![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 2 to 26 of 33. Go back in thread:
Posted by yxibow on January 18, 2009, at 3:26:32
In reply to Risk of sudden death?, posted by Deneb on January 18, 2009, at 2:26:47
> I read people who take new antipsychotics still have an increased risk of death from heart problems.
>
> I read 2 out of 1000 people die suddenly and that the risk is doubled.
>
> How worried should I be? I take Risperdal.If you're really worried about this why not get an EKG some time soon or at your next physical/doctor's appointment? Do you have heart troubles, or in your family ? Have you had any other history of QTc prolongation ?
If one out of every 500 people died suddenly from no drug related cause this country would have quite a declining population rate. I'm not quite sure where that statistic came from?
I know there was a finding from some journal in the past few days that yes, QTc prolongation is quite possible in atypicals just as it can happen in old line antipsychotics. On the other hand, Geodon was retested in a 4000 person study and the risk was found to be very minimal. Mellaril, an old antipsychotic, still continues to be used, even though it carries a much greater risk of QTc prolongation.
If the conclusion of the study was that one out of every 250 patients died suddenly I don't think there would be any antipsychotics on the market. That's a pretty extreme scenario.
I think what you're referring to is Torsades de Pointes, that was associated in Geodon and some other antipsychotics, although the original study in Geodon placed it around 1 in 4000 and I believe the study that put it back on the market concluded that it was less than that.
I think there are risks and side effects that are greater with Risperdal such as fairly high EPS and up to a 5% risk of tardive disorders. That doesn't mean that you will get any of the above especially at a minimum effective dose (MED).
I'm not trying to minimize your concern, but life is inherently both filled with risks and benefits.
So while prudence is always a good thing, I don't think that if Risperdal is working well for you that you should worry about sudden death. Yes, the chance of death is always greater in heart patients and elderly people, that is the facts of life, but going to sleep worried that you won't see the sun is not very productive I think.
In an average marathon something like 1 out of 200,000 people statistically can die. The risk of dying from cancer from chronic cigarette smoking is fairly high, depending how long one lives. As is the risk of car crashes vs. airplane travel. It comes down I think to an ultimate feeling of wanting control.
And I can understand that because control is a feeling of empowerment over your life.I guess I'm just trying to put it in perspective that everything has its risks, but never following paths can leave one behind.
Millions of people by now have taken Risperdal, it is one of the oldest atypicals and is now generic.
I hope I've offered some possible ways of viewing things and of course I wish you the best whatever choice you want to make.
-- tidings
Jay
Posted by Trans-Human on January 18, 2009, at 7:32:42
In reply to Re: Risk of sudden death? » Deneb, posted by yxibow on January 18, 2009, at 3:26:32
The dangers of anti-psychotics are very well documented. & you do not need to search far to find the Zyprexa Kills Campaign.
http://www.youtube.com/watch?v=3V1hXhX26Gw
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=364x2978394
Posted by Deneb on January 18, 2009, at 12:01:09
In reply to Re: Risk of sudden death? » Deneb, posted by yxibow on January 18, 2009, at 3:26:32
Thanks Jay. That was very informative.
This is where I read it:
http://health.yahoo.com/news/ap/med_anti_psychotic_drugs.html
I made a mistake, it's 3 out of ever 1000 people who take the drugs who suddenly die.
I think I am OK with sudden death though.
Posted by Deneb on January 18, 2009, at 12:13:32
In reply to Re: Risk of sudden death?, posted by Trans-Human on January 18, 2009, at 7:32:42
I didn't know the risk of TD was that high.
I get some weirdness with my movement. Sometimes my hands tremor, a lot, like so much I can barely use a fork.
I also get this weird thing where when I walk down the stairs, I am kind of jerky.
I've asked my pdoc about this and she says my dose is too low to cause these things. She says it's anxiety or maybe my two SSRIs that cause it.
Posted by Trans-Human on January 18, 2009, at 17:28:42
In reply to Re: Risk of sudden death? » Trans-Human, posted by Deneb on January 18, 2009, at 12:13:32
> I didn't know the risk of TD was that high.
>Unfortunately yes.
> I get some weirdness with my movement. Sometimes my hands tremor, a lot, like so much I can barely use a fork.
>
> I also get this weird thing where when I walk down the stairs, I am kind of jerky.
>
> I've asked my pdoc about this and she says my dose is too low to cause these things. She says it's anxiety or maybe my two SSRIs that cause it.Poor you. I have in times past had very bad side effects from meds; & I get side effects from what I presently take too. Personally; I don't treat the word of most doctors & psychiatrists with a very high regard. They are not known for their honesty.
Posted by yxibow on January 20, 2009, at 1:31:39
In reply to Re: Risk of sudden death? » Trans-Human, posted by Deneb on January 18, 2009, at 12:13:32
> I didn't know the risk of TD was that high.
>
> I get some weirdness with my movement. Sometimes my hands tremor, a lot, like so much I can barely use a fork.
>
> I also get this weird thing where when I walk down the stairs, I am kind of jerky.
>
> I've asked my pdoc about this and she says my dose is too low to cause these things. She says it's anxiety or maybe my two SSRIs that cause it.
I hadn't had time to digest through all of this so I don't know how inflated the risk of TD was mentioned in these "underground" sites, but the accepted amount in the evidence based psychiatry community is up to 25% per year for the old line antipsychotics, and 5% per year for atypicals.Only Risperdal has been proven so far to cause a clinically significant amount of TD.
Yes, TD is a risk of all antipsychotics, and risks and benefits have to be weighed by the individual patient.
If you extrapolate the relative risks of how strong agents are and how they present EPS, Risperdal would probably represent the most risk and Zyprexa, which has had an extensive study by the British Journal of Psychiatry to average to about 0.5% per year, Seroquel has probably the lowest risk of TD of any antipsychotic besides Clozaril.
This doesn't mean incidents can't occur -- I have had the unfortunate result of a /non/-tardive tic from Seroquel and a /possible/ tardive dystonia (stiffness in my legs mostly) from one month of Zyprexa. But then my response with EPS is rather high and this is such a unseen response.
Everyone has a freedom to speak about how they want to on these issues, but mrm... I don't know how I'm going to say these things with out breaking "civility",it really makes me feel very constricted when I can't point out that some so-called doctors are firebrands and don't back up their "studies" with good science because of how it might be interpreted by board rules,
Dr. Breggin is well known for years to be an extremely untrustful and inflammatory individual about a lot of psychiatric issues and is.... a well, "quack" by some standards. I'll leave it there.
-- tidings
Jay
Posted by Trans-Human on January 20, 2009, at 6:50:13
In reply to Re: Risk of sudden death?, posted by yxibow on January 20, 2009, at 1:31:39
> Everyone has a freedom to speak about how they want to on these issues, but mrm... I don't know how I'm going to say these things with out breaking "civility",
>
> it really makes me feel very constricted when I can't point out that some so-called doctors are firebrands and don't back up their "studies" with good science because of how it might be interpreted by board rules,
>
> Dr. Breggin is well known for years to be an extremely untrustful and inflammatory individual about a lot of psychiatric issues and is.... a well, "quack" by some standards. I'll leave it there.
>
> -- tidings
>
> JayYou are entitled to an opinion - & an opinion is what it is. Dr Breggin is a trained professional with impeccable & extensive qualifications; & considerable clinical experience; his research & understandings are backed by real world scientific study.
The only reason why some choose to refer to him as a "quack" is the same reason; that anything that doesn't adhere to the limited scientific reductionist/Bio-Chemical model of orthodox psychiatry & pays homage to medication - is referred to as quackery. Even much which is in opposition to the orthodox psychiatric model; which holds far more water; is simply ignored or written off.
IMO - The Orthodox psychiatric scientific reductionist/Bio "Chemical" view of mental illness - is the one which is seriously flawed, miss-guided; causes the most damage, & has got the most very narrow perspective on things.
But, each to their own.
Yo have no idea as to the constriction I feel & many others do in relation to the blind adherence to & dominance of the purely materialistic faith so many have put in biological psychiatry. Frustration to say the least.
Posted by Deneb on January 20, 2009, at 10:44:18
In reply to Re: Risk of sudden death? » yxibow, posted by Trans-Human on January 20, 2009, at 6:50:13
OK, I just saw pdoc. I talked to her about the risk of sudden death and she knows about the study. She said my risk is basically zero and the people who suddenly die are elderly, who are at risk of sudden death anyways.
Posted by Trans-Human on January 20, 2009, at 10:51:08
In reply to Re: Risk of sudden death?, posted by Deneb on January 20, 2009, at 10:44:18
> OK, I just saw pdoc. I talked to her about the risk of sudden death and she knows about the study. She said my risk is basically zero and the people who suddenly die are elderly, who are at risk of sudden death anyways.
>
>
They are good aren't they.
Posted by Trans-Human on January 20, 2009, at 11:30:33
In reply to Re: Risk of sudden death?, posted by Deneb on January 20, 2009, at 10:44:18
My psychiatrist told me on Monday, that there are No withdrawal effects from stopping any psychiatric medication. That any "symptom" from stopping a psychiatric med is in fact psychiatric illness.
Good aren't they; they told me that with a straight face.
You have to admire the mentality of such things.
I've been trying to figure out if they actually believed what they were saying - or it is a case of pathologicaly ignoring, denying & rejecting facts & reality. A mixture of both I would think.
I didn't argue the toss - what's the point?
Posted by gardenergirl on January 20, 2009, at 13:43:17
In reply to Re: Risk of sudden death?, posted by Trans-Human on January 20, 2009, at 11:30:33
> My psychiatrist told me on Monday, ... Good aren't they; they told me that with a straight face.
> I've been trying to figure out if they actually believed what they were saying ...I'm confused. Was "psychiatrist" in your first sentence supposed to have been plural? Otherwise, how did one person become "they"?
gg
Posted by Trans-Human on January 20, 2009, at 17:20:39
In reply to Re: Risk of sudden death? » Trans-Human, posted by gardenergirl on January 20, 2009, at 13:43:17
> > My psychiatrist told me on Monday, ... Good aren't they; they told me that with a straight face.
> > I've been trying to figure out if they actually believed what they were saying ...
>
> I'm confused. Was "psychiatrist" in your first sentence supposed to have been plural? Otherwise, how did one person become "they"?
>
> ggSemantics - I was referring to psychiatrists in general with the "They".
"They" can also be used in the singular - they used to go shopping...ect.
Posted by yxibow on January 21, 2009, at 2:49:36
In reply to Re: Risk of sudden death? » yxibow, posted by Trans-Human on January 20, 2009, at 6:50:13
> > Everyone has a freedom to speak about how they want to on these issues, but mrm... I don't know how I'm going to say these things with out breaking "civility",
> >
> > it really makes me feel very constricted when I can't point out that some so-called doctors are firebrands and don't back up their "studies" with good science because of how it might be interpreted by board rules,
> >
> > Dr. Breggin is well known for years to be an extremely untrustful and inflammatory individual about a lot of psychiatric issues and is.... a well, "quack" by some standards. I'll leave it there.
> >
> > -- tidings
> >
> > Jay
>
> You are entitled to an opinion - & an opinion is what it is. Dr Breggin is a trained professional with impeccable & extensive qualifications; & considerable clinical experience; his research & understandings are backed by real world scientific study.
>
> The only reason why some choose to refer to him as a "quack" is the same reason; that anything that doesn't adhere to the limited scientific reductionist/Bio-Chemical model of orthodox psychiatry & pays homage to medication - is referred to as quackery. Even much which is in opposition to the orthodox psychiatric model; which holds far more water; is simply ignored or written off.
>
> IMO - The Orthodox psychiatric scientific reductionist/Bio "Chemical" view of mental illness - is the one which is seriously flawed, miss-guided; causes the most damage, & has got the most very narrow perspective on things.
>
> But, each to their own.
>
> Yo have no idea as to the constriction I feel & many others do in relation to the blind adherence to & dominance of the purely materialistic faith so many have put in biological psychiatry. Frustration to say the least.
> You are entitled to an opinion - & an opinion is what it is. Dr Breggin is a trained professional with impeccable & extensive qualifications; & considerable clinical experience; his research & understandings are backed by real world scientific study.
>
> The only reason why some choose to refer to him as a "quack" is the same reason; that anything that doesn't adhere to the limited scientific reductionist/Bio-Chemical model of orthodox psychiatry & pays homage to medication - is referred to as quackery. Even much which is in opposition to the orthodox psychiatric model; which holds far more water; is simply ignored or written off.
>
> IMO - The Orthodox psychiatric scientific reductionist/Bio "Chemical" view of mental illness - is the one which is seriously flawed, miss-guided; causes the most damage, & has got the most very narrow perspective on things.
>
> But, each to their own.
>
> Yo have no idea as to the constriction I feel & many others do in relation to the blind adherence to & dominance of the purely materialistic faith so many have put in biological psychiatry. Frustration to say the least.
Yes, each to their own. The biochemical imbalance view of psychiatry is accepted by mainstream, evidence based psychiatrists. It doesn't really matter whether you were born with a tendency towards mental illness (which I was), or you have a PTSD episode after a tragic event, or some other psychological stimuli from the environment pushes against you, you still have a very real condition.And these very real conditions, have been proven at least since the very early days of OCD research. PET scans clearly illustrated activity in brain regions; whether SSRIs were used, or SSRIs and psychological treatment, usually CBT, or CBT alone, the differences became dramatic.
An organic disorder, such as a pheochromocytoma can also present itself with psychiatric manifestations. They're still affecting the same pathways and the same neurotransmitter system. And besides surgical and chemotherapeutic treatment of a tumor if feasible, certain psychiatric medications can make a person with an organic disorder that precipitates a psychiatric manifestation more functional, just as any of the other above scenarios. It doesn't mean it changes the origin, but maybe it can give someone the years they have a better feeling.
So one can believe or not what they want to believe about Breggin, but I can say for my -own- opinion that he is -potentially- a misleading risk for those who desperately need treatment.http://www.quackwatch.org/11Ind/breggin.html
Sure, he has a medical license in New York -- there are lots of doctors out there.
He was an "expert testifier" regarding Luvox and the Columbine killings and I believe did a disservice and distortion to testify for a survivor of the incident, which I do not blame for his grief and anger, but the gunmen (kids, really), could have taken any SSRI, and frankly could also have done this entirely on their own because of an undetected psychosis spectrum disorder.
Thus, Luvox fell off the earth eventually and became generic. I haven't heard of a lot of people who took fluvoxamine maleate go on double digit shooting sprees.
Of course tort was bound to come out after Columbine because each and every person wanted their /closure/, a concept that I don't really believe in because you will never really forget something, it just has to heal and it remains. I'm not trying to be indignant of the memories of the kids of Columbine.
I just think it was another opportune place for an "expert" who has his own journal and few publications compared to other professional society journals to sweep in.
Fluvoxamine still remains on the market and has been proven to be a pretty good agent for OCD as it was marketed, although other SSRIs are good in their own right.
Breggin admitted some ties in the past to Scient*l*gy (not going to go there because we're not allowed to since despite seizures of tons of tax evasion evidence and other FBI actions in the past they are a 501 (c) 'religion'...)
To each their own as has been said.
And I feel my own constriction here on the board because I have to tiptoe around things on a "medication" board which really should, with a healthy skepticism I fully agree, be devoted to people's experiences with their medication, which of course is different for everyone who takes a particular one.
Instead I see an increasing amount of topics that should really be debated on the alternative board and a bit of what I have to say, whether my tongue is tied by civility or not, anti-psychiatry.
-- tidings
-- Jay
Posted by Trans-Human on January 21, 2009, at 7:45:34
In reply to Re: Risk of sudden death? » Trans-Human, posted by yxibow on January 21, 2009, at 2:49:36
> And I feel my own constriction here on the board because I have to tiptoe around things on a "medication" board which really should, with a healthy skepticism I fully agree, be devoted to people's experiences with their medication, which of course is different for everyone who takes a particular one.
>
> Instead I see an increasing amount of topics that should really be debated on the alternative board and a bit of what I have to say, whether my tongue is tied by civility or not, anti-psychiatry.
>
> -- tidings
>
> -- JayThanks for the reply & I do appreciate your views. Breggin is controversial. I have tried & am trying to get as much perspective & balance as I can around the wide issues concerning mental health.
What I have been posting is my experience with medication; but it seems that anything that differs from a predominantly pro orthodox psychiatric, & pro med viewpoint is treated with disgust & disdain by the majority on this board.
As you say - biological psychiatry reigns supreme & is the accepted norm for understanding MH experiences (rightly or wrongly - & wrongly in my opinion, & the opinion of many others). I have never found that the strictly orthodox bio chemical model provides a very satisfactory explanation in my case. I know that I am very outspoken about this; whatever site I go on I am often met with disagreement; which ranges from irritation to outright hostility, but far from all do disagree. I find myself appeasing the orthodox view, pandering to it, & I tip toe about myself.
If the orthodox bio-medical model is so established & in line with the truth - then it should have no trouble standing up to anything - the truth is not fragile. But here is the problem; there are certain flaws & glaring issues with a purely bio chemical model. When I reasonably point these out; in a rational way - the points I simply raise, are either not acknowledged, ignored or flatly denied. This would be OK if what I am raising is nonsense; but quite the contrary; after 12 odd years of seriously study, investigation & research; I talk about things which have taken a great deal of thought to conclude; things which are corroborated with evidence.
OK - the Bio-Chemical model has a place; & for some; it is maybe the best course of action to take meds. But this Biological basis; however much people want to believe in it - is NOT categorically proved, nor established; whatever way you dress it up or try to present it. It is wrong to speak about the biological basis to "illness" such as Schizophrenia" especially, & other conditions; in terms which are solely reliant on the scientific reductionist viewpoint & as having a cause as a sole & purely biological basis. All evidence would suggest that the truth to these conditions is contrary to the generally accepted orthodox view.
To my own mind & understanding; instead of certain "alternative" views being rubbished, ignored, denied, ridiculed, & seen as quackery; it is instead the primarily orthodox view which is in reality as such; & not having a sound basis for what they claim as fact. It is certain "alternative" views which have a far sounder explanation based on truth.
In my own experience; everything which has genuinely helped me has come from outside of the framework of orthodox psychiatry. In fact I have been damaged by the orthodox paradigm. Now this is my experience; & I fully acknowledge that experience is different for everyone. Many seem satisfied with the orthodox. Many as well, however are not.
Primarily I put my "Difficulties" down to multiple causes; primarily from certain life circumstances & issues, certain psychological processes; & other things. I think that a biological cause had very little to do with anything; yes; there have been aspects of altered brain chemistry; & certain genetic influences - but not; to my understanding; as primary cause. & yet what has been the treatment? Sections; forced treatment in the form of very powerful mind altering drugs; & a denial of any factors outside of the very narrow perception that everything I have I experienced has been the result of genetics & brain chemistry. Such a paradigm in relation to my treatment has been neither effective nor true.
& what has the result been? I'm dependant on meds. & consider that I have been severely damaged by 20 years at the hands of orthodox psychiatry.
Fine if people choose such treatments - I didn't; it was against my will. It constitutes an infringement of human rights. There should be an end to forced treatment; & a freedom for people to choose appropriate treatments for themselves. I think we are living in the dark ages as far as MH treatments are concerned; & if they human race survives; I think they will look back on these times; as we look back at treatments & asylums of the 17 & 1800's - as being barbaric & ineffectual.
I have considered not posting on this site any more. It appears to be predominantly fixated with promoting & extolling the bio-chemical model as god; at the exclusion of any intelligent discussion about any other factors, research & valid perceptions in the field of mental health. I think that taking this very fixed Bio-Medical perspective, at the exclusion of taking anything else into consideration; is skewed, unbalanced, & frankly dangerous; & constitutes extreme harm for many people. But such is the general consensus for so many on this uncivilised planet.
I would have personally thought that a med board would be the place that people could honestly & rationaly debate & acknowledge ALL the different angles & perspectives to the issues of mental health in relation to chemical interventions - obviously not.
Despite some people here being intelligent; & there being a few good people who post here. In general there is a very fixed & narrow agenda at work on this site; & it feels very wrong.
I hope what I have written can be acknowledged & respected as being a valid & intelligent position based upon awareness of the facts - but like most of what I have posted here - I very much doubt it will be taken that way.
Posted by seldomseen on January 21, 2009, at 8:35:53
In reply to Re: Risk of sudden death? » yxibow, posted by Trans-Human on January 21, 2009, at 7:45:34
In reality, you may be exactly right. A chemical imbalance may NOT be the *cause* of ANY mental illness.
However, IMO that unknown does not preclude a chemical-based *treatment* of it.
I'm not trying to convince you in any way, but would ask that you consider, as an example, angina and its treatment with nitroglycerine.
Nitroglycerine is converted to nitric oxide in the blood. This nitric oxide is an extremely potent vaso-dilator, so it dilates the blood vessels in the heart (and elsewhere), helps to restore blood flow and relieves the symptoms of angina.
Now, IMO there is very little convincing direct evidence that nitric oxide levels are lower in the blood vessels of patients with angina. Nitric Oxide is a very transiently formed gas that is metabolized almost immediately upon its formation. At present there is no standardized measure of nitric oxide levels directly in patients. In fact, most of the nitric oxide literature is based on inference, yet, clearly this gas has therapeutic benefit.
Nitric Oxide may or may not target the *cause* of angina, but it certainly treats the symptoms and has saved many many lives.
It may be that mental illness follows a similar paradigm and that all these drugs are treating the symptoms and not the cause of mental illness.
So I guess the questions we should be asking are (1) "do these psychiatric medications have therapeutic benefit?" In some patients they clearly do and (2) Do they target the underlying cause of mental illenss? Don't know.
Seldom.
Posted by Trans-Human on January 21, 2009, at 9:21:21
In reply to Re: Risk of sudden death? » Trans-Human, posted by seldomseen on January 21, 2009, at 8:35:53
> In reality, you may be exactly right. A chemical imbalance may NOT be the *cause* of ANY mental illness.
>
> However, IMO that unknown does not preclude a chemical-based *treatment* of it.
I disagree
> I'm not trying to convince you in any way, but would ask that you consider, as an example, angina and its treatment with nitroglycerine.
>
> Nitroglycerine is converted to nitric oxide in the blood. This nitric oxide is an extremely potent vaso-dilator, so it dilates the blood vessels in the heart (and elsewhere), helps to restore blood flow and relieves the symptoms of angina.
>
> Now, IMO there is very little convincing direct evidence that nitric oxide levels are lower in the blood vessels of patients with angina. Nitric Oxide is a very transiently formed gas that is metabolized almost immediately upon its formation. At present there is no standardized measure of nitric oxide levels directly in patients. In fact, most of the nitric oxide literature is based on inference, yet, clearly this gas has therapeutic benefit.
>
> Nitric Oxide may or may not target the *cause* of angina, but it certainly treats the symptoms and has saved many many lives.
>
> It may be that mental illness follows a similar paradigm and that all these drugs are treating the symptoms and not the cause of mental illness.
>
> So I guess the questions we should be asking are (1) "do these psychiatric medications have therapeutic benefit?" In some patients they clearly do and (2) Do they target the underlying cause of mental illenss? Don't know.
>
> Seldom.Fair enough. I acknowledge that; but the question is; does the fact that "some" having a benefit from medications; then justify the sole use of medications as the primary & often sole treatment of "mental illness". NO it does not!
In fact I would consider that only a small minority are genuinely assisted by meds.
When we have the evidence for other more holistic & "Jungian" based paradigms as being far more effective in the majority of cases for genuinely helping people - then such evidence is particularly damming of this over simplification & dominance of biological psychiatry.
I also do not think that it is accurate or good analogy to compare "mental illness" with purely biological conditions. I don't see the logic; & this is the point I have been trying to get across & which you acknowledge - "A chemical imbalance may NOT be the *cause* of ANY mental illness". If what may well be the case & Schizophrenia & other mental illnesses are not predominantly biological in cause; then orthodox medicine is barking up entirely the wrong tree.
You wouldn't say to someone with diabetes or angina that their condition is like Schizophrenia - so why say it the other way around? It doesn't make sense.
If taking Schizophrenia as having a primary psychogenic cause; which I believe to be the case - based on the evidence - then a purely biological understanding & treatment of it is plainly wrong & flawed.
You would not treat angina with counselling. So why when the evidence points to a non biological cause in schizophrenia is the primary treatment a chemical one.
I think this observation so obvious to my mind & understanding - that I cannot fathom why it isn't the generally accepted case of understanding.
I fully agree that medication is treating symptoms; that is why they are not & never will be a cure. & why for most; medication is no more than a sticking plaster on an open wound. What we should be focusing on is cause.
Posted by seldomseen on January 21, 2009, at 11:56:26
In reply to Re: Risk of sudden death? » seldomseen, posted by Trans-Human on January 21, 2009, at 9:21:21
Oh, I think there is a lot of merit in symptom based treatment only.
I think the goal of these meds is to alleviate suffering. Do meds do that for some people? Absolutely. Therefore it is my opinion that this tree needs to be "barked up". Is it the only tree that needs barking - absolutely NOT!
Does therapy work for some people? Absolutely.
Do meds & therapy work better together? Absolutely.
As far as the angina example, well, it was an example to illustrate how effective and *essential* a symptomatic treatment can be.
You wrote:
"If taking Schizophrenia as having a primary psychogenic cause; which I believe to be the case - based on the evidence - then a purely biological understanding & treatment of it is plainly wrong & flawed."This sentence I think illustrates the primary points of our contention/agreement. I think it is too early to say that the cause of schizophrenia is purely psychogenic, or purely biological, or purely anything. At present, I think the field is still arguing over *what* schizophrenia actually *is*.
I think the *appropriate* use of medication in the suffering patient *is* indicated, if for nothing else than symptom relief. But neither therapy nor medication should be used at the exclusion of the other.
Remember, it was only in 1993 that the national institute of mental health re-joined the NIH. It was at this time that the NIMH launched its current research emphasis and funding initiatives to even explore the biological basis for mental illness. That's only 16 years. In research time and effort, this field is still in its infancy. It will take some time to acquire enough data to say anything either way.
I also hear you loud and clear that if a patient is successfully treated with medication, then that may reduce the impetus for either the physician, scientist or patient to pursue other avenues that might actually cure the condition. One has to work against the "standard of care" model and demonstrate efficacy above and beyond that current model.
However, as you pointed out, a lot of patients *aren't* successfully treated. But in those that are, would you advocate cessation of meds in order to pursue other treatments? Would that even be ethical?
Seldom
Posted by Phillipa on January 21, 2009, at 12:32:08
In reply to Re: Risk of sudden death? » Trans-Human, posted by seldomseen on January 21, 2009, at 11:56:26
Seldomseem great post haven't read all threads but agree with you. Phillipa
Posted by Trans-Human on January 21, 2009, at 12:55:02
In reply to Re: Risk of sudden death? » Trans-Human, posted by seldomseen on January 21, 2009, at 11:56:26
> However, as you pointed out, a lot of patients *aren't* successfully treated. But in those that are, would you advocate cessation of meds in order to pursue other treatments? Would that even be ethical?
>
> Seldom
>Of course not; & I do know that for some; meds are quite probably the best option. I just don't think that these successes warrant exclusion to access of other forms of treatment; I think that there should be more acknowledgement of the different fields of approach to mental illness; & a recognition of the valid work which has been done by a few pioneering souls in the field of psychology. I see too much emphasis on the purely biological. & my own experience bears this out.
In 20 years of "Illness" - the only main treatment has been meds; it has taken 20 years & over 3 years of pressure from me & a waiting list to finally get to see a psychologist on a limited basis (10 odd sessions) - that is simply unacceptable.
None of the issues I have had in my life circumstances have ever been addressed; nor support offered from the orthodox. Issues which have obviously impacted my mental health; & opportunities to address these things have been denied me from the orthodox. Which is also totally unacceptable.
But I acknowledge your valid & honest points. There needs to be a balance & an end to "either or" thinking around these issues; anything which has a benefit to people experiencing "mental illness" needs consideration.
Thank you for the reply.
Posted by Larry Hoover on January 21, 2009, at 18:44:29
In reply to Re: Risk of sudden death?, posted by Trans-Human on January 21, 2009, at 12:55:02
I've abstracted a few of your comments from earlier posts.
> What I have been posting is my experience with medication; but it seems that anything that differs from a predominantly pro orthodox psychiatric, & pro med viewpoint is treated with disgust & disdain by the majority on this board.
I have to wonder if we've been reading posts on the same website. I haven't joined in any discussions with you in the past, perhaps because our interests are not congruent, but if anything the unorthodox gets a full hearing here.
As this is a medication board, it does seem reasonable to have a biological perspective dominant. There are other boards for other, errr less orthodox subject matter.
> But this Biological basis; however much people want to believe in it - is NOT categorically proved, nor established; whatever way you dress it up or try to present it. It is wrong to speak about the biological basis to "illness" such as Schizophrenia" especially, & other conditions; in terms which are solely reliant on the scientific reductionist viewpoint & as having a cause as a sole & purely biological basis. All evidence would suggest that the truth to these conditions is contrary to the generally accepted orthodox view.
The biological model is simply that. A model. All major medication discoveries with respect to mental illness have been serendipitous. Patients treated with a drug for active tuberculosis find that their mood improves. An allergy medication does similar. And so on. The truth, first and foremost, is that they improved the mood of users. Attempts to explain just what the drug might have affected to lead to the salutatory mood change are the underpinnings of the biological model. It's used as an hypothesis generator.
> I have considered not posting on this site any more. It appears to be predominantly fixated with promoting & extolling the bio-chemical model as god; at the exclusion of any intelligent discussion about any other factors, research & valid perceptions in the field of mental health.
I hope you don't go. You're well spoken, and passionate. I can only reiterate that you're most likely to encounter biological/medication discussion on this particular board. There are other topical discussions elsewhere on this site.
Lar
Posted by seldomseen on January 21, 2009, at 20:21:49
In reply to Re: Risk of sudden death?, posted by Trans-Human on January 21, 2009, at 12:55:02
Well then, as it turns out, we are in complete agreement. I think a variety of treatment options should be considered, employed and most *certainly* be available to us.
I think you are definately smart to push for a more comprehensive approach. I'm so sorry that you have to push so hard.
It's interesting (and I guess by interesting I mean sad) that those options were denied to you. To me, it's malpractice.
My story?
My mother is bipolar with psychotic episodes (whatever that means) and my father has some kind of new fangled rage disorder, I forget the name, but he's very explosively mad a lot of the time, though I will admit, he has brought it under control these past years -either that or he's just gotten tired.I guess I would fall somewhere in the Venn diagram of major depression, bipolar, and generalized anxiety disorder, probably with a splash of OCD thrown in.
Okay, I'm Sylvia Plath ;)
I looked and looked and looked for a psychiatrist that also did psychotherapy. It took years to find.
I will admit that prozac got me out of bed, and klonopin keeps from wanting to hide under it.
But I do consider psychotherapy to be the anchor of my treatment and the thing that has proven most beneficial. The meds let me live my life, but the therapy has actually made me want to.
So, based on my experience a combination approach definately works best.
Keep pushing. You will find what you need.
Peace to you.
Seldom.
Posted by Deputy 10derHeart on January 22, 2009, at 1:34:19
In reply to Re: Risk of sudden death? » yxibow, posted by Trans-Human on January 21, 2009, at 7:45:34
>is treated with disgust & disdain by the majority on this board.
>is skewed, unbalanced, & frankly dangerous; & constitutes extreme harm for many people.
>Despite some people here being intelligent; & there being a few good people who post here
>a very fixed & narrow agenda at work on this site; & it feels very wrong.
Please don't post anything that could lead others to feel accused or put down, and please don't jump to conclusions about others (e.g., that they have a certain agenda).
If you or others have questions about this or about posting policies in general, or are interested in alternate ways of expressing yourself, please see the FAQ: http://www.dr-bob.org/babble/faq.html#civil
Follow ups regarding these issues should be directed to Admin, and should of course, be civil. Dr. Bob has oversight over deputy decisions, and he may choose a different action.
--10derHeart, acting as deputy for Dr. Bob
Posted by Trans-Human on January 22, 2009, at 4:51:19
In reply to Re: Risk of sudden death? » Trans-Human, posted by seldomseen on January 21, 2009, at 20:21:49
> My story?
> My mother is bipolar with psychotic episodes (whatever that means) and my father has some kind of new fangled rage disorder, I forget the name, but he's very explosively mad a lot of the time, though I will admit, he has brought it under control these past years -either that or he's just gotten tired.
>
> I guess I would fall somewhere in the Venn diagram of major depression, bipolar, and generalized anxiety disorder, probably with a splash of OCD thrown in.
>
> Okay, I'm Sylvia Plath ;)
>
> I looked and looked and looked for a psychiatrist that also did psychotherapy. It took years to find.
>
> I will admit that prozac got me out of bed, and klonopin keeps from wanting to hide under it.
>
> But I do consider psychotherapy to be the anchor of my treatment and the thing that has proven most beneficial. The meds let me live my life, but the therapy has actually made me want to.
>
> So, based on my experience a combination approach definately works best.
>
> Keep pushing. You will find what you need.
>
> Peace to you.
>
> Seldom.
>
>
Hi Seldom & thanks for the reply.I wanted to reply last night; but got sidetracked; I've just got up & I'm half asleep; I have a psychology appointment late this morning; I wasn't asleep until 5am. That is usual.
From a labelling perspective there has been confusion & different labels over the years - drug induced psychosis at 17; psychotic depression at 21; the resurfacing of an unknown psychotic illness at 25; & schizophrenia at 26; that was considered a miss-diagnosis at 28; & then was then re-instated a few years later. The general consensus with the LMHT (Local Mental Health Team) is that I have been suffering with paranoid schizophrenia. I don't think the "schizophrenia" label helps with anything; & I hope that the CASL (Campaign to abolish the Schizophrenia Label) Wins in getting this term abolished.
I can very much identify with all the symptoms of PTSD; & I have problems with sleep. But neither of these obvious difficulties have been addressed by the orthodox. In regards to sleep; the issues I have with sleep have very much impacted my mental states.
I have one cousin who hung themselves around 5 years ago; & another cousin who has been on a section 11 years; & is presently in a highly secure unit. It's sad.
There does appear to be elements of some kind of mental distress with family members a couple of generations ago. But I don't know clearly what went on.http://rufusmay.com/index.php?option=com_content&task=view&id=64&Itemid=9
Posted by yxibow on January 22, 2009, at 5:31:30
In reply to Re: Risk of sudden death?, posted by Trans-Human on January 22, 2009, at 4:51:19
I can appreciate not liking labels -- I don't like the idea that I have a disorder I never would have thought I would have encountered, somatoform NOS, psychosis NOS. But it is not otherwise specified, meaning it doesn't meet the standard criteria for the disorders, it is an orphan disorder that is no less distressing to me.
I don't like that it is theoretically possible that I can temporarily become "psychotic", or so a theory on a rather important psychological testing (which I think if someone is able to obtain such a thing is a valuable asset to their treatment), if I have a situation of extreme stress.
Nevertheless I know what I see, call it psychosis, or call it an unexplained hypersensitivity and exaggeration of ordinary visual phenomenon (lights too bright, headlights and taillights annoying, blinking things distracting and confusion occurs).
I also know its not what others may call reality but it is my reality, and that is also a moot point -- it is distressing and I'm quite aware of it, that which is making it more difficult to express my own intelligence and good charm at times though it is very much still there.
For me, "psychosis" and "psychotic" sometimes brings up a connotation of someone running around with a machete because they believe that someone channeled them through the television to do destruction. (please pardon me if I'm starting to offend people with such a diagnosis)
But that's not what the DSM term necessarily means really, its a clinical definition, and people with strong psychosis and psychotic features are actually usually quite distressed that they have these conditions.
I would say that 99% of schizophrenic patients are not serial killers, or depraved individuals. In fact, numbers are very introverted and at a greater risk to themselves rather than others. Sensationalist movie and television scripts might paint things otherwise, but that's not how things generally are.
Schizophrenia, schizo-affective and the schizophreniform disorders are very real conditions and have been around since we have been modern homo sapiens probably. They just were never identified like a lot of conditions.
Not all schizophrenic patients, but some can be identified on PET and MRI scans because of some changes in brain structure and certain degradation of areas due to disease progression.
What I think really is that what labels bring is stigma, and I think that's the feeling that people may have when they are labeled, which is something that organizations like NAMI are attempting to change in society, the stigma of mental illness.Today NAMI calls patients "consumers" -- you go to a mental health professional, you or insurance pays, and you get help, a service, just like any other individual.
That doesnt change the fact that the medical label is still there. And in a way its important to categorize diseases because if we want to put mental illness on par with heart conditions and other "organic" disorders, there has to be some sort of classification. This brings things together and makes more of a case for equality in insurance and other matters.
Some may still think so, but schizophrenia is not split personalities and the like -- whether origins of names from greek and latin routes may be misleading at times, this is what the medical community has settled at this time on DSM-IV-TR.There are numbers of people with schizophrenia, who with proper treatment since chlorphromazine came in and stopped drilling holes and insulin in hospitals in the 50s, and with more recent, less harsh medications, are leading productive lives and you would not know it at first.
I don't know what else you would call it -- I don't know what else you would call "depression" or "anxiety" or "bipolar" (which is a more recent scientific name, and granted better, than manic depression which didn't address that depression has polarities).
I'm just free associating here -- call your diagnosis what you wish or just not focus on the name of it at all but the recovery process for it.
Science has to call it something until (as manic depression e.g. above) there are other terms, often because there are other treatments too.-- tidings
Jay
Posted by Phillipa on January 22, 2009, at 20:23:02
In reply to Re: Risk of sudden death?, posted by yxibow on January 22, 2009, at 5:31:30
See my thread just posted that gene found between schizophenia and bi-polar disorder. Phillipa
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