Tuesday, August 20, 2019

Comments by LoganBerman

Showing 36 of 36 comments.

  • I am not going into my history because it is basically identical to yours. I know what PAWS is all to well.

    Excess Glutamate is basically what is going on with regards to withdrawal, just from a biochemistry perspective. NMDA Antagonists have been shown to improve the success rate from Benzodiazepines from the little studies that have been done. PAWS is not in the DSM, that is why there are little studies. We have to connect the dots ourselves. I am just as frustrated believe me.

  • It is ridiculous that doctors still give out a month worth of Benzodiazepines to people without explaining tolerance and dependence.

    The problem, I assume, is when you take Benzodiazepines for so long and discontinue, there is a surge of glutamate resulting in Excitotoxicity due to a down regulation of GABA.

    This is not well known but I am wondering if PAWS can be prevented by Glutamate Antagonists, something like Memantine, an Alzheimer’s drug. There are no studies being done but ironically, it is being used to augment OCD and Anxiety now, which are the biggest complaints of Benzodiazepine withdrawal.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085808/

    Not to mention, most of the new psychiatric medications being developed modulate glutamate activity at NMDA/AMPA receptors.

  • Will you are one hundred percent right. I think, unfortunately, the only real thing that is going to reform the mental health system, or psychiatry in general, is time and research.

    The movement has failed because psych survivors are never going to be taken seriously if they declare psychiatry pseudoscience or for its abolition. The movement is digging its own grave. It is pure fantasy and will never occur so that is one problem. Thomas Szasz, everything the man said is fundamentally correct but aligning himself with the lunatic cult of scientology, he lost all credibility in basically everything he stood for and became quite the hypocrite in the process. I am sure most people here will disagree with me and call me out but that is the reality and I think we have to face up to that, regardless if the individual has been afflicted immensely.

    The problem lies within the limited knowledge of the brain itself and the biochemical differences in an individual. Not everyone is inflicted with iatrogenesis while taking psychiatric medication or coming off them unfortunately. If that were the case the correlation would be so strong it would be pretty obvious to psychiatrists and the public but it’s just not happening.

    The electoral college will be abolished in the future most likely but that takes time as well. Everyone knows the system is corrupt and bought, Donald Trump is the president. The man will more than likely get into a war with North Korea or Iran if he manages to stay in office for four years because he is an imbecile just like most neocons who don’t understand consequences of regime change.

    Not to mention in America, the opiate epidemic is so bad that everything else is being pushed to the side. Inform the FDA of negative withdrawal symptoms, I have done that, because what else can I do? We have to be our own advocates in this. Inform doctors and as many people as you can. Psychiatrists know there treatments are lousy and harmful but challenging the status quo really won’t advance anything.

  • You hit the nail right on the head.

    I do agree with most people on here that these drugs have a limited roll, especially if someone has been through trauma. Psychiatrists are really hit or miss (I have had some terrible ones) but some will sit you down and talk about health history and what not, before jumping on the medication bandwagon. The mental health facility I have been to did daily blood work on literally all the patients there to look at anything that could be wrong, I assume that is most mental health facilities. Most psychiatrists do not do this though as you stated, that defiantly should change.

  • Validation and normalization work better than labeling and drugs. Not that some people don’t find the drugs helpful, and I don’t wish to ban them, but in the long run, finding someone to understand you and help you make plans is almost always the real solution. There may be the odd exception where a genetic condition really does exist, but these have been proven over time to explain only a tiny percentage of cases. Such cases should be detected and dealt with accordingly, but assuming that ALL cases of depression (or even most) are biological in origin ignores both the evidence and basic common sense.

    I agree but you are assuming all mental distress is psychological, most of the time it is, but for some people that doesn’t seem to be the case.

  • I found the the source of the 70% figure offered by LoganBerman. Not impressed.

    Nonetheless,this study shows a statistically significant associationbetween the presence o f t h e 6 7 ? T g e n o t y p e a n d a n i n c r e a s e dr i s k o f d e p r e s s i v ee p i s o d e s . A larger study in a properly def,rnedpopulation with depressive
    d i s o r d e r ( a c r o s s t h e a g e s p e c t r u m ) i s w a r r a n t e d –

    Here is another Study

    The second study, authored by George Papakostas, MD, Associate Professor of Psychiatry at Harvard Medical School and Director of Treatment-Resistant Depression Studies in the Department of Psychiatry of Massachusetts General Hospital in Boston, was an analysis of secondary endpoints in the multi-center double-blind, randomized trial of Deplin® in addition to an SSRI presented in 2011 at APA. The secondary endpoints evaluated the effects of specific metabolic biomarkers including inflammation, body mass index (BMI) and methlentetrahydrofolate reductase (MTHFR), a genetic defect.

    In the double-blind phase, 75 patients with SSRI-resistant MDD were enrolled in a 60-day study, divided into two, 30-day evaluation periods. Patients were randomized to receive one of three treatments: (1) Deplin® (L-methylfolate 15mg) in addition to an antidepressant for 60 days; (2) placebo in addition to a SSRI for 30 days followed by Deplin® 15 mg. in addition to an antidepressant for 30 days; or (3) placebo in addition to an antidepressant for 60 days. The SSRI doses remained constant during the double-blind phase of the study.

    Increased efficacy was observed with adjunctive Deplin® 15 mg versus SSRI therapy plus placebo. Pooled differences in mean changes on HDRS-17 and HDRS-28 (an expanded version of the Hamilton scale) were significantly different (p = 0.05 and 0.02, respectively).

    Compared to patients given adjunctive placebo, a numerically greater treatment effect was observed in patients given Deplin 15mg in addition to their SSRI who had an allelic variant in the MTHFR (methylentetrahydrofolate reductase) C677T genotype. Differences in mean changes in HDRS-28 were -3.75 for patients with a “T” allele (homozygote and heterozygote alleles combined) versus -1.99 for the patients with a “CC” allele (considered the “normal” allele) and marginally significant (p=0.087). An allele is an alternative form of a gene (one of a pair) that is located at a specific position on a specific chromosome. They determine genetic traits.

  • I do agree that there is no test for it, or that it can’t be observed, though I do believe it has a chemical component, as well as genetic.

    For example there is a Gene, MTHFR, which half the population has a mutation in, which means people cannot convert folate easily from their diet. This gene is also responsible for neurotransmitter production as well. You can actually get a prescription for Methylfolate (Deplin) from a pharmacy and some people have reported an improvement in symptoms. It is pretty expensive though.

    So mental illness could very well be genetic, it probably is, but it is complicated because if you have a genetic mutation you could have quote lower levels of neurotransmitters than people who don’t, which in turn would be technically an “imbalance” compared to other people. Then it would be epigenetic I guess, you know?

  • The efficacy of ZOLOFT as a treatment for major depressive disorder was established in two placebo-controlled studies in adult outpatients meeting DSM-III criteria for major depressive disorder. Study 1 was an 8-week study with flexible dosing of ZOLOFT in a range of 50 to 200 mg/day; the mean dose for completers was 145 mg/day. Study 2 was a 6-week fixed-dose study, including ZOLOFT doses of 50, 100, and 200 mg/day. Overall, these studies demonstrated ZOLOFT to be superior to placebo on the Hamilton Depression Rating Scale and the Clinical Global Impression Severity and Improvement scales. Study 2 was not readily interpretable regarding a dose response relationship for effectiveness.
    Study 3 involved depressed outpatients who had responded by the end of an initial 8-week open treatment phase on ZOLOFT 50–200 mg/day. These patients (N=295) were randomized to continuation for 44 weeks on double-blind ZOLOFT 50–200 mg/day or placebo. A statistically significantly lower relapse rate was observed for patients taking ZOLOFT compared to those on placebo. The mean dose for completers was 70 mg/day.

  • Furthermore, many of the immediate physical side effects that occur upon initiating antidepressants (headaches, nausea, dizziness, stomach problems, nightmares, etc.) tend to go into remission after 4 to 8 weeks, thus giving the patient a psychological boost from being relieved that his/her physical health is improving.

    That is defiantly not true for the majority of people though. Not to be offensive but it doesn’t sound like you have ever taken one of these medications before. It is not like, hey my stomach feels better, therefore I feel better, it is more like in a month, hey I feel better because I don’t feel like killing myself anymore.

  • Well there is no test for it simply because neurotransmitters in the brain are hard to measure. For example, the closest thing you would have for a blood test of brain neurotransmitters is a spinal tap and looking at the cerebral spinal fluid. The only with that is the Blood brain barrier, which separates the cerebral spinal fluid with blood in the brain, obviously.

    Neurotransmitters cannot cross the blood brain barrier directly, mostly procurers like amino acids can. This is why the urine tests for neurotransmitters are inaccurate for measuring them in the brain.

    Then you are looking at different receptor sites and neurotransmitters do other things, outside of brain function. Like Histamine is used by the immune system by mast cells and whatnot.

    This is why you have side effects with the medications, because neurotransmitters are doing other things in the body too.

  • Sorry, lost my cool. I think comparing SSRIs to heroin or booze or something is counterproductive.

    To Steve McCrea,

    I agree with pretty much everything you say, you make a lot of great points. A lot of psychiatrists, especially working in mental hospitals, just throw pills without getting past history and so forth. I was in a mental hospital for a while, being a mental patient myself, most of the people there were abused by their parents or were abandoned, and the doctors would just prescribe medications to help them cope.

    I’ll give you some background. I was born with severe anxiety and OCD. I was raised in a pretty wealthy family with not really a history of mental illness. Ever since I can remember, I have had terrible separation anxiety from my mother, horrible panic at pre school, anxiety from pretty much everything (loud noises, ext). I was in therapy since the age of 3 and continued until 13, with no real progress until my mother threw up here hands and we decided to see a psychiatrist, this is when the SSRIs were really picking up steam. I have tried a couple, most of which did nothing, until I found one that completely changed my life. I am able to live on my own and go to university, and what have you. The difference in my anxiety is so profound I cannot even begin to tell you.

    Maybe I can get off these medications one day, but regardless of the consequences down the road, I really could care less honestly, it is a risk benefit, especially with psychiatric medications. Do I have a chemical imbalance, I think so. Why do they work so well if not? Therapy really didn’t do much, but it helped a little.

    These meditations aren’t for people who went through a break up or something. It seems a lot of people have horrible experiences with medication because they went through some trauma and went to a GP or something, then go around and say SSRIS are mass murder pills or something.

    Mental illness is a comprehensive treatment plan. Like for diabetes, you wouldn’t just take Insulin and continue to eat horrible food, then blame the Insulin is bad medicine. Medication should be used to were you can get to therapy and start that process. Some people can go to therapy and get over their depression or anxiety, some people can’t, it just is that way sometimes I think.

  • “Tell that to Brian Williams and countless others who not only were not made better but often committed suicide despite or even due to these drugs.”

    I assume you mean Robin Williams? He was really depressed and probably suffered from Bi-Polar disorder way before he took ANY psychiatric drugs dude. He talked about it on countless podcasts and so forth. Do really think he just committed suicide because of just taking medication, be serious. He was diagnosed with Parkisons and suffered from pretty bad addiction.

    “none of these drugs has been shown to have a positive effect long-term – in fact there’s some evidence that they prevent spontaneous recovery hence making the problems chronic”

    The point is it is already chronic in some people though before medication.

  • Well when your a child, of course, your brain is very plastic, and if you went through trauma your brain will be prone to trauma in the future. That in turn I believe can alter brain chemicals and set someone up for a reaction of some kind down the line. But what if someone, and I know a few, who have had terrific childhoods, who were still horribly depressed and anxious as a child.

    For instance, they did a study in Israel in the 90s showing people with OCD and Anxiety have much lower levels of Inositol in their cerbrospinal fluid. Inositol interacts with Serotonin neurotransmission in a way we are not sure yet, but yet, there was technically a chemical imbalance that was found in these people. So saying there is no chemical basis for depression and anxiety is kind of untrue for some people. Measuring actual neurotransmitters is a lot more difficult to achieve.

    Some of the psychiatric medication are loosely based on street drugs, that is kind of why they work in the first place. The bar analogy only makes sense because it eases you after a hard work day FROM stress. But if you have a great day of work, and are still depressed, suicidal, for no reason, and have been cleared of other tests, thyroid ext, that is real mental illness. If that scares people about modern medicine were it is as of now, well, I am not sure what to tell you.

  • I agree with you GetItRight.. Stimulants are a different story though, as you said with children, which I agree with their are healthier alternatives. But again, for severe depression, SSRIs are better than placebo at reducing symptoms, that is pretty clear, not so much mild to moderate though as you stated. Medications are defiantly a last resort option for sure, but for some people, I believe they are necessary. Antidepressants might cause Mania in some people, Antipsychotics can give you diabetes and shrink your brain, however given someones circumstances, it could very well be worth it.

  • we’re medicating away symptoms, not treating a disease

    Well that is kind of how medicine works though. It isn’t an infection but it is an “illness” for some people, who have it chronic for the rest of their lives, it doesn’t go away, to say it does is kind of insulting. There are literally hundreds of different kinds of chemotherapy for people who have cancer that are individualized based on genetics and so forth. Just because there isn’t a test for it, does it mean it doesn’t exist.