Posted by SLS on May 2, 2009, at 15:15:32
In reply to Re: Poop out remedies - To Scott, posted by meltingpot on May 2, 2009, at 13:34:26
Hi Denise
> Thanks for your advice, I just feel as though I have hit this kind of impasse, the drugs do so much and then just seem to do no more and I get the same thing with every drug I try.
I know the feeling well. I may still be in that predicament myself. That is why I went ahead and added memantine at this juncture.
> Clomipramine is not working properly for me and it feels pretty much the same as Seroxat did when it stopped working. I can function ok, anxiety is not so bad but I am so tired all of the time, I feel like I have have this constant tension, in my face, head, neck and spine.
It sounds almost like the beginnings of serotonin syndrome.
> I don't really call my life much of a life at all. Again, I know the feeling well.
> There must be some method in all of this madness,
I think doctors come to create their own methods of treating people based upon the information they are presented with and their own clinical experiences.
> that's the only thing that gives me any comfort is that maybe this new (good psychiatrist) will be able to help me by using some kind of science because she is one of the few here in the UK who actually puts some thought behind it
Psychopharmacology might be more of an art than a science at this point in its evolution.
There are some doctors who try to use imaging studies to help choose treatments. Others have composed elaborate algorithms and flow charts. Science has tried to produce biological tests for affective disorders for many years, but I don't know the extent to which any of these methods are to be found in clinical practice.
> but from what you say it doesn't matter what psychiatrist I see because it's all just a crap shoot anyway.
> This psychiatrist I am seeing now is no more likely to get me better than a psychiatrist who knows less about psychopharmacology.
I was hoping not to demonstrate black-and-white thinking on this matter, but I know that is how I may have come across to you. I do think that some doctors are much better than others at diagnostics and making treatment decisions.
I said, "I would use personal theories to help discover and include drugs to try rather than exclude drugs from consideration. It is not useless to inventory drugs based upon those pharmacological properties that science has thus far reported."
This is not an all-or-nothing approach. I just wanted to impress upon you that to exclude Parnate from consideration based upon it being of the same "class" of drugs as one that you did not respond to would be premature.
See if you can find a smart doctor with a good memory and a little humility. I think part of the first visit to a new doctor should include a screening by the patient of the doctor. I have been lucky for the most part, but I have walked out on a few. It might not hurt to get other medical opinions, even if you decide to stay with your current doctor. Actually, it would be interesting to find out what other doctors consider to be the state of the art. I might be well behind the times, after all.
Which anticonvulsants have you tried?
- Scott
poster:SLS
thread:893083
URL: http://www.dr-bob.org/babble/20090426/msgs/893897.html