Posted by Ritch on July 17, 2002, at 13:51:38
In reply to Re: Someone please shoot some holes in this story..., posted by Squiggles on July 17, 2002, at 13:10:02
> About prophylaxis, well it's safer i guess.
> The point you make which I find fascinating
> is the "kindling theory" of Papolos - i have
> read about it and it would seem to suggest
> that the brain actually progresses to a worse
> and worse state if you have bipolar... that is,
> the longer you leave the bipolar brain untreated
> the higher the dose of the drug to treat it is
> necessary.
>
> Is that correct?
>
> Squiggles
I don't think it is so much the dosage of antimanic agent required for future episodes that pdocs are worried about. The kindling theory postulates that untreated bipolar leads to more frequent and more intense episodes which by definition would require more medication to treat due to the increased severity of the subsequent episodes. There is also a concern about subsequent effectiveness of any given antimanic agent used in the future which has been stopped and started. There is evidence that stopping and starting lithium seems to reduce its future effectiveness. That may be true, but it also could just be one study's (which may not have been designed properly enough) conclusions that get passed around and around until it becomes "conventional wisdom" (and isn't rethought out, just taken for granted as true). In my own personal experience I rapid cycle, but my cycle lengths haven't changed much in 25 years despite being on and then off different medications. But then my "flavor" of bipolar may be one that doesn't involve kindling OR since I seem to need medication all of the time anyways, I am actually preventing the worsened cycling, etc., that the kindling model predicts.Mitch
poster:Ritch
thread:112339
URL: http://www.dr-bob.org/babble/20020709/msgs/112670.html