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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 16 to 40 of 47. Go back in thread:
Posted by Squiggles on November 28, 2002, at 20:52:21
In reply to Re: Is there a medical term for AD poop-out?, posted by SLS on November 28, 2002, at 20:46:59
sorry, that would mean "fast-therapy" or
"fast-treatment"; maybe, "telophylaxis" as
in the limited life of telometers; you
might even use "oligophylaxis" as in a
small amount; i abstain from using terminus
for a prefix because it is Latin and you should
not mix Latin with Greek.Squiggles
Posted by Geezer on November 28, 2002, at 21:42:21
In reply to Re: Is there a medical term for AD poop-out? » Jackster, posted by Alan on November 28, 2002, at 13:18:48
> > Thanks for all your replies. It's amazing that given how common this seems to be - there's very little research/information on it out there.
> ==========================================
> That's because of the lack of proper oversight and ground rules of the FDA...a government agency incestuously related to the pharm industries.
>
> Take oversight of clinical trials away from the FDA and give it to the NIH. That is, accept as evidence only trials designed and supervised by the NIH.
>
> Failing that, ban cross-employment between the FDA and any company that it regulates for 10 or 15 years in either direction. Right now, there is a revolving door between the fox's house and the henhouse. It's bad enough that regulators are hired directly from the regulated companies. It's even worse that the FDA's "internal advocate" for a drug can and often does leave the FDA after approval of the drug to earn hundreds of thousands of dollars a year working for the maker of the drug.
>
> Actually, we probably need both of the steps above.
>
> And of course we need a law placing all directly or indirectly maker-funded research about a drug into the public domain when that drug receives FDA approval.
>
> We need to change our laws so that as part of the price for approval of a drug, ALL studies on its use in humans (at the least) get placed into the public domain. That way it won't be as easy to make distorted claims. For instance, the public and the FDA have seen only a small fraction of SKB/GSK's studies on Paxil. In the majority of them it worked worse than placebo to a statistically significant degree*. At least that's what plaintiffs in one of the class-actions suits alleged, promising to provide supporting evidence. It just shouldn't be legal to hide things like that. And now that scandals like the HRT and cox-2 inhibitor surprises are emerging (i.e. it affects more than just us "head cases") I think there's some chance the regulatory environment may change.
>
> On second thought, in the present political environment of deregulation for profit....
>
> =============
> * Still, that's an average response. It doesn't negate the fact that some people respond and some of those respond extremely well. Statistical truth and statistical inference, important as they are, have considerable limits. The closer you narrow it down to an individual case, the fuzzier the picture gets until there is no statistical picture at all when dealing with a sample of one. Just because the number of people doing well on a drug is less than the number doing well on placebo does not prove that all those people are experiencing a placebo effect or spontaneous remission. Some of them may very well be experiencing a bona fide pharmacologically therapeutic effect. It's just that one can't prove it statistically. With the right tools, one could hypothetically prove it chemically or by doing repeated double-blind crossover trials on one or more individuals.
>
> AlanAlan,
I like your idea here - the FDA is about as effective as the INS. I too would like to see some SCIENTIFIC testing and the inclusion of test results from Europe as part of full disclosure (that's where the significant numbers and long term data comes from).
Do you happen to know if SSRIs can regain their AD effect (after poop out) for a patient completing ECT? I have been struggling with Parnate for 3 weeks (it's like taking Thorazine, I can't even talk or walk straight), would love to go back to Prozac.....the best 18 months I ever had.
Thanks,
Geezer
>
>
>
>
>
Posted by ItsHowdyDudyTime on November 28, 2002, at 23:01:00
In reply to Re: Is there a medical term for AD poop-out? » Alan, posted by Geezer on November 28, 2002, at 21:42:21
completing ECT? I have been struggling with Parnate for 3 weeks (it's like taking Thorazine, I can't even talk or walk straight), would love to go back to Prozac.....the best 18 months I ever had.
>
> Thanks,
>
> Geezer
Geeezer, dopamine agonists can cause this stiffness you are talking about. Perhaps you are getting a bit too much dopamine from the parnate and have developed a "dyskinisia" from Parnate. Have you ever consulted the wonder psychopharmacology textbook "Kaplan and Saddock?" It contains a wonderful section on MAOIs as well as other useful info on neuroleptic induced movement disorders and a whole bunch of other stuff psychopharmacology related. Anyway, Kaplan and Saddock has an excellent MAOI section. Check your local medical library for a copy if you cant afford to get a copy yourself from Amazon.com or Barnes and Noble.Howdy Doody
> >
> >
> >
> >
> >
>
>
Posted by ItsHowdyDudyTime on November 28, 2002, at 23:01:50
In reply to Re: Is there a medical term for AD poop-out? » Alan, posted by Geezer on November 28, 2002, at 21:42:21
completing ECT? I have been struggling with Parnate for 3 weeks (it's like taking Thorazine, I can't even talk or walk straight), would love to go back to Prozac.....the best 18 months I ever had.
>
> Thanks,
>
> Geezer
Geeezer, dopamine agonists can cause this stiffness you are talking about. Perhaps you are getting a bit too much dopamine from the parnate and have developed a "dyskinisia" from Parnate. Have you ever consulted the wonder psychopharmacology textbook "Kaplan and Saddock?" It contains a wonderful section on MAOIs as well as other useful info on neuroleptic induced movement disorders and a whole bunch of other stuff psychopharmacology related. Anyway, Kaplan and Saddock has an excellent MAOI section. Check your local medical library for a copy if you cant afford to get a copy yourself from Amazon.com or Barnes and Noble.Howdy Doody
> >
> >
> >
> >
> >
>
>
Posted by ItsHowdyDudyTime on November 28, 2002, at 23:27:02
In reply to Is there a medical term for AD poop-out?, posted by Jackster on November 27, 2002, at 12:28:22
> I'd like to do a search on the net - but not sure what term to use.
>
> JackieJackie, I will reitterate what I said earlier only in simpler terms. Psychiatrists just dont know what causes antidepressant poop out. And they dont seem to be interested in finding out why or caring either. See, psychiatrists dont seem to be very interested in hard research or hard science. Mostly what they are interested in is psychobabble.
Psychiatrists want the same respect as other doctors in other branches of medicine that actually do real scientific research to back up their actions. But psychiatry doesnt do the hardcore kind of scientific research other doctors do in other branches of medicine. Yet they want the same respect, want to be called the title of "Doctor" etc. etc. It just doesnt jibe with me and a lot of others who have been there and done that. It also doesnt jibe with a lot of people who smartly use their internal medicine doctors or family doctors for their mental health needs and who wisely, are intuitively suspicious of psychiatrists and mental health professionals. I have oftentimes admired these kinds of individuals who refuse to see a psychiatrist, yet still are smart enough to get treated for their illness via a family doctor. Family and internal medicine doctors can prescribe many of the same drugs psychiatrists prescribe and in this era of SSRIs and atypical anti-psychotics, that is exactly what is happening oftentimes.
I wouldnt knock yourself out searching for an answer on this one. Because you wont find an answer and you will only be left feeling frustrated.
Howdy Doody
Posted by cubbybear on November 29, 2002, at 1:03:31
In reply to Re: Is there a medical term for AD poop-out?, posted by ItsHowdyDudyTime on November 28, 2002, at 23:27:02
The original question was: is there a medical term for AD "poop-out."? It's a good question. Until we know of one, any phrase that is short and to-the-point will do.
The pharmaceutical companies will no doubt come up with another silly euphemism for "poop-out"--as they did with "SSRI discontinuation syndrome" for the simple phrase "withdrawal symptoms".
In my own personal experience with poop-out, two months ago I wrote to Organon, manufacturer of Remeron, actually asking them if they could tell me why their medication QUIT WORKING. How's that? Simple and to the point. (By the way, I haven't heard a word yet from Organon. Does that tell you something?)
When speaking to your doctor (or writing letters of complaint) you can be short, straight and to the point. If you don't care much for the term "poop-out," just say that your med "quit working" or "stopped working." Even a medical quack will understand what you mean.
Posted by Geezer on November 29, 2002, at 11:19:35
In reply to Re: Is there a medical term for AD poop-out?, posted by ItsHowdyDudyTime on November 28, 2002, at 23:27:02
Hi Howdy,
First, thanks for your response to my question above about the Parnate - I will buy the book. You are probably "right on" with your assessment. I think you made the point in an earlier post that the right course of treatment for TRD is ECT and/or MAOIs, I believe you are correct on that point as well (I am just having a difficult time with Parnate)....for REAL TRD people to go from one SSRI to the next is total nonsense.
Where I agree with you the most is your point about the total lack of SCIENCE (PET scans and SPEC scans prove nothing) and lack of caring as to why drugs don't work in the field of psychiatry. I suppose the first clue that there is a lacking in the scientific area is the total inability to make an accurate DX...I have been diagnosed, missdiagnosed, and rediagnosed in the past year. After spending 30 years in the medical business I am of the belief that proper treatment follows a correct DX. When psychiatry comes up with some meaningful blood tests, some clue about genetic markers, and a few intra-cellular ADs, and some ANSWERS then maybe we will see some progress. Until that time I think I will try to work with my family doc.
Just curious.....are you old enough to remember Howdy Doody?
Thanks
Geezer
Posted by Peter S. on November 29, 2002, at 13:33:28
In reply to Re: Is there a medical term for AD poop-out?, posted by ItsHowdyDudyTime on November 28, 2002, at 23:27:02
I agree that psychiatry is not based in "science" at all. Very little (almost nothing) is understood about why anti-depressants work. Everything is completely speculative at this point. What role does serotonin or norepinphrene have in depression? Who knows? You read a lot of papers and articles and they are very confident in tone that we understand depression or bipolar disorders and that these drugs are great treatments. But when you actually talk to a lot of people you find out about the side effects the poop-out and the general ineffectiveness of many of them.But as far as psychiatrist go, there are huge differences between them. Many have no clue about different meds- they think that MAOIs are extremely dangerous and that you should only prescribe low doses. If traditional anti-depressants don't work, they throw up their hands. They don't bother keeping up with the latest cutting edge treatments because they are'nt required to. Psychiatry started out as primarily talk therapy (Freud) and I think is still rooted in this tradition.
However there are other psychiatrists who are up to date on meds and are willing to be creative and work with you on the meds. My doc is one of these- he is extremely patient and willing to listen to me and try many different alternatives. But even what these doctors do is not based in science. It is more trial and error.
Despite all this it does seem like things are inching forward- hey it's better than it was 100 years ago! I am considering getting a lobotomy though.
Peter
> > I'd like to do a search on the net - but not sure what term to use.
> >
> > Jackie
>
> Jackie, I will reitterate what I said earlier only in simpler terms. Psychiatrists just dont know what causes antidepressant poop out. And they dont seem to be interested in finding out why or caring either. See, psychiatrists dont seem to be very interested in hard research or hard science. Mostly what they are interested in is psychobabble.
>
> Psychiatrists want the same respect as other doctors in other branches of medicine that actually do real scientific research to back up their actions. But psychiatry doesnt do the hardcore kind of scientific research other doctors do in other branches of medicine. Yet they want the same respect, want to be called the title of "Doctor" etc. etc. It just doesnt jibe with me and a lot of others who have been there and done that. It also doesnt jibe with a lot of people who smartly use their internal medicine doctors or family doctors for their mental health needs and who wisely, are intuitively suspicious of psychiatrists and mental health professionals. I have oftentimes admired these kinds of individuals who refuse to see a psychiatrist, yet still are smart enough to get treated for their illness via a family doctor. Family and internal medicine doctors can prescribe many of the same drugs psychiatrists prescribe and in this era of SSRIs and atypical anti-psychotics, that is exactly what is happening oftentimes.
>
> I wouldnt knock yourself out searching for an answer on this one. Because you wont find an answer and you will only be left feeling frustrated.
>
> Howdy Doody
>
>
Posted by ItsHowdyDudyTime on November 29, 2002, at 14:57:43
In reply to Re: Is there a medical term for AD poop-out? » ItsHowdyDudyTime, posted by Geezer on November 29, 2002, at 11:19:35
> Hi Howdy,
>
> First, thanks for your response to my question above about the Parnate - I will buy the book. You are probably "right on" with your assessment. I think you made the point in an earlier post that the right course of treatment for TRD is ECT and/or MAOIs, I believe you are correct on that point as well (I am just having a difficult time with Parnate)....for REAL TRD people to go from one SSRI to the next is total nonsense.
>
> Where I agree with you the most is your point about the total lack of SCIENCE (PET scans and SPEC scans prove nothing) and lack of caring as to why drugs don't work in the field of psychiatry. I suppose the first clue that there is a lacking in the scientific area is the total inability to make an accurate DX...I have been diagnosed, missdiagnosed, and rediagnosed in the past year. After spending 30 years in the medical business I am of the belief that proper treatment follows a correct DX. When psychiatry comes up with some meaningful blood tests, some clue about genetic markers, and a few intra-cellular ADs, and some ANSWERS then maybe we will see some progress. Until that time I think I will try to work with my family doc.
>
> Just curious.....are you old enough to remember Howdy Doody?
>
> Thanks
>
> GeezerHi Geezer, I agree with everything you said. Im not an expert on SPECT and PET scans but how come you say these scans prove nothing? I was under the understanding these scans are showing the "functional" conditions of our brains when mentally ill. Could you please explain what you mean? I am interested in this subject. Psychiatry has historically been full of quackery and I certainly hope functional neuroimaging doesnt turn out to be another dead end area of psychiatry research.
As far as Howdy Doody, no I am a youngster, well relatively. Howdy Doody was long off TV when I was born. However it was my Dad's favorite TV show when he was a kid and he talks about it sometimes. I picked it to kind of describe how I perceive psychiatry...kind of like "hey...its Howdy Doody time" as in psychiatry is a big fucking joke.
Howdy Doody
Posted by ItsHowdyDudyTime on November 29, 2002, at 15:05:18
In reply to Psychiatry as a science, posted by Peter S. on November 29, 2002, at 13:33:28
Anybody who tells you there is real science in psychiatry is lying to you. There is no science in psychiatry and psychology is even worse. Psychiatry is a joke. Psychiatrists should be ashamed of themselves. If I was a psychiatrist, I wouldnt even be able to go out in daylight cause Id be so ashamed of myself. I couldnt live with the guilt of knowing I called myself a Medical Doctor, but had no real medical tests, no real medical knowledge to treat severe mental illness.
BTW, in one of Dr. Fuller E. Torrey's books he lambasts private practice psychiatry. He says the "ideal" psychiatry practice is one in which the psychiatrist sees as few psychotics and manics as possible...none if at all possible. And mostly only sees dysthymics and people with "Woody Allen syndrome." These are the folks who fuel the business of psychiatry...those with woody allen syndrome. The people with real deal mental illness are just ignored, shuffled from psychiatrist to psychiatrist because nobody really knows whats wrong with them in a medical sense and nobody really knows how to fix them.
Its sickening...
Howdy Doody
Posted by Squiggles on November 29, 2002, at 15:26:26
In reply to There is no science in psychiatry, posted by ItsHowdyDudyTime on November 29, 2002, at 15:05:18
What goes on in that mushy protoplasmic
ooze called the brain anyway?
Krispy Kream puffs is all they
see and all they sell, right Howdy?Squiggles
Posted by Geezer on November 29, 2002, at 16:51:18
In reply to Re: Is there a medical term for AD poop-out?, posted by ItsHowdyDudyTime on November 29, 2002, at 14:57:43
> > Hi Howdy,
> >
> > First, thanks for your response to my question above about the Parnate - I will buy the book. You are probably "right on" with your assessment. I think you made the point in an earlier post that the right course of treatment for TRD is ECT and/or MAOIs, I believe you are correct on that point as well (I am just having a difficult time with Parnate)....for REAL TRD people to go from one SSRI to the next is total nonsense.
> >
> > Where I agree with you the most is your point about the total lack of SCIENCE (PET scans and SPEC scans prove nothing) and lack of caring as to why drugs don't work in the field of psychiatry. I suppose the first clue that there is a lacking in the scientific area is the total inability to make an accurate DX...I have been diagnosed, missdiagnosed, and rediagnosed in the past year. After spending 30 years in the medical business I am of the belief that proper treatment follows a correct DX. When psychiatry comes up with some meaningful blood tests, some clue about genetic markers, and a few intra-cellular ADs, and some ANSWERS then maybe we will see some progress. Until that time I think I will try to work with my family doc.
> >
> > Just curious.....are you old enough to remember Howdy Doody?
> >
> > Thanks
> >
> > Geezer
>
> Hi Geezer, I agree with everything you said. Im not an expert on SPECT and PET scans but how come you say these scans prove nothing? I was under the understanding these scans are showing the "functional" conditions of our brains when mentally ill. Could you please explain what you mean? I am interested in this subject. Psychiatry has historically been full of quackery and I certainly hope functional neuroimaging doesnt turn out to be another dead end area of psychiatry research.
>
> As far as Howdy Doody, no I am a youngster, well relatively. Howdy Doody was long off TV when I was born. However it was my Dad's favorite TV show when he was a kid and he talks about it sometimes. I picked it to kind of describe how I perceive psychiatry...kind of like "hey...its Howdy Doody time" as in psychiatry is a big fucking joke.
>
> Howdy DoodyHi Howdy,
I am no expert on SPEC scans or PET scans either. SPEC scans, as I understand the basic concept, has to do with blood flow to various areas of the brain while PET imaging provides color coding for temperature variations in the brain. I don't see either test taking us any closer to a neurologic understanding of the illness nor do I see inspiration leading to more effective psyc. drugs. Recent postmortem studies on the brain tissue of depressed suicide patients has proven high intensity MRI is unable to detect neurologic abnormalities prior to death. Even if we can SEE the problem - what then? The FDA makes it all but impossible to introduce "brake through drugs" so where is the drug companies incentive to take the risk when they can simply "split isomers" on what already exists?
Your closing comment brought laughter until I had tears running down my cheeks.....all to true. We will both receive a reprimand for this one. You tell your Dad I remember Howdy Doody, Clarabell the clown, and Buffalo Bob Smith (that's about all I remember after the ECT), and I think of the show every time I walk into the pdocs office - what a joke!
I have had correspondence with E. Fuller Torrey - he is right.....I was part of a Stanley Foundation Study last year (he was director for 10 centers world wide, he has now defunded all 10 centers and put all the funding in research....if we have hope HE IS IT).
Good Luck
Geezer
>
>
Posted by oracle on November 29, 2002, at 17:05:08
In reply to There is no science in psychiatry, posted by ItsHowdyDudyTime on November 29, 2002, at 15:05:18
> Its sickening...
>
> Howdy DoodyMaking broad, general statements is, too.
Posted by Tabitha on November 29, 2002, at 17:25:39
In reply to Re: Is there a medical term for AD poop-out?, posted by ItsHowdyDudyTime on November 29, 2002, at 14:57:43
>...kind of like "hey...its Howdy Doody time" as in psychiatry is a big
Sorry Howdy, but potentially offensive language is prohibited here. I warned you before, so I'm going to have to block you from posting for a week.Tabitha (filling in for Dr Bob)
P.S. responses to this should be directed to Psycho-Babble Administration
Posted by SLS on November 29, 2002, at 17:44:40
In reply to Re: Is there a medical term for AD poop-out? » SLS, posted by Squiggles on November 28, 2002, at 20:52:21
> sorry, that would mean "fast-therapy" or
> "fast-treatment"; maybe, "telophylaxis" as
> in the limited life of telometers; you
> might even use "oligophylaxis" as in a
> small amount; i abstain from using terminus
> for a prefix because it is Latin and you should
> not mix Latin with Greek.
>
> Squiggles
Dear Squiggles,Is there any reason in particular that you spent so many words of conjecture, only to be wrong?
- Scott
Posted by Squiggles on November 29, 2002, at 17:47:12
In reply to Re: Is there a medical term for AD poop-out?, posted by SLS on November 29, 2002, at 17:44:40
Pearls before swine;
Squiggles
Posted by oracle on November 29, 2002, at 17:58:50
In reply to There is no science in psychiatry, posted by ItsHowdyDudyTime on November 29, 2002, at 15:05:18
> Anybody who tells you there is real science in psychiatry is lying to you. There is no science in psychiatry and psychology is even worse. Psychiatry is a joke. Psychiatrists should be ashamed of themselves.
I have been treated sucessfully for over 20 yrs by many different pdocs. I suspect if you have a better attitude, you might get better treatment.
Posted by SLS on November 29, 2002, at 18:37:07
In reply to Re: Is there a medical term for AD poop-out? » SLS, posted by Squiggles on November 29, 2002, at 17:47:12
Dear Squiggles:
The medical term for "poop-out" is tachyphylaxis.It would have been easy for you to just check on it first. I found your initial reply to my post both ignorant and insulting. I hope you find my sources persuasive. I would appreciate if you would give me the benefit of the doubt from now on.
Pearls. I believe my post concerning tachyphylaxis came before yours.
- Scott-----------------------------------------
Source: www.dictionary.comtach·y·phy·lax·is
n.
pl. tach·y·phy·lax·es
1. Rapid desensitization to a toxic substance produced by inoculation with
a series of small doses.2. A rapidly decreasing response to a drug following administration of the
initial doses.
http://dictionary.reference.com/search?q=tachyphylaxis
-----------------------------------------
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6521674&dopt=Abstracthttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2295591&dopt=Abstract
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2882523&dopt=Abstract
Posted by Squiggles on November 29, 2002, at 18:46:21
In reply to Re: Is there a medical term for AD poop-out? » Squiggles, posted by SLS on November 29, 2002, at 18:37:07
Well, their linguist doesn't know
Ancient Greek or demotic; mine
is better - it happens;Squiggles
Posted by Dinah on November 29, 2002, at 19:10:33
In reply to Re: Is there a medical term for AD poop-out? » Squiggles, posted by SLS on November 29, 2002, at 18:37:07
>I found your initial reply to my post both ignorant and insulting.
Please do not post anything that could lead others to feel put down.
The complete guidelines for civility can be found at:
http://www.dr-bob.org/babble/faq.html#civil
Thank you,
Dinah (acting as Deputy for Tabitha)
Posted by Dinah on November 29, 2002, at 19:12:12
In reply to Re: Is there a medical term for AD poop-out? » SLS, posted by Squiggles on November 29, 2002, at 17:47:12
> Pearls before swine;
>
> SquigglesDinah here, acting as deputy for Tabitha.
Please don't post anything that could lead others to feel put down.
The complete civility guidelines can be found at
http://www.dr-bob.org/babble/faq.html#civil
Thanks.
Posted by viridis on November 29, 2002, at 20:50:18
In reply to There is no science in psychiatry, posted by ItsHowdyDudyTime on November 29, 2002, at 15:05:18
Modern psychiatry is a mix of science, art, skill and experience. There are good and bad psychiatrists, just like in any field. The science side of it is progressing quickly,and in the next 5-10 years we'll almost certainly see the development of specific, DNA-based tests for many conditions that will narrow down the range of possible treatments on an individual basis. Meanwhile, psychiatrists do the best they can, and the good ones have pretty high success rates -- not much different from specialists in other fields (oncology, cardiology, etc.).
I think this is a time to be very optimistic -- some of us already have good treatments, and the chances of improvement for others will increase dramatically in the coming years.
Posted by Tabitha on November 30, 2002, at 19:07:10
In reply to Re: Please be civil » Squiggles, posted by Dinah on November 29, 2002, at 19:12:12
Posted by sjb on December 1, 2002, at 15:24:50
In reply to Re: no science in psychiatry--sure there is!, posted by viridis on November 29, 2002, at 20:50:18
Posted by jumpy on December 1, 2002, at 16:33:08
In reply to Re: Is there a medical term for AD poop-out? » ItsHowdyDudyTime, posted by Geezer on November 29, 2002, at 16:51:18
Hey Geezer and all,
There is on more individual we can put alittle faith in ... Dr Steven Sackeim ... director of the Biological Institutes of Psychiatry ... I'm am currently enrolled in a ECT research study through Sackeim. He is looking at the refining ECT to cause less side effects and possible use magnetic induced seizure for therapy. He is not even an M.D. ... which may to be his advantage .... see as most MD's are blindsided by the drug companies with bogus research and studies.
Jumpy
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