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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 21 to 45 of 166. Go back in thread:
Posted by flmm on July 2, 2006, at 15:32:49
In reply to Re: AD's and Future / Linkadge, posted by Klavot on July 2, 2006, at 13:56:26
I would also like to point out, if your mother was told that there are no risks to these meds, she would be in a minority of people. There is always a risk/benifit ratio!
Posted by linkadge on July 2, 2006, at 16:22:54
In reply to Re: AD's and Future / Linkadge, posted by Iansf on July 2, 2006, at 11:45:53
>I tend to agree. As a noted in my first post, >the fact that some of the same drugs are used >to treat both mood disorders and Parkinsonism >suggests the possibility of a common cause, or >at least a partial common cause. Which doesn't >necessarily exonerate SSRIs as a potential >cause of Parkinsonism. Clearly both >
>possibilities need further study
Thats a fair statment.Linkadge
Posted by linkadge on July 2, 2006, at 16:32:32
In reply to Re: AD's and Future / Linkadge, posted by flmm on July 2, 2006, at 12:56:19
>Is it possible, Linkadge, your mother would >have serious problems with or without >medication?
Anything is possable. Though both her her father and grandmother suffered the same illness without Parkinsonian symptoms till death. She was the only one who medicated for depression.
>From your posts it is clear you are not better >on or off them. Gee, coincedence?
No, I am no better mentally off of them, that does not mean I am not perhps preventing long term problems.
>There are a great many people helped by >medication, even if they do not post here! >Don't be angry at those who achieve relief.
I am not angry in the slightest. I am not evil natured. Why would I not want sombody to achieve recovery? I am simply suggesting (similar to those who conducted that study), that there is a destinct possability that the medication acually worked to promote the development of parkinson's.
>Most of us would have NO tommorrow if we could >not get thru today! I will take my chances as >there are no easy answers about mental illness. >Overanalyzing every study every person does in >the world will get most people no-where fast! >Just trying to get thru this.....You can take from this what you want. I am not trying to make decisions for anybody. Do remember that unmedicated depression often gets better on its own. It lives out its course, and most people get better even without medication.
Its not simply *one* problem that leads me to stop taking these medications. THere are a number of problems that when combined makes me believe that the risk is too great.
Linkadge
Posted by linkadge on July 2, 2006, at 16:36:29
In reply to Re: AD's and Future / Linkadge, posted by Klavot on July 2, 2006, at 13:56:26
The antidopaminergic nature of an antidepressant most likely varies from drug to drug, and on dose etc.
I would think that paxil would confer a significant risk due to it being the most potent, but its short half-life might confer some protection.
Some of the information will have accumulated based on the treatment of depression in parkinsons. Many doctors have realized that SSRI's may help the depression, but can often make the parkinson's worse.
Linkadge
Posted by linkadge on July 2, 2006, at 16:40:34
In reply to Re: AD's and Future / Linkadge, posted by flmm on July 2, 2006, at 15:32:49
My mother did not have acess to the array of information that this generation does.
Everything she read would have been biased. The internet is at least approacing an unbiased view.
Do you think her doctor would have told her about all the potential risks? Her doctor would simply tell her the risks that she was aware of.
Actually, her doctor once tried a TCA when she couldn't sleep. She told my mother that she thought to herself, "Oh my goodness what I am I doing to my Girls". Which was a reference to the many female patients she had been treating with trycyclic antidepressants.
Linkakdge
Posted by linkadge on July 2, 2006, at 16:46:00
In reply to Re: AD's and Future / Linkadge, posted by linkadge on July 2, 2006, at 16:40:34
Doctors will tell you that those who have had manic reactions to antidepressants were latently bipolar, and that the drug was simply unmaskind an underlying bipolar disorder. Do I believe that is true? The idea here is to take the focus off the drug and off psychiatry, and put it back on to the patient, afterall the patient is sick.
The same thing goes here. There is a potential problem with the medications perhaps causing parkinsonian symtpoms. Of course psychiatry is again going to try and take the blame of themselves and off their treatments and put it back onto the patient in the form of..."well, clearly you were going to get parkinson's anyway"..
Linkadge
Posted by flmm on July 2, 2006, at 19:33:30
In reply to Re: AD's and Future / Linkadge, posted by linkadge on July 2, 2006, at 16:46:00
Chronic depression does not go away on it's own!In most people it waxes and wanes. That is why people who go off medication have such a hard time. They usually need it!
Posted by linkadge on July 2, 2006, at 21:14:59
In reply to Re: AD's and Future / Linkadge, posted by flmm on July 2, 2006, at 19:33:30
No, you're right, some people do need the medication. I am not here to tell people not to take medicaton. I don't think we should stop the search for safer medications though.
Linkadge
Posted by linkadge on July 3, 2006, at 4:51:36
In reply to Re: AD's and Future / Linkadge, posted by linkadge on July 2, 2006, at 21:14:59
OTOH some researchers have noticed that those who do choose to medicate for depression often follow a completely different course of illness than those who do. Does treatment for depression make the illness a more chronic one? Thats for a different thread though.
Linkadge
Posted by flmm on July 3, 2006, at 11:00:39
In reply to Re: AD's and Future / Linkadge, posted by linkadge on July 3, 2006, at 4:51:36
I believe it is what it is! It must be treated however needed. Do you think someone is better off living in misery, proud of the fact they don't take medication? Why is it, mental illness is the one disease where you are not supposed to take medication? I don't get it! The course of the illness can change regardless of medication. Sometimes it helps, sometimes not. I know in my case, I am much better off with meds. Just because the course of the illness is not predictable, does not mean it should not be treated! These meds are all we have, they are not perfect, and I am thankfull for them as they have kept me going over 10 years. Every time I stop taking them I become the same person I was, anxious, depressed, unable to work etc. I am no better or worse than before meds, just the same!
Posted by linkadge on July 3, 2006, at 15:24:45
In reply to Re: AD's and Future / Linkadge, posted by flmm on July 3, 2006, at 11:00:39
>believe it is what it is! It must be treated >however needed. Do you think someone is better >off living in misery, proud of the fact they >don't take medication?
I don't derive any pride from the taking or not taking a medication. That makes no sense to me.
I am *not* putting anyone down for making the decision that they are making.>Why is it, mental illness is the one disease >where you are not supposed to take medication? >I don't get it! The course of the illness can >change regardless of medication. Sometimes it >helps, sometimes not. I know in my case, I am >much better off with meds.
I don't know who said not to take medication, but it wasn't me. I am not against the notion of taking medication at all.
>Just because the course of the illness is not >predictable, does not mean it should not be >treated! These meds are all we have, they are >not perfect, and I am thankfull for them as >they have kept me going over 10 years. Every >time I stop taking them I become the same >person I was, anxious, depressed, unable to >work etc. I am no better or worse than before >meds, just the same!
I am just aluding to the notion which many researchers have been suggesting/hinting at, which is the idea that the use of medication for depression may make it a more chronic one.
You must understand that I what I am posting is not directed at any one person, nor is it the product of any one person. A number of other babblers have posted articles discussing some of the same things. Even I wasn't the one who posted this article about this possable parkinson's link.
Clearly *other* people too are concerned too about exactly what these medications might do long term. Surely it is not right to try and restrict such concerns to being the manivolent plan of one poster Linkadge, nor do to I think it is foolish at all to delve into discussion of such possabilities.
I reiterate, I am not here to tell anyone to take or not take medication. I am simply brining up what I thought was pertainant subject matter.
Linkadge
Posted by Phillipa on July 3, 2006, at 19:18:54
In reply to Re: AD's and Future / Linkadge, posted by flmm on July 3, 2006, at 11:00:39
I take meds for depression and anxiety and it gets worse every year. I've tried all the SSRI"s SSNRI's the only thing that offers any type of relief is a benzo. I've taken trileptal and now lamictal to try to get rid of the depression and the pdoc is lowering my dose of the antidepressant Luvox. They just don't work for me and I don't work either but want to but can't My anxiety is too bad. And I can't believe that an SSRI is supposed to treat anxiety. They make mine worse. Love Phillipa
Posted by fuchsia on July 4, 2006, at 7:47:44
In reply to Re: AD's and Future Use of Antiparkinson Drugs » fuchsia, posted by Phillipa on July 1, 2006, at 18:47:33
> Fushia do you find lamictal as monotherphy better than an AD? And is it stimulating or calming for you. And what dose are you on? love Phillipa
Yes; for me it has been much much better than an AD.
It was both stimulating and calming. It got rid of a very distressing maelstrom of intense and unwanted moods and but it gave me the energy to do things.
I am on 400 mgs and unfortunately the AD effect has pooped out somewhat. So maybe I will have to take something else with it and then it wont be monotherapy anymore. I'm not looking forward to that.
Have you started taking it?
Posted by flmm on July 4, 2006, at 11:02:26
In reply to Re: AD's and Future / Linkadge, posted by linkadge on July 3, 2006, at 15:24:45
Again, the use of meds is not what makes the illnes chronic! The illness IS chronic!
BTW, did you here about the guy who recovered from an extensive coma, presumed to be beyond recovery? They started giving him paxil 2 years ago and he is doing better every day. What does this mean?..............
Posted by Iansf on July 4, 2006, at 11:40:58
In reply to Re: AD's and Future / Linkadge, posted by flmm on July 4, 2006, at 11:02:26
> Again, the use of meds is not what makes the illnes chronic! The illness IS chronic!
> BTW, did you here about the guy who recovered from an extensive coma, presumed to be beyond recovery? They started giving him paxil 2 years ago and he is doing better every day. What does this mean?..............Do you mean they started giving him Paxil while he was in a coma and that led to his coming out of it? Or that they gave it to him when he came out?
Posted by flmm on July 4, 2006, at 16:37:29
In reply to Re: AD's and Future / Linkadge, posted by Iansf on July 4, 2006, at 11:40:58
He came out first, was doing so-so, then they started giving paxil and he has been slowly improving!
Posted by linkadge on July 4, 2006, at 19:01:13
In reply to Re: AD's and Future / Linkadge, posted by flmm on July 4, 2006, at 11:02:26
>Again, the use of meds is not what makes the >illnes chronic! The illness IS chronic!
>BTW, did you here about the guy who recovered >from an extensive coma, presumed to be beyond >recovery? They started giving him paxil 2 years >ago and he is doing better every day. What does >this mean?..............It means some people get better. Just because you get better while on a medication doesn't mean that you got better because of a medication. You may have got better in spite of that medication.
In addition, some of the people who have made these studies have essentially been matching and comparing people with depression of equal sevarity, some who choose to medicate and some who don't. The conclusions that they came to is that antidepressants seemed to change the course of the illness. Ie, more medications required, more need for treatment in general, worse long term outcome, more functional impariment etc.
I will try to look for some of the studies that I am referring to.
Depression is often recurring, but not necessarily chronic. Ie it can come back, but it does often remit on its own.
Linkadge
Posted by linkadge on July 4, 2006, at 19:02:27
In reply to Re: AD's and Future / Linkadge, posted by flmm on July 4, 2006, at 16:37:29
Ok, so thats one case. I can give at least a dozen cases of people I know who were doing so-so, and have slowly been getting worse after starting medications.
Linkadge
Posted by Phillipa on July 4, 2006, at 19:30:57
In reply to Re: AD's and Future Use of Antiparkinson Drugs » Phillipa, posted by fuchsia on July 4, 2006, at 7:47:44
Fushia I just started on 25mg now and cutting back on luvox on 50mg and the valium at night.But I don't know what's wrong. As soon as I woke up I went back to bed and slept all day and had diarrhea. Is that a side effect of lamictal? Love Phillipa
Posted by pulse on July 5, 2006, at 1:54:34
In reply to Re: AD's and Future / Linkadge, posted by linkadge on July 4, 2006, at 19:01:13
yes, it's well known/ established for many years that recurrent depression does indeed remit on it's own.
most of us, including myself, until this final emsam faiure, have simply lacked the resolve, courage, and been unwilling to alot the time necessary - out of exteme fear - wholly understandable!...to find out that this IS very likely true for ourselves. yes, it is hard, but it's also most probably do-able.
my disclamer: as is more than obvious with 'the evil' linkage, i, too, am NOT telling anyone to NOT take these meds.
pulse
Posted by Iansf on July 5, 2006, at 13:01:39
In reply to Re: AD's and Future / Linkadge » linkadge, posted by pulse on July 5, 2006, at 1:54:34
> yes, it's well known/ established for many years that recurrent depression does indeed remit on it's own.
>
> most of us, including myself, until this final emsam faiure, have simply lacked the resolve, courage, and been unwilling to alot the time necessary - out of exteme fear - wholly understandable!...to find out that this IS very likely true for ourselves. yes, it is hard, but it's also most probably do-able.
>Where are the studies showing this? I did not take an antidepressant until I was 42 years old. I suffered from depression at least since early teens, possibly before that. It did remit, at times. But it always came back, and often stayed for long, long periods. Depression made hell of much of my life. How long exactly was I supposed to wait for it to remit for good - till I was 50? 60? 70? 80? Situational depression often remits - e.g., depression following the death of a loved one. But I know of no one who has suffered from multiple episodes of serious depression who has not continued to suffer over the years, regardless of how much effort they put in. I'm sure there are examples, but I'm willing to bet the percentage is small.
John
Posted by Klavot on July 5, 2006, at 13:19:15
In reply to Re: AD's and Future / Linkadge » linkadge, posted by pulse on July 5, 2006, at 1:54:34
> yes, it's well known/ established for many years that recurrent depression does indeed remit on it's own.
>
> most of us, including myself, until this final emsam faiure, have simply lacked the resolve, courage, and been unwilling to alot the time necessary - out of exteme fear - wholly understandable!...to find out that this IS very likely true for ourselves. yes, it is hard, but it's also most probably do-able.
>
> my disclamer: as is more than obvious with 'the evil' linkage, i, too, am NOT telling anyone to NOT take these meds.
>
> pulseI have tried psychotherapy, hypnotherapy, diet, exercise and light therapy, with little success. If only it really were as easy as that...
I think many researchers make the mistake of treating correlation and causality as the same thing (as in "SSRI users have a 2.5 times higher frequency of Parkinson's, hence SSRI's cause Parkinson's"), and I also think it is very dangerous to work on anecdote (as in "I knew someone who took Zoloft and subsequetly had a stroke" kind of thing). Many mathematical scientists (for example Serge Lang) have been very critical of the way medical scientists misuse statistics to substantiate their hypotheses.
A half-truth is worse than a lie, and it is very easy for researchers to put a particular slant on their data when testing a hypothesis. That is why you find so many contradictory studies out there.
Posted by pulse on July 5, 2006, at 16:09:46
In reply to Re: AD's and Future / Linkadge, posted by Iansf on July 5, 2006, at 13:01:39
my disclamer: as is more than obvious with 'the evil' linkage, i, too, am NOT telling anyone to NOT take these meds.
Posted by linkadge on July 5, 2006, at 17:17:37
In reply to Re: Correlation vs causality, posted by Klavot on July 5, 2006, at 13:19:15
The idea that SSRIs might actually induce parkonson's is not new.
I would not put it on the same level as SSRI's cause stroke since there is really insufficant evidence to suggest such.I suppose the first pieces of evidence were the observation that SSRI's can cause acute parkinsonian like effects. The SSRI's also often make existing parkinsons disease worse.There are also the animal studies which actually suggest that it is the SSRI itself which is inducing neuroanatomical changes in the regions of the brain controlling movement.
So you've got a study which seems to correlate SSRI use to parkinsons, but when that is coupled with the animal studies says a bit more.
The same thing goes with neuroleptics and TD. Doctors started to observe things, then hypothesis were made, and then animal studies were done to try and retest the hypothesis. I mean sure, you'll get the doctors who still denounce the association, and try and say that schizophrenia itself is a risk factor for TD, but why then do animals given Haldol develop identical symptoms to those observed in humans.
Linkadge
Posted by linkadge on July 5, 2006, at 17:32:22
In reply to Re: Correlation vs causality, posted by linkadge on July 5, 2006, at 17:17:37
There is a little blirb about it here.
http://www.biopsychiatry.com/antidepworse.htm
Linkadge
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