![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 25 of 60. This is the beginning of the thread.
Posted by Peter C on June 5, 2000, at 17:57:03
In the only long-term placebo-controlled study in 25 years of a medication used to treat clients diagnosed as bipolar, psychiatrist Charles L. Bowden of the University of Texas Health Science Center found that both lithium chloride and valproate performed about as well as a placebo in long-term treatment of bipolar symptoms, Science News reported in a May 27 edition. The Dr. Bowden's study was also summarized in the May Archives of General Psychiatry.
Posted by Todd on June 5, 2000, at 20:46:26
In reply to lithium vs. placebo, posted by Peter C on June 5, 2000, at 17:57:03
Damn! Where can we read more about this? Is the study published on a website? Do you have a URL that you can give us? This sounds incredibly interesting. Thanks in advance for any info you can provide.
Posted by Cam W. on June 10, 2000, at 5:47:43
In reply to lithium vs. placebo, posted by Peter C on June 5, 2000, at 17:57:03
Peter - A couple of years ago (1997 or 1998, I think) the British Journal of Psychiatry had a couple of articles on the lack of efficacy of lithium. Very interesting stuff. I am like most people who think that lithium monotherapy does work about 30% to 50% of the time. These articles do give one pause for introspection, though. - Cam
Posted by SLS on June 10, 2000, at 12:54:13
In reply to lithium vs. placebo, posted by Peter C on June 5, 2000, at 17:57:03
> In the only long-term placebo-controlled study in 25 years of a medication used to treat clients diagnosed as bipolar, psychiatrist Charles L. Bowden of the University of Texas Health Science Center found that both lithium chloride and valproate performed about as well as a placebo in long-term treatment of bipolar symptoms, Science News reported in a May 27 edition. The Dr. Bowden's study was also summarized in the May Archives of General Psychiatry.
Hi Peter.
Is this article posted on the Web?
If so, where can I find it?In the context of your post, it appears that the word "symptoms" may be an important operator when discussing the usefulness of these two drugs monotherapeutically. I would really like to review the article, but I don't have access to a medical school library.
Thanks.
- Scott
Posted by Cam W. on June 10, 2000, at 13:03:27
In reply to Re: lithium vs. placebo » Peter C, posted by SLS on June 10, 2000, at 12:54:13
Scott
http://archpsyc.ama-assn.org/issues/v57n5/full/yoa8223.html
-Cam
Posted by SLS on June 14, 2000, at 11:02:29
In reply to Re: lithium vs. placebo » SLS, posted by Cam W. on June 10, 2000, at 13:03:27
Dear People,
I don't think I am taking much of a risk by making the following statements:
1. Both lithium and Depakote (valproate) are substantially better than placebo in treating bipolar disorder.2. Both lithium and Depakote work in the short-term and the long-term. (Depakote may work a bit more quickly in some cases)
3. People have been kept well on lithium for DECADES.
4. Many people who have been kept well by lithium for years relapse within 4 months once they discontinued taking it.
- Many of these people respond again to lithium when it is restarted.
- Some of these people never again respond to lithium, regardless of how many times it is restarted, and regardless of how high the dosage is increased.
5. No single antidepressant works for everyone. Mood stabilizers are no different in this regard.
Just because some very important researchers take part in a study, this does not guarantee its reliability. If the design of a study were flawed, even Einstein wouldn't come up with the right results.> In the only long-term placebo-controlled study in 25 years of a medication used to treat clients diagnosed as bipolar, psychiatrist Charles L. Bowden of the University of Texas Health Science Center found that both lithium chloride and valproate performed about as well as a placebo in long-term treatment of bipolar symptoms, Science News reported in a May 27 edition. The Dr. Bowden's study was also summarized in the May Archives of General Psychiatry.
Study URL:
http://archpsyc.ama-assn.org/issues/v57n5/full/yoa8223.htmlI thought it was important to try to rip this study to shreds. I'm not sure I can. However, my conscience urges me to post on this board some evidence that lithium is an effective drug. I don't think it is in the best interests of people reading this thread to assume that the results of this study are accurate. There are some pretty big names associated with this article. However, the authors are bound by a scientific ethic to draw their conclusions based upon the results produced by their study design.
It is commendable that the investigators had the courage to submit this article, despite its obviously flawed outcome. Decades of clinical experience demonstrate that lithium is indeed superior to placebo in the treatment of bipolar disorder. I had a conversation with a scientist over the weekend about this article and its inferences. He thought it likely that it was a "failed" study, and that it shows some potential problems in its designs and results. But that is opinion.
Now, having said this, let me describe why reboxetine, an antidepressant, has not been approved by the FDA for sale in the United States. One of the studies that the FDA was depending on to reach its decision "failed". A study is said to fail when it is determined that the experiment just plain didn't work. The results of such a study can not be deemed reliable. Something went wrong.
In the investigation comparing reboxetine to Prozac to placebo, neither reboxetine nor Prozac were superior to placebo. This was a failed study. If we were to look only at this one study, Prozac should never be used again because it doesn't work. It does.
There are a bazillion other studies that demonstrate that both lithium and Depakote are superior to placebo - many, many of them conducted by these same researchers, including Dr. Bowden. Long-term? Well, one may want to decide for themselves as to the relevance of the Bowden 12-month study to developing a perspective of the "long-term" efficacy these drugs.
I don't feel like trying to pick the study apart and cite the overwhelming evidence demonstrating that lithium works. So I will try something simpler. (I hope it works)
---------------------------------------------------------
Questionaire: Looking for success stories only - obviously, no one psychotropic drug works for everyone.1. Has anyone found lithium effective for bipolar disorder or know of someone who has.
2. For how long has lithium helped?
Even a handful of success stories should help allay the fears of many people reading this board that lithium is better than sugar.
Just to help cover my butt on this one, I would want to point out that the population of participants on Psycho-Babble is probably sufficiently biased towards treatment-resistance to skew the statistical rate of success downward. In addition, I would guess that Psycho-Babble attracts far more people whose major complaint is depression rather than mania or hypomania. People who are manic or euthymic may have other things to do. In addition, lithium is not known to be terribly effective when used by itself to treat bipolar depression. It can, however, help prevent future occurrences.
Let's see what happens. I know of too many people whose lives have been changed dramatically by lithium. This contradicts the notion that lithium is no better than placebo over the long-term.
Also, one other thing. The Bowden study was designed to compare the efficacy of Depakote, not lithium. I believe it was initiated and funded by Squibb, the manufacturer of Depakote. Patients were excluded if their manic symptoms were too severe. This might indicate that the majority of patients selected were Bipolar II. Bipolar II is well known not to be particularly responsive to lithium. That Depakote was somewhat superior to lithium seems to be a good indicator of this. Oh well, I guess I started picking. Sorry. I can think of more stuff, though. Again, I am not very objective on this one. Neither am I qualified.
Oh yeah. There is nothing prohibiting the combination of effective mood stabilizers to treat people for whom one single drug is not good enough. It works.
- Scott
Posted by SLS on June 14, 2000, at 12:30:43
In reply to Re: lithium vs. placebo - An opinion, posted by SLS on June 14, 2000, at 11:02:29
Questionaire: Looking for success stories only - obviously, no one psychotropic drug works for everyone.
1. Has anyone found lithium effective for bipolar disorder or know of someone who has.
2. For how long has lithium helped?
Even a handful of success stories should help allay the fears of many people reading this board that lithium is more effective than sugar.
Posted by Todd on June 14, 2000, at 19:56:37
In reply to Lithium success stories - Are there any?, posted by SLS on June 14, 2000, at 12:30:43
OK, SLS, here's your first success story. I had my first (and only) full-blown manic episode over 10 years ago. I was hospitalized and put on lithium. Since then, I have had one small period of hypomania. Outside of that, my life has been quite normal aside from the occasional flirting with hypomania. The one time I did experience a hypomania was directly attributable to increased stress and a reduced dosage of lithium. An increase in lithium dose along with a few days of risperdal and some R&R was all it took to stabilize me. Am I lucky? Does the lithium really work? Or is it just the "idea" that lithium works that keeps me stabilized?
These are questions I ponder all the time. Perhaps 2 years after I started lithium, my prescription ran out and I was unable to refill it for about 10 days. I thought, hey, I'll be fine. But 4 or 5 days in, I started getting panic attacks. I had never experienced these before in my life. It was quite frightening. But looking back on it, my subconscious may likely have been freaking out because there was no longer a safety net. What if I get manic again? What will my life be like? Oh, my God, I can't handle this! After 5 more days of this, my prescription got refilled and the panic attacks started to fade away.
The placebo effect is very intriguing. Because we think something is helping us, it actually may be helping us, regardless of the actual "chemical" imbalance that the medication is "correcting." Perhaps we think of our meds as being the safety net, the support we need and crave in our lives. We may actually be doing this "all ourselves" and our meds are just there to "watch out for us." If the meds are stopped, we lose the safety net and feel isolated and inadequate again, and the symptoms recur. These are just thoughtful meanderings, and would never prompt me to cease my lithium use - at least not in the near future, anyway. But what if lithium was more placebo than anything else? Wow, what a concept.
Posted by BBob on June 14, 2000, at 22:36:20
In reply to Re: lithium vs. placebo - An opinion, posted by SLS on June 14, 2000, at 11:02:29
> 1. Both lithium and Depakote (valproate) are substantially better than placebo in treating bipolar disorder.Unsubstantiated declarative statement, the logical foundation of which is based on the presumed authoritI of the speaker.
> 2. Both lithium and Depakote work in the short-term and the long-term. (Depakote may work a bit more quickly in some cases)IBID
> 3. People have been kept well on lithium for DECADES.
IBID
> 4. Many people who have been kept well by lithium for years relapse within 4 months once they discontinued taking it.
>
> - Many of these people respond again to lithium when it is restarted.
>
> - Some of these people never again respond to lithium, regardless of how many times it is restarted, and regardless of how high the dosage is increased.
Niether "many" nor "some" are relational to a specific quantity, apparently reverting to previous unsubstantiated argument of authority> 5. No single antidepressant works for everyone. Mood stabilizers are no different in this regard.
"Works" "everyone" and other terms undefined. Ignore statement.
> Just because some very important researchers take part in a study, this does not guarantee its reliability. If the design of a study were flawed, even Einstein wouldn't come up with the right results.Growing evidence of need to rebut findings. What is the writer defending? A popular drug?
> > In the only long-term placebo-controlled study in 25 years of a medication used to treat clients diagnosed as bipolar, psychiatrist Charles L. Bowden of the University of Texas Health Science Center found that both lithium chloride and valproate performed about as well as a placebo in long-term treatment of bipolar symptoms, Science News reported in a May 27 edition. The Dr. Bowden's study was also summarized in the May Archives of General Psychiatry.
>
> Study URL:
> http://archpsyc.ama-assn.org/issues/v57n5/full/yoa8223.html
>
> I thought it was important to try to rip this study to shreds. I'm not sure I can. However, my conscience urges me to post on this board some evidence that lithium is an effective drug. I don't think it is in the best interests of people reading this thread to assume that the results of this study are accurate. There are some pretty big names associated with this article. However, the authors are bound by a scientific ethic to draw their conclusions based upon the results produced by their study design.
>
> It is commendable that the investigators had the courage to submit this article, despite its obviously flawed outcome.
Obvious? Kindly submit evidence, please, refering to sources other than personal authority.
Decades of clinical experience demonstrate that lithium is indeed superior to placebo in the treatment of bipolar disorder. I had a conversation with a scientist over the weekend about this article and its inferences. He thought it likely that it was a "failed" study, and that it shows some potential problems in its designs and results. But that is opinion.Indeed. Opinions previal.
>
> Now, having said this, let me describe why reboxetine, an antidepressant, has not been approved by the FDA for sale in the United States. One of the studies that the FDA was depending on to reach its decision "failed". A study is said to fail when it is determined that the experiment just plain didn't work."Plain"? "Work?" Are these terms defined?
> The results of such a study can not be deemed reliable. Something went wrong.
Something? What? What does the writer mean by wrong? Per chance does that mean does not concur with personal perceptions of personal experience?
> In the investigation comparing reboxetine to Prozac to placebo, neither reboxetine nor Prozac were superior to placebo. This was a failed study. If we were to look only at this one study, Prozac should never be used again because it doesn't work. It does.How does a stude the show Prozack "works" differ from a study that shows Prozak is associated with increased suicidal or violent ideation?
>
> There are a bazillion other studies that demonstrate that both lithium and Depakote are superior to placebo - many, many of them conducted by these same researchers, including Dr. Bowden. Long-term? Well, one may want to decide for themselves as to the relevance of the Bowden 12-month study to developing a perspective of the "long-term" efficacy these drugs.
Bazillion is an absurd term. The writer reverts to ridicule. Argument failed.
>
> I don't feel like trying to pick the study apart and cite the overwhelming evidence demonstrating that lithium works. So I will try something simpler. (I hope it works)Ridicule is indeed simple.
another writer posted: would not it be intersting if lithium worked because of placebo affect (paraphrase)
Just another opionion, reflecting curiosity rather than conviction.
(boBB is not Todd!!!)
>
>
> ---------------------------------------------------------
>
>
> Questionaire: Looking for success stories only -
\
Oops! experiment design obviously excludes well documented evidence of toxic effect. More positive results of the UT study were excluded because many subjects dropped out after experiencing negative side effects. No similar effects were reported from placebo group.
Posted by Cam W. on June 15, 2000, at 0:13:06
In reply to Re: lithium vs. placebo - An opinion, posted by BBob on June 14, 2000, at 22:36:20
>
> Unsubstantiated declarative statement, the logical foundation of which is based on the presumed authoritI of the speaker.Is this an unsubstantiated critique of a presumed authority without offering a reasonable scientically- based explanation to the contrary? If so, the critique might be presumed argumentative.
>
> Growing evidence of need to rebut findings. What is the writer defending? A popular drug?Again, perhaps opinion of the critic? A guess on the part of the critic without substantiating why he/she came to the assumptions he/she is positing? If so, this can be ignored.
>
> Obvious? Kindly submit evidence, please, refering to sources other than personal authority.Kindly submit evidence to the contrary if you feel that the critiqued statements are totally out of line with scientic reason.
>
>
> Decades of clinical experience demonstrate that lithium is indeed superior to placebo in the treatment of bipolar disorder. I had a conversation with a scientist over the weekend about this article and its inferences. He thought it likely that it was a "failed" study, and that it shows some potential problems in its designs and results. But that is opinion.
>
> Indeed. Opinions previal.Unsubstantiated declarative statement, the logical foundation of which is based on the presumed authority of the reference used (ie the scientist). Rebuttal should be ignored. Opinions prevail.
>
> Something? What? What does the writer mean by wrong? Per chance does that mean does not concur with personal perceptions of personal experience?Or does it mean that the orignal writer's personal experiences do not prevail over that of the personal perceptions of the critic?
>>
> How does a stude the show Prozack "works" differ from a study that shows Prozak is associated with increased suicidal or violent ideation?Studies need to be scientically reproduceable using the identical methods of the original study. Please show us evidence of this with any non-retrospective studies of suicidal or violent ideation. Critics own views are introduced into critique, again.
>>
> Ridicule is indeed simple.Yes, it is.
>
> another writer posted: would not it be intersting if lithium worked because of placebo affect (paraphrase)
>
> Just another opionion, reflecting curiosity rather than conviction.Posited as such. No need to restate the obvious.
>Ya know. It is easy to pick apart statements made by non-journalists. Everything on this board is heresay or opinion. The disclaimer at the top says as much. Us illiterate, non-English major types express ourselves the best way we know how. To pick apart our statements just for the sake of doing so, I believe, is mean and is meant to hurt another's feelings, rather than further science. A good rebuttal offers alternative theories and references. It does not just try to show the superior ability of the critic to twist the English language for the satisfaction of his/her own motives.
Can't we all play nice?
- Sincerely (really) Cam (not any of the Bobs).
;^)
Posted by SLS on June 15, 2000, at 9:29:00
In reply to Re: lithium vs. placebo - An opinion, posted by BBob on June 14, 2000, at 22:36:20
Dear Person,
Gee, I must have struck a nerve with you in one of my previous posts.
Perhaps it might be productive for you to try to prove your point by taking 1200mg of lithium for four weeks and see how well it doesn't work for you.
You are no journalist. If you were to keep a journal, you would have given careful consideration to sentence #2 a long time ago. I wouldn't presume to diagnose you. I would, however, presume to suggest that you find someone who can. You are quite sick. You know it. You are not happy. Get help. Meanwhile, let others continue to get theirs without vindictively using your ignorance to get in their way.
I believe someone was kind enough to point out within the contents of the following post that "BoBB has never said he suffers from any "mental illness" that I know of."
http://www.dr-bob.org/babble/20000603/msgs/35974.html
What a carelessly worded piece of evasive rhetoric. Well then, what exactly *does* BoBB say?
If you have no mental illness, then just what the hell are you doing here? Do you really manage to fool yourself into thinking you exercise any altruism by writing such garbage posts? They really are garbage. You are such a weak writer. Did you even bother to entertain the idea that your post might dissuade so much as one person from using lithium to help put his life back together? But I guess that is your mission. What is your mission? I presume to suggest that you want others to pay dearly for the injustices that the world has placed upon you. Maybe a little lithium might clear things up. Zyprexa even better.
Maybe you have no biological mental illness. If you don't, you have a hell of a lot of work ahead of you. You better get moving. You only have the rest of your life to live. Don't waste it.
Can't you find some other sandbox to play in, or have you already been kicked out of the rest of them? It doesn't take much of a charlatan to win verbal battles with depressed people, many of whom find it difficult to think their way out of a paper bag.
You actually suck at rhetoric.
I do not believe you are a journalist.
If it is so important to you to offer opinions, why don't you get up off your ass and do some research. I have. You are so ignorant. If you notice, I have not offered a single point of debate regarding the important issue regarding the efficacy of lithium. I wouldn't waste a single storage granule debating someone like you. I would need to spend months educating you just to be able to.
You are curious about nothing except the limits of your own power. Let me help you out here. You are quite limited.
I am not sincere. Stop hurting others on this board by exercising your free speech. Surely, no one would pay for it.
IBID you farewell. Hit the road. Get help. I know you won't. You have neither the intelligence nor the courage. There's my altruism. Use it wisely.
Your Friend,
Scott
P.S. Don't bother.
Posted by Oddzilla on June 15, 2000, at 9:56:03
In reply to Re: lithium vs. placebo - An opinion, posted by SLS on June 14, 2000, at 11:02:29
> Dear People,
>
>
> I don't think I am taking much of a risk by making the following statements:
>
>
> 1. Both lithium and Depakote (valproate) are substantially better than placebo in treating bipolar disorder.
>
> 2. Both lithium and Depakote work in the short-term and the long-term. (Depakote may work a bit more quickly in some cases)
>
> 3. People have been kept well on lithium for DECADES.
>
> 4. Many people who have been kept well by lithium for years relapse within 4 months once they discontinued taking it.
>
> - Many of these people respond again to lithium when it is restarted.
>
> - Some of these people never again respond to lithium, regardless of how many times it is restarted, and regardless of how high the dosage is increased.
>
> 5. No single antidepressant works for everyone. Mood stabilizers are no different in this regard.
>
>
> Just because some very important researchers take part in a study, this does not guarantee its reliability. If the design of a study were flawed, even Einstein wouldn't come up with the right results.
>
> > In the only long-term placebo-controlled study in 25 years of a medication used to treat clients diagnosed as bipolar, psychiatrist Charles L. Bowden of the University of Texas Health Science Center found that both lithium chloride and valproate performed about as well as a placebo in long-term treatment of bipolar symptoms, Science News reported in a May 27 edition. The Dr. Bowden's study was also summarized in the May Archives of General Psychiatry.
>
> Study URL:
> http://archpsyc.ama-assn.org/issues/v57n5/full/yoa8223.html
>
> I thought it was important to try to rip this study to shreds. I'm not sure I can. However, my conscience urges me to post on this board some evidence that lithium is an effective drug. I don't think it is in the best interests of people reading this thread to assume that the results of this study are accurate. There are some pretty big names associated with this article. However, the authors are bound by a scientific ethic to draw their conclusions based upon the results produced by their study design.
>
> It is commendable that the investigators had the courage to submit this article, despite its obviously flawed outcome. Decades of clinical experience demonstrate that lithium is indeed superior to placebo in the treatment of bipolar disorder. I had a conversation with a scientist over the weekend about this article and its inferences. He thought it likely that it was a "failed" study, and that it shows some potential problems in its designs and results. But that is opinion.
>
> Now, having said this, let me describe why reboxetine, an antidepressant, has not been approved by the FDA for sale in the United States. One of the studies that the FDA was depending on to reach its decision "failed". A study is said to fail when it is determined that the experiment just plain didn't work. The results of such a study can not be deemed reliable. Something went wrong.
>
> In the investigation comparing reboxetine to Prozac to placebo, neither reboxetine nor Prozac were superior to placebo. This was a failed study. If we were to look only at this one study, Prozac should never be used again because it doesn't work. It does.
>
> There are a bazillion other studies that demonstrate that both lithium and Depakote are superior to placebo - many, many of them conducted by these same researchers, including Dr. Bowden. Long-term? Well, one may want to decide for themselves as to the relevance of the Bowden 12-month study to developing a perspective of the "long-term" efficacy these drugs.
>
> I don't feel like trying to pick the study apart and cite the overwhelming evidence demonstrating that lithium works. So I will try something simpler. (I hope it works)
>
>
> ---------------------------------------------------------
>
>
> Questionaire: Looking for success stories only - obviously, no one psychotropic drug works for everyone.
>
> 1. Has anyone found lithium effective for bipolar disorder or know of someone who has.
>
> 2. For how long has lithium helped?
>
> Even a handful of success stories should help allay the fears of many people reading this board that lithium is better than sugar.
>
> Just to help cover my butt on this one, I would want to point out that the population of participants on Psycho-Babble is probably sufficiently biased towards treatment-resistance to skew the statistical rate of success downward. In addition, I would guess that Psycho-Babble attracts far more people whose major complaint is depression rather than mania or hypomania. People who are manic or euthymic may have other things to do. In addition, lithium is not known to be terribly effective when used by itself to treat bipolar depression. It can, however, help prevent future occurrences.
>
> Let's see what happens. I know of too many people whose lives have been changed dramatically by lithium. This contradicts the notion that lithium is no better than placebo over the long-term.
>
> Also, one other thing. The Bowden study was designed to compare the efficacy of Depakote, not lithium. I believe it was initiated and funded by Squibb, the manufacturer of Depakote. Patients were excluded if their manic symptoms were too severe. This might indicate that the majority of patients selected were Bipolar II. Bipolar II is well known not to be particularly responsive to lithium. That Depakote was somewhat superior to lithium seems to be a good indicator of this. Oh well, I guess I started picking. Sorry. I can think of more stuff, though. Again, I am not very objective on this one. Neither am I qualified.
>
> Oh yeah. There is nothing prohibiting the combination of effective mood stabilizers to treat people for whom one single drug is not good enough. It works.
>
>
> - Scott~~~~~~~~
The study was published in a major medical journal , do you think it would have been accepted if the experimental design was so obviously flawed? Wouldn't it have been subjected to "peer review" before it was accepted?How can there be a flawed outcome to a scientific experiment? Isn't that the point of science? To report the results? We all ways had to write in indelible ink in lab books when I took science classes!
I don't see any real point to anecdotal evidence that people have been mania free on lithium-after all the study didn't say it never works, it said it didn't work any better than a placebo.
I certainly think people should take lithium if they want to and think it helps, but I don't think it is necessary to give up one's objectivity about it. I was personally delighted to see a long term study being done. It seems like they are few and far between.
I do understand your concern though. I think it's like the reaction I have to the studies that claim alcoholics can drink moderately again. It may be true at least for some but the destruction to those who weren't able to would be so great-it's a little scary to hear.
What would be so bad if a large percentage of "cures" came from placebos? If it works it works!
Oddzilla
(not any of the bobs, not clare,
not Cam, just odd that's all)
Posted by SLS on June 15, 2000, at 15:03:41
In reply to Re: Another oppinion, posted by Oddzilla on June 15, 2000, at 9:56:03
Dear Odzilla,
I apologize for my use of imprecise phraseology. The term "flawed outcome" is an example of my flawed semantics. I guess we all make mistakes. :-) Good point.
What may be flawed is the possible conclusion that "lithium is never better than placebo" based upon the first post along this thread, which, by the way, was a perfectly objective submission regarding the existence of a published article. It was my concern that this is how the post would be interpreted.
What do you think of lithium? Did it not work for you?
Did you read the article? What did you think?
Like I said, I am neither objective nor qualified. I just happen to think that lithium is more effective than sugar, even for prophylaxis. My belief reflects the overwhelming majority of studies appearing in peer-reviewed medical journals that demonstrate this as their outcome. Check it out.
Lithium works best for pure bipolar I without mixed states in people who have had few previous occurrences of affective episodes. It can work quite well for these presentations. However, this is not what the study was designed to test. Patients who suffered from mixed states were included, and there was no limit to the number of previous episodes experienced.
The goal (I should hope) is to try to successfully treat people while they are still young and have not suffered many episodes. I was hoping the initial post "lithium vs placebo" wouldn't persuade anyone to avoid lithium altogether.
I guess my study failed. I didn't get the results I was hoping for. Perhaps I should design a new one. :-)
It is unfortunate that lithium does not work as well as we would like it to. It does work, though - at least according to scientists, doctors, and many people who continue to take it.
It is no secret that lithium is not the miracle drug that Ronald Fieve hoped it would be. We may just need to be more precise in selecting the patients most likely to respond to it.
I wish I would respond to a placebo. I guess I just need to believe. Believing in the real drugs hasn't worked.
Thanks, Oddzilla.
- Scott
Posted by danf on June 15, 2000, at 16:51:00
In reply to Re: Another oppinion, posted by SLS on June 15, 2000, at 15:03:41
Lithium works for some people, not everyone.
The study was poorly designed. That it is published in a journal means that it was published, nothing else.
All psycho-pseudo-medical scientists know that journal articles are only a sharing of study results. There is no requirement that the study be valid or applicable to real life.
Posted by Oddzilla on June 15, 2000, at 18:02:32
In reply to Re: and Another , posted by danf on June 15, 2000, at 16:51:00
> Lithium works for some people, not everyone.
> You can say that for just about anything including placebos. It's a matter of defining your terms.
> The study was poorly designed. That it is published in a journal means that it was published, nothing else.
It means that it's there for people to read and judge on its own merits. I have never shared the faith some babblers have in peer reviewed journals so I see your point! It may have been poorly designed or it may have just been misrepresented in this thread.
>
> All psycho-pseudo-medical scientists know that journal articles are only a sharing of study results. There is no requirement that the study be valid or applicable to real life.I'm not a psycho-pseudo-medical scientist so I guess I'll just have to take your word for it :)
O.
Posted by Oddzilla on June 15, 2000, at 18:22:51
In reply to Re: lithium vs. placebo - An opinion » BBob, posted by SLS on June 15, 2000, at 9:29:00
Scott this is totally unworthy of you. I like BBob and I appreciate his point of view even if I don't agree. If you don't, *Don't read his posts*. As someone who does reluctantly take medication, I am offended that you use suggesting that someone is in need of medication as a way of discounting his opinions. I don't think he's ignorant or vindictive or any of the other insulting things you say. Please be civil includes everyone even you. As Cam said
Can't we all play nice? O.>
> Gee, I must have struck a nerve with you in one of my previous posts.
>
> Perhaps it might be productive for you to try to prove your point by taking 1200mg of lithium for four weeks and see how well it doesn't work for you.
>
> You are no journalist. If you were to keep a journal, you would have given careful consideration to sentence #2 a long time ago. I wouldn't presume to diagnose you. I would, however, presume to suggest that you find someone who can. You are quite sick. You know it. You are not happy. Get help. Meanwhile, let others continue to get theirs without vindictively using your ignorance to get in their way.
>
> I believe someone was kind enough to point out within the contents of the following post that "BoBB has never said he suffers from any "mental illness" that I know of."
>
> http://www.dr-bob.org/babble/20000603/msgs/35974.html
>
> What a carelessly worded piece of evasive rhetoric. Well then, what exactly *does* BoBB say?
>
> If you have no mental illness, then just what the hell are you doing here? Do you really manage to fool yourself into thinking you exercise any altruism by writing such garbage posts? They really are garbage. You are such a weak writer. Did you even bother to entertain the idea that your post might dissuade so much as one person from using lithium to help put his life back together? But I guess that is your mission. What is your mission? I presume to suggest that you want others to pay dearly for the injustices that the world has placed upon you. Maybe a little lithium might clear things up. Zyprexa even better.
>
> Maybe you have no biological mental illness. If you don't, you have a hell of a lot of work ahead of you. You better get moving. You only have the rest of your life to live. Don't waste it.
>
> Can't you find some other sandbox to play in, or have you already been kicked out of the rest of them? It doesn't take much of a charlatan to win verbal battles with depressed people, many of whom find it difficult to think their way out of a paper bag.
>
> You actually suck at rhetoric.
>
> I do not believe you are a journalist.
>
> If it is so important to you to offer opinions, why don't you get up off your ass and do some research. I have. You are so ignorant. If you notice, I have not offered a single point of debate regarding the important issue regarding the efficacy of lithium. I wouldn't waste a single storage granule debating someone like you. I would need to spend months educating you just to be able to.
>
> You are curious about nothing except the limits of your own power. Let me help you out here. You are quite limited.
>
> I am not sincere. Stop hurting others on this board by exercising your free speech. Surely, no one would pay for it.
>
> IBID you farewell. Hit the road. Get help. I know you won't. You have neither the intelligence nor the courage. There's my altruism. Use it wisely.
>
>
> Your Friend,
> Scott
>
>
> P.S. Don't bother.
Posted by Todd on June 15, 2000, at 20:18:34
In reply to DR Bob Please read » SLS, posted by Oddzilla on June 15, 2000, at 18:22:51
This boBB/BBob bashing is getting absolutely ridiculous. I have avoided posting to all previous threads regarding the tone and "civility" of boBB's posts because there was just way too much of a commotion being made. I would have just been adding more wood to an already blazing fire. Finally, just as the embers fade into ashes, and boBB starts to share again, another fire springs up. WHY DOESN'T ANYBODY GET BOBB?
I read quite a few of boBB's posts and find him to be quite articulate and intelligent. He has piqued my imagination on more than one occasion and can be counted on for original, free-thinking feedback. boBB's opinions are most definitely his own. For this alone, he should be respected. He doesn't buy into ANYONE'S prefabricated notions about reality. boBB has thrown out all of the crap and belief systems that he was made to swallow as a child and decided long ago to be HIMSELF no matter what anybody else thinks. His opinions are hard-won after years of self-reflection and hard questioning.
boBB is in the midst of his own process, just as we all are. boBB is HERE because he is refining his views of himself and reality JUST AS YOU ARE. boBB isn't out to offend anybody in the sense that he wants to hurt anyone's feelings. He wants to offend your sensibilites so that you question them and rethink them. I can't believe that so many of you are so put off by that and fail to see what boBB is all about. boBB deliberately plays the devils advocate to keep your minds from closing off. He wants to know how you come to your opinions and offers opposing viewpoints to either strengthen or demolish your own. You can't just believe what you're told to believe or what sounds good to believe. You have to develop your beliefs from personal experience and self-scrutiny, suffering through good times and bad. The minute your mind closes and stops questioning is the moment you begin to stagnate and fail to grow. boBB may be a little stubborn and may seem a bit jaded at times, but I sense in him a lively and caring soul who wants to break through the muck just like the rest of us. He is not going to be spoon-fed ANYONE's opinions without thoroughly challenging them first. That, my babble-landers, is the beauty of personal growth. Nobody can grow for you; you have to do the work yourself. boBB has done and continues to do his work, and as he posts here he helps us do our own.
I don't think this needs to be reiterated, but I am going to say it anyway - If you don't like boBB's style, DON'T READ HIS POSTS! Simple as that. If you do find yourself getting sucked into one of his responses and discover that you are getting angry, perhaps you should turn the finger you are pointing at boBB back at yourself. Anger is a defense mechanism. We only defend that which we feel needs to be protected. Just what is it within you that needs so much protection? If the "it" within you was truly strong, it would need no defense. As far as boBB's own anger is concerned, I would say that most of his initial posts are not malevolent at all. The ones that are are in response to deliberate attacks on his character. If I were that misunderstood by so many, I would be pretty pissed off too. I don't blame him a bit.
Please do not view me as speaking from a saltbox. I am writing this because I am tired of the venom that is getting spit on these pages. I am writing to you all as a fellow human being who feels deeply and in doing so finds that we are ALL the same deep down inside. Rather than point fingers at those who offend you, try to recognize a part of yourself in their words. You would be surprised how much you'll start to learn about yourself. I am constantly amazed as I continue to stumble down my own path.
Peace and Love,
Todd (not affiliated with boBB)
Posted by claire 7 on June 15, 2000, at 20:36:56
In reply to Re: DR Bob Please read, posted by Todd on June 15, 2000, at 20:18:34
Beautifully, articulatly, and intelligently said, Todd. Thank you. (Also much spiritual content in your post..) I was very moved, and made again proud of human beings. Turns out, this CAN be a supportive place.
An aside to SLS. Your post seemed uncharacteristic to me, too. Hope you're O.K.
Posted by Cam W. on June 15, 2000, at 21:01:58
In reply to Re: DR Bob Please read » Todd, posted by claire 7 on June 15, 2000, at 20:36:56
It would really be nice if boBB stuck to one name. Then many of us 'could' be able to respect his opinion even more. As it is now, with his replying to himself, just makes us suspicious of "anything" that is said about, to, or by him. Just my opinion. - Cam
Posted by claire 7 on June 15, 2000, at 22:16:43
In reply to Re: DR Bob Please read » claire 7, posted by Cam W. on June 15, 2000, at 21:01:58
>
If I remember correctly, boBB has a few rules, plainly stated for anyone who cares to pay attention. I, for one believe him, possibly because I'm not boBB. He acknowledges his various handles openly, and he points out that he doesn't reply to himself. He also has a consistent history ,point of view, and voice, which is readily apparent to anyone who is used to reading literature, and who knows what the term "close reading" means. If it makes you feel better to believe there's only one person who thinks boBBity, go for it. As the kids like to say, whatever keeps your boat afloat.....no, whatever rows your boat....no, whatever takes your elevator to the floor you need. Gee, I don't think I know what the kids say, afterall.Best wishes, Cam.
CLAIRE
Posted by Cass on June 16, 2000, at 12:27:31
In reply to DR Bob Please read » SLS, posted by Oddzilla on June 15, 2000, at 18:22:51
I am also offended by the BBob bashing. If someone is earnestly expressing their opinion without being insulting or malicious, we should all be accepting of that person. Scott, your post to BBob was more insulting than anything BBob has ever written to my knowledge. It was full of personal assaults. I agree with claire in that it seemed uncharacteristic of you. BBob does not have to conform to anyone else's opinions. Nor does anyone have to conform to his who doesn't want to. We should exercise mutual respect.
Posted by KarenB on June 16, 2000, at 12:37:14
In reply to Re: DR Bob Please read » claire 7, posted by Cam W. on June 15, 2000, at 21:01:58
>
> It would really be nice if boBB stuck to one name. Then many of us 'could' be able to respect his opinion even more. As it is now, with his replying to himself, just makes us suspicious of "anything" that is said about, to, or by him.> Just my opinion. - Cam
And mine also.Hey, "all of you," let's try to integrate into one personhood, shall we? Then we would all know to whom we are responding. This posting under one name, then agreeing with said post under another, then complimenting your own "wisdom and insight" under another is making me a little ill. I agree with Cam, that I would most certainly respect to a greater degree someone who owned their own opinions and was not afraid to sign their(one)name to them. Even though we are all anonymous here, it takes a certain amount of courage sometimes to post what I truly feel, under KarenB. My opinions are my own and I am not afraid to own them. How about (all of) you?
Todd, PULEEESE! Do you really think that with all the suffering we have collectively had in our lives, that we are such simpletons, "believing what others have told us to believe?" Do you believe that you and BoBB (etc.) are the only ones who have questioned authority, thought through their own belief system, sought to find what is true? I view that as arrogant in the extreme, which is the problem I personally have with his (and his other self-made fans') posts. Arrogance and grandiosity. A lot of people "get BoBB." There's just not as much to get as he himself believes.
I don't need BoBB to open my eyes. They are already open. Thanks anyway.
Sincerely,
Karen
Posted by Cass on June 16, 2000, at 13:18:55
In reply to Re: I agree Cam/note to ToDD, posted by KarenB on June 16, 2000, at 12:37:14
This posting under one name, then agreeing with said post under another, then complimenting your own "wisdom and insight" under another is making me a little ill.
Perhaps people are too quick to assume that because BBob has more than one handle that it is he who agrees with his own posts and compliments himself.
Posted by claire 7 on June 16, 2000, at 14:00:38
In reply to Re: I agree Cam/note to ToDD, posted by KarenB on June 16, 2000, at 12:37:14
>
Have you ever even considered that you may be wrong about the number of boBB identities? I ask seriously, not snidely. I'm honestly trying to figure out why it is so important for you to believe that anyone who doesn't boBB-bash is boBB.
I think I've expressed at least one of my theories about it, but a new one occurs to me. I wonder if you aren't overly concerned about being "tricked", or taken for a fool. Have you felt tricked in some profound way by an important figure in your life? This must be a pretty significant fear if you (and shar, and Janice) would rather respond with cruelty to a fellow human being than risk being taken for a fool.
The fear of appearing foolish is a major disabler. It limits your ability to experience life,it limits your ability to enjoy life, and it limits the depth of self-perception you can achieve. I've gotten over the frustration of being called boBB's alter-ego, and for a while I even found it amusing, (actually, I still do, from my side of things),but I think from YOUR side of things, it's not so funny. If you were able to allow yourself to seriously think about your reaction to this situation, you might gain some insight that could be useful in your struggle against depression.
I take everyone's struggle against depression seriously, including yours, though I doubt you will believe it.
Posted by Oddzilla on June 16, 2000, at 14:00:42
In reply to Re: I agree Cam/note to ToDD » KarenB, posted by Cass on June 16, 2000, at 13:18:55
> This posting under one name, then agreeing with said post under another, then complimenting your own "wisdom and insight" under another is making me a little ill.
>
> Perhaps people are too quick to assume that because BBob has more than one handle that it is he who agrees with his own posts and compliments himself.~~~~~~~~~~~~~~~~~~~~~~~~~~~~`
To Whoever you may be:I'm not BBob. I'm a person who believes that respect includes respecting people you don't agree with. I'm not a BBob disciple. He hasn't changed my life. I don't think he is any wiser, more courageous, more insightful, or more humane than anyone else here. But- I also don't think he's any less. IF he's making you ill,by all means stop reading his posts!!!! There are one or two frequent posters I found a little pretentious and full of themselves and I quit reading their posts. And I didn't feel any need to publicly announce it. It doesn't take any courage, just a little self-discipline.
I think it does require moral courage to impose the same requirement for civility on all posters
reguardless of their opinions. I called this post to Dr. Bob's attention for that reason. I think it takes courage to post one's true feelings even knowing the risk of being accused,discounted and ridiculed by some. O.
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