![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 16 to 40 of 40. Go back in thread:
Posted by Dr. Bob on January 10, 2014, at 23:29:06
In reply to Lou's response- » linkadge, posted by Lou Pilder on January 10, 2014, at 21:25:09
> It is written here that clozaril is a drug proven to reduce the risk of suicide...
> Let us reason together here.I'd like to redirect follow-ups regarding clozaril to a separate thread. Here's a link:
http://www.dr-bob.org/babble/20140104/msgs/1058233.html
Follow-ups to support Danielj more directly are of course welcome right here. Thanks,
Bob
Posted by Phillipa on January 10, 2014, at 23:30:50
In reply to Redirect: clozaril, posted by Dr. Bob on January 10, 2014, at 23:29:06
Perfect. Thanks.
Posted by bleauberry on January 11, 2014, at 7:03:11
In reply to Re: Suicide Attempt » bleauberry, posted by SLS on January 10, 2014, at 13:51:21
Good questions, Scott. thank you. I will try.
> > Whatever the cause, it appears to me there are toxins of some kind that causing misfiring and messing up the whole mood center operations.
>
> What toxins, specifically?
Lots of long bizarre names. There is so much we don't know. One of the MDs pioneering the research and treatment on this topic goes by the name of Shoemaker. I think it would be easier to google and take a look around yourself rather than me copying and pasting the equivalent of about 3 books on this one page. The toxin I am most concerned with in my own body is Quinolic acid, and cholestyramine does a good job of clearing out my head. Weird huh? Take a drug that passes thru the intestines but makes the head feel better? That's what happens.There are pubmed articles that indicate how toxins have affinity with opioid receptors, which would obviously have indirect negative effects on dopamine and norepinephrine, and the resulting psychiatric symptom manifestation would not be a surprise. Pretty much any of the popular internet LLMDs have piles of ongoing scientific studies relating to their pioneering work. Harowitz, Burrascano...if you start studying the writings of these guys, and researching where they got their leads from, you yourself Scott would be able to write an entire book on this topic. And we need that book. There is no better science oriented guy I know of for that job than you.
Can you offer a peer reviewed study indicating that toxins do not impact the brain?
>
> What are the clinical indicators described by Danielj that leads you to your conclusions regarding her son?
The symptoms, severity, and history. To many people, all these different diagnosis and symptoms look pretty much the same all under one blanket....for example depression is depression is depression, right? Well, no. There are different kinds of depression. The subtle differences offer really powerful clues to me, because I can recognize the difference between DanielJ situation verses someone else that looks similar. Subtle clues are usually not seen, ignored, or considered idiopathic. To me, those subtle clues speak loudly and at the very least give me an idea of what we are dealing with and how to proceed.>
> Can you cite any scientific literature demonstrating that the misfiring and messing up of the whole mood center operations are produced by the toxins you allude to?
No. Science is lagging. It will catch up, if former historical patterns hold true, maybe in about 5 to 10 years. The best information out there is fragmented....a researcher here, a researcher there, a few hundred MDs, patient reports, blogs, forums, and such.
That said, type "cholestyramine lyme" into a google search box and you will find a treasure of data available to anyone curious.>
> I look forward to your thread on cholestyramine. I'm sure you will provide peer-reviewed scientific literature to corroborate the contents of your posts.
Scott you know me better than that. I operate about 5 to 10 years in advance of science peer reviews. Wait for those reviews and our lives will be done already, suffering that could have been reduced, wasn't. I am not one to wait for someone else to figure out my problems and hand the solution to me on a silver platter. I only have one life. It is mine. It does not belong to science. We each have our own journeys, our own cross to bear, and we each do the best we can in our own lives to what we think is right. And naturally, what works for us, we want to share. A person has the right as the boss of their own body to accept or reject, discern, whatever information they gather.Trust but verify. I like that. There is not a single "gray" thing I've done in my treatment that had not already proved impressive with several hundred thousand other people in the real world clinical setting. There is decent science on it all, but not the establishment type peer review stuff you are looking for. Well, that's not really true either....not that simple....I guess it depends on who one considers to be peers. If all the other LLMDs are peers, then yeah, there is a ton of peer reviewed stuff. Who qualifies to be a peer? What makes them so qualified? Versus someone else who claims to be a peer? It's all subjective. Not objective. Mostly. Generally. Science used to be science. In this day and age it seems to have morphed into science based opinion editorials. What appears to be true and fact, is accepted as so even without repeatable duplicatable reliable proof.
Global warming is an example outside of psychiatry. Too much confusing data. Choose your side. There is enough data to defend both sides. Of course, we now know that all of the peer reviewed science from the big players was completely fabricated data. Massive hoax, but they call it science. Hey, that research ship stuck in the Antartic ice....do know what they were researching?.....global warming! lol
That said, peer reviewed, in my observations, does not significantly increase the validity of whatever is being reviewed. The reviewers have been proved wrong, or misguided, all throughout history. Over and over. It repeats. Nothing new. Sometimes they get it right. But we don't know that until 10 or 20 years later when real-world practice confirms and validates. But how often does the FDA pull something from the market that was not only approved in the first place, but peer reviewed as well, with flying colors. Happens.
I think the reason you and I see the world through different lenses is because I do not trust establishment types, you do. You depend on science. I do not. Simple as that. There is no right or wrong in there. People who do things with zero peer reviewed approaches get just as much improvement, if not more, than someone else, in my experiences anyway. Human intuition and wisdom, on an individual basis, can trump the best science has to offer. That is in fact how hundreds of thousands, maybe millions of people, are gaining ground against their chronic diseases. For example, the LLMD are literally saving thousands of lives and giving life back to patients who have been severely ill for a long time. But nothing they do is peer reviewed....NOTHING. It is all the wisdom and intuition gained in the clinical setting that is healing people. Those same people, if they wait for science to catch up, will be in the grave a long time before that happens.
>
>
> - ScottI understand you do not agree with a single thing that I have to say, and that is cool. I am very respectful of what other people believe. I like varying perceptions, because I believe no one is ever completely right or wrong, that the truth is a mixture of them.
The real best way to help people involves both your points of views and mine, a mix of science and intuition, science and clinical observation, eastern medicine and western medicine, combined and honed for the individual patient on a case by case basis.
I would think anyone involved in the medical world....patients as well as clinicians....would understand that we are dealing with one of the most complex physiological things called a human body that we know very little about, relatively speaking compared to all we do know, and that every new discovery out in the field would be greeted with optimistic promise for a deeper look, rather than immediate critical trash disposal.
Black and white. Gray. I think another difference between your perceptions and mine, is science oriented humans tend to desire to box concepts in black or white compartments and there isn't much gray area inbetween. To me, that is a very dangerous approach for the patient's future and outcome. But it is a commonly adopted approach throughout the medical establishment. There is no such thing as adrenal weakness, only cushings or addisons. For the many who are having hormonal issues related to substandard cortisol operation, or HPA axis disregulation, the black and white world is not going to help them much. Matter of fact, the establishment is perfectly fine telling them to go home and get some rest and not even try to help the patient. Meanwhile, the MD operating in the gray zone already has a long list of happy patients that received some sort of prescription or procedure that was sort of out of the box and not peer reviewed.
It's all so complicated. Intertwined. So much we don't know, but we think we know plenty. We don't. If we did, we would have all sorts of answers to questions that are asked at pbabble day after day year after year. They repeat. Nothing new. Lab results themselves often offer confusing or contradictory results. Peer reviewed science is not going to help in that situation. The MDs clinical intuition is going to have to kick in. He will not have the support of scientists when he makes his decision.
I do not see and rights or wrongs, better or worse, because I believe we are in such infancy in understanding the incredibly complicated workings inside the body, that even the best scientists are poorly armed to explain things in ways that can be proved and duplicated time and again. We do eventually get there. Polio. Ulcers. Discovery of bacteria. On and on throughout history. On and on going forward. We are in the middle of it right now. Until we know as much God, it will always be that way.
But...disclaimer...all one person's opinion, based on intuition guided by experience.
Posted by SLS on January 11, 2014, at 9:48:49
In reply to Re: Suicide Attempt » SLS, posted by bleauberry on January 11, 2014, at 7:03:11
> Good questions, Scott. thank you. I will try.
>
> > > Whatever the cause, it appears to me there are toxins of some kind that causing misfiring and messing up the whole mood center operations.
> >
> > What toxins, specifically?
> Lots of long bizarre names. There is so much we don't know. One of the MDs pioneering the research and treatment on this topic goes by the name of Shoemaker. I think it would be easier to google and take a look around yourself rather than me copying and pasting the equivalent of about 3 books on this one page.Okay, one toxin is a good start. Thanks.
The toxin I am most concerned with in my own body is Quinolic acid,
Do you happen to know how quinolic acid affects the brain adversely?
> There are pubmed articles that indicate how toxins have affinity with opioid receptors, which would obviously have indirect negative effects on dopamine and norepinephrine, and the resulting psychiatric symptom manifestation would not be a surprise.
Interesting. Thanks.
Pretty much any of the popular internet LLMDs
What are LLMDs?
> Can you offer a peer reviewed study indicating that toxins do not impact the brain?
Science doesn't work that way, and you know it. Logic doesn't work that way. For example, I cannot find a peer-reviewed study indicating that the cure for depression is to smell your unwashed right foot t.i.d. Of course with mania, one would smell the left foot instead. I can't find any articles refuting this methodology, so it must be true...
I imagine bacterial endotoxins affect the brain and various CNS chemoreceptors. It may be that the malais and nausea attendant to a systemic infection is the direct effect of these endotoxins along with brain inflammation. However, that is not to say that bacterial activity is the etiology of the majority of cases of mental illness.
> > What are the clinical indicators described by Danielj that leads you to your conclusions regarding her son?
> The symptoms, severity, and history.
Let's try this again:
WHAT ARE THE CLINICAL INDICATORS DESCRIBED BY DANIELJ THAT LEADS YOU TO YOUR CONCLUSIONS REGARDING HIS SON?
Please be specific. You don't have to reply to this post at all, but direct answers to direct questions will advance greatly the worth of this dialectic.
> To many people, all these different diagnosis and symptoms look pretty much the same all under one blanket....
Not to this person.
> for example depression is depression is depression, right? Well, no.
This is manifestly true and noted by medical science for over 30 years. Please don't lecture me in a condescenting way.
> There are different kinds of depression. The subtle differences offer really powerful clues to me, because I can recognize the difference between DanielJ situation verses someone else that looks similar. Subtle clues are usually not seen, ignored, or considered idiopathic. To me, those subtle clues speak loudly and at the very least give me an idea of what we are dealing with and how to proceed.
Would you be so kind as to name just a few of these powerful clues?
What, specifically, are the subtle, loudly-speaking clues that you see with danielJ's son, and what does that tell you about what "we" are dealing with? How would you have danielJ proceed?
> > Can you cite any scientific literature demonstrating that the misfiring and messing up of the whole mood center operations are produced by the toxins you allude to?
> No. Science is lagging.
You don't think science has looked at infection, toxins, and brain inflammation as being associated with MDD or BD? You would be wrong. It seems to me that it is you who is lagging behind science.
I will disregard the rest of your lecture for now. Let's just deal with the issues listed above.
Thank you.
- Scott
Posted by bleauberry on January 11, 2014, at 12:34:13
In reply to Re: Suicide Attempt - lysed bacteria? » bleauberry, posted by SLS on January 11, 2014, at 9:48:49
Good post Scott. thank you for your thoughts.
>
> Okay, one toxin is a good start. Thanks.
>
> The toxin I am most concerned with in my own body is Quinolic acid,
>
> Do you happen to know how quinolic acid affects the brain adversely?not really, except I saw some vague thing at pubmed where it was shown the toxin binds to opioid receptors, and another one that showed how they bind with serotonin. Either way, bad news and a bizarre clinical presentation which "appears" psychiatric but is in fact not.
>
> > There are pubmed articles that indicate how toxins have affinity with opioid receptors, which would obviously have indirect negative effects on dopamine and norepinephrine, and the resulting psychiatric symptom manifestation would not be a surprise.
>
> Interesting. Thanks.
>
> Pretty much any of the popular internet LLMDs
>
> What are LLMDs?It is not a formal term, but sort of a nick-name for MDs who have a particular specialty and passion in treating Lyme disease and similar diseases that look like it. I've had 3 LLMDs. Two of them had Lyme themselves and that is where their specialty took hold....they experienced the insane suffering in real time themselves....and they overcame it....and it didn't happen with limited CDC guidelines. The other one became fascinated early in career when it was observed that pain/fatigue patients were getting better on antibiotics that had been prescribed for other unrelated reasons. For example, a Fibromyalgia patient got a tooth infection, prescribed antibiotic, and stuff happened far beyond the teeth. I guess the doc saw enough of this "pattern" that he dug deep into research, history, MD blogs, MD conferences, Lyme conferences, and such, and became an expert out of passion for the topic. In other words, antibiotics were unintentionally healing pain/fatigue patients better than the commonly accepted treatments. He put 2 + 2 together and it all made sense. He and another LLMD both told me, with sureness and conviction, that most depression patients actually have Lyme disease. To me, that was unfathomable. Insane. Impossible. Ridiculous. Left field. Out there. The problem is, I have come to see that what they said, is true. It just is not common knowledge or generally accepted, so that makes it really hard on both MDs and patients.
LLMD stands for Lyme Literate MD. Most are not. Most do not know anything more than what they learned in school, what they were told by a pharmaceutical rep, what they read in a journal, etc. All that stuff is but a smidgen of what Lyme disease actually is.
I had a D.O. work a sore hip a while back. We were talking and he seemed to be a treasure chest of information on treating Lyme disease. He even suggested a particular antibiotic that I asked my LLMD about on the next visit and I got it and it was helpful. I asked that D.O. how he knew so much. He obviously knew a lot more than the average garden variety MD on the topic of Lyme disease. Asking him where he learned all that stuff....a conference?....special training?....he said he learned it all from his patients. That is sort of another example of what I meant about the difference between the scientific world and the real world. Real world = clinical world average people.
Not a single LLMD in my State. I have to travel out of State for my appointments. Even in that State, there are only 6 of them.
>
>
> I imagine bacterial endotoxins affect the brain and various CNS chemoreceptors. It may be that the malais and nausea attendant to a systemic infection is the direct effect of these endotoxins along with brain inflammation.Absolutely! Bullseye! You said it better than me. You don't need to imagine any more however. It is real. Dangerously real.
>However, that is not to say that bacterial activity is the etiology of the majority of cases of mental illness.
Well, on the surface, I sort of agree with you there. But again, it was the two experts on the front lines who do this day in and day out, that told me that. With conviction. Until somebody can prove to me that what they said is false, I accept it as true simply because everything my eyes see in the world and on the net supports their claims more than it refutes them. And actually, it is really hard to find anything to refute them. That's because it is uncharted waters where nobody is doing any looking except the front lines guys.
My own depression convinced me. If someone had told me, back in my zyprexa/prozac days, that a variety of antibiotics were going to revive me better than the mood drugs, I would have laughed so hard. That's just not possible. Oops. I was wrong. Searching through all sorts of forums and blogs, there are a bunch of people just like me. So while I often feel like the lone sheep, I'm not.
> Let's try this again:
>
> WHAT ARE THE CLINICAL INDICATORS DESCRIBED BY DANIELJ THAT LEADS YOU TO YOUR CONCLUSIONS REGARDING HIS SON?Oh man, hard to describe. It's not so much any one particular thing, but the whole big picture. And maybe due to my own journeys I have gained some sort of instinct or skill at recognizing subtle clues that are usually glossed over or not seen at all.
As an overall approach, if someone has been in psychiatric care for more than 10 years, and it is bad enough that suicide is real risk, I cannot help but think....the problem is outside the box....so the answer is also going to be outside the box. I ask myself, what could possibly mess up the brain so bad? And why in the prefrontal cortex? And, if none of these drugs....serotonin ones, NE ones, DA ones, combinations....if all of them missed the mark, then we are clearly dealing with a situation not related to a supposed chemical imbalance. It's something else. The failed drugs told us that. We already proved it. Don't stay stuck in a game that is losing hand after hand...change the game because we are in the wrong one. That's the way I see it anyway. For me, that game change did not come until after about $35,000, 15 years, a dozen or more MDs and specialists, hospital stays, and ECT. Prior to that, I was a die hard, hard core, medication guy. Meds only. Anything else is bogus. That's where I was.
Hey Scott for me to go see that post again and examine the symptoms again to further figure why I said what I said, I would have to click off this page and start all over! Yikes. I will do that in a separate response.
>
> Please be specific. You don't have to reply to this post at all, but direct answers to direct questions will advance greatly the worth of this dialectic.
>
> > To many people, all these different diagnosis and symptoms look pretty much the same all under one blanket....
>
> Not to this person.Your experience and research is extensive.
>
> > for example depression is depression is depression, right? Well, no.
>
> This is manifestly true and noted by medical science for over 30 years. Please don't lecture me in a condescenting way.That's what sucks about forums. I was in a good mood and smiling with friendship in an engaged fun conversation when I wrote that.....but you could not see my face....and the words alone on a page can be seen differently. There was zero condescending intended so I am sorry any was perceived.
What I meant was, a toxic depression or infected depression has a particular pattern to it....responds poorly to common meds, antipsychotics work the best in those cases, ritalin, neurontin too...common meds make things worse or don't help....side effects exaggerated....frequent poop out...the need for extremely low doses or the need for extremely high doses....drug sensitivity. Add in there other symptoms such as tremor, joint pains, fatigue, brain fog, and some others, the picture gets more clear.
> Would you be so kind as to name just a few of these powerful clues?
Above are some. Most of us here have them.
>
>
> > No. Science is lagging.
>
> You don't think science has looked at infection, toxins, and brain inflammation as being associated with MDD or BD? You would be wrong. It seems to me that it is you who is lagging behind science.No I don't. I have never seen anyone talk about or share anything scientific about, so, no, I don't think they have looked at it, and even if they did, the effort does not appear authentic or thorough. Send the stuff my way. Would love to see it. What do you have?
>
> I will disregard the rest of your lecture for now. Let's just deal with the issues listed above.Not a lecture. Well, I guess maybe. The thing is Scott, you have a way of making me feel like I have to sell something or defend something or prove myself to be worthy in your eyes. And then what happens is....yeah, I get defensive, I get sensitive, and I go to town defending myself, and it looks like a lecture.
Respectful debates never get to the point of lectures. You and me both need better control of our words.
Disclaimer: IMO
>
> Thank you.
>
>
> - Scott
Posted by SLS on January 11, 2014, at 12:41:03
In reply to Re: Suicide Attempt - lysed bacteria? » SLS, posted by bleauberry on January 11, 2014, at 12:34:13
http://www.dr-bob.org/babble/admin/20131217/msgs/1058298.html
- Scott
Posted by bleauberry on January 11, 2014, at 12:49:56
In reply to Suicide Attempt, posted by Danielj on January 10, 2014, at 9:41:11
Scott. Here is my layman brain thinking out loud..
26 years old. Bang. Right off the bat, something's wrong. That's a young brain. What could go so badly wrong? And it's been 10 years? That means whatever happened, happened when he was 16 years old.
10 years. That's too long. Something is wrong. The meds are missing the mark., Why? What's up? This is not looking like a neurotransmitter thing any more. Chemical imbalance? Cough.
Schizo. Ya know, any time I see that word, infection and toxin automatically pops into my head. Something really strong impacting the brain there. Gosh, to get a brain that crazy, something is really wrong, and it aint a shortage of serotonin. Don't know what it is, but if I were to go by what my doctors see in their clinical setting everyday, then an infection has to be at the top of the list, it's the only thing I know of other than a poison that can so badly mess up the brain that way, and in fact an infection is exactly like a poison in the brain due to its chemicals which are neurotoxic.
Does that mean to me that anyone I see with schizo symptoms has an undiagnosed infection or toxin accumulation? No it does not. But those are at the top of the list for further investigation. And when it seems like the doc is running out of ideas, the meds are working badly, progress is not being made, then it makes justifiable sense to me....to get to that list.
On second reading of the author's original post, we have no knowledge whatsoever of the other variables involved in this case. Divorced? Struggling other ways? Fired from job? Girlfriend left? Dad screamed? Car in the shop can't pay? There is other stuff maybe involved that we don't know.
But again, 10 years, suicide attempt, schizo....that's pretty much all I need to see in this case. But see, someone else might look at that same scenario and say, "that's the way psychiatry is, it's all trial and error, if one med doesn't work try another", and it's all sort taken with an general attitude of "idiopathic". All this stuff "just is the way it is". ???
If I could talk with this family in person, my first question would be "where were you living when he was 16 years old"? More questions too, but that's the first one. The answer could be very important.
> I haven't posted recently but my 26 yr old son attempted suicide a couple of days ago. To make it worse we weren't notified till last night around 5 PM that he was in the ICU. He survived though we wondered how after hearing he took over 20 exrta strength excedrin drank both 3 in one oil and penetrating oil oouch! They did an endoscopy an found (thank goodness) only mild inflammation of esophagus and stomach lining.
>
> His Diag was schizo affect. and has been for nearly ten years. Taking 15 mg of Zyprexa and 100 mg Zoloft. After talking to him last night we discovered it sounded like suicidal ideations were
> what pushed him over the edge. I think maybe discontinuation of Zoloft is the first thing that will help. Interestingly enough his ideations coincide with a switch from Prozac to Zoloft.
> Your thoughts?
Posted by SLS on January 11, 2014, at 13:09:34
In reply to Re: Suicide Attempt - SLS, posted by bleauberry on January 11, 2014, at 12:49:56
13 years ago, I posted on the ASD newsgroup and rocked a few boats while I was there. One of my more significant contributions was to propose using biological probes (pharmacological challenges) to determine the nature of the mental illness being diagnosed, the location in the brain of the anomalies, and which drugs would be most likely to elicit a robust therapeutic response with minimum side effects. For instance, one might be subject to a PET scan and given a series of compounds and record what parts of the brain "light up". It is likely that Prozac and Wellbutrin will produce intraindividual and interindividual differences in brain activity. This protocol would not be limited to marketed drugs. A drug like ritanserin might be the best probe to assay 5-HT2 receptor function and to what degree the PFC lights up. The PET scan can even be active in that the subject is asked to perform various mental tasks during the procedure. There is probably a task/drug association that would indicate diagnosis and the classes of drugs to explore clinically.
Only a guess.
- Scott
Posted by jane d on January 11, 2014, at 17:16:06
In reply to Suicide Attempt, posted by Danielj on January 10, 2014, at 9:41:11
I'm so sorry. How awful for you. I can't offer any specific suggestions. I never quite reached the point of making an attempt although I spent an awful lot of my life obsessing about it. The ideation did get easier to live with over time as I learned to view it as something separate from myself. I do believe that medications can have unexpected effects in some people and that could be what happened to your son. But I also found that my despair would get worse after a med change that did not do anything once I realized that this was not going to be the cure. This got worse each time it happened.
I hope your son continues to make a good physical recovery and that you find some answers.
Jane
PS. It took a long time but my life did get better - at first only a little bit more manageable but finally much better. I hope your son gets to the same place even faster than I did.
Posted by johnLA on January 11, 2014, at 19:26:17
In reply to Suicide Attempt, posted by Danielj on January 10, 2014, at 9:41:11
i also want to say i'm sorry that you, your son, and family are going thru this.
i would work closely with your doctors of course. also, look after yourself as well. look to family, friends, church, or whoever you can lean on right now.
for what it's worth, zoloft was the first drug i ever took. the akathesia drove me to go inpatient voluntarily. i could not stop moving. i really thought i was losing my mind.
hoping things get better for you and your son.
john
Posted by Chris O on January 12, 2014, at 2:41:04
In reply to Suicide Attempt, posted by Danielj on January 10, 2014, at 9:41:11
Daniel:
I took Zoloft (briefly--for about two weeks) ten years ago and it had an extremely anxiety-promoting effect on my already extreme anxiety disorder. The psychiatrist I was seeing at the time told me: 1) He didn't think that Zoloft could be causing the anxiety and 2) He didn't think that it could be working that quickly. Because I tend to doubt my feelings so much, I essentially believe him, but still quit taking Zoloft anyway, because it was far too uncomfortable for me. (I basically felt like I was going to have a panic attack all the time. I hope your son is okay and you guys figure out a med (or other) treatment plan to get through this stressful period.
Chris
Posted by bleauberry on January 14, 2014, at 8:30:08
In reply to Re: Suicide Attempt - SLS » bleauberry, posted by SLS on January 11, 2014, at 13:09:34
I like that. I mean, it's a step in the right direction. Things are way to complicated and interwoven, it wouldn't be that simple, but indeed could help clarify the clinical picture and give some generalized direction to treatment strategy, rather than just basically guessing.
> 13 years ago, I posted on the ASD newsgroup and rocked a few boats while I was there. One of my more significant contributions was to propose using biological probes (pharmacological challenges) to determine the nature of the mental illness being diagnosed, the location in the brain of the anomalies, and which drugs would be most likely to elicit a robust therapeutic response with minimum side effects. For instance, one might be subject to a PET scan and given a series of compounds and record what parts of the brain "light up". It is likely that Prozac and Wellbutrin will produce intraindividual and interindividual differences in brain activity. This protocol would not be limited to marketed drugs. A drug like ritanserin might be the best probe to assay 5-HT2 receptor function and to what degree the PFC lights up. The PET scan can even be active in that the subject is asked to perform various mental tasks during the procedure. There is probably a task/drug association that would indicate diagnosis and the classes of drugs to explore clinically.
>
> Only a guess.
>
>
> - Scott
Posted by phidippus on January 18, 2014, at 2:21:49
In reply to Suicide Attempt, posted by Danielj on January 10, 2014, at 9:41:11
Why in gods name is he not on a mood stabilizer? Lithium can really help with suicidal ideation.
Eric
Posted by Zyprexa on January 18, 2014, at 21:18:03
In reply to Suicide Attempt, posted by Danielj on January 10, 2014, at 9:41:11
Is he taking generic zyprexa? I found there to be a difference between the two, and all the different generics. I think he needs to go up in dose, maybe 20 mg. Or do what I did and add in something else, like perphenazine. This combo has me fairly stable right now. He could also go back on zoloft at a higher dose, if that was working before. I found that I had to stick with a particular brand of generic, teva for the zyprexa, and sandoz for the perphenazine. Once you do this give it a couple of months. I also found that I had a period where I just sorted out my problems blew off steam and stabilized. My pdoc was trying to lower doses of my meds to see if I needed them because I had been stable for a while. Well I went off the deep end and thought I would loose it. I started smoking pot, just to get by, and most importantly sleep and control anger. Ayear later and I'm back up in my doses and stablizing again.
Posted by Danielj on January 20, 2014, at 14:11:27
In reply to Re: Suicide Attempt » Danielj, posted by phidippus on January 18, 2014, at 2:21:49
The care facility seem to have trouble keeping
instructions straight. We eliminated Prozac on the
first day yet it comes back for discussion that
its still on his list of meds 4 days later. Incompetent!
Also they think they can do a
transition from Zyprexa to Haldol in a week? Plus
that no one has mentioned a mood stabilizer at all
in spite of his crying attacks. My wife and I went
down there and told them to get it straightened out
or I would drive my cadillac though their front
door and yank him right out of there.
They apologized and promised to look into
it and check with the doctor tomorrow.
Posted by Phillipa on January 20, 2014, at 19:48:32
In reply to Re: Suicide Attempt Update, posted by Danielj on January 20, 2014, at 14:11:27
Why are they waiting till tomorrow? Tell them to call the doc now your Son's health is at stake. That is incompetence in my opinion having been a psych RN. So sorry for you. Phillipa
Posted by Danielj on January 21, 2014, at 12:09:08
In reply to Re: Suicide Attempt Update » Danielj, posted by Phillipa on January 20, 2014, at 19:48:32
They agreed to revise the plan (silly but they tried to act to cover their butt
by saying that they were preparing a court order to keep him for treatment
for 30 days). They definitely need to keep him (maybe not 30 days) but
until the switch over to Haldol is complete and successful.
He called from there this morning to tell us about it. Since he switched to
Haldol his thoughts are much more organized, we visit him tomorrow night
so we can check his treatment plan out. He is improving, no doubt, I think
Zyprexa was finally burning out on him. They have an as needed for
Benadryl because of the Haldol, because Cogentin gives him blurry vision.
Pray for us, I will post again tomorrow after 8 est.
Posted by Phillipa on January 21, 2014, at 21:16:12
In reply to Re: Suicide Attempt Update, posted by Danielj on January 21, 2014, at 12:09:08
Praying for you and family. Please do post an update. Phillipa
Posted by jane d on January 22, 2014, at 0:26:16
In reply to Re: Suicide Attempt Update, posted by Danielj on January 21, 2014, at 12:09:08
Good luck tomorrow. I'm glad he's doing better. He's lucky to have you involved and that the care facility knows you are involved.
Posted by Danielj on January 30, 2014, at 20:26:35
In reply to Re: Suicide Attempt Update » Danielj, posted by jane d on January 22, 2014, at 0:26:16
The switch from Zyprexa and Zoloft to Haldol and Prozac seems to be somewhat successful
we will know if my son will continue to improve soon. Our conversation at care facility last night
was the best in a while. He mentioned going back to college and taking differential equations he
has Calc. 1 & 2 and needs DE before he can take Calc 3. All that complicated math will take
his mind off himself and get it back on getting something accomplished.
We will be very happy to have him home and he will go to his new apt in a few days. We will be
5 min away by car and he will be 15 min away by bicycle.
Posted by Zyprexa on January 30, 2014, at 22:42:53
In reply to Re: Suicide Attempt Update - Coming Home Tomorrow, posted by Danielj on January 30, 2014, at 20:26:35
Did he get ects in hospital?
Posted by Danielj on February 2, 2014, at 15:18:11
In reply to Re: Suicide Attempt Update - Coming Home Tomorrow, posted by Zyprexa on January 30, 2014, at 22:42:53
No not ects. Haldol 5 mg 3 times a day, Prozac 1 in morning Wellbutrin 3 tablets in morning.
A little tremoring but that could still be Zyprexa withdrawal. No suicidal thoughts yet. He
thinks pretty clearly his memory is a bit better. Time will tell.
Posted by Phillipa on February 2, 2014, at 21:08:07
In reply to Re: Suicide Attempt Update - Coming Home Tomorrow, posted by Danielj on February 2, 2014, at 15:18:11
That's great now keep us updated please. Phillipa
Posted by Danielj on February 11, 2014, at 9:19:34
In reply to Re: Suicide Attempt Update - Coming Home Tomorrow » Danielj, posted by Phillipa on February 2, 2014, at 21:08:07
My son saw a therapist yesterday, after being on meds from the care facility Pdoc for almost a month.
Improvement is slow but steady and he's managing. He still needs a visit or a phone call to remind him
to take meds but we want to gradually decrease the reminders and make him independent.
His temperament is better than it has been in 2 years. He liked the therapist, a woman in her
30's, he had some visits with her several years ago.
His regular Pdoc is not connected with the care center and hasn't been that helpful, he might accept
a Doctor from the care center but he tried a temporary change of Docs a year and a half ago and it didn't work out.
His med regimen is posted earlier in this thread but I need to get the dosages for anyone who is interested.
Leaving Zyprexa after 10 years is a big deal I am still concerned about it.
Posted by Phillipa on February 11, 2014, at 20:07:38
In reply to Re: Suicide Attempt Update - Home and Getting well, posted by Danielj on February 11, 2014, at 9:19:34
So glad to hear your Son Is doing well thus far. This is a huge achievement for him. As for the zyprexa I am not qualified to offer an opinion. Wait and see? Phillipa
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