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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 55. This is the beginning of the thread.
Posted by uncouth on November 9, 2009, at 18:33:12
Just was reading some of Peter Breggin's anti psychopharmacology writings and I'm curious if anyone has any intelligent things to say about him. Seems to be well-informed and not making baseless claims. How much should I be worried about the Lithium, antidepressants, antipsychotics, etc. that I take causing brain damage etc.?
Posted by SLS on November 9, 2009, at 18:51:08
In reply to Peter Breggin, posted by uncouth on November 9, 2009, at 18:33:12
> Just was reading some of Peter Breggin's anti psychopharmacology writings and I'm curious if anyone has any intelligent things to say about him. Seems to be well-informed and not making baseless claims. How much should I be worried about the Lithium, antidepressants, antipsychotics, etc. that I take causing brain damage etc.?
It might be informative to discuss one issue or proposition at a time.
- Scott
Posted by Phidippus on November 9, 2009, at 22:56:47
In reply to Peter Breggin, posted by uncouth on November 9, 2009, at 18:33:12
> How much should I be worried about the Lithium, antidepressants, antipsychotics, etc. that I take causing brain damage etc.?
Lithium is a neuroprotective agent and can guard against nerve cell degeneration. SSRIs act much in the same regard, protecting the hippocampus and other brain regions from the atrophying effects of depression. Antipsychotics, on the other hand, can stunt brain growth and cause dopamanergic pathways to atrophy.
P
Posted by Phillipa on November 10, 2009, at 0:11:27
In reply to Re: Peter Breggin » uncouth, posted by Phidippus on November 9, 2009, at 22:56:47
Now number three is scarey. Phillipa
Posted by metafunj on November 10, 2009, at 5:55:05
In reply to Re: Peter Breggin » uncouth, posted by Phidippus on November 9, 2009, at 22:56:47
Someone I know who is involved in antipsychiatry says that the brain cells that are created while on ADs do not grow or function normally and that they are growing in response to replace the cells that are being killed by the drug.
Do you have any idea if that is true?
Posted by SLS on November 10, 2009, at 6:25:45
In reply to Re: Peter Breggin » uncouth, posted by Phidippus on November 9, 2009, at 22:56:47
> > How much should I be worried about the Lithium, antidepressants, antipsychotics, etc. that I take causing brain damage etc.?
> Lithium is a neuroprotective agent and can guard against nerve cell degeneration.> SSRIs act much in the same regard, protecting the hippocampus and other brain regions from the atrophying effects of depression.
I think the key word is "atrophy". I believe that the shrinking of brain tissue seen in depression is a true atrophy from disuse rather than a disease process. I could be wrong. I read that in order for an antidepressant to produce neurotrophic or neurogenic effects, it must effectively treat the depression / stress first.
If this is true, then:
AD > remission > neurogenesis.
This is in opposition to the majority view that:
AD > neurogenesis > remission.
> Antipsychotics, on the other hand, can stunt brain growth and cause dopamanergic pathways to atrophy.I never heard that.
- Scott
Posted by ColoradoSnowflake on November 10, 2009, at 11:27:43
In reply to Re: Peter Breggin, posted by SLS on November 10, 2009, at 6:25:45
What do you think Parnate does to the brain and cognition? I think it has "dumbed" be down some. I have a harder time remembering things, names especially.
What do you, who have Parnate experience, think?Thanks,
Gayle
Posted by uncouth on November 10, 2009, at 14:20:48
In reply to Re: Peter Breggin, posted by SLS on November 10, 2009, at 6:25:45
Scott,
That sequence you put forth is interesting. My primary concern right now is the potential toxicity of lithium. I have been at 600mg for 6 weeks and I can definitely tell some cognitive and memory problems. I am talking to my dr. about reducing the dose. I feel the lithium helped me get out of my suicidal pit, but now could be one of the causes of this chronic apathy and indifference I feel. I think SSRIs also contribute to that, and I'm hoping wellbutrin and agomelatine do not share that property....I for one won't ever take SSRIs again.Zyprexa WAS a significant help but the weight gain and intense hunger was too hard to manage, and it too helped me get out of "the pit". I talked to my dr. about potentially switching to asenapine (saphris) and he advised a 7 day washout from zyprexa first. Im mid way through that and now wondering if I should even be on an antipsychotic at all. Breggin is pretty convinced they are universally disabling.
But then again there is also research I believe showing increases in prefrontal activity and neurogenesis, and certianly many people ahve repsonded well to AP. So I don't know what to do.
The one thing I do believe Breggin is correct about is the "spellbinding" effect of many of these medications. They affect your ability to discern their effects. Even if you "respond" it's hard to tell what other subtle brain disfunction may be occuring.
I'm starting to wonder whether the safest bet might be a precursor strategy (L-Tryptophan, DL-Phenylalanine, Deplin, SAM-e, B12, etc.).
I don't know if Breggin has teased out differences between MAOIs/ TCAs/ and SSRIs, but he seems to think that all antidepressants are disabling, and that is effectively their mechanism of action.
Anyway, reading some of his stuff (his books are available in partial form to read on Google Books) got me thinking and a bit scared. Do I have to choose between intense emotional pain or complete numbness and affectlessness?
-uncouth
Posted by SLS on November 10, 2009, at 15:12:24
In reply to Re: Peter Breggin, posted by uncouth on November 10, 2009, at 14:20:48
Hi Uncouth.
I have no desire to produce an intelligent treatise on the whole of Peter Breggin's writings, but I do not take him seriously, despite his ability to weave a few facts into conclusions that seem logical. For instance, it is true that the volume of hippocampal tissue increases with the application of antidepressants. However, I would want to see the laboratory data that he uses to show that this is evidence of the destruction of neurons by these drugs. How does he account for the shrinking of this brain structure as is seen in depressive illness prior to any drug exposure? Holes.
> My primary concern right now is the potential toxicity of lithium.
Wise. Be sure to get regular blood tests for kidney and thyroid function. The lower the dosage of lithium, the lower is the risk of developing problems in these areas.
> I have been at 600mg for 6 weeks and I can definitely tell some cognitive and memory problems.
Lithium is known to produce impairments in these areas, although not all the time.
> I am talking to my dr. about reducing the dose. I feel the lithium helped me get out of my suicidal pit, but now could be one of the causes of this chronic apathy and indifference I feel.
Again, lithium is known to produce the side effects that you are reporting, although not everyone experiences them. I am very surprised that I don't seem to be having the flat affect and passivity that I thought lithium had produced in me in the past. I am currently at 900mg. I had a blood test for lithium level last week, but I don't know the results yet.
> I think SSRIs also contribute to that,
SSRIs can cause everything you describe.
> and I'm hoping wellbutrin and agomelatine do not share that property....I for one won't ever take SSRIs again.
If they are wrong for you, it makes sense to look elsewhere. I hope your next treatment cocktail does the trick. I would like to know if agomelatine can be combined with Parnate. Do you know anything about this?
> and now wondering if I should even be on an antipsychotic at all. Breggin is pretty convinced they are universally disabling.
In what way?
> Anyway, reading some of his stuff (his books are available in partial form to read on Google Books) got me thinking and a bit scared.
Don't be scared just yet. You might want to go Googling for material that addresses directly the validity of Breggin's claims and conclusions.
> Do I have to choose between intense emotional pain or complete numbness and affectlessness?
Probably not.
- Scott
Posted by SLS on November 10, 2009, at 16:19:20
In reply to Re: Peter Breggin, posted by ColoradoSnowflake on November 10, 2009, at 11:27:43
> What do you think Parnate does to the brain and cognition?
When it works, it makes me sharp as a tack.
> I think it has "dumbed" be down some. I have a harder time remembering things, names especially.
Just remember that you are not taking Parnate alone.
Depressive illness itself produces cognitive and memory impairments. Sometimes, people become more aware of them when they consider the possibility that they are side effects of a drug or residual effects of ECT. It happens. However, it also happens that the impairments are directly attributable to the drugs. I do recall experiencing a bit of a "brain fog" the first time I combined Parnate with desipramine. It improved with time. Also, I think that memory is one of the last things to improve as one emerges from depression. Lamictal causes me significant cognitive slowing and memory impairments. When the time is right, I am going to try to reduce the dosage.
- Scott
Posted by bleauberry on November 10, 2009, at 16:31:11
In reply to Peter Breggin, posted by uncouth on November 9, 2009, at 18:33:12
I think it will be 50 to 100 years before the theories...both pro and con...can be debated with any sense of scientific body. I think right now we are only in the pioneering stage of discovery what these meds do to the brain on a molecular level.
I think it deserves mention...and this is significantly contrary to the beliefs of most everyone here...that depression is not a disease. It is a set of symptoms caused by a disease. The disease could be a genetic flaw, toxic burden, infectious organisms (inflammation and general systemic disregulation), immune dysfunction (inflammation and general systemic), disregulation), hormone disregulation, and others. The set of symptoms resulting often fit the description of what we call depression. The impact on the brain is severe enough that we can see shrinking, damage, and lesions.
It is purely hit and miss, but in the support of ADs, the right one can actually reverse the disease...it is possible for an AD to regulate the immune system in such a way as to make Lyme go dormant...even though the patient is still infected, they are asymptomatic. On the other side of the coin, hit or miss, the AD can worsen the situation. I believe this scenario is probably true of all diseases. The ADs have the potential to either help the situation or worsen it.
Obviously the best strategy would be to identify what the cause of the set of depressive symptoms is for each patient. Much research is needed in that area. The best we can do today is probe and challenge with various substances to rule something in or rule something out.
I don't know if ADs cause brain damage. I know I experienced the so-called post-ssri syndrome, as have others here...but is that actually a post ssri thing or is a manifestation of the unknown disease that was there the whole time? Don't know.
Lithium in moderate doses probably is protective. As is magnesium, Resveratrol, Japanese Knotwood, Stephania Root, Chlorella, and at least a dozen others. Avoiding dairy, gluten, inorganic meats, inorganic veggies, inorganic fruits, various food additives and colors...all these are also protective.
Actually any substance that reduces brain inflammation and toxicity is neuroprotective. The substance to accomplish that will vary depending on the disease.
Whether Breggin is correct or not, I have no clue. I do think it is good to consider and respect all sides of a debate in psychiatry, because at this point in history, no one really knows. Someone we attack today as being a ridiculous scare-mongerer may in 50 years turn out to be completely accurate. Or not. We don't know right now.
We are all participants in a global pharmaceutical experiment that has been underway for only a few decades. It will take much more time to make any solid judgements, I believe.
Posted by SLS on November 10, 2009, at 16:57:34
In reply to Re: Peter Breggin, posted by bleauberry on November 10, 2009, at 16:31:11
Hi Bleauberry.
How do you define the word "depression" as you apply it? Semantics are critically important.
> I think it will be 50 to 100 years before the theories...both pro and con...can be debated with any sense of scientific body.
What theories? What do you mean by "pro and con"?
> I think it deserves mention...and this is significantly contrary to the beliefs of most everyone here...that depression is not a disease.
What about bipolar disorder (BD)?
> but in the support of ADs, the right one can actually reverse the disease...
What is the disease? Does major depressive disorder (MDD) count?
> it is possible for an AD to regulate the immune system
I should think it more likely that an AD helps reregulate the brain, which, in turn, regulates the immune system through the secretion of neuropeptides.
- Scott
Posted by SLS on November 10, 2009, at 17:30:50
In reply to Re: Peter Breggin » bleauberry, posted by SLS on November 10, 2009, at 16:57:34
> > it is possible for an AD to regulate the immune system
> I should think it more likely that an AD helps reregulate the brain, which, in turn, regulates the immune system through the secretion of neuropeptides.I forgot about brain-derived cytokines as being modulators of immune system function.
- Scott
Posted by uncouth on November 10, 2009, at 17:34:47
In reply to Re: Peter Breggin, posted by SLS on November 10, 2009, at 15:12:24
re: parnate + ago. i see no reason why they couldn't be used together
thanks for your response. i don't want to be seeing side effects where none actually exist, but at the same time, i feel as though i've lost something significant over the years, and despite times of "response", i haven't gotten that something back. maybe that's just the depression never fully remitting, or my life situation not improving. i don't know.
Posted by floatingbridge on November 10, 2009, at 17:46:09
In reply to Re: Peter Breggin, posted by uncouth on November 10, 2009, at 14:20:48
"Anyway, reading some of his stuff (his books are available in partial form to read on Google Books) got me thinking and a bit scared. Do I have to choose between intense emotional pain or complete numbness and affectlessness?
-uncouth"Uncouth, my understanding, (and maybe someone has said this already--I leapt ahead in the thread to write this), is that intense emotional pain has deleterious effects on the brain as well. Hopefully we can find some middle road. Is mild benzo use more damaging than non-stop stress? I'll go for benzos. As for AP's, I don't know. I've heard mixed information. But to suffer is not a good choice either.
my two uninformed cents,
fb
Posted by floatingbridge on November 10, 2009, at 17:50:10
In reply to Re: Peter Breggin, posted by bleauberry on November 10, 2009, at 16:31:11
Well, I think the discussion between BB and SLS just about nails it.
My question is does anyone suspect MAOI (such as emsam, segiline) to be more nueroprotective than an ineffective ssri or snri?
Posted by emmanuel98 on November 10, 2009, at 18:28:10
In reply to Re: Peter Breggin » bleauberry, posted by floatingbridge on November 10, 2009, at 17:50:10
I don't know what neuroprotective means. I don't know what it means to say depression isn't a disease. All I know is that I would be dead if it weren't for parnate. I had barely moved in over two months except to try and hang myself. So, for me, parnate has been neuroprotective and I don't much care what it does to my brain as long as it stops the depression. Because the depression wasn't doing me much good at all.
>
> My question is does anyone suspect MAOI (such as emsam, segiline) to be more nueroprotective than an ineffective ssri or snri?
Posted by Phidippus on November 10, 2009, at 20:10:02
In reply to Re: Peter Breggin » Phidippus, posted by metafunj on November 10, 2009, at 5:55:05
> Do you have any idea if that is true?
Sounds like a tall tale to me. It just doesn't work that way.
P
Posted by floatingbridge on November 10, 2009, at 21:14:21
In reply to Re: Peter Breggin, posted by emmanuel98 on November 10, 2009, at 18:28:10
Emmanuel, I'm very glad that parnate is working for you! Thank you for posting.
I still wonder about the potential neuroprotective properties of MAOIs--I mean, relief from emotional suffering and potential brain healing? I'd love it to be true.
Does anyone know?
fb
Posted by TriedEveryDrug on November 10, 2009, at 22:13:43
In reply to Re: Peter Breggin » uncouth, posted by Phidippus on November 9, 2009, at 22:56:47
http://en.wikipedia.org/wiki/Lithium_pharmacology#Harmful_effects_of_lithium"The average developmental score[clarification needed] for the lithium-exposed group of children was 78 points lower than the control group (siblings), but well within the normal range of 100±15.[19]"
>
> Lithium is a neuroprotective agent and can guard against nerve cell degeneration.
>
>
Posted by SLS on November 10, 2009, at 22:39:55
In reply to Litium is neuroprotective? You sure?, posted by TriedEveryDrug on November 10, 2009, at 22:13:43
>
> http://en.wikipedia.org/wiki/Lithium_pharmacology#Harmful_effects_of_lithium
>
> "The average developmental score[clarification needed] for the lithium-exposed group of children was 78 points lower than the control group (siblings), but well within the normal range of 100±15.[19]"
Unfortunately, the link for the relevant bibliography entry in this Wikipedia submission does not work. It wouldn't surprise me if lithium were to produce measurable deficits in cognitive function. The question is to what degree is it noticeable and irreversible. After all, depression produces deficits that are debilitating and, according to some, irreversible if left untreated. I guess it is a matter of degree.
- Scott
Posted by linkadge on November 11, 2009, at 6:59:54
In reply to Re: Litium is neuroprotective? You sure?, posted by SLS on November 10, 2009, at 22:39:55
Lithium can produce cognative deficits. By keeping glutamatergic neurotransmission in a very narrow range it may reduce stimulus evoked long term potentiation (learning).
This is not necessarily evidence of neurotoxicity.
The other thing is that GKS-3b inhibition produces differential effects on neuroplacticity depending on the phase of development.
Linkadge
Posted by SLS on November 11, 2009, at 7:30:25
In reply to Re: Litium is neuroprotective? You sure?, posted by linkadge on November 11, 2009, at 6:59:54
> The other thing is that GKS-3b inhibition produces differential effects on neuroplacticity depending on the phase of development.
What are some of the differences?
For those whom are unfamiliar with GSK-3b inhibition, this is one of the many biological effects of lithium. High levels of GSK-3b are associated with neuronal cell death (apoptosis). This might not always a bad thing, though. In a juvenile developing brain, a process known as pruning must take place to allow the brain to better focus its activity. Pruning allows for the degeneration of unneeded brain tissue. I'm sure Linkadge can describe any association there might be between GSK-3b and pruning.
To remain on topic: Does anyone know what Peter Breggin's views are on the use of lithium?
- Scott
Posted by manic666 on November 11, 2009, at 12:41:44
In reply to Re: Litium is neuroprotective? You sure? Breggin?, posted by SLS on November 11, 2009, at 7:30:25
i love it , i havnt got a clue what your on about, i just stick things in my mouth an hope for the best.
Posted by SLS on November 11, 2009, at 12:54:22
In reply to Re: Litium is neuroprotective? You sure? Breggin?, posted by manic666 on November 11, 2009, at 12:41:44
> i love it , i havnt got a clue what your on about, i just stick things in my mouth an hope for the best.
Perfect.
:-)
Thanks for the smile.
When I first started with doctors, I did exactly as you do. I was blindly and trustingly compliant, and never questioned a doctor's decisions. I only wanted to know the minimum necessary to get by. Eventually I reached the point where my doctors declared that I was probably untreatable. That is when I decided to take my first step into a medical school library. Actually, things are not so differenct now than they were at the beginning. What I really want to know is the minimum necessary that will help me get well.
In the meantime, I just stick things in my mouth and hope for the best.
LOL
- Scott
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