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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 51 to 75 of 84. Go back in thread:
Posted by Larry Hoover on April 25, 2003, at 22:39:52
In reply to Larry..........., posted by McPac on April 25, 2003, at 18:15:31
> Lar, I just found this info. elsewhere:
> ***I'm emphasizing THIS: "These patients do well with certain nutrients and herbs but must strictly avoid B-12 and folic acid".
>
> Why the Hell does Pfeiffer have me ON vitamin-B12 then???????? I'm really sick of this baloney. The best anti-depressant is a Smith & Wesson. No need for any response as I know that you don't know why Pfeiffer has me on it....I'm just looking for ANY possible explanation. Take care!If you look hard at any recommendations, you are bound to find contradictions and inconsistencies, even with those of other theorists who seem to otherwise be in agreement on the main arguments.
I think I best fit the high-histamine protocol, but I've found good reasons for supplementing with B-12, and a B-complex.
Statistically, you're probably most likely to be deficient in magnesium, and then, about equally likely to be deficient in zinc or B-12, followed closely by selenium and the other B-vitamins (my belief, based on evidence I've seen over time).
I think that, overall, Pfeiffer has given you good advice.
Lar
Posted by Ron Hill on April 26, 2003, at 1:17:29
In reply to Re: Lar, Re: Ron, Re: Natural Serotonin enhancers?, posted by Larry Hoover on April 25, 2003, at 17:03:54
> You can get fish oil for about $14 a gallon, too.
Larry, how can I find out the percentage of EPA, DHA, and other omega-3 fatty acids in the Su-Per Fish Oil?
-- Ron
Posted by Simon Sobo, M.D. on April 26, 2003, at 6:51:22
In reply to Re: Larry, Re: about the chemical imbalance concept » McPac, posted by Larry Hoover on April 25, 2003, at 9:56:30
It is interesting that almost all of the posts in reaction to my article have suggested still more medicines and herbs to try to treat "the chemical imbalances" they are dealing with. Actually my article is challenging the automatic assumption that the problem is necessarily chemical. It may be but it may not be. The fact is this. WE DON'T KNOW! I am not against using medications in my practice. They are often very helpful but I am claiming they exert their effect through the more general psychological effects that they have on a person and not through a specific correction of a specific chemical imbalance for a specific diagnosis. Many of you commented on the article that I cited about using amphetamines for OCD. I have never used them for OCD but I am surprised that no one mentioned the other article claiming morphine helps OCD. Actually what I was saying is that intoxicants of all varieties may help OCD symptoms. I am not advocating this as a treatment but many people with OCD lose their OCD when they get drunk (others get worse).
I became interested in the amphetamine article after one of my patients told me cocaine had helped his OCD. Here is the portion of the article that you have reacted to and then I have one further bit of clinical information,"In Obsessive Compulsive Disorder (OCD) similar problems emerge. Originally, the fact that serotonin enhancing drugs were uniquely effective led to a belief that there was a causal connection, but as early as 1991 there was confounding evidence. Thirty mg. of dextroamphetamine was found to ameliorate OCD symptoms (Joffe 1991). Moreover, while I am not advocating this as treatment, I have had patients report to me that intoxicants such as marijuana, alcohol, and cocaine have given them temporary relief from OCD symptoms. Indeed, a recent study has shown that oral morphine is reasonably effective (Franz, 2001). Once again it is possible to speculate that there is a downstream effect on serotonin, but if we use this argument we have come full circle in a tautological trap. The original reason for the serotonin-OCD chemical imbalance model was that serotonergic agents were believed to be unique in their effectiveness"
Here is the other clinical tidbit. The patient who found cocaine helpful for his OCD lost his symptoms completely when he became a Jehovah's Witness. This cure disappeared after about 6 months when he became disillusioned with the cult but it is nevertheless fascinating. OCD has something to do with uncertainty. If you can take that away, give a feeling of completeness or innocence or something like that there will be improvement. I guess morphine, SSRI's, and many intoxicants can do that for certain people, but the primary problem is probably psychological not chemical.
Posted by Larry Hoover on April 26, 2003, at 8:41:17
In reply to Re: On-line Fish Oil Product EPA/DHA Content? » Larry Hoover, posted by Ron Hill on April 26, 2003, at 1:17:29
> > You can get fish oil for about $14 a gallon, too.
>
> Larry, how can I find out the percentage of EPA, DHA, and other omega-3 fatty acids in the Su-Per Fish Oil?
>
> -- Ron
I have no idea, Ron. I doubt they're too concerned. It doesn't mention preservatives, either. How much rancidity might there be? Still, where else can you get fish oil at that price? It might be worth the $14 just to find out.Lar
Posted by Larry Hoover on April 26, 2003, at 8:58:42
In reply to Re: Larry, Re: about the chemical imbalance concept, posted by Simon Sobo, M.D. on April 26, 2003, at 6:51:22
> It is interesting that almost all of the posts in reaction to my article have suggested still more medicines and herbs to try to treat "the chemical imbalances" they are dealing with. Actually my article is challenging the automatic assumption that the problem is necessarily chemical. It may be but it may not be. The fact is this. WE DON'T KNOW! I am not against using medications in my practice. They are often very helpful but I am claiming they exert their effect through the more general psychological effects that they have on a person and not through a specific correction of a specific chemical imbalance for a specific diagnosis.
Dr., I am pleasantly surprised to see your post here. Thank you for coming forward.
If I may ask a couple questions....
Using the state/trait dichotomy, would you say that e.g. antidepressants are capable of inducing states from which a subject may find it easier to cope with their traits?
How have your peers reacted to your article? Was it published in a journal?
Regards,
Lar
Posted by McPac on April 26, 2003, at 13:16:23
In reply to Re: Larry, Re: about the chemical imbalance concept, posted by Simon Sobo, M.D. on April 26, 2003, at 6:51:22
"Here is the other clinical tidbit. The patient who found cocaine helpful for his OCD lost his symptoms completely when he became a Jehovah's Witness. This cure disappeared after about 6 months when he became disillusioned with the cult but it is nevertheless fascinating. OCD has something to do with uncertainty. If you can take that away, give a feeling of completeness or innocence or something like that there will be improvement. I guess morphine, SSRI's, and many intoxicants can do that for certain people,
....but the primary problem is probably psychological not chemical".
>>>>>>> I think it may be that the primary problem for some may be psychological but that for others it is chemical. I don't think OCD, like depression, has a singular etiological cause. Psychological resolutions may very well be the answer to help/(even end) one person's OCD without affecting another sufferer's OCD at all. Still, in other cases, even a head injury can cause/exacerbate ocd, with no psychological help required.
Posted by Caleb462 on April 26, 2003, at 15:28:32
In reply to Re: Larry, Re: about the chemical imbalance concept, posted by McPac on April 26, 2003, at 13:16:23
I have heard about the trial on oral morphine, and it actually makes lots of sense to me - as opiods are the only drug that have ever lessened my OCD symptoms.
Alcohol, pot, stimulants - generally worsen my symptoms.
Posted by McPac on April 27, 2003, at 1:43:44
In reply to Re: Larry, Re: about the chemical imbalance concept, posted by Larry Hoover on April 26, 2003, at 8:58:42
Anybody here know of something I could take during Zoloft withdrawal to ease the withdrawal symptoms...got to be something? (CAN'T do the Prozac idea! terrible reaction to Prozac) Any over-the-counter or natural ideas? I'll bet there's something that could at least help those crazy withdrawal symptoms.
Posted by Dr. Bob on April 27, 2003, at 19:45:56
In reply to Re: Larry, Re: about the chemical imbalance concept, posted by Simon Sobo, M.D. on April 26, 2003, at 6:51:22
> The patient who found cocaine helpful for his OCD lost his symptoms completely when he became a Jehovah's Witness. This cure disappeared after about 6 months when he became disillusioned with the cult...
Thanks for participating, but one goal here is support, so please don't post anything that could lead others to feel accused or put down, thanks.
Bob
PS: Follow-ups regarding posting policies, or complaints about posts, should be redirected to Psycho-Babble Administration.
Posted by Larry Hoover on April 27, 2003, at 20:42:07
In reply to Larry Hoover/Anybody, Re: about the , posted by McPac on April 27, 2003, at 1:43:44
> Anybody here know of something I could take during Zoloft withdrawal to ease the withdrawal symptoms...got to be something? (CAN'T do the Prozac idea! terrible reaction to Prozac) Any over-the-counter or natural ideas? I'll bet there's something that could at least help those crazy withdrawal symptoms.
Dr. Healey, perhaps the world's expert in withdrawal from antidepressants, does recommend liquid Prozac as the best way to proceed, due to fluoxetine's long half-life, but, he also suggest that St. John's wort will work, in the alternative.
Good luck,
Lar
Posted by McPac on April 27, 2003, at 20:56:49
In reply to Re: Zoloft withdrawal » McPac, posted by Larry Hoover on April 27, 2003, at 20:42:07
"but, he also suggest that St. John's wort will work, in the alternative".
So, according to Dr. Healey, it is okay to take St. John's Wort simultaneously with the Zoloft during the Zoloft withdrawal purpose? (I've always heard not to mix the two). Could someone take the FULL, normally recommended dose of SJW or would they need to take a smaller amt. due to the Zoloft? Lastly, Zoloft withdrawal for me could take a LONG time, as I'd like to go SLOWLY...is it safe to take the SJW w/ the Zoloft for an extended withdrawal process? Thanks!
Posted by fayeroe on April 27, 2003, at 22:13:51
In reply to Re: please be civil » Simon Sobo, M.D., posted by Dr. Bob on April 27, 2003, at 19:45:56
> > The patient who found cocaine helpful for his OCD lost his symptoms completely when he became a Jehovah's Witness. This cure disappeared after about 6 months when he became disillusioned with the cult...
>
> Thanks for participating, but one goal here is support, so please don't post anything that could lead others to feel accused or put down, thanks.
>
> Bob
>
> PS: Follow-ups regarding posting policies, or complaints about posts, should be redirected to Psycho-Babble Administration.how was this person uncivil or putting someone down? i'm confused. thanks
Posted by Larry Hoover on April 27, 2003, at 22:43:56
In reply to Lar, Re: Zoloft withdrawal, posted by McPac on April 27, 2003, at 20:56:49
> "but, he also suggest that St. John's wort will work, in the alternative".
>
> So, according to Dr. Healey, it is okay to take St. John's Wort simultaneously with the Zoloft during the Zoloft withdrawal purpose? (I've always heard not to mix the two). Could someone take the FULL, normally recommended dose of SJW or would they need to take a smaller amt. due to the Zoloft? Lastly, Zoloft withdrawal for me could take a LONG time, as I'd like to go SLOWLY...is it safe to take the SJW w/ the Zoloft for an extended withdrawal process? Thanks!The idea is given as almost an afterthought, but it's looks to me like an all-out substitution. An alternative would be to proportionately substitute SJW for the Zoloft, then reduce the dose thereafter.
"There is anecdotal evidence and some theoretical grounds to believe that another option is to substitute St John's Wort for the SSRI. If a dose of 3 tablets of St John's Wort is tolerated instead of the SSRI, this can then be reduced slowly - by one pill per fortnight or even per month."
From:
http://www.benzo.org.uk/healy.htmLar
Posted by Questionmark on April 28, 2003, at 0:49:26
In reply to Re: Larry, Re: about the chemical imbalance concept, posted by Simon Sobo, M.D. on April 26, 2003, at 6:51:22
i just want to mention that i read your article and i think you make some brilliant points in there. i'm glad i had the oppurtunity to read it.
i'm convinced that any strict biochemical explanation for OCD is probably a major oversimplification. This is unfortunate, however, because it means there is no simple cure either. Damn.
Posted by stjames on April 28, 2003, at 17:45:27
In reply to Re: please be civil » Dr. Bob, posted by fayeroe on April 27, 2003, at 22:13:51
> how was this person uncivil or putting someone down? i'm confused. thanks
>Here:
"Jehovah's Witness. .... he became disillusioned with the cult...
~~~~
Posted by McPac on April 28, 2003, at 19:38:57
In reply to Re: Lar, Re: Zoloft withdrawal, posted by Larry Hoover on April 27, 2003, at 22:43:56
I read that link, thanks Lar. Wow, still can't imagine FULLY stopping Zoloft cold turkey while substituting SJW. Those withdrawal symptoms are HELL, just can't see SJW offsetting that.
Posted by Simon Sobo, M.D. on July 20, 2003, at 18:50:16
In reply to Re: Pstims for OCD?? Really? Not!, posted by Larry Hoover on April 25, 2003, at 12:12:38
I have a program that tells me who is reading my article so I have again found discussion of my article on your board. Although I cited the article that found dextroamphetamines helpful for OCD, the real purpose of that citation and the other citation, (which mentions morphine is also helpful) is to make the point that the equation between serotonin and OCD is nonsense. Enhancing sertonin seems to create a psychological state which I describe as "well whatever" This is extremely helpful with OCD and a heck of a lot of other psychiatric difficulties, and I will use it without hesitation, but it does not mean that people with OCD necessarily have a serotonin deficency. OCD is the result of very specific psychological conflicts not a chemical imbalance. That isn't to say that SSRIs morphine, alcohol, (one of my patients told me cocaine) and possibly dextroamphetamine can't help with the symptoms. Anything that gives a feeling of "all is well" may work. I am not suggesting that people try illegal remedies just that this whole way of approaching treatment with chemicals and drugs has a significant downside. The chemical imblance model has turned out to be very flawed
Simon Sobo, MD
Posted by ace on July 20, 2003, at 23:41:36
In reply to Re: Pstims for OCD?? Really? Not!, posted by Simon Sobo, M.D. on July 20, 2003, at 18:50:16
the equation between serotonin and OCD is nonsense.
I tend to aggree. I believe it may have a role in some but not others. But the SSRI hype is absurd. What about all the other neurotransmitters!Ace.
Posted by fredxx on September 25, 2003, at 4:59:55
In reply to Re: Pstims for OCD?? Really? Not!, posted by Simon Sobo, M.D. on July 20, 2003, at 18:50:16
> OCD is the result of very specific psychological conflicts not a chemical imbalance
hi, just wanted to say i've enjoyed reading the thoughtful and informative posts on this board
as someone who has suffered from OCD for 40+ years i have given much thought to the subject
i guess we always get back to the nature nurture arguments, my current thinking is that the central issues of ocd are about punishment and harm (in my case anyway)
we live in a world of which we have but a little understanding, where we are all vulnerable, where there are a myriad of things that can and do go wrong, often catastrophicallyand where blame and punishment are dished out to all and sundry on a daily basis in an attempt to control chaos
i want to live in a world which never thought of the concepts of blame and punishment as a way of dealing with the things that go wrong in a universe based on entropy
OCD is my FEAR and LOATHING of THIS brutal world
for me it's a miracle that ANYONE is "sane" on this planet
(and i'm not sure ANYONE truly is) ;)regards to all
fredxx
Posted by Dr. Bob on September 25, 2003, at 7:57:16
In reply to Re: Pstims for OCD?? Really? Not!, posted by fredxx on September 25, 2003, at 4:59:55
> i guess we always get back to the nature nurture arguments...
Since it's not really about medication, I'd like to redirect this aspect of this discussion to Psycho-Social-Babble. Here's a link:
http://www.dr-bob.org/babble/social/20030913/msgs/263140.html
Thanks,
Bob
Posted by petroranger on December 2, 2003, at 19:57:46
In reply to Re: On-line Fish Oil Product EPA/DHA Content?, posted by Larry Hoover on April 26, 2003, at 8:41:17
i'm working on my project about enrichment of PUFAs in fish oil.If this is of interest to you, I'd love to hear of anything you come across.Actually, i've a little bit problem come out in this work...
Posted by Dr. Bob on December 5, 2003, at 6:30:45
In reply to Re: Fish Oil Product EPA/DHA Content?}}Larry, posted by petroranger on December 2, 2003, at 19:57:46
> i'm working on my project about enrichment of PUFAs in fish oil...
Sorry if it's confusing, but there are a number of boards here, and Psycho-Babble Alternative is the one for discussion of alternative treatments. Here's a link:
http://www.dr-bob.org/babble/alter/20031204/msgs/286766.html
Thanks,
Bob
Posted by RH on August 19, 2004, at 15:03:59
In reply to Re: Larry, Re: about the chemical imbalance concept, posted by Simon Sobo, M.D. on April 26, 2003, at 6:51:22
Dr. Bob:
That's great info about the effects of "recreational" drugs and alcohol on OCD. I have been researching the "chemical imbalance" theory (fraud?) and have come to the preliminary conclusion that the various "happy pills" are just europhorics of one type or another.
I am still looking for the evidence that unipolar depression or bipolar do not have underlying psycho dynamic causes. All the unipolar and bipolars I know, a small sample group of about 5, all have issues that are evident to me, but of course, not to them.
I am quite experienced with the use of marijuana. It is definately a stress reducer or masker, and it helps relieve situational depression---so then why wouldn't it relieve clinical depression? I have read in posts at "Walkers In Darkness" that some of those there, who are unipolar depressed or bipolar, claim that pot works as well as any of the happy pills they have tried and that it's side affects are more preferable. Of course, many will not want to try pot because it is against the law and it may not be socially acceptable to them.
I know a woman, my neighbor, who is unipolar depressed, although she has never to my knowledge seen a pdoc. She doses herself with marijuana daily, and has anxiety as her little baggie gets low. But like a good patient, she "refills" her "presecription" with perfect regularity every Saturday morning. I don't think she has been without pot for more than 2 or 3 days per year for the last 20 years.
I don't recommend anyone treat their issues with pot. The point is that it seems to some of us who have not tried any happy pills that they are no more than that, happy pills. The underlying issues are still there.
For the chemical imalance theory to be valid, the following study would have to have been done. Do you know if it has and can you direct me to it. Namely, a large sample group of people with no signs of unipolar or bipolar depression would have to be followed for many years, starting perhaps as teenagers, and then when some presented symptoms of depression or mania, they would have to be screened for underlying psychodynamic issues. Only those that had none could be considered as possible evidence of the brain chemical imbalance being the cause, and not the effect.
But it may be difficult to establish underlying psychodynamic issues, as moral judgements have to be made, and many in the psych community go out of their way not to do that, thus I believe confusing the issue. For instance, I found a post at "Walkers in Darkness" where a woman on meds claimed that she also benifitted from dancing nude in front of men at a strip joint. Some pdocs would say good to that. But I would say that is an expression of her problem.
In a world of therapy that avoids making moral judgements of some kind, then many underlying causes will be overlooked, and in that case there would be no recourse except to take meds.
What do you think?
RH
Posted by Jasmineneroli on August 20, 2004, at 17:17:26
In reply to about the chemical imbalance concept, posted by RH on August 19, 2004, at 15:03:59
RH:
I'm not sure what you mean by "happy" pills, because none of the drugs I've ever taken for my Generalized Anxiety Disorder (with occasional depression) have ever made me "happy". Rather, they relieve the stress/anxiety/sadness/tiredness.I think that term, as a simplistic euphemism for very complex drugs, may be taken as a bit upsetting by some of the posters here.
As to the psycho-dynamic theory vs. bio-chemical theory of mental health disorders, I can't point you to any studies.However, from my own personal experience, and from my experience working with "At-Risk" adolescents, both can cause mental health issues.
My husband suffers from Dysthymia ( a chronic form of depression) and has all his life. There is nothing in his background to indicate an external cause and an SSRI med. has completely changed his life. Seems to me that he simply has Serotonin imbalances or low Serotonin, that is corrected by a drug. In a similar way to a diabetic with insulin insufficiency. I, on the other hand, have a driven, controlling type personality, and have been subject to a lot of stressful events and hormonal changes in the past 5 years. The combination of the two has definitely caused me to "live-on adrenalin", which itself has caused chemical imbalances in my brain. Many of the kids I worked with have backgrounds, or environments, that have primed their stress responses to react constantly and they've developed OCD, PTSD, depression or anxiety from resulting neurotransmitter changes.
For both myself, and these kids, drugs have been necessary to correct the chemical imbalances, and drug therapy maybe long or life time. Then the situation(s) that created these problems, need to be changed or addressed in some way too, to reduce/relieve the stressors. Therapy/counselling may be of assistance in certain cases. For me, as a GAD sufferer, my Pdoc believes therapy to be very unsuccessful, because it just gives us something else to worry about!!!
I hope that helps your quest for an answer. It's certainly an interesting debate.
Jas
Posted by Emme on August 21, 2004, at 13:37:49
In reply to about the chemical imbalance concept, posted by RH on August 19, 2004, at 15:03:59
Hello.
First off, I'd like to say that I agree with the above poster about using the term "happy pills". It makes me feel like those of us who take them are being judged as taking the easy way out, which we're not. We take them to get us out of emotional hell to the point where we can do the things we need to do to become happy. I think if you took a poll here, you'd find a lot of people who'd rather not have to take medicine and put up with side effects, etc.
It sounds to me like your're drawing an unnecessarily tight division between biological and psychological causes of mood/anxiety disorders. They're not mutually exclusive and the interplay between them is complex at best. Studies have shown that optimal results are obtained with a combination of therapy and medication. Even if there were someone completely free of major problems in their past, they might need counseling to help cope with the impact of the illness on their life.
The balance between biochemical and psychological issues won't be the same for everyone. Mood/anxiety disorders are heterogeneous. They manifest themselves differently in everyone and the etiology for one person may be different than someone else's. Likewise, different pharmacologic approaches are needed for different people.
You might have:
- a person without major psychodynamic issues who has a mood or anxiety disorder anyway. (Although I suspect it would be tough to find anyone no issues. We all have baggage of some sort.)- another person who has an inborn vulnerability that is never expressed because they don't experience *enough* psychological distress.
- a third person with an inborn vulnerability that is triggered by distress or trauma. The biologic component of their illness is no less real than for a person with allergies who happens to end up standing in a field of ragweed.
- a fourth person who has undergone psychological stress but doesn't have depression or anxiety because their particular makeup allows them to escape it. And so on....
I think underlying psychodynamic issues needn't be thought about in terms of moral judgments. You don't need to do that in order to be effective. You need to figure out and address what's going on that isn't healthy for the individual or those around them. Isn't that what's going on with your example of the woman who dances nude? Would it make more sense to say "Your nude dancing is immoral." or to find out why she's dancing nude and say "this isn't good for you for these reasons...." Maladaptive behaviors aren't necessarily immoral.Emme
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Dr. Bob is Robert Hsiung, MD,
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