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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 68 to 92 of 146. Go back in thread:
Posted by Phillipa on October 17, 2010, at 18:30:13
In reply to Re: Thinking of coming off meds, posted by morgan miller on October 17, 2010, at 17:29:37
I feel what I was trying to say that if an MRI picked up an adenoma that could be the cause of lactation on meds? Phillipa
Posted by Maxime on October 17, 2010, at 20:26:49
In reply to Re: Thinking of coming off meds, posted by morgan miller on October 17, 2010, at 17:29:37
> > No MRIs, although I would like to get one to see what is going on. I think she would do one if I wasn't on all these meds which make my prolactin do crazy things.
>
> I don't think MRIs will show any effects of medications, so being on medications should not interfere at all with MRI results. Pet and Spect scans are what you want to evaluate brain activity.
>
>No,no, I meant a scan of my pituary gland and my thyroid. Not one of my brain (PET Scan), although would be very cool to see.
Posted by morgan miller on October 17, 2010, at 20:33:11
In reply to Re: Thinking of coming off meds » morgan miller, posted by Maxime on October 17, 2010, at 20:26:49
> > > No MRIs, although I would like to get one to see what is going on. I think she would do one if I wasn't on all these meds which make my prolactin do crazy things.
> >
> > I don't think MRIs will show any effects of medications, so being on medications should not interfere at all with MRI results. Pet and Spect scans are what you want to evaluate brain activity.
> >
> >
>
> No,no, I meant a scan of my pituary gland and my thyroid. Not one of my brain (PET Scan), although would be very cool to see.Gotchya
Posted by Maxime on October 17, 2010, at 20:34:57
In reply to Re: Thinking of coming off meds, posted by Phillipa on October 17, 2010, at 18:30:13
> I feel what I was trying to say that if an MRI picked up an adenoma that could be the cause of lactation on meds? Phillipa
Yes, that's it!
Posted by Phillipa on October 17, 2010, at 21:02:52
In reply to Re: Thinking of coming off meds » Phillipa, posted by Maxime on October 17, 2010, at 20:34:57
Why do you say that's it did you google I still haven't got to work now. Phillipa
Posted by SLS on October 18, 2010, at 4:51:49
In reply to Re: Thinking of coming off meds » morgan miller, posted by Maxime on October 17, 2010, at 20:26:49
> No,no, I meant a scan of my pituary gland and my thyroid. Not one of my brain (PET Scan), although would be very cool to see.
Or very horrifying. Most of my cerebral cortex was hypofunctional as was indicated by the color blue on repeated PET scans. This compares with healthy individuals whose brains shows up globally yellow and orange except for the ventricles. It was a horrendous finding to see how globally my brain function is affected by depression. It was not so pleasant a revelation that the U.S. NIH considered me to be "very sick".
- Scott
Posted by floatingbridge on October 18, 2010, at 12:24:58
In reply to Re: Thinking of coming off meds » Maxime, posted by SLS on October 18, 2010, at 4:51:49
I'm really, really sorry Scott.
Did they hold out the possibility of regeneration of structure or function?
Posted by SLS on October 18, 2010, at 13:13:27
In reply to Re: Thinking of coming off meds » SLS, posted by floatingbridge on October 18, 2010, at 12:24:58
> I'm really, really sorry Scott.
>
>
>
>
> Did they hold out the possibility of regeneration of structure or function?This was 1992-1993. I'm not sure what they were thinking behind their veil of objectivity. They did not commit to such predictions. Whatever were their opinions back then were very preliminary as they had not accumulated very much data by then. I have some hope that a great deal of function will reappear once I respond robustly and consistently to treatment. There is some evidence that there is a recovery of brain tissue volume in frontal white matter and the gray matter of the hippocampus as the consequence of attaining remission using antidepressants. Things get more complicated with depression in the elderly, as antidepressant treatment, especially with tricyclics, can actually induce or accelerate the development of white matter hyperintensities (lesions).
This whole thing sucks if you ask me.
- Scott
Posted by floatingbridge on October 18, 2010, at 13:48:41
In reply to Re: Thinking of coming off meds » floatingbridge, posted by SLS on October 18, 2010, at 13:13:27
>Things get more complicated with depression in the elderly, as antidepressant treatment, especially with tricyclics, can actually induce or accelerate the development of white matter hyperintensities (lesions).
Oh. That's sobering.
>
> This whole thing sucks if you ask me.Yes.
Posted by huxley on October 18, 2010, at 17:08:37
In reply to Re: Thinking of coming off meds » huxley, posted by SLS on October 15, 2010, at 5:15:37
>
> In what ways has the advice you received from Bleuberry brought about your remission? How did you change your treatment because of Bleuberry's advice? I would be grateful to learn how and what.
>
>
> - Scottbleuberry was the first person I found that had similar troubles to me coming of Zyprexa and told me what to expect and how to make it easier. This was a great help for me.
I have been stuck on a neuroleptic which is causing me horrible side effects and when I try and withdraw it I get a horrible withdrawal which my doctors told me was my original symptoms returning when it clearly wasn't.
Now stop being hypocritical, you hand out plenty of advice to people on this site on what medications to take etc..
There is plenty of ancedotal evidence around that medications can cause the problems that they are designed to cure and stopping them can be very beneficial for some people.
Not arguing that it is or isnt for maxime.
Posted by huxley on October 18, 2010, at 17:10:12
In reply to Re: Thinking of coming off meds » Maxime, posted by SLS on October 18, 2010, at 4:51:49
> > No,no, I meant a scan of my pituary gland and my thyroid. Not one of my brain (PET Scan), although would be very cool to see.
>
> Or very horrifying. Most of my cerebral cortex was hypofunctional as was indicated by the color blue on repeated PET scans. This compares with healthy individuals whose brains shows up globally yellow and orange except for the ventricles. It was a horrendous finding to see how globally my brain function is affected by depression. It was not so pleasant a revelation that the U.S. NIH considered me to be "very sick".
>
>
> - ScottSerious question. Was this scan before you started taking medication? If it was after, how do you know it wasn't a result of the medication.
Posted by SLS on October 18, 2010, at 17:10:16
In reply to Re: Thinking of coming off meds » SLS, posted by huxley on October 18, 2010, at 17:08:37
> Now stop being hypocritical
Yes sir!
- Scott
Posted by SLS on October 18, 2010, at 17:16:36
In reply to Re: Thinking of coming off meds » SLS, posted by huxley on October 18, 2010, at 17:10:12
> Serious question. Was this scan before you started taking medication?
I had already tried a bunch of drugs.
> If it was after, how do you know it wasn't a result of the medication.
You would have to do some research of your own if you really want to have that question answered. I would rather not postulate to you. See what the search engines come up with. I am all but sure you can find some commentary on the use of PET scans on drug-naive individuals.
- Scot
Posted by Lou Pilder on October 18, 2010, at 17:22:00
In reply to Re: Thinking of coming off meds » SLS, posted by huxley on October 18, 2010, at 17:08:37
huxly,
You wrote,[...plenty of...can cause the problems...stopping them could...]
Lou
http://www.dr-bob.org/babble/health/20100104/msgs/944131.html
Posted by SLS on October 18, 2010, at 17:28:40
In reply to Re: Thinking of coming off meds » SLS, posted by huxley on October 18, 2010, at 17:10:12
Here's one.
- Scott*************************************
http://www.ncbi.nlm.nih.gov/pubmed/15094258
J Affect Disord. 2004 May;80(1):55-63.
Correlation between cerebral blood flow and items of the Hamilton Rating Scale for Depression in antidepressant-naive patients.Graff-Guerrero A, González-Olvera J, Mendoza-Espinosa Y, Vaugier V, García-Reyna JC.
Instituto Nacional de Psiquiatría Ramón de la Fuente, Dirección de Servicios Clínicos, Calz. México-Xochimilco 101, Col. San Lorenzo Huipulco, Del. Tlalpan 14370, México D.F., Mexico. agraff@imp.edu.mx
AbstractBACKGROUND: The purpose of this study was to correlate the basal cerebral blood flow (CBF) in patients with major depressive disorder (MDD) with the score for each of the 21 questions in the Hamilton Rating Scale for Depression (HRSD), in order to determine the cerebral regions associated with each item.
METHODS: Fourteen antidepressant-naive patients with unipolar depression (DSM-IV criteria for MDD) participated in this study with a HRSD score of >/=20 points. CBF images obtained by SPECT were analyzed by SPM99 software. The significant correlation threshold for a priori regions (frontocortical and limbic regions) was a Z value of at least 2.25 and clusters formed by more than 10 voxels.
RESULTS: Items 1, 6, 11 and 20 were positively correlated with right medial frontal gyrus; item 7 was negatively correlated with bilateral medial frontal gyrus. Items 2 and 10 were positively correlated with right anterior and medial cingulate, respectively. Item 5 was negatively correlated with the left amygdala. Item 9 was negatively correlated with bilateral insula, and item 16 with right insula. Items 12 and 14 were positively correlated with right and left precentral frontal gyrus, respectively. Limitations: The small sample size and only out-patients included in the study.
CONCLUSIONS: The frontal cortex plays an important role in the expression of MDD symptoms. Not all the symptoms evaluated correlated with one single structure, which may explain the diverse results reported in the literature. These preliminary results support the necessity of further analyses by symptoms that could provide more specific information on the pathophysiology of MDD.
PMID: 15094258 [PubMed - indexed for MEDLINE]
Posted by SLS on October 18, 2010, at 17:36:42
In reply to Re: Thinking of coming off meds » SLS, posted by huxley on October 18, 2010, at 17:10:12
Here is another one. This particular study gives some supportive evidence to the explanations that Linkadge gives regarding possible dopaminergic hyperfunction in various limbic circuits in major depressive (MDD) order.
- Scott
Posted by SLS on October 18, 2010, at 17:46:35
In reply to Re: Thinking of coming off meds » huxley, posted by SLS on October 18, 2010, at 17:36:42
Sorry...
Psychopharmacology (Berl). 1999 Jun;144(3):282-5.
Striatal dopamine transporter density in major depression.Laasonen-Balk T, Kuikka J, Viinamäki H, Husso-Saastamoinen M, Lehtonen J, Tiihonen J.
Department of Psychiatry, Kuopio University Hospital, Finland.
AbstractRATIONALE: There are no previous data available regarding [123I]beta-CIT binding to the dopamine transporter sites in the basal ganglia in depressed patients.
OBJECTIVE: The present study tested the hypothesis that the brain DAT density in depressed patients is lower than that in matched healthy controls.
METHODS: Fifteen drug-naive outpatients with major depression and 18 healthy controls were investigated using single photon emission computerized tomography (SPECT) with a high-affinity dopamine transporter specific radioligand. 123I-labeled beta-CIT (2beta-carbomethoxy-3beta-(4-iodophenyl-tropane).
RESULTS: We found a significantly higher [123I]beta-CIT uptake in both sides of the basal ganglia in patients with major depression than in the controls (Mann-Whitney U-test, P = 0.002 on the right and P = 0.003 on the left).
CONCLUSIONS: The radioligand uptake reflecting the DAT density was significantly higher among the patients than in the controls. This finding is unexpected, since it is generally believed that monoaminergic neurotransmission is lower in depression, and therefore it could be assumed that a reduction in dopamine transmission would lead to secondary down-regulation of DAT density. However, it is possible that up-regulation of the DAT may be the primary alteration, which leads to lower intrasynaptic dopamine concentration and to lower dopamine neural transmission.
Posted by Phillipa on October 18, 2010, at 19:07:47
In reply to Re: Thinking of coming off meds - Oops., posted by SLS on October 18, 2010, at 17:46:35
Scott since it was so long ago and scans have improved would it be valuable to you to see if that is not the case now. Meaning that earlier scans lead you to believe that basically your brain was damaged and maybe it's not? Just a thought. Phillipa
Posted by morgan miller on October 18, 2010, at 19:25:20
In reply to Lou's response-dhtruz » huxley, posted by Lou Pilder on October 18, 2010, at 17:22:00
> huxly,
> You wrote,[...plenty of...can cause the problems...stopping them could...]
> Lou
> http://www.dr-bob.org/babble/health/20100104/msgs/944131.htmlThanks Lou.....
Posted by Maxime on October 18, 2010, at 20:49:30
In reply to Re: Thinking of coming off meds » Maxime, posted by Phillipa on October 17, 2010, at 21:02:52
> Why do you say that's it did you google I still haven't got to work now. Phillipa
My "that's it" was in reference to what you wrote about the MRI. I was agreeing with you.
Posted by Maxime on October 18, 2010, at 20:53:42
In reply to Re: Thinking of coming off meds » Maxime, posted by SLS on October 18, 2010, at 4:51:49
>
> Or very horrifying. Most of my cerebral cortex was hypofunctional as was indicated by the color blue on repeated PET scans. This compares with healthy individuals whose brains shows up globally yellow and orange except for the ventricles. It was a horrendous finding to see how globally my brain function is affected by depression. It was not so pleasant a revelation that the U.S. NIH considered me to be "very sick".
>
>
> - ScottScott, I am sure that it was distressing to find out about your brain function. I am really sorry about that. But at the same time did it not give you satisfaction? Proof that you are ill. I always have people doubting how sick I am and then I begin to doubt it myself. But with the scan you have proof. Or maybe you don't need that kind of validation. *hugs*
Posted by Phillipa on October 18, 2010, at 21:04:50
In reply to Re: Thinking of coming off meds » Phillipa, posted by Maxime on October 18, 2010, at 20:49:30
Maxie sorry I know now. This is the time of night when I start rushing. And I think it's something you do need to do get the MRI to rule that out. Wouldn't it be something if a simple micro or macro adenoma could have caused you all these problems. And fixable with simple surgery If needed that is. Love Phillipa
Posted by SLS on October 19, 2010, at 1:49:13
In reply to Re: Thinking of coming off meds » SLS, posted by Maxime on October 18, 2010, at 20:53:42
>
> >
> > Or very horrifying. Most of my cerebral cortex was hypofunctional as was indicated by the color blue on repeated PET scans. This compares with healthy individuals whose brains shows up globally yellow and orange except for the ventricles. It was a horrendous finding to see how globally my brain function is affected by depression. It was not so pleasant a revelation that the U.S. NIH considered me to be "very sick".
> >
> >
> > - Scott
>
> Scott, I am sure that it was distressing to find out about your brain function. I am really sorry about that. But at the same time did it not give you satisfaction? Proof that you are ill. I always have people doubting how sick I am and then I begin to doubt it myself. But with the scan you have proof. Or maybe you don't need that kind of validation. *hugs*There are people on Internet group forums for the mentally ill whom still don't validate me or that major depressive disorder and bipolar disorder are biological disorders of the CNS. There is even a recalcitrance along this thread to internalize the facts as scientists have come to know them in the 28 years since I was first diagnosed and treated. There is a lack of agreement in only the details, but not of the phenomenon. For some, brain function changes through psychotherapy. It can help remove chronic biological stresses on the brain. This easing of "depressive pressure" might yield the same result as somatic treatments for subgroups of depressives. However, I am not one of them.
I think that having been treated at some of the most highly accredited research facilities gave me the opportunity to watch the field of psychiatry evolve and be exposed to the most current trends in discovery and scientific thought.
How do I know that my affective disorder is biological? Got 28 years for an explanation?
- Scott
Posted by floatingbridge on October 19, 2010, at 12:56:30
In reply to Re: Thinking of coming off meds » Maxime, posted by SLS on October 19, 2010, at 1:49:13
Scott, this is a painful story to hear; much more poignant to live it. I for one am glad your here, willing to share your experience and knowledge and to have the wherewithal to defend it.
> > > Or very horrifying. Most of my cerebral cortex was hypofunctional as was indicated by the color blue on repeated PET scans. This compares with healthy individuals whose brains shows up globally yellow and orange except for the ventricles. It was a horrendous finding to see how globally my brain function is affected by depression. It was not so pleasant a revelation that the U.S. NIH considered me to be "very sick".
> > >
> > >
> > > - Scott
> >
> > Scott, I am sure that it was distressing to find out about your brain function. I am really sorry about that. But at the same time did it not give you satisfaction? Proof that you are ill. I always have people doubting how sick I am and then I begin to doubt it myself. But with the scan you have proof. Or maybe you don't need that kind of validation. *hugs*
>
> There are people on Internet group forums for the mentally ill whom still don't validate me or that major depressive disorder and bipolar disorder are biological disorders of the CNS. There is even a recalcitrance along this thread to internalize the facts as scientists have come to know them in the 28 years since I was first diagnosed and treated. There is a lack of agreement in only the details, but not of the phenomenon. For some, brain function changes through psychotherapy. It can help remove chronic biological stresses on the brain. This easing of "depressive pressure" might yield the same result as somatic treatments for subgroups of depressives. However, I am not one of them.
>
> I think that having been treated at some of the most highly accredited research facilities gave me the opportunity to watch the field of psychiatry evolve and be exposed to the most current trends in discovery and scientific thought.
>
> How do I know that my affective disorder is biological? Got 28 years for an explanation?
>
>
> - Scott
>
>
>
>
Posted by creepy on October 20, 2010, at 12:00:52
In reply to Re: Thinking of coming off meds » SLS, posted by floatingbridge on October 19, 2010, at 12:56:30
Depending on your illness, therapy may be able to take the place of medication.
I had about 15 good, drug-free years after a round of intense therapy. Just started EMDR and hope to put a damper on these out of control stress responses.
Ive been suffering with terrible pain and fatigue for 3 months or so, and I think its the depression returning. I attribute this to spinning my wheels in therapy for so long, not making progress.
Im off almost all of my psych meds and still hanging in there. May add an NRI or something mild to help cope with therapy.
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Dr. Bob is Robert Hsiung, MD,
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