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Dr. Bob is Robert Hsiung, MD,
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Posted by brynb on November 10, 2012, at 23:51:14
In reply to Depression is Infectious Inflammation, posted by bleauberry on November 10, 2012, at 5:35:08
Hi bleauberry,
The inflammation theory certainly makes sense, and I'm sure it's valid in some cases (yours is clear), but I can't see it as the main offender for all.
A few people on the board have been doing well by adding Minocycline to their med regimens, though its positive effects are no doubt due to more than just its anti-inflammatory properties.
I suffer from chronic asthma and allergies, and have read many articles linking depression and allergies. I take antibiotics a lot throughout the year (especially during the cold months) as I'm prone to bronchitis and sinusitis. My question is, how do you know which antibiotic is the right one to use? Do you actually feel that the antidepressant(s) treats your depressive symptoms by treating the systemic infection/disease you're suffering from?
It sounds like you've found a great doc. That's great. I hope you continue to do well.
-b
Posted by jono_in_adelaide on November 11, 2012, at 3:18:53
In reply to Re: Depression is Infectious Inflammation » bleauberry, posted by brynb on November 10, 2012, at 23:51:14
How does your LLMD explain the existance of psychiatric illness in places where there is no lymes disease (sweden, England, Australia)
Posted by SLS on November 11, 2012, at 7:02:12
In reply to Re: Depression is Infectious Inflammation » bleauberry, posted by SLS on November 10, 2012, at 22:37:59
Sorry about the poor proofreading.
I meant to say:
"Inflammation is a common reaction (denominator) in a great many human injuries and disorders. That doesn't mean that infection is the cause of them."Psychosocial stress can provoke inflammation. One pathway by which this can occur involves the neurotoxicity produced by glutamatergic hyperactivity (immunoexcitotoxicity). Anxiety is an example of this. Infection has not been implicated in this process as far as I know. Of course, this does not preclude infection from making things worse or leaving one more vulnerable to depressive reactions.
I tend to think that inflammation is the consequence of major depressive disorder (MDD) rather than its cause. The same is probably true of bipolar disorder (BD). Perhaps there is a positive feedback loop involved. Depression would produce inflammation which would worsen depression which would increase inflammation, etc. I don't think this is the majority opinion, though.
- Scott
Posted by bleauberry on November 11, 2012, at 10:53:34
In reply to Re: Depression is Infectious Inflammation, posted by jono_in_adelaide on November 11, 2012, at 3:18:53
> How does your LLMD explain the existance of psychiatric illness in places where there is no lymes disease (sweden, England, Australia)
That's an excellent question. I can't speak for my doctor because he isn't here to answer for himself but I can share my thoughts on that topic.
Lyme disease has been found virtually everywhere on the planet. Ticks have been found in places and regions where they were supposedly nonexistent. The same bacteria carried by ticks have also been found in dust mites, mosquitos, and some flies. That's just what is known, so you'll have to fill in the blanks for what isn't yet known.
Sweden, England, and Australia do have ticks. They've even been found in snow. And Alaska. This highlights the difficulties in treating lyme....there are too many myths floating around. When we get right down to hardcore nuts and bolts, what actually happens in the doctor's practice, that's where we learn. They see it first hand.
One patient got a bad reaction that looked like lyme, except it was from a barnacle scrape while swimming in the ocean. The symptoms were unexplained depression, weakness, and tiredness. It responded to Lyme treatment even though it wasn't Lyme. That is key to understand.
There are about a dozen infectious organisms that I am familiar with, and several times more I am not familiar with, that all pretty much look the same in terms of symptom presentation. Depending on the doctor seen, they all look like one of or a mixture of these, and are commonly misdiagnosed as one of these:
Depression and all psychiatric symptoms.
Fibromyalgia
Lupus
Arthritis
Chronic Fatigue Syndrome
And moreIt's really hard because tests do not exist to accurately test for any of the suspects. Instead what has to be done arechallenge trials to see what happens....the results of a trial tells a lot, one way or the other. All we know for sure, and it is mostly anecdotal since there isn't any money in it for anyone to research it, is that patients in those categories who have tried antibiotics often improve or go into remission. At this point in history each of us sort of have to fill in the blanks as to why and how on our own. That's when I prefer to hear what someone says on the topic who actually sees it 8 hours a day every day as their work. LLMDs for example understand they are potentially treating a lot more than just one simple bacteria, and when the patient gets better they may never know for sure what the bug was or what the cause of the inflammation was, only that they got better on antimicrobial strategies but not other strategies.
Posted by Phil on November 11, 2012, at 15:24:20
In reply to Re: Depression is Infectious Inflammation » jono_in_adelaide, posted by bleauberry on November 11, 2012, at 10:53:34
From the CDC
Fast FactsIn 2011, 96% of Lyme disease cases were reported from 13 states:
Connecticut
Delaware
Maine
Maryland
Massachusetts
Minnesota
New Hampshire
New Jersey
New York
Pennsylvania
Vermont
Virginia
WisconsinLyme disease is the most commonly reported vectorborne illness in the United States--in 2011, it was the 6th most common Nationally Notifiable disease. However this disease DOES NOT occur nationwide and is concentrated heavily in the northeast and upper Midwest.
Posted by jono_in_adelaide on November 11, 2012, at 18:59:00
In reply to Re: Depression is Infectious Inflammation » jono_in_adelaide, posted by bleauberry on November 11, 2012, at 10:53:34
The other question I'd ask is why dont drugs that control inflamation (NSAID's, Steroids,Immunosuppresants) releive psychiatric symptoms
Posted by jono_in_adelaide on November 11, 2012, at 19:00:56
In reply to Re: Depression is Infectious Inflammation » jono_in_adelaide, posted by bleauberry on November 11, 2012, at 10:53:34
I'm sure some people with west nile, lymes, ross river fever etc are misdiagnised as psychiatric cases by ignorannt doctors, but I realy cant beleive they are the majority.
As for CFS, i wont tell you my opinions on that, as things might get nasty
Posted by SLS on November 12, 2012, at 13:10:05
In reply to Depression is Infectious Inflammation, posted by bleauberry on November 10, 2012, at 5:35:08
I had an interesting conversation with my doctor this morning. He seems to be drifting in the direction of your doctor regarding the notion of infection mediating depression. A little searching on Google demonstrates a growing interest in this.
My doctor wrote the following articles detailing infection, inflammation, and psychiatric symptoms.
However, I also found the following article. It provides some evidence to support my contention that inflammation could be the result of MDD rather than its cause.
http://www.sciencedaily.com/releases/2012/01/120105112235.htm
The following article provides a basis for a theory that depression accompanies infection as an adaptive response.
http://www.sciencedaily.com/releases/2012/03/120301103756.htm
I think that depression normally functions to prevent an individual from spending too much time, energy, and stress in pursuing a futile goal. It allows one to accept and adapt to his environment. Major Depressive Disorder might be a derangement in the physiological dynamics of this otherwise healthy process.
http://www.scientificamerican.com/article.cfm?id=depressions-evolutionary
Looking at the big picture, it seems to me that the word "depression" represents a plethora of conditions with a broad range of etiologies. It doesn't make sense to me to look at depression as being a singular pathology.
- Scott
Posted by Phillipa on November 12, 2012, at 20:21:43
In reply to Re: Depression is Infectious Inflammation » bleauberry, posted by SLS on November 12, 2012, at 13:10:05
Hence your response to minocycline as crosses blood brain barrier. Phillip
Posted by delna on November 12, 2012, at 21:38:04
In reply to Re: Depression is Infectious Inflammation » bleauberry, posted by SLS on November 12, 2012, at 13:10:05
Hi,
I vanished for ages so I don't know if anyone remembers me. Anyway, I have been through 2 years of insanity. I have had loads of experiences with different treatments and I want to report back to everyone at some point.
On this subject though:
I have a pretty bad 'inflammatory condition' which is totally unidentifiable. My markers like hsCRP and ESR are very high. For example hs-CRP should be under 3. Mine is 25-30. hs CRP has been consistently raised for the past 2 years. I've been tested for everything because doctors were alarmed but nothing can be found.
My psychiatrist who is also part immunologist believes inflammation and depression are linked (but which came first is hard to say.) He is pushing minocycline on me as he thinks this will help depression by reducing inflammation and thus break the cycle.Am I being stupid and stubborn in resisting minocycline? He gave me a prescription which I haven't filled.
Actually, I would be a great guinea pig to test this theory. My numbers are very high so inflammation is 'visible' and quantifiable. If the numbers come down and my depression/fatigue gets better, this may suggest attacking the inflammatory pathway may be an option for others.
Also the research on the link between the two is very strong. I have papers given to me by my doctor which explore this very thing. I can share if others want them.
Please feel free to push me to try minocycline :-) I need to shake off my cynicism.
Take Care,Divya
Posted by SLS on November 13, 2012, at 6:14:12
In reply to Re: Depression is Infectious Inflammation, posted by delna on November 12, 2012, at 21:38:04
> Please feel free to push me to try minocycline :-) I need to shake off my cynicism.
http://www.dr-bob.org/babble/20120803/msgs/1023257.html
I am doing well with my present treatment regime. When I first began taking minocycline, I experienced an improvement within the first five days. However, my progress towards remission has also required an increase in my dosage of prazosin. Minocycline might work synergistically with other anti-glutamatergic drugs like Lamictal or perhaps even memantine or NAC. There is much work that needs to be done to characterize the role that minocycline will play in psychiatry.
Minocycline is not hocus pocus, and I believe is worth a try if you are really desperate to try something different.
- Scott
Posted by SLS on November 13, 2012, at 7:11:43
In reply to Re: Depression is Infectious Inflammation, posted by delna on November 12, 2012, at 21:38:04
ScienceDaily articles regarding infection and inflammation in psychiatric presentations.
Common Parasite May Trigger Suicide Attempts: Inflammation from T. Gondii Produces Brain-Damaging Metaboliteshttp://www.sciencedaily.com/releases/2012/08/120816170400.htm
Depression: An Evolutionary Byproduct of Immune System?http://www.sciencedaily.com/releases/2012/03/120301103756.htm
Targeting Inflammation to Treat Depressionhttp://www.sciencedaily.com/releases/2012/09/120903221132.htm
Inflammation in Depression: Chicken or Egg?http://www.sciencedaily.com/releases/2012/01/120105112235.htm
Childhood Adversity Increases Risk for Depression and Chronic Inflammationhttp://www.sciencedaily.com/releases/2012/07/120703133721.htm
- Scott
Posted by Delna on November 13, 2012, at 9:12:11
In reply to Re: Depression is Infectious Inflammation » delna, posted by SLS on November 13, 2012, at 7:11:43
> > Please feel free to push me to try minocycline :-) I need to shake off my cynicism.
>
> http://www.dr-bob.org/babble/20120803/msgs/1023257.html
>
> I am doing well with my present treatment regime. When I first began taking minocycline, I experienced an improvement within the first five days. However, my progress towards remission has also required an increase in my dosage of prazosin. Minocycline might work synergistically with other anti-glutamatergic drugs like Lamictal or perhaps even memantine or NAC. There is much work that needs to be done to characterize the role that minocycline will play in psychiatry.
>
> Minocycline is not hocus pocus, and I believe is worth a try if you are really desperate to try something different.
Oh, wow. Thank you Scott. That is so useful. I didn't know any of that. And although I am on Lamictal, he's given me a starter pack for mementine.
All that information is enough to convince me. And I am desperate. I am on so many stimulants but still am foggy and tired all the time.
I have come to distrust doctors but I count the experiences of other patients as extremely valuable. So Thanks for sharing your research and experience.
Good to hear you are doing better
Take Care
DivyaPS:I will be filling my prescription today :-)
Posted by SLS on November 13, 2012, at 14:20:44
In reply to Re: Depression is Infectious Inflammation » SLS, posted by Delna on November 13, 2012, at 9:12:11
Hi Divya.
> PS:I will be filling my prescription today :-)
:-)
The only serious side effect to look out for is brain swelling (pseudotumor cerebri). This is rare, but you should know the signs and symptoms:
------------------------------------------------------
Moderate to severe headaches that may originate behind your eyes, wake you from sleep and worsen with eye movement
Ringing in the ears that pulses in time with your heartbeat
Nausea, vomiting or dizziness
Blurred or dimmed vision
Brief episodes of blindness, lasting only a few seconds and affecting one or both eyes (visual obscurations)
Difficulty seeing to the side
Double vision (diplopia)
Seeing light flashes (photopsia)
Neck, shoulder or back pain
----------------------------------------------------
The other side effect of minocycline that concerns me is the possible discoloration of teeth and finger nails that has been reported with long term use. I don't know how common this is, but I think the discoloration can be irreversible. I hope these things don't scare you. I just think that you should know as much as possible about a drug before being treated by it.
So far, minocycline has treated me well. There are no side effects that I can detect.
I started at 100 mg/day (50 mg twice a day) and then increased to 200 mg/day (100 mg twice a day). For me, 200 mg/day was decidedly more effective than 100 mg/day.
- Scott
Posted by delna on November 13, 2012, at 19:45:36
In reply to Re: Depression is Infectious Inflammation » Delna, posted by SLS on November 13, 2012, at 14:20:44
> Hi Divya.
>
> > PS:I will be filling my prescription today :-)
>
> :-)
>
> The only serious side effect to look out for is brain swelling (pseudotumor cerebri). This is rare, but you should know the signs and symptoms:
>
> ------------------------------------------------------
>
> Moderate to severe headaches that may originate behind your eyes, wake you from sleep and worsen with eye movement
>
> Ringing in the ears that pulses in time with your heartbeat
>
> Nausea, vomiting or dizziness
>
> Blurred or dimmed vision
>
> Brief episodes of blindness, lasting only a few seconds and affecting one or both eyes (visual obscurations)
>
> Difficulty seeing to the side
>
> Double vision (diplopia)
>
> Seeing light flashes (photopsia)
>
> Neck, shoulder or back pain
>
> ----------------------------------------------------
>
> The other side effect of minocycline that concerns me is the possible discoloration of teeth and finger nails that has been reported with long term use. I don't know how common this is, but I think the discoloration can be irreversible. I hope these things don't scare you. I just think that you should know as much as possible about a drug before being treated by it.
>
> So far, minocycline has treated me well. There are no side effects that I can detect.
>
> I started at 100 mg/day (50 mg twice a day) and then increased to 200 mg/day (100 mg twice a day). For me, 200 mg/day was decidedly more effective than 100 mg/day.
>
>
> - Scott
Again Scott, thanks for for that. I know minocycline is rotten in many ways, I have taken it before and am aware of the nasty side effects. But my other options are worse, like adding another AP on top of the sulpiride. I already developed metabolic syndrome which sucks.
Can I ask you an off topic question please?
Why is lurasidone considered similar to ziprasidone? I can find no similarity but have read patient posts saying they are like twins.
thanks
Divya
Posted by Phillipa on November 13, 2012, at 20:09:57
In reply to Re: Depression is Infectious Inflammation » SLS, posted by delna on November 13, 2012, at 19:45:36
Delna I remember you. Weren't you living in India or some foreign land? As for the minocycline did you experience the headaches & dizzyiness. As I was given it for a dermatology problem and after 4 doses of 70mg had the dizzyness & headache but it didn't wake me. Also the lupus had me concerned and yes the gum and nail discoloration. But it crosses the blood brain barrier and others don't. What did you take it before for? I still have my script for 70mg and yes it's fresh. I did notice improvement of bowels first day. I did have problems with trying to take it without calcium/magnesium. I still test positive for lymes so thought also if true it might help? Phillipa
Posted by delna on November 13, 2012, at 20:28:47
In reply to Re: Depression is Infectious Inflammation » delna, posted by Phillipa on November 13, 2012, at 20:09:57
> Delna I remember you. Weren't you living in India or some foreign land? As for the minocycline did you experience the headaches & dizzyiness. As I was given it for a dermatology problem and after 4 doses of 70mg had the dizzyness & headache but it didn't wake me. Also the lupus had me concerned and yes the gum and nail discoloration. But it crosses the blood brain barrier and others don't. What did you take it before for? I still have my script for 70mg and yes it's fresh. I did notice improvement of bowels first day. I did have problems with trying to take it without calcium/magnesium. I still test positive for lymes so thought also if true it might help? Phillipa
Yes Phillipa, India.
I had it for acne and it made me dizzy too. But that was years ago and I used to overfocus of sensations.
My doc thinks the inflammation is causing the fatigue, brain fog & lows hence the minocycline. I dropped off my script but I shall have a test to determine baseline values for inflammatory markers first.Phillipa, I don't understand. Why is your lymes not fully treatable? Does nothing help?
Divya
Posted by Phillipa on November 13, 2012, at 21:11:45
In reply to Re: Depression is Infectious Inflammation » Phillipa, posted by delna on November 13, 2012, at 20:28:47
Delna it's a difficult illness to understand first IGA rises dramatically & usually ANA the marker for autoimmune diseases. So with both up high very high was hard to figure out if had an autoimmune illness or lymes only. The rheumatologist said I was a bunch of autoimmun diseases that were all at low levels so it was decided that it was lymes. For two years antibiotics. The last time saw the infection control specialist 2.5 years ago was still positive based on IGG which rises after IGA does and then the IGA lowers and even with reinfection will never ever rise again. So they watch to see if IGG rises again meaning new infection. At the time the ICD didnt know what to do gave me doxycycline l00mg for twice a day. A Month later had some minor surgery and had to go off it per that doc as he used another antibiotic post surgery. I just never started it again. So still after about 4 months deciding whether should give the minocycline another go and see if feel better. So how bad were the headaches and dizzyness? Will you please keep me posted? Phillipa
Posted by SLS on November 14, 2012, at 5:01:41
In reply to Re: Depression is Infectious Inflammation » Phillipa, posted by delna on November 13, 2012, at 20:28:47
> I dropped off my script but I shall have a test to determine baseline values for inflammatory markers first.
What markers are you being tested for?
Ziprasidone and lurasidone are chemically related and share some properties. For me, both drugs produced brain-fog and cognitive impairments at moderate dosages. I found that ziprasidone was helpful for a week or so to reduce my bipolar depression. The major differences between these two drugs in my mind are:
1. Ziprasidone is a weak to moderate potency inhibitor of both norepinephrine and setoroning reuptake (SNRI).
2. Lurasidone is a serotonin 5-HT7 receptor antagonist.
Both drugs are antagonists at dopamine D2 and serotonin 5-HT2a receptors, and are partial agonists at the 5-HT1a receptor.
There is a growing body of evidence that lurasidone is effective for treating depression. Ziprasidone has not garnered as much interest for this indication.
- Scott
Posted by neversaynever on November 14, 2012, at 13:55:53
In reply to Depression is Infectious Inflammation, posted by bleauberry on November 10, 2012, at 5:35:08
Antibiotics are to kill infection, so how long do you take them to kill infection of the brain , it should if working kill infection in weeks so why take it long term. Plus what happen,s when you body becomes immune to antibiotics an you get a phsyical illness that needs antibiotics to stop you from dieing ??????????
Posted by Delna on November 14, 2012, at 14:24:30
In reply to Re: Depression is Infectious Inflammation, posted by neversaynever on November 14, 2012, at 13:55:53
> Antibiotics are to kill infection, so how long do you take them to kill infection of the brain , it should if working kill infection in weeks so why take it long term. Plus what happen,s when you body becomes immune to antibiotics an you get a phsyical illness that needs antibiotics to stop you from dieing ??????????
Hi
In this situation minocycline is not being used for its antibacterial properties. It has independent anti-inflammatory properties and can reduce inflammation, even in the brain.
You do not build immunity to antibiotics. Bugs can become immune to them. Minocycline is uniquely needed for very specific, v limited conditions so its okay to take it. Countless other antibiotics exist. Plus you cannot assume that ,if bugs sensitive to minocycline are indeed inhabiting your brain, they will not be wiped out. Drug résistance does not happen so easily. The bugs need to mutate their genetic makeup first.
Posted by Delna on November 14, 2012, at 14:40:27
In reply to Re: Depression is Infectious Inflammation » delna, posted by Phillipa on November 13, 2012, at 21:11:45
> Delna it's a difficult illness to understand first IGA rises dramatically & usually ANA the marker for autoimmune diseases. So with both up high very high was hard to figure out if had an autoimmune illness or lymes only. The rheumatologist said I was a bunch of autoimmun diseases that were all at low levels so it was decided that it was lymes. For two years antibiotics. The last time saw the infection control specialist 2.5 years ago was still positive based on IGG which rises after IGA does and then the IGA lowers and even with reinfection will never ever rise again. So they watch to see if IGG rises again meaning new infection. At the time the ICD didnt know what to do gave me doxycycline l00mg for twice a day. A Month later had some minor surgery and had to go off it per that doc as he used another antibiotic post surgery. I just never started it again. So still after about 4 months deciding whether should give the minocycline another go and see if feel better. So how bad were the headaches and dizzyness? Will you please keep me posted? Phillipa
That does sound complicated! Sorry you have to deal with all that.
I will keep u posted.
About the dizziness, that was nearly 15 years ago so i cant remember. But it was enough to make me switch to doxycycline. The dermatologist told me its one of the temporary side effects that will pass but I didn't believe him.
I'm starting really low. I think at 20mg. I will let you know how it goes.
Take Care
D
Posted by g_g_g_unit on November 14, 2012, at 18:56:09
In reply to Re: Depression is Infectious Inflammation, posted by delna on November 12, 2012, at 21:38:04
> Hi,
> I vanished for ages so I don't know if anyone remembers me. Anyway, I have been through 2 years of insanity. I have had loads of experiences with different treatments and I want to report back to everyone at some point.
> On this subject though:
> I have a pretty bad 'inflammatory condition' which is totally unidentifiable. My markers like hsCRP and ESR are very high. For example hs-CRP should be under 3. Mine is 25-30. hs CRP has been consistently raised for the past 2 years. I've been tested for everything because doctors were alarmed but nothing can be found.
> My psychiatrist who is also part immunologist believes inflammation and depression are linked (but which came first is hard to say.) He is pushing minocycline on me as he thinks this will help depression by reducing inflammation and thus break the cycle.
>
> Am I being stupid and stubborn in resisting minocycline? He gave me a prescription which I haven't filled.
>
> Actually, I would be a great guinea pig to test this theory. My numbers are very high so inflammation is 'visible' and quantifiable. If the numbers come down and my depression/fatigue gets better, this may suggest attacking the inflammatory pathway may be an option for others.
>
> Also the research on the link between the two is very strong. I have papers given to me by my doctor which explore this very thing. I can share if others want them.
>
> Please feel free to push me to try minocycline :-) I need to shake off my cynicism.
> Take Care,
>
> Divya
>Hey delna .. just wanted to say that it's really nice to see a familiar name; I had wondered what had happened to you after you disappeared, as I recall you were in a pretty bad place.
I'm in a similar position -- backed-into-a-corner, skeptical and hopeless about further treatment propositions etc. since I've tried just about everything ..
Posting on another board, however, someone strongly suggested I try Augmentin XR or a similar anti-biotic .. apparently their son was totally asymptomatic for strep (which is one cited cause of early-onset OCD) and, after failing to respond to conventional treatment, experienced quite a dramatic remission in symptoms.
My case is kinda different (OCD onset at 19), but I'm thinking about asking my GP to prescribe an AB ..
Posted by Phillipa on November 14, 2012, at 20:32:24
In reply to Re: Depression is Infectious Inflammation » delna, posted by g_g_g_unit on November 14, 2012, at 18:56:09
I used to get strep all the time. Only with testing for strep did it get diagnosed. I do think I need an antibiotic and darn was at dermatologist's today and it didn't cross my mind to ask for doxy. Phillipa
Posted by Phillipa on November 14, 2012, at 20:35:34
In reply to Re: Depression is Infectious Inflammation » Phillipa, posted by Delna on November 14, 2012, at 14:40:27
Delna thanks. Phillipa
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