Re: Side Effects

by Petrichor Wed Feb 13, 2013 3:11 pm

doofus_maximus wrote:
This... I stopped coming to this forum because I find it hard to wade through million and one RaShMan's posts about Akbar and others.

That is a true tragedy...I feel exactly the same about his inane posts and find myself wondering about the limits of free speech in light of megaphone snatchers.

I wonder if there is a way to *completely* wipe out a poster from my user experience of such - i don't want to see even headers of posts, i might be okay to see if someone else responds and quotes the ignored poster.

by doofus_maximus Wed Feb 13, 2013 3:28 pm

Huzefa Kapasi wrote:
atcg wrote:
Huzefa Kapasi wrote:
i'll wait for you. but from what i understand (a layman's perspective): addiction and physical dependence are indistinguishable in symptomology. the difference is in the craving. if i stop smoking, i am de-addicted. but the craving might never die (which might trigger the addiction again). with ADs, once you are over the withdrawals, the is NEVER a craving for there never was a craving in the first place (provided your anxiety/depression is in remission). there has to be distinction between craving (psychological) and addiction (physiological).

HK, firstly caveats: I am just an informed citizen just like you. Just to be clear, we are not researchers in this area and there are all sorts of competing claims with nice little $ signs attached. This is the context.

Now, here is my understanding: There are neurochemicals and an imbalance caused by whatever reason - genetic, compulsive behavior or other factors result in mental illness - the illness can be of different grades and different effects. You could have a mild case of the 'blues', be a bit more emotional at times of stress etc. There can also be cases where the mind has crossed the rubicon, so to speak, and get into a state of perpetual state of disrepair - a fairly stead state of under/over production of certain fluids in the cranium. This is the point, I define, as the line where professional psychiatric help is a necessity.

The action of SSRI's, or the various generations of psychoactive drugs are not firmly established - there are very nice researchers with finely granular statistical and other tools that are able to make 'educated guesses' about the drug action - these go through up's and down's for various theories.

All drugs whether heroin, alcohol, nicotine or any of the psychoactive drugs cause to a lesser or more degree, some form of physical dependence. This is the effect of the drug in the system to co-exist with the naturally occurring chemicals in the body to achieve a certain state of equilibrium. There are studies that have established, specifically for psychoactive drugs treating depression, that physical dependence on the drug exists in a significant percentage of the patient population - hence the general public's so-called *misconception* that they are 'addictive' (which is a bad word denoting the craving you talk about). Physical dependence is the body's inability to regain that state of equilibrium which was established when the drug was coexisting with the neurochemicals.

Finally another caveat - I hope I have explained my 'beliefs' to you in as much detail I possibly can. It is your prerogative to 'belittle' it or do what you want with it. This is my last post on the subject. Adios.
ok hear me out in my last post:

(i) if you need the meds you are already at a bit of a disadvantage for not enough research has gone into developing newer ADs as has gone into meds. used to treat cancer (for various reasons). so you are being dished the same meds. from 1950s (the decade of the BIGGEST breakthrough in psychiatry) in newer forms but with lesser side effects (they don't eat your liver, heart as much). but, again, this is true for all drugs but i suspect more for psychotropic drugs.

(ii) you mentioned "chemical imbalance" to support the use of these newer ADs. your intention was otherwise. the fact is that we do not know how they work -- definitely NOT chemical imbalance (read up on the net please). they use heuristics in psychiatry with the accent being on lesser side effects -- that is the strait jacket the pharma industry is caught in for the patent gets beaten by the generics and they have to reinvent the old drug to win back the patent. the mechanism of action of the SSRIs and the (older) TCAs is the same -- enhance serotonin re-uptake.

Did you mean to write inhibit serotonin re-uptake

however, the modern ADs are "selective." they don't disturb other neurotransmitters (and organs) as much and, guess what, they demonstrate better efficacy. that is what led the pharma companies to touting them as agents that could restore the "chemical imbalance." a few suits or perhaps the media made them backtrack from advertising them as "drugs that fix chemical imbalance". they work but we don't know HOW. but they work and have lesser side effects than the TCAs.

(iii)
Physical dependence is the body's inability to regain that state of equilibrium which was established when the drug was coexisting with the neurochemicals.
nonsense. SSRIs do not conform to this classification. prove me otherwise. if this is true, how can there be people who have stopped SSRIs and are normal after more than a year? or patients who relapse after 3 years?

by Idéfix Wed Feb 13, 2013 3:29 pm

atcg wrote:I wonder if there is a way to *completely* wipe out a poster from my user experience of such - i don't want to see even headers of posts ...

I looked into that, but no such luck.

by Propagandhi711 Wed Feb 13, 2013 3:33 pm

atcg wrote:
Propagandhi711 wrote:
xlation: I tried to come across as a virile expert in a sensitive area where I have no real expertise and got called out. I'll try to save face now by dismissing your experience & research as "beliefs" while my internet research and prejudices continue to be projected as solid.

xlation back: I, Propa, have no skin in this game either way but like to be an agent provocateur simply coz I can be.

that's not a bad xlation, but not entirely true. I have seen at close range people that suffered from mild form of depression to full blown clinical one. not entirely skin free

by Petrichor Wed Feb 13, 2013 3:38 pm

Propagandhi711 wrote:
that's not a bad xlation, but not entirely true. I have seen at close range people that suffered from mild form of depression to full blown clinical one. not entirely skin free

I am assuming that you have also seen them get off meds and lead a productive, emotionally happy and engaged life, then? Which is fine and dandy but my only point was that there is a significant number of patients for whom physical dependency is a real issue.

by doofus_maximus Wed Feb 13, 2013 3:39 pm

The risks associated with dependence and/or suicide ideation in adults using SSRI's are limited whereas SSRI's use in children/adolescents carry a heavier risk.

Recently a comprehensive review of new age AD's were done which parsed through 17 clinical trial data and concluded that children/adolescents have a higher risk of suicide when using these drugs as compared to placebo.

http://www.ncbi.nlm.nih.gov/pubmed/2315222

Nineteen trials of a range of newer antidepressants compared with placebo, containing 3335 participants, were included. The trials excluded young people at high risk of suicide and many co-morbid conditions and the participants are likely to be less unwell than those seen in clinical practice. We judged none of these trials to be at low risk of bias, with limited information about many aspects of risk of bias, high drop out rates and issues regarding measurement instruments and the clinical usefulness of outcomes, which were often variously defined across trials. Overall, there was evidence that those treated with an antidepressant had lower depression severity scores and higher rates of response/remission than those on placebo. However, the size of these effects was small with a reduction in depression symptoms of 3.51 on a scale from 17 to 113 (14 trials; N = 2490; MD -3.51; 95% confidence interval (CI) -4.55 to -2.47). Remission rates increased from 380 per 1000 to 448 per 1000 for those treated with an antidepressant. There was evidence of an increased risk (58%) of suicide-related outcome for those on antidepressants compared with a placebo (17 trials; N = 3229; RR 1.58; 95% CI 1.02 to 2.45). This equates to an increased risk in a group with a median baseline risk from 25 in 1000 to 40 in 1000. Where rates of adverse events were reported, this was higher for those prescribed an antidepressant. There was no evidence that the magnitude of intervention effects (compared with placebo) were modified by individual drug class.
AUTHORS' CONCLUSIONS:
Caution is required in interpreting the results given the methodological limitations of the included trials in terms of internal and external validity. Further, the size and clinical meaningfulness of statistically significant results are uncertain. However, given the risks of untreated depression in terms of completed suicide and impacts on functioning, if a decision to use medication is agreed, then fluoxetine might be the medication of first choice given guideline recommendations. Clinicians need to keep in mind that there is evidence of an increased risk of suicide-related outcomes in those treated with antidepressant medications.

by Marathadi-Saamiyaar Wed Feb 13, 2013 3:41 pm

atcg wrote:
doofus_maximus wrote:
This... I stopped coming to this forum because I find it hard to wade through million and one RaShMan's posts about Akbar and others.

That is a true tragedy...I feel exactly the same about his inane posts and find myself wondering about the limits of free speech in light of megaphone snatchers.

I wonder if there is a way to *completely* wipe out a poster from my user experience of such - i don't want to see even headers of posts, i might be okay to see if someone else responds and quotes the ignored poster.

I am seriously considering doing a PP on Rashmun Sir ji... So much of negative energy and time and a few more months I might even become like him.

Of course, I know the downside as well - some others would love to wipe me out too...(even in real life)... Razz

by doofus_maximus Wed Feb 13, 2013 3:44 pm

Huzefa Kapasi wrote:
Propagandhi711 wrote:HK, have you looked into testosterone therapy or is that a different tack from your issues? I know several guys have been prescribed that injection for mild depression like symptoms in their 40s
thanksss. i will look this up as soon as i have finished my light therapy sessions to cure depression.

First get a blood test done to check for your natural testosterone levels. If it is abnormally low, then go for the testosterone therapy.

by Propagandhi711 Wed Feb 13, 2013 3:47 pm

atcg wrote:
Propagandhi711 wrote:
that's not a bad xlation, but not entirely true. I have seen at close range people that suffered from mild form of depression to full blown clinical one. not entirely skin free

I am assuming that you have also seen them get off meds and lead a productive, emotionally happy and engaged life, then? Which is fine and dandy but my only point was that there is a significant number of patients for whom physical dependency is a real issue.

a) not seen them get off meds successfully. one tried to but the depression returned and turned too debilitating for her to function so she's back on them after great push from close family and friends. I wouldnt characterize it as a physical dependency...I dont know what that means in context of meds like antidepressants, statins etc..yes you need to keep taking them but that's because they suppress/treat a chronic issue.

b) for the mild depressives, I've seen them 'cured' but again how do we know for sure?

by Guest Wed Feb 13, 2013 4:24 pm

[quote="doofus_maximus"]

ashaNirasha wrote:
Huzefa Kapasi wrote:
ashaNirasha wrote:

p.s. you should post more often.

I'd like to but forums don't work at my speed.

And this forum is not easy to catch up to unlike Sulekha CH. It is much harder to wade through. Some body bring the reverse chronological order already.

This... I stopped coming to this forum because I find it hard to wade through million and one RaShMan's posts about Akbar and others.

Mission is getting accomplished for RaShMan: filling the forum with junk and thereby driving ppl away.

by Guest Thu Feb 14, 2013 1:43 am

atcg wrote:doi: 10.1177/0269881104046527
J Psychopharmacol June 2004 vol. 18 no. 2 285-287

enjoy!

i really do not know how to access this. but let me point you to the highly publicized case of brook shields: http://en.wikipedia.org/wiki/Brooke_Shields#Postpartum_depression

she took an SSRI to combat post partum depression. weaned off of it after a while. and she is leading a normal life now. all through, she was hounded by tom cruise for using an AD.

i also stated above that psychotropic meds (SSRIs in particular) perhaps have more side effects than other meds. the fact is that i really do not know this with any certainty and i should not have said it.

by Guest Thu Feb 14, 2013 1:48 am

Huzefa Kapasi wrote:
atcg wrote:doi: 10.1177/0269881104046527
J Psychopharmacol June 2004 vol. 18 no. 2 285-287

enjoy!
i really do not know how to access this. but let me point you to the highly publicized case of brook shields: http://en.wikipedia.org/wiki/Brooke_Shields#Postpartum_depression

she took an SSRI to combat post partum depression. weaned off of it after a while. and she is leading a normal life now. all through, she was hounded by tom cruise for using an AD.

i also stated above that psychotropic meds (SSRIs in particular) perhaps have more side effects than other meds. the fact is that i really do not know this with any certainty.

Tom cruise is a scientologist and scientologists believe that taking psychiatric drugs is against their belief system. They also consider psychiatrists to be evil people and enemies of humanity.

by Guest Thu Feb 14, 2013 1:54 am

doofus_maximus wrote:
Huzefa Kapasi wrote:the mechanism of action of the SSRIs and the (older) TCAs is the same -- enhance serotonin re-uptake.

Did you mean to write inhibit serotonin re-uptake

oops. yes. Smile

thanks for the correction.

by Guest Thu Feb 14, 2013 4:08 am

doofus_maximus wrote:
Huzefa Kapasi wrote:
Propagandhi711 wrote:HK, have you looked into testosterone therapy or is that a different tack from your issues? I know several guys have been prescribed that injection for mild depression like symptoms in their 40s
thanksss. i will look this up as soon as i have finished my light therapy sessions to cure depression.

First get a blood test done to check for your natural testosterone levels. If it is abnormally low, then go for the testosterone therapy.

oh, i thought props was joking. i did not know low testosterone can cause depression. thanks!

by Idéfix Thu Feb 14, 2013 11:48 am

Huzefa Kapasi wrote:
doofus_maximus wrote:
Huzefa Kapasi wrote:
Propagandhi711 wrote:HK, have you looked into testosterone therapy or is that a different tack from your issues? I know several guys have been prescribed that injection for mild depression like symptoms in their 40s
thanksss. i will look this up as soon as i have finished my light therapy sessions to cure depression.

First get a blood test done to check for your natural testosterone levels. If it is abnormally low, then go for the testosterone therapy.

oh, i thought props was joking. i did not know low testosterone can cause depression. thanks!

Testosterone therapy is another thing pharma companies are heavily advertising to the general public these days in the US. You can't watch CNN for 20 minutes in the morning without watching at least two ads for those pills. The only other steady fixture on that channel is ads from law firms that encourage patients who were harmed by bad drugs to go after pharma companies.

by Propagandhi711 Thu Feb 14, 2013 11:53 am

Huzefa Kapasi wrote:
doofus_maximus wrote:
Huzefa Kapasi wrote:
Propagandhi711 wrote:HK, have you looked into testosterone therapy or is that a different tack from your issues? I know several guys have been prescribed that injection for mild depression like symptoms in their 40s
thanksss. i will look this up as soon as i have finished my light therapy sessions to cure depression.

First get a blood test done to check for your natural testosterone levels. If it is abnormally low, then go for the testosterone therapy.

oh, i thought props was joking. i did not know low testosterone can cause depression. thanks!

it can cause mild forms of depression. I am not a doctor but I play one with the ladies in private

by Maria S Thu Feb 14, 2013 11:59 am

Propagandhi711 wrote:
oh, i thought props was joking. i did not know low testosterone can cause depression. thanks!

it can cause mild forms of depression. I am not a doctor but I play one with the ladies in private[/quote]

Very good Dr. DUT.
I think most people know low Estrogen levels in women does the same..depression, anxiety, insomnia..all kinds of mood disorders..hormonal supplements can help (am not big on prescribing them- for long term either).

by Guest Thu Feb 14, 2013 12:17 pm

Propagandhi711 wrote:it can cause mild forms of depression. I am not a doctor but I play one with the ladies in private

LOL! so do i but only in fantasies.

by Guest Thu Feb 14, 2013 12:18 pm

Well. From what I know, HK's depression is drug induced.

by Propagandhi711 Thu Feb 14, 2013 12:20 pm

Vidya Bagchi wrote:Well. From what I know, HK's depression is drug induced.

so you and I are doctors now?

by Hellsangel Thu Feb 14, 2013 12:21 pm

Huzefa Kapasi wrote:
Propagandhi711 wrote:it can cause mild forms of depression. I am not a doctor but I play one with the ladies in private
LOL! so do i but only in fantasies.

Gives a whole new meaning to 'Physician, heal thyself!'

by Guest Thu Feb 14, 2013 12:21 pm

ya, vidya is right.

by Guest Thu Feb 14, 2013 12:22 pm

Propagandhi711 wrote:
Vidya Bagchi wrote:Well. From what I know, HK's depression is drug induced.

so you and I are doctors now?

Uh oh. One of us gotta be the patient.

by Propagandhi711 Thu Feb 14, 2013 12:27 pm

Vidya Bagchi wrote:
Propagandhi711 wrote:
Vidya Bagchi wrote:Well. From what I know, HK's depression is drug induced.

so you and I are doctors now?

Uh oh. One of us gotta be the patient.

I have the thermometer so you be the patient. I like to take temperature first from 3 different places to establish baseline. meet me this evening in my office.

by Guest Thu Feb 14, 2013 12:48 pm

doctor-nurse, doctor-patient fantasies. ui ma. childhood memories. once when i was 12 [content deleted by Admin]. so since then it has been a recurring theme. Smile

by Propagandhi711 Thu Feb 14, 2013 12:50 pm

Maria S wrote:
Propagandhi711 wrote:
oh, i thought props was joking. i did not know low testosterone can cause depression. thanks!

it can cause mild forms of depression. I am not a doctor but I play one with the ladies in private

Very good Dr. DUT.
I think most people know low Estrogen levels in women does the same..depression, anxiety, insomnia..all kinds of mood disorders..hormonal supplements can help (am not big on prescribing them- for long term either).[/quote]

I think there's a great deal of skepticism currently abt testosterone replacement therapy because of misunderstanding on the role of testosterone - ppl think it's just for the two Fs - fighting and f'ing but it has impact on several other areas of a man's health. such skeptics are misinformed

by Propagandhi711 Thu Feb 14, 2013 12:53 pm

Huzefa Kapasi wrote:doctor-nurse, doctor-patient fantasies. ui ma. childhood memories. once when i was 12 [Content deleted by Admin]. so since then it has been a recurring theme.

you can tell us...so you played a gynec at 12? why so did I, sir. the patient's name was sandhya and she's a doctor living in UK currently, in a mild twist of irony.

by Maria S Thu Feb 14, 2013 1:11 pm

Propagandhi711 wrote:

I think there's a great deal of skepticism currently abt testosterone replacement therapy because of misunderstanding on the role of testosterone - ppl think it's just for the two Fs - fighting and f'ing but it has impact on several other areas of a man's health. such skeptics are misinformed

Beyond the benefits of both (I agree about the role/impact on men's overall health)..it has medical, legal and ethical implications..and there are some major differences between estrogen "supplements" and testosterone "boosters".
*Estrogen supplements are legal in the US, while Testosterone boosters- some are legal *like Creatine and some are illegal *Anabolic steroids- AAS (schedule 3 and 4). In India and many other countries..AAS are not always illegal.
Certainly - there has to be a great deal of caution in prescribing all of them..but one can say "gender medicine" (beyond strictly medical parameters)- has its interests/controversies too.. political, philosophical..leading to all kinds of substance/drug categorizations and usage.

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