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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by zonked on July 5, 2010, at 6:27:21
Anybody know where the biological treatment of mood disorders is headed--10, 20 years from now?
We had the SSRI era, and recently the antipsychotic era--what's next? Realistically..
-z
Posted by linkadge on July 5, 2010, at 8:46:04
In reply to What's up for 10 years from now?, posted by zonked on July 5, 2010, at 6:27:21
Well the SSRI era has lasted more like 2 decades. I think were in for another decade of SSRI's and antipsychotics.
Linkadge
Posted by europerep on July 5, 2010, at 9:59:41
In reply to Re: What's up for 10 years from now?, posted by linkadge on July 5, 2010, at 8:46:04
I'd guess the next thing to come would be NMDA antagonists, or possibly specific kappa-antagonists, that do not influence mu- and delta-receptors.. but when? hmm...
Posted by zonked on July 5, 2010, at 10:03:06
In reply to Re: What's up for 10 years from now?, posted by europerep on July 5, 2010, at 9:59:41
> I'd guess the next thing to come would be NMDA antagonists, or possibly specific kappa-antagonists, that do not influence mu- and delta-receptors.. but when? hmm...
Hi europerep,
Are you in the UK? Always wondered how the NHS handled prescriptions--is everything formulary? (Ie are there some drugs that NHS won't cover even with gratuitous pdoc bitching, that you have to pay for out of pocket?)
-z
Posted by Phillipa on July 5, 2010, at 10:54:04
In reply to Re: What's up for 10 years from now? » europerep, posted by zonked on July 5, 2010, at 10:03:06
10-20 years I guess I won't be around then and definitely too old to benefit. Sounds like l00's of years will go by before if ever it really changes. Philllipa
Posted by europerep on July 5, 2010, at 11:00:57
In reply to Re: What's up for 10 years from now? » europerep, posted by zonked on July 5, 2010, at 10:03:06
hey zonked..
no, luckily I'm not British - nothing against the British, but the NHS doesn't seem to be that great for those citizens who do actually need medical services..
I am German actually, the health care system here is quite good actually, although I do have a private insurance that reimburses basically any med I get prescribed, I am not sure how that works with other health insurance services.. but so far I haven't had to pay anything out of pocket :-)..
Posted by ed_uk2010 on July 5, 2010, at 15:38:07
In reply to Re: What's up for 10 years from now? » europerep, posted by zonked on July 5, 2010, at 10:03:06
>Always wondered how the NHS handled prescriptions--is everything formulary? (Ie are there some drugs that NHS won't cover even with gratuitous pdoc bitching, that you have to pay for out of pocket?
A very wide range of medicines (both licensed and unlicensed), medical devices, dressings and food items (eg. gluten free , nutritional supplements etc) are available on NHS prescription. Nevertheless, most doctors (including psychiatrists) tend to stick to the meds recommended by the local or national formulary. Generic usage is very high and new drugs take time to gain acceptance. There are many NHS prescribing guidelines to which doctors adhere to to a varying extent.
In short, there are very few medicines which strictly cannot be prescribed on the NHS. There is, however, a tendency to use older more established meds in preference to expensive new brands. Some doctors may refuse to prescribe certain expensive products. This does not normally mean that they cannot prescribe them, it's more a case of them being advised not to prescribe certain products so they don't.
Posted by Trepanist on July 5, 2010, at 22:38:02
In reply to Re: What's up for 10 years from now? » zonked, posted by ed_uk2010 on July 5, 2010, at 15:38:07
Hopefully no more meds, I would like to see some genetic engineering, pre-birth. Probably won't see that for another 100 years.
Posted by europerep on July 6, 2010, at 12:09:11
In reply to Re: What's up for 10 years from now?, posted by Trepanist on July 5, 2010, at 22:38:02
> Hopefully no more meds, I would like to see some genetic engineering, pre-birth. Probably won't see that for another 100 years.
hmm, I am not sure about that.. even if I am a little simplistic here, if parents learned to actually love their children we would already be a great step further!
Posted by jade k on July 6, 2010, at 16:34:59
In reply to Re: What's up for 10 years from now?, posted by linkadge on July 5, 2010, at 8:46:04
> Well the SSRI era has lasted more like 2 decades. I think were in for another decade of SSRI's and antipsychotics.
>
> LinkadgeTake that back!
~Jade :-(
Posted by jade k on July 6, 2010, at 16:56:09
In reply to Re: What's up for 10 years from now?, posted by europerep on July 6, 2010, at 12:09:11
> if parents learned to actually love their children we would already be a great step further!
I'm hearing that you feel this is currently the exception, not the rule. Am I correct?
~Jade
Posted by Michael Bell on July 6, 2010, at 17:07:25
In reply to What's up for 10 years from now?, posted by zonked on July 5, 2010, at 6:27:21
My guess? 1) direct agonists and antagonists rather than reuptake inhibitors and 2)more focus on hormones and neuropeptides (i.e. oxytocin, allopregnenolone, etc.)
Posted by jade k on July 7, 2010, at 20:31:43
In reply to Re: What's up for 10 years from now? » europerep, posted by jade k on July 6, 2010, at 16:56:09
> > if parents learned to actually love their children we would already be a great step further!
>
> I'm hearing that you feel this is currently the exception, not the rule. Am I correct?
>
> ~JadeHow about: "if MORE parents learned to actually love their children we would already be a great step further!"
I'm sure there's some truth to that :-)
~Jade
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Posted by europerep on July 9, 2010, at 16:23:13
In reply to Re: What's up for 10 years from now? » jade k, posted by jade k on July 7, 2010, at 20:31:43
hey jade..
sorry for replying to your question on my post earlier, I wasn't feeling that good - as you know ;) - and I was busy, and so on..
what I wrote was basically what came to my mind when someone mentioned genetic engineering, which made me think of children, kids, education, etc.. and of course when I said "if parents learned.." then this was with my parents in mind.. they were never "bad parents" at all, but for my mom especially certain things were always more important: how the family looked on the outside, her sons' success vs. the other children's success (esp. school-wise), whether her kids were perfectly socially integrated ("different" is BAD)...
this has caused me many, many problems, and I started distancing myself from my parents at a very young age.. I kind of feel like through what my mom did (or did not do), she has "waived" her right to actually be loved by me.. after some difficult years, and about a year where I did not have any contact with her at all, our relation is somewhat normalized now.. although she has hurt me very, very much, I do not want to hurt her "in retaliation".. she has had a difficult life herself, and I have to say that I doubt that, as an adult, she has actually ever been happy - at least I have never really seen her laugh, and there is not one photo where she is "authentically" smiling.. I see all that, and I don't want to cause her more problems, but at some point I am still very disappointed, and hurt by her actions and attitudes..of course, I see so many parents who show true affection for their children, and I am glad everytime I see it. I was certainly not going to rant against "parents" as a whole, but sometimes I have the impression that for some parents, children are not an end, but a means, through which they obtain something, and I find that very wrong.. are you a mother, jade? if so, then I am sure you are a great one :) and you are right of course, "if more parents learned to love their children, we would be a giant step further" is a better way to say it.. ;)
Posted by jade k on July 9, 2010, at 22:29:40
In reply to Re: What's up for 10 years from now?, posted by europerep on July 9, 2010, at 16:23:13
> hey jade..
hey europerep!
>
> sorry for replying to your question on my post earlier, I wasn't feeling that goodI'm not sure what you're apologising for...and I know you haven't been feeling well :-( Sometimes I forget "a post" is not a complete picture of the "poster" if that makes sense. I did feel bad later, after getting to know you some on your other thread. Thats why I came back to clarify :-)
>
> what I wrote was basically what came to my mind when someone mentioned genetic engineering, which made me think of children, kids, education, etc.. and of course when I said "if parents learned.." then this was with my parents in mind.. they were never "bad parents" at all, but for my mom especially certain things were always more important: how the family looked on the outside, her sons' success vs. the other children's success (esp. school-wise), whether her kids were perfectly socially integrated ("different" is BAD)...
> this has caused me many, many problemsI'm really sorry, and I should have been more empathetic. You had a reason for your post and I should have let it be.
> and I started distancing myself from my parents at a very young age.. I kind of feel like through what my mom did (or did not do), she has "waived" her right to actually be loved by me.. after some difficult years, and about a year where I did not have any contact with her at all, our relation is somewhat normalized now.. although she has hurt me very, very much, I do not want to hurt her "in retaliation"..
Thats really impressive. Your conflicted feelings about her I'm sure are painful. I hope you don't "stuff" it. Sounds like you would be an excellent candidate for therapy of some kind. Its often said "we must forgive our parents", not for them but for us.
>she has had a difficult life herself, and I have to say that I doubt that, as an adult, she has actually ever been happy - at least I have never really seen her laugh, and there is not one photo where she is "authentically" smiling.. I see all that, and I don't want to cause her more problems, but at some point I am still very disappointed, and hurt by her actions and attitudes..
As children we look to our parents for so many things, I'm sure it was difficult for you to be raised by someone who was unable to experience joy. It sounds like on the one hand, you feel cheated, and on the other you feel enough compassion towards her to recognise that maybe she didn't have much to give.
I hear that you are hurt and disappointed. I see now why you are concerned about how much nurture plays a role in mental illness, as compared with nature.
This question has been a recurrent theme on the board lately, nature vs nurture. I DO believe depression (and many mental illnesses) can be caused by childhood neglect and abuse. I also believe that some simply are genetic, and all the parental love in the world can't prevent some disorders from presenting.
>
> of course, I see so many parents who show true affection for their children, and I am glad everytime I see it.Sounds like you will make a caring and attentive parent some day.
>I was certainly not going to rant against "parents" as a whole, but sometimes I have the impression that for some parents, children are not an end, but a means, through which they obtain something, and I find that very wrong..
So do I :-(
>are you a mother, jade? if so, then I am sure you are a great one :) and you are right of course, "if more parents learned to love their children, we would be a giant step further" is a better way to say it.. ;)
Yes, I am a mother (you can tell?). If you truly enjoy your kids, there is nothing that compares (for me). With children, suddenly, you are not the most important person in your life! WHAT? Imagine that! Your "stuff" just goes to the wayside, and their welfare trumps everything else. They're so much fun!(and exhausting!)
Maybe thats why I'm in crisis. I'll soon be suffering from empty nest syndrome....see! they come in handy for all sorts of things, lol.
Btw-good parenting can make all the difference in the world to a child that DOES present with a mental illness. I hope we can all agree on that.
You're a cool guy europerep...keep the faith
~Jade
ps-My babblemail is on, write me anytime.
Posted by sigismund on July 10, 2010, at 3:24:17
In reply to Re: What's up for 10 years from now?, posted by europerep on July 9, 2010, at 16:23:13
>especially certain things were always more important
That's it, exactly.
Posted by SLS on July 10, 2010, at 4:56:56
In reply to Re: What's up for 10 years from now? » europerep, posted by jade k on July 9, 2010, at 22:29:40
> This question has been a recurrent theme on the board lately, nature vs nurture. I DO believe depression (and many mental illnesses) can be caused by childhood neglect and abuse. I also believe that some simply are genetic, and all the parental love in the world can't prevent some disorders from presenting.
Agreed. My guess is that it is not an either-or scenario for most cases of depression. Both nature and nurture (or lack of it) contribute to its induction. I see the causations of depression to lie along a continuum ranging from being predominantly genetic to predominantly psychological. One of the problems with the English language is that it uses the same one word - "depression" - to describe multiple phenomena. This leads to a great deal of confusion and perhaps a lack of empathy. Many mentally healthy people who experience occasional situational depressions often generalize their experience to everyone else. They just don't know any better. Even now, 20 years after the "Decade Of The Brain", there is still a need for educating the general public as to the phenomenology of mental illness. It is sad.
- Scott
Posted by europerep on July 10, 2010, at 7:55:33
In reply to Re: What's up for 10 years from now? » europerep, posted by jade k on July 9, 2010, at 22:29:40
hi jade..
haha, what I meant to say was "sorry for NOT replying earlier to your response in this thread".. I remember spotting the mistake and adding the "not" when I reread my post yesterday, but then I probably still clicked on "submit post" rather than "preview edited post".. anyway, all I meant to say is I hadn't forgotten what you said on here..
but you do not have to apologize for what you wrote.. or for not being empathetic, because you are! :-)
actually (this is going to get complicated...), I was thinking that YOU were a little upset about my original statement which, technically, was expressing criticism towards ALL parents (it wasn't intended to so of course, but it might have read as if..).. and, following this thought, I was wondering whether you yourself have children, and hence the question whether you do.. :)it's true that therapy would be ideal for me.. there are so many issues that would need to be "solved", and some of them could even be solved rather easily, but for this problem with my mother...I know that I will not be able to really "forgive" her, until I succeed at overcoming the problems she has caused me (or that she contributed to magnify).. or in other words, until I will be living a life that satisfies me, and that gives me at least some of the basic things that life gives to almost "everyone" around me.. maybe that is egoistic, and I should be able to separate these things, but I am not..
and what I meant by "waiving" her rights is basically just that.. my life is about me now, and the very first priority, that goes above all else, is to get better and to be happy myself.. if doing this enters in conflict with doing what she wants me to do, then I do not hesitate anymore to choose what is right for me.. it may seem cold, but at this particular point, I am not willing to do a compromise between her needs and mine.. I have lost SO much time of my life, I do not have anymore of it go give away like that.. of course, I am willing to do anything that is good for her, or that she enjoys, that doesn't keep me from pursuing my goal of getting health-y/ier.. as an example, she doesn't like psychopharmacologic drugs, and she didn't like it when I got them prescribed, she let me know clearly that she didn't want me to take them, asking me ALL the time when I would finally finish the treatment, etc.. I do not even enter any discussion on that with her now, because I know her attitude, even if she tries to pack it in more friendly words, and I don't want to hear none of it.. her constant pressure back then (when I was 17-18) made me REDUCE the dosage I took in a period where I would have needed MORE, and I wonder whether I could have better dealt with my problems then, and feel better now, had I not listened to her..I do not want to "capture" this thread and the nature vs. nurture debate, so I will indeed babblemail you a little later, ok?
see you then..ER
Posted by jade k on July 10, 2010, at 12:38:21
In reply to Re: What's up for 10 years from now? » jade k, posted by europerep on July 10, 2010, at 7:55:33
> hi jade..
Hey ER,
Not sure I like that, lol, reminds me of Emergency Room.
>
> haha, what I meant to say was "sorry for NOT replying earlier to your response in this thread"..Yeah, I got that.
> but you do not have to apologize for what you wrote.. or for not being empathetic, because you are! :-)
Thanks! Glad I can be useful here.
> actually (this is going to get complicated...)
Nah, just correcting your grammar :-)
Glad we got that straightened out.
> it's true that therapy would be ideal for me.Sounds like it ER, maybe get some help with setting bounderies with your mom.
>until I will be living a life that satisfies me, and that gives me at least some of the basic things that life gives to almost "everyone" around me.
Of course you deserve these things. And you have every right as a young man to do what you need to get well.
> my life is about me now, and the very first priority, that goes above all else, is to get better and to be happy myself.
I agree 100%
>if doing this enters in conflict with doing what she wants me to do, then I do not hesitate anymore to choose what is right for me.
Good for you! You must make the decisions that work towards your goals, even if they make her uncomfortable...thats fine.
>babblemail you a little later, ok?
Anytime,
~Jade
> see you then..
>
> ER
Posted by Questionmark on July 11, 2010, at 4:35:24
In reply to Re: What's up for 10 years from now?, posted by SLS on July 10, 2010, at 4:56:56
I absolutely agree with this post.
Brilliantly put.> Agreed. My guess is that it is not an either-or scenario for most cases of depression. Both nature and nurture (or lack of it) contribute to its induction. I see the causations of depression to lie along a continuum ranging from being predominantly genetic to predominantly psychological. One of the problems with the English language is that it uses the same one word - "depression" - to describe multiple phenomena. This leads to a great deal of confusion and perhaps a lack of empathy. Many mentally healthy people who experience occasional situational depressions often generalize their experience to everyone else. They just don't know any better. Even now, 20 years after the "Decade Of The Brain", there is still a need for educating the general public as to the phenomenology of mental illness. It is sad.
>
>
> - Scott
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