![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 5 to 29 of 29. Go back in thread:
Posted by SLS on August 24, 2001, at 17:13:38
In reply to martin jensen book - Elizabeth, Lorraine, others?, posted by may_b on August 24, 2001, at 11:03:53
> Hi
>
> I ordered this book and showed it to my psychiatrist and my gp. [ Both excellent people. GP especially is very respectful.] Both blew the book off. I am heartened to see Lorraine refers to this book favourably. I am wondering what you think, Elizabeth. Also, what experiences others have had trying to get their doctors to take it seriously.
>
> As I am heading back into another stressful year of teaching unsupported by any psychotropic, I am looking for any help I can get. (I am still too scared of Parnate to go back to it.)
>
> Thanks,
> may_bHi there.
I haven't read the book, but I wanted to say a few things.
The treatment approaches of Martin Jensen, MD are often discussed in this forum. There have been some rather vigorous discussions regarding their veracity and the advisability of using them. These discussions have generally revolved around the concept of screening for those drugs that will be effective for each individual by using short trials of each and choosing those that have produced at least a mild improvement.
I still have yet to encounter someone who has actually implemented and adhered to a 4-5 day drug trial strategy and report an unequivocal robust long-term remission of depression using only those drugs that were chosen using this protocol.
Caveat: It must be taken into consideration that a large percentage of the people posting on Psycho-Babble have not been satisfactorily treated, even when given adequate trials of different antidepressants. Many represent difficult cases that have demonstrated a history of poor response to those medical treatments that the majority of cases in the general population find effective. I doubt I would ever have bothered looking for web sites like this were I to respond well to previous treatments. It is quite possible that the majority of those people who were initially treated using Dr. Jensen's methods are now living happily ever-after and remain invisible to Internet mental health sites.
That being said, I would be hesitant to recommend to anyone that they try to discover which medications will be effective for them by taking each drug for five days or less. I don't believe that there is enough reliable data or scientific investigation into this approach to warrant that it be used as a first-line treatment. Nevertheless, the notion is appealing.
For the majority of people, a significant therapeutic effect from standard antidepressant treatment takes several weeks to become evident. There are some people who experience an improvement during the first and second weeks, but it is more often the case that a response is not seen until the person has been exposed to the drug for at least two weeks. This would represent the minimum amount of time that would pass under the ideal circumstance of being treated with the right dosage of medication in the first place. It will of course take longer if the initial dosage is insufficient.
It is my guess that people who have a history of refractoriness to drug treatment or whose depression is especially severe and chronic will need longer to respond to an antidepressant and need higher dosages. If you don't fall into either of these categories, and you are not in urgent need of relief, it might be worth a try. You could at least choose from those drugs deemed "eligible" by the screening process the one that produces the least undesirable side-effects.
I hope you find what you need quickly.
- Scott
Posted by JohnL on August 24, 2001, at 18:54:12
In reply to martin jensen book - Elizabeth, Lorraine, others?, posted by may_b on August 24, 2001, at 11:03:53
I like his book a lot. The strategies in it were what saved me from a 10 year stay in a depression dungeon.
Both my GP and my psychiatrist found many valid points in Jensen's methods, and some debateable ones too. But like most anything else, it is not a bible. Instead I think it is better used to help one lay out their own unique roadmap. It provides strategy and organization, where otherwise there is not enough of that. Too much hit and miss and not making any sense out of it all. The book teaches how to read clues. Reading those clues leads to a quicker find of the right medicine.
His methods led me through quick trials of the SSRIs I had not yet tried. Then his method had me run through the stimulants. For the first time in my life, I found a hint of something that could work. But the usual poopout tolerance thing set in quick. Still though, at least I knew I was on to something.
Then the antipsychotics were next. The only things is, that's where my search stopped. Bingo, I hit a jackpot. It was Zyprexa.
Big improvement with Zyprexa, but not total. Still though, at least now I knew which drugs worked best. My favorite of the SSRIs was Prozac. It helped. So I voted it in. My favorite stimulant was Adrafinil. It was great, especially with Prozac, so I voted it in. My favorite AP was Zyprexa. It was in. And thus my three way cocktail of minimum doses and I feel better than I ever have in my entire life.
It was Jensen's book that made it all happen. I would probably still be stuck back in SSRI land with no hope in sight and a bunch of doctors shrugging their shoulders, if not for the book to give some direction and strategy to the whole thing.
I do not agree with his 5 day trial thing though. Personally I think it should be 2 weeks, maybe 3 max. That's what I did. One new drug every two weeks, and then I could go back and choose my favorites. It worked like a charm.
John
Posted by Lorraine on August 24, 2001, at 22:27:02
In reply to Re: martin jensen book - Elizabeth, Lorraine, others?, posted by JohnL on August 24, 2001, at 18:54:12
> > >[John] I like his book a lot. The strategies in it were what saved me from a 10 year stay in a depression dungeon.
Right. The problem with sequential long term trials is that if you are treatment resistent, it could be 25 years before you hit the right combo. If you look at Preskorn's column "Do you feel lucky" (www.preskorn.com/columns/9801.html), he does the math using 600 possible drugs in combinations of 2, 3, 4 and 5. The odds of hitting the right combo is 1 in 179,000; 1 in 35,820,200; 1 in 5,346,164,850 and 1 in 637,262,850,120. My thought when I read this was, well why is he using a universe of 600 drugs? I mean I have eliminated certain classes of drugs (SSRI's) by this time and why not just look at the big players. So I took my remaining drugs to try short list drawing from the categories of stimulants, MAOs and Anticonvulsants. I came up with a list of say 18 drugs to try in various combos (hey, this is already much better than 600, right?). Then I eliminated those drugs on the list that I had already tried unsuccessfully. Now my list is down to 10 drugs to try in various combos--not too many right? Ok, but when you crank out the math, my odds using a two drug combo are 1 in 45 and using a three drug combo are 1 in 240. Well, you get the drift, we could be going through trials a long long long long time if we do "adequate" trials. There is a fallacy in this thinking, but I think it is small. The fallacy is that once you eliminate a drug b/c of side effects, you don't need to include it in combos and Preskorn's formula (which is pure statistics) does not take this into account. However, my use of just 10 drugs is surely too small as well so it all evens out in the wash.
My experience has not been that us treatment resistent folks need longer trials--my n of 1 doesn't--and, frankly, I don't have the life to waste doing my trials "adequately".
Nor do I believe that there is a true or accurate method to the madness of prescribing these drugs. Everyone is throwing darts from what I see. They have to be because we do not know enough now to determine with any degree of accuracy which drugs will work with which people. Different pdocs have theories--some seem more plausible than others--but, really, this prescribing stuff is still at the "art" stage.
[John wrote:]
> > > Both my GP and my psychiatrist found many valid points in Jensen's methods, and some debateable ones too. But like most anything else, it is not a bible. Instead I think it is better used to help one lay out their own unique roadmap. It provides strategy and organization, where otherwise there is not enough of that.This is my point as well. At this juncture in the road, any organizational approach is extremely useful. We like to pooh-pooh new ideas as not backed by enough research or science, but, let's face it, by the time they are we will all be long dead and turning in our graves. The only currency that I have to spend is my time.
> [John wrote:]
> His methods led me through quick trials of the SSRIs I had not yet tried. Then his method had me run through the stimulants. For the first time in my life, I found a hint of something that could work.I have not been using Jensen per se nor have I shared his book with my pdoc. What I have done though is speed up my trials with a pdoc that understands the desirability of doing that. Stimulants and benzos take one or two days to know if they work, if they have bad side effects etc. My experience with mood stabilizers led me to quickly determine whether there was a prayer of hope in them or not quite quickly (5 days to 2 weeks). The MAOs take more time and require a washout between trials. Still, I'm not inclined to give a drug that is not making me feel better pretty quickly an extended trial--life is too short.
> > > [John wrote:] Still though, at least now I knew which drugs worked best. My favorite of the SSRIs was Prozac. It helped. So I voted it in. My favorite stimulant was Adrafinil. It was great, especially with Prozac, so I voted it in. My favorite AP was Zyprexa. It was in. And thus my three way cocktail of minimum doses and I feel better than I ever have in my entire life.Good for you John. You decided to try something different and it worked for you. I'm glad.
> > > It was Jensen's book that made it all happen. I would probably still be stuck back in SSRI land with no hope in sight and a bunch of doctors shrugging their shoulders, if not for the book to give some direction and strategy to the whole thing.
His book made me think differently as well.
> > > I do not agree with his 5 day trial thing though. Personally I think it should be 2 weeks, maybe 3 max. That's what I did. One new drug every two weeks, and then I could go back and choose my favorites. It worked like a charm.Like I said above, I think it depends on the drug. Quick acting drugs can have shorter trials than longer acting drugs.
Lorraine
P.S. by the way, John, it was your earlier posts that caused me to buy his book in the first place and decide for myself notwithstanding the controversy surrounding his methods.
Posted by may_b on August 24, 2001, at 22:43:44
In reply to Re: martin jensen book - Elizabeth, Lorraine, others?, posted by JohnL on August 24, 2001, at 18:54:12
Posted by Janelle on August 24, 2001, at 22:52:17
In reply to martin jensen book - Elizabeth, Lorraine, others?, posted by may_b on August 24, 2001, at 11:03:53
I can't quite get a handle on what this book is all about from the posts here - could someone indicate what it discusses and what the TITLE is? Is it available in large bookstores? Thanks.
Posted by Jane D on August 24, 2001, at 23:05:49
In reply to Re: martin jensen book - , posted by Lorraine on August 24, 2001, at 22:27:02
>
> Right. The problem with sequential long term trials is that if you are treatment resistent, it could be 25 years before you hit the right combo. If you look at Preskorn's column "Do you feel lucky" (www.preskorn.com/columns/9801.html), he does the math using 600 possible drugs in combinations of 2, 3, 4 and 5. The odds of hitting the right combo is 1 in 179,000; 1 in 35,820,200; 1 in 5,346,164,850 and 1 in 637,262,850,120. My thought when I read this was, well why is he using a universe of 600 drugs? I mean I have eliminated certain classes of drugs (SSRI's) by this time and why not just look at the big players. So I took my remaining drugs to try short list drawing from the categories of stimulants, MAOs and Anticonvulsants. I came up with a list of say 18 drugs to try in various combos (hey, this is already much better than 600, right?). Then I eliminated those drugs on the list that I had already tried unsuccessfully. Now my list is down to 10 drugs to try in various combos--not too many right? Ok, but when you crank out the math, my odds using a two drug combo are 1 in 45 and using a three drug combo are 1 in 240. Well, you get the drift, we could be going through trials a long long long long time if we do "adequate" trials. There is a fallacy in this thinking, but I think it is small. The fallacy is that once you eliminate a drug b/c of side effects, you don't need to include it in combos and Preskorn's formula (which is pure statistics) does not take this into account. However, my use of just 10 drugs is surely too small as well so it all evens out in the wash.
....Lorraine,
There is a fallacy in the original calculation too and I think it's a big one. It's the assumption that there is only one combination that will work. Probably there are many. There is so much overlap in what these drugs do.Jane
Posted by Lorraine on August 25, 2001, at 0:44:30
In reply to What IS the MARTIN JENSEN bk about?!, posted by Janelle on August 24, 2001, at 22:52:17
It is called "Diagnosis & treatment of Brain chemical Imbalance" It is not in bookstores. You can order it from his office: 949-363-2600. It is a self-published book of around 350 pages bound with those curly things on the side.
Posted by Lorraine on August 25, 2001, at 0:49:03
In reply to Re: martin jensen book - » Lorraine, posted by Jane D on August 24, 2001, at 23:05:49
> > > Lorraine,
> There is a fallacy in the original calculation too and I think it's a big one. It's the assumption that there is only one combination that will work. Probably there are many. There is so much overlap in what these drugs do.I do sooooo hope you are right. In my 7 years of depression, I have only had one drug work and it no longer works on me. So while I hope you are right and in theory you should be, I'm pretty sensitive to a lot of meds and the side effects become unbearable. I now have a terminal arm rash < vbg > that is going to bounce me off Parnate tomorrow. Argh!
Posted by JohnL on August 25, 2001, at 6:11:04
In reply to What IS the MARTIN JENSEN bk about?!, posted by Janelle on August 24, 2001, at 22:52:17
> I can't quite get a handle on what this book is all about from the posts here - could someone indicate what it discusses and what the TITLE is? Is it available in large bookstores? Thanks.
The book is called "The Successful Treatment of Brain Chemical Imbalance". Last time I looked it was available at Amazon.com, and also in local retail stores. The quickest easiest way to get it though is directly from his website. It is very reasonably priced.
There are several basic ideas in the book, listed below:
1. The closer a drug is to targeting the real underlying chemistry problem, the quicker it will work and the better it will be tolerated.
2. The farther away a drug is from targeting the real underlying chemistry problem, the longer it will take to work, if it ever works at all. The drug can work, but does so indirectly through chain reaction domino effects, resulting in delayed response, or no response, and increased side effects.
3. There are ten different general categories of brain chemical imbalance, all of which can result in similar psychiatric symptoms. For example, while most doctors treat depression with SSRIs, that assumes a chemistry of low serotonin, which is only one of ten possible general problem areas.
4. Rapid fire trials of drugs are tried in order to weed out the duds and to highlight the good ones. This is for comparison. Generally three drugs from each category are tried. Then later you go back and choose the favorites for longer term trials. There are superior matches and inferior matches. Quick trials can separate the two, because superior matches almost always show some kind of hint of a good response in a very short time (which relates to #1 above). When a drug happens to hit a bullseye, it is usually quite obvious and encouraging. Longer trials are still needed for full response, but the short trials allow you to eliminate inferior matches to shorten the list of drugs to consider.
5. All responses to drugs, whether they be bad, good, or neutral, provide clues as to what the real underlying chemistry problem might be. The book helps provide ways of looking for the clues and understanding what they mean.While Jensen uses 5 day short trials to identify the superior matches, I personally think it should be about 2 weeks. So I modified his strategy for myself to two weeks. The cool thing about his method is that it is not written in stone, it can be customized to fit each individual patient. The general principles still apply, but you can modify or vary the details.
I have a lot of psychiatric books. But if I had to choose to keep just one, Jensen's book would be the one. It is the only one that provides realworld down to earth methods and strategies to make this hit-and-miss game have some reason to it. Other books are great for theory and general principles, but Jensen's book is great for hands on details. It is designed purely to help a patient get well in the shortest amount of time, and it provides all the tools to accomplish that.
John
Posted by Dr. Bob on August 25, 2001, at 8:07:27
In reply to What IS the MARTIN JENSEN bk about?!, posted by Janelle on August 24, 2001, at 22:52:17
> Is it available in large bookstores?
Why go to a large bookstore when you can order right here? And help support this site. :-)
http://www.dr-bob.org/books/babble.html
Bob
Posted by Lorraine on August 25, 2001, at 10:56:07
In reply to Re: What IS the MARTIN JENSEN bk about?!, posted by JohnL on August 25, 2001, at 6:11:04
> > > I have a lot of psychiatric books. But if I had to choose to keep just one, Jensen's book would be the one. It is the only one that provides realworld down to earth methods and strategies to make this hit-and-miss game have some reason to it. Other books are great for theory and general principles, but Jensen's book is great for hands on details. It is designed purely to help a patient get well in the shortest amount of time, and it provides all the tools to accomplish that.
> JohnI agree, John. See my message earlier on 8/24--it responds to many of your points but I didn't put your name in the subject because I wanted it addressed to the thread generally.
Lorraine
Posted by Lorraine on August 25, 2001, at 10:56:57
In reply to Re: available here, posted by Dr. Bob on August 25, 2001, at 8:07:27
> > Is it available in large bookstores?
>
> Why go to a large bookstore when you can order right here? And help support this site. :-)
>
> http://www.dr-bob.org/books/babble.html
>
> Bob
Posted by susan C on August 25, 2001, at 13:49:04
In reply to Re: What IS the MARTIN JENSEN bk about?!, posted by JohnL on August 25, 2001, at 6:11:04
John Thank you for a summary, I appreciate the benerit of your experience...a question for you...how can you get to maximum dose in only 2 weeks, or fivce days...I often have SE if I go up to quickly, I did a trial of 5 months on depakote to find possible amount, after 4 weeks showed it helped some, with what i like to call 'reluctant' side effects. Meaning: the slight benefit is better than the non overwhelhming side effects...I have the book on my list to investigate and Dr dash bob, I will order it through your link :o)
Susan C.> > I can't quite get a handle on what this book is all about from the posts here - could someone indicate what it discusses and what the TITLE is? Is it available in large bookstores? Thanks.
>
> The book is called "The Successful Treatment of Brain Chemical Imbalance". Last time I looked it was available at Amazon.com, and also in local retail stores. The quickest easiest way to get it though is directly from his website. It is very reasonably priced.
>
> There are several basic ideas in the book, listed below:
>
> 1. The closer a drug is to targeting the real underlying chemistry problem, the quicker it will work and the better it will be tolerated.
> 2. The farther away a drug is from targeting the real underlying chemistry problem, the longer it will take to work, if it ever works at all. The drug can work, but does so indirectly through chain reaction domino effects, resulting in delayed response, or no response, and increased side effects.
> 3. There are ten different general categories of brain chemical imbalance, all of which can result in similar psychiatric symptoms. For example, while most doctors treat depression with SSRIs, that assumes a chemistry of low serotonin, which is only one of ten possible general problem areas.
> 4. Rapid fire trials of drugs are tried in order to weed out the duds and to highlight the good ones. This is for comparison. Generally three drugs from each category are tried. Then later you go back and choose the favorites for longer term trials. There are superior matches and inferior matches. Quick trials can separate the two, because superior matches almost always show some kind of hint of a good response in a very short time (which relates to #1 above). When a drug happens to hit a bullseye, it is usually quite obvious and encouraging. Longer trials are still needed for full response, but the short trials allow you to eliminate inferior matches to shorten the list of drugs to consider.
> 5. All responses to drugs, whether they be bad, good, or neutral, provide clues as to what the real underlying chemistry problem might be. The book helps provide ways of looking for the clues and understanding what they mean.
>
> While Jensen uses 5 day short trials to identify the superior matches, I personally think it should be about 2 weeks. So I modified his strategy for myself to two weeks. The cool thing about his method is that it is not written in stone, it can be customized to fit each individual patient. The general principles still apply, but you can modify or vary the details.
>
> I have a lot of psychiatric books. But if I had to choose to keep just one, Jensen's book would be the one. It is the only one that provides realworld down to earth methods and strategies to make this hit-and-miss game have some reason to it. Other books are great for theory and general principles, but Jensen's book is great for hands on details. It is designed purely to help a patient get well in the shortest amount of time, and it provides all the tools to accomplish that.
> John
Posted by JohnL on August 25, 2001, at 14:06:03
In reply to Re: What IS the MARTIN JENSEN bk about?! John, posted by susan C on August 25, 2001, at 13:49:04
Susan,
I don't think many of us could get up to the maximum dose in such a short amount of time. The thing is though, when the right med is stumbled on to, even just a small dose will show some positive results. The whole idea is to weed out inferior matches. Superior ones should be the ones that give at least a hint of improvement in 2 weeks or less on even small doses.For example, it took me three months on 20mg Paxil for it to do anything. But with Prozac, a mere 2.5mg gave me more benefit in three days than a full dose of Paxil did in three months. The reason I started with just 2.5mg was because, like you, I was sensitive to side effects.
So Prozac was the superior match for me, Paxil was the inferior match. Prozac was deserving of a longer trial at higher doses. Eventually I worked up to 20mg Prozac. But regardless, I knew I was on to something good when Prozac gave me noticeable improvement at such a small dose in such a short time. That's what we're looking for in Jensen's strategies. We just want to weed out the duds and try to uncover the good ones. The good ones will make themselves known even at small doses.
Good question by the way. I find it difficult to explain in writing.
> John Thank you for a summary, I appreciate the benerit of your experience...a question for you...how can you get to maximum dose in only 2 weeks, or fivce days...I often have SE if I go up to quickly, I did a trial of 5 months on depakote to find possible amount, after 4 weeks showed it helped some, with what i like to call 'reluctant' side effects. Meaning: the slight benefit is better than the non overwhelhming side effects...I have the book on my list to investigate and Dr dash bob, I will order it through your link :o)
> Susan C.
Posted by Janelle on August 25, 2001, at 17:06:02
In reply to martin jensen book - Elizabeth, Lorraine, others?, posted by may_b on August 24, 2001, at 11:03:53
Thanks for all the great info and summary about the Martin Jensen book - I'm going to look into getting it although my finances are SEVERELY limited. I agree with you 100% that Jensen's "5 day rapid trials" should really be more like TWO WEEK trials - that's what I've done (2-3 weeks), and after the initial side effects which happen (at least to me) immediately, I basically "know" by the next couple of weeks if the med is going to do anything or not. Thanks again for your respponse under here!
-Janelle
Posted by Janelle on August 25, 2001, at 17:21:57
In reply to Re: available here, posted by Dr. Bob on August 25, 2001, at 8:07:27
I couldn't get to the book site from the link given here, so I clicked on books and saw that the link should be:
Posted by Mitch on August 26, 2001, at 13:15:53
In reply to Re: What IS the MARTIN JENSEN bk about?!, posted by JohnL on August 25, 2001, at 6:11:04
John,
Thanks for that information. I have been on some type of polypharmacy for years now and I would have to agree with that philosophy whole-heartedly. I *never* have taken a med that I had a clearly unpleasant reaction to that ever turned into anything resembling efficacy.
Mitch
Posted by Zo on August 26, 2001, at 16:14:28
In reply to Re: What IS the MARTIN JENSEN bk about?! » JohnL, posted by Mitch on August 26, 2001, at 13:15:53
For years a very intuitive friend and I secretly applied our own "Jensen Method". . .not only because it was immensely easier on us (med trials suck) (can I say suck?) -- and who would believe this, for not only were we nutsos, we were FEMALE nutsos -- but we each could tell immediately, like on the first day, if a med was gonna fly. The body speaks! Sometimes it would take another few weeks for the positive result to reappear. But bodily intuition is as the best guidance you're ever going to get. By now, I routinely use it to run my meds and supplements, not only what to take but how much. One way through the vast thicket.. . .
Zo
Posted by Dr. Bob on August 26, 2001, at 21:07:31
In reply to Re: available here- LINK wrong;should BE: » Dr. Bob, posted by Janelle on August 25, 2001, at 17:21:57
> I couldn't get to the book site from the link given here, so I clicked on books and saw that the link should be:
>
> http://www.dr-bob.org/books/babble.htmlOops, thanks for pointing that out. ^ the above version, with the ".html", will take you directly to the recommendations from Babblelanders.
Bob
Posted by SLS on August 26, 2001, at 23:39:23
In reply to Re: Women's Intuition, posted by Zo on August 26, 2001, at 16:14:28
> For years a very intuitive friend and I secretly applied our own "Jensen Method". . .not only because it was immensely easier on us (med trials suck) (can I say suck?) -- and who would believe this, for not only were we nutsos, we were FEMALE nutsos -- but we each could tell immediately, like on the first day, if a med was gonna fly. The body speaks! Sometimes it would take another few weeks for the positive result to reappear. But bodily intuition is as the best guidance you're ever going to get. By now, I routinely use it to run my meds and supplements, not only what to take but how much. One way through the vast thicket.. . . > > Zo
Dear Zo,Thanks for posting your thoughts and experiences. You are definitely not nutsos. Your intuition rings true with what I have seen for myself.
I think what you describe is exactly what Dr. Jensen looks for within the first five days of treatment. I believe that this type of initial "blip" can be a valid prognosticator of eventual response to a medication. It might very well be a consistent phenomenon for a certain percentage of people. The problem is, just how large a percentage of people will always experience a brief positive effect from the drugs that they will later respond to? How large a percentage of people will not experience a blip from any medication, yet respond to almost all of them? I think it is absolutely imperative to determine the answers to these questions, whether it be through retrospective analyses of case histories or prospective double-blind studies. Otherwise, some very easily treatable people will end up going through half a dozen drugs before their doctors get the bright idea of continuing at least one of them for longer than five days.
To me, five day trials might make sense. Two week trials definitely don't.
- Scott
Posted by JohnL on August 27, 2001, at 3:36:24
In reply to Re: Women's Intuition - You've got my vote!, posted by SLS on August 26, 2001, at 23:39:23
>The problem is, just how large a percentage of people will always experience a brief positive effect from the drugs that they will later respond to?***Most. No percentage given. Based purely on adecdotal evidence from this board and from my own doc's office.
>How large a percentage of people will not experience a blip from any medication, yet respond to almost all of them?
***None. Again, anecdotal. In these cases, the response is hardly ever, if ever, a full adequate response.
>I think it is absolutely imperative to determine the answers to these questions, whether it be through retrospective analyses of case histories or prospective double-blind studies. Otherwise, some very easily treatable people will end up going through half a dozen drugs before their doctors get the bright idea of continuing at least one of them for longer than five days.
***If they are so easily treatable, then they will logically pass the 5 day test with flying colors. They can weed out a bunch of inferior match drugs and focus on superior ones in the same time it would take someone else to try just one.
> To me, five day trials might make sense. Two week trials definitely don't.***Though we disagree a little on the length of a trial period, it's nice to see you coming around. I remember months ago you were dead set on full 8 week trials being the only way to treat anyone. You scoffed very loudly at short trials. It's nice to see your horizons and insight have broadened.
>
>
> - Scott
Posted by SLS on August 27, 2001, at 9:50:40
In reply to Re: Women's Intuition - You've got my vote!, posted by JohnL on August 27, 2001, at 3:36:24
Hi John.
> >The problem is, just how large a percentage of people will always experience a brief positive effect from the drugs that they will later respond to?> ***Most. No percentage given. Based purely on anecdotal evidence from this board and from my own doc's office.
You will forgive me if I deem what you call evidence as perhaps specious, given the magnitude of the consequences should you be wrong. I would be more comfortable with at least a compilation of these anecdotes and some reasonable accounting for the total population from which it is derived. Even so, I doubt you would accept as fact a contention of mine if I were to tell you that I have sufficient proof purely from evidence on this board and from my own doc's office, especially if doing so would sabotage your treatment.
> >How large a percentage of people will not experience a blip from any medication, yet respond to almost all of them?
> ***None.
***OK, if you say so.
> Again, anecdotal. In these cases, the response is hardly ever, if ever, a full adequate response.
Again, I find this specious. You can't possibly make such a statement without either citing specific data or practicing psychiatry for a number of years and drawing upon your clinical experience. I can hardly believe that you are writing this stuff. I sometimes think that your sincere and passionate desire to help people draws you towards immoderation.
> >I think it is absolutely imperative to determine the answers to these questions, whether it be through retrospective analyses of case histories or prospective double-blind studies. Otherwise, some very easily treatable people will end up going through half a dozen drugs before their doctors get the bright idea of continuing at least one of them for longer than five days.
> ***If they are so easily treatable, then they will logically pass the 5 day test with flying colors.
I am quite baffled by your logic. It seems to me that such can only be determined empiracally. Besides, that a conclusion is derived from logic does not necessitate its veracity. Ptolemy produced an absolutely brilliant model of the solar system using a logical construction of epicycles to explain planetary motion. It worked very well and proved that the Earth was at the center of the Universe.
> They can weed out a bunch of inferior match drugs and focus on superior ones in the same time it would take someone else to try just one.
> > To me, five day trials might make sense. Two week trials definitely don't.
> ***Though we disagree a little on the length of a trial period,
I don't know if you have taken notice, but you also disagree strongly with the man whom you deem smart enough to know more about treating depression than most of the rest of the psychiatric world. I guess Dr. Jensen should just take your word for it because of your purely anecdotal evidence. He probably just threw a pair of dice across the room and came up with a 2 and a 3.
> it's nice to see you coming around.
Actually, I think it is you who have not yet come around to accept Martin Jensen's drug screening protocol. As I have emphatically noted in previous threads, 5 day trials mean 5 day trials - not 2 week trials. His method makes sense. Yours does not. I would be most appreciative if you would retrieve Dr. Jensen's book from your trash and send it to me.
> I remember months ago you were dead set on full 8 week trials being the only way to treat anyone.
I think if you were to go back and read more closely my posts, you would find this statement to be inaccurate.
> You scoffed very loudly at short trials.
At times. I have also remained open and genuinely inquisitive. I was motivated enough to discover if there was data to be retrieved from this board to lend support to investigate Jensen's ideas further. I am usually pretty motivated to seek the truth, especially when it might improve so greatly the quality of my life.
Quite a while ago, I established a basis by which a structured discussion of Dr. Jensen's treatment protocol might be conducted. I delineating a set of categories of drugs to be considered - standard antidepressants (which I defined in a list), psychostimulants, antipsychotics, anticonvulsants, etc.) and suggested a series of questions that I thought would help to more precisely define the points of issue and the data to be considered. I also invited and strongly encouraged others to evaluate and modify my questions and the manner of investigation. I think I actually tried to develop a survey for people posting on PsychoBabble to submit in an effort to gather data instead of relying upon my memory and my subjective impressions of the posts I selected to read.
No one bothered. Not even you.
http://www.dr-bob.org/babble/20000429/msgs/32396.html
> It's nice to see your horizons and insight have broadened.What do you know of my insights?
Hmmm.
I probably lean towards a reliance upon current medical consensus. I tend to give established investigative institutions and mainstream medicine the benefit of the doubt. Although I don't always agree with them, I always try to respect them.
*** By the way - before I forget - how many 2 week trials showing a trend towards improvement do you terminate before you determine that you have screened enough candidates to choose among them the "best match". (See below)
4-5 day trials make more sense to me - that is, if Jensen knows what he's talking about. I can't know for sure without reading his book, but from how you have described it, I think you may be missing his point and with it the very foundation of his treatment method. I don't think you should modify it to 2 weeks. It defeats the purpose and is counterproductive.
Thanks for your insights regarding my insight.
- Scott
---------------------------------------------------
From:http://www.dr-bob.org/babble/20010822/msgs/76327.html
"4. Rapid fire trials of drugs are tried in order to weed out the duds and to highlight the good ones. This is for comparison. Generally three drugs from each category are tried. Then later you go back and choose the favorites for longer term trials. There are superior matches and inferior matches. Quick trials can separate the two, because superior matches almost always show some kind of hint of a good response in a very short time (which relates to #1 above). When a drug happens to hit a bullseye, it is usually quite obvious and encouraging. Longer trials are still needed for full response, but the short trials allow you to eliminate inferior matches to shorten the list of drugs to consider."
Posted by SLS on August 28, 2001, at 8:23:34
In reply to Re: Women's Intuition, posted by Zo on August 26, 2001, at 16:14:28
> For years a very intuitive friend and I secretly applied our own "Jensen Method". . .not only because it was immensely easier on us (med trials suck) (can I say suck?) -- and who would believe this, for not only were we nutsos, we were FEMALE nutsos -- but we each could tell immediately, like on the first day, if a med was gonna fly. The body speaks! Sometimes it would take another few weeks for the positive result to reappear. But bodily intuition is as the best guidance you're ever going to get. By now, I routinely use it to run my meds and supplements, not only what to take but how much. One way through the vast thicket.. . .
>
> Zo
Hi Zo.What drugs did you finally end up with? Can you describe the course of your response over time?
Thank you.
- Scott
Posted by Zo on August 28, 2001, at 15:18:13
In reply to Re: Women's Intuition » Zo, posted by SLS on August 28, 2001, at 8:23:34
We've certainly gotten better than we ought to, Pat and I. Both 20 year CFS vets, and we have lives. Don't know if you know much about CFS, but people usually don't. This is in large part because we continue to press on, and are both fortunate to work with a premier med pdoc, who *expects* our treatment to evolve over time, as it has. Meds get changed, they do their work and something else is needed. Better meds come on the market. I'd go mad if I didn't have some inner guidance on what to try and how much to take. I combine his suggestions with my intuition.
It's not hard to find these methods of checking with your body, and I if my body says No over a period of time, I don't even bother swallowing a test pill. Me, I use the breath. One way is to close your eyes, get quiet, and ask yourself, What is my Yes? Feel what that feels like. Then ask, and what is my No? Try it a few times. You may find a sinking feeling on No. A rising, glad feeling or breath for Yes. Others feel it in their overall balance; they seem to balance freely, even sway a little, with something their body wants, and feel their legs get locked and heavy on No.
This all began when some of us,*desperate* to figure out what to take, back in the '80s when AD side effects just sucked, looked for a way to use Applied Kinesiology on ourselves. Since then, it's become so much a part of my program, I can trust it for meds, doses, and follow it implicity, unless I'm sick or occasionally proved wrong. It isn't infallible, but it's more reliable, because it comes from within *you*, than someone else's guess.
Plus it saves a *lot* of money at the health food store. Who *is* that lady standing quietly at the vitamin shelves? By now, I just have to hold a bottle next to my gut, my solar plexus.
Lest you think this the thinking of a New Age Flake, I assure you. I long ago realized if I was gonna get out of this mess, I had pick the cream of every crop, scientific, psychological, spiritual whatever spoke to me. . .and be very careful about what I rejected.
Which I think is part of the healing itself. . .to become more Whole. Which suggests, doesn't it, a gathering, an inclusion.
I think this might be much harder for men to adopt, and to do. . but would happily be proved wrong about that.
Zo
Posted by Phil on August 28, 2001, at 20:23:03
In reply to Re: Using The Breath - long » SLS, posted by Zo on August 28, 2001, at 15:18:13
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.