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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 46 to 70 of 166. Go back in thread:
Posted by flmm on July 5, 2006, at 19:37:10
In reply to Re: Correlation vs causality, posted by linkadge on July 5, 2006, at 17:32:22
I agree with john, chronic depression does not remit on it's own, in most people. I too had depression and anxiety in early childhood, only too find relief after 20 years of suffering. My life is better on meds, no doubt. Without I had no life to speak of! So celebrate (all you med haters), stay off your meds and be miserable! Just please, don't bring us down with you. You made your choice, don't ruin mine. Maybe there is another board for chronic depression med haters to reside?............
Posted by ttee on July 5, 2006, at 23:42:21
In reply to Re: Correlation vs causality, posted by flmm on July 5, 2006, at 19:37:10
If I was doing well on my meds, I wouldn't be spending any time on babble and would be enjoying life. Unfortunatly, 99% of the people here are in the MAJORITY that psycho meds don't seem to work so well. Over 9 million Americans suffer from treatment resistant depression, and to qualify to be a member of this club you need to have failed at least 4 meds. Hope your meds don't poop out.
Posted by fuchsia on July 6, 2006, at 0:05:48
In reply to Re: AD's and Future Use of Antiparkinson Drugs » fuchsia, posted by Phillipa on July 4, 2006, at 19:30:57
> 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
Phillipa, I guess it might be hard to work out whether something is a lamictal side effect or a luvox withdrawal effect. Diarrhoea may be a rare side effect of lamictal but it's not one I've had. I didn't have sleepiness either.
fuchsia
Posted by Klavot on July 6, 2006, at 3:17:27
In reply to Re: AD's and Future Use of Antiparkinson Drugs » Phillipa, posted by fuchsia on July 6, 2006, at 0:05:48
Linkadge, what is your opinion of Wellbutrin? Does Wellbutrin have the same issues as SSRI's?
What would be a good (non-antidopaminergic) augmentation to Wellbutrin to treat excessive pessimism, suicidal ideation, rejection oversensistivity, etc?
I do feel that Zoloft contributes to my apathy and lack of motivation (which are present even without Zoloft), but what are my alternatives?
Posted by Klavot on July 6, 2006, at 16:20:21
In reply to Re: AD's and Future Use of Antiparkinson Drugs, posted by Klavot on July 6, 2006, at 3:17:27
With all due respect, where do the Zoloft bashers get that Zoloft reduces dopaminergic activity? I have just been to numerous websites where it says that Zoloft is a weak dopamine reuptake inhibitor!
BTW, my handwriting improves and my hands are more steady when I'm on Zoloft, hardly what one would expect of a drug contributing to Parkinson's.
Posted by linkadge on July 6, 2006, at 18:29:18
In reply to Re: Correlation vs causality, posted by flmm on July 5, 2006, at 19:37:10
I am not a med hater. I don't see why my comments warrent such. If you feel better, then great. I hope for your sake it actually lasts.
I also hope for your sake that you don't develop some of the mentioned possabilities.I am not expecting anyone to arive at the same conclusions and decisions that I have.
I'm just letting people know why I have made the decisions that I did.
Linkadge
Posted by linkadge on July 6, 2006, at 18:35:25
In reply to Re: Correlation vs causality, posted by ttee on July 5, 2006, at 23:42:21
I agree. I think there are misconceptions about the overall efficacy of these "wonderdrugs". The problem is that nobody goes around saying that they're on an antidepressant. Most people would like to keep that personal. So, we don't really know how many people actually respond to these drugs and how many don't. You can't trust the drug company's information.
Since drug companies don't have to release information about failed drug trials, how can we really get a full picture?
I honestly don't know anybody who has taken just one medication and then there life was happy ever after.
If they work for you, no questions asked, then count yourself lucky.
Linkadge
Posted by linkadge on July 6, 2006, at 18:47:10
In reply to Re: AD's and Future Use of Antiparkinson Drugs, posted by Klavot on July 6, 2006, at 16:20:21
You are right, zoloft is a weak dopamine reuptake inhibitor. Of all the SSRI's, zoloft may posess the most dopaminergic activity due to this.
It is all about the ratio though. Serotonin and dopamine work on kind of a yin-yang system to controll motivation and satisfaction. Too much serotonin and you could become apathetic and amotivational, since serotonin acts to supress certain dopaminergic circutry. Too much dopamine, and you just 'want' all the time, but are unable to find any satisfaction.
Sertraline is not completely exempt from certain occurances of parkonsonian symtpoms and such happenings.
http://psy.psychiatryonline.org/cgi/content/full/42/2/163-a
But I think it is necssary to look at some of these occurances from a different angle. Reduction of dopamine does not in itself cause parkinson's. Parkinson's is actually due to descruction of dopaminergic neurons. If an SSRI or lithium acutally induces parkinsons, then it is somehow contributing to destruction of dopaminergic neurons.
My theory was that the SSRI's have been show to significantly reduce melatonin concentration. Melatonin seems to have significant neuroprotective and antiaging properties. Melatonin is responsable for maintining GDNF, a growth factor which is both protective of and trophic to the dopaminergic system. If long term use of an SSRI acutally leads to parkinsons, it may be an indirect conseqence of long term reduction in melatonin concentration.
Thats just my theory.
Linkadge
Posted by Phillipa on July 6, 2006, at 20:01:39
In reply to Re: Correlation vs causality » ttee, posted by linkadge on July 6, 2006, at 18:35:25
Link the people I know have no problem saying they are on antidepressants. Their reaction and they say everyone they know is on some type of medication. I know my next door neighbor a teacher takes up to 6mg of xanax and lexapro. The neighbors across the street both take zoloft . And the wife uses a fentanyl patch. No one thinks anything about talking about meds. It seems like it's almost bragging to say you're on Meds. Not so around l0years a go but then most of the nurses I worked with took benzos and Ad's SSRI's. Love Phillipa
Posted by Klavot on July 7, 2006, at 2:01:49
In reply to Re: AD's and Future Use of Antiparkinson Drugs, posted by linkadge on July 6, 2006, at 18:47:10
Posted by pulse on July 7, 2006, at 8:17:49
In reply to Re: Correlation vs causality, posted by flmm on July 5, 2006, at 19:37:10
on the contrary, i'd say it's abundantly clear that not one of us is a med hater; rather, we are better, safer med WISHERS.
unlike many to most others, i'm in no way tx resisteant. i am 'med sensitive.'
however, far more problemetic, i'm also med side-effects intolerant, meaning: they never go away any longer, no matter how long the trial of ad or combos, all classes. also of all stabilzers as augmentors, or any & all other augmentors, including t3.
of course, you'd have to read more than this thread to know this, as most of us do.
in no way am i taking away from linkage's/ others likely legitimate concerns.
my new disclaimer (altho i think it's wholly unecessary, i'm just feeling 'expansive'): never did i say i wanted ANYONE to suffer.
pulse
Posted by linkadge on July 7, 2006, at 15:09:35
In reply to Re: Correlation vs causality » linkadge, posted by Phillipa on July 6, 2006, at 20:01:39
I suppose it could be slightly different with women (?).
Linkadge
Posted by flmm on July 7, 2006, at 21:42:54
In reply to Re: Correlation vs causality, posted by ttee on July 5, 2006, at 23:42:21
Ttee, my meds have "pooped out" more times then I can mention! You know what I do? Try another med and do something different in my life to help it more! Can't just sit back and whine....
Thanx for the passive agressive response!
Posted by linkadge on July 8, 2006, at 18:37:42
In reply to Re: Correlation vs causality TTee, posted by flmm on July 7, 2006, at 21:42:54
Yeah, meds are just a way to take your mind off of whats bothering you. For me, it wasn't the med that helped so much as it was the idea that "I was getting help", and that "things were going to be different".
You have to believe.
Linkadge
Posted by ttee on July 9, 2006, at 10:14:40
In reply to Re: Correlation vs causality TTee » flmm, posted by linkadge on July 8, 2006, at 18:37:42
Too bad they outlawed prescribing sugar pills. Sounds to me that they work the best with the least (but not zero) side effects. :-) I suppose the sugar could led to weight gain.
Posted by SLS on July 9, 2006, at 10:45:55
In reply to Re: Correlation vs causality, posted by ttee on July 5, 2006, at 23:42:21
> Unfortunatly, 99% of the people here are in the MAJORITY that psycho meds don't seem to work so well.
According to STAR*D, the majority of people remitted by their third drug trial.
- Scott
Posted by SLS on July 9, 2006, at 10:57:47
In reply to Re: Correlation vs causality » ttee, posted by SLS on July 9, 2006, at 10:45:55
> > Unfortunatly, 99% of the people here are in the MAJORITY that psycho meds don't seem to work so well.
>
> According to STAR*D, the majority of people remitted by their third drug trial.And the majority of the people entering the study displayed a recurrent course of illness and were inherently more difficult to treat.
- Scott
Posted by gardenergirl on July 9, 2006, at 13:29:50
In reply to Re: Correlation vs causality TTee, posted by flmm on July 7, 2006, at 21:42:54
> We have problems that get excaserbated by scare mongers! (from http://www.dr-bob.org/babble/20060701/msgs/663335.html )
and
> Thanx for the passive agressive response!
Please don't post anything that could lead others to feel accused or put down.
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#civilFollow-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.
Regards,
deputy gg
Posted by linkadge on July 9, 2006, at 15:38:46
In reply to Re: Correlation vs causality » ttee, posted by SLS on July 9, 2006, at 10:45:55
>According to STAR*D, the majority of people >remitted by their third drug trial.
Which study are you referring to ?
Linkadge
Posted by SLS on July 9, 2006, at 19:17:42
In reply to Re: Correlation vs causality, posted by SLS on July 9, 2006, at 10:57:47
> > > Unfortunatly, 99% of the people here are in the MAJORITY that psycho meds don't seem to work so well.
> >
> > According to STAR*D, the majority of people remitted by their third drug trial.
>
> And the majority of the people entering the study displayed a recurrent course of illness and were inherently more difficult to treat.
"Combined with previous reports from the project, the new finding suggests that about 60% of people who have depression can gain complete remission by the time they've tried three drugs."http://www.usatoday.com/news/health/2006-07-01-depression-drug_x.htm
----------------------------------------------
From the McMan's Bipolar Newsletter:
"When Newsletter 8#3 reported on the STAR*D second round results a few months ago, Frederick Goodwin MD, co-author (with Kay Jamison PhD) of "Manic-Depressive Illness" got back to me with this observation:
"I noticed that the cohort they studied had a mean of six previous episodes; this means that they were relatively highly recurrent unipolar patients..."
----------------------------------------------
- Scott
Posted by linkadge on July 9, 2006, at 20:11:47
In reply to Re: Correlation vs causality, posted by SLS on July 9, 2006, at 19:17:42
Perhaps, I've seen statistics suggesting the rate of remission is lower than this. It depends on your critera.
I remember my doctor claimed I was in remssion, based on the few questions he asked me during my effexor trial. Perhaps if he had asked me if I was still suicidal that would have changed his opinion about what he percieved as remssion.
Other factors need to be considered. Unfortunately, younger people are more likely tend to respond to antidepressants, I think (though I may be wrong) that they are more likely to respond to placebo as well.
Linkadge
Posted by linkadge on July 9, 2006, at 20:44:50
In reply to Re: Correlation vs causality, posted by linkadge on July 9, 2006, at 20:11:47
http://www.dissidentvoice.org/July06/Levine01.htm
Althought, there are a few comments near the end of the article which I do not agree with.Linkadge
Posted by SLS on July 10, 2006, at 5:40:09
In reply to couldn't have said it better myself, posted by linkadge on July 9, 2006, at 20:44:50
> http://www.dissidentvoice.org/July06/Levine01.htm
Having been a research patient at the NIMH and having followed the work of many of the investigators of the STAR*D project, I disagree with the characterization of these entities as being corrupt and their treatment of science as a bastardization thereof. If you wish to feel indignance at anything, perhaps it should be at the pittance of funds allocated these institutions to pursue the understanding and effective treatment of mental illness by national governments. It is indeed disquieting that so many of our most brilliant minds are being distracted by private enterprise for lack of monetary allocation. Nevertheless, I am confident that most remain faithful to their moral motives and scientific ethics. I have dealt with some of these people personally.
- Scott
Posted by linkadge on July 10, 2006, at 16:53:45
In reply to Re: couldn't have said it better myself, posted by SLS on July 10, 2006, at 5:40:09
Language, and heated tone asside, he made some very valid points. Why was a placebo arm not used?
Were thay afraid of what it might show ?
That is of course why there is so much heated debate about the use of active placebo's. Those incharge are afraid of what they might, and often do show.
You can't convince me by attacking his tone, to convince me, you'd need to attack some of the valid points he made which in themselves essentially still stand posed free of emotional tone.
Linkadge
Posted by SLS on July 10, 2006, at 21:34:12
In reply to Re: couldn't have said it better myself, posted by linkadge on July 10, 2006, at 16:53:45
> Language, and heated tone asside, he made some very valid points. Why was a placebo arm not used?
I don't believe it was the goal of the study to separate out an active treatment from a placebo. It was an attempt to test treatment algorithms in real-world clinical settings and determine treatment success rates. Placebo response rates in double-blind clinical trials are already well established.
> Were thay afraid of what it might show ?
What makes you think that they would be afraid to show anything? More conspiracy theories? They certainly weren't afraid to show the dismal results of the third step of their treatment algorithm. Neither mirtazapine nor nortriptyline monotherapy produced a remission rate of 20% for those who had failed to respond adequately to the two previous steps. Their reporting was manifestly unbiased. There was no attempt made to declare any of the treatments used as producing a remission rate of greater than 50%.
- Scott
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