (We're all fairly pragmatic).
Its just that there's damage.
But damage is a part of life, everywhere.
And I like to complain too.
I hope this is not evasive.
Declan
Posted by linkadge on September 25, 2005, at 10:16:46
In reply to Re: NEUROLEPTICS » med_empowered, posted by yxibow on September 24, 2005, at 21:02:26
I think the only antipsychotic that has been shown to have any significant impact on suicide in schitsophrenia is clozapine.
Linakdge
Posted by linkadge on September 25, 2005, at 10:37:01
In reply to Re: linkadge what would you suggest for depression » Declan, posted by yxibow on September 25, 2005, at 1:08:35
>>Damage I do believe is a bit of a harsh statement.
I don't believe it is. Dammage is a binary thing. Either the drug has done dammage or it has not.
Yes the drug may have been around for 10 years, but are the tests of the drugs continuous?, or is it a series of 4 month studies that cannot show long term effects.>Even older medications like Mellaril have been >black boxed for their QT interval issues while >Geodon has been re-evaluated extensively with >nearly no danger in that realm.
I don't think we are checking enough. I don't think that the drug companies are required to check if a drug is corkscrewing serotonin receptors.
>Not to mention suicide.Yeah, how about a statistically significant increased risk of suicide. England banned all but prozac for treating kids.
>Neurons are neurons and untreated >neuropsychiatric disorders can also "destroy" >the brain in the same way as medication can.Actually in many paradigms the SSRI's do not protect against stress induced hippocampal morphology. Tianeptine and lithium do have a more protective effect.
Linkadge
Posted by crazy teresa on September 25, 2005, at 10:40:17
In reply to Re: linkadge what would you suggest for depression?, posted by linkadge on September 24, 2005, at 19:54:20
And I'm so, so very sorry this has happened to you.
I would think the doctors probably believe you, too, however, since they are powerless to do anything to counter what you've experienced and perhaps even attributed to the problem, they would never admit it. Malpractice and all.
Linkadge, are you still on meds?
In my experience, my doctor will just ask me what I want a script for. She knows I read up before I see her, and I appreciate the fact that she must not think I'm a total nutbag, but at the same time, doesn't that reduce her to some kind of a basic drug dealer, at least in theory?
Yes, I am less depressed on Effexor, but my short-term memory is crap. My hands shake all the time. I've gained weight. My sinuses do very bizzare things. I could go on.
If I decied to discontinue using, how long will the withdrawl last? Will the side effects reverse or are they permanent in some cases?
Would you consider posting a recording of your piano playing on social? I'd love to hear you play!
Thank you for sharing all this with us. Is there a specific way I could go about supporting and encouraging you?
crazy t
Posted by linkadge on September 25, 2005, at 11:30:37
In reply to I believe you! » linkadge, posted by crazy teresa on September 25, 2005, at 10:40:17
I'll see if that is something I can do.
The worst of the emotional withdrawls ended after about 4 months. But many of the physical problems are enduring. Brain zaps during movement etc...
Linkadge
Posted by linkadge on September 25, 2005, at 11:37:33
In reply to Re: I believe you!, posted by linkadge on September 25, 2005, at 11:30:37
The faster recording I have at home (away at school now), but I can try to post a recording of something else.
Linakdge
Posted by crazy teresa on September 25, 2005, at 15:28:19
In reply to Re: I believe you!, posted by linkadge on September 25, 2005, at 11:37:33
Posted by linkadge on September 25, 2005, at 19:56:38
In reply to I'm excited! Any you choose is fine!!! (nm) » linkadge, posted by crazy teresa on September 25, 2005, at 15:28:19
It may take a little time, but I'll see what I can do.
Linkadge
Posted by med_empowered on September 26, 2005, at 1:34:16
In reply to Re: I'm excited! Any you choose is fine!!!, posted by linkadge on September 25, 2005, at 19:56:38
Hi! I'm sorry if my message came off as too harsh...I think what I'm trying to get at is that the meds used in psychiatry, and the general approach to mental illness, dehumanizes people..plus, docs and companies still aren't being honest about what these drugs can do to people. Anyway, I noticed in one of your posts that you said you're on meds, but you'd like to quit. I've been there...at the height of my craziness, I was on 7-8 *daily* meds. Now, I'm taking Saint John's wort and although I still struggle, I think I'm doing better than I have in a long, long time (this isn't me telling anyon "go off your meds and go to GNC"; I'm just saying..this is my experience). Benzo withdrawal is probably the worst, but my withdrawal from Cymbalta was surpisingly rough. I mean, the initial effects--nausea, fatigue, etc.--weren't all that bad, and they only lasted for about a month. The real problem was the bumped up anxiety, the weird mood instability (I'm thinking the withdrawal made that *worse*, but it certainly didn't *cause* all of it), and the erratic sleep. I quit cold-turkey off of 90mgs Cymbalta (which is 30mgs above the FDA-approved, marketed dose; my shrink got a little *creative* I guess). Anyway, withdrawal is rough, and I wouldn't recommend doing it just now if you have reall stressful events going on (divorce, illness, deaths in the family, that kind of thing) that could exacerbate any emotional issues that pop up. But..*gradual* withdrawal be much, much less painful than *abrupt* withdrawal. Just talk to your doc and lay it out for her--the drugs were good for a while, thanks bunches, but now its time to withdraw, and anything that can be done to minimize side-effects would be *great*. With Effexor, the good news is that although the withdrawl is rough, its been around long enough for a good doc to know what to expect, so withdrawal problems can be anticipated and handled as they pop up. If you can do it, and if you're interested, some sort of therapy can be *tremendously* helpful; if not, some sort of introspective, soul-searching self-exploration will also be of use. The thing is that, for me at least, quitting the meds didn't just result in phsyical symptoms; suddenly, I had all these issues that had been more or less suppressed through medication that I had to deal with, somehow. Since I've had some bad experiences with therapists in my area, I opted to go it alone...its been rough, but I think its been worth it, too; I've gotten more writing done in the last couple months than I have in years, and I feel much better *and* more in-tune with my true Self than I have ever before. So...if you opt to ditch effexor and other meds, it can be done, assuming your doc is capable and you can also do necessary follow-up work with the emotional stuff; on the other hand, you may decide to continue Effexor and/or other medications...either way, just know that you do have options. Good luck!
Posted by crazy teresa on September 26, 2005, at 18:57:25
In reply to Hi, Teresa!, posted by med_empowered on September 26, 2005, at 1:34:16
I didn't think you sounded harsh at all.
I just can't appreciate the way mental health is handled in this area. In my experience, the pdoc will only see you once every 3 mos. or so, for 5-10 mins. at the max, write the scripts, push you out the door. The T's are ok, but I don't know. I gave up both because I can have the gen. prac. write a script for 6 mos. and I don't have the hassles of all the visits. I think I'd gone as far I could go with the only T available (per my ins.) without driving an hour.
The kind of T treatment I'd be most interested in trying just aren't in the middle of these cornfields. But I understand what you're saying about feeling better on meds., only masking the real problems.
Don't think I could work through it alone w/out meds. at this point in time. Maybe when the kids are a little older. How in the world were you able to cope?
I hated feeling like a psycho-bitch on wheels with permanent PMS. It's scary to think that's what I'd be going back to. And I'm sure my husband really wouldn't look forward to it! ;~}
Maybe I could move in with you for a while until I get myself straightened out? LOL!!!
Thanks for your input. I think youare amazingly brave!
crazy t
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.