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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 2 of 2. This is the beginning of the thread.
Posted by SLS on December 11, 2022, at 9:56:20
This is a repost of my reply to [Name].
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Hi, [Name].
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> Thank you for your comments, SLS. I will reply in more detail later.
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Okay. I look forward to it.
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> The effects I described are less noticeable now, probably because the improvement is becoming a new baseline. It may sound silly, but I've also noticed that I'm better at whistling. I regard that as a possible drug effect on psychomotor function.
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1.No! This not a side effect at all!2.It is a step towards remission - or at least towards a robust response!
3.YOU ARE RESPONDING!
4.Way to go!
5.Keep doing what you are doing! Don't change a single thing (for now)!
6.Be patient!
7.A full remission can take as long as a YEAR for Treatment-Resistant Depression!
8.Wait at least 6 more weeks at the same dosages of everything you are currently taking before making changes or declaring the trial a failure!
9.If you are continuing to see an improvement - but not remission - seriously consider finding augmenters / adjuncts. If you are not currently taking low-dosage lithium, you might consider adding this first or reducing the dosage to 300 mg/day if you are already taking it. Prescription lithium carbonate only!
10.If it is obvious that you are significantly improved, don't give your treatment another thought!
11.Engage in activities without thinking about your illness or its treatment. A truly therapeutic response can be either gradual or rapid. In my experience, a gradual improvement results in a more robust response and is more likely to persist long-term.!
12.Have fun!
13.Stay away from the computer and find other things to do. Get out of the house!
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For ME, my symptoms of depression include:
1.Psychomotor retardation.2.Drifting gait from side to side while walking: Ataxia.
3.Inability to sing on key. The timbre of my voice changes.
4.Being generally clumsy.
5.Difficulty tracking fast-moving objects e.g. I am unable to track a baseball in the outfield. The ball jumps all over the place while in the air. I often missed catching it. Once I began to respond well to treatment, I was able to track the ball normally. I most often caught it. How cool is that?
6.Dry mouth. My guess is that this is a symptom of the illness. It exists in the absence of drug side-effects, and completely resolves upon remission - normal salivation. The dry mouth is probably the result of "dysautonomia" (a generic term) resulting from an imbalance of the in the autonomic nervous system - too much sympathetic and too little parasympathetic. I had guessed this as a strong possibility in 1982 while I was waiting to be treated for the very first time at Columbia. In 1990, I was treated by a doctor who agreed with me. In fact, he was the one who taught me that the name for this condition was dysautonomia. It is not "familial dysautonomia", which most often affects people of Jewish descent.
ALL OF THESE THINGS DISAPPEAR UPON RESPONSE TO TREATMENT!
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* I know this sounds pretentious (very), but, like most of us, I had been about 10 years ahead of the curve since the 1980s. I would say that psychiatry has now caught up with us at Psycho-Babble due to the establishment of translational medicine research. This was another idea that I came up with in the early 1990s - before there was such a thing. I had recognized that there was very little communication between pure neuroscience research and the clinical application of neuroscience discoveries. I called the remedy for this the "clinical application of neuroscience". I was close to writing an essay about it, but what would I do with it? It ends up that my research clinician at the NIH went on to join the fledgling department of translational medicine for Johnson & Johnson in Belgium. He started out in their brain imaging department. He learned how to perform PET scans of the brain and poking people's spinal canal (lumbar puncture) for CSF fluid by practicing on me. He missed the first 2 punctures. Not fun. My brain was one of the first to be scanned. They actually built their own cyclotron. None existed at the time to synthesize FDG (fluorodeoxyglucose). This substance is utilized by the body in place of glucose in the brain and the body. The more active a tissue, the more glucose is consumed (broken-down / metabolized). However, when cells split the FDG-labelled glucose molecule for energy, matter (electrons) and antimatter are released and quickly collide, thereby producing an annihilation event. Gamma-rays are released and detected on the inner surface of the imaging tube - much like a MRI. The release of gamma-rays is a direct measure of tissue activity. The PET scan is an invaluable tool for locating cancerous tissue throughout the entire body. Cancerous tissue is much more active than normal body cells. More gamma-rays are released as glucose (FDG) is consumed at a higher rate.The following is a typical PET scan comparison brain activity between people with depression and people without depression. My scans at the NIH looked very similar. The scans were rendered just like a weather map.
Orange = Very Active
Yellow = Active
Blue = InactiveScary, right?
- Scott
Posted by SLS on December 11, 2022, at 16:21:38
In reply to Performing your drug trials - More suggestions., posted by SLS on December 11, 2022, at 9:56:20
Oops.
Sorry...
I forgot to explain completely how the use of FDG (flourodeoxyglucose) liberates gamma-rays.
PET = Positron Emission TomographyThe two particles that are liberated upon the cell's metabolizing a FDG molecule instead of a normal glucose molecule are:
1. Electrons = Matter
2. Positrons = Antimatter (Positively charged electrons)
When these two particles collide, both are annihilated. They are converted into pure energy, in this case, in the form of gamma-rays. The rays are detected, measured, and rendered as an image.
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Again:
1. A typical rendering of comparative PET scans in depression:
2. Fluordeoxyglucose (FDG)https://en.wikipedia.org/wiki/Fluorodeoxyglucose_(18F)
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PET scans are not limited to using FDG. There are a plethora of other radio-labelled substances used for imaging various biological processes.
Enjoy...
- Scott
This is the end of the thread.
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