![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 2 to 26 of 31. Go back in thread:
Posted by Lou Pilder on June 3, 2015, at 5:36:28
In reply to Stop Almost All Psych Meds to Prevent Harm., posted by Phillipa on June 2, 2015, at 19:51:15
> So what do you think about this? Phillipa
> Medscape Medical News > Psychiatry
> 'Stop Almost All Psychiatric Meds to Prevent Harm,' Expert Says
> Liam Davenport
> June 01, 2015
> 42 comments
> PrintEmail
> EDITORS' RECOMMENDATIONS
>
> Almost all psychotropic drugs could be stopped without causing any harm and with little loss of benefits, saving hundreds of thousands of lives and leading to happier and longer-lived populations, says a Danish expert in a head-to-head editorial debate.
>
> Writing ahead of a debate in London over the use of psychiatric drugs, Peter C. Gøtzsche, MD, Nordic Cochrane Centre, Rigshospitalet, Copenhagen, Denmark, believes these medications offer few benefits compared with placebo and may cause more than half a million deaths per year in the United States and Europe.
>
> Consequently, 98% of psychotropic drugs should be dropped. These include all antidepressant, attention-deficit/hyperactivity disorder, and dementia drugs and all but 6% of the antipsychotics and benzodiazepines currently in use.
>
> "Because psychotropic drugs are immensely harmful when used long term, they should almost exclusively be used in acute situations and always with a firm plan for tapering off, which can be difficult for many patients," Dr Gøtzsche argues.
>
> Concerns "Overinflated"
>
> In response, Allan H Young, MD, PhD, professor of mood disorders at the Institute of Psychiatry, Psychology and Neuroscience at King's College London, believes that many of the concerns over psychiatric drugs are "overinflated."
>
> Writing with John Crace, a psychiatric patient and parliamentary sketch writer for The Guardian newspaper, in London, Dr Young says that "psychiatric drugs are rigorously examined for efficacy and safety, before and after regulatory approval."
>
> The editorialists add: "[They] are as beneficial as other treatments used for common, complex medical conditions."
>
> The editorial was published online May 20 in the BMJ as part of the 52nd Annual Maudsley Debate.
>
> In setting out his case against the current use of psychiatric drugs, Dr Gøtzsche says that randomized trials have overstated the benefits of the drugs, because "almost all" are biased.
>
> This is because the patients are already taking another psychiatric drug. When they are then randomly assigned to receive placebo after a short washout period, they go "cold turkey" and experience withdrawal, thus exaggerating the benefits of the study drug.
>
> In addition, many studies are inadequately blinded, and meta-analyses have indicated that the benefits of psychiatric drugs are minimal and often occur only a few days before similar effects are seen with placebo.
>
> Deaths Underreported
>
> More worrying, however, is the widespread underreporting of deaths associated with psychiatric drugs. Dr Gøtzsche estimates that there have been 15 times more suicides among people taking antidepressants than reported by the US Food and Drug Administration.
>
> Using conservative excess death rates among people aged at least 65 years of 1% for antipsychotics, 1% for benzodiazepines and similar drugs, and 2% for antidepressants, he calculates that the drugs are together responsible for 3693 deaths per year in Denmark.
>
> This translates to a staggering 539,000 deaths per year in the United States and European Union combined.
>
> In conclusion, Dr Gøtzsche argues that, given the above, psychotropic drugs should be reserved almost exclusively for acute patients.
>
> "We need new guidelines to reflect this. We also need widespread withdrawal clinics because many patients have become dependent on psychiatric drugs, including antidepressants, and need help so that they can stop taking them slowly and safely," he adds.
>
> Long-term Harms "Minimal"
>
> In contrast, Dr Young and Crace observe that "people with poor mental health often have poor physical health and poorer (long term) outcomes in both aspects of health."
>
> The increased death rates seen in psychiatric patients are consequently only partly due to suicide and, in fact, are largely attributable to coexisting physical health disorders.
>
> The authors add that an analysis of meta-analyses by Leucht et al revealed that psychiatric drugs are generally as efficacious as drugs used for other complex medical conditions.
>
> Moreover, the long-term harms associated with psychiatric drugs are minimal if guidelines are followed, and several studies have indicated that there is an inverse correlation between mortality and cumulative use.
>
> There are also several safeguards for the monitoring of drugs, including spontaneous reporting databases, prescription event monitoring, electronic health records, and patient registries.
>
> "Taking all this into account, we contend that the motion that the long term use of psychiatric drugs is causing more meaningful harm than good is not correct and the evidence, such as it is, suggests the contrary," they conclude.
>
> The editorialists have disclosed no relevant financial relationships.
>
> BMJ. Published online May 20, 2015. AbstractPhillip,
You wrote,[...So what do you think about this?....].
Many of you already know that I have been trying so hard to save lives, prevent life-ruining conditions and addictions by posting here what I think could save your life, the life of a child or one that is in your care that is prescribed psychotropic drugs. But there are prohibitions posted to me here by Mr. Hsiung. Prohibitions that I think could mark the difference between you being a live person or a corpse. And I am abiding by those prohibitions.
So let no man deceive you and say that what I post here could cause your death or suicide. For I am abiding by the prohibitions to me and those that have been killed by the drugs allowed to be promoted here or had suicidal thoughts induced into them from the drugs and killed themselves, their blood will not be upon me. For I have come to seek those that are lost, those that are shackled to their drugs and to free the captives to be led out of depression and addiction into a marvelous life of peace and joy. This all would come from a Jewish perspective as revealed to me that is prohibited by Mr. Hsiung for me to post here. Yet today, it is supportive by Mr. Hsiung and his deputies of record to allow anti-Semitic propaganda to be posted here with impunity and worse, that Mr. Hsiung states that by him doing such, it will be good for his community as a whole in his thinking for the anti-Semitism to be seen as supportive here even though it is against his rules to post what could put down those of other faiths.
You see, it has been revealed to me how these drugs kill not only the taker of the drugs, but innocent people being killed by the effects of mind-altering chemicals in the drugs inducing suicidal and homicidal thoughts in those that take them. And if the prohibitions to me by Mr. Hsiung were not posted to me here, I think that those that have been killed by the drugs here and any innocent people killed by readers here, could be alive today.
And you mothers. Before you allow your child to be drugged in collaboration with a psychiatrist, heed my warnings here by reading my posts here. And look at the posts that are allowed to decrease the respect , regard and confidence in which I am held and that could induce hostile and disagreeable opinions and feelings toward me that are allowed with impunity to be posted here that could also defame Judaism and me as a Jew here which could have in my thinking a singular purpose which IMHHHO could lead you astray to have contempt for Jews and me as a Jew here which IMHHHHO could contribute to a mind-set of hate that could be thought to be created and developed here toward Jews that could trap you into a vortex of depression as thinking that anti-Semitic hate is supportive by a psychiatrist that has strict rules not to post what could put down those of other faiths and worse, that by him allowing the hate to be seen as supportive here, it will in his thinking be good for this community as a whole. That argument has been used to justify slavery, to justify infanticide, to justify segregation, to justify discrimination, to justify genocide, to justify hate. And worse, My Hsiung states that he wants you to put your trust in him for what he does here. That is a powerful influence to have readers continue to take mind-altering drugs that could cause addiction and life-ruining conditions and death and to influence vulnerable readers to hate Jews.
You see, it has been revealed to me who was the first to tell people to put their trust in them that could lead to their deaths by following the trust. And who were those that followed the first that today led those following to their deaths. The article posted here by Phillipa agrees with me in what I have been trying to post here for years, and maybe you will put your trust in that doctor. And I think that's good. Thanks.
Lou
Posted by Tomatheus on June 3, 2015, at 14:04:07
In reply to Stop Almost All Psych Meds to Prevent Harm., posted by Phillipa on June 2, 2015, at 19:51:15
I think that a decision to stop the prescribing of all antidepressants would be a bad idea. Although I think it's questionable as to how many patients with clinical depression actually benefit from antidepressants, I do think that some individuals benefit from the medications and that withholding the medications can have serious consequences on the livelihoods of patients suffering from clinical depression.
I also think it's interesting that Dr. Gøtzsche didn't state whether he felt that lithium and anticonvulsants should continue to be used for bipolar disorder. Though I do feel that antidepressants are limited in terms of their efficacy, I think that lithium has an established track record of efficacy in treating classic cases of bipolar disorder. I certainly hope that Dr. Gøtzsche wouldn't advocate withholding lithium for the treatment of bipolar patients, especially given the medication's long record of efficacy.
Tomatheus
Posted by europerep on June 3, 2015, at 16:32:00
In reply to Stop Almost All Psych Meds to Prevent Harm., posted by Phillipa on June 2, 2015, at 19:51:15
The debate that the article is referring to at the beginning of the text can be seen here:
https://www.youtube.com/watch?v=9oH9ovmmAXk
Posted by Phillipa on June 3, 2015, at 18:46:16
In reply to Re: Stop Almost All Psych Meds to Prevent Harm. » Phillipa, posted by europerep on June 3, 2015, at 16:32:00
Interesting and thanks for posting video. For those who watched it and listened what are you thoughts on meds now the same or different . Since I've taken benzos long term for many years this concerns me personally as well.
Posted by baseball55 on June 3, 2015, at 20:13:03
In reply to Stop Almost All Psych Meds to Prevent Harm., posted by Phillipa on June 2, 2015, at 19:51:15
Well that's alarmist in the extreme. Given that the US has about 40,000 suicides a year and the EU - while I couldn't find data on annual suicides - has a lower suicide rate and about the same population....500,000 per year in the US and EU combined? There are fewer than 1m worldwide (WHO) and most are in asia, with 1/2 the worlds population and a culture in which suicide is more widely accepted as a reasonable response to distress.
These figures make no sense whatsoever. Suicide rates in the US and EU have fallen since the late 1980s (WHO, OECD, CDC), a period where anti-depressant use has soared.
I find this irresponsible.
Posted by Phillipa on June 3, 2015, at 21:01:23
In reply to Re: Stop Almost All Psych Meds to Prevent Harm., posted by baseball55 on June 3, 2015, at 20:13:03
Baseball so in your opinion medications do work? Thanks for responding. Phillipa
Posted by Christ_empowered on June 4, 2015, at 18:55:31
In reply to Stop Almost All Psych Meds to Prevent Harm., posted by Phillipa on June 2, 2015, at 19:51:15
I kinda see the point. I mean, if 1% of the population has schizo-something and another 1% severe bipolar, maybe 1% psychotic depression or whatever...why are so many people on meds?Also...related point...if psychiatry is really about helping the mentally ill, why have so many shrinks given up on the severely mentally ill and also on people who use insurance?
I do think antidepressants often cause more problems for the more moderately, mildly ill than no treatment at all would...which translates into lost $$$ for the economy.
Posted by baseball55 on June 4, 2015, at 19:08:50
In reply to Re: Stop Almost All Psych Meds to Prevent Harm. » baseball55, posted by Phillipa on June 3, 2015, at 21:01:23
Posted by baseball55 on June 4, 2015, at 19:11:45
In reply to Re: Stop Almost All Psych Meds to Prevent Harm. » baseball55, posted by Phillipa on June 3, 2015, at 21:01:23
> Baseball so in your opinion medications do work? Thanks for responding. Phillipa
My opinion regarding the efficacy of ADs is not the issue. The issue is that the article you posted presented numbers that are patently and demonstrably false. Information on suicide rates can be found easily at WHO and OECD, both reliable public sources.
Posted by Phillipa on June 4, 2015, at 20:45:46
In reply to Re: Stop Almost All Psych Meds to Prevent Harm., posted by baseball55 on June 4, 2015, at 19:11:45
Thanks says a lot to discount this. At the end of the articles are replies from those in medical field and they also don't agree
Posted by rose45 on June 12, 2015, at 8:21:57
In reply to Re: Stop Almost All Psych Meds to Prevent Harm. » baseball55, posted by Phillipa on June 4, 2015, at 20:45:46
I can only speak for myself, but MAOIs have saved my life. I become totally suicidal when I am off drugs. MAOIs give me the chance to lead a more or less normal life. I become a totally different person.
I have no idea whether they are causing some form of harm that I am not aware of. They are not a cure, because I have to be on them for the rest of my life. But I have severe depression, and they make a 100% difference.
Without them I would have committed suicide years ago, because the pain of my depression is unbearable.It is possible that many people are put on anti depressants when they dont really need them, and it may be the medication doesnt really help them.
You cant lump everyone into the same box. People should find out for themselves.
Posted by SLS on June 12, 2015, at 11:47:54
In reply to Re: Stop Almost All Psych Meds to Prevent Harm., posted by rose45 on June 12, 2015, at 8:21:57
> I can only speak for myself, but MAOIs have saved my life. I become totally suicidal when I am off drugs. MAOIs give me the chance to lead a more or less normal life. I become a totally different person.
>
> I have no idea whether they are causing some form of harm that I am not aware of. They are not a cure, because I have to be on them for the rest of my life. But I have severe depression, and they make a 100% difference.
> Without them I would have committed suicide years ago, because the pain of my depression is unbearable.
>
> It is possible that many people are put on anti depressants when they dont really need them, and it may be the medication doesnt really help them.
>
> You cant lump everyone into the same box. People should find out for themselves.Very well said.
It is unfortunate that there is a sizable proportion of severely depressed people who have yet to find an effective treatment. Most of the people posting on this forum are members of this treatment-resistant group. Treatment failures here outnumber treatment successes by such a large margin, that it would seem that psychotropic drugs don't work at all.
I envy you. I wish for you continued health.
- Scott
Posted by Christ_empowered on June 12, 2015, at 15:12:17
In reply to Re: Stop Almost All Psych Meds to Prevent Harm., posted by baseball55 on June 4, 2015, at 19:11:45
I think the severely mentally ill aren't well served by the "helping professions" or Big Pharma. The atypicals are an improvement, the newer ADs are OK, etc., but...I don't think there's been a whole lot of progress since Marplan, Thorazine, Tofranil, Miltown, Librium, etc.
Posted by rose45 on June 12, 2015, at 16:26:21
In reply to Re: Stop Almost All Psych Meds to Prevent Harm. » rose45, posted by SLS on June 12, 2015, at 11:47:54
> > I can only speak for myself, but MAOIs have saved my life. I become totally suicidal when I am off drugs. MAOIs give me the chance to lead a more or less normal life. I become a totally different person.
> >
> > I have no idea whether they are causing some form of harm that I am not aware of. They are not a cure, because I have to be on them for the rest of my life. But I have severe depression, and they make a 100% difference.
> > Without them I would have committed suicide years ago, because the pain of my depression is unbearable.
> >
> > It is possible that many people are put on anti depressants when they dont really need them, and it may be the medication doesnt really help them.
> >
> > You cant lump everyone into the same box. People should find out for themselves.
>
> Very well said.
>
> It is unfortunate that there is a sizable proportion of severely depressed people who have yet to find an effective treatment. Most of the people posting on this forum are members of this treatment-resistant group. Treatment failures here outnumber treatment successes by such a large margin, that it would seem that psychotropic drugs don't work at all.
>
> I envy you. I wish for you continued health.
>
>
> - ScottScott,
I feel so bad for people who cannot be helped. I know what a living hell depression is and I truly wish I could do something to help others. I often think I was extremely lucky to have been put on nardil as a first choice in hospital when I became severely ill. I had suffered depression all my life until then, but was very anti- medication, so I just suffered and refused to take anything, even for sleep. But then, it became so bad, that I didnt recognise it as depression any more. It became something entirely different, and I had no choice but to take medication.
I dont know whether I was saved by the fact that I only started taking meds late in life, and resisted taking anything for many years. I really dont understand much about it, except that I do feel lucky that at least the maois work for me. Its not a 100% cure, but at least I dont have to be in constant mental pain.
I pray that researchers will come up with something soon. They seem to be beating cancer and so many other illnesses, its time they got to the root of mental illness.
Posted by Meltingpot on July 8, 2015, at 10:26:46
In reply to Stop Almost All Psych Meds to Prevent Harm., posted by Phillipa on June 2, 2015, at 19:51:15
I find the thoughts of Gotzsche really scarey and it makes me very angry. Especially this:-
"exclusively be used in acute situations and always with a firm plan for tapering off, which can be difficult for many patients," Dr Gøtzsche argues"
Would Dr Gotzsche argue that pain killers should only be used in acute situation and there should always be a firm plan for coming off them??? Would this Doctor expect people in Pain just to continue to suffer and manage their pain. What does he suggest that people do instead of taking their psychiatric medication, sit in a room meditating for hours, surrounded by bonsai trees and alpha wave music in the background??? or spend endless years in therapy going over and over the same ground???
What makes Dr Gotzsche think everyone should come off all their medication? What makes him an expert. What reason would there be for doing this? Admittedly, some people do come off antidepressants and are ok, I did (mainly because of all the scaremongering) and was ok for three years but I could NEVER come off them now. I'd rather be DEAD than not on medication. For this Doctor to imply that all people should come off their psyciatric medication is downright reckless. We had a lady in the UK with schizophrenia who came off her meds when she was pregnant because she didn't want to harm her new born child. A couple of days after the baby was born the woman walked out of the hospital with her baby (unnoticed by any of the hospital staff) and threw herself and her new born baby off a bridge.
I think that Dr Gotzsche could have said "people should be encouraged to come off medication if they want to and feel that they can" What does this Dr Gotzsche consider as "Acute" exactly? A person having their stomach pumped from an overdose? Being in hospital having your wrists bandaged??
I think we should all petitition against this man.
Also, I've never understood how the placebo effect is supposed to work in a very depressed person. When I have been at my lowest point I have had no expectations of anything working. I've never had a placebo response to anything. It either works or it doesn't. I know how a placebo feels, it's a very vague feeling, where you can't be sure. I think only people who are very suggestible have placebo response. I have a friend who has a very vivid imagination, she only has to take a handful of vitamin B tablets for her to feel full of energy (I kind of question this and am sure it is her imagination)
Anyway, sorry to go on but how I feel off meds haunts me. I've had two so called specialists (I've seen many over the years, some very good and sympathetic) imply that I should come off medication. One refused to help me and told me to go away and practice "Mindfulness" after I had told him that I had been pacing up and down, wretching and was feeling like I just wanted to kill myself. He had a lovely grey sports car parked outside his surgery, I wanted to scratch my car keys down the side of it and then just tell HIM to be "mindful" about the damage.
Denise
Posted by rose45 on July 9, 2015, at 8:12:33
In reply to Doesn't anyone else find this scarey?, posted by Meltingpot on July 8, 2015, at 10:26:46
> I find the thoughts of Gotzsche really scarey and it makes me very angry. Especially this:-
>
> "exclusively be used in acute situations and always with a firm plan for tapering off, which can be difficult for many patients," Dr Gøtzsche argues"
>
> Would Dr Gotzsche argue that pain killers should only be used in acute situation and there should always be a firm plan for coming off them??? Would this Doctor expect people in Pain just to continue to suffer and manage their pain. What does he suggest that people do instead of taking their psychiatric medication, sit in a room meditating for hours, surrounded by bonsai trees and alpha wave music in the background??? or spend endless years in therapy going over and over the same ground???
>
> What makes Dr Gotzsche think everyone should come off all their medication? What makes him an expert. What reason would there be for doing this? Admittedly, some people do come off antidepressants and are ok, I did (mainly because of all the scaremongering) and was ok for three years but I could NEVER come off them now. I'd rather be DEAD than not on medication. For this Doctor to imply that all people should come off their psyciatric medication is downright reckless. We had a lady in the UK with schizophrenia who came off her meds when she was pregnant because she didn't want to harm her new born child. A couple of days after the baby was born the woman walked out of the hospital with her baby (unnoticed by any of the hospital staff) and threw herself and her new born baby off a bridge.
>
> I think that Dr Gotzsche could have said "people should be encouraged to come off medication if they want to and feel that they can" What does this Dr Gotzsche consider as "Acute" exactly? A person having their stomach pumped from an overdose? Being in hospital having your wrists bandaged??
>
> I think we should all petitition against this man.
>
> Also, I've never understood how the placebo effect is supposed to work in a very depressed person. When I have been at my lowest point I have had no expectations of anything working. I've never had a placebo response to anything. It either works or it doesn't. I know how a placebo feels, it's a very vague feeling, where you can't be sure. I think only people who are very suggestible have placebo response. I have a friend who has a very vivid imagination, she only has to take a handful of vitamin B tablets for her to feel full of energy (I kind of question this and am sure it is her imagination)
>
> Anyway, sorry to go on but how I feel off meds haunts me. I've had two so called specialists (I've seen many over the years, some very good and sympathetic) imply that I should come off medication. One refused to help me and told me to go away and practice "Mindfulness" after I had told him that I had been pacing up and down, wretching and was feeling like I just wanted to kill myself. He had a lovely grey sports car parked outside his surgery, I wanted to scratch my car keys down the side of it and then just tell HIM to be "mindful" about the damage.
>
>
> Denise
>Which country do you live in, Denise ?
I live in England, and all the psychiatrists I have seen, on the NHS have told me that I will likely have to stay on meds for my entire life. Noone has ever suggested I wean myself off them. Quite the contrary.
>
>
Posted by Meltingpot on July 10, 2015, at 4:09:03
In reply to Re: Doesn't anyone else find this scarey? » Meltingpot, posted by rose45 on July 9, 2015, at 8:12:33
Hi Rose,
I live in the UK and most of the psychiatrists (I've seen quite a few, privately and on the NHS for various reasons, in many cases they have left and I've been referred to someone else. Most of the pscychiatrists I've seen have been really understanding, one private one did tell me that I would probably have to take medication for the rest of my life. There have just been two who have had a totally difference stance and I have hated their attitude to this day (and them too :-))!
What have you been diagnosed with?
Denise
Posted by SLS on July 10, 2015, at 6:37:00
In reply to Rose, posted by Meltingpot on July 10, 2015, at 4:09:03
> one private one did tell me that I would probably have to take medication for the rest of my life. There have just been two who have had a totally difference stance and I have hated their attitude to this day (and them too :-))!
What is the downside of continuing to take medication?
What is the downside of not taking medication?Taking medication now might turn out to be a temporary bridge to the development of other types of treatments. For me, I am looking at brain stimulation techniques.
ECT = electroconvulsive therapy
rTMS = repetitive transcranial magnetic stimulation
dTMS = deep transcranial magnetic stimulation
sTMS = synchronized transcranial magnetic stimulation
tDCS = trancranial direct current stmulation
DBS = deep brain stimulation
VNS = vagus nerve stimulation
MST = magnetic seizure therapyI wish sTMS were available. I also like the initial results of tDCS. Unfortunately, these treatments are not ready for prime time.
The best US FDA approved non-invasive treatment might be dTMS. One study reported Its efficacy to lie closer to ECT than to rTMS. The FDA approved dTMS rather quickly, and surprised the manufacturer (Brainsway). Brainsway was not ready to ship more than 100 devices to the US.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3280107/
The problem that emerged in this study was that the dTMS treatment was reported to be less tolerable than rTMS, although dTMS works better. dTMS is also reported to work faster than ECT at 2 weeks. However, dTMS was less effective after 4 weeks. These results need to be verified with additional studies. Perhaps, with time, the settings of the dTMS device can be optimized to address tolerability issues.
It is important to understand that whether it be drug therapy, ECT or TMS, TRD patients usually need maintenance treatment to prevent relapse. One person on Psycho-Babble who did not respond to medication alone went on to respond to rTMS. She undergoes maintenance treatments every 6 months.
- Scott
Posted by stan_the_man70 on July 10, 2015, at 10:53:34
In reply to ECT / rTMS / dTMS / sTMS / tDCS / DBS / VNS / MST, posted by SLS on July 10, 2015, at 6:37:00
Thanks for all the info
Apparently you can buy your own PEMF product rather inexpensively $429
http://www.micro-pulse.com/collections/all
This one is by Dr Robert Dennis and he also has youtube videos
http://www.micro-pulse.com/There are other PEMF products
You can even build your own rather inexpensivelyDr Pawluk has reviewed various products
http://drpawluk.com/products/Video reviews
http://pemfproducts.com/Some more explanation about PEMF (pulsed electromagnetic fields)
http://www.pemf.com/en/You can even buy PEMF helmets and so on and download programs to run.
Many other companies sell these products and have video testimonials/explanations/youtube. For example:
http://masmagnetics.com/product/mas-special-multi/I am new to this. I have not tried this. But its similar to taking NADH for the cell energy mitochondrial cycle.
Please no flames.
Regards.-----------------------------------------------
> > one private one did tell me that I would probably have to take medication for the rest of my life. There have just been two who have had a totally difference stance and I have hated their attitude to this day (and them too :-))!
>
> What is the downside of continuing to take medication?
> What is the downside of not taking medication?
>
> Taking medication now might turn out to be a temporary bridge to the development of other types of treatments. For me, I am looking at brain stimulation techniques.
>
> ECT = electroconvulsive therapy
> rTMS = repetitive transcranial magnetic stimulation
> dTMS = deep transcranial magnetic stimulation
> sTMS = synchronized transcranial magnetic stimulation
> tDCS = trancranial direct current stmulation
> DBS = deep brain stimulation
> VNS = vagus nerve stimulation
> MST = magnetic seizure therapy
>
> I wish sTMS were available. I also like the initial results of tDCS. Unfortunately, these treatments are not ready for prime time.
>
> The best US FDA approved non-invasive treatment might be dTMS. One study reported Its efficacy to lie closer to ECT than to rTMS. The FDA approved dTMS rather quickly, and surprised the manufacturer (Brainsway). Brainsway was not ready to ship more than 100 devices to the US.
>
> http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3280107/
>
> The problem that emerged in this study was that the dTMS treatment was reported to be less tolerable than rTMS, although dTMS works better. dTMS is also reported to work faster than ECT at 2 weeks. However, dTMS was less effective after 4 weeks. These results need to be verified with additional studies. Perhaps, with time, the settings of the dTMS device can be optimized to address tolerability issues.
>
> It is important to understand that whether it be drug therapy, ECT or TMS, TRD patients usually need maintenance treatment to prevent relapse. One person on Psycho-Babble who did not respond to medication alone went on to respond to rTMS. She undergoes maintenance treatments every 6 months.
>
>
> - Scott
Posted by SLS on July 10, 2015, at 13:46:53
In reply to Re: ECT / rTMS / dTMS / sTMS / tDCS / DBS / VNS / MST » SLS, posted by stan_the_man70 on July 10, 2015, at 10:53:34
Thanks, Stan the Man.
My doctor was loaned some sort of "poor-man's" TMS machine to evaluuate for the manufacturer. I was to come in daily for a few weeks, depending on my reaction. I placed the coil over the left side of my forehead. I reacted to two treatments by feeling much worse, and aborted the trial. It took a few days to recover. I was stupid. After feeling worse from left-side placement, I didn't think to try right side placement. I had already known about the reciprocal relationship between frequency and lateral positioning. I don't know why I didn't make the connection.
10-20 Hz / left = antidepressant
10-20 Hz / right = depressant / antimanic1-5 Hz / left = depressant / antimanic
1-5 Hz / right = antidepressantI should have tried right side positioning, just in case the frequency generated by the machine was in the lower range. It was not adjustable. My doctor was unaware of this lateralization. However, that magnetic stimulation could have such a profound negative effect on my mood gives me hope that I would respond positively to properly applied tissue stimulation treatments. A few people are applying 1 Hz / right for depression with success rather than the original 10 Hz / left.
- Scott
Posted by rose45 on July 10, 2015, at 14:21:15
In reply to Re: ECT / rTMS / dTMS / sTMS / tDCS / DBS / VNS / MST » stan_the_man70, posted by SLS on July 10, 2015, at 13:46:53
> Thanks, Stan the Man.
>
> My doctor was loaned some sort of "poor-man's" TMS machine to evaluuate for the manufacturer. I was to come in daily for a few weeks, depending on my reaction. I placed the coil over the left side of my forehead. I reacted to two treatments by feeling much worse, and aborted the trial. It took a few days to recover. I was stupid. After feeling worse from left-side placement, I didn't think to try right side placement. I had already known about the reciprocal relationship between frequency and lateral positioning. I don't know why I didn't make the connection.
>
> 10-20 Hz / left = antidepressant
> 10-20 Hz / right = depressant / antimanic
>
> 1-5 Hz / left = depressant / antimanic
> 1-5 Hz / right = antidepressant
>
> I should have tried right side positioning, just in case the frequency generated by the machine was in the lower range. It was not adjustable. My doctor was unaware of this lateralization. However, that magnetic stimulation could have such a profound negative effect on my mood gives me hope that I would respond positively to properly applied tissue stimulation treatments. A few people are applying 1 Hz / right for depression with success rather than the original 10 Hz / left.
>
>
> - ScottI wonder what percentage of people are helped by this procedure. There are trials currently going on in the Uk, but I dont know whether I should volunteer, or not.
Posted by rose45 on July 10, 2015, at 14:25:00
In reply to Rose, posted by Meltingpot on July 10, 2015, at 4:09:03
> Hi Rose,
>
> I live in the UK and most of the psychiatrists (I've seen quite a few, privately and on the NHS for various reasons, in many cases they have left and I've been referred to someone else. Most of the pscychiatrists I've seen have been really understanding, one private one did tell me that I would probably have to take medication for the rest of my life. There have just been two who have had a totally difference stance and I have hated their attitude to this day (and them too :-))!
>
> What have you been diagnosed with?
>
>
> DeniseDenise, I have clinical depression, which is really helped only by MAOIs. None of the other medications work for me. But I cannot cope at all without medication. MAOIs have been a real miracle drug for me, but there are side effects and I dread to think what damage they may be doing that I am unaware of.
How about you?
Posted by Meltingpot on July 16, 2015, at 15:02:32
In reply to ECT / rTMS / dTMS / sTMS / tDCS / DBS / VNS / MST, posted by SLS on July 10, 2015, at 6:37:00
Hi Scott,
It's nice to see you on the board still as I've always found your posts really encouraging, helpful and informative.
I agree with you, I am taking my medication in the hope that one day something better (even a cure) will come along. The state of being feels unbearable without medication.
I have tried rTMS years ago in Vancouver and it didn't seem to do anything and I tried 8 treatments of ECT (4 bilateral) which didn't seem to do anything either. But one thing I would say is that when I came round after each treatment I felt particularly horrible, like I'd been somewhere not very nice in my own head.
I seem to remember you saying that you had tried ECT and felt quite good for about half an hour and then nothing after that so I'm surprised you are optimistic about Deep rTMS but then like you say you did respond to TMS (be it in a negative way) so it must have done something.
I have been following the DBS trials quite closely as it is something I might consider when they know more about who it works for and which areas to target. Afterall, if you had the operation which area would you want them to target the anterior cingulate, the nucleous accumbens, or any of the other areas that they are experimenting with? I'm sure I primarily suffer from some kind of existential anxiety rather than depression as I don't tend to cry a lot and feel sad with it, mainly agitated and anxious(II really hope that the trials that the military will be doing with DBS prove to be fruitful.
I have been considering VNS but you hear so few positive reports from it, I'm not sure it is worth the bother.
Denise
Posted by SLS on July 17, 2015, at 9:01:38
In reply to Scott, posted by Meltingpot on July 16, 2015, at 15:02:32
> Hi Scott,
Hi. :-)
Long time, no see.
> It's nice to see you on the board still as I've always found your posts really encouraging, helpful and informative.
Thanks. I sometimes wonder if others feel the same way. I kinda don't think so. I generally don't get responsess to the threads I start, even when it is a request for help. Perhaps I come off as being a megalomaniac.
Oh, well.
> I am taking my medication in the hope that one day something better (even a cure) will come along. The state of being feels unbearable without medication.
What features of your depression do medications mitigate?
I feel that I have gone as far as I can with pharmacotherapy. I might add NAC in a few weeks. It is likely to take several months to work if it is going to work at all.
> I have tried rTMS years ago in Vancouver and it didn't seem to do anything and I tried 8 treatments of ECT (4 bilateral) which didn't seem to do anything either.
Supposedly a full trial of ECT comprises 12 - 15 treatments.
> But one thing I would say is that when I came round after each treatment I felt particularly horrible, like I'd been somewhere not very nice in my own head.
Was the core depression worse, or was this something different present in addition to depression?
> I seem to remember you saying that you had tried ECT and felt quite good for about half an hour and then nothing after that so I'm surprised you are optimistic about Deep rTMS.
I never tried any type of TMS. However, if I am going to give it a try, I want to use the best available. I'm not going through two courses of treatments. dTMS makes more sense for me if the presentation of comparative data showing its superiority is accurate and repeatable.
> I have been following the DBS trials quite closely as it is something I might consider when they know more about who it works for and which areas to target. Afterall, if you had the operation which area would you want them to target the anterior cingulate, the nucleous accumbens, or any of the other areas that they are experimenting with?
I agree with everything you said here.
> I'm sure I primarily suffer from some kind of existential anxiety rather than depression
You would be surprised just how much severe biogenic depression can feel like an existential crisis, especially when there is some anxiety present. Depression can change the content and perception of one's own thoughts.
> as I don't tend to cry a lot
Neither do I. My affect is too flat and there is psychomotor retardation. I usually don't have the energy to cry.
> and feel sad with it
The qualifiers for depressive disorder can include:
1. Sadness or depressed mood
and/or
2. Lack of interest or pleasure
For the most part, #2 qualifies me for a depressive mood disorder. However, earlier in my history melancholy, agitation, and anxiety were present.
> mainly agitated and anxious
Do you respond at all to tricyclics or SNRIs?
What has been your history of reactions to Nardil and Parnate?
> I have been considering VNS but you hear so few positive reports from it, I'm not sure it is worth the bother.
One of my doctors likes it. Perhaps they have refined the protocol.
Do you think there might be any bipolarity involved in your case?
> Denise
- Scott
Posted by Hugh on July 18, 2015, at 11:56:43
In reply to ECT / rTMS / dTMS / sTMS / tDCS / DBS / VNS / MST, posted by SLS on July 10, 2015, at 6:37:00
tPCS appears to be more effective than tDCS.
http://medicalxpress.com/news/2015-07-non-invasive-brain-technique.html
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0131779
In addition to doing tDCS, foc.us can do tPCS. It can also do tACS.
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