Posted by Ritch on July 17, 2002, at 10:35:20
In reply to Re: Someone please shoot some holes in this story..., posted by Squiggles on July 17, 2002, at 8:49:03
> Hi Mitch,
>
> Two interesting points:
>
> 1. Misdiagnosing and therefore mistreating
> a mental illness on a chronic basis, can present
> problems.
>
> 2. Treating a chronic mental illness with
> the wrong drugs can also present problems;
>
> Granted to both;
>
> My point is different: that prophylaxis assumes
> that the illness is chronic. You say that getting
> off presented with bad symptoms; I am not sure
> if that is a result of the withdrawal or the illness
> coming back.
>
> I recall reading in Kraeplin that mania aNd
> depression can have cycles that span from 7 to 11
> years. I can understand that from an economic
> and risk-benefit medical view prophylaxix may
> be more efficacious - but I can't say that it
> is correct.
>
> Squiggles
Squiggles,Thanks for clarifying that. I was off meds for about three years. But, I have two (and at times three) sets of cycles going at the same time. I have got a seasonal pattern that causes 4 major mood flips during any given year. Then there is a three week cycle (a few days mild hypo-a few days depressed, a few days OK). And during the most intense part of the seasonal bipolar depressions I develop a daytime cycle where I am alert and feel ok in the morning and then in the evening I get simultaneously agitated and very fatigued (kind of a mixed thing). So, in conclusion (in my own personal case), I might as well be taking meds all of the time (and they help).
But, to address the prophylaxis issue... I also agree that if you aren't experiencing any mania for a reasonable duration of time-what's the point in taking antimanic agents for prophylaxis? I assume you are disputing the "kindling" theory? I don't firmly disbelieve it, but I wouldn't be surprised if that changes or is significantly modified in the coming years. I knew someone who went for quite some time without developing mania and he *did* stop his lithium for months at a time, and then would resume it when he started showing signs of mania, and it controlled them OK. They would just push the dose up aggressively when they kicked in. He didn't take any antidepressants.
Mitch
poster:Ritch
thread:112339
URL: http://www.dr-bob.org/babble/20020709/msgs/112656.html