Posted by Nickengland on October 5, 2005, at 10:42:10
In reply to Re: Professor at Med School Says Wean off All Meds » Nickengland, posted by SLS on October 4, 2005, at 19:51:00
Hello Scott
Ahh my previous post did possibly come across slightly antipsychiatry/antimeds lol My apologies, that was not my intention, just trying to cover some middle-ground :-)
>Tell that to a lithium responder.
Yes!...My mother is one of nearly 20 years, same dosage, never been upped, never been lowered and keeps her well.
>I disagree with this characterization.
Lithium carbonate is an antimanic medicine. Priadel (The brand of Lithium my Mother takes) is used to
*control the symptoms* of 1. Mania (a state of high excitability and exaggerated emotions) and hypomania (a mild form of mania) 2. Bipolar depression. (where the mood changes between manaia and depression) when treatment with other antidepressant drugs has not been successful. 3. Aggressive behaviour or intentional self half. It is also used to prevent mood problems which occur frequently.It says in the drug information leaflet that the drug is used to control the symtoms?
>When one responds robustly to an antidepressant, there is a global improvement of all symptoms simultaneously.
:-) All symptoms. Which suggests the medication is treating the symtoms of the illness - which suggests it is keeping the illness under control.
>This indicates to me that some core process or processes have been modulated by the treatment such that the illness itself goes into remission.
"The definition "Remission" in bipolar means a return to the level of mood symptoms seen in the general population. A limitation to this definition is that it does not include functionality level.
In the majority of cases, symptoms will be brought under control. "For any given episode, the prognosis of that episode being over is extremely good...you can almost count on it." More challenging is decreasing the number of total episodes, and regaining previous function - that is, how long does it take before the person can do what they used to do before they got sick. According to Dr. Ketter (based on his clinical experience), It can take months or years after a remission of symptoms to build back previous function." (That was taken from another website http://www.schizophrenia.com/moodswing%20pages/bpQandA.htm#remission)
>I don't think that the word "cure" serves well to describe treatment success with mood illness. "Remission" seems more appropriate.
A Long-Term Illness That Can Be Effectively Treated
Even though episodes of mania and depression naturally come and go, it is important to understand that bipolar disorder is a long-term illness that currently has no cure. Staying on treatment, even during well times, can help keep the disease under control and reduce the chance of having recurrent, worsening episodes."Yes I agree that remssion is appropriate to describe the treatment success in todays climate for mental illness. The word cure doesn't serve well, as of yet, because there isn't one, but that said I don't think we should be afraid to use the word in the hope that in the future this is something that will become a reality, or closer to.
>You should see the difference in brain function between depressive episode versus remission as imaged by a P.E.T. scan. In relapse, most of the brain appears blue and inactive. In remission, the whole brain lights up yellow, orange, and red. This is virtually identical to the portrayal of a healthy brain. Semantics aside, this person no longer has to contend with any aspect of depression other than maintaining the effective treatment.
:-)
>I have experienced a full remission. Depression was completely absent. I functioned as if I had no mood illness. I was unbound to begin putting my life and my psyche in order.
:-)
>Looking into the future, I believe that our ever-expanding ability to look at how the brain functions through imaging techniques like PET, SPECT, and fMRI will allow for a biological testing protocol that will be able to identify effective drugs for each individual using an array of compounds as biological probes. In addition, genetic microarrays might be able to screen for deficiencies and excesses of particular gene products. This would help identify which genes are turned on and which ones are turned off. A gene-activity profile can be constructed to produce a matrix from which abnormal function can be characterized and treated.
Yes!...This is what I hope the future will bring too :-)
I think my wording would have sounded better with regards to medications being answer if I would have said it like this. In the present, drugs are are the answer to go on by when dealing with the serious mental illness which requires such help. Using myself for an example, I have to have drugs everyday. When faced with Bipolar disorder, if I did not take medication I run the risk of literally destroying my life and the high chance of losing it. Not being a gambling man as such, i'm not willing to run that risk anymore because of the destruction the illness has already caused me in the past. Therefore, I am willing if need be to take the drugs i'm currently on now (if they still work and do not cause damage of course!) for the rest of my life indefintely. However the side effects, possible longterm damages of the drugs and realisation that the illness could be better controlled, are the things which make me personally think that although they are the answer for today so to speak, in tomorrows world I have the hope that there will be better furture treatments that will provide an even better answer to one I currently have to day. That said lol I am forever grateful for the answer in which I find in the drugs I take today..
Its like, my thinking is looking at past, present and furture treatments. In the past, for example a couple of hundred years ago people were locked up and left to die, that was the answer then. Today the answer is drug treatments, which is a great step forward! In a couple of hunded years time will lithium still be the gold standard for Bipolar disorder? I feel that as much as these treatments are excellent at bringing the illness into remission - I just have this feeling that there is still more in the way of working towards a cure, (although we're getting close possibly) firstly controling the illness and secondly minimising the side effects of the medications currently used, like the permanent changes in kidney structure and function lithium can cause for example.
Psychiatry in general is still in its infancy, and like that of an infant it cannot know all the answers just yet, especially when working with what could be considered the most complex organ known to mankind in the entire universe. I for one though am grateful for the answers that have been discovered so far.....the learning and future treamtments are quite literally mind boggling :-)
Kind regards
Nick
poster:Nickengland
thread:562069
URL: http://www.dr-bob.org/babble/20051003/msgs/563155.html