Posted by yxibow on January 12, 2009, at 1:46:03
In reply to Re: Scared to try Lamictal - seeking opinions please, posted by Garnet71 on January 11, 2009, at 9:47:31
> Thanks Jay. BUT-your missing the whole point. In treating a cancer patient-there is evidence of cancer to treat.
I can sense the anger and frustration, I'm not missing the point.
> In treating 'our' disorders-they do not collect evidence. AND-the mechanisms of how some of the drugs work are a mystery according to the researchers and drug companies themselves.
".... drug X does not affect transmitter Y, the mechanism is not exactly known...." yes, I know about the phraseology, but the same can and is said about medications for other disorders, pain medication for example.
And I do believe that if you can't treat anything else in a condition, while at the same time attempting to do no harm, treating pain is important.
> I think part of the reason there are few tests designed and/or used for us (such as brain scans, neurotransmitter tests) is that people like 'us' are still devalued by society.Well that's one way of looking at it, there is and has always been a stigma about mental illness not being on par as it should be recognized as a biological disorder.
But also, even the best MRI or even a SPECT will not tell you how to treat a complex psychiatric disorder. We don't have transmitter level scanning, and I don't think that will really trump things more than genetic testing, stem cell research, genomic tests for P450 metabolism in this century. It just isn't possible.
About the only thing a MRI can possibly show is the tissue damage caused by some severe forms of schizophrenia and related disorders, at this point.
> Also-why are alzheimer's, parkinson's, epileptics etc., NOT treated by psychiatrists, but people like 'us' are resorted to the trial and error medicine?
Well if you put it as an US thing, it doesn't really serve well -- there is just the facts of how psychiatry has evolved. I still say we have come a long way from the sanitoriums of yesteryear but we do have a long way to go. Only research and time will tell.
Alzheimer's is also a trial and error condition at the moment, you realize -- the few medications out there prolong wellbeing and memory functionality in those who respond to them, but it is ultimately a fatal condition, just as life is itself. But that doesn't mean that one shouldn't have a purpose and be happy, I'm not trying to be dour.
Parkinson's is also a potentially fatal and debilitating condition, especially early onset, as in Michael J Fox, but there are time tested medications that can prolong functionality and give people a better grasp on life. Some of those, anticholinergics, by the way, are used in psychiatry to counteract side effects.Parkinson's and epilepsy are neurological conditions. Neurology is also a young frontier. Only this past year was tetrabenazine approved as an orphan drug for Huntington's Chorea -- off label it is a trial treatment that has shown some use in other dyskinesias, including TD, in psychiatry.
I have been unfortunately affected by certain psychiatric medications, in a condition really never seen by science exactly, I am probably the only one in North America on the combination of medications and the condition I have. And I have been to a neurologist about the non-tardive orobuccal tic I have.
I can tell you that neurology is a heartbreaking field, a frontier. There are some relations between some psychiatric disorders and neurological conditions, but often and it has been sad for me, that diagnoses are often just that, a diagnosis.
Medications, yes, there are some available for the tic and the probable dystonic (multiple) iatrogenic disorders, but the benefits are not always better than the risks.If someone has a really bad tic disorder, botox can be used, with the caveat that sunken jaws and drooling can occur.
But contrasting that with psychiatry for example, it is known that those who suffer from Tourette's and other tic conditions can be worsened by the use of amphetamine and stimulant substances. By the same nature, reducing dopamine levels at particular transmitters has been successful in some types of tourette's (such as Orap [pimozide]). I don't know that Orap would be used now because of risks, probably atypical neuroleptics would be employed.
> I think its archaic, medically unprofessional, irresponsible, and unethical to prescribe so many people SSRIs w/o conducting any tests. I seriously think they cause permanent damage or dependence. So many people are given these drugs with no investigation.
Let us just say I had the opportunity to work for a leading scientist at the time when SSRIs were just coming to this country -- Luvox came out first in Europe (after a previous disastrous drug) but Prozac came out first here after it had already been in use in Europe.
There radioactive dyed PET scans clearly showed that both the use of SSRIs in OCD and/or behaviour therapy were both effective. It was groundbreaking work. So yes, investigation has been done.
And still continues to be done for other disorders. But these are research tools -- it is not yet the time when PET/SPECT can be an individual thing, both for its cost and because it will not diagnose something beyond evidence based trials involving multiple controls and those who are afflicted by a particular disorder.
> I realize these drugs really help a lot of people, but my main concern is with SSRIs and their widespread use and lack of testing for the disorders they are prescribed for.
Sometimes SSRIs are overprescribed, but there is a chicken and egg question about the lurid publications of suicides in teenagers.
Yes, its conceivable that they can accentuate it -- its also much more possible that the patient was already suicidal in the first place.
Luvox was made generic and the company fled most likely because of one incident -- Columbine.
But the perpetrators could have easily been prescribed something else as well, and from multiple examinations may have suffered something much more than depression.
> By the way, I also do not take over the counter medicines--ever-for coughs, colds, or flu. Only aspirin or advil for headaches if absolutely necessary.
Well a lot of OTC medications are a big business, they don't do anything to particularly cure a cold, you can't, but if you really have a nasty flu or cold and you want to address a particular symptom, I'd say generic acetaminophen, guaifenesin, and in sparing doses dextromethorphan, pseudoephedrine, and chlorpheniramine maleate have their uses, provided they do not clash with anxiety, depression, or medications you are taking for those conditions.The trouble is the combination medications that you can't adjust your own dose, I don't believe in things like NyQuil and the like which are full of alcohol and other things that are unnecessary
I never took medicine for my OCD when I was hospitalized some years ago. I did take Prozac afterward and it was helpful in continuing my behavior therapy. I never used to take a lot of medications out of fear -- I have never normally taken aspirin because of the risk of Reye's syndrome even though I am well past it.I do take Pepto-Bismol now though, although Imodium is more effective for some things.
But that's just my story. You're still welcome to be skeptical and critical as a number of people are, and I have never said that I am not either at times.
-- tidings-- Jay
poster:yxibow
thread:872702
URL: http://www.dr-bob.org/babble/20090104/msgs/873484.html