Posted by franco neuro on March 22, 2005, at 15:38:57
In reply to Re: rEEG System Helps Guide Prescribing, posted by Daniel Hoffman, M.D. on March 22, 2005, at 8:51:16
Please allow me to throw my two cents into this discussion. Generally when I see a doctor post a message on psycho-babble I figure they're here trying to drum up business. Forgive my cynicism, but it's born of the experiences I've had in dealing with the medical community over the past few years. Having said that, I found the following sentence from your previous post very intriguing.
> There could be a few ways to treat a problem. E.G., if you can't tolerate SSRI's for example, maybe the same could be accomplished with a beta blocker and a stimulant (just as a hypothetical), in which case tolerability is resolved.
This tells me that you are someone who thinks outside of the box. A quality I've yet to come across in any of the doctors I've seen. And believe me I've seen dozens of doctors over the past few years. Maybe I'm just a hard case. Five or six years ago I went through a particularly stressful period. The dysthymia and GAD that I had chosen to ignore for the previous decade suddenly turned into a full blown neurosomatic disorder. I now have chronic pain, chronic fatigue, IBS, anhedonia and depression. (I ask you how could one not be depressed with the aforementioned problems?) In a headlong rush to find relief I bounced from doctor to doctor. And like many (if not most) of the people on this website, I began bouncing haphazardly from one medication to another while learning nothing in the process.
About two years ago I decided to become my own "medical detective." One of the books I read was "The Edge Effect" by Dr. Eric Braverman. It's an interesting, although somewhat simplistic book. In fairness, any book dealing with brain function that is aimed at the general public has to be "simplified" or no one would understand it. In the book he talks about how QEEG "Brain Mapping" is a large part of his diagnostic process. I was looking for a doctor who used this so I went to see him and had it done. (Ridiculously overpriced of course.) According to him the test showed that I have very low dopamine. Now I don't know if he used a comparative database or his own experience in using this device but it was the result I had come to expect. Here's why:
1. I'd been experimenting with amino acids during the past year and found that tyrosine helped me. Tyrosine, of course, is the precursor to dopamine and norepinephrine.
2. My father and uncle both take medications for parkinsonism. A condition of low dopamine. Perhaps indicating a genetic predisposition toward dopamine burnout.
3. SSRI's have not helped me. While slightly elevating mood they have tended to increase apathy and make my physical symptoms worse. Not only that. When I recently stopped taking Zoloft I had the best 2 or 3 days physically and mentally that I've had in a few years. Perhaps this is due to my serotonin level dropping below the pre-medication baseline for a couple of days until my brain was able to compensate for the cessation of the medication by increasing endogenous levels/transmission. I'm not a scientist so I may be totally wrong about this. However, if this is the case than maybe I'd benefit form a serotonin antagonist along with a dopaminergic med. Unfortunately when it comes to raising dopamine levels, our choices are few.
It would be nice to talk to Dr. Braverman about this but he isn't around much. He's been on Larry King and Neil Cavuto so I'm starting to worry that he aspires to be a celebrity. Even when he happens to be in the office it's virtually impossible to see him for more than a minute. So the frustration continues. If it gets bad enough maybe I'll hop in the car and drive to Colorado. Not likely though. I'm too darned tired. For now I think I'll just try picking a psychopharmacologist out of the phone book. It shouldn't be hard considering there are only 3 listed.
So the point of this rather long winded post is that I believe that the evidence taken in it's entirety may finally be pointing me in the right direction. In my case at least, the QEEG may have proven itself to be of use. Of course had my QEEG come up with a result other than the one I expected, I would be even more confused than ever. But until I get on the right medication and correct (as much as is possible) the suspected imbalance and start to feel better (God willing) I won't be able to say for sure how much it has helped me.
By the way, are you familiar with the work of Dr. Jay A. Goldstein? I was considering going out to California to see him but he retired last year. I just read his book "Tuning the Brain". Awesome book. It's a must read. Particularly if some of your patients with psychological problems have concomitant neurosomatic disorders. He's got me thinking that an NMDA antagonist might also help me. Although dopamine itself antagonizes NMDA. He's twenty years ahead of the rest of the medical community. No offense intended. :-)
poster:franco neuro
thread:455823
URL: http://www.dr-bob.org/babble/20050322/msgs/474105.html