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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by scatterbrained on March 27, 2006, at 20:47:37
I don't know about you guys but from my personal experience and understanding, stimulants given to people with depression is not always the greatest long term idea for one main reason, they STOP WORKING. People with ADD/ADHD without a mood disorder tend to not have this problem, they can go on for years taking the same dose. Unfortunatly, the doctors I have seen don't seem to understand this. They will switch to another Stimulant or combine two instead if it stops working.I read all the time on this board about Adderal or other stims wearing off after a few days and people are at a loss for what to do.Desipramine is used for ADD and is an antidepressant, why is this not used instead of the stims, probably one reason, the drug is not as new as provigil or focalin or adderal xr. Psychiatry is PATHOLOGICALLY obsessed with the newest most fasionable drug, to the point where they don't even know how to use the drugs that have come prior. Another example of this preoccupation is present in their bias towards SSRI's .
Posted by ed_uk on March 28, 2006, at 15:40:13
In reply to desipramine vs stimulants for comorbid ADD/ Depres, posted by scatterbrained on March 27, 2006, at 20:47:37
Some good points
Ed
Posted by ed_uk on March 28, 2006, at 15:41:00
In reply to Re: desipramine vs stimulants for comorbid ADD/ Depres » scatterbrained, posted by ed_uk on March 28, 2006, at 15:40:13
PS. That was sincere. I just read my post and it didn't sound very nice.
Ed
Posted by scatterbrained on March 28, 2006, at 16:09:55
In reply to Re: desipramine vs stimulants for comorbid ADD/ Depres » ed_uk, posted by ed_uk on March 28, 2006, at 15:41:00
sounded sincere to me, thanks
Posted by med_empowered on March 29, 2006, at 0:17:24
In reply to desipramine vs stimulants for comorbid ADD/ Depres, posted by scatterbrained on March 27, 2006, at 20:47:37
some docs do ADs for ADD/ADHD but they're usually older. Also, for some reason (in the US at least) they don't use desipramine; they tend more towards wellbutrin, effexor, etc. in high, intolerable doses. There's also use of the atypical antipyschotics now, which is disturbing (I'm picturing thousands of kids with TD and AP-induced cognitive problems). Maybe we should phase out psychiatry, and just give general docs education is psychopharmacology. I think for all the $$$ pumped into psychiatry, the "profession" has been rather disappointing in producing any sort of results.
Posted by scatterbrained on March 29, 2006, at 1:20:55
In reply to Re: desipramine vs stimulants for comorbid ADD/ De, posted by med_empowered on March 29, 2006, at 0:17:24
It's so disturbing to give kids with ADD antipsychotics. Why won't psychiatrists go with what works instead of experimenting. There is going to be a major backlash like there has been with giving kids SSRI's a while back, it's just a matter of time. I've found that the psychiatrists I have seen who have a large pediatric population tended to have been the most morally bankrupt. I guess it has to do with pediatric psychiatry being the most financially fruitful varient of psychiatry, so with money comes corruption. And it's easier to manipulate parents and children then it is an educated adult.
Posted by med_empowered on March 29, 2006, at 2:18:18
In reply to Re: desipramine vs stimulants for comorbid ADD/ De » med_empowered, posted by scatterbrained on March 29, 2006, at 1:20:55
I agree--shrinks treating kids kind of scare me. I think because kids are helpful anyway; even with well-intentioned, good parents, they're still at the mercy of those who care for them. What do you do when a kid has a "mental illness" because the world around them sucks (bad parents, etc.) ? Medicate them? And..what do you treat kids and other with, anyway? Stimulants have a pretty long track record with ADD, so I don't mind that (although it'd be nice if *fewer* kids were given these drugs), but I do have problems when we start calling troubled kids "ODD" ("oppositional defiant disorder") and RXing fun things like Moban (an old neuroleptic) for pretty much the express purpose of shutting them up. THIS is medicine? THIS is healing? Plus..child psychiatry raises a question: who is this doctor working for? The kid? The parents? Society at large? Ideally, a doctor works as his/her patient's advocate--she is her patient's doctor and does whatever she can to improve that persons life. In psychiatry as a whole, but especially in child psychiatry, I see a lot of docs deviating from this and using their patients.
Posted by SLS on March 29, 2006, at 7:50:20
In reply to Re: desipramine vs stimulants for comorbid ADD/ De, posted by med_empowered on March 29, 2006, at 2:18:18
For which pediatric conditions are neuroleptics prescribed?
Thanks.
- Scott
Posted by med_empowered on March 29, 2006, at 15:59:01
In reply to Re: desipramine vs stimulants for comorbid ADD/ De, posted by SLS on March 29, 2006, at 7:50:20
Neuroeltpics are used for Oppositional Defiant Disorder, an increasing number of ADD/ADHD cases, management of childhood-onset bipolar disorder, and of course psychotic disorders of varying sorts. There have been some news articles lately showing that more and more children are receiving antipsychotics at younger and younger ages. Also, a couple years ago the state of Florida found that its foster children tended to be waaaay overmedicated for "disorders" that seemed to disappear after they turned 18. Former foster children have come forward to speak out about lingering ill-effects, like poor memory and concentration. Some of the combos RX'd by shrinks for these kids were ridiculous--2+ stimulants, various anitpsychotics, mood-stabilizers, so on and so forth.
Posted by ADDmom32 on March 30, 2006, at 1:42:49
In reply to Re: desipramine vs stimulants for comorbid ADD/ De, posted by med_empowered on March 29, 2006, at 15:59:01
> Neuroeltpics are used for Oppositional Defiant Disorder, an increasing number of ADD/ADHD cases, management of childhood-onset bipolar disorder, and of course psychotic disorders of varying sorts. There have been some news articles lately showing that more and more children are receiving antipsychotics at younger and younger ages. Also, a couple years ago the state of Florida found that its foster children tended to be waaaay overmedicated for "disorders" that seemed to disappear after they turned 18. Former foster children have come forward to speak out about lingering ill-effects, like poor memory and concentration. Some of the combos RX'd by shrinks for these kids were ridiculous--2+ stimulants, various anitpsychotics, mood-stabilizers, so on and so forth.
Your thoughts on this subject just made me want to jump up and scream "YEAH!"I'm ADD - take Adderall XR and Cymbalta for depression. This combo works for me BUT my personal experience is that there is NO magic pill/combo. Diet, exercise and talk therapy have been pertinent to my "recovery". ALL of that is HARD WORK for someone who is depressed.
Now imagine you are a depressed parent trying to cope with an ADD/ADHD, ODD, or PTS child or two or three ... now imagine the kid is NOT yours, you don't have that "bond" and there are no "precious memories" to get you through the chaos and pain an emotionally unstable child can dish out.
Dr. says give the kid this magic pill/combo and you can shut him up and then you don't have to deal with child, complaining teachers, babysitters (parents HAVE to go to work) & maybe you can get kid back on school bus.
Seems like quick easy crisis mgmt.But backlash is HEAVY.
I KNOW my "disorders" come from my childhood/young adult history. I'm sure I was born with plenty of "chemical predisposition" but I have NO DOUBT environment has played a HUGE role.
My son was diagnosed as ODD at 5 years of age.
I was blessed with a wonderful child Psy Dr and a Psychologist who worked together with me to help me with parenting skills, behavior modification, and my own depression. Through the grace of God, sending me this wonderful support team I have never put any of my children on any drugs.BUT it's HARD, HARD, work. And not just for me.
In many ways the practice of doping up kids for their behavior is not so different from antibiotics prescrpts for every cold. Parents swear they WANT, sometimes NEED a quick crisis mgmt solution... DEMAND it.
Dr.s are human too. It takes a tremendous amount of morale fiber and emotional strength not to "just give it to 'em".
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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