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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Hordak on June 30, 2018, at 14:42:38
His homepage: https://psychotropical.info/
Google scholar: https://scholar.google.com.au/citations?user=ea6KeD0AAAAJ&hl=en
https://www.wikigenes.org/e/author/e/627669.html
Posted by linkadge on July 2, 2018, at 12:20:46
In reply to What is your opinion on P. K. Gillman + his views?, posted by Hordak on June 30, 2018, at 14:42:38
I've read a lot of his information and he seems to know his stuff.
An area of focus is the combinations and toxicity (or lack therof) of MAOIs and other antidepressants.
Linkadge
Posted by Hordak on July 2, 2018, at 13:38:30
In reply to Re: What is your opinion on P. K. Gillman + his views?, posted by linkadge on July 2, 2018, at 12:20:46
Indeed. Although he seems to have a personal aversion to Mirtazapine. He bashes it at every opportunity ^^ :=D
Posted by Hordak on July 2, 2018, at 13:40:19
In reply to Re: What is your opinion on P. K. Gillman + his views?, posted by Hordak on July 2, 2018, at 13:38:30
> Indeed. Although he seems to have a personal aversion to Mirtazapine. He bashes it at every opportunity ^^ :=D
And his combination of choice seems to be: Sertraline + Nortriptyline...
And after that Nardil/Parnete/Anafranil.
Posted by ed_uk2010 on July 2, 2018, at 14:40:16
In reply to What is your opinion on P. K. Gillman + his views?, posted by Hordak on June 30, 2018, at 14:42:38
I find Dr. Gillman's website very interesting. For sure, he is right that a lot of psychiatrists appear to have a very poor understanding of medication.
Posted by Hordak on July 2, 2018, at 17:24:09
In reply to Re: What is your opinion on P. K. Gillman + his views?, posted by ed_uk2010 on July 2, 2018, at 14:40:16
> I find Dr. Gillman's website very interesting. For sure, he is right that a lot of psychiatrists appear to have a very poor understanding of medication.
Or a good understanding of "Gifts"... :=D
Posted by linkadge on July 2, 2018, at 18:36:30
In reply to Re: What is your opinion on P. K. Gillman + his views?, posted by Hordak on July 2, 2018, at 17:24:09
I think his main aversion to mirtazapine in in how it is marketed (i.e. as a dual action drug).
I think (don't quote me) that he suggests it can be used with MAOIs, owing to the fact that is is not as serotnergic as marketed.
He may be a bit overly critical of mirtazapine. I personally think mirtazapine can be very effective, and also useful as an adjunct.
Linkadge
Posted by Hordak on July 6, 2018, at 11:16:01
In reply to Re: What is your opinion on P. K. Gillman + his views?, posted by linkadge on July 2, 2018, at 18:36:30
> I think his main aversion to mirtazapine in in how it is marketed (i.e. as a dual action drug).
>
> I think (don't quote me) that he suggests it can be used with MAOIs, owing to the fact that is is not as serotnergic as marketed.
>
> He may be a bit overly critical of mirtazapine. I personally think mirtazapine can be very effective, and also useful as an adjunct.
>
> Linkadge
>Yes, he also "corroborates" that Mirtazapine is primarily an anti-histamine with anti-H1-potency 100-fold of its anti-5HT-potency.
Posted by linkadge on July 6, 2018, at 19:26:43
In reply to Re: What is your opinion on P. K. Gillman + his views?, posted by Hordak on July 6, 2018, at 11:16:01
That's true. However, a molecule will begin to affect secondary targets once the primary target becomes saturated. In other words, that 100:1 ratio will narrow once h1 receptors become saturated.
Mirtazapine can be more sedating in lower doses. I mainly use it because it is such an effective sleep aid, and it does offset SSRI side effects to some extent.
Linkadge
Posted by pedr on July 7, 2018, at 7:17:51
In reply to What is your opinion on P. K. Gillman + his views?, posted by Hordak on June 30, 2018, at 14:42:38
Enormously knowledgeable about MAOIs and happily gives detailed advice over the phone for a few bucks. Apparently is very nice to speak with.
Posted by Hordak on July 7, 2018, at 15:58:24
In reply to Re: What is your opinion on P. K. Gillman + his views?, posted by linkadge on July 6, 2018, at 19:26:43
> That's true. However, a molecule will begin to affect secondary targets once the primary target becomes saturated. In other words, that 100:1 ratio will narrow once h1 receptors become saturated.
-----------------------------Exactly! That's what I've been saying for some time now, so that's why I don't understand Gillman's criticism.
Posted by linkadge on July 7, 2018, at 17:25:58
In reply to Re: What is your opinion on P. K. Gillman + his views? » linkadge, posted by Hordak on July 7, 2018, at 15:58:24
My hunch is that because his focus is on MAO and reuptake inhibiting mechanisms, he doesn't see mirtazapine as a 'true' antidepressant.
However, there is quite a bit of literature suggesting that 5-ht2 antagonists and alpha-2 antagonists have antidepressant effects. For example, 5-ht2c antagonists and alpha-2 antagonists have independent neurotrophic properties.
To be honest, I wish that mirtazapine was my first antidepressant. I honestly think I would have recovered a bit better. I think all the reuptake stuff altered my brain in adolecence.
Linkadge
Posted by Hordak on July 9, 2018, at 8:56:19
In reply to Re: What is your opinion on P. K. Gillman + his views? » Hordak, posted by linkadge on July 7, 2018, at 17:25:58
> To be honest, I wish that mirtazapine was my first antidepressant. I honestly think I would have recovered a bit better. I think all the reuptake stuff altered my brain in adolecence.
>
> Linkadge
>
>How was your experience with it?
Posted by linkadge on July 9, 2018, at 17:42:01
In reply to Re: What is your opinion on P. K. Gillman + his views? » linkadge, posted by Hordak on July 9, 2018, at 8:56:19
I'm still using small amounts for sleep. It can be very effective for sleep in low doses (i.e. even 1mg likely has significant antihistamine effects).
I did try it once as a sole antidepressant (tapering from citalopram). Although it controlled some symptoms, it didn't seem to be enough.
Mind you, I think the switch from citalopram induced a withdrawal.
I say that I wish I used it as first agent, because my first depression was primarily linked to insomnia. My symptoms now seem to be different, perhaps owing to use of other medicaitons.
Linkadge
Posted by bleauberry on July 11, 2018, at 9:11:57
In reply to What is your opinion on P. K. Gillman + his views?, posted by Hordak on June 30, 2018, at 14:42:38
I used to read all of Gillman's stuff. Some of it sounded ordinary but some of it was profound. All of it was helpful to me. But none of it really does much to improve the quality of life for any of us. That's because it all seems to focus on the narrow mono-therapy approach of healing psychiatric diseases with only brain-chemical manipulating substances. I personally think that is way too limited of a way to think of disease in the human body. It isn't just in the brain and it isn't just a neurotransmitter thing that is going on.
I suggest that adding other non-prescription strategies to anything Gillman writes about will get better results than just the things he writes about.
That said, I appreciated the fact that his writings and his thoughts on medication approaches went further than your average doctor or psychiatrist thinks about.
This is the end of the thread.
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