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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 7 to 31 of 43. Go back in thread:
Posted by SLS on June 17, 2005, at 9:09:23
In reply to Re: Is There A Magic Pill?, posted by ixus on June 17, 2005, at 0:06:47
Maybe it was magic beans that made me feel so well. They looked just like pills, though.
I really hope that the addition of Trileptal acts like a magic pill for me. I would love to come back here and speak more persuasively as to the magic that medicines can exert on severe depression. If Trileptal doesn't work out for me, I will continue to chase the remission I once had and that occasionally teases me by returning for a few days to a few weeks before disappearing again.
It is crazy not to believe. After 23 years of failed trials save one, I still do. Ah... now I get it. *I'm* the one who's crazy. Perhaps, I can't help but to believe because I have witnessed first hand evidence that has stared me in the face for over two decades. Having worked for two psychopharmacologists as a research assistant, seeing the same patients on a monthly basis, and having participated in research as a patient at the NIH among perhaps 50 others, what I have seen is unequivocal in my eyes.
There are magic pills for many people who will attest to that fact. I just don't know where they are right now on PB. Of course, the population here is skewed towards treatment-resistance. People who respond successfully to medication don't jump on Google to figure out why they responded so well. Anyway, I *can* attest to the existence of magic pills. You only need to have a good long-term memory and one real experience of remission to convince you. I have both.
If exercise works for people to bring them to remission, then it is indeed magic for them. It is not magic for me. Exercise is worth performing even if it is not. As a bodybuilder, I left a pictorial legacy as to my dedication to exercise when I was in my early twenties. The exercise combined both aerobic and anaerobic types. I found that it did not effect the quality or magnitude of the biological depression. However, I did feel better for exercising much in the same way a mentally healthy person feels better from exercise.
One thing that the magic of medication cannot do is to strip one of the psychosocial issues, if any, that will continue to reside after the depression remits. These issues might have been exactly those that triggered the depression in the first place. Some issues are a direct result of the depression itself because of how chronic depression affects one's psyche and life's circumstances. However, it is much easier to process psychotherapy in the absence of a biological depression such that learning becomes much easier and the changes made in cognition and behavior more persistent. Depression is often a multifactorial illness. Psychology affects biology. Biology affects psychology. They are inextricable. For a population deemed MDD, the contributions of both lie along a spectrum. For some, it will be an illness dictated solely by one's biology. For others, the biology remains nominal while psychosocial maladjustment manifests as depression. Many people reside somewhere between the two poles where the two dimensions interact to precipitate and perpetuate depression. The trick here is to treat both simultaneously.
Ha ha! I'm going to find my magic pill. When I do, I will soar like Icharus, but without need of wings.
:-b
In the meantime, I am going to continue to exercise.
- Scott
Posted by Ktemene on June 17, 2005, at 10:09:47
In reply to Re: Is There A Magic Pill?, posted by SLS on June 17, 2005, at 9:09:23
Posted by yesac on June 17, 2005, at 11:11:43
In reply to Re: Is There A Magic Pill?, posted by SLS on June 17, 2005, at 9:09:23
I don't think there's a magic pill either. There might be for some people, but like Scott (?) said, those people aren't here.
I do think that there are drugs that can help people to some extent, even treatment-resistant people. Drugs can alleviate some symptoms, ease some of the pain. It might not be perfect. Often I think that combinations of drugs are necessary, because all psychiatrists can really do is treat symptoms one by one. There is no one single drug that can solve all symptoms.
It's like with non-psychiatric problems--- pills just don't do it all, they can't fix everything. Our society thinks we're so advanced, but there are so many unsolved (medical) issues, even simple ones that have plagued humanity for ages. Like warts, for example. I suppose that might sound like a really stupid example, but do you know how hard it can be to get rid of a wart? No it's not lethal, it's maybe not even that much of a problem, but it's annoying, and there is no treatment that can wipe it out for sure.
On another note, I have kind of a joke going with my psychiatrist that he's concocting my perfect drug in his back room. One day he'll have it ready, and I will finally know what happiness is!
Posted by TamaraJ on June 17, 2005, at 12:05:42
In reply to Re: Is There A Magic Pill?, posted by SLS on June 17, 2005, at 9:09:23
Posted by rainbowbrite on June 17, 2005, at 12:06:39
In reply to Re: Is There A Magic Pill?, posted by yesac on June 17, 2005, at 11:11:43
I think survector (sp) may very well be my magic pill, although I cant access it to test it out :-(
FRom the little research I have done and from wha tI know abou tmy brain chemistry (haha not much) I think its for me!!
Posted by rainbowbrite on June 17, 2005, at 12:20:29
In reply to I think I know mine, posted by rainbowbrite on June 17, 2005, at 12:06:39
I thought I was going to get to be next. I guess great minds think at the same time :-)
Posted by RetiredYoung on June 17, 2005, at 12:24:02
In reply to Re: Is There A Magic Pill?, posted by yesac on June 17, 2005, at 11:11:43
Thanks to everyone for this thread; it's very interesting.
My take is this: it's all relative. Over the past seventeen years, I have thought that I'd found *the* pill(s) to fix everything several times. Unfortunately, it never seems to last. Some combination of poop-out and real world stress events inevitably kick up and render the "magic" of my life-changing pill(s) impotent. The other problem I've had is that the side effects from something that is working almost too good to be true, are almost too bad to be true.
Some examples: Pamelor worked great for me for depression years ago; until my doctor realized that my resting pulse was 115 and I would burn my heart out with long term use of Pamelor. Also, Lexapro worked very well for me for over a year, until the dreaded poop-out occurred; raising the dosage up to 50mg didn't resolve it.
Right now, I'm on Prozac and Zyprexa. It's been somewhat magical for me, but of course my food expenses are up 150%.
If there is a trick, it's to use the window you're given when a med or med combo is working well for you to really dig in and get therapy, learn to meditate, fix your job or relationship problems, ...whatever..., so that the next time your remission ends, your legs are a bit stronger to stand on your own.
Regards,
Jim
Posted by Chairman_MAO on June 17, 2005, at 12:56:23
In reply to Is There A Magic Pill?, posted by Phillipa on June 16, 2005, at 21:28:48
If I added a psychostimulant to my drug regime and switched from buprenorphine to a full opioid agonist, I'd probably wake up like that, heh.
Posted by ed_uk on June 17, 2005, at 16:25:31
In reply to Re: Is There A Magic Pill?, posted by SLS on June 17, 2005, at 9:09:23
Posted by ed_uk on June 17, 2005, at 16:34:02
In reply to Re: Is There A Magic Pill?, posted by RetiredYoung on June 17, 2005, at 12:24:02
Hi Jim :-)
>Pamelor worked great for me for depression years ago; until my doctor realized that my resting pulse was 115 and I would burn my heart out with long term use of Pamelor.
I've never been convinced that TCA-induced sinus tachycardia was harmful to the heart, I don't think there's any evidence that it is. My resting heart rate was about 110 when I was on lofepramine. I took it for almost three years, I don't believe it did me any harm. Sinus tachycardia can be dangerous for people with coronary heart disease but I don't think it's really an issue for most people. Don't rule out going back on Pamelor some day! You could always add a small dose of atenolol if you were concerned. Atenolol would slow your heart rate.
Kind regards,
Ed.
Posted by SLS on June 17, 2005, at 17:04:00
In reply to Re: Is There A Magic Pill? » RetiredYoung, posted by ed_uk on June 17, 2005, at 16:34:02
> Hi Jim :-)
>
> >Pamelor worked great for me for depression years ago; until my doctor realized that my resting pulse was 115 and I would burn my heart out with long term use of Pamelor.
>
> I've never been convinced that TCA-induced sinus tachycardia was harmful to the heart,Me neither.
One thing that offsets the accelerated heart rate is the reduction in the load that the heart must work against. It is the NE alpha-1 antagonist properties of TCAs that dilates blood vessels to allow for this.
> I don't think there's any evidence that it is. My resting heart rate was about 110 when I was on lofepramine.
Mine has been over 100 on all of the tricyclics I have been on. Neither my doctors nor I have had any concerns about this.
> Don't rule out going back on Pamelor some day!
It would be a tragedy to rule out an effective drug on the basis of an acceptably accelerated heart rate. TCAs are supposed to do this.
> You could always add a small dose of atenolol if you were concerned. Atenolol would slow your heart rate.
That's a great idea. Of course you can always see if pindolol lives up to its proposed action as an augmentor of antidepressants while slowing the heart.
- Scott
Posted by linkadge on June 17, 2005, at 18:06:08
In reply to Re: Is There A Magic Pill?, posted by SLS on June 17, 2005, at 17:04:00
When I go to my psychiatrist, many times I am all smiles, and I say the medicince is working great and it has improved my life in every which way. Then I go home and want to shoot myself.
I know that personally, I sometimes give the doctor a false sence of the medicines doing more than they really are.
Why do I do this? I really don't know. I have the feeling that doctors will get mad at me. I also do a lot of mind reading. I think, well if I tell him the truth then he's just going give me zyprexa. So I say to myself, no pill will make things improve so I might as well just lie to him.
I also find that I get a lecture if I tell him things are not doing well.
I might tell the truth if I thought there was a pill that could help, but I don't believe there is so I just say they are working, and then go home and want to kill myself.
So you see, it is possable (although very sad) that doctors can get a false sence that their medications are doing a lot more good for people than they really are.
Both times I was in the hospital, I got so bored and so depressed about being there, that I faked improvement just so I could get out of there. I say, yeah, these medications are really helping.
But when I leave I am no better than when I went in. But at least on the outside I have more control. If I want to hang myself there is nobody to take away my belt.
Linkadge
Posted by linkadge on June 17, 2005, at 18:19:43
In reply to Re: Is There A Magic Pill? » SLS, posted by linkadge on June 17, 2005, at 18:06:08
The real magic pills are things like lithium. Of course nobody who takes them will admit they are magic but they are more magic than antidepressants in my oppinion.
I think that the brain works incredably hard to maintain a homeostasis. I read somewhere that the more pleasure you experience, then the more your brain becomes sensitive to pain, and the more pain you experience, the more your brain becomes sensitive to pleasure. It cannot be escaped, the brain is always one step higher than the mind.
Linkadge
Posted by linkadge on June 17, 2005, at 18:30:34
In reply to Re: Is There A Magic Pill?, posted by linkadge on June 17, 2005, at 18:19:43
I have also found that the newer AD's like the SSRi's (**for me**) always seemed to activate my HPA axis. This always created a very quick short term fix, as the cortisol boost gave me a bit of a high, but I think that in the long term the HPA axis dysregulation caused more problems.
Please note, that all of these are just my experiences. I don't want to propose that everybody will react the same way as I have, but on the same hand I believe my account is important in order to get a complete picture.
Linkadge
Posted by ed_uk on June 17, 2005, at 18:35:58
In reply to Re: Is There A Magic Pill? » SLS, posted by linkadge on June 17, 2005, at 18:06:08
>If I want to hang myself there is nobody to take away my belt.
Oh Link, I wish there was some way I could help you.
~Ed
Posted by Phillipa on June 17, 2005, at 18:45:59
In reply to Re: Is There A Magic Pill? » linkadge, posted by ed_uk on June 17, 2005, at 18:35:58
Most of you are right. There is no magic pill. The responses that hit home the most were the ones about working on your personal life. That's hard work with a lot of sacrifices. And the potential to really feel upset. And then most people won't understand why you did what you did. Well they're not in my shoes. A lot of thinking needs to go on. Fondly, phillipa
Posted by Phillipa on June 17, 2005, at 21:31:59
In reply to Re: Is There A Magic Pill?, posted by Phillipa on June 17, 2005, at 18:45:59
Since there was such a great response to my Thread I think I'll post another one. Thinking about what to post now. Fondly, Phillipa
Posted by paul_d_234 on June 17, 2005, at 22:02:41
In reply to Re: Is There A Magic Pill?, posted by Phillipa on June 17, 2005, at 18:45:59
The magic pill(s) is the one(s) that work for you.
Posted by Declan on June 17, 2005, at 22:16:38
In reply to Re: Is There A Magic Pill?, posted by RetiredYoung on June 17, 2005, at 12:24:02
Minaprine would have been worth a look at, at least for me.
Posted by 4WD on June 17, 2005, at 22:24:09
In reply to Is There A Magic Pill?, posted by Phillipa on June 16, 2005, at 21:28:48
> I would love to wake up in the morning like the lady in the lunesta comercial and smile and begin to sing "Oh What A Beautiful Morning, Oh What A Beautiful Day," etc. Is there a magic pill for this. I can dream can't I? Fondly, Phillipa
Hi PHillipa
There's no pill I know of that can make me wake up that way. There is a pill, though that can make me feel that way in about 30 minutes. Unfortunately it's a prescription pain pill and I abuse it. Or at least I used to abuse it. Oh well.
Marsha
Posted by Declan on June 17, 2005, at 22:30:25
In reply to Re: Is There A Magic Pill? » SLS, posted by linkadge on June 17, 2005, at 18:06:08
Yeah Linkadge, that's what happens to me. And when I'm there it's true enough, as long as it doesn't go badly. Maybe I just like to please and if the appointment goes OK then I feel OK. And then at other times..... Is that what being reactive is? Atypical depression/reactive depression?
And I'm sure that doctors have trouble getting accurate feedback. When my mother had ECT they thought it worked because they thought it would. Took them a couple of hundred years, was it?, to stop using mercury.
Declan
Posted by linkadge on June 18, 2005, at 4:00:54
In reply to Re: Is There A Magic Pill?, posted by Declan on June 17, 2005, at 22:30:25
I have gotten to the point where In many ways I don't care. It seems that there is no way of communicating my state fully to the doctors.
You get a little bit of intuition about how your brain works and how you respond to the drugs.
I can't really describe how most antidepressants make me so akathesic that I want to kill myself.
They say, oh thats just the depression talking. But I *know* what I know, its like I just feel it is impossable to get anywhere with the doctors so I just give up.Last summer I was *really* intent on getting better. I wanted so much to enter the next school year not suicidal. I complained and compained about how the celexa was making things worse, but they couldn't see how that was, so I ended up trippling my celexa, which did nothing but make me a zombie who slept 24/7 and didn't care about anything he used to enjoy. And I am not the type of person who is going to say "I told you so" I'd rather just give up.
The psychiatric community, which is supposed to improve the state of learned helplessness, does a good job at making it much worse for me.
I feel I have had psychiatry do to me what Michael Jackson's plastic surgeons have done to him.
I need some doctor who is going to throw away his patient records and give me a fresh assesment.
Linkadge
Posted by linkadge on June 18, 2005, at 4:05:06
In reply to Re: Is There A Magic Pill?, posted by linkadge on June 18, 2005, at 4:00:54
I know I do a lot of complaining. But it takes a heck of a lot of exercise and will power just to come hear and compain. Most of the time I think it is worthless to even bother trying to communicate my feelings. So I hope it doesn't bother this board, but it is a step for me.
Linkadge
Posted by linkadge on June 18, 2005, at 4:34:50
In reply to Re: Is There A Magic Pill? » linkadge, posted by ed_uk on June 17, 2005, at 18:35:58
I don't really want people to hurt because I am hurting, I really just need to let people know how things are going or not going.
But, hey if anyones got any ideas I'm always all ears.
Linkadge
Posted by linkadge on June 18, 2005, at 4:36:09
In reply to Re: Is There A Magic Pill?, posted by linkadge on June 18, 2005, at 4:34:50
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