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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 22 to 46 of 96. Go back in thread:
Posted by Justherself54 on July 17, 2008, at 14:37:45
In reply to Re: Want to stop meds ... should I?-chrzrhowd » Maxime, posted by Lou PIlder on July 17, 2008, at 7:00:46
As much as we'd all love being med free, perhaps staying on them and enjoying the stability may be the prudent thing to do. After a period of time, if you're still feeling great, you could revisit stopping them with your pdoc.
When I titrated off Nardil I was feeling pretty good and stayed off an AD for a little over a month. It didn't take long after that for the depression to creep back...and I was so hoping I could be free of meds.
Enjoy yourself in the "right now". You can take as much time as you need to make the decision to go off them. I'm so glad you're feeling better.
Posted by cumulative on July 17, 2008, at 16:28:18
In reply to Want to stop meds ... should I?, posted by Maxime on July 16, 2008, at 20:48:26
I would not discount that the medicines may be assisting your current state of well-being, and considering your history, I would think very long and hard about taking the risk, at least for some time.
Posted by Lou PIlder on July 17, 2008, at 16:38:33
In reply to Re: Want to stop meds ... should I? » Maxime, posted by SLS on July 17, 2008, at 4:49:16
> Dear Maxime,
>
> Either you are hypomanic with its attendant lack of good judgment, or you have fallen into the trap of:
>
> "I feel great. I guess I don't need meds anymore."
>
> Just what in the hell do you think is keeping you feeling so good? Please exercise some common sense and realize that you must remain on your miracle treatment for at least 14 months. If it were me, I would not entertain the notion that I were somehow cured.
>
> My recommendation is for you to remain on your present treatment, and research for yourself the clinical outlook for people with your severity and chronicity of depression. The outlook for such a situation is to remain in treatment indefinitely. In the future, there may be better treatments - perhaps even 1 month treatment protocols. But that is not true at the moment. At the moment, it is imperative that you don't make that mistake in logic. Just continue to live a life that, for you, seemed impossible previously.
>
> Remember, your illness, if left untreated, gets worse with each episode. You might also not be able to "recapture" the antidepressant response, despite reinstating your current treatment.
>
> Maxime, I'm afraid that were you to find yourself again in the position of having severe depression and become treatment resistant, you might head in the direction of suicide. That would be a tragic consequence for your discontinuing your treatment at so early a juncture.
>
> Don't rock the boat.
>
> Examine why you have such a disdain for remaining on medication. Acceptance of the facts will be difficult, but ultimately life-saving.
>
> Are you hypomanic?
>
> What drugs are you currently taking?
>
>
> - Scott
>Scott,
You wrote,[...either you are hypomanic...or you have fallen into the trap of...exercise some XXX and realize that you XXX...].
I am unsure as to the grammatical structure of your statments here as to some concerns that I have that could be cleared up if I was to know the following. If you could reply with the infomation that I am requesting, then I could have a better understanding of your statements here and respond accordingly.
A. In,[...either you are hypomanic...or you have fallen into the trap of...], could there be some other possibility IYO other than the two that you have written here?
B.In,[...exercise some XXX...] could you explain what you are wanting to mean by {common sense} here?
Lou
Posted by Lou PIlder on July 17, 2008, at 17:00:43
In reply to Re: Want to stop meds ... should I?, posted by SLS on July 17, 2008, at 5:11:07
> I forgot to return the subject line to its previous content along this thread.
>
> Lou, please stop changing subject lines simply to redundantly add your name to it. It is an assumption that you are responding to the thread without having to say so in the subject line. You really disrupt the continuity of threads when you do that.
>
> Altruism?
>
>
> - Scott
>
Scott,
You wrote,[...to XXX add your name to it...You..XXX the continuity of threads...].
I am unsure as to your grammatical structure of your statment here as to how you arrived at the following. If you could post here what you used to write what is in question here, then I could have the oportunity to respond accordingly.
A. What did you use to state that a change in a subject line by me is connected with,[...simply to XXX add my name to it...]?
B. Members here change the subject line for many reasons, and I have reasons for doing so also. What do you use to state that by changibg a subject line that I {XXX the continuity of threads}.
Lou
Posted by Lou PIlder on July 17, 2008, at 17:20:28
In reply to Re: Want to stop meds ... should I?, posted by SLS on July 17, 2008, at 5:11:07
> I forgot to return the subject line to its previous content along this thread.
>
> Lou, please stop changing subject lines simply to redundantly add your name to it. It is an assumption that you are responding to the thread without having to say so in the subject line. You really disrupt the continuity of threads when you do that.
>
> Altruism?
>
>
> - Scott
Scott,
You wrote,[...Altruism?...]
I am unsure as to what you are wanting to mean here by posting that. If you could post here what you are wanting to mean by that, then I could have the opportunity to respond accordingly.
Lou
Posted by bleauberry on July 17, 2008, at 18:28:48
In reply to Want to stop meds ... should I?, posted by Maxime on July 16, 2008, at 20:48:26
My vote is to stay on the meds at the same doses and the same time of day and the same diet and everything. Don't change a thing.
Whether the recovery is a result of trauma or meds doesn't matter. What does matter is that at this time in history, those meds are part of your current biochemical makeup. Those molecules are playing a part in your current biochemistry. Take them away, and who knows what will happen. With a history of severe depression and severe instability, I vote to not rock the boat in any way shape or form. You are STABLE, do not purposely create UNSTABLE, which will happen if those molecules are removed.
At some point in the distant future maybe reconsider. But not before the year 2010. Make it a goal to feel as good as you do now all the way through 2008 and 2009. That definitely will not happen if you withdraw those meds, if for no other reason, the trauma and trials of the weaning withdrawals themselves. Don't go begging for more strain than life itself provides.
My vote: Don't change a thing.
Posted by Maxime on July 17, 2008, at 18:59:41
In reply to Re: Want to stop meds ... should I?-chrzrhowd » Maxime, posted by Lou PIlder on July 17, 2008, at 7:00:46
You may have noticed that in many of my posts that they are directed to {friends}, for I consider all here to be my friends and I would like to post here from my perspective what I see from your post as to asnswer your question as to being in the crossroad as to which road to take.
> My perspective may be different from others here concerning as to which road to take and I would like to continue here if you would want me to. I will do so if you post here that you would like for me to post from my perspective.
> Lou
>Of course I would like hear from your perspective.
Maxime
Posted by Maxime on July 17, 2008, at 19:03:24
In reply to Want to stop meds ... should I?, posted by Maxime on July 16, 2008, at 20:48:26
Wow, I really appreciate the time everyone took to respond.
I am going to listen to you and stay on the meds. I think that is what I wanted to hear anyway. I am stable for the first time and so changing anything would not be good.
I haven't had this much life in me for so many years ... I have been blessed.
Maxime
Posted by SLS on July 17, 2008, at 21:04:13
In reply to Thank you, everyone, posted by Maxime on July 17, 2008, at 19:03:24
> I haven't had this much life in me for so many years ... I have been blessed.
I know the feeling. Congratulations. You deserve it.
- Scott
Posted by linkadge on July 17, 2008, at 21:36:51
In reply to Re: Want to stop meds ... should I?, posted by Dinah on July 16, 2008, at 23:55:25
>If I ever feel truly well again, I will do >exactly what I'm doing at that point forever, >because I won't want to jeopardize something >I've hoped for for so long.
Unfortunately theres no guarentee that continuing to take what you were on when you felt better will keep you well.
I've been on meds when they work and its nice to think "all I've got to do is keep taking this and I'll be fine" but it doesn't always work that way.
Linkadge
Posted by linkadge on July 17, 2008, at 21:46:44
In reply to Re: Want to stop meds ... should I? » Maxime, posted by SLS on July 17, 2008, at 4:49:16
>Either you are hypomanic with its attendant lack >of good judgment, or you have fallen into the >trap of:
>"I feel great. I guess I don't need meds >anymore."
But, if you recall, she said she was not feeling well on meds at all and thats why she attempted suicide and ended up in the coma. She said she felt better since then. Because of the timing of the remission, it can't be attributed to medications.
Don't fall into SLS line of thinking that there is only one way to stay well. Certain people with severe depression feel better off meds. Some people with even severe depression get little or no help from meds. Many people with severe depression remit (with or without meds) and no longer need them. This needing to take medication for depression for the rest of your life theory is a relatively new idea. Sometimes meds make people feel worse and hinder recovery. There have been times where I much feel better (even if not completely well) off meds.
I'd say do what you want to do and trust your intuition. If you want to try a med holliday, especially from meds that have only been working marginally, I say go for it. The idea that you will lapse miserably is not always true. Its an idea pushed by doctors and drug companies, but not one that is necessarily accurate.
Linkadge
Posted by linkadge on July 17, 2008, at 21:48:56
In reply to Re: Thank you, everyone » Maxime, posted by SLS on July 17, 2008, at 21:04:13
Was maxime on meds when she attempted suicide? Well?
Linkadge
Posted by Lou PIlder on July 17, 2008, at 21:57:06
In reply to Re: Thank you, everyone, posted by linkadge on July 17, 2008, at 21:48:56
> Was maxime on meds when she attempted suicide? Well?
>
> LinkadgeLinkadge,
If you could explain some more from your perspective of the aspects of your posts, I would appreciate it.
Lou
Posted by Dinah on July 17, 2008, at 22:01:14
In reply to Re: Want to stop meds ... should I? » Dinah, posted by linkadge on July 17, 2008, at 21:36:51
There's no guarantee, no.
But I don't feel fine now. If I feel fine at some point, I'll keep doing what I'm doing when I feel fine. If I stop feeling fine, I'll look at changes then.
Posted by JohnnyBLinux on July 17, 2008, at 22:40:32
In reply to Lou's encourgement for Linkadge- rvltrew » linkadge, posted by Lou PIlder on July 17, 2008, at 21:57:06
Taken from Linkdage's recent post:
>> Was maxime on meds when she attempted suicide?
Taken from Maxime's original post:
>> I changed my meds a bit in February, but something else happened in Feb as well. I attempted suicide and ended up in a coma.
The answer to Link's question is 'yes', she was on meds when she attempted suicide. Please, correct me if I'm wrong.
Ultimatey, Maxime will either make the decision to stop her medication(s) herself or make it concurrently with her doctor.
Anyway, Lou, this is my humble opinion on the matter. Let me know if anything remains unclear. Have a g'night!
Cheers.
-JBLinux
Posted by Deputy 10derHeart on July 17, 2008, at 23:15:11
In reply to Re: Want to stop meds ... should I?, posted by SLS on July 17, 2008, at 5:11:07
> Lou, please stop changing subject lines simply to redundantly add your name to it.
>You really disrupt the continuity of threadsPlease don't post anything that could lead others to feel accused or put down, and please don't pressure others. I wouldn't have included the pressuring aspect if it were only the above remark, however, this is the fifth time you have mentioned this to Lou.
Just to clarify the PB guidelines as I understand them, it is fine to change the subject line of threads for any reason and as often as you wish. It is also fine to change the subject line back, for example, by using a [nm]. It is not okay to pressure others by demanding, threatening, or even asking them - if it is *repeatedly* - to do a thing, or stop doing a thing, on the boards. I don't think that was worded very artfully, but hopefully the meaning will come through despite my writing deficiencies.
And Scott, I do know you've also publicly thanked Lou for not changing subject lines, and I appreciate the time and effort taken to do so.
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#civil
Follow-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.
-- 10derHeart, acting as deputy for Dr. Bob
Posted by SLS on July 18, 2008, at 5:03:37
In reply to Please be civil » SLS, posted by Deputy 10derHeart on July 17, 2008, at 23:15:11
Thanks 10derHeart. I will try different ways of changing back subject lines.
I will ask more politely.
- Scott
Posted by SLS on July 18, 2008, at 5:07:13
In reply to Re: Want to stop meds ... should I? » Dinah, posted by linkadge on July 17, 2008, at 21:36:51
> >If I ever feel truly well again, I will do >exactly what I'm doing at that point forever, >because I won't want to jeopardize something >I've hoped for for so long.
>
> Unfortunately theres no guarentee that continuing to take what you were on when you felt better will keep you well.Therefore, people shouldn't ever try to treat their diseases because the treatment might not work?
- Scott
Posted by SLS on July 18, 2008, at 5:25:26
In reply to Re: Want to stop meds ... should I? » SLS, posted by linkadge on July 17, 2008, at 21:46:44
She is feeling well. Given her history, I wonder why? Oh, I see, the meds chosen didn't work in the past, so the different meds she is now taking probably aren't really working now. The hell with statistics and anecdotes demonstrating a high probability of relapse when the patient treats for less than a year. Actually a physician at Mount Sinai, NY told me that they prefer to treat for 14 months as a minimum. This was in 1986. In Maxime's case, I believe most doctors would have her remain on drugs indefinitely. Indefinitely might mean that she might have to wait for something like gene therapy to come along.
As for seizures, for how long does a single ECT seizure bring about remission? How long does a single seizure of any sort improve depression. I don't see how you could possibly make a case for such things. Relapse. You gotta keep performing the treatments on a regular basis. Why should now be any different? I know, miracle cures. After all, they do happen. I guess we should all discontinue our medication to see which of us have the miracle thing going on.
Go ahead. Recommend to Maxime to stop taking her meds. I would like to see that. And while you are at it, you might as well go med-free indefinitely yourself and allow us to witness your algorithms at work. Maybe exercise for a robust and continuing remission for MDD or BD?
Don't you fret about SLS's way of thinking. He's ok with it.
- Scott
Posted by SLS on July 18, 2008, at 5:27:57
In reply to Re: Thank you, everyone, posted by linkadge on July 17, 2008, at 21:48:56
> Was maxime on meds when she attempted suicide? Well?
Why don't you ask her?
Well?
- Scott
Posted by SLS on July 18, 2008, at 5:30:40
In reply to Re: Thank you, everyone, posted by SLS on July 18, 2008, at 5:27:57
Sorry for exceeding the posting limit. My mistake.
- Scott
Posted by Midnightblue on July 18, 2008, at 10:58:32
In reply to Re: Thank you, everyone, posted by linkadge on July 17, 2008, at 21:48:56
I think she is on a very different combination of meds now. And I think that has made the difference.
MB
Posted by blueboy on July 18, 2008, at 10:59:59
In reply to Re: Want to stop meds ... should I?-flzcnclu?? » blueboy, posted by Lou PIlder on July 17, 2008, at 12:58:04
[...]
> > > I changed my meds a bit in February, but something else happened in Feb as well. I attempted suicide and ended up in a coma. My psychiatrist doesn't know if my remission is the results of the meds I am on ... or the coma.
[...]
> > But when AD's work, their effect is sometimes characterized by an initial suicide attempt. That makes me tend to think that the AD is at least partly responsible for your relief from depression.
>
> blueboy,
> You wrote,[...sometimes characterized by an innitial suicide attempt...].
> I am unsure as to if there is or is not a correlation with the aspect of an AD working with an attempted suicde.Could you post here any facts to support the statement in question? If you could, then I could have the opportunity to respond accordingly.1) A psychiatrist who had been practicing for over 30 years told me this. In fact, he said that in his experience "the most dangerous time for suicide is the weeks after a good drug treatment is started". His theory to explain it was that the patient would be activated enough to carry out a pre-existing tendency, but that was just a hypothesis.
2) A lot of AD's now carry a black box warning about suicide attempts, especially for teenagers. There is a definite "official" perception of a significant increase in suicide risk early in AD treatment.
3) Her pdoc thought that the meds might be the cause of her recovery.
4) She is taking the meds and is feeling enormous relief from depressive symptoms.
There isn't a lot of research on the hypothesis, largely due to the doctors' reactions of immediately discontinuing AD treatment after a suicide attempt. Even more, there is a disinclination to run a trial where patients who have started an AD treatment and then attempt suicide are continued on the AD, to see if they attempt suicide again. The possibility of lawsuits and ethical sanctions are too high.
5) Researchers have seen clues, however, that the phenomenon occurs. E.g., in Science Daily, "New UCLA Study Disputes Antidepressant/Suicide Link" (University Of California - Los Angeles (2005, February 7). There, Dr. Julio Licinio, a professor of psychiatry and endocrinology at the David Geffen School of Medicine and a researcher at the UCLA Neuropsychiatric Institute, who has been studying the problem for decades, stated:
"When people start antidepressant therapy, the first symptom to be alleviated is low energy, but the feeling that life isn't worth living is the last to go. Prior to taking SSRIs, depressed people may not have committed suicide due to their extreme lethargy. As they begin drug therapy, they experience more energy, but still feel that life isn't worth living. That's when a depressed person is most in danger of committing suicide."
6) If her suicide attempt was in fact tied to the onset of AD treatment, it means that the drug was doing *something* directly affecting her depression. Since she first attempted suicide and has since experienced a major remission of symptoms, the facts strongly suggest that the suicide and recovery are steps in a series of events.
Posted by blueboy on July 18, 2008, at 11:02:52
In reply to Re: Want to stop meds ... should I? » SLS, posted by linkadge on July 17, 2008, at 21:46:44
> But, if you recall, she said she was not feeling well on meds at all and thats why she attempted suicide and ended up in the coma. She said she felt better since then. Because of the timing of the remission, it can't be attributed to medications.
>It most certainly can.
http://www.sciencedaily.com/releases/2005/02/050205102643.htm
Posted by SLS on July 18, 2008, at 12:07:42
In reply to Re: Want to stop meds ... should I? » Lou PIlder, posted by blueboy on July 18, 2008, at 10:59:59
Nice post.
- Scott
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