Psycho-Babble Medication | about biological treatments | Framed
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Re: Meds

Posted by Toby on September 24, 1998, at 10:27:52

In reply to Remeron, posted by DL on September 23, 1998, at 22:20:10

15 mg of Remeron does work in some people and I have several patients who have gotten relief with 15 mg alone, but many people need to go on up to 45 or 60 mg per day. Weight gain can be a problem at the low doses, not so much at doses above 30 mg, and it is mostly because of some increased craving for sweets and carbohydrates, so watch those. LFT's are "Liver Function Tests." In the clinical studies, 2% of patients had elevations in one of the enzymes that the liver makes; in most of these patients, the enzyme returned to normal and the patients did not have any symptoms of liver trouble. You probably don't need blood work done specifically for starting Remeron. Every patient should have baseline blood work done at the very beginning of treatment for depression or anxiety so that medical causes of depression can be ruled out. If that was done for you when you first started seeking treatment, you probably don't need to repeat most of it. However, the thyroid situation is interesting (if you'll pardon that word). Even if the blood work shows normal or borderline normal levels of thyroid hormone, if you clinically show evidence of hypothyroidism, a small dose of Cytomel (NOT Synthroid) may be very helpful in treating your depression. As far as the CBC goes, stress can cause drops in the white count but it is also a normal finding in about 20% of the population. If there was nothing else suspicious in your CBC, it is probably normal for you. Bottom line, unless it has been several years since you have had any routine blood work done for general health reasons, the only test I would recommend that you really should get for now would be the TSH and the thyroid antibody test.
During the EMDR, you want to try really hard to bring up that painful physical feeling you get in your throat and chest. Think about whatever you have to to keep that feeling going. That will help you to keep from blocking out the pictures. And it doesn't really even matter if the pictures are present before your eyes (with the eye movements, most people can't "see" the pictures well anyway), as long as you "just think about the event" and keep that physical feeling going, your brain will be processing things. And suddenly, that feeling will decrease in intensity, and the event won't hold as much power anymore. From there, it gets progressively easier and easier. And what you process during the session, stays processed; in other words, you don't just get temporary relief, it's permanent. You can try, but the feeling will not be able to get back to the same intensity as it was before, in which case your brain will view that event as "not very important anymore." That's the part that's hard to understand until you experience it because of course those terrible experiences are important and they do matter, but they are stuck in the kind of feeling that "it's still happening, I can't get away" and that causes them to be important in a destructive way and not allow you to grow past them. When your brain experiences them as "not important anymore" the events become important as a learning experience and possibly as a way to galvanize you into age-appropriate action to take care of yourself, but no longer "important" in an overwhelming, frozen-in-time kind of way. You just have to experience it to really get it, but you probably already know that that's kind of the way you want it to be, you just can't get there. Well, good luck on Sat.




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Psycho-Babble Medication | Framed

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