![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 26 to 50 of 66. Go back in thread:
Posted by ricker on November 7, 2008, at 13:44:46
In reply to What is your definition of a 'Miracle Drug'?, posted by SLS on November 6, 2008, at 17:34:50
I'm not holding my breath, they can't cure the common cold!
Posted by linkadge on November 7, 2008, at 17:57:03
In reply to Re: What is your definition of a 'Miracle Drug'?, posted by ricker on November 7, 2008, at 13:44:46
I drug that works now, works later
and doesn't leave you more f*ck*d up down the road.Seeing as nobody in this room has taken a drug that fits that definition, I see no proof of the existence of a miracle drug.
Linkadge
Posted by Sigismund on November 7, 2008, at 18:07:36
In reply to Re: What is your definition of a 'Miracle Drug'?, posted by linkadge on November 7, 2008, at 17:57:03
The miracle drugs are the herbs that civilisation refined and rendered toxic.
Take your pick, there's quite a few.
Posted by JadeKelly on November 7, 2008, at 18:42:57
In reply to Re: What is your definition of a 'Miracle Drug'?, posted by linkadge on November 7, 2008, at 17:57:03
> I drug that works now, works later
> and doesn't leave you more f*ck*d up down the road.
>
> Seeing as nobody in this room has taken a drug that fits that definition, I see no proof of the existence of a miracle drug.
>
> Linkadge
Maybe they are well and have left the building.~Jade
Posted by Zyprexa on November 7, 2008, at 19:09:57
In reply to What is your definition of a 'Miracle Drug'?, posted by SLS on November 6, 2008, at 17:34:50
Made life berable. Got me out of the house. Removed pain from my stomack. Made my head think straight. Got me to excell at work. Made me happy with life. Made me a better person that before. Gave me my appatite back. Got me to sleep again. Pleasant to take, no harsh side effects.
Posted by elanor roosevelt on November 8, 2008, at 1:26:36
In reply to Re: What is your definition of a 'Miracle Drug'? » yxibow, posted by JadeKelly on November 7, 2008, at 5:45:33
a miracle drug would return me to my upbeat days before the meds
and keep anger and darkness away
Posted by linkadge on November 8, 2008, at 7:26:02
In reply to Re: What is your definition of a 'Miracle Drug'? » linkadge, posted by JadeKelly on November 7, 2008, at 18:42:57
I know but you didn't read all three postulates of my definition.
Sure, they may be "well" and have left the building but:
2) Will the drug work down the road ?
3) Will the drug not cause irriversable damage to their brain or body?
Linkadge
Posted by SLS on November 8, 2008, at 9:16:44
In reply to Re: What is your definition of a 'Miracle Drug'? » JadeKelly, posted by linkadge on November 8, 2008, at 7:26:02
> I know but you didn't read all three postulates of my definition.
>
> Sure, they may be "well" and have left the building but:
>
> 2) Will the drug work down the road ?That is a question that has been answered. The answer is YES. People have been kept well on antidepressants for decades. I have had the privilege to encounter these people and the doctors who treat them to be able to report with surety that your question has THE answer, and it is in the affirmative.
> 3) Will the drug not cause irriversable damage to their brain or body?
50 years of tricyclics and MAOIs, and 20 years of SSRIs cast doubt that such things occur. It is much more dangerous to allow someone to remain severely and suicidally depressed than to take a "chance" that these will eventually show themselves to be toxic in real life years and years and years down the road. As of now, they do not seem to be toxic IN REAL LIFE.
- Scott
Posted by 49er on November 8, 2008, at 12:11:03
In reply to Re: What is your definition of a 'Miracle Drug'?, posted by SLS on November 8, 2008, at 9:16:44
Hi Scott,
<< That is a question that has been answered. The answer is YES. People have been kept well on antidepressants for decades. I have had the privilege to encounter these people and the doctors who treat them to be able to report with surety that your question has THE answer, and it is in the affirmative.>>
Hmm, I know people who have a different answer, including myself. Antidepressants have destroyed my life. I will spare you the details but you can find similar stories on the Paxil Progress Boards, run by an RN whose son almost committed suicide/homicide on Paxil. The board gets about 1 million to 3 million hits per month.
<< Will the drug not cause irriversable damage to their brain or body?
>
> 50 years of tricyclics and MAOIs, and 20 years of SSRIs cast doubt that such things occur.>>You might want to look at these two citations:
http://tinyurl.com/3va3j2
http://tinyurl.com/6h89p2Also, check this site out:
http://qualitycounts.com/drugs/antidepressants.html
It has some articles in favor of ADS but also has some articles that show they have long term risks.
<<It is much more dangerous to allow someone to remain severely and suicidally depressed than to take a "chance" that these will eventually show themselves to be toxic in real life years and years and years down the road. As of now, they do not seem to be toxic IN REAL LIFE.>>
Now, we're getting to the crux of the issue. Regarding when side effects start appearing, I started having problems 5 years after starting ADS. Many I know report similar experiences, including some who have adverse reactions immediately.
A far as someone being suicidally depressed, meds is not the only answer. Fish oil capsules, vitamin D, and CBT are among many things that have shown to help. Charles Barber, who is not antimeds and is in the mental health field, wrote about CBT helping severe depression in some cases.
Also, recently, a study came out in Science Daily that shows St. Johns Wort to be helpful with major depression. St. Johns Wort is not side effect free but in my opinion, compared to psych meds, it is a piece of cake.
If the person who is suicidally depressed makes a fully informed choice to go on meds, I have no problem with that. But since these are powerful meds, the physicians should reassess on a regular basis with the patient whether the meds are still needed. Sentencing someone to life on meds is simply wrong and unjust the links I have provided show the risk of long term side effects.
Again, if the person feels their risk of suicide is greater than the med risks and is fully informed of all the options, I have no problem with that. But many times, that is not the case.
Scott, I am happy the meds are working for you and have given you a new life. But as with any issue, there is always another side to the story and I hope you will take the time to understand my point of view.
Obviously, I totally agree with what Linkage has posted.
49er
Posted by Justherself54 on November 8, 2008, at 12:51:50
In reply to Re: What is your definition of a 'Miracle Drug'?, posted by 49er on November 8, 2008, at 12:11:03
I now believe there is no miracle drug for me. Just ones that poop out and/or don't work when revisited. I feel like the walking wounded.
Posted by linkadge on November 8, 2008, at 15:16:47
In reply to Re: What is your definition of a 'Miracle Drug'?, posted by SLS on November 8, 2008, at 9:16:44
>That is a question that has been answered. The >answer is YES.
No, the answer is "we don't know". When a person takes a drug for a long period of time and remains well, there is no way of telling whether it is the drug that kept them well, or whether they naturally went into remission.
Also, nobody has proven that these medication are not toxic to the body / brain in the long term.
So, sorry, I don't think you have satisfied *my* 3 criteria of a miracle drug.
Linkadge
Posted by linkadge on November 8, 2008, at 15:23:36
In reply to Re: What is your definition of a 'Miracle Drug'?, posted by 49er on November 8, 2008, at 12:11:03
Thanks for your comments. I thinnk people just *want* to belive certain things. Some people just put blinders up.
I am not saying AD's don't do something for some people. But, there is no such thing as a *miracle* drug.
My mother thought doxapin was a miracle drug. Her psychiatrist recently told her that her newly diagnosed type II diabeties was probably related to use of doxapin. Doxapin was also giving her severe hypertension for a long time before anybody diagnosed it. The funny thing is that she won't believe it. She has put doxapin on this pedastal and will not believe anything negative about it. But you know, some people are just like that. I think my mother needs a little more grey matter in certain cortial regions.
Linkadge
Posted by JadeKelly on November 8, 2008, at 18:23:38
In reply to Re: What is your definition of a 'Miracle Drug'? » 49er, posted by linkadge on November 8, 2008, at 15:23:36
I thinnk people just *want* to belive certain things. Some people just put blinders up.
>So very true, we do agree on one thing.
I for one do not have blinders on. I do believe certain things. For Example:
1. Scary behavior while one is on an A/D is not always the meds fault. Could it not be true that the very problem that caused this person to seek meds also caused the behavior? Yes, it could.
2. If a person who has led a relatively problem free existance for 40 years, suddenly faces, lets say, 10 tragedies/losses in a fairly short time, suddenly feels numb, can't work, can't get out of bed, can't socialize, can't eat, can't cry, doesn't really feel much, and this lasts for 2-3 years, do you really think that this person is going to hop up one day in remission? When all efforts at talking and "clean Living" haven't changed a da*n thing? I wonder what damage has already been done to this person's brain chemistry, spirit, and body? Don't you?
3. Lets just leave that person in bed and wait for a drug that ABSOLUTELY has no long term adverse effects. Lets wait for a drug that works for THE REST OF THIS PERSONS LIFE, when said med may only be needed for say, 1 year to restore this persons chemistry.
4. Hel*, Lets not even have a look at what meds have worked on similar cases because, well, that med might show signs of toxicity when this formally fully functioning person turns 99.
5. Might, maybe, could. I could be run over by a truck tomorrow. I'm betting this person doesn't just "want to", but DOES believe that NO LIFE is far more dangerous than a lot of A/D's on the market. In fact, I'm CERTAIN of it.
~Jade
Posted by SLS on November 8, 2008, at 18:28:37
In reply to Re: What is your definition of a 'Miracle Drug'?, posted by 49er on November 8, 2008, at 12:11:03
Hi.
>> That is a question that has been answered. The answer is YES. People have been kept well on antidepressants for decades. I have had the privilege to encounter these people and the doctors who treat them to be able to report with surety that your question has THE answer, and it is in the affirmative.>>
>
> Hmm, I know people who have a different answer, including myself.I'm sorry to hear that. I know people who have not been adequately treated too. Would you say such an experience represents the majority or the minority?
> Antidepressants have destroyed my life. I will spare you the details
Don't spare me the details if you have the energy to share them. I would really like to know.
Many people experience a suicidal reaction to certain antidepressants, but usually not all of them. Some people become suicidal because the drug makes them feel worse. Others become suicidal because the drug makes them feel better.
It is too bad that the Internet produces so many horror stories without demonstrating the success rate that represents the majority. Happy people have nothing to complain about, I guess.
- Scott
Posted by Justherself54 on November 8, 2008, at 19:33:02
In reply to Re: What is your definition of a 'Miracle Drug'?, posted by SLS on November 8, 2008, at 18:28:37
Happy people have nothing to complain about, I guess.
That sentence upset me. Unfortunately, I'm not feeling articulate enough to express why.
Posted by SLS on November 8, 2008, at 19:56:14
In reply to Re: What is your definition of a 'Miracle Drug'? » SLS, posted by Justherself54 on November 8, 2008, at 19:33:02
> Happy people have nothing to complain about, I guess.
>
> That sentence upset me. Unfortunately, I'm not feeling articulate enough to express why.I had meant to convey the idea that people who respond well to treatment don't usually show up on the Internet looking for negative things to say about their experiences. Hyperbole, perhaps.
- Scott
Posted by yxibow on November 9, 2008, at 3:39:23
In reply to Re: What is your definition of a 'Miracle Drug'?, posted by SLS on November 6, 2008, at 19:31:37
> I guess I should have used the term "Miracle Drug Treatment". I certainly am experiencing a miracle of modern psychopharmacology. However, I must take 4 drugs for my miracle to happen.
>
> Where would we be were we to be born 300 years ago? For me, nearly all of modern medicine is a miracle when considered in this context. I am very appreciative of man's modern medical inventions. Penicillin is a miracle drug, despite an increasingly treatment resistant population of microbes.
>
> It is a matter of attitude. No scientist owes the rest of us anything. Why do so many of us place blame on scientists when they don't accomplish what we want them to? Anyone can find fault with the system. However, I almost never see on this forum a recognition of what is right about the system. I am very much in favor of improving the system. However, disparagement alone is not terribly constructive in my opinion.
>
> Any treatment that brings me to remission is a miracle treatment for me.
>
> My miracle drugs:
>
> Parnate 80mg
> nortriptyline 150mg
> Lamictal 200mg
> Abilify 20mg
>
>
> - Scott
I appreciate your semantics of what you think is a "miracle drug treatment".For me, I guess I know in my mind that there is no perfect world and there is no magic bullet for anything.
I agree with you on antibiotics, and that was my example of one of the few agents that we can say probably is a cure and not a palliative, should they work.
I wasn't trying to put anyone's hopes down -- if I was misunderstood in this thread I apologize. I have a hard time having the hope to hope. So maybe I was projecting.
I was just trying to define the definition between a cure and and a palliative. A cure is something that happens spontaneously, or e.g. your cancer remits and you never have it again.
A palliative, which are what lots of agents are, are things that allow us to have as normal a life as possible against all odds and if I sounded maudlin that they wouldn't last -- well I am an experience that not all things last in quite the same way as you think they should and what I thought was a "cure" was in fact palliatives.Oxford Dictionary:
palliative
A. adj.
1. a. That relieves the symptoms of a disease or condition without dealing with the underlying cause.
B. n.
1. a. A treatment that gives temporary or symptomatic relief; something that serves to alleviate or mitigate pain, disease, suffering, etc.
Here is where I underline "symptomatic relief". That's the important part. To me, and perhaps only me. Your symptoms are at bay.
But lest this not please give some people less hope than they may already have. There are a lot of agents out there, sometimes the new ones aren't always the best, sometimes they are.
I hope you find in your mind a "miracle drug", even if I disagree with the word in psychiatry -- god only knows I wish I could have a miracle happen spontaneously, and that is my definition of a miracle, not someones else.I hope this clarifies that I have a hard time grasping on to the word miracle, but if it is something that people consider what has allowed them to live a productive life in the Here and Now, call it what ever you want.
-- best wishesJay
Posted by SLS on November 9, 2008, at 10:17:28
In reply to Re: What is your definition of a 'Miracle Drug'? » SLS, posted by yxibow on November 9, 2008, at 3:39:23
"What is your definition of a Miracle Drug?"
Midnight Blue portrayed my definition quite succinctly: "One that works."
We all have our individual requirements of a treatment before we deem it a miracle. I can certainly understand your reluctance to call any current treatment for mental illness a miracle.
One thing that I have learned in this thread is that there are some pretty high standards to be placed on a drug before it can be called a miracle. Doubtless, my spiritual nature tends to have me look at nearly everything in Creation as being a miracle. Lots and lots of little things.
For over 25 years, I have been looking for a treatment that would bring me into remission; thereby ending the pain, misery, and lack of functionality. My miracle has occurred, and it comes in the form of 4 brown vials. I thank God every day for this miracle. My life stopped at age 17. I am now 48. How could I view my current successful response to treatment as anything short of a miracle? Side effects and special diets are minor nuisances to me.
- Scott
Posted by JadeKelly on November 9, 2008, at 11:54:38
In reply to Re: What is your definition of a 'Miracle Drug'?, posted by SLS on November 6, 2008, at 19:31:37
Scott, just curious as I am on parnate (may have to switch to other MAOI, hope not) How long have you been on this drug regimen? Did it take a while to tweak individual doses before you got the response you have now? Why did you switch to Parnate from Nardil? In your opinion, if I have to switch from Parnate, whats the closest MAOI to it? Hope to hear from you, congrats on finding "your miracle". 25 years is a long time.
Regards~Jade
Posted by 49er on November 9, 2008, at 12:41:59
In reply to Re: What is your definition of a 'Miracle Drug'?, posted by Justherself54 on November 8, 2008, at 12:51:50
> I now believe there is no miracle drug for me. Just ones that poop out and/or don't work when revisited. I feel like the walking wounded.
I am so sorry to hear that. I hope you find a solution that works for you.
I felt that way the last few years of meds before I started slowly tapering off of them. In spite of tapering very slowly, I have hit a rough patch. But seeing what is possible with good windows when I feel like a normal high functioning human being with real emotions that don't incapacitate me, encourages me.
Anyway, I wish you all the luck in the world.
49er
Posted by 49er on November 9, 2008, at 12:49:57
In reply to Re: What is your definition of a 'Miracle Drug'? » 49er, posted by linkadge on November 8, 2008, at 15:23:36
>
<<My mother thought doxapin was a miracle drug. Her psychiatrist recently told her that her newly diagnosed type II diabeties was probably related to use of doxapin. Doxapin was also giving her severe hypertension for a long time before anybody diagnosed it. The funny thing is that she won't believe it. She has put doxapin on this pedastal and will not believe anything negative about it. But you know, some people are just like that. I think my mother needs a little more grey matter in certain cortial regions. >>Hi Linkage,
I am so sorry to hear this. I know from personal experience it is very frustrating when people refuse to believe that drugs have nasty side effects.
As hard as this must be for you, I am very grateful to you for sharing this. I am going through a rough patch with tapering my meds and at times, have wondered whether I can succeed even though I know I have to due to the nasty side effects of the meds. Hearing this news about Doxepin although it shook me up initially since I had no idea, this was a possible side effect, reminds me that I am doing the right thing.
I am impressed that a psychiatrist made the connection as many times, they deny that drugs have side effects even though I just came from a site that lists blood sugar irregularities as a side effect of Doxepin.
49er
Posted by 49er on November 9, 2008, at 13:09:01
In reply to Re: Blinders On » linkadge, posted by JadeKelly on November 8, 2008, at 18:23:38
Hi Jade,
<<Scary behavior while one is on an A/D is not always the meds fault. Could it not be true that the very problem that caused this person to seek meds also caused the behavior? Yes, it could.>>Agreed. But too often the role of ADs in crimes is denied even though the common reaction from people who know the person who committed the criminal behavior is one of absolute astonishment.
When I say that, I don't mean people who are in denial but who are truly shocked that this person committed a crime.
<<If a person who has led a relatively problem free existance for 40 years, suddenly faces, lets say, 10 tragedies/losses in a fairly short time, suddenly feels numb, can't work, can't get out of bed, can't socialize, can't eat, can't cry, doesn't really feel much, and this lasts for 2-3 years, do you really think that this person is going to hop up one day in remission? When all efforts at talking and "clean Living" haven't changed a da*n thing? I wonder what damage has already been done to this person's brain chemistry, spirit, and body? Don't you? >>
No argument with anything you have said. As long as the person is fully aware of the risks of taking antidepressants and there is periodic evaluation of whether the he/she should continue the meds, I have no problems with that. But many times, that isn't done.
>
<<Lets just leave that person in bed and wait for a drug that ABSOLUTELY has no long term adverse effects. Lets wait for a drug that works for THE REST OF THIS PERSONS LIFE, when said med may only be needed for say, 1 year to restore this persons chemistry. >>Again, I have no argument with what you said. But unfortunately, people are being put on drugs for life instead of one year and without an evaluation as to whether the med continues to be needed.
<<Hel*, Lets not even have a look at what meds have worked on similar cases because, well, that med might show signs of toxicity when this formally fully functioning person turns 99.>>
As I mentioned in my response to SLS, I started experiencing toxic when I hit the 5 year mark. Many people I know have reported experiencing symptoms earlier than that.
Robert Hedaya, a psychiatrist who wrote "Antidepressant Survival Program" says that up to 80% of people on psych meds suffer severe side effects. He is definitely not anti-meds but says they create imbalances in several systems.
<< Might, maybe, could. I could be run over by a truck tomorrow. I'm betting this person doesn't just "want to", but DOES believe that NO LIFE is far more dangerous than a lot of A/D's on the market. In fact, I'm CERTAIN of it.>>
>
It is about odds. I think they are greater in incurring an AD side effect than being run over by a truck. Remember, only 1 to 10% of all adverse effects are ever reported to the FDA so the odds of incurring a side effect might be even greater than what the drug books would lead you to believe.49er
Posted by 49er on November 9, 2008, at 13:35:45
In reply to Re: What is your definition of a 'Miracle Drug'?, posted by SLS on November 8, 2008, at 18:28:37
Hi Scott,
<<I'm sorry to hear that. I know people who have not been adequately treated too. Would you say such an experience represents the majority or the minority?>>
Thanks.
The question I was responding to in your post was, "Will the drug work down the road and you had given an enthusiastic yes.
What I was trying to say was that all drugs poop out eventually. Laurie Yorke, the RN, who runs Paxil Progress Boards says that you can buy time by raising the dose or changing the drug. But eventually, you're going to have a hard time getting the drug to work and will need to add more drugs which of course, results in a greater chance of side effects.
As far as being adequately treated, it depends on what the definition is. Usually, the doctor's definition is different from the patient's. So I really can't answer your question.
<<Don't spare me the details if you have the energy to share them. I would really like to know.>>
Thanks, I started to but I can't focus long enough to be coherent. But fun included suicidal ideation from Prozac, a hearing loss from Remeron and a worsening of my learning disability symptoms, including memory loss. I also have tinnitus.
These meds made me so numb and apathetic that my condo is infested with roaches. Fortunately, I will be able to afford to fix the problem and I am grateful for that.
<<Many people experience a suicidal reaction to certain antidepressants, but usually not all of them. Some people become suicidal because the drug makes them feel worse. Others become suicidal because the drug makes them feel better.>>
Mine was definitely a suicidal reaction. I stupidly talked my current psychiatrist into prescribing it again 5 years ago. He really didn't want to.
The 2nd time, it didn't fortunately cause suicidal ideation but caused severe agiatation.
By the way, I don't have BP and my current psychiatrist agrees with that.
<<It is too bad that the Internet produces so many horror stories without demonstrating the success rate that represents the majority. Happy people have nothing to complain about, I guess.>>
Hmm, I saw a success rate of 50% on the NIMH website for 50% of the symptoms. I haven't been able to find the link but I am not making this up:) That will teach me to save stuff like that.
The star D study said 33% and according to a statistician I know, that is the right interpretation.
I have seen even lower estimates of success rate but to be fair, I will stick to those figures.
49er
Posted by SLS on November 9, 2008, at 14:21:09
In reply to Re: 'Miracle Drug' Questions for Scott » SLS, posted by JadeKelly on November 9, 2008, at 11:54:38
Hi Jade.
You always ask great questions. I only wish that my answers could be great as well. The practice of psychopharmacology can make idiots out of the most intelligent of people. We just don't know enough.
> Scott, just curious as I am on parnate (may have to switch to other MAOI, hope not)
Did you see my post to you regarding your hypertensive reaction to Parnate? It might be a startup transient effect that will resolve fairly quickly. I believe in the dosage range used by doctors who use MAOIs routinely to be 40-80mg. I really hope you can establish a Parnate treatment without side effects.
> How long have you been on this drug regimen?
I have experienced a significant response to my regime for over two years with Nardil as the MAOI. Having switched from Nardil to Parnate is producing a more satisfactory and stable improvement. I had plateaued on Nardil.
> Did it take a while to tweak individual doses before you got the response you have now?
Yes. I have demonstrated the need for each drug by tapering off of it, relapsing, and re-titrating back up. In this way, I found that I do better at 20mg of Abilify than I had at 10mg.
Take note of the drugs that helped you, even if only temporarily or producing but a partial improvement. I chose drugs to combine based on such a list.
> In your opinion, if I have to switch from Parnate, whats the closest MAOI to it?
The only two MAOIs that are connected so closely are Nardil and Marplan. Both are hydrazine derivatives. Marplan is often milder than Nardil regarding side effects and taxing the liver.
EMSAM is a propargyl derivative. In some ways, it is more like Parnate than Nardil. It produces amphetamine-like metabolites that are energizing. EMSAM can also help with social anxiety along with depression.
Thanks for the well-wishes. For those people who followed my story since I began posting in 1999, they would describe witnessing an intense and unrelenting depression in me. I think many of them would be surprised that I could get so well after such an odyssey. I was ALL BUT unresponsive to everything. I always looked at my reactions to medication as clues to what might eventually work for me - whether those reactions be good or bad.
I don't have the energy to tell the complete story as to how I came to take the drugs that are currently working. I wish I did, just to be able to give you more structure to work with.
Which drugs have you had any kind of positive response to? Which drugs made your core depression worse - not including side effects?
- Scott
Posted by linkadge on November 9, 2008, at 14:23:57
In reply to Re: Blinders On » linkadge, posted by JadeKelly on November 8, 2008, at 18:23:38
>If a person who has led a relatively problem >free existance for 40 years, suddenly faces, >lets say, 10 tragedies/losses in a fairly short >time, suddenly feels numb, can't work, can't get >out of bed, can't socialize, can't eat, can't >cry, doesn't really feel much, and this lasts >for 2-3 years, do you really think that this >person is going to hop up one day in remission?
Yes, most mid life crisis usually pass.
Linkadge
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