![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 48 to 72 of 90. Go back in thread:
Posted by linkadge on November 5, 2006, at 13:49:25
In reply to Re: wait a second?, posted by clint878 on November 5, 2006, at 12:31:58
>Antidepressant-induced mania, however, is not >something that just goes away after you stop >taking the pills.
I don't think that is something that has been thoroughly tested. The protocols insist that the patient be placed on mood stabilizers right away, before seeing what coming off the drug might do. Thats not fair. Antidepressants can induce mania in animal models. My mother had a manic episode on a TCA. She has since been on lithium. I would argue that the mania would have subsided if the drugs had been removed. If you take street drugs like meth, and have a manic episode, that doesn't mean you have bipolar. They will not put you on lithium for life. But somehow antidepressants are different? They're still messing with your neurotransmitters. The science isn't exact.
>Manic episodes, even those induced by >antidepressants, can last for weeks or months. >The patient might commit suicide as a result.
Not always though. A lot of people get stuck on drugs they probably don't need.
>More importantly, though, it's been shown that >very few people EVER recover fully from a manic >episode, suffering permanent cognitive >dysfunction as a result.
Its hard to say too, because all the drugs that are used in bipolar can cause major cognitive impairment. When I came off lithium, my grades improved 2 letter grades. They have stayed that way. Again, this could be a way that doctors pawn off the cognitive side effects of mood stabilizers an AP's. Well, bipolar causes cognitive impairment. Whatever cognitive impairment is caused by bipolar, the drugs make it 10X worse.
>As to poop-out and all the other things you >brought up, those just hint at bipolarity and >could certainly be caused by other things. But >with antidepressant-induced mania, if you >weren't bipolar before, you are NOW.
Hey, I can agree with that. What I was implying with the drug induced mania is this. We think there is a link between epileptic like brain activity, and some forms of mania. That is why anticonvulsants work in bipolar. So, if a drug can induce seizure like activity in normal people, is it too much of a stretch to suggest that they induce mania like acitivity in normal people?
Psychiatrists will never admit that their drugs can induce mania in normal people since then it is their fault. Instead, they simply pawn it off as underlying bipolar. Then it becomes "your" fault.
Linkadge
Posted by linkadge on November 5, 2006, at 13:53:47
In reply to Re: wait a second? » linkadge, posted by Squiggles on November 5, 2006, at 12:44:18
I have heard it directly from psychiatrists, as well as many places on the internet. You can ask SLS for instance, he's probably heard of it. Something to do with worsening if kindling perhaps ?
If you have a subscription to psychiatry online.
http://ajp.psychiatryonline.org/cgi/reprint/152/12/1810.pdf
Posted by Squiggles on November 5, 2006, at 13:58:45
In reply to Re: wait a second?, posted by linkadge on November 5, 2006, at 13:49:25
Whether medications can induce mania,
depression, or any other affective/cognitive
or even psychotic state, is not in dispute.
I think drs. would admit it. The important
question, (i think) is -- what kind of med,
how long taken? what dose? For example, do
you think that 1 valium tablet taken and then
stopped will turn a normal person into
a manic-depressive?Most of my reading on this subject proposes
that alcohol, or drugs, or shock, can induce
a full-blown psychotic state, BUT only in
people who already have a natural propensity to
become ill given the right trigger at the right
time.Squiggles
Posted by Squiggles on November 5, 2006, at 14:13:37
In reply to Re: wait a second?, posted by linkadge on November 5, 2006, at 13:53:47
I don't have access to that. But I have
read of this in many places through my
meandering. *If* it's true, it has not
happened to me a few times -- the last one
it took 12 hrs. to restabilize when the
pharmacy gave me the botched batch. It took
six months to become bipolar again, after
20 yrs. of stability. It was a test in
dose juggling, but i succeeded.And, *if* this is known in the medical arena, it is a good thing i turned down a proposal to
switch to another drug. Because if another
drug did not work, then I would not have been
able to go back to lithium.Squiggles
Posted by johnnyj on November 5, 2006, at 14:53:32
In reply to Re: wait a second? » linkadge, posted by Squiggles on November 5, 2006, at 14:13:37
I was told by the pdoc that fire me recently that lithium causes no withdrawal. I believe this doc gave me a good dx but somethings he says seems to contradicte what I have read out there. He also told me that lunesta has no withdrawal. That is not what the company says either. When I told him I felt better without the lithium, and that it took about 3 weeks, he basically said I was lying and that is not possible. I was on lithium for unipolar augmentation. I have often wondered if the lithium caused some depression/anxiety in me and affected my sleep. I also had REM rebound when I stopped lithium which he also told me was not true. I don't believe I made all of it up but I questioned myself after he berated me. I am not sure what to think.
johnnyj
Posted by Squiggles on November 5, 2006, at 14:58:02
In reply to lithium » Squiggles, posted by johnnyj on November 5, 2006, at 14:53:32
I think that you should get another
doctor, as you seem to be having trouble
with this one: fired you? I didn't
know that doctors hired patients now --
was if for a drug trial perhaps?Squiggles
Posted by johnnyj on November 5, 2006, at 15:14:34
In reply to Re: lithium » johnnyj, posted by Squiggles on November 5, 2006, at 14:58:02
Squiggles, I posted this in an above post.
There must be something wrong with me. Today my pdoc fired me. He was a new doc for me, someone that finally gave me a good dx. I saw him 4 months ago, twice and then had to wait until a few weeks ago to see him. We talked about me trying therapy first and went over all of my stuff. He didn’t appear to remember a lot of my stuff from the first two visits but he said he wanted to see me again last time, so today I went. He said he respected my try at therapy but that I ask too many questions and it is a waste of his and my time. He seemed like he had decided to fire me before I came.
I told him I am having problems with lunesta and I was dizzy, and nauseated and had vivid drams., and that it appears a lot of people are too and that I thought I had some lithium withdrawal. He said “THERE is NO such thing.” He told me I was against all meds and I told him I was afraid. Basically, I was making everything up and I wonder if I have been? Am I just so ill as I don’t know it? The funny thing is I went there ready to give meds a try and he wouldn’t hear it. He said “go get a second opinion” “you don’t listen to my recommendations” “We go over the same thing, and you ask questions about meds”
I told him I hadn’t started the meds he suggested yet and we hadn’t even gone over the dosage, He said we “did go over that” The guy gave me ambien to try last time instead of lunesta and then says “I didn’t know you were on lunesta” today WHAT??? I was shaking and stunned as I left the office. I guess I am some big screw up. Where do I go now?? I am alone.
Posted by Squiggles on November 5, 2006, at 15:25:40
In reply to Re: lithium, posted by johnnyj on November 5, 2006, at 15:14:34
I'm afraid that you have to be
tactful with medical staff these days;
make an effort. They are under tremendous
stress. What I do, when I see my doctor
is take a shopping list of questions and
suggestions about my drugs. And I start
the meeting with a review of what's been
going on since i last saw him.I think that helps the doctor. I try to
be a good patient, even though i do have many
doubts and questions, because it is hard
to establish a working relationship.I'm sorry it has not worked out for you.
Don't take it personally. Now, you'll have
to decide if you can find someone else. If
your dr. suggested a second opinion, then
you already have an opportunity to ask for
someone else.Squiggles
Posted by linkadge on November 5, 2006, at 16:05:31
In reply to Re: wait a second? » linkadge, posted by Squiggles on November 5, 2006, at 13:58:45
>Most of my reading on this subject proposes
>that alcohol, or drugs, or shock, can induce
>a full-blown psychotic state, BUT only in
>people who already have a natural propensity to
>become ill given the right trigger at the right
>time.Well, I am proposing that there need not be any history, or predisposition to a mental disorder for one to have a negative reacton to a medication. When you're on antidepressants, you're on drugs. Cocaine for instance, will induce euphoria in 99% of people who take it.
Thats not a manic episode, and no prior mental history is needed.As far as seizures go, a drug can induce a seizure in anyone. Sure, some will have a higher seizure threshold, but a higher dose of a drug could still induce a seizure. Same thing goes with any drug. You are altering the brain chemistry, and there are no guarentees after that.
Its like coffee. If the dose is high enough, caffine can induce anxiety/panic in just about everybody.
People taking a antidepressant already have one strike against them. They have a mental illness. At that point, it is very easy to dismis drug effects as an additional mental illness.
Doctors are always denying that antidepressants can cycling in normal people. When a doctor dignoses bipolar disorder based on a reaction to an antidepresant, they are ignoring the possability that the drug was the sole cause of the manic episode. As a result, an individual suffers years of mood stabilizers, when the mania may well have abated upon dose reduction of the antidepressant.
Linkadge
Posted by linkadge on November 5, 2006, at 16:07:18
In reply to Re: wait a second? » linkadge, posted by Squiggles on November 5, 2006, at 14:13:37
Not to say that lithium never works the second time around, just to say there is a possability it will not work.
Linkadge
Posted by linkadge on November 5, 2006, at 16:15:11
In reply to lithium » Squiggles, posted by johnnyj on November 5, 2006, at 14:53:32
>I was told by the pdoc that fire me recently >that lithium causes no withdrawal.
Any psychatric drug can cause withdralw. Lithium is no exception. Insomnia, anxiety, mood swings, rebound excitation, rebound mania, irritability, all possable withdrawl symptoms.
>I believe this doc gave me a good dx but >somethings he says seems to contradicte what I >have read out there. He also told me that >lunesta has no withdrawal. That is not what the >company says either. When I told him I felt >better without the lithium, and that it took >about 3 weeks, he basically said I was lying and >that is not possible.
Of course it is possable. Depression can be a nasty side effect of lithium therapy for many people. I hated lithium. It made colors very grey for me. It made my life very grey, nothing to look forward to, no interests etc, etc.
>I was on lithium for unipolar augmentation. I >have often wondered if the lithium caused some >depression/anxiety in me and affected my sleep. >I also had REM rebound when I stopped lithium >which he also told me was not true.Of course it is true. Lithium supresses REM. I hate those doctors who deny everything. They think it is in your best interest that they lie to you. They think they are doing you a favor.
>I don't believe I made all of it up but I >questioned myself after he berated me. I am not >sure what to think.
There are plenty of cases in which lithium therapy is very inappropriate and tends to make depression worse. Lithium can mess with hormones, ie thyroid. It also lowers DHEA-S. Which is a hormone with powerful antidepressant properties in some populations. Lithium is generally useless in depressons whoose underpinnings are related to low dopamine. Lithium is anti-dopaminergic. It actually gave me EPS.
Linkadge
Posted by clint878 on November 5, 2006, at 16:25:48
In reply to Re: wait a second?, posted by linkadge on November 5, 2006, at 13:49:25
Take a look at:
http://bjp.rcpsych.org/cgi/content/full/180/4/293, which details the cognitive function of bipolar patients. One part mentions that patients on no medications also have difficulty.
Posted by Squiggles on November 5, 2006, at 16:54:05
In reply to Re: wait a second?, posted by linkadge on November 5, 2006, at 16:05:31
Even if you are right, which in some
of the more extreme examples you are--
once depression or anxiety or manic-depression
begins, there is a change in the brain which
may not be irreversible; no more irreversible
than if it were genetic or "endogenous".
You still need to be treated as if you
were a natural born bipolar.Squiggles
Posted by Phillipa on November 5, 2006, at 17:02:44
In reply to Re: lithium » johnnyj, posted by Squiggles on November 5, 2006, at 14:58:02
Squiggles they do fire you . I just had one do it to me a few months back. Cause I wouldn't take 80mg of geodon never having taken an antipsychotic before he said that I should get a second opinion and refuse to keep me on lamictal which he had just said he wanted me to continue. Anytime I questioned him in the l0minute appointment he got angry. So go get a second opinion is firing you. And would you take 80mg of geodon when the lowest dose is 20mg. Shouldn't you start there? And also adding two meds at once and increaing another all at the same time is negligent in my opinion. As how would you know what was causing what? Love Phillipa
Posted by Squiggles on November 5, 2006, at 17:16:23
In reply to Re: wait a second?, posted by clint878 on November 5, 2006, at 16:25:48
> Take a look at:
>
> http://bjp.rcpsych.org/cgi/content/full/180/4/293, which details the cognitive function of bipolar patients. One part mentions that patients on no medications also have difficulty.Before I ever was diagnosed as bipolar, I was
enrolled in Psychology -- i almost finished the degree, but then switched to Philosophy for the M.A. Even then, i never trusted the cognitive tests, reminding me too much as the offspring of the Rocharch tests and the highschool tests.
As for the neuroanatomical changes in the brain (especially after years of lithium), there is the contrary school of thought on how lithium actually acts as a neurogenerative agent:1.Neuropharmacology 43 (2002) 11731179 www.elsevier.com/locate/neuropharm
Lithium induces brain-derived neurotrophic factor and activates
TrkB in rodent cortical neurons: An essential step for
neuroprotection against glutamate excitotoxicity
Ryota Hashimoto a, Nobuyuki Takei b, Kazuhiro Shimazu c, Lori Christ a, Bai Lu c,
De-Maw Chuang a,
a Molecular Neurobiology Section, Mood and Anxiety Disorders Program, National Institute of Mental Health, National Institutes of Health,
Bethesda, MD, 20892-1363, USA
b Department of Molecular Neurobiology, Brain Research Institute, Niigata University, Niigata, Niigata, 951-8585, Japan
c Unit on Synapse Development & Plasticity, National Institutes of Child Health and Human Development, National Institutes of Health,
Bethesda, MD, 20892-4480, USA
Received 26 February 2002; received in revised form 18 July 2002; accepted 6 August 2002
Abstract
Mechanisms underlying the therapeutic effects of lithium for bipolar mood disorder remain poorly understood. Recent studies
demonstrate that lithium has neuroprotective actions against a variety of insults in vitro and in vivo. This study was undertaken to
investigate the role of the brain-derived neurotrophic factor (BDNF)/TrkB signaling pathway in mediating neuroprotection of lithium
against glutamate excitotoxicity in cortical neurons. Pretreatment with either lithium or BDNF protected rat cerebral cortical neurons
from glutamate excitotoxicity. The duration of treatment required to elicit maximal neuroprotection by BDNF (1 day) was much
shorter than that by lithium (6 days). K252a, an inhibitor of Trk tyrosine kinases, and a BDNF neutralizing antibody suppressed
the neuroprotective effect of lithium. Treatment of cortical neurons with lithium increased the cellular BDNF content in 3 days
and the phosphorylation of TrkB at Tyr490 in 5 days, suggesting that long-term lithium administration enhances BDNF
expression/secretion, leading to the activation of TrkB receptor. Lithium failed to protect against glutamate excitotoxicity in cortical
neurons derived from homozygous and heterozygous BDNF knockout mice, although lithium fully protected cortical neurons pre-
pared from wild type mice littermates. Taken together, these data suggest that the BDNF/TrkB pathway plays an essential role in
mediating the neuroprotective effect of lithium.
Published by Elsevier Science Ltd.
Keywords: Lithium; BDNF; TrkB; Excitotoxicity; Neuroprotection; Cerebral cortical neuron
--------------2.http://www.psycheducation.org/depression/meds/ManjiLithium.htm
"Lithium: How Good is it?
Many people worry that lithium is one of psychiatry's "Big Guns", something we use for patients with really severe mental illnesses. They think, "Hey, I'm not that sick", and conclude that lithium is not right for them.
They don't know that lithium, in lower doses, is used in plain depression (not bipolar, not severe). In fact, for depression that hasn't fully responded to an antidepressant, one research group calls it "Step 1A" -- the thing to do, in some cases, before switching to another antidepressant.
But one of the strongest arguments for lithium is the way it appears to protect neurons. So I wanted to show you the world's expert on how lithium works, talking about this aspect of lithium's potential benefits. His full comments, on a range of topics, from his interview with a great bipolar advocacy organization, can be read on this link at the Child and Adolescent Bipolar Foundation (CABF).
Here are Dr. Manji's comments about lithium (it's a little technical; look for the few ideas I put in bold if you're getting bogged down):
CABF: Speaking of lithium, your research has uncovered some of its intriguing beneficial properties. Can you highlight the most important ones?
MANJI: Many of the genes that are considered neuroprotective [keep brain cells from dying when stressed] are being remarkably turned on by lithium. Is lithium actually neuroprotective? We hadn't thought this way before. A number of studies have taken animal cells and tried to kill them by causing stroke, etc. These studies have consistently shown that lithium, if administered before you try to do the bad things (such as induce a stroke), protects the animal's neurons. In lithium-treated brains, the size of the resulting stroke is smaller, the number of neurons that die is lower, etc. That was amazing. Since these studies were done in rats, you need to be careful about jumping to conclusions that lithium is neuroprotective in people.
Wayne Drevets' group published a finding in Nature about five years ago that in a part of the pre-frontal cortex of bipolar patients or patients with familial recurring unipolar depression, there was almost a 40% reduction in the amount of gray matter. That was a remarkable finding that you have such a reduction in a discrete part of brain. We spoke to him about our lithium findings and asked him to reanalyze the data. He had a small group of patients who had been treated with lithium for a long time and they did not show the brain atrophy compared with the bipolar patients. Interestingly all of the patients with unipolar depression, whether or not they had been treated with antidepressants, still showed the atrophy. That was a suggestion that bipolar treatments might have a protective effect.
Valproate (Depakote) in the prefrontal cortex seemed to have the same type of neuroprotective properties. Lithium and depakote do not have identical effects in every brain area, but in this area they did. Brains treated with chronic lithium or valproate seemed not to have the atrophy in the prefrontal cortex. But it was a very small sample and a crossectional study [type of study whose design restricts its findings to association between variables, not proof of cause]. He studied them once. We don't know if it was a cause or effect. Is it the people who don't have the atrophy who responded to the drug in the first place?
We did some studies taking bipolar patients off their meds -- they were referred to us because their treatments weren't working. In every case, they either hadn't been on lithium or had been on lithium sparingly -- had started on it, had side effects, switched, and the new med was not working. These are bipolar depressed patients. We did MRI scans and MRS spectroscopy and then put them on lithium in a blinded fashion for 4-6 weeks. Then we did the scans again. We found that almost every single person taking lithium had an increase in N-acetylaspartic acid (NAA) [an amino acid that is viewed as a marker of neuronal health]. And the actual amount of gray matter was going up when they were treated chronically with lithium. This study was done together with Dr. Greg Moore¹. This was happening in areas of the patients' brains that had been atrophied. The increase was not due to swelling from water retention. The increase was seen only in areas where the brain matter had previously atrophied.
Our working hypothesis, and I think it is reasonable, is that lithium is turning on some of these growth signaling pathways and reversing the damage. It seems that the cells are shrunken, not dead, and are capable of going back to their normal sizes and sending normal projections. What lithium seems to be doing is turning on the signaling pathways that produce growth factors in the brain, such as brain-derived neurotrophic factor (BDNF), and where you have atrophy, turning on this pathway seems to be capable of reversing it. And that is a remarkable finding.
A couple of other studies since then have compared lithium-treated patients with untreated patients. They showed that the lithium-treated patients have the increase in gray matter, suggesting that lithium is causing the increase. If that is the case, lithium has a neurotrophic [nourishing to neurons] effect. Would lithium, then, be beneficial in any bipolar patient, even if he or she can't tolerate it or if his or her symptoms respond better to another mood stabilizer? One question is tolerability. We've done a number of animal studies with low-dose lithium. We found that in animals, with a dose of lithium that is one-half or one-third of a usual dose, you still get a large increase in bcl-2, a neuroprotective protein. This suggests that it is quite possible that even low-dose lithium will exert these effects. Many studies are being planned using low-dose lithium as an additional agent in patients being treated with something else. We will add low-dose lithium and follow them for 2-3 years with repeated MRIs and neuropsych testing to see if the addition would be enough to provide neuroprotective effects that would help them long-term with the illness, even if something else is their appropriate treatment for symptoms. That is extremely important. It is a devastating long-term illness, and brain atrophy may be responsible for that. If we can intervene early on and prevent that, there is reason to believe you will have a big impact on the overall course of the illness."
Squiggles
Posted by clint878 on November 5, 2006, at 18:02:01
In reply to Re: wait a second? » clint878, posted by Squiggles on November 5, 2006, at 17:16:23
Well, I agree that lithium is probably a protective agent, so there's no argument there. An interesting question would be whether people who are treated with lithium have superior performance on these cognitive tests to people who are not treated with any medication.
The issue with performing such a comparison is that the lithium-treated patients will perform better simply because they probably feel better in terms of mood. There would need to be strict controls on mood symptoms to determine that.
Second, I don't understand why very little research is being done on this topic of cognitive dysfunction. There are all sorts of drugs in the pipeline to control acute mania, for example. While there are drugs that have been shown to combat this dysfunction (like galamantine), there is no established standard of care like there is for mood symptoms. Perhaps there's more money to be made on the former.
Something like 70% of patients with bipolar disorder are disabled. My guess is that the major contributor to this disability burden is cognitive dysfunction, not mood symptoms.
Why do I make this guess? I can say this from experience. I graduated with a master's degree in computer science, and started out with a very well-paying job, but now I have difficulty following conversations at work. Writing is not a problem, but listening to people leads to no understanding, and often to embarrassment when I say something that implies I completely misunderstood the topic.
Yet, my mood is the best it has been in my entire life. Unless something changes soon, I will probably be forced out of this job eventually. Maybe I can work from home where I don't need to deal with people in real-time.
Heck, this post took me almost an hour to write and proofread, because my memory is so poor that I continually forget what word I was going to use next.
Could something else be causing these problems? Sure. But it would have to be very coincidental that they began the same day the mania began, before I took any medication, and haven't remitted since.
Posted by Squiggles on November 5, 2006, at 18:30:34
In reply to Re: wait a second?, posted by clint878 on November 5, 2006, at 18:02:01
> Well, I agree that lithium is probably a protective agent, so there's no argument there. An interesting question would be whether people who are treated with lithium have superior performance on these cognitive tests to people who are not treated with any medication.
If you mean while on lithium versus "normal" people, then you would be asking for a test
on increased intelligence, right? I don't know.
But the clinical interest for neurogenerative agents such as lithium is more for degenerative diseases which affect cognitive function, such as Parkinson's.
>
> The issue with performing such a comparison is that the lithium-treated patients will perform better simply because they probably feel better in terms of mood. There would need to be strict controls on mood symptoms to determine that.That would apply to all drugs that alleviate anxiety and depression, as these conditions distract people from thinking clearly.
>
> Second, I don't understand why very little research is being done on this topic of cognitive dysfunction. There are all sorts of drugs in the pipeline to control acute mania, for example. While there are drugs that have been shown to combat this dysfunction (like galamantine), there is no established standard of care like there is for mood symptoms. Perhaps there's more money to be made on the former.
>
Is galamantine Wellbutrin? or is it a condition?
I think a mood disorder is far more important in a person's life than whether he can read Kant or cant.:-)
> Something like 70% of patients with bipolar disorder are disabled. My guess is that the major contributor to this disability burden is cognitive dysfunction, not mood symptoms.I don't think so. Anyone who has gone through the mania and depression will tell you how alien the experience is; how terrifying and debilitating. Infact, cognitive status is hardly changed except for the way it is swayed by the violent emotions.
>
> Why do I make this guess? I can say this from experience. I graduated with a master's degree in computer science, and started out with a very well-paying job, but now I have difficulty following conversations at work. Writing is not a problem, but listening to people leads to no understanding, and often to embarrassment when I say something that implies I completely misunderstood the topic.To me that sounds like undertreated depression
or just plain burn-out.
>
> Yet, my mood is the best it has been in my entire life. Unless something changes soon, I will probably be forced out of this job eventually. Maybe I can work from home where I don't need to deal with people in real-time.You sound very familiar.
>
> Heck, this post took me almost an hour to write and proofread, because my memory is so poor that I continually forget what word I was going to use next.I don't even pay attention to such detail.
>
> Could something else be causing these problems? Sure. But it would have to be very coincidental that they began the same day the mania began, before I took any medication, and haven't remitted since.I don't know -- there are many possibilities - you can't pin it on one thing-- check it out with a biologically inclined doctor.
Squiggles
Posted by linkadge on November 5, 2006, at 20:57:01
In reply to Re: wait a second?, posted by clint878 on November 5, 2006, at 16:25:48
Some interesting things they noted though:
>A retrospective study of probands with bipolar >disorder by Sigurdsson et al (1999) reported >that delayed language, social or motor >development precedes the onset of bipolar >disorder
Ie, congitive impariment may contribute to bipolar and not the other way around.
>To date there are no longitudinal studies to >assess whether cognitive deficits in bipolar >disorder show a progressive course or their >association with age of illness onset.
>Such studies, alongside studies conducted in >high-risk groups (i.e. first-degree relatives of >probands with bipolar disorder), would help to >establish the temporal evolution and aetiology >of the bipolar ‘encephalopathy’.
Linkadge
Posted by linkadge on November 5, 2006, at 21:07:26
In reply to Re: wait a second? » linkadge, posted by Squiggles on November 5, 2006, at 16:54:05
>Even if you are right, which in some
>of the more extreme examples you are--
>once depression or anxiety or manic-depression
>begins, there is a change in the brain which
>may not be irreversible;Not necessarily if the mania is drug induced. There is no evidence that drug induced mania is associated with all of the of biochemical abnormalities seen in geniune bipolar.
>no more irreversible
>than if it were genetic or "endogenous".
>You still need to be treated as if you
>were a natural born bipolar.Thats where I disagree. Consider an anticholinergic drug like cogentin. It will make people really dumb. Drug induced dementia. But it is not permanant, and while it may look exactly like alzheimers, it abates completely when the drug is removed.
Same thing goes for stimulant psychosis. Stimulant psychosis eventually abates upon withdrawl of the stimulant. Antipsychotics are not necessary long term.
So, if you treat a drug induced state like a real one, you may not be doing the right thing. You may be drugging somebody unnessicarily.
Linkadge
Posted by linkadge on November 5, 2006, at 21:15:13
In reply to Re: wait a second? » clint878, posted by Squiggles on November 5, 2006, at 17:16:23
Believe it or not, there is a lot of controversy about the neuroprotective/neurotoxic actions of lithium.
Lithium has proconvulsant and anticonvulsant effects. Lithium can be *highly neurotoxic* if it goes over the upper blood level.
Also, when lithium is combined with the cholinergic agent pilocarpine, it can induce a model of temporal lobe epilepsy.
http://www.cogsci.ecs.soton.ac.uk/cgi/psyc/newpsy?7.32
Linkadge
Posted by Squiggles on November 5, 2006, at 21:33:44
In reply to Re: wait a second?, posted by linkadge on November 5, 2006, at 21:07:26
Of course, like most, I would very much
like to reverse the series of events that
have led to my present medicated state.
I have lost much, there is no doubt of that.
However, there is not much chance of that
as my doctor is against it, and so is the
medical establishment, and my very own
experience is proof that when off it (and
very gradually at that - i.e. 6 months) the
bipolar state returned. I can only be thankful
that I was able to stabilize myself.I have to go now. But i saw your next post and
will read it more carefully tomorrow.tx
Posted by Squiggles on November 6, 2006, at 7:05:43
In reply to Re: wait a second?, posted by linkadge on November 5, 2006, at 21:15:13
> Believe it or not, there is a lot of controversy about the neuroprotective/neurotoxic actions of lithium.
>There is no controversy at all. It is well
known that lithium is toxic over a certain dose.
Like some drugs, it has a narrow therapeutic index; that is , it does not take much deviation in dose range to become toxic. Warfarin is like that for example, and many other drugs.
> Lithium has proconvulsant and anticonvulsant effects. Lithium can be *highly neurotoxic* if it goes over the upper blood level.Doh!
>
> Also, when lithium is combined with the cholinergic agent pilocarpine, it can induce a model of temporal lobe epilepsy.Now why would i want to combine it with a drug
for xerostomia induced by cancer? I don't have that condition.>
> http://www.cogsci.ecs.soton.ac.uk/cgi/psyc/newpsy?7.32
>
>
> Linkadge
>
>Linkadge, this post is exactly the kind of post that I was asking for an information editor on for this group. I understand that Dr. Bob cannot hire the entire staff of the American Psychiatric Association to help out, but i would say you are coming close to fear-mongering.
Nobody likes the side effects of psychiatric drugs. I have said this over and over on the board -- we need better drugs. But this message is not what I need anyway. You may as well tell someone on chemotherapy that the reason he is so sick is because of the chemotherapy -- yeah he knows that. But he takes it for a reason.
Squiggles
Posted by Squiggles on November 6, 2006, at 8:04:59
In reply to Re: wait a second?, posted by linkadge on November 5, 2006, at 21:15:13
I would appreciate it if anyone reading
this could tell me which province in Canada
or state in the US is likely to have the LEAST number of anti-psychiatry mental health workers?We may move in a few years and I would
like to safeguard my sanity.Tx
Squiggles
Posted by linkadge on November 6, 2006, at 12:14:23
In reply to Re: wait a second? » linkadge, posted by Squiggles on November 6, 2006, at 7:05:43
The truth isn't fear mongering and you you don't need to listen to me, if you don't need to.
All I am saying is the that there can be a bad side to the drug. My mother is a prime example. A university graduate with zero cognitive problems starting lithium therapy, she now has a hard time reading large print childrens books. The only difference is 20 years of lithium.
No, I cannot proove anything, but this is just the way I see things.
Linkadge
Posted by Squiggles on November 6, 2006, at 13:11:28
In reply to Re: wait a second?, posted by linkadge on November 6, 2006, at 12:14:23
> The truth isn't fear mongering and you you don't need to listen to me, if you don't need to.
>
> All I am saying is the that there can be a bad side to the drug. My mother is a prime example. A university graduate with zero cognitive problems starting lithium therapy, she now has a hard time reading large print childrens books. The only difference is 20 years of lithium.
>
> No, I cannot proove anything, but this is just the way I see things.
>
>
>
> Linkadge
>
>
>
>
>Maybe you need glasses too.
Squiggles
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