![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by bleauberry on March 24, 2018, at 6:38:54
***my own comments are added in parenthesis
***when I say "in the real world" I am referring to two Medical Doctors and one Nurse Practitioner who have treated me and shared with me their own clinical experience with psychiatric patients - their experience is more valuable to me than the gathered literature of this study, which had no patients and no doctors, just literature gathered, and analyzed from the vantage point of academia not real world experience - we have no idea how complete, incomplete, biased, slanted, or whatever, the gathered literature was. But regardless, this one study supports my claims that everyone here needs to consider this stands a more than 50/50 chance of being their actual problem.Lyme disease: a neuropsychiatric illness.
Fallon BA1, Nields JA.
Author information
Abstract
OBJECTIVE:
Lyme disease is a multisystemic illness that can affect the central nervous system (CNS), causing neurologic and psychiatric symptoms. The goal of this article is to familiarize psychiatrists with this spirochetal illness.
METHOD:
Relevant books, articles, and abstracts from academic conferences were perused, and additional articles were located through computerized searches and reference sections from published articles.
RESULTS:
Up to 40% (ACCORDING TO REAL DOCTORS NOT GATHERED LITERATURE THE REAL ESTIMATED PERCENTAGE IS CLOSER TO 90% - my own comments) of patients with Lyme disease develop neurologic involvement of either the peripheral or central nervous system. Dissemination to the CNS can occur within the first few weeks after skin infection. Like syphilis, Lyme disease may have a latency period of months to years before symptoms of late infection emerge. Early signs include meningitis, encephalitis, cranial neuritis, and radiculoneuropathies (EARLY SIGNS ARE OFTEN NOTHING AT ALL - my own comments) Later, encephalomyelitis and encephalopathy may occur. ("MAY" OCCUR - maybe, might, may, but leaves out 100 other potential problems). A broad range of psychiatric reactions have been associated with Lyme disease including paranoia, dementia, schizophrenia, bipolar disorder, panic attacks, major depression, anorexia nervosa, and obsessive-compulsive disorder. Depressive states among patients with late Lyme disease are fairly common, ranging across studies from 26% to 66% (real world is closer to 90%) The microbiology of Borrelia burgdorferi sheds light on why Lyme disease can be relapsing and remitting and why it can be refractory to normal immune surveillance and standard antibiotic regimens. (this is why the books are so important, as to understand the science that is happening in the body)
CONCLUSIONS:
Psychiatrists who work in endemic areas (not just endemic areas - everywhere - people move, ticks show up where they are not supposed to, ticks fly with birds anywhere, ride on mice) to include Lyme disease in the differential diagnosis of any atypical psychiatric disorder. Further research is needed to identify better laboratory tests and to determine the appropriate manner (intravenous or oral) and length (weeks or months) of treatment among patients with neuropsychiatric involvement.(this kind of research and testing is simply not possible - because the infections present themselves differently from person to person, depending on genetics and condition of the immune system, with psychiatric symptoms being the common denominator in 9 out of 10 cases. one patient can get better in 2 weeks of treatment, another requires 2 months, another 9 months, me 36 months, and often multiple medications are required, which vary from patient to patient, depending on their presentation. This would be impossible to accurately test in a lab setting) the variables are too massive to try to squeeze nice and neat into a box, or into "more research".
One patient may have 'clusters of symptoms' which are more consistent with Bartonella than Borellia. Or maybe Babesia. Depending on the presentation, they require different prescriptions. Antibiotics effective against Borellia are not very effective against the other 2. Babesia is a parasite that requires treatment with anti-malaria meds and herbs. I'm just briefly mentioning these things to show how impossible it would be to test populations in a clinical setting.
More research is NOT needed. What IS NEEDED is for existing current psychiatrists and patients to study and learn the information which we already have. We have all we need already. Everything we need is found in a book called "Why Can't I Get Better" - Richard Horowitz.
In my case 3 years treatment, following 20 years of failed meds and failed ECT, multiple suicide attempts, then 2 years remission, and now treatment on 3 antibiotics again due to relapse - thankfully my current relapse (or possibly new infection from fire wood) doesn't have the same dark psychiatric stuff the original presentation did - this one presents itself as massive anxiety, tremors, stage fright, shaking, for no explainable reason - my condition is the kind of thing doctors prescribe Lorazepam for - but that won't cure anything - antibiotics will.
This article only mentions one of the Lyme infections - the spirochete. It does not mention the other common co-infections, which include Bartonella (bacteria), Babesia (parasite), Mycoplasma (cell wall deficient bacteria), chlamydia, rickettsiosis, and a dozen or so more, including some viruses - all of which cause the entire spectrum of psychiatric illnesses.
We attempt to manage symptoms with reuptake inhibitors, and then exotic combos which fall short of successful management, and have obviously nothing to do with the infection itself, or inflammation, or endotoxins, or anything useful. Psychiatric drugs are awesome for managing short term or acute symptoms. But for long lasting enduring maximum improvement of quality of life, that requires a more comprehensive effort than merely seeing the doc for a psychiatric prescription. That rarely results in the desired outcomes, if you ask me. Imo
You have other symptoms besides your mood and behavior issues. It is wrong to assume those are separate issues from your psychiatric issues. Skin, gastro, muscles, bones, eyes, ears, hormones, glands - there is more going on that just your mood, and without writing another book to explain it all, they are attached to the mood issues. They are not separate issues.
We wonder why we can't get better. Sometimes it is because we just don't have all the information we need. Like, for example, the knowledge that chronic stealth unsuspected infections and psychiatry are married into a nice cozy deceptive marriage. Lyme is called THE GREAT IMITATOR for a reason! THE GREAT DECEIVER. Depression, Anxiety. Schizophrenia. Arthritis. Fibromyalgia. Chronic Fatigue Syndrome. Lupus. Multiple Sclerosis. Skin symptoms. Muscle symptoms. Bone symptoms. Gastrointestinal symptoms. On and on. Every part of the body can be impacted. Usually there are multiple issues going on that can be grouped into 'clusters of symptoms' which paint a story. Ticks can cause just about any disease or syndrome you can think of. The Great Imitator. There are even cases where the lesions on the brains of MS patients disappeared with long term antibiotic treatment. Alzheimers can improve with antibiotics. Dementia. It all should cause anybody with a little bit of curiosity to ask more questions and learn as much about this as possible. Because the potential benefits are huge! And, in my opinion, significant gains are within reach, even when the best of psychiatry has fallen short of desired goals.
One single nymph tick which is smaller than the tip of a writing pen can do all of that and you will never even see the tick. They are in cities, lawns, states where they aren't supposed to be, and of course anywhere off of the concrete sidewalk. I have actually personally seen ticks crawling up the bricks on the side of Walmart by the automotive department. Ticks are not supposed to crawl on rocks! Or across streets! But they do! Seen it myself.
Those in the know claim this issue is epidemic. I happen to agree, based on wisdom gathered by experience.
Personally, I say forget about the term "lyme". It is misleading. It is natural for people to think "oh that only happens to other people" or "I don't recall a tick bite" or "I never had a rash" or "my test was negative" or "I am too healthy" or whatever. On and on.
What really matters is not the name you give it, but the strategies employed. The blanket shotgun strategies, as well as some pinpoint tactics, include 4 basic pillars for the entire comprehensive treatment plan to get any psychiatric patient to their fullest functionality. 1.Anti-microbials 2.Anti brain inflammation. 3.Anti-systemic inflammation. 4.Toxin removal.
Some doctors do all that with just prescription antibiotics and time. When the pathogenic load is reduced in the body, the other symptoms automatically improve.
Some doctors do all that with just herbs and supplements. But many agree that many patients need meds to 'get over the hump'. Herbs are amazing for anti inflammation, anti toxin, and anti microbial, but often fall slightly short of remission.
Some doctors combine hybrid strategies of meds plus herbs. That is my favorite treatment approach because it covers so much of the mysteries we will never have answers for. And the results are better and faster than either meds alone or herbs alone.
The Chinese doctors describe it as "Support the righteous and dispel the evil". Doing that clears the brain of mood symptoms in ways that SSRIS and TCAs simply cannot do. 'Support the righteous' is translated as - support the immune system, balance the immune system, balance the hormones, remove toxins, help the body in every way'. 'Dispel the evil' means eliminate or reduce pathogenic insults and bad living habits, such as a sugary diet'
Really there is just too much to say and too little space. Need to write a book. How about suggestions for the title?
What Every Psychiatrist Should Know About Ticks. ???
Posted by SLS on March 24, 2018, at 7:19:05
In reply to Lyme disease - a neuropsychiatric disease, posted by bleauberry on March 24, 2018, at 6:38:54
This guy is a hell of a doctor. I hope you find some of what he writes helpful.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5481283/
- Scott
Posted by bleauberry on March 24, 2018, at 8:01:35
In reply to Re: Lyme disease - a neuropsychiatric disease » bleauberry, posted by SLS on March 24, 2018, at 7:19:05
That is very interesting. Thank you for that.
My personal hypothesis is that most - maybe 7 of 10 - suicides are actually due to a serious brain insult from an ongoing unsuspected tick-born infection, not due to a life crisis.
I also commonly see the 'molehill to mountain' phenomenon, where normal every day things which are molehills in your life - issues but not big issues - become unsurmountable mountains. Nothing actually changed except your perception. The issue which is a molehill in your life didn't suddenly turn into a mountain - but your perception of it did. That is very commonly what a tick-born infection does to a person's thinking and behavior. And it is my hypothesis that in this stage is where suicide is at great risk, because the person has no idea what is happening, feels totally out of control, and because the mountain looks so huge it feels hopeless. Hopeless = suicide.
Disseminating new knowledge upon physicians and psychiatrists seems ridiculously, painfully, almost torturously slow. I am always encouraged when progress is made.
As an example, when I got my clinical diagnosis and started treatment 5-6 years ago, there were no LLMDs in my state. None. I had to drive 6 hours round trip to Dartmouth Medical School in a neighboring state to see one of the six LLMDs in that state. I later switched to my 2nd LLMD who was only a 3 hour round trip. But today, in my own state, there are two LLMDs and one LLNP. These people already know today, especially in terms of psychiatry, what the average doctor probably won't know for another 5-10 years. The process is torturously slow! And the CDC is little assistance, though they seem to be slowly admitting over time they kind of got it wrong all these years on some of their initial assumptions of tick born disease.
For short term or acute management of symptoms these are my general population favorites:
Prozac first, Zoloft 2nd.
Zyprexa first, Abilify or Seroquel 2nd.
Ritalin first, Adderall second.
Nortriptyline
Alprazolam or LorazepamFor long term:
Comprehensive, psychiatric meds are only a portion of a larger integrated approach.Maximum time from beginning of psychiatric treatment to either remission or maximum functionality - significant improvements - 5 years. I think when we take longer than that, as I did, as many here do, then we are doing something wrong and should be more curious, asking more questions, expanding the field of knowledge outside of the limited scope of brain-altering chemicals.
That is just my vantage point and opinion, based on the school of hard knocks and experience.
> This guy is a hell of a doctor. I hope you find some of what he writes helpful.
>
> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5481283/
>
>
> - Scott
Posted by SLS on March 24, 2018, at 8:37:11
In reply to Lyme disease - a neuropsychiatric disease, posted by bleauberry on March 24, 2018, at 6:38:54
Bleauberry, you wrote,
"In my opinion, all psychiatric patients should do a 3 month trial of Cordyceps mushroom - the dose is 6000mg and up."
Dr. Bransfield has not yet begun to follow your protocol. I'll ask him the next time I see him as to why not. He will, on certain patients, utilize doxycycline based on clinical presentation and not biological tests... just in case Lyme or some other tick-borne disease is involved. It was the first thing he added to my regime while we began to formulate a plan for the use of psychiatric medications. It was interesting that 3 months of doxycycline had no effect on my disease state while minocycline improved my depression within 3 days. How would you explain this? Anti-bacterial (inhibit protein synthesis)? Intrinsic anti-inflammatory activity in the brain (microglia)? Glutamatergic activity modulation (glutamate release)? The two drugs are not the same. Two people aren't the same. I definitely wouldn't generalize that minocycline is just another tetracycline class antibiotic. If doxycycline doesn't help, minocycline might.
- Scott
Posted by SLS on March 24, 2018, at 8:48:40
In reply to Re: Lyme disease - a neuropsychiatric disease » SLS, posted by bleauberry on March 24, 2018, at 8:01:35
> That is very interesting. Thank you for that.
>
> My personal hypothesis is that most - maybe 7 of 10 - suicides are actually due to a serious brain insult from an ongoing unsuspected tick-born infection, not due to a life crisis.Where did you get the "7 of 10" statistic? That seems rather high.
> I also commonly see the 'molehill to mountain' phenomenon, where normal every day things which are molehills in your life - issues but not big issues - become unsurmountable mountains. Nothing actually changed except your perception.
Depending on the underlying pathology, CBT will help some people while antidepressants will help others. Ideally, pharmacotherapy and psychotherapy can be employed together.
> For short term or acute management of symptoms these are my general population favorites:
>
> Prozac first, Zoloft 2nd.
> Zyprexa first, Abilify or Seroquel 2nd.
> Ritalin first, Adderall second.
> Nortriptyline
> Alprazolam or LorazepamNice list.
Why did you choose Prozac over Lexapro?
- Scott
Posted by Phillipa on March 24, 2018, at 9:10:33
In reply to Re: Lyme disease - a neuropsychiatric disease, posted by SLS on March 24, 2018, at 8:48:40
I had Lymes disease never took an herb and don't take anymore antibiotics. All one needs it 2-4 weeks of doxycycline. I did get IV Rocephin for two days and got rid of the pic line and took Biaxin XL for two years 2 months on and two off. Years later at age 72 I take minimal miniscule not even theraputic doses of luvox and lexapro and same with valium & xanax. And Vita C 2000mg a day taken for over 40 years, MVI, Cal/MG with D and Magnesium at night. That is it. This whole lymes thing is simply nuts. And that's my rant. Continue on. Phillipa
Posted by linkadge on March 24, 2018, at 10:01:56
In reply to Re: Oh for goodness sake!!!!, posted by Phillipa on March 24, 2018, at 9:10:33
I agree.
(sorry blueberry). It's not all Lymes disease.
Linkadge
Posted by bleauberry on March 25, 2018, at 6:01:46
In reply to Re: Lyme disease - a neuropsychiatric disease » bleauberry, posted by SLS on March 24, 2018, at 8:37:11
SLS I have some great chapters in books with immense information - both traditional and scientific - on Cordyceps. In the coming days if I can I will try to gather together some of the main highlights as it pertains to psychiatry.
So Doxy did nothing but Mino had a good response in 3 days. I doubt anyone on earth can actually explain that but I think I have a reasonable hypothesis.
Borellia is a tricky bacteria, intelligent, with the ability to morph itself into 3 different forms. Within minutes of exposure to danger, such as a hot immune system or antibiotics, they switch into either the L form or the cystic form. Whichever of the two forms they switch into - and they can do this literally in minutes to hours - the different forms are not susceptible to the same antibiotics.
For example Doxy is effective against the main form of Borellia, but not the cystic form. It could be that as soon as you started dosing Doxy, they morphed, and the Doxy was no longer the right choice. In simple terms, it is more wide spectrum than Doxy is.
But Mino is different. It has the ability to do things that Doxy cannot do. Tetracycline - Doxy's dad - is also different than either, and has characteristics unique to it. Mino has been used in other longterm protocols unrelated to lyme, for cell-wall deficient bacteria and other obscure things that Doxy is not appropriate for.
When a suspected lyme patient starts treatment, there is a short window of "feeling better than in a long time" which usually happens between day 2 and day 5. It sounds like that may have happened with you on day 3.
But it is more complicated than that. I am not aware of any patients who ever got better on any single antibiotic. In every case, other than acute cases, it has required multiple antibiotics to cover the spectrum of potential pathogens we will never be able to successfully test for, and these antibiotics are usually switched out and traded for other ones on a monthly or bimonthly basis - this is why any clinical trials on the subject as worthless - the clinical trials do not in any way duplicate real actions in the clinical setting.
So I would hypothesize that in your body Doxy did not hit a target but Mino did. My journeys have taught me that the benefits of Mino in terms of psychiatry accrue over months and even years, not days or weeks. The 3-day thing you experienced was - in my opinion - a clue that you were on the right path.
It's all detective work. We have to search for hints and clues and try to make sense of them. The Doxy/Mino thing you experienced offers clues.
> Dr. Bransfield has not yet begun to follow your protocol. I'll ask him the next time I see him as to why not. He will, on certain patients, utilize doxycycline based on clinical presentation and not biological tests... just in case Lyme or some other tick-borne disease is involved. It was the first thing he added to my regime while we began to formulate a plan for the use of psychiatric medications. It was interesting that 3 months of doxycycline had no effect on my disease state while minocycline improved my depression within 3 days. How would you explain this? Anti-bacterial (inhibit protein synthesis)? Intrinsic anti-inflammatory activity in the brain (microglia)? Glutamatergic activity modulation (glutamate release)? The two drugs are not the same. Two people aren't the same. I definitely wouldn't generalize that minocycline is just another tetracycline class antibiotic. If doxycycline doesn't help, minocycline might.
>
>
> - Scott
>
>
Posted by bleauberry on March 25, 2018, at 6:10:56
In reply to Re: Lyme disease - a neuropsychiatric disease, posted by SLS on March 24, 2018, at 8:48:40
> > That is very interesting. Thank you for that.
> >
> > My personal hypothesis is that most - maybe 7 of 10 - suicides are actually due to a serious brain insult from an ongoing unsuspected tick-born infection, not due to a life crisis.
>
> Where did you get the "7 of 10" statistic? That seems rather high.Good question. Just instinct. Wisdom guided by hard knocks and experience. Maybe it's 8 out of 10, maybe it's 3 out 10, I estimate 7 out of 10, but I think the point that matters is that lyme causes the deep dark depression that leads to hopelessness and suicide. A very popular musician in my area recently blew his head off following 20 years of battling what he suspected was lyme (he had a regular doctor not a LLMD). So I have seen it.
Just an instinctual guess.
>
> > I also commonly see the 'molehill to mountain' phenomenon, where normal every day things which are molehills in your life - issues but not big issues - become unsurmountable mountains. Nothing actually changed except your perception.
>
> Depending on the underlying pathology, CBT will help some people while antidepressants will help others. Ideally, pharmacotherapy and psychotherapy can be employed together.
>
> > For short term or acute management of symptoms these are my general population favorites:
> >
> > Prozac first, Zoloft 2nd.
> > Zyprexa first, Abilify or Seroquel 2nd.
> > Ritalin first, Adderall second.
> > Nortriptyline
> > Alprazolam or Lorazepam
>
> Nice list.
>
> Why did you choose Prozac over Lexapro?I like the way prozac boosts levels of all the neurotransmitters, not just serotonin, and how it synergies with antipsychotics to increase neurotransmitters in ways other SSRI/AP combinations don't. Prozac+Zyprexa for example is amazing on paper. I like that prozac has some extra mechanisms to it besides just serotonin reuptake inhibition. While Lexapro is helpful to many people, I think prozac would have been better for many of them. Prozac has less sexual dysfunction than lexapro and less of the numbing effect, anecdotally speaking. I like the long half life of prozac. And that it is easy to dissolve in juice for custom dosing for sensitive patients to get started or to wean off.
>
>
> - Scott
Posted by bleauberry on March 25, 2018, at 6:21:42
In reply to Re: Oh for goodness sake!!!! » Phillipa, posted by linkadge on March 24, 2018, at 10:01:56
Everyone is on their own journey and nobody is responsible for you except you.
I find it curious that the people in life who reject new ideas, or reject ideas which do not conform to their world view, or reject success stories, are the people who generally make less progress in whatever their pursuit is.
I think asking questions and curiosity make more sense than outright rejection without any good reasoning or foundation of knowledge/experience to make such a rejection.
But that's just me. My doctor tells me that most of her patients are not like that, that most of them just want a prescription. Most patients are not really interested in comprehensive protocols, longterm strategies, or trying new things outside their comfort zone. They just want a prescription.
I get that. Totally. Been there done that. I get it.
> I agree.
>
> (sorry blueberry). It's not all Lymes disease.
>
> Linkadge
>
Posted by SLS on March 25, 2018, at 6:45:38
In reply to Re: Lyme disease - a neuropsychiatric disease » SLS, posted by bleauberry on March 25, 2018, at 6:01:46
> But Mino is different. It has the ability to do things that Doxy cannot do.
Okay. Facts are helpful. What does Mino do that Doxy cannot do?
- Scott
Posted by ed_uk2010 on March 25, 2018, at 10:21:49
In reply to Lyme disease - a neuropsychiatric disease, posted by bleauberry on March 24, 2018, at 6:38:54
Hi Blue,
I was wondering, did lumbar puncture form part of your diagnosis of Lyme disease of the central nervous system?
Posted by Prefect on March 25, 2018, at 19:36:47
In reply to Lyme disease - a neuropsychiatric disease, posted by bleauberry on March 24, 2018, at 6:38:54
20 years ago I came down with hepatitis but tested negative for all hep viruses. Since then I've had a neuropsychiatric illness that involves derealization, panic, anxiety, disassociation, cognitive dysfunction, sensory and balance problems, as well as postural tachycardia and IBS.
I've got a doctor now in Toronto who's trying to convince me I have Lyme disease. I've tested negative for it, but positive for Bartonella and Mycoplasma Pneumonia which are lyme coinfections.
I'm sceptical. I never had the classic Lyme symptoms, or a tick rash, mostly gastrointestinal and neuropsychiatric.
I'm actually seeing him tomorrow. Is it even worth letting him put me on antibiotics after 20 years?! I thought the antibiotics only work if you do it 6 months after infection.
Posted by beckett2 on March 25, 2018, at 20:33:07
In reply to Lyme disease - a neuropsychiatric disease, posted by bleauberry on March 24, 2018, at 6:38:54
Much of my illness started after childbirth. Shortly thereafter, I tested positive for Hashimoto's thyroiditis which I can only control by keeping my TSH levels around 1. However, I've never regained my health mental and physical :(
I haven't tested positive for other immune disorders, and in my case, I think the insult of an emergency c section combined with family history of hypothyroidism, and voilá!
While I question the rate at which LAD is implicated in MI, I agree that physical illness and insults can express as MI.
Sidenote: Last year I contracted Lyme. Fortunately, I had a bull's eye and received treatment-- I think I'm fine. Because I live somewhere that Lyme is considered 'rare', I was dismissed by the first doc I saw at the walk-in clinic. I went to another and was tested right away. So, yeah, the first doc was able to ignore symptoms because he could only see what he thought he should.
With more information, doctors (and researchers)will look at MI differently because they'll expect to see something different. Until then....
Posted by Prefect on March 30, 2018, at 20:47:32
In reply to Re: Lyme disease - a neuropsychiatric disease » SLS, posted by bleauberry on March 24, 2018, at 8:01:35
Bleauberry:
What portion of the following cocktail would you suggest if your symptoms are anxiety/derealization/dissociation/cognitive impairment/executive functioning problems? And would Low Dose Naltrexone have any possible place here too?
Prozac first, Zoloft 2nd.
Zyprexa first, Abilify or Seroquel 2nd.
Ritalin first, Adderall second.
Nortriptyline
Alprazolam or Lorazepam
Posted by bleauberry on April 19, 2018, at 12:24:09
In reply to Re: Lyme disease - a neuropsychiatric disease » bleauberry, posted by beckett2 on March 25, 2018, at 20:33:07
WOW! What a story.
The really sad thing here is that Dr #1 was the one who sentenced me to 20+ years of treatment resistant psychiatric illness.
The happy ending is that 20 years later I found Dr #2 and he did his job correctly.
I still battle against chronic Lyme relapses, or maybe new infections, but the psychiatric nightmare is well under control.
It is scary that one wrong decision by one doctor can ruin another human being's entire life, via incompetency. If you ask me, most psychiatrists are incompetent because they know diddly squat about mid stage or late stage lyme, they know diddly squat about diagnostics or recognizing clusters of symptoms, and 9 of 10 lyme patients have psychiatric symptoms! So if any doctors should be experts on Lyme, it should be psychiatrists! But no. They know very little.
> Much of my illness started after childbirth. Shortly thereafter, I tested positive for Hashimoto's thyroiditis which I can only control by keeping my TSH levels around 1. However, I've never regained my health mental and physical :(
>
> I haven't tested positive for other immune disorders, and in my case, I think the insult of an emergency c section combined with family history of hypothyroidism, and voilá!
>
> While I question the rate at which LAD is implicated in MI, I agree that physical illness and insults can express as MI.
>
> Sidenote: Last year I contracted Lyme. Fortunately, I had a bull's eye and received treatment-- I think I'm fine. Because I live somewhere that Lyme is considered 'rare', I was dismissed by the first doc I saw at the walk-in clinic. I went to another and was tested right away. So, yeah, the first doc was able to ignore symptoms because he could only see what he thought he should.
>
> With more information, doctors (and researchers)will look at MI differently because they'll expect to see something different. Until then....
Posted by bleauberry on April 19, 2018, at 12:37:55
In reply to Re: Lyme disease - a neuropsychiatric disease » bleauberry, posted by Prefect on March 30, 2018, at 20:47:32
Ok that is a tough question. Good question.
Right off the bat I like Ritalin. Because it by itself stands a decent shot at improving or eliminating all of the symptoms you listed.
My greatest fear when I started Ritalin was that it would increase anxiety. In the early stages it did, and when it wore off it did. So the trick was to titrate gradually and to not let doses wear off.
I started at just 2.5mg and then wouldn't dose it a gain until I felt like I needed to. In a few weeks I was up to 60mg. I did frequent dosing - 10mg 6 times a day instead of the customary 20mg 3 times. Way better that way. It was maybe 2 to 3 weeks in that I realized I was calm, peaceful, sleeping better than ever, and yet I was engaged in life, sociable, interested in hobbies, and living again.
For whatever reason, I think Adderall is more common. But I personally feel Ritalin is more effective in more ways and is safer for long term.
I like prozac first and Zoloft second. But any of the antidepressants can make the executive function stuff worse and add in a new symptom of emotional numbness.
If it were me I put heavy emphasis on Ritalin and then see how it goes. If I thought I needed to add something else a few weeks later, I would keep ssri doses very low - for example prozac 5mg - 20mg, or Zoloft 25mg -75mg. And for zyprexa 2.5mg or 5mg. those low doses can improve your symptoms without introducing a bunch of new problems.
LDN is novel treatment for a wide variety of conditions and I always think it is worth a shot. It involves some effort to get a compounding pharmacy and devote a couple months to it. I was on it for a month. It was rough going in the first couple weeks - worsened my depression - but felt better in the final weeks - calm, peace, and sociable mood. Overall I was just too unstable at the time and I do not remember why I ditched it. I think it was around that time I figured I had to go full bore into antibiotics and screw the psychiatric stuff. But my limited experience with LDN showed me there is a lot of potential with it for psychiatry, lyme, chronic fatigue, and other conditions.
> Bleauberry:
>
> What portion of the following cocktail would you suggest if your symptoms are anxiety/derealization/dissociation/cognitive impairment/executive functioning problems? And would Low Dose Naltrexone have any possible place here too?
>
> Prozac first, Zoloft 2nd.
> Zyprexa first, Abilify or Seroquel 2nd.
> Ritalin first, Adderall second.
> Nortriptyline
> Alprazolam or Lorazepam
Posted by SLS on April 19, 2018, at 17:07:24
In reply to Re: Lyme disease - a neuropsychiatric disease, posted by bleauberry on April 19, 2018, at 12:24:09
> 9 of 10 lyme patients have psychiatric symptoms!
Citations?
Even if 10 of 10 Lyme patients have psychiatric symptoms, that would still represent less than 1% of the general population. Only 1.135% of people with depression would have Lyme Disease with your numbers. That is still quite high, but not high enough to suggest that everyone with depression be treated for it.
How about suggesting a specific first-line treatment for Lyme to resolve depression. You don't have to guarantee anything. Don't be afraid to be direct and concise. That would be very helpful to me since focus and concentration while reading are difficult for me.
Thanks.
The actual rate of depression among Lyme cases, in my estimation, is probably no higher than 26% given the overdiagnosis of Major Depressive Disorder*. This would bring down the cases of Lyme among depressed patients to 0.295% = 1 in 338. This number is still pretty high. However, if we had 338 people with depression currently posting on Psycho-Babble, only 1 would require treatment for Lyme. We don't have 338 people posting on Psycho-Babble. If the numbers are off, they are not off by that much. They suggest that it is unlikely that even 1 person here has Lyme. It is important to take into consideration that the incidence of Lyme Disease varies greatly regionally, and that the population of Psycho-Babble is waited heavily towards treatment resistant depression.
* https://www.ncbi.nlm.nih.gov/pubmed/7943444
USA:
Population = 325,000,000
Depression = 10% = 32,500,000
Lyme incidence = 369,000
Lyme with depression = 26%
Depression with Lyme = 0.295%
- Scott
Posted by bleauberry on April 24, 2018, at 11:54:51
In reply to Re: Lyme disease - a neuropsychiatric disease, posted by SLS on April 19, 2018, at 17:07:24
Scott I did not claim that 9 out of 10 Lyme patients have psychiatric symptoms.
I did claim that 9 out of 10 psychiatric patients have Lyme.
The citations I have are anecdotal - two family doctors shared what has happened in their clinics over a couple decades - long story short, a lot of people with psychiatric diseases and other mystery diseases got better on antibiotics but not conventional treatments.
Call it lyme, call it mystery, call it tick-born, call it dunno, call it whatever, doesn't matter. The fact is people are experiencing profound healing with their psychiatric troubles and their mystery diseases with antibiotics. Explain any way you want. Give it a name any way you want. It changes nothing. Patients are getting better with LLMDs when they don't get better with other doctors. That doesn't change no matter how much skepticism or what you call it.
There are a few thousand LLMDs in the USA at this point. Any one of them will confirm for you pretty much anything I have said. They are doctors. I am not. So I think it makes sense for you to find one of them, schedule an appointment for an initial evaluation and a second opinion, and ask your questions of them instead of me. They can answer questions better than me, answer questions more thoroughly than me, accept and deflect pessimism better than me, and stand a real chance of getting you better than you are.
> > 9 of 10 lyme patients have psychiatric symptoms!
Flip it backwards - 9 out of 10 psychiatric patients have lyme. If that sounds profound, it's because it is. It is a primary reason there are so many psych patients being inadequately treated.
There is only one thing more profound - that we have so many psychiatric patients suffering from inadequate care. THAT is profound.>
> Citations?
>
> Even if 10 of 10 Lyme patients have psychiatric symptoms, that would still represent less than 1% of the general population. Only 1.135% of people with depression would have Lyme Disease with your numbers. That is still quite high, but not high enough to suggest that everyone with depression be treated for it.
>
> How about suggesting a specific first-line treatment for Lyme to resolve depression. You don't have to guarantee anything. Don't be afraid to be direct and concise. That would be very helpful to me since focus and concentration while reading are difficult for me.
>
> Thanks.
>
> The actual rate of depression among Lyme cases, in my estimation, is probably no higher than 26% given the overdiagnosis of Major Depressive Disorder*. This would bring down the cases of Lyme among depressed patients to 0.295% = 1 in 338. This number is still pretty high. However, if we had 338 people with depression currently posting on Psycho-Babble, only 1 would require treatment for Lyme. We don't have 338 people posting on Psycho-Babble. If the numbers are off, they are not off by that much. They suggest that it is unlikely that even 1 person here has Lyme. It is important to take into consideration that the incidence of Lyme Disease varies greatly regionally, and that the population of Psycho-Babble is waited heavily towards treatment resistant depression.
>
> * https://www.ncbi.nlm.nih.gov/pubmed/7943444
>
> USA:
> Population = 325,000,000
> Depression = 10% = 32,500,000
> Lyme incidence = 369,000
> Lyme with depression = 26%
> Depression with Lyme = 0.295%
>
>
> - ScottThese calculations only apply to an assumption of "9 out 10 lyme patients have psychiatric symptoms". But the topic of discussion is actually backwards from that - "9 out of 10 psychiatric patients have lyme".
Does that mean that I think most of the people at babble actually have a tick born disease instead of whatever their doctors diagnosed? Yes that is correct.
I think our psychiatric medicines work a whole lot better when we get accurate diagnosis for the rest of the body. None of us can possibly expect a monoamine manipulating chemical to overcome a systemic stealth stubborn infection. But we do. We actually think serotonin or dopamine or agonism or antagonism, any of them, they have the power to end disease and restore wellness. Don't think so. Psych meds can help. But they won't get us to the finish line.
Posted by SLS on April 25, 2018, at 6:37:47
In reply to Re: Lyme disease - a neuropsychiatric disease » SLS, posted by bleauberry on April 24, 2018, at 11:54:51
Hi Bleauberry
> Scott I did not claim that 9 out of 10 Lyme patients have psychiatric symptoms.
>
> I did claim that 9 out of 10 psychiatric patients have Lyme.
> > > 9 of 10 lyme patients have psychiatric symptoms!> > The actual rate of depression among Lyme cases, in my estimation, is probably no higher than 26% given the overdiagnosis of Major Depressive Disorder*. This would bring down the cases of Lyme among depressed patients to 0.295% = 1 in 338. This number is still pretty high. However, if we had 338 people with depression currently posting on Psycho-Babble, only 1 would require treatment for Lyme. We don't have 338 people posting on Psycho-Babble. If the numbers are off, they are not off by that much. They suggest that it is unlikely that even 1 person here has Lyme. It is important to take into consideration that the incidence of Lyme Disease varies greatly regionally, and that the population of Psycho-Babble is waited heavily towards treatment resistant depression.
> > * https://www.ncbi.nlm.nih.gov/pubmed/7943444
> >
> > USA:
> > Population = 325,000,000
> > Depression = 10% = 32,500,000
> > Lyme incidence = 369,000
> > Lyme with depression = 26%
> > Depression with Lyme = 0.295%> These calculations only apply to an assumption of "9 out 10 lyme patients have psychiatric symptoms". But the topic of discussion is actually backwards from that - "9 out of 10 psychiatric patients have lyme".
I really made one calculation regarding Lyme Disease.
"Depression with Lyme = 0.295%"
"...the cases of Lyme among depressed patients to 0.295% = 1 in 338"
If I were to use the more liberal value, 66% instead of 26%, the number would still be around (1 in 100) rather than (90 in 100). I have no way of knowing the incidence of Lyme in treatment-resistant depression (TRD), but I imagine the numbers are somewhat higher.
On the other hand, according to the article, approximately 40% of people with Lyme Disease display some sort of psychiatric symptoms (including depression). I'm sure lots of people are waiting for an accurate tool for diagnosing Lyme Disease.
- Scott
This is the end of the thread.
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