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Dr. Bob is Robert Hsiung, MD,
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Posted by SLS on October 18, 2010, at 17:10:16
In reply to Re: Thinking of coming off meds » SLS, posted by huxley on October 18, 2010, at 17:08:37
> Now stop being hypocritical
Yes sir!
- Scott
Posted by SLS on October 18, 2010, at 17:16:36
In reply to Re: Thinking of coming off meds » SLS, posted by huxley on October 18, 2010, at 17:10:12
> Serious question. Was this scan before you started taking medication?
I had already tried a bunch of drugs.
> If it was after, how do you know it wasn't a result of the medication.
You would have to do some research of your own if you really want to have that question answered. I would rather not postulate to you. See what the search engines come up with. I am all but sure you can find some commentary on the use of PET scans on drug-naive individuals.
- Scot
Posted by Lou Pilder on October 18, 2010, at 17:22:00
In reply to Re: Thinking of coming off meds » SLS, posted by huxley on October 18, 2010, at 17:08:37
huxly,
You wrote,[...plenty of...can cause the problems...stopping them could...]
Lou
http://www.dr-bob.org/babble/health/20100104/msgs/944131.html
Posted by SLS on October 18, 2010, at 17:28:40
In reply to Re: Thinking of coming off meds » SLS, posted by huxley on October 18, 2010, at 17:10:12
Here's one.
- Scott*************************************
http://www.ncbi.nlm.nih.gov/pubmed/15094258
J Affect Disord. 2004 May;80(1):55-63.
Correlation between cerebral blood flow and items of the Hamilton Rating Scale for Depression in antidepressant-naive patients.Graff-Guerrero A, González-Olvera J, Mendoza-Espinosa Y, Vaugier V, García-Reyna JC.
Instituto Nacional de Psiquiatría Ramón de la Fuente, Dirección de Servicios Clínicos, Calz. México-Xochimilco 101, Col. San Lorenzo Huipulco, Del. Tlalpan 14370, México D.F., Mexico. agraff@imp.edu.mx
AbstractBACKGROUND: The purpose of this study was to correlate the basal cerebral blood flow (CBF) in patients with major depressive disorder (MDD) with the score for each of the 21 questions in the Hamilton Rating Scale for Depression (HRSD), in order to determine the cerebral regions associated with each item.
METHODS: Fourteen antidepressant-naive patients with unipolar depression (DSM-IV criteria for MDD) participated in this study with a HRSD score of >/=20 points. CBF images obtained by SPECT were analyzed by SPM99 software. The significant correlation threshold for a priori regions (frontocortical and limbic regions) was a Z value of at least 2.25 and clusters formed by more than 10 voxels.
RESULTS: Items 1, 6, 11 and 20 were positively correlated with right medial frontal gyrus; item 7 was negatively correlated with bilateral medial frontal gyrus. Items 2 and 10 were positively correlated with right anterior and medial cingulate, respectively. Item 5 was negatively correlated with the left amygdala. Item 9 was negatively correlated with bilateral insula, and item 16 with right insula. Items 12 and 14 were positively correlated with right and left precentral frontal gyrus, respectively. Limitations: The small sample size and only out-patients included in the study.
CONCLUSIONS: The frontal cortex plays an important role in the expression of MDD symptoms. Not all the symptoms evaluated correlated with one single structure, which may explain the diverse results reported in the literature. These preliminary results support the necessity of further analyses by symptoms that could provide more specific information on the pathophysiology of MDD.
PMID: 15094258 [PubMed - indexed for MEDLINE]
Posted by SLS on October 18, 2010, at 17:36:42
In reply to Re: Thinking of coming off meds » SLS, posted by huxley on October 18, 2010, at 17:10:12
Here is another one. This particular study gives some supportive evidence to the explanations that Linkadge gives regarding possible dopaminergic hyperfunction in various limbic circuits in major depressive (MDD) order.
- Scott
Posted by SLS on October 18, 2010, at 17:46:35
In reply to Re: Thinking of coming off meds » huxley, posted by SLS on October 18, 2010, at 17:36:42
Sorry...
Psychopharmacology (Berl). 1999 Jun;144(3):282-5.
Striatal dopamine transporter density in major depression.Laasonen-Balk T, Kuikka J, Viinamäki H, Husso-Saastamoinen M, Lehtonen J, Tiihonen J.
Department of Psychiatry, Kuopio University Hospital, Finland.
AbstractRATIONALE: There are no previous data available regarding [123I]beta-CIT binding to the dopamine transporter sites in the basal ganglia in depressed patients.
OBJECTIVE: The present study tested the hypothesis that the brain DAT density in depressed patients is lower than that in matched healthy controls.
METHODS: Fifteen drug-naive outpatients with major depression and 18 healthy controls were investigated using single photon emission computerized tomography (SPECT) with a high-affinity dopamine transporter specific radioligand. 123I-labeled beta-CIT (2beta-carbomethoxy-3beta-(4-iodophenyl-tropane).
RESULTS: We found a significantly higher [123I]beta-CIT uptake in both sides of the basal ganglia in patients with major depression than in the controls (Mann-Whitney U-test, P = 0.002 on the right and P = 0.003 on the left).
CONCLUSIONS: The radioligand uptake reflecting the DAT density was significantly higher among the patients than in the controls. This finding is unexpected, since it is generally believed that monoaminergic neurotransmission is lower in depression, and therefore it could be assumed that a reduction in dopamine transmission would lead to secondary down-regulation of DAT density. However, it is possible that up-regulation of the DAT may be the primary alteration, which leads to lower intrasynaptic dopamine concentration and to lower dopamine neural transmission.
Posted by Phillipa on October 18, 2010, at 19:07:47
In reply to Re: Thinking of coming off meds - Oops., posted by SLS on October 18, 2010, at 17:46:35
Scott since it was so long ago and scans have improved would it be valuable to you to see if that is not the case now. Meaning that earlier scans lead you to believe that basically your brain was damaged and maybe it's not? Just a thought. Phillipa
Posted by morgan miller on October 18, 2010, at 19:25:20
In reply to Lou's response-dhtruz » huxley, posted by Lou Pilder on October 18, 2010, at 17:22:00
> huxly,
> You wrote,[...plenty of...can cause the problems...stopping them could...]
> Lou
> http://www.dr-bob.org/babble/health/20100104/msgs/944131.htmlThanks Lou.....
Posted by Maxime on October 18, 2010, at 20:49:30
In reply to Re: Thinking of coming off meds » Maxime, posted by Phillipa on October 17, 2010, at 21:02:52
> Why do you say that's it did you google I still haven't got to work now. Phillipa
My "that's it" was in reference to what you wrote about the MRI. I was agreeing with you.
Posted by Maxime on October 18, 2010, at 20:53:42
In reply to Re: Thinking of coming off meds » Maxime, posted by SLS on October 18, 2010, at 4:51:49
>
> Or very horrifying. Most of my cerebral cortex was hypofunctional as was indicated by the color blue on repeated PET scans. This compares with healthy individuals whose brains shows up globally yellow and orange except for the ventricles. It was a horrendous finding to see how globally my brain function is affected by depression. It was not so pleasant a revelation that the U.S. NIH considered me to be "very sick".
>
>
> - ScottScott, I am sure that it was distressing to find out about your brain function. I am really sorry about that. But at the same time did it not give you satisfaction? Proof that you are ill. I always have people doubting how sick I am and then I begin to doubt it myself. But with the scan you have proof. Or maybe you don't need that kind of validation. *hugs*
Posted by Phillipa on October 18, 2010, at 21:04:50
In reply to Re: Thinking of coming off meds » Phillipa, posted by Maxime on October 18, 2010, at 20:49:30
Maxie sorry I know now. This is the time of night when I start rushing. And I think it's something you do need to do get the MRI to rule that out. Wouldn't it be something if a simple micro or macro adenoma could have caused you all these problems. And fixable with simple surgery If needed that is. Love Phillipa
Posted by SLS on October 19, 2010, at 1:49:13
In reply to Re: Thinking of coming off meds » SLS, posted by Maxime on October 18, 2010, at 20:53:42
>
> >
> > Or very horrifying. Most of my cerebral cortex was hypofunctional as was indicated by the color blue on repeated PET scans. This compares with healthy individuals whose brains shows up globally yellow and orange except for the ventricles. It was a horrendous finding to see how globally my brain function is affected by depression. It was not so pleasant a revelation that the U.S. NIH considered me to be "very sick".
> >
> >
> > - Scott
>
> Scott, I am sure that it was distressing to find out about your brain function. I am really sorry about that. But at the same time did it not give you satisfaction? Proof that you are ill. I always have people doubting how sick I am and then I begin to doubt it myself. But with the scan you have proof. Or maybe you don't need that kind of validation. *hugs*There are people on Internet group forums for the mentally ill whom still don't validate me or that major depressive disorder and bipolar disorder are biological disorders of the CNS. There is even a recalcitrance along this thread to internalize the facts as scientists have come to know them in the 28 years since I was first diagnosed and treated. There is a lack of agreement in only the details, but not of the phenomenon. For some, brain function changes through psychotherapy. It can help remove chronic biological stresses on the brain. This easing of "depressive pressure" might yield the same result as somatic treatments for subgroups of depressives. However, I am not one of them.
I think that having been treated at some of the most highly accredited research facilities gave me the opportunity to watch the field of psychiatry evolve and be exposed to the most current trends in discovery and scientific thought.
How do I know that my affective disorder is biological? Got 28 years for an explanation?
- Scott
Posted by floatingbridge on October 19, 2010, at 12:56:30
In reply to Re: Thinking of coming off meds » Maxime, posted by SLS on October 19, 2010, at 1:49:13
Scott, this is a painful story to hear; much more poignant to live it. I for one am glad your here, willing to share your experience and knowledge and to have the wherewithal to defend it.
> > > Or very horrifying. Most of my cerebral cortex was hypofunctional as was indicated by the color blue on repeated PET scans. This compares with healthy individuals whose brains shows up globally yellow and orange except for the ventricles. It was a horrendous finding to see how globally my brain function is affected by depression. It was not so pleasant a revelation that the U.S. NIH considered me to be "very sick".
> > >
> > >
> > > - Scott
> >
> > Scott, I am sure that it was distressing to find out about your brain function. I am really sorry about that. But at the same time did it not give you satisfaction? Proof that you are ill. I always have people doubting how sick I am and then I begin to doubt it myself. But with the scan you have proof. Or maybe you don't need that kind of validation. *hugs*
>
> There are people on Internet group forums for the mentally ill whom still don't validate me or that major depressive disorder and bipolar disorder are biological disorders of the CNS. There is even a recalcitrance along this thread to internalize the facts as scientists have come to know them in the 28 years since I was first diagnosed and treated. There is a lack of agreement in only the details, but not of the phenomenon. For some, brain function changes through psychotherapy. It can help remove chronic biological stresses on the brain. This easing of "depressive pressure" might yield the same result as somatic treatments for subgroups of depressives. However, I am not one of them.
>
> I think that having been treated at some of the most highly accredited research facilities gave me the opportunity to watch the field of psychiatry evolve and be exposed to the most current trends in discovery and scientific thought.
>
> How do I know that my affective disorder is biological? Got 28 years for an explanation?
>
>
> - Scott
>
>
>
>
Posted by creepy on October 20, 2010, at 12:00:52
In reply to Re: Thinking of coming off meds » SLS, posted by floatingbridge on October 19, 2010, at 12:56:30
Depending on your illness, therapy may be able to take the place of medication.
I had about 15 good, drug-free years after a round of intense therapy. Just started EMDR and hope to put a damper on these out of control stress responses.
Ive been suffering with terrible pain and fatigue for 3 months or so, and I think its the depression returning. I attribute this to spinning my wheels in therapy for so long, not making progress.
Im off almost all of my psych meds and still hanging in there. May add an NRI or something mild to help cope with therapy.
Posted by Deputy Racer on October 20, 2010, at 12:38:08
In reply to Re: Thinking of coming off meds » SLS, posted by huxley on October 18, 2010, at 17:08:37
>
> Now stop being hypocritical...Please don't post anything that could lead others to feel accused or put down.
If you have any questions regarding the posting policies on this site, please read the FAQ, located at http://www.dr-bob.org/babble/faq.html#civil Follow ups to this action should be directed to the Administration board and should themselves be civil.
Dr Bob has ultimate authority over all administrative issues on this site, and may choose at any time to revise or reverse any action taken by a deputy.
Deputy Racer
Posted by huxley on October 20, 2010, at 20:48:58
In reply to Re: Thinking of coming off meds » huxley, posted by SLS on October 18, 2010, at 17:28:40
Thanks for digging them up for me sls.
Sorry if what I said was no civil.I wonder if these scans will be able to show the effects of psych meds on the brain.
Interesting times ahead.
Posted by Maxime on October 20, 2010, at 21:31:27
In reply to Re: Thinking of coming off meds » Maxime, posted by SLS on October 19, 2010, at 1:49:13
So I have an appt. with my pdoc for next Friday to discuss how I might reduce my meds. I will also talk to him about TMS and TDSC. I have already lowered my Nortrip from 75 mg to 50 mg. I am sure he won't mind.
I am really looking forward to my appt on the 29th. I will be very shocked if says that he thinks I should stay on my current cocktail.
Posted by floatingbridge on October 21, 2010, at 0:13:59
In reply to Re: Thinking of coming off meds, posted by Maxime on October 20, 2010, at 21:31:27
Maxime, having access to rTMS would be so wonderful for you. I have been reading far more good review, barely negative--at most, no effect.
Good luck in your next steps.
Posted by floatingbridge on October 21, 2010, at 0:15:46
In reply to Please be civil » huxley, posted by Deputy Racer on October 20, 2010, at 12:38:08
Posted by SLS on October 21, 2010, at 2:40:17
In reply to Re: Thinking of coming off meds » SLS, posted by huxley on October 20, 2010, at 20:48:58
> Thanks for digging them up for me sls.
> Sorry if what I said was no civil.
>
> I wonder if these scans will be able to show the effects of psych meds on the brain.Yup. Good idea.
PET scans have been used since the early 1990s to produce images of people who are given test doses of various psychotropic compounds. I was one of the first subjects to be experimented with in this way. They used a compound known as idazoxan, to which I was naive, as a single dose. It lit up my frontal cortices in the image. Unfortunately, idazoxan made me feel significantly more depressed when it was given to me as a clinical treatment. My guess is that this was due to the ability of idazoxan to block NE alpha-2 receptors. It was a bit hellish there for a few months.
- Scott
Posted by bearfan on October 21, 2010, at 17:52:10
In reply to Thinking of coming off meds, posted by Maxime on October 13, 2010, at 22:32:42
Well if you think you can be still be stable and productive without or with less meds, I don't see what the problem is. If Parnate is causing long term weight gain, it's probably not the best long term solution for you. If you plan on staying with Adderall XR, maybe a milder drug as desimpramine or something else is a better option.
Posted by Maxime on October 21, 2010, at 22:37:59
In reply to Re: Thinking of coming off meds » Maxime, posted by floatingbridge on October 21, 2010, at 0:13:59
> Maxime, having access to rTMS would be so wonderful for you. I have been reading far more good review, barely negative--at most, no effect.
>
> Good luck in your next steps.Thank you so much!!!
Posted by Maxime on October 21, 2010, at 22:41:55
In reply to Re: Thinking of coming off meds, posted by bearfan on October 21, 2010, at 17:52:10
> Well if you think you can be still be stable and productive without or with less meds, I don't see what the problem is. If Parnate is causing long term weight gain, it's probably not the best long term solution for you. If you plan on staying with Adderall XR, maybe a milder drug as desimpramine or something else is a better option.
I don't know if the Parnate is causing weight gain or not. It never did before when I was on it. I think it's the Notriptaline.
Desipramine remains an options as well.
I will see what my doctor has to say about everything. What I am really hoping is that he will be able to get me on the list for TMS because he used to practice at the psych hospital where it is available.
Posted by Phillipa on October 22, 2010, at 19:41:22
In reply to Re: Thinking of coming off meds » bearfan, posted by Maxime on October 21, 2010, at 22:41:55
Then it sounds like a strong possibility that you can get into the studies. Phillipa
Posted by maxime on October 22, 2010, at 22:15:59
In reply to Re: Thinking of coming off meds » Maxime, posted by Phillipa on October 22, 2010, at 19:41:22
> Then it sounds like a strong possibility that you can get into the studies. Phillipa
I know! I am giddy with anticipation! I would really love to the chance to have it done. Anything to help me.
Will keep you posted.
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