Psycho-Babble Medication Thread 530123

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Re: Long post (sorry) » linkadge

Posted by Jazzed on July 20, 2005, at 21:27:25

In reply to Re: Bad (but expected) news about ADs » mworkman, posted by linkadge on July 20, 2005, at 17:49:39


>
> According to:
>
> http://www.biopsychiatry.com/antidepskep.htm
>
>
> "Two of the largest and most reputable trials found only negligible differences between tricyclic antidepressants and placebo."
>

This site appears to be pro pharmacological site, particularly the development of opiates and ecstatcy for "paradise engineering". Unfortunately, if this is true, then we will have to wait until the next century for this to occur. Also, if this is the case, then research and development of new pharmaceuticals for mental illness is vital.

From this site:

" This feeling of absolute well-being will surpass anything contemporary human neurochemistry can imagine, let alone sustain. The story gets better. Post-human states of magical joy will be biologically refined, multiplied and intensified indefinitely. Notions of what now passes for tolerably good mental health are likely to be superseded. They will be written off as mood-congruent pathologies of the primordial Darwinian psyche. Such ugly thoughts and feelings will be diagnosed as typical of the tragic lives of emotional primitives from the previous era. In time, the deliberate re-creation of today's state-spectrum of normal waking and dreaming consciousness may be outlawed as cruel and immoral. "

" Life-long happiness of an intensity now physiologically unimaginable can become the genetically-preprogrammed norm of mental health. "

Today's images of opiate-addled junkies, and the lever-pressing frenzies of intra-cranially self-stimulating rats, are deceptive. Such stereotypes stigmatise, and falsely discredit, the only remedy for the world's horrors and everyday discontents that is biologically realistic."

"States of "dopamine-overdrive" can actually enhance exploratory and goal-directed activity. Hyper-dopaminergic states can also increase the range and diversity of actions an organism finds rewarding. So our descendants may live in a civilisation of well-motivated "high-achievers", animated by gradients of bliss. Their productivity may far eclipse our own. "


"The Hedonistic Imperative outlines how genetic engineering and nanotechnology will abolish suffering in all sentient life."


"Yet the therapeutic implications of a recognition that dysfunctional endogenous opioid systems underlie a spectrum of anxiety-disorders and depression are too radical - at present - for the medical establishment to contemplate. In consequence, the use of opioid-based pharmacotherapies for "psychological" pain is officially taboo. The unique efficacy of opioids in banishing mental distress is neglected. Their unrivalled efficacy in treating "physical" nociceptive pain is grudgingly accepted. "

" Within a few centuries, it will be technically if not ideologically feasible to abolish suffering of any kind. If we wish to do so, then genetic engineering and nanotechnology can be used to banish unpleasant modes of consciousness from the living world. "

"The ideological obstacles to a happy world, however, are more formidable still. For we've learned how to rationalise the need for mental pain - even though its nastier varieties blight innumerable lives, and even though its very existence will soon become optional. "

" Needless to say, subtleties and technical complexities abound here. The very meaning of being "nice" to anyone or anything, for instance, is changed if well-being becomes a generic property of mental life. Either way, once suffering becomes biologically optional, then only sustained and systematic malice towards others could allow us to perpetuate it for ever. "

"Next century and beyond, however, the development of highly selective, site-specific designer drugs and innovative gene-therapies may enhance our native opioid function and revolutionise mental health. Therapeutic intervention targeted on the opioid pathways will potentially enrich the quality of life of even the nominally "well", not least because - by the more enlightened health standards of posterity - we may all be reckoned mentally ill."


" Critically, such gradients of celestial bliss can also be lucid, serene, entactogenic and empathetic - i.e. MDMA-like and better, not manic or vulgarly hedonistic. The godlike powers of tomorrow's biotechnologists will allow the neurological substrates of empathy and self-insight to be permanently up-regulated. Aesthetically, the mundane ugliness of life in the present epoch can be replaced by gradations of (to us) unimaginable beauty. Potentially again, an E-like magic can imbue the texture of normal waking consciousness. If we so wish, our emotional palette can be genetically enriched, mixed and then pharmacologically refined in ways that transcend the crude primary colours of our Darwinian past. "


" Inevitably, talk of treating humans like organic robots, and then mooting a baseline of mental health many orders of magnitude richer than the Darwinian mind can contemplate, sounds fantastical today. In the context of our traditional conceptual framework, the idea of an analogue of Moore's law for successive generations of human mental health evokes cloud-cuckoo-land, not a global health-plan. Amid the messiness of our daily lives, the prospect of using biotechnology to abolish suffering, and a post-Darwinian transition to paradise-engineering, strikes most of us as fanciful, its liberatory potential just a mirage. At best, such heady words fall lifelessly off the page or screen. Yet a major discontinuity - a momentous evolutionary transition in the development of life on earth - is imminent as the biotechnology revolution unfolds. The advent of genomic medicine is set to challenge the old Darwinian regime of natural selection and the emotionally crippled minds it spawned. "

"Today, of course, empathogens and entactogens are outlawed for any purpose. The states of consciousness they induce are criminalised. People who take such agents are stigmatised as "drug abusers". Yet some MDMA users feel, rightly or wrongly, they've been granted a tantalising glimpse of what true mental health may be like in centuries to come; and an insight into what the rest of us are missing."

" There is perhaps a single predictable time of life when taking crack-cocaine is sensible, harmless and both emotionally and intellectually satisfying. Indeed, for such an occasion it may be commended. Certain estimable English doctors were once in the habit of administering to terminally-ill cancer patients an elixir known as the "Brompton cocktail". This was a judiciously-blended mixture of cocaine, heroin and alcohol. The results were gratifying not just to the recipient. Relatives of the stricken patient were pleased, too, at the new-found look of spiritual peace and happiness suffusing the features of a loved one as (s)he prepared to meet his or her Maker."

Interesting reading if you have the time and if you are so inclined...
http://www.hedweb.com/hedethic/tabconhi.htm


Jazzy

 

Sorry Off Topic For A Moment Thanks

Posted by Phillipa on July 20, 2005, at 21:35:53

In reply to Re: Bad (but expected) news about ADs, posted by linkadge on July 20, 2005, at 21:20:45

Thanks Scott. It was the MDD one that had me. It's so obvious though. The other two that I hadn't seen were OCPD and PMDD. BTW how is OCPD different than OCD? See they don't teach nurses any of this and I'd like to again work. I've talked with the NC Board of Nursing. Since I have an active license I can go back to work without a refresher course except all the major hospitals in Charlotte [hope to move there] require a refresher course. That means 2months of med/surg and 2mths minimum of course work on computer. Then if they hired me I would have to work full time for at least a few months. I don't think I could handle the stress of all this after being out of work for 8yrs. But I feel since psych is my bag that if I could wow them with what I know I stand a change of being hired. The stress of the full day of back and forth between hospitals and Board let me know that I still have it in me to fight to win but it left me emotionally drained. So now I question my ability to work. So, thanks to Carolina who has provided me with a lot of hospital numbers and Community Health tele numbers I can continue to look for a job that doesn't require the schooling. I feel this site provides more knowledge than any nursing course could. I just hope I can get my meds straight. Fondly, Phillipa

 

Re: Bad (but expected) news about ADs » SLS

Posted by Jazzed on July 20, 2005, at 21:40:08

In reply to Re: Bad (but expected) news about ADs » linkadge, posted by SLS on July 20, 2005, at 19:30:15

>
> I wish Larry Hoover were here to provide a links to his treatises of this question. I don't have the intellectual resources and knowledge to address this issue as intelligably and pursuasively as he did.

Does this help?

http://www.healthyplace.com/Communities/Depression/news/teen_suicide.asp

http://my.webmd.com/content/article/75/89677.htm

http://my.webmd.com/content/article/79/96376.htm

http://www.uchsc.edu/news/bridge/2004/December%202004/suicide.html

Of course, there are plenty of sites which state just the opposite. So it comes down to whether or not you're inclined to use medications for yourself or your children. IMHO, if you opt for medication, I think it's a case of the right medication, for the right person, in the right dose, no matter what the age.

Jazzy

 

Re: My experience with ADs

Posted by Jazzed on July 20, 2005, at 22:00:31

In reply to Re: Bad (but expected) news about ADs » SLS, posted by Jazzed on July 20, 2005, at 21:40:08

My own experience with ADs has been that the theraputic window is small. Again, that is for me. Too little didn't work, too much made things worse.

Teens/kids, unfortunately, are not always the ones who determine, or help determine, the dosage that might be effective. I got significantly depressed on various medications, suicidally so, fortunately that abated after the drug was withdrawn. I would guess, from that experience alone, that parents don't always have the information that kids can have an adverse reaction to their medication, and what they perceive as "bad" or "fussy" behavior could be a serious adverse reaction.

When I was a teen-ager, and seriously depressed, I was not given the choice of whether or not to take medication, or asked my opinion as to how the medications were affecting me. I can say that most of the effects were detrimental because I was given too much or the wrong medication (I don't know), not to mention I had a terrible psychiatrist.

Now, as an adult, I can choose to take them or not, to take something else or not. I wish there were a one size fits all answer to all mental illness.
Jazzy

 

Re: Bad (but expected) news about ADs » linkadge

Posted by Jazzed on July 20, 2005, at 22:07:36

In reply to Re: Bad (but expected) news about ADs, posted by linkadge on July 20, 2005, at 21:20:45

> I really was not interested in the study at all, I was merely trying to find a statistic for canadian suicide.
>
> Do you have a more accurate statistic for the suicide rates in canada ?
>
> Sorry could not read all your post, have to go to work now.
>
>
> Linkadge
Sorry, once I got to reading that information, I got really carried away.

There's a lot of information if you google, unfortunately, the stats vary from site to site as to whether rates are affected by ADs. From what I can gather, it appears that most sites are saying there appears to be "no direct correlation" between the use of SSRIs and the teen suicide rate.

I still maintain that it depends on the person, and whether they are accurately dosed with the correct medication for what ails them. Of course, I'm no scientist, I'm just going by my own experience, which is basically of no value to anyone other than myself (and my own kids should they ever need anything other than their ADD meds).

Jazzy

 

Re: Bad (but expected) news about ADs

Posted by linkadge on July 21, 2005, at 15:30:18

In reply to Re: Bad (but expected) news about ADs » linkadge, posted by Jazzed on July 20, 2005, at 22:07:36

My main problem with AD's is that they cause so much dysregulation that it is hard to tell what they do, if anything.

Think of it this way. I am in school. If I can't sleep, think, concentrate, then I am going to do poorly. That alone will make me depressed.

If I don't take them, I might do better, which might help my confidence and my mood.

They don't fit well into my lifestyle at all. And I find their side effects so disruptive at times, it is hard to tease out any antidepressant effect.


Linkadge

 

Re: About my post..and Suicide... » linkadge

Posted by SLS on July 21, 2005, at 19:53:12

In reply to Re: About my post..and Suicide..., posted by linkadge on July 20, 2005, at 19:38:34

> That is assuming that receptor dysregulation is the cause of depression.

What *exactly* the problem is doesn't make antidepressants work any less.

Actually, we don't even know enough to say that the primary site of abnormality *isn't* rectified by antidepressants. Again, though, this makes no less real the complete remission of an illness that antidepressants can produce.


- Scott

 

Re: About my post..and Suicide... » SLS

Posted by rod on July 21, 2005, at 20:00:40

In reply to Re: About my post..and Suicide... » linkadge, posted by SLS on July 21, 2005, at 19:53:12

> > That is assuming that receptor dysregulation is the cause of depression.
>
> What *exactly* the problem is doesn't make antidepressants work any less.
>
> Actually, we don't even know enough to say that the primary site of abnormality *isn't* rectified by antidepressants. Again, though, this makes no less real the complete remission of an illness that antidepressants can produce.
>
>
> - Scott
>

*signed*


regards

roland

 

Re: About my post..and Suicide... » Jakeman

Posted by SLS on July 21, 2005, at 20:00:55

In reply to Re: About my post..and Suicide..., posted by Jakeman on July 20, 2005, at 20:08:46

Hi, Jake.

> > > Then we have to worry about the fact that long-term effects (>6 monthes) have not been tested.
> >
> > I'm sorry, I'm a little confused here. The long-term effects of what have not been tested?
> >
>
> I meant the long-term effects of antidepressants have had little study. It's my understanding that clinical trials are usually less than six months.

This is true of most studies. Unfortunately, most of the clinical trials that involve antidepressants have rarely exceeded 10 weeks. However, there have been a few longitudinal studies that have followed people for five years and more. One of the most important findings of such studies is that the dosage of an antidepressant that successfully treats the depression acutely is the same dosage that should be used for long-term maintenance.

What sorts of things are you interested in discovering with long-term studies? Just curious.


- Scott

 

Re: About my post..and Suicide... » linkadge

Posted by SLS on July 21, 2005, at 20:05:28

In reply to Re: About my post..and Suicide..., posted by linkadge on July 20, 2005, at 20:11:24

> "Let's keep things simple - empirical. Some compounds are antidepressants. Some are not. What we see through imaging is instructive, but not yet predictive"
>
> Yes, exactly. Some compounds are antidepressants. The ones that make rats swim longer in a tank are antidepressants. That doesn't say much.
>
> Linkadge

Come on, those are only paradigms that are used for screening compounds for *potential* antidepressants. They are not designated as being antidepressants at this stage of investigation. Their potential as antidepressants is tested further in human studies. They don't become antidepressants until they show efficacy in human beings.


- Scott

 

Re: Bad (but expected) news about ADs » linkadge

Posted by SLS on July 21, 2005, at 20:09:37

In reply to Re: Bad (but expected) news about ADs, posted by linkadge on July 20, 2005, at 20:19:09

> ADs have reduced the rate of adolescent suicide, despite the fact that they have produced suicide in a small percentage.
> ---------------------------------------------
>
> Just because certain youths don't commuit suicide on the drugs doesn't mean that the drugs prevented suicide. Many times people just get better.

At what rate? How does this rate of spontaneous remission compare with the observered rates of suicide prevention that these drugs demonstrate?

Antidepressant Medications for Children and Adolescents: Information for Parents and Caregivers

http://www.nimh.nih.gov/healthinformation/antidepressant_child.cfm


- Scott

 

Re: About my post..and Suicide... » linkadge

Posted by SLS on July 21, 2005, at 20:20:46

In reply to Re: About my post..and Suicide..., posted by linkadge on July 20, 2005, at 20:25:39

> That is correct. These drugs have not been tested nearly as long as we take them for.

Nor have most other drugs once they are approved. Am I missing your point? No guarantees. There is always some degree of uncertainty as to the long-term effects of a drug once it is approved. That's why there are COSTART reporting and Phase IV investigations.

> We have a panic attack at the notion that our drugs might stop working one day, and that we might not be able to take them indefinately, and yeild the same results.

Yup.

The same with drugs for AIDS, cancer, diabetes, hypertension, heart-failure, Parkinsons...

> As a result we cling to the notion that these drugs are fixing some deficiancy,

How do we know that they are not?

> because that notion leads us to believe that their workings are more natural. Why do we buy into the chemical imballence theory?

Because it reflects what we have observed clinically and investigationally.

> Mainly because it comforts us.

It never comforted me. I *wanted* my suffering to be 100% psychological because it meant that *I* was in control of my destiny. It was within my power to get well using psychotherapy and hard work. I was *extremely* pissed off when I discovered it was biological.

> Comfort us it may, but save us it will not. As if, knowing how the drug works will keep it working.

Exactly. Empirical. Things work or they don't. Antidepressants work.


- Scott

 

Re: Bad (but expected) news about ADs » Jazzed

Posted by SLS on July 21, 2005, at 20:27:49

In reply to Re: Bad (but expected) news about ADs » linkadge, posted by Jazzed on July 20, 2005, at 20:36:59

Hi Jazzed.

I agree with you.

I come across more claims of a decreasing rate of suicide than I do an increasing rate of suicide. However, things are more complicated when trying to evaluate the success rate of medical intervention. In any event, I thought the following was instructive:

Preventing Suicide: Individual Acts Create a Public Health Crisis

http://www.healthyplace.com/Communities/Depression/nimh/suicide_5.asp


- Scott

 

Re: About my post..and Suicide...

Posted by linkadge on July 21, 2005, at 20:34:33

In reply to Re: About my post..and Suicide... » linkadge, posted by SLS on July 21, 2005, at 19:53:12

"Again, though, this makes no less real the complete remission of an illness that antidepressants can produce"

I could accept the fact that an adequate explaination hasn't been found if they worked.
A lack of explaination to their workings also befuttles issues such as poop-out, and potential neurotoxicity.

Linkadge

 

Re: Long post (sorry)

Posted by thealmighty on July 21, 2005, at 20:45:48

In reply to Re: Long post (sorry) » linkadge, posted by Jazzed on July 20, 2005, at 21:27:25

hey

 

Re: About my post..and Suicide... » linkadge

Posted by SLS on July 21, 2005, at 20:45:55

In reply to Re: About my post..and Suicide..., posted by linkadge on July 21, 2005, at 20:34:33

> > "Again, though, this makes no less real the complete remission of an illness that antidepressants can produce"

> I could accept the fact that an adequate explaination hasn't been found if they worked.

> A lack of explaination to their workings also befuttles issues such as poop-out,

Give them a chance!

What do you think these neuroscientists and psychiatric investigators are doing, staring at the screen savers on their computers?

> and potential neurotoxicity.

Which drugs carry this potential?

Is there any data to support the statements that antidepressants produce neurotoxicity?


- Scott

 

Re: About my post..and Suicide...

Posted by linkadge on July 21, 2005, at 20:46:34

In reply to Re: About my post..and Suicide... » Jakeman, posted by SLS on July 21, 2005, at 20:00:55

"One of the most important findings of such studies is that the dosage of an antidepressant that successfully treats the depression acutely is the same dosage that should be used for long-term maintenance. "

That is what was claimed for benzodiazapines 30 years ago.

That again is buying into the whole flawed theory. What doctors claim of the drug, and what the drug actually turns out to be, are two totally different things.


Psychiatrists would like an antidepressant to be a drug that:

1) Works
2) Continues to Work (no poop out / tollerance)
3) Is safe
4) Produces few side effects
5) Non addicting (requires no dose escalation)

This is what doctors *want* an antidepressant to be. But no drug meets this criteral.

1) They sometimes work and sometimes don't
2) They can poop out, people can become tollerant
to their effects. This board is proof of that.
3) We have no idea of their long term safety.
I am proof of safety issues that docotors
never anticipated.
4) They produce many side effects, some of which
we might not even be aware.
5) Often require dose escalation, augmentation,
and have withdrawl bad enough to be common
household knowledge

Linkadge


 

Re: About my post..and Suicide...

Posted by linkadge on July 21, 2005, at 20:50:21

In reply to Re: About my post..and Suicide... » linkadge, posted by SLS on July 21, 2005, at 20:05:28

"They don't become antidepressants until they show efficacy in human beings."

And they become antidepressants even if they don't show efficacy in human beings. Drug companies just keep testing the drug till they find one study that shows "sufficant evidence"

Drug companies could show that breakfast sausage was an antidepressant if they wanted to.


Linkadge

 

Re: Bad (but expected) news about ADs

Posted by linkadge on July 21, 2005, at 20:52:05

In reply to Re: Bad (but expected) news about ADs » linkadge, posted by SLS on July 21, 2005, at 20:09:37

Unmedicated depression usually remits within a year. Rarely longer. Antidepressants are taken on average much longer than a year. Antidepressnats worsen the course of the illness.

Linkadge

 

Re: About my post..and Suicide... » linkadge

Posted by SLS on July 21, 2005, at 20:54:42

In reply to Re: About my post..and Suicide..., posted by linkadge on July 21, 2005, at 20:46:34

> "One of the most important findings of such studies is that the dosage of an antidepressant that successfully treats the depression acutely is the same dosage that should be used for long-term maintenance. "
>
> That is what was claimed for benzodiazapines 30 years ago.
>
> That again is buying into the whole flawed theory. What doctors claim of the drug, and what the drug actually turns out to be, are two totally different things.


Work in this area is not new:

1: J Affect Disord. 1993 Mar;27(3):139-45. Related Articles, Links


Comparison of full-dose versus half-dose pharmacotherapy in the maintenance treatment of recurrent depression.

Frank E, Kupfer DJ, Perel JM, Cornes C, Mallinger AG, Thase ME, McEachran AB, Grochocinski VJ.

Department of Psychiatry University of Pittsburgh School of Medicine, PA 15213.

Recent evidence points to the prophylactic efficacy of maintaining recurrent unipolar patients on the same dose of antidepressant medication that was used to treat the acute episode (Frank et al., 1990; Kupfer et al., 1992). Therefore, the question of whether such patients should be tapered to a lower maintenance dose after successful resolution of an acute episode is clearly important. In this report we describe a small randomized clinical trial in which patients were assigned to either full-dose or half-dose maintenance treatment for a period of 3 years. Survival analysis suggests that superior prophylaxis can be achieved with a full-dose as compared to a half-dose maintenance treatment strategy (p < 0.07). Mean survival time for the full-dose subjects was 135.17 (SE 19.75) weeks as compared to 74.94 (SE 19.78) weeks (median of 43.1 weeks) for the half-dose subjects. We conclude that for patients who have suffered several recurrences, full-dose maintenance treatment is the more effective prophylactic strategy.

Publication Types:
Clinical Trial
Randomized Controlled Trial

PMID: 8478502 [PubMed - indexed for MEDLINE]


- Scott

 

Re: About my post..and Suicide...

Posted by linkadge on July 21, 2005, at 20:58:06

In reply to Re: About my post..and Suicide... » linkadge, posted by SLS on July 21, 2005, at 20:20:46

I was *extremely* pissed off when I discovered it was biological.


Have you ever heard the statement "I never knew I was depressed untill I took prozac" I believe it is a line from Kramer's "Listening to Prozac",

I think a lot of people could be convinced that they have had some sort of chemical imballence if you give them the right dose of the right "high octane mood brightener". You don't need to be depressed for these drugs to have an effect. Just like you don't need to have ADD for Ritalin to enhance your concentration. It comes with a price however.


Linkadge

 

Re: Bad (but expected) news about ADs

Posted by linkadge on July 21, 2005, at 20:59:04

In reply to Re: Bad (but expected) news about ADs » Jazzed, posted by SLS on July 21, 2005, at 20:27:49

Reduced suicide rate could also be a result of the effect of being "treated".

Linkadge

 

Re: About my post..and Suicide... » linkadge

Posted by SLS on July 21, 2005, at 21:02:42

In reply to Re: About my post..and Suicide..., posted by linkadge on July 21, 2005, at 20:50:21

> > "They don't become antidepressants until they show efficacy in human beings."

> Drug companies could show that breakfast sausage was an antidepressant if they wanted to.

I disagree with this premise, despite understanding the cynicism that society has developed towards the pharmaceutical industry more recently.


- Scott

 

Re: About my post..and Suicide...

Posted by linkadge on July 21, 2005, at 21:08:35

In reply to Re: About my post..and Suicide... » linkadge, posted by SLS on July 21, 2005, at 20:45:55

"What do you think these neuroscientists and psychiatric investigators are doing, staring at the screen savers on their computers?"

Probably developing another SSRI.


"Which drugs carry this potential? "

The neuroleptics, certain anticonvulsants, and any drug which we haven't proven to be non neurotoxic.


Is there any data to support the statements that antidepressants produce neurotoxicity?

Yes, my walking problems, neck twisting, brain zaps, and of course the lack of information suggesting that the meds are non-neurotoxic.

Although I don't like Breggin that much. He does point to certain studies of neurotoxicity, that have not been adequately countered in my oppinion.


Linkadge

 

Re: About my post..and Suicide...

Posted by linkadge on July 21, 2005, at 21:14:47

In reply to Re: About my post..and Suicide... » linkadge, posted by SLS on July 21, 2005, at 20:54:42

Well full dose is always going to be better than half-dose. That doesn't proove that full dose is always sufficiant. Some of U.S. most prominant psychitrits have talked about the issues of poop-out. Poop-out is not uncommon.


Linkadge


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