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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 28 to 52 of 96. Go back in thread:
Posted by Maxime on July 17, 2008, at 18:59:41
In reply to Re: Want to stop meds ... should I?-chrzrhowd » Maxime, posted by Lou PIlder on July 17, 2008, at 7:00:46
You may have noticed that in many of my posts that they are directed to {friends}, for I consider all here to be my friends and I would like to post here from my perspective what I see from your post as to asnswer your question as to being in the crossroad as to which road to take.
> My perspective may be different from others here concerning as to which road to take and I would like to continue here if you would want me to. I will do so if you post here that you would like for me to post from my perspective.
> Lou
>Of course I would like hear from your perspective.
Maxime
Posted by Maxime on July 17, 2008, at 19:03:24
In reply to Want to stop meds ... should I?, posted by Maxime on July 16, 2008, at 20:48:26
Wow, I really appreciate the time everyone took to respond.
I am going to listen to you and stay on the meds. I think that is what I wanted to hear anyway. I am stable for the first time and so changing anything would not be good.
I haven't had this much life in me for so many years ... I have been blessed.
Maxime
Posted by SLS on July 17, 2008, at 21:04:13
In reply to Thank you, everyone, posted by Maxime on July 17, 2008, at 19:03:24
> I haven't had this much life in me for so many years ... I have been blessed.
I know the feeling. Congratulations. You deserve it.
- Scott
Posted by linkadge on July 17, 2008, at 21:36:51
In reply to Re: Want to stop meds ... should I?, posted by Dinah on July 16, 2008, at 23:55:25
>If I ever feel truly well again, I will do >exactly what I'm doing at that point forever, >because I won't want to jeopardize something >I've hoped for for so long.
Unfortunately theres no guarentee that continuing to take what you were on when you felt better will keep you well.
I've been on meds when they work and its nice to think "all I've got to do is keep taking this and I'll be fine" but it doesn't always work that way.
Linkadge
Posted by linkadge on July 17, 2008, at 21:46:44
In reply to Re: Want to stop meds ... should I? » Maxime, posted by SLS on July 17, 2008, at 4:49:16
>Either you are hypomanic with its attendant lack >of good judgment, or you have fallen into the >trap of:
>"I feel great. I guess I don't need meds >anymore."
But, if you recall, she said she was not feeling well on meds at all and thats why she attempted suicide and ended up in the coma. She said she felt better since then. Because of the timing of the remission, it can't be attributed to medications.
Don't fall into SLS line of thinking that there is only one way to stay well. Certain people with severe depression feel better off meds. Some people with even severe depression get little or no help from meds. Many people with severe depression remit (with or without meds) and no longer need them. This needing to take medication for depression for the rest of your life theory is a relatively new idea. Sometimes meds make people feel worse and hinder recovery. There have been times where I much feel better (even if not completely well) off meds.
I'd say do what you want to do and trust your intuition. If you want to try a med holliday, especially from meds that have only been working marginally, I say go for it. The idea that you will lapse miserably is not always true. Its an idea pushed by doctors and drug companies, but not one that is necessarily accurate.
Linkadge
Posted by linkadge on July 17, 2008, at 21:48:56
In reply to Re: Thank you, everyone » Maxime, posted by SLS on July 17, 2008, at 21:04:13
Was maxime on meds when she attempted suicide? Well?
Linkadge
Posted by Lou PIlder on July 17, 2008, at 21:57:06
In reply to Re: Thank you, everyone, posted by linkadge on July 17, 2008, at 21:48:56
> Was maxime on meds when she attempted suicide? Well?
>
> LinkadgeLinkadge,
If you could explain some more from your perspective of the aspects of your posts, I would appreciate it.
Lou
Posted by Dinah on July 17, 2008, at 22:01:14
In reply to Re: Want to stop meds ... should I? » Dinah, posted by linkadge on July 17, 2008, at 21:36:51
There's no guarantee, no.
But I don't feel fine now. If I feel fine at some point, I'll keep doing what I'm doing when I feel fine. If I stop feeling fine, I'll look at changes then.
Posted by JohnnyBLinux on July 17, 2008, at 22:40:32
In reply to Lou's encourgement for Linkadge- rvltrew » linkadge, posted by Lou PIlder on July 17, 2008, at 21:57:06
Taken from Linkdage's recent post:
>> Was maxime on meds when she attempted suicide?
Taken from Maxime's original post:
>> I changed my meds a bit in February, but something else happened in Feb as well. I attempted suicide and ended up in a coma.
The answer to Link's question is 'yes', she was on meds when she attempted suicide. Please, correct me if I'm wrong.
Ultimatey, Maxime will either make the decision to stop her medication(s) herself or make it concurrently with her doctor.
Anyway, Lou, this is my humble opinion on the matter. Let me know if anything remains unclear. Have a g'night!
Cheers.
-JBLinux
Posted by Deputy 10derHeart on July 17, 2008, at 23:15:11
In reply to Re: Want to stop meds ... should I?, posted by SLS on July 17, 2008, at 5:11:07
> Lou, please stop changing subject lines simply to redundantly add your name to it.
>You really disrupt the continuity of threadsPlease don't post anything that could lead others to feel accused or put down, and please don't pressure others. I wouldn't have included the pressuring aspect if it were only the above remark, however, this is the fifth time you have mentioned this to Lou.
Just to clarify the PB guidelines as I understand them, it is fine to change the subject line of threads for any reason and as often as you wish. It is also fine to change the subject line back, for example, by using a [nm]. It is not okay to pressure others by demanding, threatening, or even asking them - if it is *repeatedly* - to do a thing, or stop doing a thing, on the boards. I don't think that was worded very artfully, but hopefully the meaning will come through despite my writing deficiencies.
And Scott, I do know you've also publicly thanked Lou for not changing subject lines, and I appreciate the time and effort taken to do so.
If you or others have questions about this or about posting policies in general, or are interested in alternative 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 SLS on July 18, 2008, at 5:03:37
In reply to Please be civil » SLS, posted by Deputy 10derHeart on July 17, 2008, at 23:15:11
Thanks 10derHeart. I will try different ways of changing back subject lines.
I will ask more politely.
- Scott
Posted by SLS on July 18, 2008, at 5:07:13
In reply to Re: Want to stop meds ... should I? » Dinah, posted by linkadge on July 17, 2008, at 21:36:51
> >If I ever feel truly well again, I will do >exactly what I'm doing at that point forever, >because I won't want to jeopardize something >I've hoped for for so long.
>
> Unfortunately theres no guarentee that continuing to take what you were on when you felt better will keep you well.Therefore, people shouldn't ever try to treat their diseases because the treatment might not work?
- Scott
Posted by SLS on July 18, 2008, at 5:25:26
In reply to Re: Want to stop meds ... should I? » SLS, posted by linkadge on July 17, 2008, at 21:46:44
She is feeling well. Given her history, I wonder why? Oh, I see, the meds chosen didn't work in the past, so the different meds she is now taking probably aren't really working now. The hell with statistics and anecdotes demonstrating a high probability of relapse when the patient treats for less than a year. Actually a physician at Mount Sinai, NY told me that they prefer to treat for 14 months as a minimum. This was in 1986. In Maxime's case, I believe most doctors would have her remain on drugs indefinitely. Indefinitely might mean that she might have to wait for something like gene therapy to come along.
As for seizures, for how long does a single ECT seizure bring about remission? How long does a single seizure of any sort improve depression. I don't see how you could possibly make a case for such things. Relapse. You gotta keep performing the treatments on a regular basis. Why should now be any different? I know, miracle cures. After all, they do happen. I guess we should all discontinue our medication to see which of us have the miracle thing going on.
Go ahead. Recommend to Maxime to stop taking her meds. I would like to see that. And while you are at it, you might as well go med-free indefinitely yourself and allow us to witness your algorithms at work. Maybe exercise for a robust and continuing remission for MDD or BD?
Don't you fret about SLS's way of thinking. He's ok with it.
- Scott
Posted by SLS on July 18, 2008, at 5:27:57
In reply to Re: Thank you, everyone, posted by linkadge on July 17, 2008, at 21:48:56
> Was maxime on meds when she attempted suicide? Well?
Why don't you ask her?
Well?
- Scott
Posted by SLS on July 18, 2008, at 5:30:40
In reply to Re: Thank you, everyone, posted by SLS on July 18, 2008, at 5:27:57
Sorry for exceeding the posting limit. My mistake.
- Scott
Posted by Midnightblue on July 18, 2008, at 10:58:32
In reply to Re: Thank you, everyone, posted by linkadge on July 17, 2008, at 21:48:56
I think she is on a very different combination of meds now. And I think that has made the difference.
MB
Posted by blueboy on July 18, 2008, at 10:59:59
In reply to Re: Want to stop meds ... should I?-flzcnclu?? » blueboy, posted by Lou PIlder on July 17, 2008, at 12:58:04
[...]
> > > I changed my meds a bit in February, but something else happened in Feb as well. I attempted suicide and ended up in a coma. My psychiatrist doesn't know if my remission is the results of the meds I am on ... or the coma.
[...]
> > But when AD's work, their effect is sometimes characterized by an initial suicide attempt. That makes me tend to think that the AD is at least partly responsible for your relief from depression.
>
> blueboy,
> You wrote,[...sometimes characterized by an innitial suicide attempt...].
> I am unsure as to if there is or is not a correlation with the aspect of an AD working with an attempted suicde.Could you post here any facts to support the statement in question? If you could, then I could have the opportunity to respond accordingly.1) A psychiatrist who had been practicing for over 30 years told me this. In fact, he said that in his experience "the most dangerous time for suicide is the weeks after a good drug treatment is started". His theory to explain it was that the patient would be activated enough to carry out a pre-existing tendency, but that was just a hypothesis.
2) A lot of AD's now carry a black box warning about suicide attempts, especially for teenagers. There is a definite "official" perception of a significant increase in suicide risk early in AD treatment.
3) Her pdoc thought that the meds might be the cause of her recovery.
4) She is taking the meds and is feeling enormous relief from depressive symptoms.
There isn't a lot of research on the hypothesis, largely due to the doctors' reactions of immediately discontinuing AD treatment after a suicide attempt. Even more, there is a disinclination to run a trial where patients who have started an AD treatment and then attempt suicide are continued on the AD, to see if they attempt suicide again. The possibility of lawsuits and ethical sanctions are too high.
5) Researchers have seen clues, however, that the phenomenon occurs. E.g., in Science Daily, "New UCLA Study Disputes Antidepressant/Suicide Link" (University Of California - Los Angeles (2005, February 7). There, Dr. Julio Licinio, a professor of psychiatry and endocrinology at the David Geffen School of Medicine and a researcher at the UCLA Neuropsychiatric Institute, who has been studying the problem for decades, stated:
"When people start antidepressant therapy, the first symptom to be alleviated is low energy, but the feeling that life isn't worth living is the last to go. Prior to taking SSRIs, depressed people may not have committed suicide due to their extreme lethargy. As they begin drug therapy, they experience more energy, but still feel that life isn't worth living. That's when a depressed person is most in danger of committing suicide."
6) If her suicide attempt was in fact tied to the onset of AD treatment, it means that the drug was doing *something* directly affecting her depression. Since she first attempted suicide and has since experienced a major remission of symptoms, the facts strongly suggest that the suicide and recovery are steps in a series of events.
Posted by blueboy on July 18, 2008, at 11:02:52
In reply to Re: Want to stop meds ... should I? » SLS, posted by linkadge on July 17, 2008, at 21:46:44
> But, if you recall, she said she was not feeling well on meds at all and thats why she attempted suicide and ended up in the coma. She said she felt better since then. Because of the timing of the remission, it can't be attributed to medications.
>It most certainly can.
http://www.sciencedaily.com/releases/2005/02/050205102643.htm
Posted by SLS on July 18, 2008, at 12:07:42
In reply to Re: Want to stop meds ... should I? » Lou PIlder, posted by blueboy on July 18, 2008, at 10:59:59
Nice post.
- Scott
Posted by linkadge on July 18, 2008, at 15:11:49
In reply to Re: Want to stop meds ... should I? » linkadge, posted by SLS on July 18, 2008, at 5:25:26
>As for seizures, for how long does a single ECT >seizure bring about remission? How long does a >single seizure of any sort improve depression. I >don't see how you could possibly make a case for >such things.
Some people who are treated with ECT remit from symptoms, Ie the ECT aborts the depressive episode.
I think it is also important to look at family history for the natural course of the disorder.
For instance, unmedicated, my grandfather had 4 depressive episodes (severe) in his lifetime. There were no meds back then. He was well inbetween episodes. That was the same general course of illness for my greatgrandmother (his mother).
Anyhow, depression can get better between episodes and it may not be necessary to treat for that entire time. Some even suggest that you are preventing full recovery with continuous treatment.
Linkadge
Posted by linkadge on July 18, 2008, at 15:12:55
In reply to Re: Thank you, everyone » linkadge, posted by Midnightblue on July 18, 2008, at 10:58:32
My mother's only suicide attempt was while on meds. The same meds she is on now.
Linakdge
Posted by linkadge on July 18, 2008, at 15:37:54
In reply to Re: Want to stop meds ... should I?, posted by blueboy on July 18, 2008, at 11:02:52
I don't think AD medication has made any significant drop in suicide rates. According to the following U.S. data, suicide rates have been steadily increasing since 1979 (and earlier). The increase peaked in the late 80's early 90's and has remained fairly constant since. If there has been a small drop in recent years, it is indeed a *very small* reduction, and certainly not a reduction to the levels of before 1979. I.e. if you look at the whole picture, there is nothing to suggest that antidepressant medication is at all responsable for the relatively miniscule drop in overal U.S. suicide rates.
Take a look for yourself. Let me know if you have any data for a larger study period.
http://fathersforlife.org/suicides/US_suicide_deaths.htm
Linkadge
Posted by linkadge on July 18, 2008, at 15:38:56
In reply to Re: Want to stop meds ... should I? » blueboy, posted by SLS on July 18, 2008, at 12:07:42
>Nice post.
>- ScottAny post that agrees with your point of view is a "nice post".
Linkadge
Posted by SLS on July 18, 2008, at 19:14:29
In reply to Re: Want to stop meds ... should I?, posted by linkadge on July 18, 2008, at 15:38:56
> >Nice post.
>
>
> >- Scott
>
> Any post that agrees with your point of view is a "nice post".So how is it that I still find your posts relevant enough to defer to you when something is beyond my knowledge?
It was a nice post. It was well thought-out and organized. The observations were accurate and the conclusions logical. It was a respectable effort.
- Scott
Posted by SLS on July 18, 2008, at 19:27:35
In reply to Re: Want to stop meds ... should I? » blueboy, posted by linkadge on July 18, 2008, at 15:37:54
So what?
http://www.suicide.org/suicide-statistics.html#death-rates
- Scott
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