Psycho-Babble Medication Thread 847169

Shown: posts 1 to 25 of 54. This is the beginning of the thread.

 

The stakes are too high.

Posted by SLS on August 19, 2008, at 8:11:07

The stakes are too high for us to think we can manage our illnesses based upon our own personal theories or biases.

This really calls for a longer post, but this is where I'm at right now. I am losing hope that the majority of people posting on Psycho-Babble will begin to look at scientific data rather than try to theorize their way into believing they have accomplished more than our researchers have. The NIH has pleaded that the details of investigation become public knowledge.

It is very dangerous to think that we know more than doctors and that we are well beyond the point of accepted medical science. As of August 19, 2008, medicine has huge amounts of data, but little understanding. The jigsaw puzzle has not been assembled yet.

Why bother with a post like this?

I see too many people aborting drug trials early, only to plead with their doctors to try something else that their simplistic theories encourage. I see too many people become cynical towards doctors and drugs, developing a global opinion that drugs don't work and doctors are clueless. This is tragic.

One will almost never get well if each drug trial is aborted before 6 weeks. Why would someone even consider taking drugs if they have the opinion that drugs don't work? That seems very odd to me.

When treating depression, it increases the rate of success by being positive and constructive. Why sabotage your treatment with an armament of negative thoughts? Not smart.

Belief systems have an impact on mental health. It is imperative that someone learn to manage psychosocial stress so that the same old depressive pressures prevent them from responding to drug treatment or relapsing during the course of remission.

Is it fun to be a skeptic or a cynic? I think that for some people, it is. Some people love drama. It seems that provocation and debate can have its emotional rewards. I know I have involved myself in ongoing contraversy. It is stimulating.

What good is stating a contraversial opinion without doing the investigation on Google or Medline to substantiate it? Even these two resources do not provide a consistency of data and conclusions. Citations are often more persuasive than personal conjecture. They certainly help provide a basis for belief.

Bottom line: Spend more time trying different treatments and less time expounding their worthlessness. Begin to focus more on clinical observation than choosing drugs based on personal theory. Maybe here lies the problem. Some people consistently sabotage their treatment and will never get well.

The stakes are too high to invest ourselves in theory and self-medication rather than the treatment by professonals, whether guided by heuristics or algorithms.

Take your medication as prescribed and stop worrying about being "med sensitive". You are supposed to be sensitive to these powerful drugs. Try lower and slower if necessary. Some of this sensitivity are startup side effects that often mitigate after a few months on a drug. If you are med sensitive, then spend some time theorizing how you might best establish a clinically therapeutic dosage and stay on the drug long enough for a clinically therapeutic period of time.

I think I project a great deal of my recent success using drug therapy onto the majority. It is wishful thinking, I know, but sometimes wishful thinking leads to success.

Don't stop.

You have only one chance at life. Don't waste too many ticks of the clock thinking that you are smarter than man's current compendium of knowledge.

By the way, drugs work.


- Scott

 

Re: The stakes are too high. » SLS

Posted by Hygieia's Bowl on August 19, 2008, at 8:53:53

In reply to The stakes are too high., posted by SLS on August 19, 2008, at 8:11:07

I agree with your post. I realize this is coming out of my experience.

I agree discussions can be, uh, interesting, but having been here many years, the trend I see is every say 3-6 months there is - while wrapped in different packaging - the age old: "Do meds work and if they do or don't is it worth it...?". I understand that is the lowest common denominator in all of this. While some claim to enjoy this bantering about, I really don't. I think it generally just leads to discord.

I think differing is fine but seeing as this deals with the very and varying essence of who we are as individuals, it gets really personal really fast - most time I've seen this type of "debate" just turn into arguments and infightings.

I think a few folks also have problem discerning treatment resistance from treatment noncompliance.

 

Re: The stakes are too high.

Posted by bulldog2 on August 19, 2008, at 10:01:12

In reply to The stakes are too high., posted by SLS on August 19, 2008, at 8:11:07

> The stakes are too high for us to think we can manage our illnesses based upon our own personal theories or biases.
>
> This really calls for a longer post, but this is where I'm at right now. I am losing hope that the majority of people posting on Psycho-Babble will begin to look at scientific data rather than try to theorize their way into believing they have accomplished more than our researchers have. The NIH has pleaded that the details of investigation become public knowledge.
>
> It is very dangerous to think that we know more than doctors and that we are well beyond the point of accepted medical science. As of August 19, 2008, medicine has huge amounts of data, but little understanding. The jigsaw puzzle has not been assembled yet.
>
> Why bother with a post like this?
>
> I see too many people aborting drug trials early, only to plead with their doctors to try something else that their simplistic theories encourage. I see too many people become cynical towards doctors and drugs, developing a global opinion that drugs don't work and doctors are clueless. This is tragic.
>
> One will almost never get well if each drug trial is aborted before 6 weeks. Why would someone even consider taking drugs if they have the opinion that drugs don't work? That seems very odd to me.
>
> When treating depression, it increases the rate of success by being positive and constructive. Why sabotage your treatment with an armament of negative thoughts? Not smart.
>
> Belief systems have an impact on mental health. It is imperative that someone learn to manage psychosocial stress so that the same old depressive pressures prevent them from responding to drug treatment or relapsing during the course of remission.
>
> Is it fun to be a skeptic or a cynic? I think that for some people, it is. Some people love drama. It seems that provocation and debate can have its emotional rewards. I know I have involved myself in ongoing contraversy. It is stimulating.
>
> What good is stating a contraversial opinion without doing the investigation on Google or Medline to substantiate it? Even these two resources do not provide a consistency of data and conclusions. Citations are often more persuasive than personal conjecture. They certainly help provide a basis for belief.
>
> Bottom line: Spend more time trying different treatments and less time expounding their worthlessness. Begin to focus more on clinical observation than choosing drugs based on personal theory. Maybe here lies the problem. Some people consistently sabotage their treatment and will never get well.
>
> The stakes are too high to invest ourselves in theory and self-medication rather than the treatment by professonals, whether guided by heuristics or algorithms.
>
> Take your medication as prescribed and stop worrying about being "med sensitive". You are supposed to be sensitive to these powerful drugs. Try lower and slower if necessary. Some of this sensitivity are startup side effects that often mitigate after a few months on a drug. If you are med sensitive, then spend some time theorizing how you might best establish a clinically therapeutic dosage and stay on the drug long enough for a clinically therapeutic period of time.
>
> I think I project a great deal of my recent success using drug therapy onto the majority. It is wishful thinking, I know, but sometimes wishful thinking leads to success.
>
> Don't stop.
>
> You have only one chance at life. Don't waste too many ticks of the clock thinking that you are smarter than man's current compendium of knowledge.
>
> By the way, drugs work.
>
>
> - Scott
>

What bothers me is the intent of some people. One has the right to believe that meds don't work but is it than time to move on ? People come here for info on meds and certain persons seem to delight on telling horror stories on that med or going on rants against meds.

1. Because your trials failed is not a scientific study that prove meds do not work.

2. Because your neighbor stopped using ad's and felt better does not mean meds do not work.

If one believes meds do not work why stay on the forum and try to discourage people from trying meds ? Sometimes I get the feeling some become bitter because their trials failed and wish failure on others by trying them to discourage some from even starting. Remember you're playing God with somebody's life. If they stop their meds or never start them it could cost their life or destroy a family.
If one believes in the all natural approach than go to boards devoted to that approach and contribute there.

 

Re: The stakes are too high. » SLS

Posted by Midnightblue on August 19, 2008, at 10:48:02

In reply to The stakes are too high., posted by SLS on August 19, 2008, at 8:11:07

I wish doctors would give more support to help through the side effects of a new or difficult to take drug. I hate it when they throw a prescription at you and say "here, take this, you need it."

I just recently had to stop taking a powerful antibiotic. The meds I had to take to ease the side effects were causing equal or worse side effects.

I am now hoping the infection is gone. I never did get to see my doctor, just an NP who didn't read my chart, wouldn't listen to me, and messed up when she wrote the prescriptions.

MB

 

Re: The stakes are too high. » SLS

Posted by Marty on August 19, 2008, at 11:29:18

In reply to Re: The stakes are too high. » SLS, posted by Midnightblue on August 19, 2008, at 10:48:02

I agree with EVERY single things you wrote in your post. Theorizing should be only for entertainment purpose. When off the med-trial protocol chart, psychiatrists already know the appropriate evidence-based "theories/logics" on which to work on to guide them on the med trial path...

That said, when you tried almost everything, theorizing becomes somehow therapeutic in that it's not only entertaining anymore but also feels empowering and gives (usually false) hope ! .. That can be a good thing IF:

1. It doesn't influence (significantly) the course of med trial your psychiatrist judge to be appropriate.

2. It doesn't makes you feel negative about the meds your psychiatrist wants you to take because it doesn't fit your homebrew theory.

3. Your quest for knowledge in your pursue of the next awesome theory/med trial doesn't become OBSESSIVE !


I considerer myself guilty of #3 for many years now and I think I'm not alone on this board. I'm addicted to empowerment and hope harvesting and PBabble is one of my pushers.

/\/\arty

 

Re: The stakes are too high.

Posted by Nadezda on August 19, 2008, at 11:49:48

In reply to Re: The stakes are too high. » SLS, posted by Marty on August 19, 2008, at 11:29:18

I also agree with Scott. I know it's hard to remain optimistic after long trials of several drugs, with the prospect of other failed trials ahead, and no real promise of any particular result. But it's worth it to go ahead with the best possible treatments. There simply is no other way, no other hope at the moment. If there were one magic pill, or a formula for knowing which pill would help which person, that would be wonderful. Someday perhaps.

But for right now, all we have is the drugs and clinical practice that's there. Most doctors are doing their best; why would they do anything else? Maybe they aren't the most sympathetic; definitely many aren't. But who else can be really even vaguely put our trust in? Alternative medications that haven't been tested and promise great results? That, I fear, will be another blind alley.

And there are studies that show that after experimentation, many, really most, people can find a drug or combination of drugs that works. There are side effects-- which can be a huge problem-- and all the disappointments-- but it's better, finally, if you go through all that and are able to live a substantially better life. The cost is awful, and a drug that works doesn't take that away-- but if you don't give up, you're likely to find a meaningful treatment-- if you don't-- as I said, you have no hope, other than some sort of miraculous period of remission. If you have that, I felicitate you-- but many many people never do.

Nadezda

 

Re: The stakes are too high.

Posted by ricker on August 19, 2008, at 12:46:15

In reply to The stakes are too high., posted by SLS on August 19, 2008, at 8:11:07

Less is more. When I started treatment in the 80's, I would follow the doctors directives, to the best of my abilities.

Then comes the internet and suddenly, everyone is a pdoc or certified pharmacologist.

Mentally ill patients can be extremely desperate, gullible and influenced. So, when we log into our personal on-line mental health clinic, we can instantly justify our failures.

Strenght in numbers. If one person says drug A causes this, well, it must be so? I think the biggest placebo effect bar none is the internet forums.

We belive the experts really don't care, have no idea how the drugs work, and don't know as much as us?

I know for a fact that mental illness is the only disability where a patient can have a consult with a specialist and pretty much demand what their prescribed treatment should be.

Other healthcare fields have proven treatments and that's what the patients are offered...end of story... no second guessing.

Oh, but we are educated people that prepare ourselves for each and every p/doc appointment. We walk out of the office with a script in hand that WE believe is the best course of treatment.

The thing is, our doctors actually know more than what many of us believe. And they certainly know that if we walk out of their office with a script that is a "terrible drug" that causes this or that, we will be back in short order begging for a change in course.

We know all these negative effects will happen because our on-line mental health clinic says so.
The docs know this too, they see it every day and know the power of the placebo.

The thought of questioning my pdocs treatment years ago was just that, a thought. But now I can march in there with this internet empowerment and explain why I should give drug B a try.

So I get MY drug of choice. And as it absorbs it's way throughout my body, I can quickly surf the net looking for all these strange side effects. I will find them and when I do, well, that's the moment the "drug" loses it's theraputic value.

I must make another appointment with my p/doc asap, how dare he prescribe this terrible stuff?

 

Re: The stakes are too high.

Posted by Phillipa on August 19, 2008, at 12:49:34

In reply to Re: The stakes are too high., posted by Nadezda on August 19, 2008, at 11:49:48

I agree that some do need meds for life. But if all did there would be no openings in pdocs offices at all as the population grows and with this comes the need for more docs. I take what my doc says and its low doses as age plays a big part in my own trials as at the end of that time line. I'll thrilled that someday many of you will be around when the brain and it's mechanisms are fully understood and testing will allow a doc to prescribe the right med for you. Like an antibiotic for an infection. Or insulin for diabetes. Phillipa

 

Re: The stakes are too high.

Posted by llurpsienoodle on August 19, 2008, at 12:51:44

In reply to Re: The stakes are too high., posted by Nadezda on August 19, 2008, at 11:49:48

I find it interesting that one of the symptoms of clinical depression is hypochondria, indeed, "melancholia" and "hypochondria" have been used alternatingly during some periods in history to describe what has now become known as 'depression' what a bland word. Sounds like a weather pattern. blah.

Another interesting tidbit is the observation that of all the natural sciences, [presuming that psychology is a natural science] psychology alone holds the possibility that publishing reports can affect the very subject of empirical investigation.

Charcot, memorably, hypnotized his female hysteria patients finding that they indeed showed some of the characteristic hysteria symptoms of the day. The cluster of symptoms seems bizarre and arcane to us nowadays, but in Victorian times, this syndrome was a part of the culture. As a culture-bound mental illness, it was expected that female hysterics would display certain postures and symptoms, including somatic symptoms. The line between physiological neurology and psychology has been blurred from the beginning of psychology.

Part of the magic of medicine is the interface between mind and body. Submitting our physicial woes to the care of an expert confers some healing, even when that expert administers nothing more than a sugar pill. Some of that magic is lost when a double-blind study becomes more transparent. Placebo effects disappear when the "authoritative" treatment is revealed to be no more than a sugar pill. The mind, in seeking to make meaning of one's treatment "allows" the body to heal, perhaps even facilitating healing. By denying ourselves the optimism that a treatment may work (even if it's week 5 out of a 6-week trial) we may suffer.

How much do we sacrifice by stripping experts of their authority? By memorizing receptor subclasses and their respective agonists, we may neglect the large part of physicians' knowledge that is acquired through their interactions with scores of patients, over the life of their careers.

Empiricism in medicine takes the form of published, peer-review studies, but one cannot neglect the more casual empirical observations made over the course of a lifetime of practice.

Often in the search for a comprehensive theory of some mental illness scientists fail to appreciate the contribution of individual differences. Large studies of samples use methodology that is often insensitive to meaningful individual variation. For instance, Freud's early hypothesis that all neuroses were a result of early childhood sexual abuse was rejected by him later in his career, because he somehow "knew" that surely not ALL of his patients were molested. This theory neglected to consider that neurosis, unlike tuberculosis, may not be caused by a single factor (a bacterium, for instance). Another example is the monoamine theory of depression. If depression were a homogeneous condition, one might expect all people to respond to a treatment in similar fashion. The current empirical research on mental disorders seems stuck in the pattern of defining an illness in ever narrower terms, in the hope that its cause may be reduced to a single factor, be it a gene, or a neurotransmitter, or a childhood event. Of course, most of us know (if not abstractly, then from personal experience) that mental illness is a complicated thing; even if one falls neatly into a diagnostic category, one may not respond with the standard therapy.

A good doctor can often suggest a novel or unorthodox combination, based on her experience with treatment-resistant patients, and by having observed a diverse range of symptom clusters and illness subtypes. The qualities of the human mind that permit judicious application of therapies to symptoms is far beyond what a computer or a textbook can accomplish. Human doctors are experts in decision making, and they have more information available to them than we do. Our knowledge of our own responses to treatments must contribute to their decision-making as well. But I'm not convinced that it can supplant a doctor's experience and power to observe us without being wrapped up in our consciousness (and possibly hypochondria)

-Ll

 

Re: The stakes are too high.

Posted by bulldog2 on August 19, 2008, at 14:58:23

In reply to The stakes are too high., posted by SLS on August 19, 2008, at 8:11:07

> The stakes are too high for us to think we can manage our illnesses based upon our own personal theories or biases.
>
> This really calls for a longer post, but this is where I'm at right now. I am losing hope that the majority of people posting on Psycho-Babble will begin to look at scientific data rather than try to theorize their way into believing they have accomplished more than our researchers have. The NIH has pleaded that the details of investigation become public knowledge.
>
> It is very dangerous to think that we know more than doctors and that we are well beyond the point of accepted medical science. As of August 19, 2008, medicine has huge amounts of data, but little understanding. The jigsaw puzzle has not been assembled yet.
>
> Why bother with a post like this?
>
> I see too many people aborting drug trials early, only to plead with their doctors to try something else that their simplistic theories encourage. I see too many people become cynical towards doctors and drugs, developing a global opinion that drugs don't work and doctors are clueless. This is tragic.
>
> One will almost never get well if each drug trial is aborted before 6 weeks. Why would someone even consider taking drugs if they have the opinion that drugs don't work? That seems very odd to me.
>
> When treating depression, it increases the rate of success by being positive and constructive. Why sabotage your treatment with an armament of negative thoughts? Not smart.
>
> Belief systems have an impact on mental health. It is imperative that someone learn to manage psychosocial stress so that the same old depressive pressures prevent them from responding to drug treatment or relapsing during the course of remission.
>
> Is it fun to be a skeptic or a cynic? I think that for some people, it is. Some people love drama. It seems that provocation and debate can have its emotional rewards. I know I have involved myself in ongoing contraversy. It is stimulating.
>
> What good is stating a contraversial opinion without doing the investigation on Google or Medline to substantiate it? Even these two resources do not provide a consistency of data and conclusions. Citations are often more persuasive than personal conjecture. They certainly help provide a basis for belief.
>
> Bottom line: Spend more time trying different treatments and less time expounding their worthlessness. Begin to focus more on clinical observation than choosing drugs based on personal theory. Maybe here lies the problem. Some people consistently sabotage their treatment and will never get well.
>
> The stakes are too high to invest ourselves in theory and self-medication rather than the treatment by professonals, whether guided by heuristics or algorithms.
>
> Take your medication as prescribed and stop worrying about being "med sensitive". You are supposed to be sensitive to these powerful drugs. Try lower and slower if necessary. Some of this sensitivity are startup side effects that often mitigate after a few months on a drug. If you are med sensitive, then spend some time theorizing how you might best establish a clinically therapeutic dosage and stay on the drug long enough for a clinically therapeutic period of time.
>
> I think I project a great deal of my recent success using drug therapy onto the majority. It is wishful thinking, I know, but sometimes wishful thinking leads to success.
>
> Don't stop.
>
> You have only one chance at life. Don't waste too many ticks of the clock thinking that you are smarter than man's current compendium of knowledge.
>
> By the way, drugs work.
>
>
> - Scott
>

As I stated in another post I believe in diet and exercise to be as healthy as I can be on my own. While I'm in good shape for my age and my blood tests also come back as wonderful that has not innoculated me from panic attacks, anxiety and depression. I believe some of this is genetic as some in my immediate family had some of these mental disturbances. So one would have to be naive to believe that eating well and exercising will make one immune from mental disease. For those with situational anxiety or depression there maybe hope to conquer your mental issues with diet and exercise if an improper life caused them to begin with. However those with mental disease with genetic roots or early childhood trauma are unlikely to eat or exercise their way out of mental illness anymore than you correct a faulty heart valve with exercise.
I myself am not in remission and I take full responsibilty for it. I have aborted numerous drug trials because of the inabilty to tolerate sides. But I realize i pay a price for this decision in that my life is not as full as it could be.

 

Re: The stakes are too high.

Posted by seldomseen on August 19, 2008, at 18:09:39

In reply to The stakes are too high., posted by SLS on August 19, 2008, at 8:11:07

I've always thought that if I was smarter than my doctor, then it was time to get a new doctor.

 

Re: The stakes are too high.

Posted by Hygieia's Bowl on August 19, 2008, at 18:42:58

In reply to Re: The stakes are too high., posted by seldomseen on August 19, 2008, at 18:09:39

Maybe there's tendency to see the views of the vocally active (can't think of another way to express that) and see it as the way the "most" feel or behave or handle their treatment plans?

Maybe I'm "vocalling" the obvious?;)

 

Re: The stakes are too high. » Hygieia's Bowl

Posted by atmlady on August 19, 2008, at 22:18:53

In reply to Re: The stakes are too high., posted by Hygieia's Bowl on August 19, 2008, at 18:42:58

I agree with you, Hy.

As much as I rant on about the evil Lexapro, and despite the 10 or 12 or perhaps 100 other people on babble who also cannot tolerate Lexapro, I know there are 1,000,000 or more people out there who love Lexapro, who don't experience weight gain or sexual side effects. I wish I was one of them. I REALLY, REALLY do.

Unfortunately, I am on on one of the short ends of the Lexapro-effectivity bell curve. I am on babble because I want to find a solution that works for me, not because I enjoy complaining about my pdoc or my symptoms. I'd wager that the majority of people on babble are like me, and that more babblers are lurkers than are posters. And when the lurkers DO post, you'll find that many of them have been on their current meds 2, 3, 10 years or so.

If you go back and search the babble boards going back a few years, you'll see the same pattern that exists today: a core group of 40 or so regular posters (those having major difficulty finding the right med) and the occasional random posting of a lurker. For the most part, the regular posters of of two years ago are not the regular posters of today. Could this mean they have found what they were seeking? The med(s) that worked for them? That's my assumption, and it gives me hope that two years from now, WE will have found our solutions, too!

Don't remember where I read this, but I love the saying "Leap, and the net will find you." Those of us who are experimenting, I view as leaping. When I lamented to my new pdoc that it seemed like I could either be happy, but fat and anorgasmic or I could be depressed, he threw up his hands as if, well, what can I do about it, that's just the way it is. But I'm not accepting that, at least not without a fight. I'm going to exhaust every avenue (because I have finally accepted that I need medication after years of saying NO NO NO). Maybe I'll find my magic combo in two years. Maybe in 20 years I'll just give up and say to heck with men, to heck with what I look like, I don't care, give me an IV of Lexapro. But either way, I think I'll still lurk on babble, still want to learn, still need the comfort of knowing I'm not the only one who refuses to settle for something less than the perfect anti-depressant.


 

Re: The stakes are too high.

Posted by Cecilia on August 20, 2008, at 0:26:13

In reply to The stakes are too high., posted by SLS on August 19, 2008, at 8:11:07

There are many different types of side effects. I could care less if a med decreases my libido, which is already zero, and I am already fat, with very painful health problems as a result, so while I don't want to gain any more weight, I would be willing to if an antidepressant actually worked; it would mean a shorter and more physically painful life, but a short period of less emotional pain before I died would be worth it. I think of side effects in terms of "can I function with this?". I could not function with Effexor unless I wanted to spend my entire life within 2 feet of the bathroom, and yes, I started at the smallest possible dose. I could not function with the severe eye pain of Emsam or Nardil. Some meds I have given up on before the magic six weeks and others I have forced myself through a trial despite horrible side effects but it has nothing to do with any theories, just what I can stand. Some of the trials I have forced myself through have been basically self punishment for being depressed. My pdoc, who is supposed to be an expert on treatment resistant depression has long since run out of ideas and could care less, just tells me to try therapy again, when I have already spent a fortune on useless therapy. I stand in awe of the high doses of meds that you are able to tolerate, Scott, but everybody's metabolism is different. Nobody wants to be depressed and we are all doing the best we can. Cecilia

 

Re: The stakes are too high. » Cecilia

Posted by SLS on August 20, 2008, at 5:08:11

In reply to Re: The stakes are too high., posted by Cecilia on August 20, 2008, at 0:26:13

Hi Cecilia.

> There are many different types of side effects. I could care less if a med decreases my libido, which is already zero, and I am already fat, with very painful health problems as a result, so while I don't want to gain any more weight, I would be willing to if an antidepressant actually worked; it would mean a shorter and more physically painful life, but a short period of less emotional pain before I died would be worth it. I think of side effects in terms of "can I function with this?". I could not function with Effexor unless I wanted to spend my entire life within 2 feet of the bathroom, and yes, I started at the smallest possible dose. I could not function with the severe eye pain of Emsam or Nardil. Some meds I have given up on before the magic six weeks and others I have forced myself through a trial despite horrible side effects but it has nothing to do with any theories, just what I can stand. Some of the trials I have forced myself through have been basically self punishment for being depressed. My pdoc, who is supposed to be an expert on treatment resistant depression has long since run out of ideas and could care less, just tells me to try therapy again, when I have already spent a fortune on useless therapy.

> I stand in awe of the high doses of meds that you are able to tolerate,

Don't be. My lack of sensitivity is probably an index of treatment resistance because of my exposure to many different drugs. I didn't get that way overnight, to be sure.

I'm sorry that 12.5mg of Effexor was intolerable for you. The first antidepressant I tried was imipramine. The doctors at Columbia Presbyterian started me at 10mg and had me increase the dosage very slowly. Yes, I had side effects at 50mg, but I was able to get up to 450mg after a few months. I am probably a rapid metabolizer of P450 D26 enzyme. Still, most people tolerated 150-200mg.

> Scott, but everybody's metabolism is different. Nobody wants to be depressed and we are all doing the best we can.

Understood.

I am fortunate that my doctor and I work collaboratively. I do present him with ideas and data, some of which I owe to Psycho-Babble.

I really don't care how people get well, as long as the treatment is inherently safe.

As I said in my first post, I realize that I am projecting onto others my own success. I figure someone ought to.


- Scott

 

Re: The stakes are too high. » SLS

Posted by Cecilia on August 20, 2008, at 6:47:40

In reply to Re: The stakes are too high. » Cecilia, posted by SLS on August 20, 2008, at 5:08:11

I am glad that you finally had success and hope it lasts. It's just that from my experiences with lower doses I can not begin to imagine taking the high doses of Nortriptyline and Nardil you take. I have learned the hard way to always always start with the quarter of the smallest tablet available, with some like Wellbutrin and Nortriptyline I worked up over many many months. I was counting out beads on Cymbalta, could never make it up to a therapeutic dose. Some people really ARE med sensitive. I have also learned the hard way that due to my anxiety I can not tolerate anything with norephineprine. Interesting that going through so many trials made you more able to tolerate meds, with me it's been the opposite. Some meds that were tolerable (though not helpful) on a first trial were unbearable on a second. Who knows what all these meds have done to my brain. I think my depression is secondary to my anxiety, which is probably secondary to genetic factors and a lousy childhood. Anyway, just felt hurt by the implication that people don't get better because they aren't willing to put up with side effects, when I had been through SO many horrible ones. But of course I understand that everyone is different, I am so constantly amazed at people giving up effective meds because of loss of libido, so incredibly jealous of them for actually finding a med that works with what to me is a meaningless side effect but what is obviously a deal breaker for them. But obviously that is their right, everybody has different priorities in life. Cecilia

 

Re: The stakes are too high. » atmlady

Posted by Hygieia's Bowl on August 20, 2008, at 7:33:13

In reply to Re: The stakes are too high. » Hygieia's Bowl, posted by atmlady on August 19, 2008, at 22:18:53

Hey There Ms. atm

> I agree with you, Hy.

I am so very pumped as I rarely get an agreement. ; )

I am slowly realizing I am allowing the posted experiences of a few to cloud how I preceive and evaluate the manner in which folks are going about their treatment plans and maybe, just maybe, I'm not seeing the forest for the trees.

I wish you the very best in your quest. I've been doing well for some years now and it's a wonderful thang.

 

Re: The stakes are too high. » Cecilia

Posted by SLS on August 20, 2008, at 8:03:35

In reply to Re: The stakes are too high. » SLS, posted by Cecilia on August 20, 2008, at 6:47:40

Don't get mad at me for trying.

Something I read recently demonstrated that, for certain drugs, more is better when it comes to a starting dosage to avoiding side effects. Prozac and Geodon are examples. Prozac at 20mg is probably less problematic than at 5mg. At lower dosages, it can be anxiogenic, at higher dosages it becomes anxiolytic and antidepressive. The same thing has been shown to be true of Geodon. It is less problematic at 40mg than it is at 20mg. I wonder if Abilify follows a similar pattern. I also wonder if at lower dosages, Effexor is more dopaminergic relative to serotonin and norepinephrine and more likely to produce a nausea that lingers.

With Abilify, I started at 20mg. I had very little problem with agitation, restlessness, or anxiety. The doctor who managed me was pretty smart.

Anyway, I am still on your side, even if my current positive outlook becomes annoying.

Any chance of mixing Wellbutrin with Lamictal?


- Scott


 

Re: The stakes are too high. - SLS

Posted by Justherself54 on August 20, 2008, at 11:32:39

In reply to Re: The stakes are too high. » Hygieia's Bowl, posted by atmlady on August 19, 2008, at 22:18:53

I'm not as articulate as some who post but here goes..I noticed in one of you posts you had put med sensitive in quotes. I consider my self med sensitive or side effect sensitive and so does my pdoc. I have had cease med trials early but have given some a fair trial despite some grim side effects. It just becomes a matter of how much you are willing to tolerate.

Despite a weight gain of 20 pounds on an already obese body I stuck with Nardil, even though it caused awful urinary problems. I had to have a potty downstairs as I'd never made it up the stairs. Going out was a lovely challenge. I had the drunken sailor walk, my typing looked like I had developed severe dyslexia. Oh, and the clincher which make my pdoc pull me off it..projectile vomiting in my sleep...nothing like waking up choking every night.

I'm on parnate right now, waiting for it to give me some partial benefit as I've put in so much time giving it a "fair trial", despite the fact I clench my back muscles so badly at night I wake up with my back arched and completely off the mattress. I have fibromyalgia and it's playing havoc with it.

On the flip side, amitriptaline got one day's trial as it knocked me out cold for 12 hours. So did nortriptaline.

Effexor made me want to hang off the ceiling like a scared cat. Wellbutrin made me a non-functioning zombie.

Paxil, Zoloft, Lexapro were great, except they all quit working within 6 months to a year and also added 60 pounds. I was quite slim and attractive at one time, now I feel like a beached whale.

I won't even go into the mood stabilizers.

We all have different tolerances for this meds. I read the posts where someone has achieved remission and I'm so happy for them. For me, when I achieve remission, I have to simply enjoy it while it lasts, because for me, it never does.

And when I read posts where someone has gained a ton of weight on these meds, my heart bleeds for them, as being obese not only affects your health, it also adds to your depression and erodes your self esteem.

One has to be careful when achieving remission, as you feel you've won the battle...in my experience when I've achieved remission, it's just a cease fire until the next battle begins and I'm pretty scared as I'm just about out of ammunition.

I don't blame my doctor, the drug companies, my childhood nor myself, it is what it is..

I come to babble as I don't feel so alone, as there are many who are dealing with constant failed med trials. Who am I to say anyone hasn't given some of them a fair trial. We each have our own unique makeup and perhaps some are in just too fragile a state to cope with heavy side effects.

 

Re: The stakes are too high. » bulldog2

Posted by Bob on August 20, 2008, at 12:12:32

In reply to Re: The stakes are too high., posted by bulldog2 on August 19, 2008, at 14:58:23


> As I stated in another post I believe in diet and exercise to be as healthy as I can be on my own. While I'm in good shape for my age and my blood tests also come back as wonderful that has not innoculated me from panic attacks, anxiety and depression. I believe some of this is genetic as some in my immediate family had some of these mental disturbances. So one would have to be naive to believe that eating well and exercising will make one immune from mental disease. For those with situational anxiety or depression there maybe hope to conquer your mental issues with diet and exercise if an improper life caused them to begin with. However those with mental disease with genetic roots or early childhood trauma are unlikely to eat or exercise their way out of mental illness anymore than you correct a faulty heart valve with exercise.
> I myself am not in remission and I take full responsibilty for it. I have aborted numerous drug trials because of the inabilty to tolerate sides. But I realize i pay a price for this decision in that my life is not as full as it could be.


I wouldn't be too hard on yourself for not being in remission or feeling that side effects are intolerable. There are, after all, two sides to the issue in this post.

There really are people who's quality of life is so reduced from side effects that the meds are only technically tolerable, just like someone who hasn't eaten in three days could technically choose to not eat a plate of food sitting in front of them.

Although we have to be careful about choosing meds based on our theories, all the treatments are based on theories that are in the end, disconcertingly similar in many cases.

 

Re: The stakes are too high. » Cecilia

Posted by Bob on August 20, 2008, at 12:17:55

In reply to Re: The stakes are too high., posted by Cecilia on August 20, 2008, at 0:26:13

> There are many different types of side effects. I could care less if a med decreases my libido, which is already zero, and I am already fat, with very painful health problems as a result, so while I don't want to gain any more weight, I would be willing to if an antidepressant actually worked; it would mean a shorter and more physically painful life, but a short period of less emotional pain before I died would be worth it. I think of side effects in terms of "can I function with this?". I could not function with Effexor unless I wanted to spend my entire life within 2 feet of the bathroom, and yes, I started at the smallest possible dose. I could not function with the severe eye pain of Emsam or Nardil. Some meds I have given up on before the magic six weeks and others I have forced myself through a trial despite horrible side effects but it has nothing to do with any theories, just what I can stand. Some of the trials I have forced myself through have been basically self punishment for being depressed. My pdoc, who is supposed to be an expert on treatment resistant depression has long since run out of ideas and could care less, just tells me to try therapy again, when I have already spent a fortune on useless therapy. I stand in awe of the high doses of meds that you are able to tolerate, Scott, but everybody's metabolism is different. Nobody wants to be depressed and we are all doing the best we can. Cecilia


Excellent post, Cecelia. I too am amazed at what Scott and some others on this board are able to tolerate, when in some cases for me, practically any one of the meds in their cocktail would present severe problems for me. It's odd to find oneself in a position of envy (for lack of a better term) of someone who can take large cocktails of AD's.

 

Re: The stakes are too high. » SLS

Posted by Bob on August 20, 2008, at 12:24:42

In reply to Re: The stakes are too high. » Cecilia, posted by SLS on August 20, 2008, at 8:03:35

> Don't get mad at me for trying.
>
> Something I read recently demonstrated that, for certain drugs, more is better when it comes to a starting dosage to avoiding side effects. Prozac and Geodon are examples. Prozac at 20mg is probably less problematic than at 5mg. At lower dosages, it can be anxiogenic, at higher dosages it becomes anxiolytic and antidepressive. The same thing has been shown to be true of Geodon. It is less problematic at 40mg than it is at 20mg. I wonder if Abilify follows a similar pattern. I also wonder if at lower dosages, Effexor is more dopaminergic relative to serotonin and norepinephrine and more likely to produce a nausea that lingers.


Scott, have you come across any articles in the med literature that you might be able to point me two about the differing responses at different doses?


>
> With Abilify, I started at 20mg. I had very little problem with agitation, restlessness, or anxiety. The doctor who managed me was pretty smart.

Isn't it difficult to say with certainty why you responded the way you did to Abilify since you already had a number of meds on board which would be producing significant anxiolytic effects, and thus fighting any restlessness you might have otherwise gotten from Abilify?


>
> Anyway, I am still on your side, even if my current positive outlook becomes annoying.
>
> Any chance of mixing Wellbutrin with Lamictal?
>
>
> - Scott
>
>
>

 

Re: The stakes are too high. » Bob

Posted by SLS on August 20, 2008, at 12:33:14

In reply to Re: The stakes are too high. » SLS, posted by Bob on August 20, 2008, at 12:24:42

Hi Bob.


Are All Atypical Antipsychotics Equal for the Treatment of Cognition and Affect in Schizophrenia?

Chairperson: Stephen M. Stahl, MD, PhD; Faculty: Herbert Y. Meltzer, MD; Jonathan M. Meyer, MD; Lili C. Kopala, MD, FRCPC


Copyright © 2004 The Center for Health Care Education, LLC

"Are All Atypical Antipsychotics Equal for the Treatment of Cognition and Affect in Schizophrenia?"

A symposium held at the Hilton New York in New York, New York, on May 2, 2004.


Stephen Stahl:

"Here's a very interesting thing about ziprasidone. Have you ever given ziprasidone at 20 mg and had a patient become activated and agitated? If you have, the reason is that the dosing is too low. Because this is such a powerful 5HT2C antagonist, at low doses, that's all it does. It doesn't have any dopamine antagonism, so it's potentially activating -- at least for those people whose genes don't want to have their 5HT2C receptors blocked. Have you ever given a dose of fluoxetine (Prozac) to a patient and had them have an activation? Fluoxetine is the only other drug that has powerful 5HT2C antagonist properties; in fact, fluoxetine has more powerful antagonist properties than reuptake blocking properties. To prevent this, you've got to do a counterintuitive thing, which is to stop using 20 mg, because you're going to make patients "go bonkers." You've got to use probably 60 mg to have enough robust D2 on board so that the patient doesn't get activated. This is an art. Some patients tolerate different doses than others; but the counterintuitive thing is that you raise the dose, you get less activation. If you've had bad experience with this particular drug, that might help you understand how to dose it."


- Scott

 

Re: The stakes are too high. - SLS

Posted by SLS on August 20, 2008, at 12:35:10

In reply to Re: The stakes are too high. - SLS, posted by Justherself54 on August 20, 2008, at 11:32:39

> I noticed in one of you posts you had put med sensitive in quotes. I consider my self med sensitive or side effect sensitive and so does my pdoc.

Your point is well taken, and I do apologize.


- Scott

 

Re: The stakes are too high. - Above post is to: (nm) » Justherself54

Posted by SLS on August 20, 2008, at 12:38:38

In reply to Re: The stakes are too high. - SLS, posted by Justherself54 on August 20, 2008, at 11:32:39


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