Posted by JohnL on May 4, 2000, at 1:57:09
In reply to Re: Shorter comparisons breed hope , posted by KarenB on May 3, 2000, at 12:07:21
> Hi.
>
> Just me with my $.02 again...from a strictly emotional point of view:
>
> If nothing else, it seems to me that when in the pit of despair, one unsuccessful 6-8 week trial after another is enough to send one straight to the bottom of the pit.
>
> Why not try to find an AD (QUICKLY!) that opens the suffering patient's eyes at least for a moment, to see that there is hope and that feeling well IS POSSIBLE. Even if there is no solid proof as of yet that it continues in the long term, it would give me the will to go on - to try other meds within the same class at least.
>
> When I have been at my lowest, the one thought that conjures the strongest suicide ideology is the one that says, "I'm never going to get better - I'm always going to feel like this."
>
> If I had put my trust in a doc who was bent on SSRIs and insisted on the long term trials suggested, I may be dead today.
>
> KarenKaren,
You make a very good point. In reading a book called The Successful Treatment of Brain Chemical Imbalance, by Dr Jensen, he discusses your point also. He stresses it is very important to give the patient hope, to keep them busy, and to offer them a sense of ownership in their own treatment. When leaving the doctor's office with three trial-size prescriptions of three different meds to be compared seperately in three short trials, in addition to one or two antidote pill samples for adverse reactions, and training/instructions on exactly how to dose them, how much time, washout time, what to do if an adverse reaction, etc...this all gives the patient a sense of ownership and keeps hope alive. The patient is no longer a suffering guinnea pig of some doctor, but rather a recovering sufferer engaged in the aggressive active mode of their own recovery. Worth mentioning though, I think, is that this method is not appropriate for someone who is in a suicidal state or a psychotic state.But for the patient who has a history of multiple failures with multiple drugs and/or doctors, this method does indeed provide hope. And as you mention, there are times when nothing is more important than mere hope. That is number one before anything else. Being involved in a quick trial regimen accomplishes that.
As a personal example, my doctor already knew I had tried Paxil, Zoloft, and Prozac. All were somewhat effective after 2 to 3 month trials, but there were still considerable residual symptoms. By then more than a year has passed, and I was still suffering. My hope was very very low, actually nonexistent. So it became obvious I should try drugs of other classes, but he wanted to be sure I was on the best match SSRI before doing that. So he prescribed two weeks each of Effexor, Celexa, and Luvox, with a one day washout inbetween. I was of course skeptical of any more SSRIs, BUT I suddenly had HOPE. He said I could then choose my favorite. I liked that idea. Personal ownership. Hope. Unfortunately none of the SSRIs turned out to be the best match for me. But it didn't take long doing the same procedure in other drug classes to stumble onto something that did work. And the whole time the one most important thing I had lost was revived....HOPE.
JohnL
poster:JohnL
thread:31785
URL: http://www.dr-bob.org/babble/20000429/msgs/32205.html