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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Steve on August 24, 2000, at 11:36:49
Hi everyone.
I have treatment-resistant depression, and have been tried on more than 20 meds by doctors who simply didn't know what to do. Now my doctor says that I have brain damage from all the different meds. Does anyone know anything about the damages meds would cause, and how they would manifest themselves?
Posted by stjames on August 24, 2000, at 12:12:00
In reply to Meds and brain damage, posted by Steve on August 24, 2000, at 11:36:49
> Hi everyone.
>
> I have treatment-resistant depression, and have been tried on more than 20 meds by doctors who simply didn't know what to do. Now my doctor says that I have brain damage from all the different meds. Does anyone know anything about the damages meds would cause, and how they would manifest themselves?James here...
While there are always going to be reports of this
one does not find them backed up in medical journals. The anti psychotics do have soem long term effects in some people that could be called
damage. If your doc is taking about these, I would say he is right, if he is talking about AD's then you need to find another doc. My opinion. Didn't you ask this question b4 ? Maybe it was someone else.james
Posted by Cam W. on August 24, 2000, at 21:56:40
In reply to Meds and brain damage, posted by Steve on August 24, 2000, at 11:36:49
> Hi everyone.
>
> I have treatment-resistant depression, and have been tried on more than 20 meds by doctors who simply didn't know what to do. Now my doctor says that I have brain damage from all the different meds. Does anyone know anything about the damages meds would cause, and how they would manifest themselves?
Steve - What were the meds and their dosages, length of therapy of each med and particular combinations. Tardive dyskinesia and neuroleptic malignant syndrome are two forms of brain damage that come to mind, but, if you look at the percentages, very, very few people who are treated with psychotropic medication ever develop any form of brain damage (but it does happen), What form of brain damage has occured to you? What are your symptoms, so we may be able to determine where the damage has occurred? - CAm
Posted by Oddzilla on August 24, 2000, at 22:11:24
In reply to Re: Meds and brain damage » Steve, posted by Cam W. on August 24, 2000, at 21:56:40
Hi Steve Here is an excerpt from the June 21 online chat with Dr. Glenmullen,a Harvard professor of Psychiatry. It is on abc.com. You have an unusual doctor to be concerned and knowledgeable about the possibility of brain damage. I urge you to discuss your concerns with him directly. Good luck! Oddzilla
--------------------------------------
Brandon593 asks: Do you know what percent of people get a movement disorder like that lady on 20/20?
--------------------------------------------------------------------------------
Dr. Joseph Glenmullen
We know a great deal about these movement disorders from an earlier class of medications called major tranquilizers. These movement disorders typically occur after patients have been on medication for some time. In the case of major tranquilizers, it took 30 years for the FDA to require that a warning be added to the information on the major tranquilizers. It was found that about 50 percent of patients got the kind of tick disorders that you could see on 20/20. Unfortunately, in about 50 percent of those cases, the ticks were permanent.
We do not know enough about how many patients on Prozac-type antidepressants might get these kind of tick disorders. Prozac-type antidepressants have been on the market for a little over 10 years. When major tranquilizers had been on the market for about 10 years and some psychiatrists were trying to raise the alert about these ticks, many psychiatrists said that they were "rare" and that patients shouldn't be warned about them.
Some psychiatrists insisted that the drugs weren't causing them, but later research showed this was not true. But, with many drugs, there is what we call a 10-20-30 year pattern, where it's at about 10 years after a new class of drugs is introduced that one starts to see what will be the most serious side effects of the drug. But we lack a systematic program for monitoring long-term side effects in this country.
Only four percent of the FDA budget goes to monitoring long-term side effects. A recent commissioner of the FDA, Dr. David Kessler, wrote in a medical journal that only about one percent of serious long-term side effects come to the attention of the FDA. So because we lack systematic monitoring, it takes about 20 years for enough cases to accumulate for people to be really concerned.
Unfortunately, it can take still another 10 years before slow bureaucratic regulatory agencies and professional organizations step in to change prescribing patterns. The tick disorders with major tranquilizers are a very good example of this 10-20-30 year pattern.
We are at the 10 year mark with Prozac-type antidepressants. We have patients complaining of neck and jaw stiffness, teeth-grinding, muscle spasms, tremors, ticks and other movement disorders. Unfortunately, as was the case with major tranquilizers when they had been on the market for 10 years, we do not have good information on how many patients are suffering these movement disorders or how many might eventually get the tick disorders like you saw on 20/20.
So the important point here is that all patients should know that psychiatrists are concerned about these movement disorders. It's important to comment that the tick disorder seen on tonight's show apparently originally appeared when the patient was put on Prozac.
In Prozac Backlash I describe a patient who had been on Prozac for two years and developed a very different type of tick. She developed facial ticks — uncontrollable sticking out of her tongue. We stopped the drug and the worst of these ticks took months to disappear. But she is still left with permanent twitching around her mouth.
There are many patients with much more mild muscle spasms and twitches. Patients will describe their legs being very restless while they are sleeping in bed, and perhaps their spouse is awoken by it. Other patients say their arms or legs will jump a little bit while they are reading or doing activities like that. Other patients describe stiffness in the muscles of their neck or jaws.
Because we lack adequate studies of these movement disorders, we have no way of knowing how many patients are affected by just mild versions of these ticks or twitches, or how many patients have or may get the more severe ones, like the ones that were seen on 20/20.
I think the important thing for patients to know is that this is an important concern about Prozac-type antidepressants, and this is one of the reasons why one should have regular reevaluations of whether or not one still needs the drug. If you have any concerns about ticks, twitches, muscle spasms, teeth grinding, or jaw stiffness or tremors on your antidepressant, you should ask your
> > Hi everyone.
> >
> > I have treatment-resistant depression, and have been tried on more than 20 meds by doctors who simply didn't know what to do. Now my doctor says that I have brain damage from all the different meds. Does anyone know anything about the damages meds would cause, and how they would manifest themselves?
>
>
> Steve - What were the meds and their dosages, length of therapy of each med and particular combinations. Tardive dyskinesia and neuroleptic malignant syndrome are two forms of brain damage that come to mind, but, if you look at the percentages, very, very few people who are treated with psychotropic medication ever develop any form of brain damage (but it does happen), What form of brain damage has occured to you? What are your symptoms, so we may be able to determine where the damage has occurred? - CAm
Posted by stjames on August 25, 2000, at 2:14:18
In reply to Re: Meds and brain damage, posted by Oddzilla on August 24, 2000, at 22:11:24
Although Prozac is not a TCA,as a class people have been on TCA's
for 50 yrs. No signicant problems has been found with them in terms of long term use.
I am willing the extrapolate this fact to the SSRI's and most AD's.
Having been on them for 15 yrs, no movement disfunction or other scary
stuff has turned up. I;ve been off the AD's for a month or more in the past, so nothing is being
masked. The dperession returns, though, and it is clear how well the meds
work for me.I would like to hear what the original poster has to say, ie Cams
questions. I don't want to get into to a good/bad med
set here, I think we did that the last time this situation
came up. Steve, if you are having problems, give us some info so
we can help you. The point is not to prove you do or don't have damage,
it is to understand what is going on with you so we can support
and help you.james
Posted by Steve on August 26, 2000, at 0:39:09
In reply to Re: Meds and brain damage » Steve, posted by Cam W. on August 24, 2000, at 21:56:40
>
>
> Steve - What were the meds and their dosages, length of therapy of each med and particular combinations. Tardive dyskinesia and neuroleptic malignant syndrome are two forms of brain damage that come to mind, but, if you look at the percentages, very, very few people who are treated with psychotropic medication ever develop any form of brain damage (but it does happen), What form of brain damage has occured to you? What are your symptoms, so we may be able to determine where the damage has occurred? - CAmI've essentially been on all the ssris, and many tricyclics. Adding all the meds I've taken up, I think the number is actually closer to 30 than it is to 20. For a while my docs thought I might be bipolar II so we tried lithium augmentation and a few other antiepileptics. I have a whole list of the meds, but suffice it to say that many if not most meds are on it. I'll be happy to send a list to Cam W.
My main complaints are that my memory is pathetic, ( I often forget conversations and the like from previous days) and that I have problems finding words, even more so in the foreign language I used to speak fluently. I have gone from an honors student to somebody who has trouble holding his own at a community college. I attribute this in part to one doc who didn't take lithium blood levels until I had a tiny partial seizure, and another doc who for reasons that he never explained (frustration and bewilderment?) tried me on Risperdal and Perphenazine, to the point that I had quite a bit of trouble to concentrate.
Anyway the point my doctor made is similar to a point that Cam W made in previous points, namely that meds work by changing the physiology of the brain. He said that by taking a med for long enough for the brain to adjust to it, and then changing the med, you not doing your brain any favors, to the contrary that I had damage similar to what you would see in someone who had abused multiple street drugs. When I pressed him on the point he said that you get protein tangles and the like. He also said that a small minority of depressives including myself have problems with the ssris and tricyclics, because both cause the release of noradrenalin which worsens some depressions. FWIW I take Lamictal right now, which is great for my mood, but slows me down even more.
I guess I should be thankful that I am no longer depressed, but somehow it hurts me to realize that my doctors forgot Hippocrate's injunction to first do no harm. If I would have to do it again, I'd find the best doctor I could afford right of the bat, and not be one of those hard to treat cases.
Posted by Steve on August 26, 2000, at 11:22:02
In reply to Re: Meds and brain damage, posted by Steve on August 26, 2000, at 0:39:09
In the above post are answers to the questions you asked.
Posted by stjames on August 27, 2000, at 0:06:47
In reply to Re: Meds and brain damage, posted by Steve on August 26, 2000, at 0:39:09
Well, lithum toxic levele and seziures and brain damage
could cause brain damage. of course, no question there.
But what bothers me is that all drugs used for psyco
are being lumped together and ascribed as having
the same effect, ie brain damage, just a street drugs are being lumped together
also. There is no question that some street drugs are harmful
but as many have taken some illicts for 100's of years with no effect
we arrive at another untruth. One of the indicators of a hoax is the tend to
generalize and draw conclusions. The "you get protein tangles and the like"
is fishy. More half science, this does happen (sligtly different termonolgy) in Altshimers and maybe parkinsons
but there is no proof anywhere of this with AD's.Steve, it seems you are most conserned with memory
problems. Read up on "Smart Drugs" and discuss with your doc.
I can't recomend any for you because your neurology is far from normal.
I have posted about them in the past so look to the archives. Right now
several drugs are hitting ther market for Altshimers to improve memory. One
of them should prove to be effective,safe and free of major side effects.
This med is going to be very sucsessful in the general population as it ages
and will be a company I want to invest in.james
Posted by judy1 on August 28, 2000, at 12:29:15
In reply to Re: Meds and brain damage, posted by Steve on August 26, 2000, at 0:39:09
Dear Steve,
Having been on numerous meds myself (bipolar/panic disorders), I consulted a neurologist with a list of complaints similar to yours. He ordered neuropsych testing which showed a significant decrease in my IQ and specific cognitive problems. I have been on most of the mood stabilizers, both typical and atypical antipsychotics, benzos and ssri's until my cycling worsened. I was told that depression can skew results of testing, but if you find a specific area of difficulty through the testing, than maybe it's something that can be addressed. I wish you the best of luck.
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