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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 6 to 30 of 118. Go back in thread:
Posted by linkadge on July 19, 2005, at 15:57:46
In reply to Here we go again..., posted by SLS on July 19, 2005, at 15:03:11
I totally agree with med empowered. Even the best psychiatrists believe that AD's only try and controll the symptoms of depression, as oppsed to ever targeting the root cause.
Dr. Manji for instance, doesn't really believe in Antidepressants. He believes in mood stabalizers, but that is a different issue entirely.
Companies have to perform like 10 trials just to get one that shows the drug was better than the placebo.
I think that popping the drug is just a reminder that we have some support.
So if they just didn't work, that'd be one thing, but the fact that I am walking proof that they are not benign placebos is another thing.
Linkadge
Posted by linkadge on July 19, 2005, at 16:00:09
In reply to Re: Bad (but expected) news about ADs, posted by Tom Twilight on July 19, 2005, at 15:43:13
But thats exactly it, if they did *work* why wouldn't we see a reduced suicide rate?
I think the suicide rate is a good outward indicator of how some people still feel internally.
Linkadge
Posted by SLS on July 19, 2005, at 16:20:04
In reply to Re: Here we go again..., posted by linkadge on July 19, 2005, at 15:57:46
> I totally agree with med empowered. Even the best psychiatrists
Be careful, I have worked with many of the "best" psychiatrists and psychiatry departments at major universities, although I refuse to list them. They disagree with both you and med_empowered. So, I guess we haven't settled very much by anonymous name dropping.
> believe that AD's only try and controll the symptoms of depression, as oppsed to ever targeting the root cause.
I disagree with both you and med_empowered. When I responded well to antidepressants, it certainly did "bust" the underlying illness, not just selected symptoms. It cured everything. I am led to believe by your words that you have not experienced such a thing. I am ready to challenge you for as long as it takes for you to become convinced that the illness itself goes into remission.
> Dr. Manji for instance, doesn't really believe in Antidepressants.
Show me.
> He believes in mood stabalizers, but that is a different issue entirely.
I'm glad he does. I have been on all of the major mood-stabilizers. They don't work. Manji must be wrong, then, otherwise I would be in remission, right?
> Companies have to perform like 10 trials just to get one that shows the drug was better than the placebo.
Placebo controls don't seem to make for very good trials when treating depression. This is becoming a field in and of itself. The high rate of placebo response make placebo controls almost meaningless. Take out the placebo, and these drug trials all of a sudden show robust results in favor of response.
http://www.srmhp.org/0201/media-watch.html
Check out the work of Quitkin et al. dealing with the placebo effect.
> I think that popping the drug is just a reminder that we have some support.
I have all the support I need. I don't need to take colored sugar pills to make me feel comfortable. If these drugs were so inert, how do you explain that they have such potent side effects? If they are capable of exerting side effects, what logic is there to exclude the possibility that they are also potent therapeutically?
> So if they just didn't work, that'd be one thing, but the fact that I am walking proof that they are not benign placebos is another thing.Now you've got it.
Linkadge, if you do indeed have MDD or BD, and you do finally respond to antidepressants and/or mood stabilizers, you will be whistling a different tune. I think you might be projecting your own failure to respond to drugs to an inability of these drugs to work for anybody. This is wrong.
Don't worry, you'll get there. I truly hope that it is sooner than later. I can't wait to here that new tune you'll be whistling.
Be well.
- Scott
Posted by SLS on July 19, 2005, at 16:21:07
In reply to Re: Bad (but expected) news about ADs » Tom Twilight, posted by linkadge on July 19, 2005, at 16:00:09
> But thats exactly it, if they did *work* why wouldn't we see a reduced suicide rate?
What? Where are you getting your information from?
- Scott
Posted by Meri-Tuuli on July 19, 2005, at 16:21:48
In reply to Re: Bad (but expected) news about ADs » Tom Twilight, posted by linkadge on July 19, 2005, at 16:00:09
But not everyone commits suicide who doesn't feel well... maybe a better indicator would be days off? I don't know. Plus men are more likely to commit suicide, but women are more likely to be depressed.
They work for me!
Posted by linkadge on July 19, 2005, at 16:21:50
In reply to Re: Here we go again..., posted by linkadge on July 19, 2005, at 15:57:46
I wonder what the first explainations for why freud was going cookey under the influence of cocaine were. Cocaine didn't make him psychotic, it only "unmasked" his predisposition to psychosis.
Linkadge
Posted by Nickengland on July 19, 2005, at 16:23:12
In reply to Re: Bad (but expected) news about ADs » Tom Twilight, posted by linkadge on July 19, 2005, at 16:00:09
One thing to remember is (and this is my experience) with anti-depressants - they are not "pro happiness" pills.
I have never had much or any luck with anti depressants to be honest - I've had more "anti depressant" effects from mood stabilisers which have no proof of, or even claim to have anti depressant properties from either drugs companies or studies that i know of. Work that one out lol
I have taken " pro happiness" pills and it did work extreamly well at producing excellent happiness results. MDMA Ecstacy* Even this is flawed though, for the 8 hours of happiness I recieved, I then have 4-5 days of induced depression from it.
Kind regards
Nick
* Disclaimer - I am not advocating the use of Ecstacy for happiness, its dangerous and can cause death & I no longer use any form of illigal substances.
Posted by Nickengland on July 19, 2005, at 16:28:17
In reply to Re: Bad (but expected) news about ADs, posted by SLS on July 19, 2005, at 16:21:07
> But thats exactly it, if they did *work* why wouldn't we see a reduced suicide rate?
Take all the anti-depressants off the market and out of reach of the world population - I then believe you would see an increase in suicide.
Kind regards
Nick
Posted by linkadge on July 19, 2005, at 16:30:42
In reply to Re: Here we go again... » linkadge, posted by SLS on July 19, 2005, at 16:20:04
"When I responded well to antidepressants, it certainly did "bust" the underlying illness, not just selected symptoms."
No offence, but that is impossable for you to know. Didn't these majic pills make you manic ?
Even though sinequan made my mother manic, and sent her into a downward spiral of psychwards, dirty antipsychotics, and experimentational mood stabalizing agents, she still contends that it was a gift from god, and that it cured her.
Why does she say this? Because if she says otherwise, the last 20 years of her life have been lived in vain.
Linkadge
Posted by linkadge on July 19, 2005, at 16:41:08
In reply to Re: Bad (but expected) news about ADs, posted by Nickengland on July 19, 2005, at 16:28:17
We have been recording the rate of suicide long before antidepressants were ever introduced.
http://biopsychiatry.com/suicide.html
Linkadge
Posted by SLS on July 19, 2005, at 16:49:01
In reply to Re: Bad (but expected) news about ADs, posted by Tom Twilight on July 19, 2005, at 15:43:13
> I’m very tired at the moment, but I’m going to attempt to write the best response I can.
I know the feeling. It probably takes me as much time to write one sentence as it does for most people to write a paragraph. That's why my posts are usually so short. If you want to win a debate with me, just overwhelm me with sheer volume of words. Let this be our little secret, though. OK?
> Firstly I certainly agree that many antidepressants don’t work very well for a lot of people.
I think the critical question isn't how many people will respond to a specific drug. The critical question is what is the rate of response for any one person when given access to all of the drugs available. If you look at it this way, the rate of response to antidepressants is approximately 85%. It might be higher when combinations are considered.
> In my opion this is especially true of the newer ones like SSRIs.
In my mind, SSRIs are already old - or at least middle-aged. I still get the feeling that the TCAs, Effexor, and MAOIs produce a greater rate of response than the SSRIs. Still, the SSRIs have an important place in psychiatry and may still make sense as being a first line treatment.
> Having said this there are several things to consider; firstly the term Antideprssant covers a wide array of drugs so its hard to generalise about them.
I think that's a fair comment.
> Secondly we’re all different, so even if a certain antidepressant such as Moclobemide doesn’t work for most people, it will still work well for the people it does help, if you see what I mean.
I sure do. This is why I get upset when people say they would like to see a particular drug discontinued or never make it to market. To my knowledge, there isn't a single drug approved for depression that hasn't worked magic for at least some people, even if that subpopulation be relatively small. Why take away a tool when there are people who still benefit from it. Personally, I think moclobemide sucks compared to most others. But the hell if I'm going to take it out of the mouths of those who are living their lives happily and productively because of the availability of that drug.
> Combinations of anitdepressants can also be more effective than the individual drugs, so this is another consideration.
The more tools to work with, the better. These drugs work. I can prove it, but I'm hoping I won't have to. I thought we were well beyond that by now. Why are some people so motivated to throw away the only tools we have right now? Why are they so motivated to disuade others from using them? Lastly, what are these people to offer us in lieu of these tools? I'm not implying that they don't have anything else to offer, but let us here what these alternatives are.
- Scott
Posted by SLS on July 19, 2005, at 16:54:34
In reply to Re: Bad (but expected) news about ADs, posted by linkadge on July 19, 2005, at 16:41:08
> We have been recording the rate of suicide long before antidepressants were ever introduced.
>
> http://biopsychiatry.com/suicide.htmlAh. That's the thing. This is a study of the rates of REPORTING.
- Scott
Posted by TamaraJ on July 19, 2005, at 17:18:34
In reply to Re: Bad (but expected) news about ADs » Tom Twilight, posted by SLS on July 19, 2005, at 16:49:01
I know that the first time I was put on an AD at the age of 35 I DID have a very good response, which was in no way placebo. As a matter of fact, after two weeks on the drug, I was ready to throw in the towel because the side effects were so bad and I actually felt worse. I stuck it out, although I was convinced that it would never help me. Then over the course of about a week or two, I started to feel better - the severe anxiety I had been experiencing (which was worsened by start-up side effects) began to subside and the depression started to lift. It was such an incredible relief, and I don't regret having taken Paxil, my first AD.
My second depression took hold about 9 years later, but was more the result of severe iron deficiency. And, after two more physical illnesses, the depression deepened. This time, it has been a struggle trying to find an AD to at least part the veil enough so that I can do the things that I know will help me get completely back on my feet, although, for the most part (and until recently), I had been making a point of exercising daily, trying to eat well and taking vitamins and other supplements to improve my physical condition.
I, personally, am about to give up. I can't live like this anymore - trying one drug after another. I have tried to maintain some faith that I will be fortunate enough to have a similar response to another med, or combination of meds, as I did to Paxil 9 years ago. But, I am demoralized and tired, and, as pitiful as this sounds, I have lately just been hoping for a heart attack in my sleep to put me out of my misery. Can't believe I just said that, but it actually feels good to get it off my chest.
I started Zoloft just over two weeks ago, and have been at 75mg for 3 days now. I feel worse than I did before I started the Zoloft, if that is possible. Although I am no longer as apprehensive and experiencing as much anticipatory anxiety, I am exhausted and down and thinking about how I wish I was dead (not something I usually think about). Maybe Zoloft isn't for me. Maybe I should just stick with Nortriptyline and go back to experiement with natural supplements. Maybe it is a case of it gets worse before it gets better. I don't know, I just don't know.
All I know is that I don't know what to believe anymore - past experience tells me ADs work - current experience tells me maybe they don't work as well as I thought or as well the second time around. I want to believe they do work. I want to maintain some hope that I will be me again - not euphoric, not down, but somewhere in between.
Is it too much to ask? Sorry for the rant.
Posted by linkadge on July 19, 2005, at 17:25:01
In reply to Re: Bad (but expected) news about ADs » Tom Twilight, posted by SLS on July 19, 2005, at 16:49:01
Combinations of drugs can also do more harm, and cause more unknown and potentially permanant side effects.
We don't do enough studies on how single drugs affect the brain, let alone taking combinations of drugs.
I just think they're overrated thats all.
Linkadge
Posted by linkadge on July 19, 2005, at 17:26:56
In reply to Re: Bad (but expected) news about ADs » linkadge, posted by SLS on July 19, 2005, at 16:54:34
I don't know what you are saying.
Linadge
Posted by linkadge on July 19, 2005, at 17:34:54
In reply to Re: Bad (but expected) news about ADs » SLS, posted by linkadge on July 19, 2005, at 17:26:56
Ahh, that first experience!
Thats the thing. I had a good first experience, Tamara had a good first experience, SLS, my mother, my uncle, my best friend, my french teacher, all had good first experiences, I know a good 30 people who have had good first experiences and are now hooked on boards like this trying to recapture something.
Don't mean to be a downer but...
Isn't it surprising, thats what keeps most illegal drug users coming back for more, was one good experience, that they can never fully recapture.
Linkadge
Posted by med_empowered on July 19, 2005, at 17:45:30
In reply to Re: Bad (but expected) news about ADs, posted by linkadge on July 19, 2005, at 16:41:08
The Study, as I understand it, was publicly funded (there weren't any Scientologists bank-rolling it or anything, lol). I say this news is "expected" or at least "not unexpected" because we've all had or known people who had problems with ADs and/or didn't get any meaningful amount of relief, AND b/c of all the coverage as of late on the power of Big Pharma to manipulate every aspect of the health industry, including (in the US) the FDA (Factoid: 10% of the FDA's budget comes FROM Big Pharma.) I think the common tactic of casting suspicion on those who would DARE to question the status quo, whether it be in psychiatry or elsewhere, reveals a desperate attempt to MAINTAIN the status quo and sustain a sort of Orthodoxy in science, which is completely inappropriate. A number of other publications have criticised ADs and other psychiatric drugs--some were laughed off, some were simply ignored or pushed to the fringe. My problem is this: it seems that Psychiatry has become so obsessed with the "broken brain" theory of mental illness/personal problems that is has chosen to rididcule, minimize, and ignore other potentially helpful perspectives. Even now, in the wake of evidence that ADs sometimes increase suicidality and that they do, indeed, carry serious side-effect risks, psychiatrists often seem to be so hooked on the "broken brain idea"--and the power, prestige, and drug-company money that comes with it-- that they will fight to protect their pet theory (belief is probably a better word) from any data, even the best, that dares question it. In science, the idea is that one should pursue the truth, or something close to it. How can psychiatrists be said to be "pursuing the truth" when they close off all avenues of research and inquiry except for the "acceptable" ones? How can a "science" claim objectivity and intellectual rigor when it attacks those who dare ask questions or raise concerns? I dont doubt that the antidepressants have helped some people--and thats great. But, remember what they teach you in basic statistics: anecdotal evidence is terribly flawed; the "bigger picture" usually gives more insight into the matter. So yes, I know several people who have been helped by antidepressants, but I also know that larger studies have, overall, pointed only to a relatively weak depression-fighting effect. As for suicide...I also know that tricyclics and MAOIs were introduced in the 1950's, which is also the decade that saw the introduction of Thorazine and the real "birth" of psychopharmacology. Since then...suicide rates HAVE gone up, especially among children and teens. MORE people are kept in prisons than ever before in US history. MORE people abuse drugs. Are our brains somehow MORE broken than they were in the 1950s? I doubt it. I think life is complex, people are complex, and the problems that people have--whether you call them "issues" or "mentall illness"-- are also infinitely complex. I mean, ask yourself: do we just have less serotonin than we did the 50s? Or, maybe, could widespread social isolation, materialism, discrimination, world hunger/poverty, war, and problems like the AIDS epidemic lead to the kind of widespread confusion and misery you see today? Granted, people have always had problems, but this promise that Prozac and company will make it better is recent...and it seems to be a hollow promise, indeed. Overall, I think psychiatry's failing, it fatal flaw, is its self-importance, its arrogance. For thousands of years, people have searched for answers about life and happiness/unhappiness. As a result, humanity has art, religion, philosophy, music...things that make life meaningful, full, rich...and worth living. How can psychiatry, which emerged from the madhouse with claims of "curing the insane" even TRY to compare itself to these endeavors? How can psychiatrists dare to assert that their expensive little pills are some how of equal value as, say, the teachings of Jesus, Buddha, or Gandhi in explaining and healing life's pain? And how can a profssion which views anyone who isnt smiling, happy, always productive, with a proper sleep schedule, healthy sex life and "good attitude" as somehow diseased and deviant claim to be "empowering" and "helpful" ? Those who refuse psychiatric medications or deny their diagnoses are often told they "lack insight." Ask yourself--when a psychiatrist tries to reduce a PERSON to symptoms and disorders and reduces the incredible complexity of existence to the clump of brain cells in our head--who is it, really, that "lacks insight" ?
Posted by Jen Star on July 19, 2005, at 17:54:37
In reply to About my post..and Suicide..., posted by med_empowered on July 19, 2005, at 17:45:30
I agree with you on a lot of what you say. I think it's dangerous to get too "into" any one method to cure something as fragile and mysterious (even to the best neurologists and researchers!) as the human mind. If we focus on drugs to the exclusion of religion, meditation, etc, we are losing out.
As I said before, Lexapro works for me (or I think it does...either way there is something strong and amazing going on in my head and in my brain.)
But I think in general we as a society are starting to overmedicate in general -- taking drugs for certain conditions because of the clever advertising. And I DO think that drugs are approved very quickly without enough solid research on their effects or side-effects. Think about fen/phex and the heart valve issues; Vioxx/Celebrex and the heart attacks/strokes/etc; Accutane and birth defects.
I read that in the 1800's mercury and arsenic were commonly prescribed by the best educated doctors to cure common ailments -- and ended up killing people. It just seems that in our quest to make ourselves healthier, we sometimes get stuck in setbacks along the way.
I wouldn't argue that medical care is excellent, and it's getting better all the time. But I do think that it's not perfect, and that it's a good idea to investigate other remedies to see what works.
I believe that mental illness is real. I'm just not sure that our drugs really work to "fix" it. I hope that as tech. advances, our drugs become more refined and can really help the majority of people.
JenStar
Posted by Jen Star on July 19, 2005, at 17:58:56
In reply to About my post..and Suicide..., posted by med_empowered on July 19, 2005, at 17:45:30
I think diet and the foods available may be a factor in the rising rates of cancer, mental illness, MS and more. The research is "out" on this still and the FDA & many doctors don't agree. BUT -- people are starting to believe and think that things like excess MSG, flavor and color-enhancing chemicals in our foods, preservatives, insecticides, etc. are not meant to be ingested by humans and may in fact be affecting our immune systems and neurological systems.
I've read about a lot of people who claim to have cured various illnesses in themselves by doing dramatic 'back to nature' organic diets, avoiding processed foods and many chemicals.
It's food for thought (no pun intended!)
JenStar
Posted by Jazzed on July 19, 2005, at 18:03:36
In reply to Here we go again..., posted by SLS on July 19, 2005, at 15:03:11
SLS,
Once again, I think you are brilliant! I agree with you wholeheartedly.
My opinion, for what it's worth....
I don't think any one drug, or class of drugs, works for all people who are depressed, or that any one drug works for anyone 100% of the time, or that the "recommended dose" works the same (or as it should) for all people who are depressed. I also think that if someone is suicidal, they might not find the drug that will work for them before they (unfortunately) commit suicide.I think the number of choices available today are a lot better than the number of choices that were available years ago. I also have hope that the drugs to treat mental illnesses will get better and better with more research and development. While I'm sure the "bottom line" will always be a factor, and managed health care (or lack of health care, or NHS) will continue to interfere with the ability to get proper care for mental illness, there has to be some hope that things will get better, and more choices will be out there for people suffering from mental illnesses. I do worry about how managed healthcare will be, with regard to mental health, for our kids when they reach adulthood.
Aren't there a lot more people "functioning" at a much higher level today than there were years ago? I really don't know, this is a question.
As far as my personal situation is concerned with regard to medication, I trust my p-doc to help me find what will work best for me.
Jazzy
Posted by KaraS on July 19, 2005, at 18:30:48
In reply to Not sure what to believe anymore, posted by TamaraJ on July 19, 2005, at 17:18:34
Dear Tamara,
It breaks my heart to see you going through so much trouble with all of these drugs. I know it's getting harder and harder to do but try to keep remembering how much you were helped by the Paxil for so many years. You felt worse initially on the Paxil too. There's still plenty of time for things to turn around on the Zoloft. It's still way too early to judge it. If it can happen once for you, then it can definitely happen again.
As for the hope that you might have a heart attack at night and not wake up, I bet there are few people on this board who HAVEN'T had that thought! I know I certainly have. Especially lately. It would all be so much easier... but then we'd miss all of the good times ahead that are going to happen for us when we feel good again.
(((((Tamara)))))
K
Posted by ed_uk on July 19, 2005, at 18:33:25
In reply to About my post..and Suicide..., posted by med_empowered on July 19, 2005, at 17:45:30
Hi Med,
>As a result, humanity has art, religion, philosophy, music...things that make life meaningful, full, rich...and worth living.
Ahh music... I love it. I'm listening to Albinoni right now.
Thank you for your interesting posts :-)
Kind regards
~Ed
Posted by linkadge on July 19, 2005, at 18:57:55
In reply to About my post..and Suicide..., posted by med_empowered on July 19, 2005, at 17:45:30
Just to counter. I think there is some good in psychiatry. For instance, there are fewer seizures these days thanks to anticonvulsants. But on the other side, epileptic patients treated with anticonvulsants are at a higher risk for depression, and suicide.
Psychiatry is amazed by "effect". They love being able to poke around in the brain and do all sorts of neet things. But the fact remains that you can do a lot of poking around without really getting anywhere. We poke around with such a shallow knowledge of what we're doing. We love the effect of being able to take a pill and feel better. It gives us as sence of controll. But that sence of controll might not be cost free.
I also think that psychiatry ignores the large picture. If you come in with insomnia, they think it is great that they can get you to sleep, but don't really notice that their drug also seems to reduce your daytime alertness. They dismiss the colaterall dammage left right and center.
I really like the term "brain disabling treatments". I don't like Breggin much, but I like that term. It is so true that oftentimes the theraputic effect occurs conncurrently with some sort of loss of mental function. You take the drug and after a lot of pushing and pulling you end up "getting by" but never really better. Just kind of a zombie, numb to the good things too.
Kind of like a chemical lobotomy. Sure you're not crying, and you're not sad, but come to think of it you're really not anything anymore.I would not go so far as to say that psychiatry has been able to do nothing, but I totally agree with you when you say that they definately overestimate their abilities, and underestimate their dammage.
I was never suicidal before taking an AD, but it is so clear cut to me that there is a problem, because after stopping them I now feel suicidal. Why? Really I feel so suicidal because I have lost all my faculties, I still can't go 10 minautes without experiencing a brain zap or a terrable neck twisting sensation. I may have to live with this for the rest of my life.
I don't want a majic pill, I just want my orignial life back. I feel like Michael Jackson who, at the end of all his plastic sugery relizes, "What the hell have I done to myself!". I just wanted a little bit of a nicer nose, I've screwed up my entire face !! Its exactly like plastic surgery. Most people get into this because they want "a little work done" so to speak. But the silocone can explode folks, the silicone can explode.
Now, in order to avert the guilt I feel over ever getting myself into this mess, I continue to buy into the "theres something wrong with me".
No more.
At this stage of the game my best bet is to just let go, and stay deformed for fear of making it worse.
Linkadge
Posted by Jakeman on July 19, 2005, at 20:28:59
In reply to Re: About my post..and Suicide... » med_empowered, posted by linkadge on July 19, 2005, at 18:57:55
I guess one can assume that there's some correlation between depression and suicide.
Here are suicide rates from various countries from WHO:
http://www.who.int/mental_health/prevention/suicide/suiciderates/en/
USA suicide rates http://www.afsp.org/statistics/USAagegroup.htm
Looking over these charts I could not infer anything. Other than the fact that men kill themselves more than women.
Some of the data my be bad, I don't know. The only thing that's clear is that mental illness is universal, whether medication helps I don't know.
Interesting data to explore though.
warm regards ~Jake
Posted by Jakeman on July 19, 2005, at 20:39:40
In reply to Re: About my post..and Suicide... » med_empowered, posted by ed_uk on July 19, 2005, at 18:33:25
> Hi Med,
>
> >As a result, humanity has art, religion, philosophy, music...things that make life meaningful, full, rich...and worth living.
>
> Ahh music... I love it. I'm listening to Albinoni right now.
>
> Thank you for your interesting posts :-)
>
> Kind regards
>
> ~Edthanks ed, you reminded me to turn on my itunes player and listen to some trippy ambient music.
~Jake
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Dr. Bob is Robert Hsiung, MD,
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