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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 18 to 42 of 116. Go back in thread:
Posted by SLS on April 15, 2008, at 20:16:27
In reply to Re: Wierd Some I know In real Life Feel Better off ADs » bulldog2, posted by Glydin on April 15, 2008, at 16:07:03
Hi all.
I know this is pretty silly, but if person number 1 doesn't respond to an AD, the worst we can say is that the drug might not work for anyone. The best we could say is that it might work for other people, but not person number 1. If person number 2 does respond to an AD, the worst we can say is that the drug works for at least one person. The best we can say is that 50% of people respond to medication.
I respond to medication. The worst I can say is that I am the only person in the world who responds to my treatment regime. The best I can say is that everyone has the potential to get well.
What got me well? Vigilance, persistence, hope, and patience. Observing which drugs I maintained a partial response to. Combining some of these drugs together and further augmenting them with still other drugs and tweaking dosages. Then, forget about drugs for awhile. Like maybe 3 weeks. Then assess and make adjustments as necessary. Now, wait.
It seems simple enough. In reality, it is hard as hell. It is extremely difficult to avoid despair and hopelessness.
There are magic pills.
This is most true for people with properly diagnosed affective and anxiety disorders. Once one obtains a good response to medication, then it is possible to better process the issues of everyday life - just like real people.
I'm feeling wonderful. The addition of Deplin 4 months ago made the difference. Deplin takes 2-4 months to work. Fortunately, I know that going in. So, I simply popped my "medical food" every day and didn't think much more about it. At some point, I said, "I'll be damned." I have been improving steadily. It seems to be sticking. I have a lot of detritus to clean up. Depression leaves devastation in its wake with wreckage everywhere. Well, if I do all of this additional work psychologically, doesn't that prove that there are no magic pills? No. The pills still work their magic so that one can just begin to process their outer and inner worlds. Many people have no need for remedial psychotherapy. People with unhealthy brains can have healthy minds. Give them the right pill, and they jump off the couch they had laid on motionless for years, ready and capable to begin living on the best terms their new-found awakening offers them. Some chronic depressives have been able to practice self-actualization despite their biological depression. The magic here is having a healthy brain once again facilitate a healthy mind.
Let's just say that for Scott, there are magic pills.
Severe depression begins - 17 yrs.
First diagnosed properly and treated - 22 yrs.
First remission (6 months) - 27 yrs.
Became completely unresponsive to medication - 30 yrs.
Became partially responsive to medication - 40 yrs.
Robust response (finally) - 48 yrs.60 psychotropic drugs (foreign or unmarketed).
Multiple permutations of drug combinations.
ECT.
Psychotherapy.
Food allergy rotation diet.
Other stuff.
A lot of crying.There is a lot of good advice and healthy perspective to be found along this thread.
Currently:
Nardil 90mg
nortriptyline 150mg
Lamictal 200mg
Abilify 20mg
Deplin 7.5mgGod has been very good to me.
- Scott
Posted by SLS on April 15, 2008, at 20:22:13
In reply to Wierd Some I know In real Life Feel Better off ADs, posted by Phillipa on April 14, 2008, at 13:40:46
> Strange a few people I know feel sooo much better since they weaned off their ad's
This is very often the result of a biological rebound caused by the abrupt dosage reduction of some drugs. It is temporary. I see lots of these people go back to their drugs without delay once the rebound disappears.There is also the reduction in the load of side-effects, both physical and mental, that can often be a relief once they dissipate.
- Scott
Posted by atmlady on April 15, 2008, at 20:44:50
In reply to Re: Wierd Some I know In real Life Feel Better off, posted by SLS on April 15, 2008, at 20:16:27
SLS, beautifully said. I am actually tearing up reading your post, because it is so much like my own struggle. I don't think anyone here "wants" to be on meds of any sort. Because they all come with side effects, and yeah, if you're on the "wrong" med for you, then I suppose you WOULD feel better off when you stop it. I get angry sometimes that there isn't an easy answer for depression - something that works for practically everyone, like penicillan. Why do I have to do through this trial and error and .... well, you know. But I am convinced that all of our struggles and obstacles serve to make us stronger, smarter and in the end, better people - if we allow it. ANyway, that's my take. Not as eloquent as your wonderful post, which should be displayed somewhere for posterity for shizzle
Posted by Phillipa on April 15, 2008, at 21:24:56
In reply to Re: Wierd Some I know In real Life Feel Better off, posted by SLS on April 15, 2008, at 20:16:27
Scott you are truly a remarkable person to me and always have been. Seriously though how did you manage to get a great pdoc mine have been so shoddy. So you think my next door neighbor since she was on lexapro for years with six mg of xanax and recently taken off effexor on a year with same xanax. And now down to 3mg of xanax will crash in a matter of time? I'm serious. You have done work with NIMH right? Love Phillipa ps between you and Ron and Henyro Deplin is definitely coming back on board. I have no fear of what I prefer to call a vitamin as was a health freak for many years. Thanks you .
Posted by alienatari on April 15, 2008, at 23:03:41
In reply to Wierd Some I know In real Life Feel Better off ADs, posted by Phillipa on April 14, 2008, at 13:40:46
It's been about 7 months or so since I stopped taking medication and I cannot convey how much better I feel off psychiatric meds. Not only was my cognitive functioning impaired significantly, I had reached the stage where all I did was sleep because I was so exhausted from the medication side effects. I didn't shower for a month, or shave, or cut my nails. It was disgusting! So I gradually stopped all of my medication. When I was finally off all my meds, including my AD, my depression started to lift. I could think again, I was no longer impotent, I have lost 27kg of weight (59 pounds) that I had gained from medication. Now, If I am having a bad day or have insomnia I will take a valium but It ends up causing more problems then its worth most of the time, for me anyway.
I think a lot of doctors seem to forget about the paradoxical reactions to medications that can occur. While I was put on respirodone for anxiety, I became psychotic. I was very paranoid. A few weeks after stopping respiridone my paranoia was totally gone.
I am not anti-med but it sure as hell feels great to be off them and I no longer have depression anyway so there is no point in being on them. My OCD is still there of course but I manage it with CBT now.
I am not saying everyone should stop taking their medication, as we are all different, but for me it was the right thing to do and I wish I had done it a lot sooner then I did.
Posted by alienatari on April 15, 2008, at 23:17:53
In reply to Re: Wierd Some I know In real Life Feel Better off ADs, posted by bulldog2 on April 14, 2008, at 16:00:35
Wow, I actually just read the posts underneath the original post by phillipa. I think some of you should be ashamed of yourselves attacking her like that. How dare you!
So a board about psychiatric medication has to only be about the positives and not the negatives of psychotropic medication? That is ridiculous!
Phillipa is actually not anti-meds at all if you actually knew her and even if she was, why do so many people feel so threatened and have to justify their own medical treatment? Maybe deep down, you know in your heart that the medication your taking is doing nothing and your still miserable and suffering even though your taking fist fulls of drugs daily... Maybe a reality check is needed for some of you?If you want to take meds take them, if you don't want to then don't. Do whatever helps in your treatment but censoring other people because it doesn't fit your agenda is pathetic, and quite sad actually.
Posted by Dr. Bob on April 16, 2008, at 3:14:46
In reply to Re: Some of you should be ashamed of yourselves, posted by alienatari on April 15, 2008, at 23:17:53
> I think some of you should be ashamed of yourselves attacking her like that.
Please don't post anything that could lead others to feel accused or put down. If you want to support someone else, it's more civil just to support them directly.
But please don't take this personally, either, this doesn't mean I don't like you or think you're a bad person.
I encourage anyone who has questions about this or about posting policies in general, or is interested in alternative ways of expressing themselves, to see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
http://www.dr-bob.org/babble/faq.html#enforceFollow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above post, should of course themselves be civil.
Thanks,
Bob
Posted by antiserial on April 16, 2008, at 7:07:55
In reply to Re: Wierd Some I know In real Life Feel Better off » Phillipa, posted by SLS on April 15, 2008, at 20:22:13
> > Strange a few people I know feel sooo much better since they weaned off their ad's
>
>
> This is very often the result of a biological rebound caused by the abrupt dosage reduction of some drugs. It is temporary. I see lots of these people go back to their drugs without delay once the rebound disappears.I wonder how often this is the case, as others instead feel worse when quitting ADs. This poses another problem, because it makes people convinced that they "need" an AD afterall (I was one of them). The normalization of the brain chemistry can for some people take a very long time. I guess people should be patient whether they want to try meds, or quit meds.
Posted by SLS on April 16, 2008, at 9:33:21
In reply to Re: Wierd Some I know In real Life Feel Better off » SLS, posted by antiserial on April 16, 2008, at 7:07:55
You bring up some very interesting observations. I am particularly happy that you are feeling better without drugs.
> I guess people should be patient whether they want to try meds, or quit meds.
Big time!
- Scott
Posted by Abby Cunningham on April 16, 2008, at 9:37:37
In reply to Re: Wierd Some I know In real Life Feel Better off » antiserial, posted by gardenergirl on April 15, 2008, at 15:21:17
Well I for one know many people who are much better off after discontinuing benzodiazepines. I am on them myself (25+ years) and unlike those who develop tolerance right away I did not. I even cut my dosage in half 3 years ago.
However, a long-term use of benzodiazepines can definitely cause paradoxical reactions such as agoraphobia, anxiousness, depression, etc. Plus I am an accidental addict (cannot withdraw without excruciating symptoms). So I agree that drugs can have their place and even be life-savers for some, but those of us who are on benzos and can't get off them can be a living hell.
Abby
Posted by SLS on April 16, 2008, at 9:49:53
In reply to Re: Wierd Some I know In real Life Feel Better off » gardenergirl, posted by Abby Cunningham on April 16, 2008, at 9:37:37
>but those of us who are on benzos and can't get off
Try nibbling a small piece of a tablet whenever you feel the withdrawal symptoms appear. You might have to do this several times a day. There is nothing that says you have to take your benzo as a once or twice a day schedule. You take the smallest dose that will allow you to go 4-6 hours of relief. It works wonderfully for me with benzos, Effexor, Cymbalta, and SSRIs.The other thing you can experiment with is the usage of a pro-GABA mood-stabilizer to take while you are weaning off the benzo. Depakote might be ideal for this. Also, Neurontin, Lyrica, or Topamax.
- Scott
Posted by Betula on April 16, 2008, at 11:51:18
In reply to Re: Wierd Some I know In real Life Feel Better off ADs » bulldog2, posted by antiserial on April 15, 2008, at 10:00:57
> SSRIs make people apathetic. This enables people to be indifferent towards depressive thoughts and angst. Emotional flatness might be a good thing for some people, but the fact is that some people are better off without this. Sexual side effects and weight gain aren't exactly mood-elevating, either.
>
> The truth can be demoralizing, but there's no reason to give people false hopes.I agree with every word you say anti-serial.
If anti-depressants work, then why are they so many people on this board for whom they fail?
Everyone knows that, for example, paracetamol is effective against high fevers for nearly everyone.
Why don't we think that SSRIs are that effective? Everyone accepts that sometimes SSRIs work, sometimes they don't. Therefore, they are not that effective for depression, as paracetamol is for high fevers.
And actually, there have been quite a few studies which show that SSRIs are often no more effective than placebo. That is a fact.
May I refer disbelievers (and believers for that matter) to this popular news article, talking about the orginal research:
http://news.bbc.co.uk/2/hi/health/7263494.stm
I think what makes this study particulary accurate is the fact that:
-they reviewed data on 47 clinical trials.
-they reviewed published clinical trial data, and unpublished data secured under Freedom of Information legislation.
This means that they also included the unfavourable studies that the big pharmacetical companies DO NOT publish because it shows their drugs in a bad light. AFAIK, it is not possible to obtain this data in the USA.
So there you have it. Antidepressants have little use, FACT.
Posted by gardenergirl on April 16, 2008, at 13:23:16
In reply to They just don't work. FACT., posted by Betula on April 16, 2008, at 11:51:18
"FACT" for you, that is, not for all. For clarity's sake, given your conclusion, I suppose if one were to substitute "opinion" or "interpretation" for "FACT", more might be inclined to agree.
gg
Posted by SLS on April 16, 2008, at 13:55:21
In reply to They just don't work. FACT., posted by Betula on April 16, 2008, at 11:51:18
I believe your information is inaccurate.
No.
I'm sorry.
I KNOW it is inaccurate.
By the way, drugs work for me. But lets see how you are going to refute my experience. Actually, don't bother. You would be wasting both our breaths.
- Scott
Posted by Betula on April 16, 2008, at 14:53:16
In reply to Re: They just don't work. FACT. » Betula, posted by SLS on April 16, 2008, at 13:55:21
Hey, great that the drugs work for you. Super!
Posted by bulldog2 on April 16, 2008, at 14:58:45
In reply to They just don't work. FACT., posted by Betula on April 16, 2008, at 11:51:18
> > SSRIs make people apathetic. This enables people to be indifferent towards depressive thoughts and angst. Emotional flatness might be a good thing for some people, but the fact is that some people are better off without this. Sexual side effects and weight gain aren't exactly mood-elevating, either.
> >
> > The truth can be demoralizing, but there's no reason to give people false hopes.
>
> I agree with every word you say anti-serial.
>
> If anti-depressants work, then why are they so many people on this board for whom they fail?
>
> Everyone knows that, for example, paracetamol is effective against high fevers for nearly everyone.
>
> Why don't we think that SSRIs are that effective? Everyone accepts that sometimes SSRIs work, sometimes they don't. Therefore, they are not that effective for depression, as paracetamol is for high fevers.
>
> And actually, there have been quite a few studies which show that SSRIs are often no more effective than placebo. That is a fact.
>
> May I refer disbelievers (and believers for that matter) to this popular news article, talking about the orginal research:
>
> http://news.bbc.co.uk/2/hi/health/7263494.stm
>
> I think what makes this study particulary accurate is the fact that:
>
> -they reviewed data on 47 clinical trials.
>
> -they reviewed published clinical trial data, and unpublished data secured under Freedom of Information legislation.
>
> This means that they also included the unfavourable studies that the big pharmacetical companies DO NOT publish because it shows their drugs in a bad light. AFAIK, it is not possible to obtain this data in the USA.
>
> So there you have it. Antidepressants have little use, FACT.
>
>You seem to use the term ssri and ad as if they are one. There are many classes of ads and many treatment options.
The fact that so many people come to this board ...how many people come to this board in relationship to the total population of people with emotional disorders? Probably far less than
1 % if that.
Even on this board there are successes and failures.
Why does everything have to be so black or white.Meds help some and some do not respond and some may not even need them
But why take away the hope of people who are suffering? Their own trials will tell them if meds work.
Posted by SLS on April 16, 2008, at 15:42:45
In reply to Re: They just don't work. FACT., posted by Betula on April 16, 2008, at 14:53:16
> Hey, great that the drugs work for you. Super!
Thanks. It took 25 years to get it right!
Who cares how you get well, Betula? Just do it. I'll throw up a prayer for you.
I would be extraordinarily happy to see you get well, however you make it happen. Hell, if I were told that I would get well drinking horse piss, I would (gulp)... Well, maybe not.
I would encourage you to continue to search for literature that affirms and those that refute the question of how effective antidepressants really are - especially in drug-combination treatments. I hope you can convince yourself that among these various drugs you will find your magic pills. I am convinced that they exist. I came to this conclusion in 1982 when they first worked for me. I find the medical and popular literature quite persuasive in demonstrating to me that treatment can be effective in at least 85% of people. I wish it were 100%. One day...
Good luck.
- Scott
Posted by Betula on April 17, 2008, at 9:13:07
In reply to Re: They just don't work. FACT. - Who cares? :-) » Betula, posted by SLS on April 16, 2008, at 15:42:45
Sure, I could find magic pills that would relieve me of my OCD/anxiety/depression, but they would just mask the underlying cause. The depression etc would return once I quit the pills. And this I know because I've been down that route.
I do not think it is healthy to take these pills indefinately. I view them as short term band aids to help you get through tough periods. That is all. I do not think they were even designed to be taken for extended periods of time, or at least, certainly the SSRIs weren't. And I certainly do not want to be one of those ones who become addicted for life or have terrible discontinuation sydromes. And let us not forget they haven't been around for all that long - who knows what happens to you if you take Effexor (yes, I know not technically an SSRI, but the same principles apply) for 20 years and try to wean off?? The drug companies sure as hell don't know. I am really not convinced we know enough about SSRIs to really say for sure. And let us not forget the pharma companies hiding information about the increased risk of suicide. Even if they didn't hide it, at least this is something unpredicted to come out of these drugs. Who knows what'll happen with say, 25+ years of use of lexapro? No-one simply knows for sure.
Actually, for me, therapy is proving to be a far far better remedy for me than any pills were. Its really great I have to say.
Contrary to what you might think, I am actually open minded about the whole thing - it was my belief a few years ago that there was a 'cure' but now, after everything I've seen, I think SSRIs, in particular, are not very good - to put it mildly, and I don't think the pharma companies are being particulary honest about their findings either.
Hence why I like this study because it actually includes unpublished data that the pharma companies didn't publish (presumably because it shows their drugs in a bad light).
So. I used to be pro-SSRIs, now I'm very much anti. Or rather, I just don't think they work particulary effectively and I wish people would see that. And I think you'd be better spending your health and time and money doing something else to help. And I think there's alot to be said for getting to the root cause of the depression/anxiety etc rather than just using drugs to mask the symptoms - because otherwise you'll end up with a lifetime of AD drug use, which I don't consider to be particulary healthful. You might want to take that risk, but I certainly don't and won't.
Posted by bulldog2 on April 17, 2008, at 12:10:26
In reply to Re: They just don't work. FACT. - Who cares? :-), posted by Betula on April 17, 2008, at 9:13:07
> Sure, I could find magic pills that would relieve me of my OCD/anxiety/depression, but they would just mask the underlying cause. The depression etc would return once I quit the pills. And this I know because I've been down that route.
>
> I do not think it is healthy to take these pills indefinately. I view them as short term band aids to help you get through tough periods. That is all. I do not think they were even designed to be taken for extended periods of time, or at least, certainly the SSRIs weren't. And I certainly do not want to be one of those ones who become addicted for life or have terrible discontinuation sydromes. And let us not forget they haven't been around for all that long - who knows what happens to you if you take Effexor (yes, I know not technically an SSRI, but the same principles apply) for 20 years and try to wean off?? The drug companies sure as hell don't know. I am really not convinced we know enough about SSRIs to really say for sure. And let us not forget the pharma companies hiding information about the increased risk of suicide. Even if they didn't hide it, at least this is something unpredicted to come out of these drugs. Who knows what'll happen with say, 25+ years of use of lexapro? No-one simply knows for sure.
>
> Actually, for me, therapy is proving to be a far far better remedy for me than any pills were. Its really great I have to say.
>
> Contrary to what you might think, I am actually open minded about the whole thing - it was my belief a few years ago that there was a 'cure' but now, after everything I've seen, I think SSRIs, in particular, are not very good - to put it mildly, and I don't think the pharma companies are being particulary honest about their findings either.
>
> Hence why I like this study because it actually includes unpublished data that the pharma companies didn't publish (presumably because it shows their drugs in a bad light).
>
> So. I used to be pro-SSRIs, now I'm very much anti. Or rather, I just don't think they work particulary effectively and I wish people would see that. And I think you'd be better spending your health and time and money doing something else to help. And I think there's alot to be said for getting to the root cause of the depression/anxiety etc rather than just using drugs to mask the symptoms - because otherwise you'll end up with a lifetime of AD drug use, which I don't consider to be particulary healthful. You might want to take that risk, but I certainly don't and won't.
>Some have endogenous depression and do not respond to talk therapy. For years before the age of ADs people did only talk therapy and some just did not respond.
I agree if talk therapy plus diet,supplements and exercise, transendental meditation work than that is the best road. Also maois and tcas have been around for around 50 years. There is so much more than ssris if you have a skilled pharmacologist.
There are some who have depression caused by life circumstances and they may respond to talk therapy. But like any organ in the body the brain can also be malfunctioning and talk therapy cannot fix that. Many people committ suicide each year because their depression is not adequately treated. All meds have potential sides and we treat our high bp, high cholesterol etc..Yes diet and exercise would be preferable for these conditions but drugs still are there when other measures have failed.
Really won't post more on this thread..It's getting beaten to death. But remember what worked for you won't necessarily work for others and what didn't work for you may work for others.each person't situation and chemistry are unique. We have a tendency to think that we can extrapolate our experiences and believe that's how it will play out with others.
Posted by Shadowplayers721 on April 17, 2008, at 15:02:15
In reply to Wierd Some I know In real Life Feel Better off ADs, posted by Phillipa on April 14, 2008, at 13:40:46
I have been under the impression that people suffer from different types of depression. Some types of depression can be chronic, self-limited, or recurrent.
Therefore, the medication needs would be very individual and would change accordingly.
On a high note.: It's great to hear that some are feeling better without medication & no longer in need of it. :)
Posted by Shadowplayers721 on April 17, 2008, at 15:15:33
In reply to They just don't work. FACT., posted by Betula on April 16, 2008, at 11:51:18
I would like to read the actual case study. Do you know where I may find that link? Thank you.
Posted by Larry Hoover on April 17, 2008, at 15:27:51
In reply to Re: They just don't work. FACT., posted by Shadowplayers721 on April 17, 2008, at 15:15:33
> I would like to read the actual case study. Do you know where I may find that link? Thank you.
I did a critique of the actual article, within which is a link to the full text. See: http://www.dr-bob.org/babble/20080221/msgs/815551.html
Lar
Posted by 10derHeart on April 17, 2008, at 15:56:49
In reply to Re: They just don't work. FACT. - Who cares? :-), posted by Betula on April 17, 2008, at 9:13:07
I believe in some cases - maybe I'd even say many cases - people aren't at all "just using drugs to mask the symptoms." For example, say someone does want to get to the root of the illness (and I'm not at all sure that concept applies across the board) through therapy, they first have to somehow find a therapist, call a T. for an appointment, and get themselves to that therapist's office. For people with crippling depressive or anxiety symptoms, well, you might as well ask them to climb Mt. Everest.
If you can't get out of bed, can't eat, sleep, and/or suffer from symptoms such as severe apathy, lethargy, anxiety, tearfulness, etc., you often can't even imagine doing things like picking up a phone, dressing yourself or driving to a therapist's office.
I'm just saying you can't be helped by therapy if you are too ill to "do" therapy. This is where even a somewhat effective AD can be a life-saving and critical tool for some people.
Posted by Larry Hoover on April 17, 2008, at 16:01:27
In reply to Re: They just don't work. FALLACY. » Shadowplayers721, posted by Larry Hoover on April 17, 2008, at 15:27:51
> > I would like to read the actual case study. Do you know where I may find that link? Thank you.
>
> I did a critique of the actual article, within which is a link to the full text. See: http://www.dr-bob.org/babble/20080221/msgs/815551.html
>
> LarI just took a quick read through what I wrote earlier, and I realize that I might have expressed one point a little more clearly. What I said was:
"Now, here's a very illustrative figure, Figure 4: http://medicine.plosjournals.org/perlserv/?request=slideshow&type=figure&doi=10.1371/journal.pmed.0050045&id=96831
First, the zero line is no difference (i.e. superiority) of drug or placebo. Below zero is placebo superiority, whereas above it is drug superiority. What's the pattern tell you? Do we find just as many points below the zero line, and just as far from it, as we do above it? "
What I should then have done is answer the question. The answer is a resounding NO! But, that's what we'd see if there was no difference between placebo and drug response. We'd see similar scatter above and below the zero effect size line. Instead, we see near absolute dominance of drug over placebo, and often times very substantial dominance, in individual trials.
The paper's conclusions are unsupported by the evidence.
In fact, Kirsch might have argued that the cost of psychotherapy could be eliminated by sugar pills, but I doubt he'd have suggested that.
Lar
Posted by 10derHeart on April 17, 2008, at 16:01:58
In reply to Re: They just don't work. FACT. - Who cares? :-) » Betula, posted by 10derHeart on April 17, 2008, at 15:56:49
I didn't mean in some cases there are people who don't want to get to the root, i.e., find out the basics of what might be causing their illness. I meant I'm unsure - and I think so are the "experts" - that there is any specific "root" to be able to get down to...biology, situational, both, etc. it's just so often about as clear as mud 'why' any given person is suffering from depression.
Hope *that* was a little clearer than mud.
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