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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by linkadge on November 2, 2009, at 9:21:45
I have noticed that the big buzz over lamotrigine seems to have died down significantly. It seems it was prescribed to everybody, truly helped only a few and then gone with the wind.
Thoughts?
Linkadge
Posted by Phillipa on November 2, 2009, at 11:28:40
In reply to The lamitrigine fad - come and gone?, posted by linkadge on November 2, 2009, at 9:21:45
Interesting I tried it got to 50 then excessive spitting. No more sample packs? Phillipa
Posted by Maxime on November 2, 2009, at 11:30:32
In reply to The lamitrigine fad - come and gone?, posted by linkadge on November 2, 2009, at 9:21:45
I think you are right. It became a big thing when it was said to be as effective as lithium for bipolar disorder. Personally, the stuff just made me very depressed and I have bipolar disorder.
Posted by ricker on November 2, 2009, at 11:59:56
In reply to The lamitrigine fad - come and gone?, posted by linkadge on November 2, 2009, at 9:21:45
> I have noticed that the big buzz over lamotrigine seems to have died down significantly. It seems it was prescribed to everybody, truly helped only a few and then gone with the wind.
>
> Thoughts?
>
> LinkadgeI think all meds seem to have their moment in the limelight and slowly fade away.
I also believe lamictal is still one of the better drugs out there so maybe it's not a matter of gone with the wind, but rather, silence is golden?Regards, Rick
Posted by Phidippus on November 2, 2009, at 12:42:33
In reply to The lamitrigine fad - come and gone?, posted by linkadge on November 2, 2009, at 9:21:45
Well, I was on the bandwagon and got up to 300 mg before realizing it was making me horribly depressed, hypochondriacal and totally psychotic.
P
Posted by linkadge on November 2, 2009, at 18:10:58
In reply to Re: The lamitrigine fad - come and gone? » linkadge, posted by Phidippus on November 2, 2009, at 12:42:33
I think the sad part is that there is remarkably little *data* to suggest that it is effective as a mood stabilizer. I remember reading the GSK trial registry and seeing that something like 10 trials had been done in mood disorders and only one was positive - of course this was the study that was broadcast across every clinical psychiatry website.
Linkadge
Posted by Bob on November 3, 2009, at 0:38:29
In reply to Re: The lamitrigine fad - come and gone?, posted by ricker on November 2, 2009, at 11:59:56
>
> I think all meds seem to have their moment in the limelight and slowly fade away.
> I also believe lamictal is still one of the better drugs out there so maybe it's not a matter of gone with the wind, but rather, silence is golden?
>
> Regards, Rick
>
>I totally agree with this. So many meds come and go as fads for the treatment of psych disorders. Sometimes they experience a second fad as an adjunctive treatment or in a combination with something else.
Posted by bleauberry on November 3, 2009, at 18:59:38
In reply to The lamitrigine fad - come and gone?, posted by linkadge on November 2, 2009, at 9:21:45
I think this phenonmenon is basically true of the vast majority of psych meds. That is, the longer the time they are on the market, the less benign their side effect profiles appear and the less efficacy they appear to have...in comparison to the hype of the earlier years.
Realtime testing over an extended period of time usually brings out the truth.
Not that any particular med isn't a miracle for someone, because that obviously does happen from time to time. Just not as often as fads or trends would have us think.
With all that in mind, it is still hard to beat the meds that have been with us for half a century, or the herbs that have been with us for many centuries. The newcomers just really don't having anything new to offer that can convincingly trounce the time-tested older ones.
My views on that.
Posted by Bob on November 3, 2009, at 19:08:31
In reply to Re: The lamitrigine fad - come and gone?, posted by bleauberry on November 3, 2009, at 18:59:38
> I think this phenonmenon is basically true of the vast majority of psych meds. That is, the longer the time they are on the market, the less benign their side effect profiles appear and the less efficacy they appear to have...in comparison to the hype of the earlier years.
>
> Realtime testing over an extended period of time usually brings out the truth.
>
> Not that any particular med isn't a miracle for someone, because that obviously does happen from time to time. Just not as often as fads or trends would have us think.
>
> With all that in mind, it is still hard to beat the meds that have been with us for half a century, or the herbs that have been with us for many centuries. The newcomers just really don't having anything new to offer that can convincingly trounce the time-tested older ones.
>
> My views on that.Well, hopefully one day something will come along that will have a true benefit over what's out there. If not, then that means we will never get any better at treatment than where we stand now.
Bob
Posted by herpills on November 4, 2009, at 10:57:56
In reply to The lamitrigine fad - come and gone?, posted by linkadge on November 2, 2009, at 9:21:45
I think a lot of people may still be taking it just not talking about it? It is meant to be a long term med. Perhaps because it has a more narrow use then SSRIs it's just not used as often.
herpills
> I have noticed that the big buzz over lamotrigine seems to have died down significantly. It seems it was prescribed to everybody, truly helped only a few and then gone with the wind.
>
> Thoughts?
>
> Linkadge
Posted by linkadge on November 4, 2009, at 17:08:46
In reply to Re: The lamitrigine fad - come and gone?, posted by herpills on November 4, 2009, at 10:57:56
I think the biggest challenges in the treatment of severe depressive disorders is teasing apart the antidepressant and euphoriant effects of certain promising agents.
Many of the drugs they pull like amineptine and nomifenasine are due (at least in part) to potential for addiction. Yet, these agents were particularly effective in certain groups of severly depressed individuals.
Triple reuptake inhibitors....or prescription cocaine? You be the judge.
Linkadge
Posted by bleauberry on November 4, 2009, at 18:32:02
In reply to Re: The lamitrigine fad - come and gone? » bleauberry, posted by Bob on November 3, 2009, at 19:08:31
>
> Well, hopefully one day something will come along that will have a true benefit over what's out there. If not, then that means we will never get any better at treatment than where we stand now.
>
> Bob
>I think most of the successful treatments already exist.
I feel the problem is in the diagnosis. We aren't addressing the causes of depression. For the entire medical community to assume without even an iota of science to support it that a chemical imbalance is the cause and the only cause of depression has got to be the most profound ignorant arrogant stance I have ever seen man display.
Example. Depressed patient. Many symptoms of hypothyroidism. Will the psychiatrist test thyroid? Probably not. If so, probably just TSH. Ok, a real good psych comes along and test the whole panel. Thyroid appears "within generally accepted boundaries". Well, at this point, a doctor has to (and a few do) say "I can't ignore symptoms of hypothyroid staring at me in the face, regardless of what this lab test says. This patient has to be tried on several thryoid strategies, simply to rule it in or rule it out if nothing else. Symptoms are symptoms, there they are right in front of me." Does that actually happen? Hardly ever. No, instead, it must be, has to be, a serotonin imbalance, even with zero evidence...completely dismissing the obvious evidence.
Or how about a doctor seeing the patient does not have amalgam fillings (do they ever actually inquire or look? No.), but upon deeper probing the patient did have several large amalgams a few years ago that got replaced because they were old and cracking. That doctor has to say, "There is enough evidence to suspect a significant amount of mercury got into the brain." Or lead...did the doctor ask if the house has PCV pipes or old copper pipes with lead solder joints? Any previous signifcant exposure in the automobile industry or petroleum industry? I mean, at this point, in my mind, the patient has to be tried on some low level chelation protocols to see what happens...to rule it in or rule it out. A nontoxic person taking a few low doses of DMSA will feel nothing and experience near zero risk. A toxic person taking a few low doses of DMSA will know for sure they are dumping a lot of metals. How about at least, if nothing else, do a DMSA urine challenge test to see what level of metals are stored in fat tissues. Is this ever done? Hardly ever.
Or how about a doctor asking if the patient has ever lived in a tick area. Ever been bitten by a tick. Ever had a rash that looks like this...hold up some photos. Ever tried any of these herbs or teas (strong antimicrobials.) What color is the tongue...pinkish, yellowish, or whitish? How about a stool sample and a special urine sample to see what telltale microbial chemicals, if any, are in there. If there is even the slightest hint of a possibility here, it makes sense to do some probing with mild nontoxic antimicrobial herbs/foods to see what happens...to rule it in or rule it out.
Does the patient have a gluten intolerance? Easy lab test for that. I know from personal experience the depession gluten can cause. I have seen the miraculous almost overnight depression cures from people who went gluten-free at other forums.
Hormones. Ever witnessed the dramatic mood swings, profound deep depression, or a woman at the wrong time of the month, or a woman in menopause? Those are proof positive that hormones play a huge role in our moods and neurotransmitters. Probably one of the most involved in all that is cortisol. Have we done a 24 hour 4 sample saliva cortisol test? Probably not.
In the meantime, heroic efforts can be made with psych meds to hopefully, fingers crossed, get the patient feeling better while the detective work is under way. The problem today is...the detective work never even gets started and is totally ignored. The actual cause of the depression is not considered, and thus it severely limits the universe of potential agents to reverse it.
In myself as well as other people, these are some of the world's best antidepressants I have ever seen, that truly restore people to the person they used to be before they got sick...
DMSA
Doxycycline
Low Dose Naltrexone + DLPA
Adrenal extracts and herbs
Olive Leaf ExtractTo name a few.
Notice, none of them are mood altering agents, yet they completely obliterated longstanding depressing where psych meds could not.
Back to my point...the agents we need already exist...we just aren't using them.
If we stick to just the psychiatric meds, well, yeah, I agree with you, we need better stuff. Until then, it is a purely experimental game of hoping upon the right med or the right mix. In that regard, probably the MAOIs, the oldest dirtiest TCAs, and a small handful of the newer med combos are I think the best odds of success. When was the last time someone said, "I've been on Zoloft (or Prozac or whatever) for over 10 years and it still works like a miracle."? It happens, but hardly ever. Instead, they are grief stories of poopout, resistance, bizarre neurological side effects. But in the MAOI or TCA category, longterm success stories are not uncommon.
I just think we are missing the obvious causes of depression...many of which are not things that psych drugs will address or reverse.
For sure though, a drug that can mimic oxycodone, hydrocodone, vicodan...without the tolerance or addiction....wow...now that would be it. The ultimate antidepessant. It wouldn't cure any of the depression causes, but it sure would over-ride them in a hurry. I love the way a single one of those pills can completely erase Lyme disease, mercury/lead, and 15 years of psych med failure, in about 3 hours. (I don't take them, but discovered this post-op)
On that topic, at patient rating forums, probably the best antidepressant on the planet...that is hardly ever used for that purpose...is Tramadol. Serious resistant patients, just like many of us here, have discovered its miracles by accident during post-op or broken bones or whatever it was they were prescribed it for pain. It has withdrawals as bad or worse than Effexor, works similar to effexor in theory, has weak opioid action, has tolerance issues or abuse issues for some people, but seems to trounce even the MAOIs and TCAs in terms of ability to get people back into families and life and jobs and happiness. Some bad outcomes as well, as with anything.
My overall point...I think most of the meds we need to overcome our ills are already here. We are just misdiagnosing, not diagnosing at all, and using poorly chosen meds.
Posted by Phillipa on November 4, 2009, at 19:15:21
In reply to Re: The lamitrigine fad - come and gone? » Bob, posted by bleauberry on November 4, 2009, at 18:32:02
I must say that the throw meds at the patient like candy is true in my experiences. I've sought treatments with endos, infection control specialists referrals from a psych doc I had. Been treated. Still have same anxiety but it's morphed as during menopause anxiety sky high now less but in different way. There are a lot of diseases that come with aging that effect the mind and autoimmune diseases which you have no control over having. But some quite a few I know IRL have great results from long term use of SSRI's. My sister, neice, neighbors are some. I love talking to people and meds do get discussed frequently and many are being successfully treated with SSI's. Also know quite a few who said I'm not putting up with these side effects and got off them are out there working and dong well and feeling good my own children belong in that category. I'm the odd ball. You all knew that anyway. Love Phillipa
Posted by Netch on November 5, 2009, at 5:19:46
In reply to Re: The lamitrigine fad - come and gone?, posted by Phillipa on November 4, 2009, at 19:15:21
My impression is that Lamictal may help some BPs with depression. But long term success rate for most AD drugs is not impressive.
This is the end of the thread.
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