Posted by yxibow on January 11, 2009, at 4:43:45
In reply to Re: Scared to try Lamictal - seeking opinions please » JadeKelly, posted by Garnet71 on January 10, 2009, at 18:28:40
> Thanks Jade.
>
> Yes, I am really jaded about psychiatry. But if you think about it, what other field of medicine prescribes meds by 'trial and error'?All.
There are no guarantees in life, but it isn't necessarily exactly by "trial and error". Its evidence based.
That is, the evidence that particular substances have been beneficial far more than harmful and have shown proven peer reviewed clinical use are employed.
> Imagine if docs said, uh, she has the symptoms of cancer, let's try radiation therapy and see if it works.
Well, actually cancer agents are considered excellent for some heartbreaking situations if they work 10% of the time. This is why ethically cancer drugs are usually tested against other cancer drugs and not controls. It would be a travesty to receive a sugar pill if your life could be prolonged even by a prior agent.
Cancer is unpredictable. The best detection of certain types of cancer are examinations done in annual physical or gynecological exams.Prostate cancer caught early can be operated on, radiation therapy, and other means. Caught late, well I can't go into it but lost a neighbor to it.
50% of men are likely to have some form of prostate problems when they reach a senior age. Most are BPH, or benign prostate hypertrophy. Colonoscopies are a valuable but imperfect tool in determining benignity.
Childhood leukemia of certain forms are fairly treatable today, although also there is no certainty.
> It sounds ridiculous. The brain is just too important of a body part to treat via trial and error....
We live in the middle ages in psychiatry. This is just a matter of fact, of what we have in 2009. Stem cell and other genetic research will allow us to probe further into many disorders into this century if we allow research. Sometimes, even if you fail to respond to new agents, time tested old agents may be of better use.
We do not live in the 1940s, before chlorpromazine (Thorazine), which though an ancient drug today and one not to be taken lightly, helped the lives of many seriously ill patients who were subjected to insulin shots, drills, lobotomies, and other things that would be inhumane today.
It is all better living through chemistry, in a sense, to use a very dated phrase.
You either choose to live with what you have, or take into account that there will be side effects of agents that may well benefit your functionality. Sometimes living with what ails you may be better than high risks that won't allow you to benefit as much as you can from life and your friends and family. This is one of the choices of patients facing cancer.
> I'll keep you posted. I just hope insurance pays for this.
Lamictal is now generic, lamotrogine.
But the same very slow titration is still the same, to protect you and your safety not from the small rash, but the rare BIG one (SJS). Hopefully your doctor is following the standard protocol, which takes several months to get to a typical dose of like 200mg.
You do have a right to know the benefits and risks of a voluntarily taken agent. If your doctor is not providing this, it is hasty or a disservice to you.At the same time, reading the entire PDR or PI of a medication would probably well put off people from any medication.
And two of the most useful and mass produced agents out there would probably not be allowed today -- aspirin, and especially acetaminophen (paracetamol). I won't go into LD50 issues but they are severe. Yet, they can stop some pretty nasty fevers cold.
Yes, there are some pretty serious agents out there like drugs used for heart patients, amiodarone which has a plasma life of like a year, and heparin. But they are also life savers too, potentially.Don't take this as any criticism of your skepticism. It is always good to have a healthy balance of skepticism when entering anything.
-- best wishesJay
poster:yxibow
thread:872702
URL: http://www.dr-bob.org/babble/20090104/msgs/873305.html