![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Maxime on April 17, 2005, at 22:22:42
Tomorrow I am going to see a psychopharmacologist. I really don't think it's going to help. Then I tried to be more positive about it ... and it lasted all of 3 minutes. Then I came across the article below and I realise that my negativity is really just realism.
Maxime
On the Rocks with a Twist of Lime
From Kimberly Bailey & Marcia Purse,Your Guide to Bipolar Disorder.
by Andy "Electroboy" BehrmanThere have been so many times, in sessions with my psychiatrist, that I've wondered, "Hey, why not throw in a twist of lime; I'm on every other possible medication in the pharmacy - - or for that matter - - on the entire planet."
And that little dark green sliver of lime does pay homage to the fact that most psychiatrists (and psychiatric patients) refer to their combinations of medications (or 'meds' for short) - - whether they be anti-depressants, anti-psychotics or mood stabilizers - - as 'cocktails'. It’s common terminology, albeit a bit cynical and disparaging to the field of psychopharmacology. However, I don’t know anyone who doesn’t know anyone who doesn’t call their 'medication regime' by the term 'cocktail'.
I was at a cocktail party (there’s that annoying word again) in Los Angeles when I first moved here, talking about what seems to be the illness of the decade, bipolar disorder, which also happens to be mine. Someone came right up to me and asked, "So, what 'cocktail' are you on?" This brings up an entirely different issue about the appropriateness of asking complete strangers at a social function about their medication, but let’s put that point aside for the time being.
I made the decision to confront the question directly, responding openly and honestly by telling the questioner (a dead ringer for Johnny Depp) that I was on the 'Hollywood Cocktail'. The Johnny Depp look-alike looked surprised.
"What’s in the Hollywood Cocktail?" he asked, with an extremely curious look.
"It’s Depakote, Topamax, Geodon, Klonopin and Ambien," I responded, sputtering off a long list of 'meds'.
He looked at me like I was ingesting enough pills and capsules to sedate all of Tinseltown. Little did he know that over the years I had tried more than forty-five different medications to control my manic depression and side effects, and that during some periods I took more than twelve medications at once - - sometimes totaling more than thirty pills and capsules throughout the day. Yes, I was a human guinea pig. My own doctor didn’t even know exactly what drug was doing what for me and what wasn’t. So I was right - - it was all guess work after all. But the cocktail was working, and wasn’t that all that mattered anyhow?
And that’s why psychopharmacology really is - - guess work. It’s one of those weird sciences (I don’t really even consider it a science. It’s more like a hobby, like stamp collecting or knitting, except you need a degree and a license to practice it.) where I imagine doctors wearing white lab coats, white caps and protective booties while mixing pills and potions. You’re in a huge laboratory and there’s steam coming out of all kinds of glass flasks and the doctors are feeding these concoctions to innocent rats and rabbits. Teams of scientists are observing their behavior and taking copious notes while the animals spin around their treadmills. Psychopharmacology is not an exact science at all. Sometimes I fantasize it’s much like Italian cooking - - some extra spices thrown in here, a splash of wine there. Let’s just see how the rats and rabbits like that. It’s embarrassing to say, but I got my own doctor to admit that psychopharmacology is a tiny bit like decorating and a lot like bartending.
by Andy "Electroboy" Behrman
Let me explain. A decorator chooses paint colors for the walls and fabrics for the couch and chairs, and gets a feel for how his client will feel living in this space. Will the inhabitant feel cozy or too cold? Is the room too uptight? Then the decorator can make changes - - he can warm up the paint color, add some fabrics or some pillows or some antiques to give a different feel to the room. So, ultimately, the 'patient' will be able to live in comfort. A bartender, too, has to get a sense of what his customer wants. Does he just want to drink a few beers through the night and get toasted, or does he want to get blasted within the first hour with a strong few shots of good Mexican tequila?
I was on my same cocktail for about two years and stayed relatively even-keeled. Last week, my new doctor thought he’d tinker with the cocktail and upped the dosage of one of my mood stabilizers. In two days, the new mixture had knocked me flat on my face - - almost as if I had downed a whole bottle of gin in one sitting. I couldn’t get out of bed. Let alone form sentences. Like the old days of being sedated and coming out of recovery after electroshock, I got him on the phone and slurred to him about my need to quickly come off the dosage. I was perfectly happy with my little 'night-cap' and I was going to be the one to make the decision this time.
"I'll have another cocktail," is a common line you’ll hear in a bar. But it’s also one you’ll hear around a psychiatrist’s office, because psychopharmacology is a science of trial and error. It takes quite a few attempts to find the right combination of meds - - the right cocktail to stabilize people with psychiatric illnesses. In my case, it took nearly seven years to stabilize my bipolar disorder, and by the time we had dealt with that successfully we had a new issue to deal with - - an illness referred to as schizoaffective disorder, which required finding the right anti-psychotic that wouldn’t leave me with crazy side effects such as shuffling feet and twitching.
I’ve finally found a brand new cocktail. I take it once a night and it’s only one pill. I guess that wouldn't even be a cocktail -- maybe just a shot. I'm much happier on this one pill, much more stable and able to function productively and effectively. In my next article I'll tell you about this new drug that has really changed my life.
Posted by Sarah T. on April 17, 2005, at 22:59:11
In reply to Psychopharmalogy ... a lot like bartending, posted by Maxime on April 17, 2005, at 22:22:42
Some of the bartenders I've met know more than most of the pdocs I've been to. But there are exceptions, and I hope to find one of those exceptions some day.
Posted by Phillipa on April 17, 2005, at 23:03:48
In reply to Re: Psychopharmalogy ... a lot like bartending » Maxime, posted by Sarah T. on April 17, 2005, at 22:59:11
Maxime, You have sounded better. I'm almost afraid to ask! But, I wish you all the best of luck tomorrow. Fondly, Phillipa
Posted by Maxime on April 18, 2005, at 10:13:28
In reply to Re: Psychopharmalogy ... a lot like bartending, posted by Phillipa on April 17, 2005, at 23:03:48
Posted by Maxime on April 18, 2005, at 10:16:16
In reply to Re: Psychopharmalogy ... a lot like bartending, posted by Phillipa on April 17, 2005, at 23:03:48
> Maxime, You have sounded better. I'm almost afraid to ask! But, I wish you all the best of luck tomorrow. Fondly, Phillipa
Phillipa, you can never go by how I sound. I wear so many masks. Let's just say that nothing has changed for over a year. I have been severely depressed. I try to help people on the board and try to sound positive. But inside, I am a mess.
Thanks for caring though. No one in real life does.
Maxime
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.