![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 9 to 33 of 33. Go back in thread:
Posted by d0pamine on November 21, 2007, at 15:48:42
In reply to Re: Dopaminergics: Hazardous in long term?, posted by linkadge on November 21, 2007, at 10:12:52
I've been exactly where Mishal describes and while it's quite enjoyable and productive, and there is a price to be paid eventually for sleep deprivation. I'm with Linkadge balance and moderation in all things is the only path to sustainability.
Posted by bulldog2 on November 21, 2007, at 16:05:08
In reply to Re: Dopaminergics: Hazardous in long term? » linkadge, posted by d0pamine on November 21, 2007, at 15:48:42
> I've been exactly where Mishal describes and while it's quite enjoyable and productive, and there is a price to be paid eventually for sleep deprivation. I'm with Linkadge balance and moderation in all things is the only path to sustainability.
Possibly take off a couple days a week or one week a month. Dopaminergics tend to lose their effect over time.
Posted by rvanson on November 21, 2007, at 18:56:11
In reply to Dopaminergics: Hazardous in long term?, posted by Mishal on November 21, 2007, at 9:40:14
> Reason for asking this question is I feel like overly enthusiastic in all my activities.
>
> This has been the ending days of second week on Trivastal. I am experiencing many of the benefits of this med. But is there a hitch for all these?
>
> When I work, I am fully soaked up in the work. When I read, I am more than focused on the thing I am reading. Whilst I surf, I am so keen to pursue topics after topics. Most of my nighttime, I am stupidly surfing Wikipedia going from one tab to many.
>
> And things in the department of sex is also the same.
>
> While most would consider this as undesirable, I enjoy it. But what alarms me most is whether this sprightliness leads me to something drastic progressively?
>
> I asked myself for a Trivastal prescription though my shrink was unwilling. I could convince him eventually pointing at tremors in my hands.
>
> What swayed me to Trivastal is the mechanism of its action. A med that selectively acts on dopamine and noradrenalin could definitely of some use in an apathetic, anhedonic guy like me.
>
> And Trivastal proves to be effective. But is it more than it?
>
>Dont look a gift horse in the mouth very closely.
Only time will tell if this med is the correct one to fight adhedonia as soon I will find out for myself :-)
Posted by bleauberry on November 21, 2007, at 22:05:57
In reply to Re: Dopaminergics: Hazardous in long term? » Mishal, posted by rvanson on November 21, 2007, at 18:56:11
>
> Only time will tell if this med is the correct one to fight adhedonia as soon I will find out for myself :-)
>Me too.
Back to the post. Is it hypomania? Or is it a med working really good and it feels so great to be alive? Is the energy and lack of sleep a side effect? I don't know the answers. If one were to look at symptoms of hypomania, they are all present. But some people have a hypomanic type personality all their lives. They key, as someone said, is control.
For control, maybe consider taking something to tone it down a bit. A tiny bit of an SSRI? A little bit of lithium? A little bit of depakote? Lunesta or some other sleep med for nights? Maybe even a tiny dose of zyprexa or seroquel?
The kind of energy you are burning will lead to problems. For one, your adrenal glands will become exhausted. When that happens, it takes a very long time, strick diets, strick lifestyles, trials of different herbs and adrenal extracts, and sometimes even hydrocortisone replacement. When the adrenals burn out, the resulting low cortisol results in numerous bodily breakdowns, including poor nutritional absorption, haywire immune system, gut fungal and virus overgrowth, food intolerances, anxiety, depression, on an on.
So whether it is hypomania or not doesn't really matter as I see it. What does matter is that your body is not accustomed to the kind of energy it expending, and probably never will be, which means you are withdrawing funds from your savings account at a rapid rate. That's why I say finding a way to tone things down and yet keep a fair portion of the anti-anhedonia effect would be wise, so as to never burn out either physically or mentally. The mind and body need lots of rest every night, most especially when in a state that could be seen as hypomania, whether it actually is not.
If it is hypomania, you will deny it at this point. That is classic hypomania. The problem with hypomania is that it never ever lasts, for anyone. It will escalate to fullblown mania, or fall to pieces to deep depression. The resulting efforts at treating the battle damage will be much harder than you've ever dealt with before.
Honestly, hard to tell over the net, it doesn't sound like hypomania to me. A combo of some dopaminergic stuff, noradrenergic stuff, and just feeling darn good after feeling like crap for so long. But it needs to be in fair portion, tamed down, controlled, and not allowed to upset a normal bodily daily cycle. Figure out a way to get your life closer to normal rather than better than normal.
Posted by Mishal on November 22, 2007, at 4:19:25
In reply to Re: Dopaminergics: Hazardous in long term?, posted by linkadge on November 21, 2007, at 13:41:00
Link,
Thank you for your time. Meanwhile..
> That is totally possible, and I cannot tell you if what you are experiencing is normal or hypomania. It is impossible for me to do that online. If, however, you are questioning your level of happiniess, or it seems you are well beyond a normal persons level of interest, energy etc, then it might be good to discuss it with your doctor.
Dear, I can't question my level of happiness because I was an unhappy person from the very beginning. I suffered a lot from undiagnosed depression and ADHD, that effectively destroyed my childhoood, education and all the good that was there.
If it is to shed the liveliness that these two wonderful medications blessed to me, that would by all means restore the normal myself. But I hate being my old self again. I hope you get me here.> Do you genuinly have parkinsonian symptoms?
Most probably yes. I do have tremors in my hands that been worsened after being on SSRIs.
> If you are feeling "better than well", and if you continue to feel little need for sleep, then there may be something wrong.
I don't feel better than well, but I never felt this better in my life. Could this be hypomania? Let it be.. I can't care.
I was sort of hypersomnolent prior to being on Provigil. The med took away the edge of it and now Trivastal adds to the benefit. But the important thing is all the good that I experience are easily nullified right after popping a little bit of Xanax or Ativan (Benzos). That's why and how I started to hate benzos in general. I know sleeping is there in my medicine cabinet, though I would always care not to touch them again (if possible)> Because the body fights back. The body desires homeostasis, and if you push it beyond that it may not function optimally, it will also try to counteract the hypomania. Some drug induced hypomania also initiates rapid cycling, which can be had to treat.
This is really annoying. If my body fights back again to retain that old lethargic, somnolent and sombre myself; I will have to say I hate having such a steel.
A sleepy, gloomy myself can easily be restored if I keep my Provigil pills away. Should I try?
Why should I? I born with some deficits. If I correct them does that mean I do not do justice to myself?
Cheers
Mishal
Posted by Mishal on November 22, 2007, at 4:40:47
In reply to Re: Dopaminergics: Hazardous in long term?, posted by bleauberry on November 21, 2007, at 22:05:57
> For control, maybe consider taking something to tone it down a bit. A tiny bit of an SSRI? A little bit of lithium? A little bit of depakote? Lunesta or some other sleep med for nights? Maybe even a tiny dose of zyprexa or seroquel?Hi Blueb,
I often take Neurontin at night and despite all this cheerfulness the cap helps me sleep. But I purposefully delay taking it at night not to spoil the fun.
> The kind of energy you are burning will lead to problems. For one, your adrenal glands will become exhausted............
I understand but these are the worst possibilities. I don't strive that much to go beyond control.
> If it is hypomania, you will deny it at this point. That is classic hypomania. The problem with hypomania is that it never ever lasts, for anyone. It will escalate to fullblown mania, or fall to pieces to deep depression.Listen please. I have all reasons to believe I was born with defects. There never was a cheerful myself in the past prior to Provigil.
Now I am excited because I never felt this good before. Does this mean there is a manic to blow? Or would I again sink in depression? As you said, beyond recovery?
Really annoying..
Posted by anonymoose on November 22, 2007, at 6:08:16
In reply to Re: Dopaminergics: Hazardous in long term? » linkadge, posted by Mishal on November 22, 2007, at 4:19:25
Mishal,
Do you have any other parkinsonian symptoms? I have a few symptoms myself that could be considered "parkinsonian-like." None of which I can remember having before my dysthymic/anhedonic problems started about 10 years ago.
- jaw tremor (constant, involuntary chattering of the teeth; no bruxism/griding, though)
- hand tremor (appears whenever dysthymic symptoms worsen)
- restless legs (constant)
- memory loss (procedural memory impaired more than declarative; prompting definitely elicits improved recall; I can still kick ass at Jeopardy! but have to re-learn the same programming skills week after week required for my job)
- hypophonia and alogia (in correlation with the severity of the dysthymia)
- masked facial expression (in correlation with severity of the dysthymia)
- micrographia (i can't even read my own handwriting anymore)
- worsening motor coordination
- excessive daytime somnolence (this was the first symptom I ever noticed; eventually falling asleep in *every* class of every day, or every time i tried to read something over a page long)
- oily skin and face
I referenced most of these symptoms off the Wikipedia page for PD. I don't think I actually have PD, but rather feel these symptoms are the result of worsening dopaminergic deficits, the original cause of which I'm unable to identify. Before it all started, I was a happy, well-functioning teen.I'm now going on day 4 of Mirapex 0.75mg tid and Selegiline 5mg/day. Nothing really profound yet. But I did just add B-complex supplementation which I think might make a big difference for me, too. Currently my complete cocktail is:
1. Mirapex 0.75mg/tid
2. Selegiline 5mg/day3. ENADA NADH 5mg/day
4. One-a-Day Men's Health Multivitamin
5. B-complex (Walgreen's brand)
6. DL-Phenylalanine (DLPA) 800mg/day
7. Omega-3 fish oils 2000mg/dayI may add some TMG or magnesium, eventually, to see if they help.
Still keeping my fingers crossed for a good sustained therapeutic response from either/both the Mirapex/Selegiline.
-J
> > Do you genuinly have parkinsonian symptoms?
>
> Most probably yes. I do have tremors in my hands that been worsened after being on SSRIs.
>
Posted by Mishal on November 22, 2007, at 6:23:08
In reply to Re: Dopaminergics: Hazardous in long term? » Mishal, posted by anonymoose on November 22, 2007, at 6:08:16
> Mishal,
>
> Do you have any other parkinsonian symptoms?Hi anonymoose,
Right now I am being aware of other symptoms of Parkinson's too. I have tremors and RLS.
Besides I have problem with memory. I don't know whether this can be a Parkinsonian one. Most often, I fail to recall name of the persons that were very familiar to me. It is like a black out for some minutes to hours, but eventually I succeed. But it is quite disturbing when I fail to get the name of the person used to sit right in front of me in my office though I get it right later after struggling a lot.
My doc said there is nothing to worry. But I am yet to be convinced.
Posted by linkadge on November 22, 2007, at 10:20:43
In reply to Re: Dopaminergics: Hazardous in long term? » linkadge, posted by Mishal on November 22, 2007, at 4:19:25
Thats really why I am saying "I don't know". You probably know best yourself whether how you feel is normal or not.
It just seemed to me that if you were coming on here essentially asking if such a such was excessive, from what you described I'd say yes, but that is, as you know, not a complete assesment
by any strech.Linkadge
Posted by Dr. Bob on November 22, 2007, at 16:02:57
In reply to Re: Dopaminergics: Hazardous in long term? » Mishal, posted by anonymoose on November 22, 2007, at 6:08:16
> I can still kick [*]ss at Jeopardy!
Please don't use language that could offend others.
But please don't take this personally, either, this doesn't mean I don't like you or think you're a bad person.
If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please first see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
http://www.dr-bob.org/babble/faq.html#enforceFollow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above post, should of course themselves be civil.
Thanks,
Bob
Posted by anonymoose on November 23, 2007, at 11:10:33
In reply to Re: please be civil » anonymoose, posted by Dr. Bob on November 22, 2007, at 16:02:57
My bad, that was an oversight on my part.
> > I can still kick [*]ss at Jeopardy!
>
> Please don't use language that could offend others.
>
> But please don't take this personally, either, this doesn't mean I don't like you or think you're a bad person.
>
> If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please first see the FAQ:
>
> http://www.dr-bob.org/babble/faq.html#civil
> http://www.dr-bob.org/babble/faq.html#enforce
>
> Follow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above post, should of course themselves be civil.
>
> Thanks,
>
> Bob
Posted by cumulative on November 23, 2007, at 16:48:58
In reply to Re: Dopaminergics: Hazardous in long term?, posted by linkadge on November 21, 2007, at 13:41:00
>Do you genuinly have parkinsonian symptoms? If you invent a symptom to get a treatment that you think is in your best interest, there might be somthing wrong. I don't know if you do or do not have parkinsonian symptoms thought, so I can't say.
I disagree.
If I wanted to get a dopamine agonist on prescription for depression or another use, but the doctors in my area were scared and conservative, I would happily fake Parkinsonian symptoms.
Because, the fact is, I should not require a permission slip from anyone in order to take anything whatsoever.
Posted by cumulative on November 23, 2007, at 16:52:02
In reply to Re: Dopaminergics: Hazardous in long term? » bleauberry, posted by Mishal on November 22, 2007, at 4:40:47
If you're asking if there'll be a price to be paid for continuous, long-term sleep deprivation, I'm sorry to say but the answer is definitely YES.
You can find a balance between low-sleep hypomania and depression, or even between hypomania and the dull normalcy that some here seem to claim is the "goal" of treatment with medication (the goal invented by who exactly?) -- personally, I place this happy medium at euthymia, or even hyperthymia.
Truly, consider adding a late-night a2 agonist (clonidine should help sleep and also curb some of the adrenergic effect during the day), or low doses of a mood stabilizer like lithium orotate.
Posted by linkadge on November 23, 2007, at 19:55:49
In reply to Re: linkadge, posted by cumulative on November 23, 2007, at 16:48:58
>If I wanted to get a dopamine agonist on >prescription for depression or another use, but >the doctors in my area were scared and >conservative, I would happily fake Parkinsonian >symptoms.
>Because, the fact is, I should not require a >permission slip from anyone in order to take >anything whatsoever.
It seems to me to be kind of ironic that on one hand sombody should believe that they are so deficiant in motivation chemicals (ie dopamine), yet on the other they are so motivated to get a particular treatment that they are willing to fake the symptoms of a serious disorder to get a particular treatment.
These drugs are not candy. Doctors take many things into consideration when decidion whether or not to presrcibe a certain treatment. Two dopamine agonists were recently pulled from the market for their propensity to induce severe cardiac valve dammage.
Could you imagine if you sustained life threatening valve damage from the treatment of a disorder one faked?
There is more to a doctors decision than simply "will this treatment work or not".
If you think your doctors decision is incompetent, I'd advise getting a second opinion.
Another issue is that when dealing with psychoactive drugs, it is impossible to acurately asess the integrity of a patients logic, when making such decisions. For instance, patients who fake pain symptoms to get opiates may believe that their actions are justified, but in the bigger picture, their actions are not justified, and the doctor has every good medical reason to deny such patients pain killers.
Linkadge
Posted by cumulative on November 24, 2007, at 0:20:52
In reply to Re: linkadge, posted by linkadge on November 23, 2007, at 19:55:49
>It seems to me to be kind of ironic that on one hand sombody should believe that they are so deficiant in motivation chemicals (ie dopamine), yet on the other they are so motivated to get a particular treatment that they are willing to fake the symptoms of a serious disorder to get a particular treatment.
Nonsense. It can be hard to get up and get to the doctor, but even with poor motivation when you pour all your energy into something you can get it done. Often that's still not enough energy or motivation to be functional. Depressives tend to dwell on their depression -- hence the intense, some would say somewhat aspergers-like knowledge of pharmacology that some people here have.
Your reasoning is deeply circular, and designed to defend the institution.
>Doctors take many things into consideration when decidion whether or not to presrcibe a certain treatment.
Right. Like which drug company reps are giving them the best kickbacks. That's why SSRIs, barely better than placebo, are used so widely; why dangerous, poorly researched antipsychotics are all the rage.
>Two dopamine agonists were recently pulled from the market for their propensity to induce severe cardiac valve dammage.
These are ergoline derivative dopamine agonists, of which piribedil and pramipexole are not, a fact that is easily discerned from about two minutes of research.
>Could you imagine if you sustained life threatening valve damage from the treatment of a disorder one faked?
Not relevant here at all. Secondly, it's up to the PERSON to do their OWN RESEARCH if they're doing something like this, because it's their body and their mind.
>There is more to a doctors decision than simply "will this treatment work or not".
Too bad most pdocs I've met are idiots.
>If you think your doctors decision is incompetent, I'd advise getting a second opinion.
Sucks for those of us living in rural areas.
>Another issue is that when dealing with psychoactive drugs, it is impossible to acurately asess the integrity of a patients logic, when making such decisions.
Paternalist claptrap.
>For instance, patients who fake pain symptoms to get opiates may believe that their actions are justified, but in the bigger picture, their actions are not justified
I strongly disagree. When nothing else has worked, it's an excellent idea to try for a sustainable supply of opioids -- very effective antidepressant, antimanic, antianxiety agents. You are blinded by ideology.
Posted by Deputy Racer on November 24, 2007, at 2:08:25
In reply to Re: linkadge, posted by cumulative on November 24, 2007, at 0:20:52
>
> Nonsense. -- hence the intense, some would say somewhat aspergers-like knowledge of pharmacology that some people here have.
>
> Your reasoning is deeply circular, and designed to defend the institution.
> >
> Too bad most pdocs I've met are idiots.
>
>
>
> Paternalist claptrap.
>
>You are blinded by ideology.Please don't post anything which could lead others to feel accused or put down, even if you don't agree with their opinions. Also, please be sensitive to others, which includes those who may have Asperger's Syndrome.
If you have any questions regarding the posting policies on this site, please read the FAQ, located at http://www.dr-bob.org/babble/faq.html#civil Follow ups to this action should be directed to the Administration board and should themselves be civil.
Dr Bob has ultimate authority over all administrative issues on this site, and may choose at any time to revise or reverse any action taken by a deputy.
Deputy Racer
Posted by cumulative on November 24, 2007, at 2:08:36
In reply to Re: linkadge, posted by cumulative on November 24, 2007, at 0:20:52
Upon looking at my post now (and not as depressed as I was then), I find that my tone was really unnecessary. I apologize -- I have a history of being combative, and often get needlessly defensive -- even/especially on the internet, or interestingly enough with people I like. linkadge I've learned a lot from your very intelligent posts and your friendly presence, and I know we can carry on this discussion reasonably. Again, sorry for my jerkishness.
- nick
Posted by anonymoose on November 24, 2007, at 2:59:38
In reply to Re: linkadge, posted by cumulative on November 24, 2007, at 0:20:52
Cumulative,
I couldn't agree with you more on those points. Especially got a good chuckle out of this one:
>
> >There is more to a doctors decision than simply "will this treatment work or not".
>
> Too bad most pdocs I've met are idiots.
>You're not alone in this observation. Of all the well-meaning pdocs I've met, not a single one has made a medication selection that has ever actually decreased my overall suffering. Most seem to still subscribe to the same overly simplistic treatment model: "Oh, so you've got 'the depression?' It must be a 'serotonin deficiency.' Here's the current SSRI flavor-of-the-month. If that doesn't work, we'll move you onto something 'newer or stronger,' like Effexor or Cymbalta."
My last pdoc, as I was trying to explain to him the particular nature of my depressive symptoms (e.g. anhedonia and apathy, but no anxiety or panic attacks, etc.), so he could make a more informed treatment decision, told me: "Well, to be honest with you, I don't really pay much attention to the proposed mechanism of action for these meds. Because you never really know...you know?" He didn't want to prescribe a dopamine agonist for me because he wasn't too familiar with them...so he passed me off to the Pharm.D. instead.
Posted by linkadge on November 24, 2007, at 11:16:37
In reply to Re: linkadge, posted by cumulative on November 24, 2007, at 2:08:36
Its not that I don't think people have a right to the most effective treatment, its just that I know a few people who get themselves into deeper problems by beliving they know which treatment is best, with a little more than a few online posts and some essentially clinically useless information about theoretical drug mechanisms.
I do believe it is in the patients best, long term interest, to be fully honest about symptoms and how medications are working.
Many bipolars, for instance, hide manic tendencies in order to avoid such a diagnosis. They may believe they will be better off with just antidepressants. This may increase rapid cycling, neurological consequences, and perhaps risk of suicide.
Nobody knew that the parkinsons meds that were removed from the marked were that dangerous. To say that a person should have just done their homeowork doesn't make sense.
Doctors may avoid the prescription of certain drugs based on his own experiences.
For instance, before the risk of diabeties for olanzapine was fully established, I'm sure many doctors had some experience with the drug messing with people metabolically. As such, they may stray away from the off lable prescription of the substance for good reasons, even though there are no formal FDA warnings about the issue. As such, somebody who thinks they are doing whats best for themselves, are not considering what the doctor is.
For instance, to me, a prescription of wellbutrin would be a good next choice, seeing as I havn't tried it before and SSRI's are making me somewhat apathetic. The doctor said no however, becuase I am a underweight, have problems sleeping, have lots of anxiety, and have a history of some EEG abnormalities.
Now perhaps I don't like the doctors decision, so I go in and lie about symptoms of ADHD, nicotine addiction, and or severe lack of energy, no anxiety or insomnia. Then while this may change the doctors decision, it could still be a bad choice given the truth about my actual symptoms.
Before it was discovered that bupropion is not really working via a dopaminergic mechanism, how many people thought, "I am dopamine deficiant, therefore wellbutrin is my best choice, and I will do anything necessary to get it".
Thats the problem with all this online stuff is that many times it is found out to be only partially correct, or sometimes incorrect.
Linkadge
Posted by bulldog2 on November 24, 2007, at 12:21:53
In reply to Re: linkadge, posted by linkadge on November 24, 2007, at 11:16:37
> Its not that I don't think people have a right to the most effective treatment, its just that I know a few people who get themselves into deeper problems by beliving they know which treatment is best, with a little more than a few online posts and some essentially clinically useless information about theoretical drug mechanisms.
>
> I do believe it is in the patients best, long term interest, to be fully honest about symptoms and how medications are working.
>
> Many bipolars, for instance, hide manic tendencies in order to avoid such a diagnosis. They may believe they will be better off with just antidepressants. This may increase rapid cycling, neurological consequences, and perhaps risk of suicide.
>
> Nobody knew that the parkinsons meds that were removed from the marked were that dangerous. To say that a person should have just done their homeowork doesn't make sense.
>
> Doctors may avoid the prescription of certain drugs based on his own experiences.
>
> For instance, before the risk of diabeties for olanzapine was fully established, I'm sure many doctors had some experience with the drug messing with people metabolically. As such, they may stray away from the off lable prescription of the substance for good reasons, even though there are no formal FDA warnings about the issue. As such, somebody who thinks they are doing whats best for themselves, are not considering what the doctor is.
>
> For instance, to me, a prescription of wellbutrin would be a good next choice, seeing as I havn't tried it before and SSRI's are making me somewhat apathetic. The doctor said no however, becuase I am a underweight, have problems sleeping, have lots of anxiety, and have a history of some EEG abnormalities.
>
> Now perhaps I don't like the doctors decision, so I go in and lie about symptoms of ADHD, nicotine addiction, and or severe lack of energy, no anxiety or insomnia. Then while this may change the doctors decision, it could still be a bad choice given the truth about my actual symptoms.
>
> Before it was discovered that bupropion is not really working via a dopaminergic mechanism, how many people thought, "I am dopamine deficiant, therefore wellbutrin is my best choice, and I will do anything necessary to get it".
>
> Thats the problem with all this online stuff is that many times it is found out to be only partially correct, or sometimes incorrect.
>
> Linkadge
>
>
> I think you give most doctors to much credit for their knowledge of pharmcology. There are those on babble who have done more research and know more about psych meds than their p-docs. Most docs in general in the US get most of their knowledge about meds from the pharm rep and don't know much more than you or I if you can read the insert which the doc may not even bother to do.
Also i've found that docs in general tend to precribe the lastest and greatest meds out and hand samples out like candy. These meds are the newest and therefore it could take years to know what long term sides could emerge.
I know of personal instances where docs precribed meds in error where there was an interaction with another med the patient was on.
Trusting your docs knowledge of meds (often very minimal- a phram rep presentation) could give one a false sense of confidence that could cost you your health and maybe your life.
If you read the pdr for a drug thoroughly (drug interactions and precautions) you probably know more than your doc.
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Posted by Dr. Bob on November 24, 2007, at 13:39:14
In reply to Re: linkadge, posted by cumulative on November 24, 2007, at 2:08:36
Posted by linkadge on November 24, 2007, at 14:13:38
In reply to Re: linkadge, posted by bulldog2 on November 24, 2007, at 12:21:53
I understand that some paitents may be better informed than their doctors about certain aspects things, but I still don't see how that equates to a paitent having better judgement about the whole medical picture. When you fake a disease, you screw up the whole medical picture, which can make things very difficult to sort out in the future.
Many doctors weren't born yesterday, and if they suspect you are faking symptoms, which there are many ways for them to know, it can go in your chart which can make treatment very difficult in the future.
Cumulative brought up the point that SSRI's are generally no better than placebo. That is an interesting point, because I know individuals who are do darn convinced that they need to be on prozac, for some strange reason, that they fake the syptoms of depression to get on it.
Thats the problem with boards like this, is that in some ways they just act to fuel a "self doctor"
type of fire that is often full of misconceptions etc.
Linkadge
Posted by bulldog2 on November 24, 2007, at 14:58:39
In reply to Re: linkadge, posted by linkadge on November 24, 2007, at 14:13:38
> I understand that some paitents may be better informed than their doctors about certain aspects things, but I still don't see how that equates to a paitent having better judgement about the whole medical picture. When you fake a disease, you screw up the whole medical picture, which can make things very difficult to sort out in the future.
>
> Many doctors weren't born yesterday, and if they suspect you are faking symptoms, which there are many ways for them to know, it can go in your chart which can make treatment very difficult in the future.
>
> Cumulative brought up the point that SSRI's are generally no better than placebo. That is an interesting point, because I know individuals who are do darn convinced that they need to be on prozac, for some strange reason, that they fake the syptoms of depression to get on it.
>
> Thats the problem with boards like this, is that in some ways they just act to fuel a "self doctor"
> type of fire that is often full of misconceptions etc.
>
>
> Linkadge
>
>
> You're right about not deceiving doctors. Your doctor should certainly be aware of all the meds your on before prescribing and symptoms should not be faked.My point is doctors often don't see the whole medical picture anymore in this age of specialists and insurances that overload doctors with patient overloads.I have no problem with patients looking for answers when the tradtional approach has not worked. Even if that means doing rigorous homework and self prescribing.
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Posted by rgb on November 24, 2007, at 16:45:14
In reply to Dopaminergics: Hazardous in long term?, posted by Mishal on November 21, 2007, at 9:40:14
(to original poster)
Odd. I thought direct dopamine agonists weren't supposed to have psychostimulant-type effects. Enjoy :) Maybe it also has something to do with the alpha2 effects.
Anyway, if you are getting stimulant effects from it, maybe watch out for stimulant psychosis (e.g. paranoia, thinking everything refers to yourself). I don't know anything else about the long-term effects.
Posted by Dr. Bob on November 25, 2007, at 20:57:04
In reply to Re: please be civil » Dr. Bob, posted by anonymoose on November 23, 2007, at 11:10:33
This is the end of the thread.
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