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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by b2chica on April 30, 2014, at 14:46:18
is it true that every relapse we have it causes a little more brain damage?
i heard a doc say this 'in passing and not directed at me.
Posted by linkadge on April 30, 2014, at 16:13:48
In reply to relapse and brain damage, posted by b2chica on April 30, 2014, at 14:46:18
I think we know that relapse is associated with certain alterations in brain structure. However, there is no proven cause and effect relationship.
It could be that neuroprotective agents (which may not have antidepressant effects in their own right) may prevent depressive relapses.
Chronic depression is associated with shrinking hippocampal volume, for instance. However, the hippocampus can regain volume with successful treatment (as has been shown in PTSD for instance). So I don't know if the situation is not preventable, or modifiable.
Linkadge
Posted by linkadge on April 30, 2014, at 16:15:09
In reply to relapse and brain damage, posted by b2chica on April 30, 2014, at 14:46:18
Depressive episodes, for instance, are associated with elevate whole brain glutamate levels.
It could be that lowering glutamate, is an effective strategy to prevent depression induced brain alterations.
Linkadge
Posted by klein on May 1, 2014, at 0:36:07
In reply to relapse and brain damage, posted by b2chica on April 30, 2014, at 14:46:18
> is it true that every relapse we have it causes a little more brain damage?
> i heard a doc say this 'in passing and not directed at me.I would think so, yeah. I'm guessing that's where the psychological aspect comes into play, relapse causes high levels of stress which ultimately lead to morphological changes in the brain. yay! =/
Posted by klein on May 1, 2014, at 0:41:23
In reply to Re: relapse and brain damage, posted by linkadge on April 30, 2014, at 16:15:09
> Depressive episodes, for instance, are associated with elevate whole brain glutamate levels.
>
> It could be that lowering glutamate, is an effective strategy to prevent depression induced brain alterations.
>
> LinkadgeHey Linkadge, right on! This one is a classic:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2701287/
"(blahblah) These findings resonate with research in depressed patients, which indicates that these individuals have an overactive HPA axis and abnormal brain glutamatergic levels"
And apparently tianeptine reverses and even prevents stress-induced damage to the hippocampus and regulates glutamate levels as you mentioned:
"We conclude with a discussion of findings which indicate that tianeptine accomplishes its anti-stress effects by normalizing stress-induced increases in glutamate in the hippocampus and amygdala."
They also blast SSRIs:
"Daily administration of tianeptine blocks the chronic stress-induced reduction of hippocampal volume, as well as the retraction of CA3 (neurons) dendrites in the hippocampus. In contrast, the SSRIs fluoxetine and fluvoxamine were ineffective in preventing the stress-induced changes in CA3 morphology"
Tianeptine is one weird drug. Of course Big Pharma have the resources to brush away the drug which contradicts their inhibitor model.
Anyway, it does sound like ADs work in a roundabout way to stabilize the glutaminergic system (among other things I guess).
Fortunately the damage can be reversed with drugs and other stuff, such as exercise, proper nutrition, maybe even spiritual practice etc. But still, -reversible or not- sometimes I still struggle a lot to acccept that my seemingly endless depression is caused by a damaged brain.
Posted by Christ_empowered on May 1, 2014, at 14:09:06
In reply to Re: relapse and brain damage » linkadge, posted by klein on May 1, 2014, at 0:41:23
I dunno. I told my latest shrink (clinic, they keep changing) about my psychotic episodes, and he talked about brain changes, inflammation, etc.Psychiatry really isn't scientific. I don't know how or why this happened, but they just sell us a bunch of overpriced palliatives. Its sort of like the emotional equivalent of pain management.
Posted by phidippus on May 1, 2014, at 14:20:32
In reply to relapse and brain damage, posted by b2chica on April 30, 2014, at 14:46:18
No
Eric
Posted by linkadge on May 1, 2014, at 15:23:44
In reply to Re: relapse and brain damage » b2chica, posted by phidippus on May 1, 2014, at 14:20:32
I don't think that SSRIs are completely ineffective as neuroprotective agents.
There are studies suggesting that SSRI's can exert neuroprotective effects.
I think too, that its necessary to look beyond just medication in trying to help the brain heal. A couple of things come to mind.
- exercise
- diet
- glucose control
- omega 3
- antioxidant / nutrient intake
- lithium
- niacin (highly neuroprotective)
- magnesium
- HDAC inhibitors (i.e. quercetin)
- nutriceudicals (i.e. blueberries, green tea)a neurorestorative lifestyle:
- social interaction
- learning new things / new experiences
- music
- religion
- mediation (enhances grey matter)Linkadge
Posted by Christ_empowered on May 1, 2014, at 21:59:50
In reply to Re: relapse and brain damage, posted by linkadge on May 1, 2014, at 15:23:44
...so, do you think maybe old school Orthomolecular might be on to something? Its based on high dose niacin/niacinamide (pick either, or mix), plus high dose c, e, b-complex, b-6, zinc, selenium, plus basically whatever else you want. The more recent OM people recommend fish oil on top of the old school protocol. Some recommend amino acids.
Your list reminds me of the life I've been fortunate enough to develop lately. I get to take OM nutrients, do Born Again Christianity, learn new things, etc....and I've never felt better. Meds are still necessary, but they actually *work* and they don't cause too many problems.
Anyway......what's with lithium? Its been recommended to me before, but I'm scared of it, particularly in combo with Abilify (or any neuroleptic).
Posted by linkadge on May 2, 2014, at 16:23:38
In reply to for linkadage.., posted by Christ_empowered on May 1, 2014, at 21:59:50
Lithium is not a bad medication and low doses can be highly tolerable and effective.
I don't necessarily believe in orthomolecular per se. In other words, I don't think that schizophrenics use up niacin faster. I do believe, however that certain vitamins can act like pharmaceuticals. Niacin and valproate share some common targets. Omega-3 also shares common targets with other mood stabilizers.
Taking your medication as prescribed all the while eating a steady diet of McDonnalds is not going to get you well any time soon.
There was a study in mice that showed that a high fat diet significantly decreased the responsiveness of mice to fluoxetine, for example/
Posted by Beckett on May 2, 2014, at 23:51:25
In reply to relapse and brain damage, posted by b2chica on April 30, 2014, at 14:46:18
You want me to cheer you up?
I don't think it is a hard and fast rule either. Have you experienced this?
Posted by B2chica on May 19, 2014, at 15:53:12
In reply to Re: relapse and brain damage » b2chica, posted by Beckett on May 2, 2014, at 23:51:25
i was actually meeting a friend for lunch in a hospital cafeteria, we happened to sit next to a table of docs discussing MDD and ptsd treatments, one commented about how each relapse causes brain damage...
i would have loved to turn around and ask him to explain.. but uh.. ya, i didn't.anyway, i know that it causes CHANGES in neuronal pathways, but i dont see that as damage, because i know that the brain is able to recreate new pathways.
...thanks all
b2
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