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RE: Generic Antidepressants - 11/16/2010 1:50:50 PM

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Tigger

"My first hand experience is that talk therapy can deal with depression- for certain people." I'm one of them-I've tangled with this disease since I was a kid and been through several rounds of therapy. Haven't seen a shrink in over a decade, so maybe it's under control. In terms of your description- been there, done that (except I punched some holes in walls.) I wish I could do more for you other than offer the virtual hug...

Sam

(in reply to tiggerspoohbear)

RE: Generic Antidepressants - 11/16/2010 1:55:45 PM

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Sam--

Respectfully,

On point #5: the first page she wrote clearly about her situation.

Somehow in your zeal you mssed it.

You make a valid point about rural areas.

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RE: Generic Antidepressants - 11/16/2010 6:54:51 PM

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Thanks to my fellow strugglers who have posted!

Sam, if you meant well, it sure as shooting didn't come off that way. I asked a specific question, and you launched into a judgmental rant knowing nothing about me. Do you sincerely think that I would have given up my money, my libido, my fast-thinking, slender, energetic self if TALKING was a viable solution?

I am a happy person with a wonderful life. Without my meds, I am a non-functional person with a wonderful life. Coping skills will only take anyone so far. Ask anyone with ADHD.

My doctor says that these drugs are a crapshoot, and we truly don't have a handle on why some work and some don't. Heaven knows I tried more than one on the way, and still experiment with new ones when they come out. I suspect that many drgus are like that, why else would there be so many antihistamines, and cholesterol drugs, and what have you?

Next month I am trying a run of thhe real effexor and seeing if I get the same symptoms at the same time. We'll see if there really is a difference.

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RE: Generic Antidepressants - 11/16/2010 8:04:46 PM

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sam-

How do you explain manic-depression? Schizophrenia? Those disorders aren't fixed with talk therapy, they need medication.

If talk therapy was a universal cure for depression, we wouldn't have seen ECT, insulin treatments, and institutionalization all those decades.

It's like saying talk therapy will cure my migraines, when it's now know that they are caused by excess activity in the "lower" brain.

(in reply to LadyHibiscus)

RE: Generic Antidepressants - 11/16/2010 8:10:27 PM

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quote:

ORIGINAL: LadyHibiscus

Do you sincerely think that I would have given up my money, my libido, my fast-thinking, slender, energetic self if TALKING was a viable solution?

Heck, Hibbie knows why I'm scattered. She met Thing 2. If you weren't a little crazy before you talk to her, you sure might be when you're done. Bless my Thing 2. She really does have a lot to share.

*just kidding, I adore my daughter to pieces*

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RE: Generic Antidepressants - 11/16/2010 8:52:19 PM

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I find that T2 has a very cheering effect, once the initial shock wears off! :)

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RE: Generic Antidepressants - 11/17/2010 6:38:28 AM

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ROFL... and Linea is convinced that T2 doesn't speak because she's quiet when she comes over. I just haven't pulled T2's string out far enough before Linea gets there is all.

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RE: Generic Antidepressants - 11/17/2010 6:43:31 AM

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Lady Hib et al.

Yes, I meant well. I made a mistake in not realizing that my aggravation with the current state of mental health treatment in this country would be misconstrued as an attack on people taking meds. I know first hand that docs are only too happy to prescribe strong psychoactive drugs before investigating other alternatives. Since clearly you had investigated those alternatives, my assumption was in error.

Let me explain my thought process a bit- perhaps my reaction and posts will become clearer. In your initial posts, you commented that meds were expensive and were seeking alternatives. You also commented that your doc had said that your serotonin levels were a problem, and hence needed meds, but finding the correct drug was a crapshoot. (I'm paraphrasing here- please correct me if I've gotten the story wrong.)

I have issues with the methodology that would lead you to these statements.

First- did your doc measure your serotonin levels? If not- then it's guesswork on his/her part. An analogy may help here. Would you accept a doc's recommendation that you go on a statin based solely on getting on a scale? Or would you think that measuring things like blood pressure, lipoprotein levels, cholesterol levels etc would be a good idea first? So if your serotonin levels weren't measured- it's guesswork. If they were, well at least there's some method of tracking progress.

Second- the idea that strong drugs should be prescribed as a "crapshoot" is something of an anathema to me. There is finally some progress in this area in cancer meds, where before prescribing a particular chemotherapeutic for breast cancer- there is a genetic test that is done to make sure it's a cancer that may actually respond to the drug. From my perspective- these tests should be developed for psychopharmaceuticals as well. Patients should be demanding this of their docs.

Third- most of the well trained docs I know are appalled by the violation of the Hippocratic oath- "First- do no harm." that has gotten thrown out the window with widespread rapid fire prescribing of psychoactive drugs as noted by other posters. It's bad medicine- pure and simple. and yet it's become the de facto standard of care.

To other posters who seem to think that I've advocated throwing away their meds.... Please don't misinterpret my comments in this fashion. I do think that as a population we are using too many strong psychoactive drugs which have become the first choice in the treatment of depression. There are three legs to this problem: insurance companies, pharmaceutical companies, and the organizations of psychiatry. Given the side effects of these drugs, investigating a treatment option- talk therapy, prior to using them for the treatment of depression makes sense. However, talk therapy as has been noted by many posters, cannot cure all diseases, and is certainly inappropriate treatment for any number of ailments.

Sam

(in reply to LadyHibiscus)

RE: Generic Antidepressants - 11/17/2010 7:13:33 AM

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quote:

ORIGINAL: samboct

First- did your doc measure your serotonin levels? If not- then it's guesswork on his/her part. An analogy may help here. Would you accept a doc's recommendation that you go on a statin based solely on getting on a scale? Or would you think that measuring things like blood pressure, lipoprotein levels, cholesterol levels etc would be a good idea first? So if your serotonin levels weren't measured- it's guesswork. If they were, well at least there's some method of tracking progress.

Second- the idea that strong drugs should be prescribed as a "crapshoot" is something of an anathema to me. There is finally some progress in this area in cancer meds, where before prescribing a particular chemotherapeutic for breast cancer- there is a genetic test that is done to make sure it's a cancer that may actually respond to the drug. From my perspective- these tests should be developed for psychopharmaceuticals as well. Patients should be demanding this of their docs.

Third- most of the well trained docs I know are appalled by the violation of the Hippocratic oath- "First- do no harm." that has gotten thrown out the window with widespread rapid fire prescribing of psychoactive drugs as noted by other posters. It's bad medicine- pure and simple. and yet it's become the de facto standard of care.

Sam

First point-- That is often determined by a standard practice in medicine called differential diagnosis.
Different neurotransmitters behave differently.
A good intake session with one's Pdoc often gives basic clues as to which ones are off.

Second point-- Competant physicians let their patients know what the potential side effects are, which ones require an immediate phone call and follow their patients closely in the beginning to make certain the medication they are being put on is doing them no harm. Psychiatrists are no different. They know that in some patients who are severely depressed medication may make them more prone to suicide. They know that in some patients the side effects may be intolerable and schedule an appointment within 2 weeks to check on that and tell them to call before that if they have an issue. They sometimes titre the dose more slowly to help minimise that. They order appropriate blood tests as needed.

I am a bit disheartened by your slamming the mental health care system without hearing any statements about what you are doing to raise said standard of care.
Are you personally involved in patient advocacy on a local or state level?

I realise that may come off as defensive-making and really it is not meant to. It is just that so much could be done by impassioned people such as yourself and it usually isn't.

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RE: Generic Antidepressants - 11/17/2010 7:40:31 AM

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Angelika

I thought differential diagnosis was used to determine diseases- not levels of compounds in the bloodstream or in the brain?

In terms of your second point- fine in theory. In practice- how about this one...

South Carolina: Murder Conviction Upheld

By THE ASSOCIATED PRESS
Published: June 12, 2007
The state Supreme Court upheld the murder conviction of a teenager who claimed antidepressants led him to kill his grandparents and set their house on fire when he was 12. The court ruled against several arguments made by the teenager, Christopher Pittman, including the contention that he was denied a speedy trial before he was sentenced to 30 years in prison in February 2005. He was 15 at the time of his sentencing. His lawyers argued that he had been involuntarily intoxicated by the antidepressant Zoloft at the time of the shooting. Pfizer, the manufacturer of Zoloft, has said the drug “didn’t cause his problems, nor did the medication drive him to commit murder.”

I know a bit more about this case- there were some additional reports. The kid was under the care of a GP- not a psychiatrist when Zoloft was prescribed. The kid was compliant and took the drug like he was supposed to. The physician following him- didn't recognize the signs of an adverse reaction- and the kid snapped with the tragic consequences. So the kid did show up in his office- but the damn doc who had no business prescribing the drug in the first place blew it. A competent psychiatrist would have caught that the kid was "a bit restless, agitated" (IIRC) according to the docs notes and realized that the kid was having an adverse reaction. And our wonderful legal system puts the kid away.....

I'll send you a PM about what I'm doing personally...

Sam

(in reply to angelikaJ)

RE: Generic Antidepressants - 11/17/2010 7:52:31 AM

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Differential diagnosis goes by symptoms.

With psych meds it is often trial and error as there is no formula (just as with statins, and often SSRIs are the first tried, but there are certain things: if someone is anxious certain SSRIs are often more effective. Same with OCD features. Wellbutrin can make anxiety worse.
If someone has difficulty getting out of bed, putting them on a sedating
anti-depressant is less indicated.

The example you cited is horrific.
Because of the well known issues of the dangers of adolescents and anti-depressants a GP is not qualified to prescribe them for teens.

And I did not mean to publicly call you out

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RE: Generic Antidepressants - 11/17/2010 8:17:29 AM

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Yes, Sam, you have the story wrong again.

ALL I wanted from this thred was people's experiences with generic antidepressants. Hence the title of the thread.

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RE: Generic Antidepressants - 11/17/2010 7:54:49 PM

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samboct-

It's not possible to measure seratonin levels in a live brain. You can get an approximation (and the emphasis is approximation) by measuring the metabolites in blood.

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RE: Generic Antidepressants - 11/17/2010 8:42:58 PM

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Umm Thorn?

I think you're a little out of date. Check this reference out....

http://www.ingentaconnect.com/content/ben/cpd/2010/00000016/00000018/art00001?token=004f173452e47e8275c277b425747675276743424442e7975592f653b672c57582a72752d7075c1

Sam

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RE: Generic Antidepressants - 11/17/2010 8:59:59 PM

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I feel the need to throw my 1/2 cent worth.....

sam, you do realize that in this day and age all most psychiatrists do is prescribe medicine correct? Very very few psychiatrists actually do therapy.... And even fewer of them would be appropriate to do so.

Kali

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RE: Generic Antidepressants - 11/18/2010 5:31:18 AM

tiggerspoohbear

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I know this all to be too true. Psychiatrists are trained in diagnosing their patients and trying to find the right cocktail, if necessary, and they sure as hell don't do talk therapy. You're lucky most times if you get 15 minutes, and I'm being generous here.

It would be a lot more helpful if they took more time to talk to you to find out if there's any problems, but they hide behind their books and their prescription pad. I've gone thru a number of them and have very little respect for the profession.

The ones I've dealt with were all older gentlemen, they refused to speak to my psycho-therapist, psychologist or counsellor who had a much better idea of my state of mind than they did. And listening to me? Well that was out of the question. After all, I was *only* the patient and didn't know a thing. Sorry, but I know my own mind and body, and know when something's off. Being ignored by the very person who's supposed to be helping you is the ultimate insult.

'Nuff said.

< Message edited by tiggerspoohbear -- 11/18/2010 5:34:08 AM >

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RE: Generic Antidepressants - 11/18/2010 6:06:18 AM

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Hi Kali

Yup, I do. If you want to find a psychiatrist that still does talk therapy- you need to find an analyst- hence my link to the American Psychoanalytic Association given in a previous post (www.apsa.org) Roughly two thirds of analysts are psychiatrists, although the percentage is decreasing (more psychologists and social workers are being trained). And there are still psychiatrists that do talk therapy without being an analyst, but odds are the analysts will know them. Unfortunately as you point out- most psychiatrists these days do not do talk therapy- Tiggers experience is all too common. Its an asinine way to do medicine- both expensive and ineffective.

Note-psychologists are receiving more training in talk therapy than psychiatrists these days- and often their rates are lower too. Unfortunately the lack of standards makes it tough to figure out who's well trained and who isn't- there are way too many people doing talk therapy that have a desire to help- and not enough training to be effective.

Sam

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RE: Generic Antidepressants - 11/18/2010 6:50:12 AM

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I was blessed to have had a psychiatrist that believed in open communication.
My therapist referred me to her, when he saw I was struggling and it was beyond what therapy could help with.
He knew me well and made a wise and educated choice in recommending her.
(btw: he was amazing and did NOT have a PHD or MSW after his name).

So with my permission he filled her in on me and they shared concerns.

Too, once when I was in her office -with my permission - the psychiatrist called my physician when I was having a health issue that wasn't responding to treatment, and facillitated a conversation so that "we could have a plan".

They shared blood work results.
(The psychiatrist is the one who first tested my vitamin D levels.)

I simply won't have it any other way now.

When I had my intake with her, it lasted 2 hours and when my insurance circumstances changed and I could no longer see/afford my therapist (he went sliding scale first) she took over my therapy as well.

I think it is important to interview the people that we see and find people who match our needs.

Poohbear is in a little bit of a different situation, I realise.

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RE: Generic Antidepressants - 11/18/2010 7:00:08 AM

tiggerspoohbear

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I wish I'd had the same help you did Angelika. It's been really tough anywhere in Canada to get the help one needs and to get docs to co-operate with each other. It's as if they see each other as the "enemy" while I'm stuck in the middle. That's the last thing I need.

Bureaucracy, mental health systen, agencies, you name it. I can barely look after myself day to day most times, and having to fight with them is on the other side of ridiculous. Even the provincial government gets involved, but not in a good way. I feel like I'm in a no-win situation and no one is willing to try to help me get the help I need. It's frustrating to say the least. I try to fight the good fight, but it's not easy and never will be.

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RE: Generic Antidepressants - 11/18/2010 7:44:05 AM

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Poohbear,

Here in the US, there are advocacy groups such as the National Alliance of the Mentally Ill and various agencies both nationally and in the individual states.

Do you have those in Canada?

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