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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 31 to 55 of 55. Go back in thread:
Posted by linkadge on November 11, 2009, at 15:38:36
In reply to Re: Peter Breggin » 49er, posted by uncouth on November 11, 2009, at 14:57:40
I do feel that many psychiatric drugs can cause... well...brain damage.
Depression can too, but I agree that almost all side effects of psychiatric drugs get blamed on the underlying condition.
I think that depression has been (for me) the bigger offender in terms of cognative problems, that being said I know some drugs have left me feeling off.
Lithium appears to be neuroprotective in vitro and in animal models of neurodegenerative diseases. Lithium, through gsk-3b inhibition also appears to slow the development of the plaques characteristic of alzheimers disease.
One study seemed to suggest that those who had been taking long term lithium had a reduced risk of developeming alzheimers.
More than one study too suggests that lithium is trophic to human grey matter.
Linkadge
Posted by SLS on November 11, 2009, at 15:40:58
In reply to Re: Litium is neuroprotective? You sure? Breggin?, posted by linkadge on November 11, 2009, at 15:30:47
> I'm not exactly sure of the association. If GSK-3b gets too high then (as SLS mentioned) there can be cell death. If GSK-3b gets too low there is also a reduction in some forms of placticity. GSK-3b is important for triggering axonal growth in the early stages of developement. GSK-3b inhibition is supposedly partially responsible for the tetarogenic effects of lithium and divalproex.
>
> I also know that mild gsk-3b inhibition improves neurotransmission but if gsk-3b inhibition gets too low there are significant derangements in normal brain function (ie sensorimotory gating deficicts, latent inhibition issues). I think some studies have found that gsk-3b is dramatically reduced in schizophrenia.
The depth and scope of your knowledge always astounds me - even when we are angry with each other.:-)
I wish I had your memory for detail. Maybe someday...
- Scott
Posted by linkadge on November 11, 2009, at 15:46:49
In reply to Re: Litium is neuroprotective? You sure? Breggin? » linkadge, posted by SLS on November 11, 2009, at 15:40:58
Well thanks. There is so much that I don't know though. I just remember the results of some studies, I don't know much about the interaction of all these enzymes, proteins, etc.
Linkadge
Posted by floatingbridge on November 11, 2009, at 17:05:18
In reply to Re: Litium is neuroprotective? You sure? Breggin?, posted by SLS on November 11, 2009, at 7:30:25
Hey there, Is NAC supposed to help with this?
>
> 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).addressed to all you brains on this thread,
:-)
fb
Posted by bleauberry on November 11, 2009, at 17:30:44
In reply to Re: Peter Breggin » bleauberry, posted by SLS on November 10, 2009, at 16:57:34
Hi SLS,
Just to set the tone, I am not entering into a serious discussion in this thread, just kind of tossing the ball back and forth in a friendly discussion. So let's play.> Hi Bleauberry.
>
> How do you define the word "depression" as you apply it? Semantics are critically important.Depression is everything you and I know it to be, consistent with the symptoms listed in DSM. Either one symptom or multiple symptoms. The problem occurs when an unsusptected disease manifests itself primarily as depression, and yet that primary disease goes undiagnosed or unrecognized.
>
> > 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"?By pro I mean some people strongly praise meds as the way to go, while the cons (like Breggin) attack them. You are a strong pro, I am a modest pro, Breggin is a 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)?Borrelia and cousins, Candida and cousins, immune dysregulation, and toxic burden can all manifest as bipolar symptoms. Just off the top of my head as the most common and easy to explain why the symptoms occur, I am sure there are others.
>
> > but in the support of ADs, the right one can actually reverse the disease...
>
> What is the disease? Does major depressive disorder (MDD) count?I don't know. Is chronic diarrhea a disease? I think it is a symptom, right? There is something else wrong? I see mood disorders as being similar...they are outward clusters of symptoms that correlate with something else causing them. The "something else" is the disease, the mood disturbance is the symptoms of that disease.
>
> > 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 would think it probably could work either way from case to case. I just wish it would happen more often.
>
>
> - Scott
Posted by Sigismund on November 11, 2009, at 22:20:27
In reply to Re: Peter Breggin » uncouth, posted by 49er on November 11, 2009, at 14:13:23
>I knew I had but didn't realize how much until I started taking phosphatidyl serine which supposedly helps with dementia.
That's what I was hoping.>While it isn't the total answer, it definitely has helped.
I'm not so sure. At least it doesn't really f*ck you up.>Unfortunately, it is causing insomnia which is another post.
I was hoping it would help with insomnia. Hmmm.
Posted by SLS on November 12, 2009, at 7:35:06
In reply to Re: Peter Breggin, posted by bleauberry on November 11, 2009, at 17:30:44
> Depression is everything you and I know it to be, consistent with the symptoms listed in DSM. Either one symptom or multiple symptoms. The problem occurs when an unsusptected disease manifests itself primarily as depression, and yet that primary disease goes undiagnosed or unrecognized.
Ok. Then, for you, the word "depression" is a symptom or symptom cluster rather than a disease.
Now, you see, I believe that major depressive disorder (MDD) is a disease whose symptom cluster is approximated by the primitive diagnostic algorithm contained in the DSM IV. Do other diseases present similarly to MDD? Yup. Not too long from now, differential diagnostic procedures will use biomarkers to confirm MDD. This might be in the form of neuroimaging or the assay of gene activity as can be ascertained using microarrays.
> > > 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"?
>
> By pro I mean some people strongly praise meds as the way to go, while the cons (like Breggin) attack them. You are a strong pro, I am a modest pro, Breggin is a con.This is where I think it is necessary to parse one declaration at a time. It would be informative to select one of Breggin's claims and detail the biological evidence that he uses to support it. I don't think we need to wait 50 - 100 years to be able to repudiate or confirm his assertions.
> > What about bipolar disorder (BD)?
>
> Borrelia and cousins, Candida and cousins, immune dysregulation, and toxic burden can all manifest as bipolar symptoms. Just off the top of my head as the most common and easy to explain why the symptoms occur, I am sure there are others.Drugs can do it, too. Prednisone can produce manic, depressive or schizoid reactions. Even clonidine (Catapress), a common hypotensive, is known to be depressogenic. As you say, bipolar "symptoms". Yes, other conditions can present symptoms that look like bipolar disorder. That does not make BD any less of a singular entity.
> > > but in the support of ADs, the right one can actually reverse the disease...
> >
> > What is the disease? Does major depressive disorder (MDD) count?
>
> I don't know. Is chronic diarrhea a disease?Since you are so quick to attribute mood symptoms to various diseases of miscellaneous biological systems, why are you so slow to acknowledge the existence of psychiatric disorders of the brain? I am sure you have seen the evidence for this described over and over on this forum.
Maybe I was not direct enough in the questions I posed you. Perhaps you could answer a few now? Regardless of how many different pathologies there are that might present with psychiatric symptoms:
1. Do you believe that there exists a brain disease known as major depressive disorder?
2. Do you believe that there exists a brain disease known as bipolar disorder?
3. Do you believe that there exists a brain disease known as schizophrenia?
- Scott
Posted by bleauberry on November 12, 2009, at 16:15:56
In reply to Re: Peter Breggin » bleauberry, posted by SLS on November 12, 2009, at 7:35:06
>>
> Maybe I was not direct enough in the questions I posed you. Perhaps you could answer a few now? Regardless of how many different pathologies there are that might present with psychiatric symptoms:
>
> 1. Do you believe that there exists a brain disease known as major depressive disorder?Yes.
>
> 2. Do you believe that there exists a brain disease known as bipolar disorder?Yes.
>
> 3. Do you believe that there exists a brain disease known as schizophrenia?Yes.
>
>
> - ScottMy frustration is that for the most part, it is always blindly assumed that every single patient that presents with symptoms has a brain disease. Efforts are never made, pre-meds, during meds, or post-meds, to do some basic detective work to rule things in or rule things. If we were to rule out 70% of the most common underdiagnosed causes of depression...the ones I harp about frequently...then we would have much more certainty in saying this particular patient has a brain disease.
Posted by SLS on November 12, 2009, at 16:26:13
In reply to Re: Peter Breggin » SLS, posted by bleauberry on November 12, 2009, at 16:15:56
> My frustration is that for the most part, it is always blindly assumed that every single patient that presents with symptoms has a brain disease. Efforts are never made, pre-meds, during meds, or post-meds, to do some basic detective work to rule things in or rule things. If we were to rule out 70% of the most common underdiagnosed causes of depression...the ones I harp about frequently...then we would have much more certainty in saying this particular patient has a brain disease.
I agree.
- Scott
Posted by ace on November 12, 2009, at 20:22:34
In reply to Re: Peter Breggin » Phidippus, posted by metafunj on November 10, 2009, at 5:55:05
> 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?I havent seen any evidence to that effect.
Who is this person? A public figure?A lot of those guys are just treading the same old boaring water that Szasz did so very long ago...
Posted by Sigismund on November 12, 2009, at 20:31:46
In reply to Re: Peter Breggin » metafunj, posted by ace on November 12, 2009, at 20:22:34
>A lot of those guys are just treading the same old boaring water that Szasz did so very long ago...
I don't think Szasz has anything much in common with Breggin, any more than either do with Laing, Esterson and Cooper.
Posted by Katgirl on November 14, 2009, at 15:42:05
In reply to Re: Peter Breggin » bleauberry, posted by SLS on November 12, 2009, at 7:35:06
Is this guy one of the "anti-medication" experts? Take care before throwing your medications away. My ex-husband spent our entire marriage insisting I was less than because I took 10-20mg of Paxil. I was inundated with books and articles by people like this. The fact that I had such bad withdrawal from Paxil seemed to prove their point. HOWEVER, after going through prolonged paxil withdrawal even after the slowest reduction EVER, I ended up in a treatment resistant depression because my brain/body could no longer tolerate any of the medications. I spent two years in abject hell, and another three in moderate hell after a semi successfull course of rTMS that at least gave me enough biochemical stability on which to build from. I am much much much better than I was, but nowhere near normal when it comes to anxiety levels. I have to stay on a very rigid schedule to have anywhere close to normal funcitioning. I would like to go back to school or God forbid, date some day but that is out of the question with my anxiety. I pray in my lifetime that either a new medication will come along that I can take or that I will very slowly continue to make progress. I am an odd case when it comes to this subject, because yes, in my case I DO think that paxil (or rather withdrawal to it) did profoundly alter my brain chemistry in that I no longer react to any medications the way I used to. So yes, the drugs have dangers, I whole heartedly beleive that. But if I could go back in time you can bet that I would have stayed on my little bitty does of 10mg paxil for the rest of my life and been able to actually LIVE a full life.
Posted by SLS on November 14, 2009, at 15:57:51
In reply to Re: Peter Breggin, posted by Katgirl on November 14, 2009, at 15:42:05
I am sorry - I mean REALLY sorry - that this has happened to you.
For what it is worth, I think employing prolonged taper periods for antidepressants and benzodiazepines is one of the worst things you can do to your brain. My guess is that it keeps the brain in an in-between state of withdrawal that fosters a kindling effect that ultimately produces deleterious hypersensitivities to these drugs - perhaps even treatment resistance. This is only conjecture on my part.
- Scott
Posted by SLS on November 14, 2009, at 16:00:35
In reply to Re: Peter Breggin, posted by Katgirl on November 14, 2009, at 15:42:05
Oh.
I forgot.
Welcome and thank you for posting.
I wish you a better future than has been your past. There are many smart and experienced people here. Maybe they can help you find what you are looking for.
- Scott
Posted by Alexanderfromdenmark on November 14, 2009, at 16:17:35
In reply to Re: Peter Breggin » Katgirl, posted by SLS on November 14, 2009, at 15:57:51
What is a protracted withdrawel in your opinion?
I think with lexapro I went down 2,5 mg at a time. Tapering like that for a few months. Was that too slow?
Posted by floatingbridge on November 14, 2009, at 18:19:25
In reply to Re: Peter Breggin, posted by Katgirl on November 14, 2009, at 15:42:05
Katgirl,
Thanks for posting. For a long time, I felt less of a person as well. I still sometimes do. I'm very sorry that you got this message from your husband.
I think the anti-med fanatics really hurt people more than help. They instill fear rather than invite fruitful discussion and reflection on what may be best for any given individual. And there is enough stigma already to deal with!
And welcome--as Scott said, there are lots of wise and knowledgeable people here willing to share their experience.
take care,
fb
> Is this guy one of the "anti-medication" experts? Take care before throwing your medications away. My ex-husband spent our entire marriage insisting I was less than because I took 10-20mg of Paxil. I was inundated with books and articles by people like this. The fact that I had such bad withdrawal from Paxil seemed to prove their point. HOWEVER, after going through prolonged paxil withdrawal even after the slowest reduction EVER, I ended up in a treatment resistant depression because my brain/body could no longer tolerate any of the medications. I spent two years in abject hell, and another three in moderate hell after a semi successfull course of rTMS that at least gave me enough biochemical stability on which to build from. I am much much much better than I was, but nowhere near normal when it comes to anxiety levels. I have to stay on a very rigid schedule to have anywhere close to normal funcitioning. I would like to go back to school or God forbid, date some day but that is out of the question with my anxiety. I pray in my lifetime that either a new medication will come along that I can take or that I will very slowly continue to make progress. I am an odd case when it comes to this subject, because yes, in my case I DO think that paxil (or rather withdrawal to it) did profoundly alter my brain chemistry in that I no longer react to any medications the way I used to. So yes, the drugs have dangers, I whole heartedly beleive that. But if I could go back in time you can bet that I would have stayed on my little bitty does of 10mg paxil for the rest of my life and been able to actually LIVE a full life.
Posted by SLS on November 14, 2009, at 19:07:20
In reply to Re: Peter Breggin, posted by Alexanderfromdenmark on November 14, 2009, at 16:17:35
> What is a protracted withdrawel in your opinion?
Anything that allows one to experience withdrawal symptoms, either intermittently or continually, for an extended period of time. This is really a larger issue than I am prepared to discuss right now. There are ways to discontinue medications without relying on a fixed dosage schedule.
> I think with lexapro I went down 2,5 mg at a time. Tapering like that for a few months. Was that too slow?I don't think that is too slow, especially if you are under no time constraints and are not experiencing withdrawal symptoms. Somewhere, there is a balance. You don't want to taper too quickly, otherwise the withdrawal symptoms become too severe. If you are trying to discontinue medications in an effort to be medication-free, you would want to taper slowly. However, some people advocate discontinuing antidepressants and benzodiazepines by reducing the dosage at a rate of 10% every 3-4 weeks. If one were to begin to taper from a dosage of Lexapro of 40mg beginning today, he would not reach the endpoint until early 2011. And still, it is very likely that one would experience some withdrawal symptoms upon each dosage reduction. What's that all about? I don't understand it. I have yet to see a clinical study supporting such an algorithm. I only see accounts of people who still suffer during these protracted taper periods. The funny thing is, when confronted with a case like this, their answer is to cut back to 5% reductions.
There are lots of opinions as to how to best go about discontinuing an antidepressant. I came up with my own method. It allows me to discontinue Effexor 300mg within two weeks with almost no withdrawal symptoms. Prior to using this method, which I like to call a flexible-dose strategy, I would experience all the nasty stuff that comes with SRI discontinuation, including the brain zaps. Yuck. I am also able to discontinue benzodiazepines equally fast.
I guess the bottom line is that I can't recommend a universally effective taper strategy. Depending on who you talk to, the taper period can be anywhere from 3 days to 3 years. I would rather shoot for 3 weeks.
If you are not experiencing withdrawal symptoms, then I guess you are doing something right. Whatever it is, keep doing it.
- Scott
Posted by Phillipa on November 14, 2009, at 21:10:38
In reply to Re: Peter Breggin, posted by Katgirl on November 14, 2009, at 15:42:05
Katgirl that is almost the same thing that happened to me l0mg of paxil for two years went off biting off a tiny piece took about two weeks to get off without zaps. But still had benzos. But since then none work. I know my thyroid being damaged is part of the reason. But if I'd not listened to the pdoc and gotten in his celexa trial I would have been fine on l0mg of paxil as had gone back on it. Phillipa
Posted by 49er on November 15, 2009, at 1:18:47
In reply to Re: Peter Breggin » Alexanderfromdenmark, posted by SLS on November 14, 2009, at 19:07:20
<<However, some people advocate discontinuing antidepressants and benzodiazepines by reducing the dosage at a rate of 10% every 3-4 weeks. If one were to begin to taper from a dosage of Lexapro of 40mg beginning today, he would not reach the endpoint until early 2011. And still, it is very likely that one would experience some withdrawal symptoms upon each dosage reduction. What's that all about? I don't understand it. I have yet to see a clinical study supporting such an algorithm. I only see accounts of people who still suffer during these protracted taper periods. The funny thing is, when confronted with a case like this, their answer is to cut back to 5% reductions. >>
I guess you are talking about me:) By the way, in another post, you criticized me for confronting a position you took as you said you didn't criticize me directly. I thought you had a good point but now you're kind of doing the same thing.
I have never said that tapering slowly means that you will be completely free of withdrawal symptoms. But based on how I have seen people suffer horribly on this board from tapering too fast, I will bet their symptoms would be alot less if they slowed down.
What difference does it make how long it takes? The person who takes 3 weeks. vs. the person who takes 3 years may actually suffer longer than the person who took 3 years. So really, no time is saved.
Tapering slowly gives your brain time to adjust to the neurochemical changes these drugs have made throughout the body. This isn't an issue of lowering a drug like Tylenol.
There isn't a clinical study because drug companies have no interest in studying withdrawal and psychiatrists keep advocating tapering schedules according to what the drug companies say. Not all of them but quite a few.
All I know SLS is if I had tapered the way my psychiatrist wanted me to which would have have been alot faster, there is no way I would have been as successful in tapering off of my meds. I would probably still be on all of them.
People on the Paxil Progress boards who tapered slowly are doing alot better than the folks who cold turkeyed or tapered too quickly. Many people who cold turkeyed or tapered too quickly said they wish they had found Paxil Progress Boards.
Anyway, to relate this thread back to the original comment, while I mentioned alot of good things Breggin has done, one of my criticisms ironically is that people like him aren't very helpful as far as helping people get off of meds.
49er
Posted by SLS on November 15, 2009, at 2:59:18
In reply to Re: Peter Breggin » Katgirl, posted by Phillipa on November 14, 2009, at 21:10:38
> Katgirl that is almost the same thing that happened to me l0mg of paxil for two years went off biting off a tiny piece took about two weeks to get off without zaps.. Phillipa
Phillipa: That is EXACTLY how to do it!
- Scott
Posted by SLS on November 15, 2009, at 3:27:06
In reply to Re: Peter Breggin » SLS, posted by 49er on November 15, 2009, at 1:18:47
> <<However, some people advocate discontinuing antidepressants and benzodiazepines by reducing the dosage at a rate of 10% every 3-4 weeks. If one were to begin to taper from a dosage of Lexapro of 40mg beginning today, he would not reach the endpoint until early 2011. And still, it is very likely that one would experience some withdrawal symptoms upon each dosage reduction. What's that all about? I don't understand it. I have yet to see a clinical study supporting such an algorithm. I only see accounts of people who still suffer during these protracted taper periods. The funny thing is, when confronted with a case like this, their answer is to cut back to 5% reductions. >>
> I guess you are talking about me:)You can find this kind of protracted fixed-dose taper schedule suggested elsewhere on the Internet. I happen to know that you are a proponent of using it, but I did not think it proper to use your name or write anything that would allude to it.
I understand how impassioned you are to reduce pain and suffering. I just happen to disagree with your way of going about it.
- Scott
Posted by 49er on November 15, 2009, at 5:32:16
In reply to Re: Peter Breggin » 49er, posted by SLS on November 15, 2009, at 3:27:06
<< You can find this kind of protracted fixed-dose taper schedule suggested elsewhere on the Internet. I happen to know that you are a proponent of using it, but I did not think it proper to use your name or write anything that would allude to it.>>
Ok, now I understand.
Where did you find it as I know of very few places that suggest that schedule? Maybe I have more allies than I think:) Breggin advocates 10% but suggests it be done every 2 weeks.
<<I understand how impassioned you are to reduce pain and suffering. I just happen to disagree with your way of going about it.>>
Fair enough.
49er
Posted by Katgirl on November 15, 2009, at 9:31:08
In reply to Re: Peter Breggin, posted by 49er on November 15, 2009, at 5:32:16
Thanks everyone for making me feel so welcome! Sometimes I feel like a diabetic trying to live without insulin, as I know I have brain disfunction but can't take the meds. Yesterday I was profoundly upset by all I still can't do, but I FINALLY got some sleep last night and that always helps. So today I will try to focus on what I can do and be grateful that I'm not as bad as I was five years ago. SLS, I do believe I had some kind of kindling/damage from the withdrawal. I have no idea if my brain can slowly learn to compensate for this, or if I will always be facing the world with "one brain lobe" (instead of one arm :) tied behind my back. (OK, stupid attempt at humor). Thanks again all!
Posted by bleauberry on November 16, 2009, at 18:18:14
In reply to Re: Peter Breggin, posted by Katgirl on November 15, 2009, at 9:31:08
Your story is so heartfelt. It hit me hard because it is so similar to my own.
I had no problem switching amongst meds at normal to high doses. It wasn't until after I had been taken off all meds that things changed dramatically. And now, like you, it is as if a door had been closed and locked behind me, that I may never return to where I was. Tiny amounts of any meds and many common supplements or herbs affect me profoundly, almost always in a negative way.
I do believe there is hope however. Though we don't know anything about it at this board, and though it would seem bizarre, strange, unscientific, whatever...people do get well all the time with homeopathy. By homeopathy, I am talking micro doses...1/6th to 1/100th or even 1/1000th the doses other people take.
For us science minded people, it doesn't make sense...how could 3 drops (maybe 1mg) of st johns wort per day bring remission when it is supposed to be 300mg 3 times a day? Well, the homeopathy doctors have their explanations, and it kind of makes sense, but still, it is a new way of thinking to those of us here. Not new to them, but new to us.
My Lyme doctor practices this, without knowing it. Many of his patients are very sensitive. He has had good luck with doses like 1mg Lexapro. Of course, he isn't thinking homeopathy and probably never heard of it, but that is in fact what he is doing. And it works.
What I am trying to say is that I am totally convinced there is hope and there are answers...but that they will involve dramatically different doses of things than before. For whatever reason, our bodies will reject normal doses but embrace microscopic doses. It's almost as if all we need is a hint to wake everything up.
Posted by Katgirl on November 17, 2009, at 9:19:17
In reply to Re: Peter Breggin, posted by bleauberry on November 16, 2009, at 18:18:14
WOW!! I could have written your post as well!! I am extremely sensitive to EVERYTHING now, and not just psychiatric drugs. Allergy medicines that I took for years I can no longer tolerate, or can only take at a much reduced rate only every couple of days. So I tried to get allergy shots instead (kind of a medical form of homeopathy :) but unfortunately went in to anaphylactic shock after 5 months of shots, so that ended that (still trying to get the body back together after that fiasco!!) For me, I suspect even 1mg of Lexapro would be too much for me at this point (based on the 2years where they threw just about every med they could think at me. After getting somewhat better from rTMS, the thing that has seemed to help the best is just not re-assulting my brain. (And yes, all the herbal stuff is too much as well!!) It means I live a limited life at the moment. Not the life I wanted or ever pictured for myself. But it is a far cry better than the hell I was in for five years. Thanks so much for posting.
This is the end of the thread.
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