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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 66 to 90 of 90. Go back in thread:
Posted by linkadge on November 5, 2006, at 21:07:26
In reply to Re: wait a second? » linkadge, posted by Squiggles on November 5, 2006, at 16:54:05
>Even if you are right, which in some
>of the more extreme examples you are--
>once depression or anxiety or manic-depression
>begins, there is a change in the brain which
>may not be irreversible;Not necessarily if the mania is drug induced. There is no evidence that drug induced mania is associated with all of the of biochemical abnormalities seen in geniune bipolar.
>no more irreversible
>than if it were genetic or "endogenous".
>You still need to be treated as if you
>were a natural born bipolar.Thats where I disagree. Consider an anticholinergic drug like cogentin. It will make people really dumb. Drug induced dementia. But it is not permanant, and while it may look exactly like alzheimers, it abates completely when the drug is removed.
Same thing goes for stimulant psychosis. Stimulant psychosis eventually abates upon withdrawl of the stimulant. Antipsychotics are not necessary long term.
So, if you treat a drug induced state like a real one, you may not be doing the right thing. You may be drugging somebody unnessicarily.
Linkadge
Posted by linkadge on November 5, 2006, at 21:15:13
In reply to Re: wait a second? » clint878, posted by Squiggles on November 5, 2006, at 17:16:23
Believe it or not, there is a lot of controversy about the neuroprotective/neurotoxic actions of lithium.
Lithium has proconvulsant and anticonvulsant effects. Lithium can be *highly neurotoxic* if it goes over the upper blood level.
Also, when lithium is combined with the cholinergic agent pilocarpine, it can induce a model of temporal lobe epilepsy.
http://www.cogsci.ecs.soton.ac.uk/cgi/psyc/newpsy?7.32
Linkadge
Posted by Squiggles on November 5, 2006, at 21:33:44
In reply to Re: wait a second?, posted by linkadge on November 5, 2006, at 21:07:26
Of course, like most, I would very much
like to reverse the series of events that
have led to my present medicated state.
I have lost much, there is no doubt of that.
However, there is not much chance of that
as my doctor is against it, and so is the
medical establishment, and my very own
experience is proof that when off it (and
very gradually at that - i.e. 6 months) the
bipolar state returned. I can only be thankful
that I was able to stabilize myself.I have to go now. But i saw your next post and
will read it more carefully tomorrow.tx
Posted by Squiggles on November 6, 2006, at 7:05:43
In reply to Re: wait a second?, posted by linkadge on November 5, 2006, at 21:15:13
> Believe it or not, there is a lot of controversy about the neuroprotective/neurotoxic actions of lithium.
>There is no controversy at all. It is well
known that lithium is toxic over a certain dose.
Like some drugs, it has a narrow therapeutic index; that is , it does not take much deviation in dose range to become toxic. Warfarin is like that for example, and many other drugs.
> Lithium has proconvulsant and anticonvulsant effects. Lithium can be *highly neurotoxic* if it goes over the upper blood level.Doh!
>
> Also, when lithium is combined with the cholinergic agent pilocarpine, it can induce a model of temporal lobe epilepsy.Now why would i want to combine it with a drug
for xerostomia induced by cancer? I don't have that condition.>
> http://www.cogsci.ecs.soton.ac.uk/cgi/psyc/newpsy?7.32
>
>
> Linkadge
>
>Linkadge, this post is exactly the kind of post that I was asking for an information editor on for this group. I understand that Dr. Bob cannot hire the entire staff of the American Psychiatric Association to help out, but i would say you are coming close to fear-mongering.
Nobody likes the side effects of psychiatric drugs. I have said this over and over on the board -- we need better drugs. But this message is not what I need anyway. You may as well tell someone on chemotherapy that the reason he is so sick is because of the chemotherapy -- yeah he knows that. But he takes it for a reason.
Squiggles
Posted by Squiggles on November 6, 2006, at 8:04:59
In reply to Re: wait a second?, posted by linkadge on November 5, 2006, at 21:15:13
I would appreciate it if anyone reading
this could tell me which province in Canada
or state in the US is likely to have the LEAST number of anti-psychiatry mental health workers?We may move in a few years and I would
like to safeguard my sanity.Tx
Squiggles
Posted by linkadge on November 6, 2006, at 12:14:23
In reply to Re: wait a second? » linkadge, posted by Squiggles on November 6, 2006, at 7:05:43
The truth isn't fear mongering and you you don't need to listen to me, if you don't need to.
All I am saying is the that there can be a bad side to the drug. My mother is a prime example. A university graduate with zero cognitive problems starting lithium therapy, she now has a hard time reading large print childrens books. The only difference is 20 years of lithium.
No, I cannot proove anything, but this is just the way I see things.
Linkadge
Posted by Squiggles on November 6, 2006, at 13:11:28
In reply to Re: wait a second?, posted by linkadge on November 6, 2006, at 12:14:23
> The truth isn't fear mongering and you you don't need to listen to me, if you don't need to.
>
> All I am saying is the that there can be a bad side to the drug. My mother is a prime example. A university graduate with zero cognitive problems starting lithium therapy, she now has a hard time reading large print childrens books. The only difference is 20 years of lithium.
>
> No, I cannot proove anything, but this is just the way I see things.
>
>
>
> Linkadge
>
>
>
>
>Maybe you need glasses too.
Squiggles
Posted by clint878 on November 6, 2006, at 15:36:19
In reply to Re: wait a second?, posted by linkadge on November 6, 2006, at 12:14:23
But as I said earlier, there are studies showing that the disease itself could have caused this cognitive deterioration. If so, there are (albeit sparsely-researched) treatments available.
It may also be that lithium toxicity caused the decline, not the lithium itself.
Posted by clint878 on November 6, 2006, at 15:40:01
In reply to Re: wait a second? » linkadge, posted by Squiggles on November 6, 2006, at 7:05:43
Well, I think it's important to keep in mind that the people who post here most frequently are also the ones most likely to have problems. There are probably thousands of people who made a few posts here, got the right treatment, and are doing excellently with few or no side effects.
The people who are left are the minority who are still trying to get things working right.
Posted by linkadge on November 6, 2006, at 15:43:32
In reply to Re: wait a second? » linkadge, posted by Squiggles on November 6, 2006, at 13:11:28
Pardon my gramatical error. I am typing on the go.
You don't need to listen to me if you don't want to. It is not my intention to tell anybody what to do. I am *not* saying that these medications are useless, and have no theraputic value, I am simply saying there there are risks involved. Risks of which I am sure you are well aware.
In my mother's case, by "large print books", I am simply referring to the fact that she cannot read simple literature. She has suffered lithium toxicity on several occasions. Each occasion producing a marked deterioration in cognition.
Teasing me won't change what psychiatric drugs are, or aren't.Linkadge
Posted by lukeds on November 6, 2006, at 15:54:54
In reply to Re: Best way of killing myself, posted by clint878 on November 4, 2006, at 13:25:11
It is an aggresive method but if the drugs can't help you, may be the psychosurgery could help you.
Read this document, there are indications for major depression and social anxiety.
http://neurosurgery.mgh.harvard.edu/Functional/psysurg.htm
It is not LOBOTOMY, there are differents surgeries for the brain, the lobotomy is only one of many, and the it is not used now.
I don't know in what country do you live, but maybe in your country the social security cover these kind of surgeries.
Subcaudate tractotomy
In patients with depression and OCD, total improvement or improvement with minimal symptoms was clinically observed in two thirds of the patients.Anterior Cingulotomy
This improvement was greatest in patients with chronic pain and depression but negligible in those with the diagnosis of schizophrenia.Depression might still be helped with surgery and should not be excluded.
Greetings. lukeds.
Posted by Squiggles on November 6, 2006, at 15:56:00
In reply to Re: wait a second?, posted by linkadge on November 6, 2006, at 15:43:32
I'm sorry that your mother has suffered
lithium toxicity. I hope she finds
a doctor who checks her lithium levels
regularly.I recommend Dr. Mogens Schou's
"Lithium Treatment of Manic Depressive Illness: A Practical Guide by Mogens Schou" (Paperback - Dec 1992)He died recently.
Squiggles
Posted by Squiggles on November 6, 2006, at 17:56:27
In reply to Re: wait a second? » linkadge, posted by Squiggles on November 6, 2006, at 15:56:00
Another excellent handbook of psychiatric
information is"Recognition and Treatment of Psychiatric Disorders" -- A Psychopharmacology Handbook
for Primary Care, by Charles B. Nemeroff, Ph.D. and
Alan F. Schatzberg, MD.Not only is lithium mentioned in here and detailed for toxicity, but other potentially lethally toxic
ADs, like imipramine, at the wrong dose, under the wrong conditions.Squiggles
Posted by clint878 on November 6, 2006, at 20:27:49
In reply to Re: wait a second? » linkadge, posted by Squiggles on November 6, 2006, at 15:56:00
Someone used the word "irreversible" when referring to such things as cognitive damage caused by bipolar disorder, or lithium toxicity, or so forth.
I wouldn't give up hope in this case, no matter how bad your mother seems. The reason is that the definition of "irreversible" changes over time. For example, fifty years ago, there was little hope when someone lost a limb. Now, we reconnect the nerves to a prosthetic and people actually regain their sense of touch.
Probably within ten years, there will be treatments developed to not only restore cognitive function in impaired people, but also to improve it above "normal" levels in ordinary people. In forty years, my guess is that people will look back at the smartest people today and think they were horribly dumb.
There are some who say that all we need to do is stay alive until the next advance, and then again to the next advance, and so on, until you live forever. Regardless of how realistic that is, there is likely to be significant progress in dealing with presently "irreversible" damage.
Posted by Squiggles on November 7, 2006, at 8:39:58
In reply to Re: wait a second? » linkadge, posted by Squiggles on November 6, 2006, at 15:56:00
BTW, do you know how high your mother's
blood levels were when she reached toxicity?
Was she taking other drugs? How was she
treated to bring the lithium levels back
to normal?I hope she is OK now. As Dr. Kay Jamison
writes (and she herself has experienced
toxicity -- see "An Unquiet Mind") it is
a very dangerous state to be in.
Squiggles
Posted by Dr. Bob on November 7, 2006, at 8:40:42
In reply to Re: wait a second? » linkadge, posted by Squiggles on November 6, 2006, at 13:11:28
> Maybe you need glasses too.
Please don't post anything that could lead others to feel accused or put down.
But please don't take this personally, either, this doesn't mean I don't like you or think you're a bad person.
If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please first see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
http://www.dr-bob.org/babble/faq.html#enforceFollow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above post, should of course themselves be civil.
Thanks,
Bob
Posted by linkadge on November 7, 2006, at 11:51:20
In reply to FrequentFryer there is still a hope for you! Read., posted by lukeds on November 6, 2006, at 15:54:54
I saw a show on the SST. It was pretty dramatic. One guy was well after 30 years of miserable responses to medications. The lady had no response.
Linkadge
Posted by linkadge on November 7, 2006, at 11:54:08
In reply to Re: wait a second? » Squiggles, posted by Squiggles on November 7, 2006, at 8:39:58
She accidentally doubled her dose, which at the time was like 3000mg The tests indicated that she probably went over, but can't recall the exact blood level. She's accidentally (?) done this a few times. Each time she's just a little less "there".
Linkadge
Posted by Squiggles on November 7, 2006, at 12:28:12
In reply to Re: wait a second?, posted by linkadge on November 7, 2006, at 11:54:08
> She accidentally doubled her dose, which at the time was like 3000mg The tests indicated that she probably went over, but can't recall the exact blood level. She's accidentally (?) done this a few times. Each time she's just a little less "there".
>
> LinkadgeThis is a common problem with many drugs, especially with senior citizens.
It might be a good idea to make sure that she
has a WEEKLY container pill dispenser, and that she fills each day with the exact amount of pills. While doing that, it should be considered an important part of the week, and double-checked.
In nursing homes, this is done for the patient.Squiggles
Posted by Phillipa on November 7, 2006, at 19:54:29
In reply to Re: wait a second? » linkadge, posted by Squiggles on November 7, 2006, at 12:28:12
I doubt Link's Mom is a senior citizen since he's so young unless he's the youngest of other siblings. Love Phillipa
Posted by Squiggles on November 7, 2006, at 20:01:50
In reply to Re: wait a second? » Squiggles, posted by Phillipa on November 7, 2006, at 19:54:29
I must have missed the age, if posted.
Squiggles
Posted by FrequentFryer on November 8, 2006, at 18:27:58
In reply to Re: Best way of killing myself, posted by clint878 on November 4, 2006, at 21:06:50
> The fact that these antidepressants "poop out" all the time strongly hints at bipolarity, as well as your uncle's diagnosis.
>
> Take a look at http://www.psycheducation.org/depression/STEPBipolarityIndex.htm, an index from Harvard used to test for a bipolar diagnosis. Just from what I hear here, you probably have about 40 points on that scale, and if you were young when you first became depressed, the score is probably higher.
>
> Also, lithium alone is not that useful when depression is the primary symptom. Lamictal, Symbayx, or Seroquel are the best for bipolar depression, although I would never take the latter two as they are too risky.CLOSE! I scored 35... Still I dont really want to take lithium, Lamictal might be ok though.
Posted by FrequentFryer on November 9, 2006, at 2:23:31
In reply to Re: Best way of killing myself » clint878, posted by Phillipa on November 4, 2006, at 21:48:48
> What if a med never worked and you were told you were dysphorica as a child? And then had panic disorder in your 20's which was treated well with benzos till your 50's then you became depressed with the anxiety and panic still there. Could you be bipolar. Heck to have a med work for a few weeks there is so much I would do.. Love Phillipa
Hey Phillipa have you tried d-Amphetamine?
Posted by FrequentFryer on November 9, 2006, at 2:32:14
In reply to Re: Best way of killing myself » Phillipa, posted by FrequentFryer on November 9, 2006, at 2:23:31
> > What if a med never worked and you were told you were dysphorica as a child? And then had panic disorder in your 20's which was treated well with benzos till your 50's then you became depressed with the anxiety and panic still there. Could you be bipolar. Heck to have a med work for a few weeks there is so much I would do.. Love Phillipa
>
>
> Hey Phillipa have you tried d-Amphetamine?
>It might give you a couple of good weeks
Posted by FrequentFryer on November 9, 2006, at 16:20:57
In reply to FrequentFryer there is still a hope for you! Read., posted by lukeds on November 6, 2006, at 15:54:54
> It is an aggresive method but if the drugs can't help you, may be the psychosurgery could help you.
>
> Read this document, there are indications for major depression and social anxiety.
>
> http://neurosurgery.mgh.harvard.edu/Functional/psysurg.htm
>
> It is not LOBOTOMY, there are differents surgeries for the brain, the lobotomy is only one of many, and the it is not used now.
>
> I don't know in what country do you live, but maybe in your country the social security cover these kind of surgeries.
>
> Subcaudate tractotomy
> In patients with depression and OCD, total improvement or improvement with minimal symptoms was clinically observed in two thirds of the patients.
>
> Anterior Cingulotomy
> This improvement was greatest in patients with chronic pain and depression but negligible in those with the diagnosis of schizophrenia.
>
> Depression might still be helped with surgery and should not be excluded.
>
> Greetings. lukeds.
>
>
Thanks for pointing that out Luke, I still have a few other options left though, hopin this tryciclic works out,
This is the end of the thread.
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