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Dr. Bob is Robert Hsiung, MD,
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Posted by undopaminergic on December 9, 2021, at 13:38:46
In reply to Novel treatment for schizophrenia, posted by SLS on December 9, 2021, at 8:42:24
>
>
>
> A potential new approach for the treatment for both positive and negative
> symptoms of schizophrenia:
>
>
> -------------------------------------------------------------------------
>
> From MDLinks:
>
> https://tinyurl.com/3e63t2r5
>
> A potential new approach for the treatment of schizophrenia:
>
[...]
> The research was published in Cell Reports."
>This maybe?
https://www.cell.com/cell-reports/pdf/S2211-1247(21)01427-3.pdf-undopaminergic
Posted by Lamdage22 on December 10, 2021, at 10:22:06
In reply to Novel treatment for schizophrenia, posted by SLS on December 9, 2021, at 8:42:24
Thanks. Not any time soon though :( Not sure if I have negative symptoms or depression or if it even matters.
Posted by undopaminergic on December 10, 2021, at 10:49:15
In reply to Re: Novel treatment for schizophrenia, posted by Lamdage22 on December 10, 2021, at 10:22:06
> Thanks. Not any time soon though :(
Actually, I think it would be possible to acquire the drug they used as a research chemical.
> Not sure if I have negative symptoms or depression or if it even matters.
I'm not sure about that either.
-undopaminergic
Posted by Lamdage22 on December 10, 2021, at 10:53:35
In reply to Re: Novel treatment for schizophrenia, posted by undopaminergic on December 10, 2021, at 10:49:15
Too risky for my taste. I can understand how you can be compelled to do it though, as I have been there.
> Actually, I think it would be possible to acquire the drug they used as a research chemical.
Posted by undopaminergic on December 10, 2021, at 11:21:50
In reply to Re: Novel treatment for schizophrenia, posted by Lamdage22 on December 10, 2021, at 10:53:35
When was that, if you don't mind telling?
> Too risky for my taste. I can understand how you can be compelled to do it though, as I have been there.
>
> > Actually, I think it would be possible to acquire the drug they used as a research chemical.
>
>-undopaminergic
Posted by Lamdage22 on December 10, 2021, at 12:04:47
In reply to Re: Novel treatment for schizophrenia, posted by undopaminergic on December 10, 2021, at 11:21:50
Basically few years ago before I started supplements. I was in a clinic focused on non-medical approaches at the same time I started the supplements. No med changes. Not for two years before that. Not until today. My recuperation seems to be based on psychotherapy and nutrient therapy. It is why I am advocating for these things here, because they may help others, here, too. Not saying to quit all meds, just dont make it a religion.
Posted by undopaminergic on December 10, 2021, at 12:13:23
In reply to Re: Novel treatment for schizophrenia, posted by Lamdage22 on December 10, 2021, at 12:04:47
What substance(s) would you have liked to acquire?
> Basically few years ago before I started supplements. I was in a clinic focused on non-medical approaches at the same time I started the supplements. No med changes. Not for two years before that. Not until today. My recuperation seems to be based on psychotherapy and nutrient therapy. It is why I am advocating for these things here, because they may help others, here, too. Not saying to quit all meds, just dont make it a religion.
-undopaminergic
Posted by Lamdage22 on December 10, 2021, at 12:21:19
In reply to Re: Novel treatment for schizophrenia, posted by undopaminergic on December 10, 2021, at 12:13:23
Rapastinel. I wasnt too close to doing it. It occupied my mind for a few days. Thats all. I could have invested that time into the things I mentioned in my last post, and would have gotten more out of it. Rapastinel proved to be a failure in trials. Unfortunately, that happens to many previously promising compounds. It could have been dangerous, too.
Posted by undopaminergic on December 10, 2021, at 14:12:48
In reply to Re: Novel treatment for schizophrenia, posted by Lamdage22 on December 10, 2021, at 12:21:19
> Rapastinel. I wasnt too close to doing it. It occupied my mind for a few days. Thats all. I could have invested that time into the things I mentioned in my last post, and would have gotten more out of it. Rapastinel proved to be a failure in trials. Unfortunately, that happens to many previously promising compounds.
>I think most of these compounds would be very useful in select individuals, so they should be made clinically available.
-undopaminergic
Posted by Lamdage22 on December 10, 2021, at 23:52:37
In reply to Re: Novel treatment for schizophrenia, posted by undopaminergic on December 10, 2021, at 14:12:48
$$$... it wouldn't be profitable...
> I think most of these compounds would be very useful in select individuals, so they should be made clinically available.
>
> -undopaminergic
>
Posted by undopaminergic on December 11, 2021, at 7:23:45
In reply to Re: Novel treatment for schizophrenia, posted by Lamdage22 on December 10, 2021, at 23:52:37
Well, it's better than nothing, isn't it? It's usually the failure to outperform placebo that keeps them from the market. Placebo is actually a pretty powerful treatment, especially in a randomised trial population.
> $$$... it wouldn't be profitable...
>
> > I think most of these compounds would be very useful in select individuals, so they should be made clinically available.
> >
> > -undopaminergic
> >
>
>-undopaminergic
Posted by Lamdage22 on December 13, 2021, at 7:29:47
In reply to Re: Novel treatment for schizophrenia, posted by undopaminergic on December 11, 2021, at 7:23:45
I agree, what I meant is that if only a minority benefits from rapastinel, the drug company wont pursue it, because it is not economical. That is part of the problem that I see. Most of the time you only get the substances that support the manufacturer the most, not you.
There are exceptions but generally
Posted by SLS on December 13, 2021, at 8:22:27
In reply to Re: Novel treatment for schizophrenia, posted by undopaminergic on December 9, 2021, at 13:38:46
Hi, UD.
> > A potential new approach for the treatment for both positive and negative
> > symptoms of schizophrenia:
> >
> >
> > -------------------------------------------------------------------------
> >
> > From MDLinks:
> >
> > https://tinyurl.com/3e63t2r5
> >
> > A potential new approach for the treatment of schizophrenia:
> >
> [...]
> > The research was published in Cell Reports."
> >
>
> This maybe?
> https://www.cell.com/cell-reports/pdf/S2211-1247(21)01427-3.pdf
>
> -undopaminergic
I interpret this article as referring to positive symptoms only.
- Scott
Posted by undopaminergic on December 13, 2021, at 8:32:21
In reply to Re: Novel treatment for schizophrenia » undopaminergic, posted by SLS on December 13, 2021, at 8:22:27
> Hi, UD.
Hi, SLS.
> > https://www.cell.com/cell-reports/pdf/S2211-1247(21)01427-3.pdf
> >
> > -undopaminergic
>
>
> I interpret this article as referring to positive symptoms only.Actually, I read it and it focussed mostly on cognitive symptoms.
-undopaminergic
Posted by Lamdage22 on December 13, 2021, at 9:58:57
In reply to Re: Novel treatment for schizophrenia, posted by undopaminergic on December 10, 2021, at 11:21:50
Can something that improves negative symptoms cause depression? I dont get it. The two problems sound identical.
Posted by undopaminergic on December 13, 2021, at 10:15:27
In reply to Re: Novel treatment for schizophrenia, posted by Lamdage22 on December 13, 2021, at 9:58:57
> Can something that improves negative symptoms cause depression?
Probably not in the same individual, but as you know, a drug that works for someone may not work for someone else.
> I dont get it. The two problems sound identical.
The anhedonia and apathy are identical, but negative symptoms does not necessarily include a depressed mood, more likely it's flat.
-undopaminergic
Posted by Lamdage22 on December 13, 2021, at 14:42:06
In reply to Re: Novel treatment for schizophrenia, posted by undopaminergic on December 13, 2021, at 10:15:27
So according to that definition, I have both negative symptoms and depression. That would make most sense. For most of my life I have been depressed and socially anxious/withdrawn but never psychotic until I tried MAOI. So the negative symtoms came ontop of that after I was psychotic.
It would be best if doctors found a cause rather than treating symtoms. Like they do with NMDA receptor encephalitis. An underlying issue. I bet you that most of the time there is something going on beneath the symptoms. Psychiatrists admit that they are not treating root causes most of the time.
> but negative symptoms does not necessarily include a depressed mood, more likely it's flat.
>
> -undopaminergic
>
Posted by SLS on December 14, 2021, at 8:30:46
In reply to Re: Novel treatment for schizophrenia, posted by undopaminergic on December 13, 2021, at 10:15:27
> > Can something that improves negative symptoms cause depression?
>
> Probably not in the same individual, but as you know, a drug that works for someone may not work for someone else.
>
> > I dont get it. The two problems sound identical.
>
> The anhedonia and apathy are identical, but negative symptoms does not necessarily include a depressed mood, more likely it's flat.
>
> -undopaminergicWhile I was hunting for articles that refer to any differences that may exist between anhedonia and apathy, I found something that is more important than nomenclature. The dichotomy described in the two major subtypes of Major Depressive Disorder has been applied since 1980. To my knowledge, Michael Liebowitz and the research team at Columbia were the first to identify this difference.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6042519/
"Features of depression: melancholia, anhedonia, apathy
Different types of depression are associated with markedly different symptoms. Depression with melancholic features is associated with anhedonia, lack of mood reactivity, sadness, weight loss, insomnia, psychomotor agitation, and worse mood in the morning. Depression with atypical features, on the other hand, is associated with a distinct cluster of symptoms, and includes leaden paralysis, fatigue, weight gain, hypersomnia, mood reactivity, sensitivity to social rejection, and worse mood in the evening. It is currently unclear whether the inclusion of such profoundly different clusters of symptoms under the umbrella of a single disorder is a help or a hindrance for the development of treatments. The association of tricyclic antidepressants with better outcomes for melancholic depression [12] and bupropion for atypical depression [13], suggests (but does not mandate) differences in the underlying biology."
- Scott
Posted by undopaminergic on December 14, 2021, at 8:54:33
In reply to Re: Novel treatment for schizophrenia, posted by Lamdage22 on December 13, 2021, at 14:42:06
> So according to that definition, I have both negative symptoms and depression. That would make most sense. For most of my life I have been depressed and socially anxious/withdrawn but never psychotic until I tried MAOI. So the negative symtoms came ontop of that after I was psychotic.
>What negative symptoms appeared after the psychosis?
For many people, the negative symptoms actually precede psychosis, sometimes by a long time.
> It would be best if doctors found a cause rather than treating symtoms.
Of course.
> Like they do with NMDA receptor encephalitis. An underlying issue. I bet you that most of the time there is something going on beneath the symptoms. Psychiatrists admit that they are not treating root causes most of the time.
>If the disorder/disease is understood, such as with Parkinson's disease, it is a neurological and not psychatric condition. So psychiatrists are kind of doomed to treat patients without knowledge of the underlying causes.
-undopaminergic
Posted by SLS on December 14, 2021, at 9:15:50
In reply to Re: Novel treatment for schizophrenia, posted by Lamdage22 on December 13, 2021, at 14:42:06
> It would be best if doctors found a cause rather than treating symtoms. Like they do with NMDA receptor encephalitis. An underlying issue. I bet you that most of the time there is something going on beneath the symptoms. Psychiatrists admit that they are not treating root causes most of the time.
This has been the focus of scientific research since the 1950s. Unfortunately, there is no consistency in findings.
- Scott
Posted by SLS on December 14, 2021, at 10:04:41
In reply to Re: Novel treatment for schizophrenia, posted by undopaminergic on December 14, 2021, at 8:54:33
UD,
> If the disorder/disease is understood, such as with Parkinson's disease, it is a neurological and not psychatric condition.
Is Bipolar Disorder a neurological disease?
Why or why not?
- Scott
Posted by Lamdage22 on December 14, 2021, at 12:08:12
In reply to Re: Novel treatment for schizophrenia » Lamdage22, posted by SLS on December 14, 2021, at 9:15:50
So you could say mental disorders are not understood very well, although they have been trying? I really hope they make some progress. Id be much more willing to try medical treatment if it would take care of the root cause. Its psychological for me too. Some crazys were/are made crazy.
> This has been the focus of scientific research since the 1950s. Unfortunately, there is no consistency in findings.
>
>
> - Scott
Posted by undopaminergic on December 14, 2021, at 12:40:23
In reply to Re: Novel treatment for schizophrenia » undopaminergic, posted by SLS on December 14, 2021, at 8:30:46
> > > Can something that improves negative symptoms cause depression?
> >
> > Probably not in the same individual, but as you know, a drug that works for someone may not work for someone else.
> >
> > > I dont get it. The two problems sound identical.
> >
> > The anhedonia and apathy are identical, but negative symptoms does not necessarily include a depressed mood, more likely it's flat.
> >
> > -undopaminergic
>
>
>
> While I was hunting for articles that refer to any differences that may exist between anhedonia and apathy,
>The two are very different in my experience and understanding. Anhedonia is the lack of reward, pleasure, enjoyment from doing things you would normally. While that is of course a symptom that reduces motivation to engage in activities, it's nothing like apathy, which takes away *all* (or most) of the motivation and interest for doing things. I think you could summarise it as anhedonia taking away the "liking" of activities, and apathy taking away the "desire" for activities. You can also call apathy "anticipatory" anhedonia, with "regular" anhedonia being "consummatory".
> I found something that is more important than nomenclature. The dichotomy described in the two major subtypes of Major Depressive Disorder has been applied since 1980. To my knowledge, Michael Liebowitz and the research team at Columbia were the first to identify this difference.
>
> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6042519/
>
> "Features of depression: melancholia, anhedonia, apathy
>
> Different types of depression are associated with markedly different symptoms. Depression with melancholic features is associated with anhedonia, lack of mood reactivity, sadness, weight loss, insomnia, psychomotor agitation, and worse mood in the morning. Depression with atypical features, on the other hand, is associated with a distinct cluster of symptoms, and includes leaden paralysis, fatigue, weight gain, hypersomnia, mood reactivity, sensitivity to social rejection, and worse mood in the evening. ...
>I have a little of both. I have anhedonia, worse mood in the morning, fatigue, and initial insomnia that is followed by hypersomnia.
-undopaminergic
Posted by undopaminergic on December 14, 2021, at 13:18:26
In reply to Re: Novel treatment for schizophrenia » undopaminergic, posted by SLS on December 14, 2021, at 10:04:41
> UD,
SLS,
> > If the disorder/disease is understood, such as with Parkinson's disease, it is a neurological and not psychatric condition.
>
> Is Bipolar Disorder a neurological disease?Not at present.
> Why or why not?
It's too poorly understood to be considered a neurological condition, and much for that reason, the treatment consists mostly of experimentation to find mood stabilising drugs. Compare that to Parkinson's disease where L-dopa is a safe bet (if it does not respond to L-dopa, it's probably not Parkinson's -- could be manganism for instance).
Also, there are often psychological factors involved in bipolar disorder.
-undopaminergic
Posted by SLS on December 14, 2021, at 20:08:59
In reply to Re: Novel treatment for schizophrenia » SLS, posted by undopaminergic on December 14, 2021, at 13:18:26
> > UD,
>
> SLS,
>
> > > If the disorder/disease is understood, such as with Parkinson's disease, it is a neurological and not psychatric condition.
> >
> > Is Bipolar Disorder a neurological disease?
>
> Not at present.
>
> > Why or why not?
>
> It's too poorly understood to be considered a neurological condition
I think the basis upon which you define neurological disorders is arbitrary.There are hundreds of thousands of scientific works that demonstrate anomalies in both structure and function of the brain in Bipolar Disorder. Isn't that de facto neurological?
In *your* opinion, is the *resultant* disease state in Bipolar Disorder a neurological condition, or is it exclusively psychological?
Seizure disorders (epilepsy) were described some 4000 years ago. It has been poorly understood throughout history until the recent advent of electrophysiological measuring instruments and neuroimaging techniques. Despite how late in history science has elucidated the neurological basis of epilepsy, the categorization of epilepsy as a neurological disorder predates this.
> Also, there are often psychological factors involved in bipolar disorder.
How is this statement of yours salient to the categorization of Bipolar Disorder? Psychological factors are also involved in:
In 1992, a PET scan was performed on me at the National Institutes of Health. The images demonstrated that my brain activity was significantly lower in select regions compared to healthy controls.
In spring of 1982, I had come to the conclusion that Bipolar Disorder and Unipolar Major Depressive Disorder were both caused by pathologies in neurological function. That year, I made it a major goal of mine to educate others as to how I experience depression and what causes it. I was quite convincing. The way I explained things to others allowed most of them to understand the biological nature of affective disorders to their own experiences. I taught people using scientific details, analogies, and metaphors. I refused to allow anyone to continue believing that MDD and BD were diseases of the mind alone when it is indeed a disease with neurobiological underpinnings.
My ultimate goal was to destigmatize mental illness in general, as well as to prevent the stigmatization of me by society. I did this by teaching one person at a time. It is a continuing endeavor.
The hell if I'm going to stay silent when so much is at stake. I will continue to offer resistance to anyone who acts to, by design or ignorance, stymie or sabotage societal progress in its perception of mental illness.
Q: What prevents you from coming to the conclusion that Bipolar Disorder is a neurological disease?
- Scott
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