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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Bubba on May 19, 2002, at 15:14:40
Hey Everyone,
Many drugs cause abnormal behavior in normal people. For example, cocaine causes euphoria and alcohol causes disinhibition in normal individuals. The same hold true with psychiatric medications. MAO inhibitors cause euphoria, neurontin causes disinhibition and benzodiazapenes disinhibition in normal people.
When someone with a anxiety or unipolar depression takes the same medication and has the same reaction, we are labeled as Manic or Bipolar. Why is this?
Bubba
PS Same holds true with lithium. Normal people who take lithium feel depressed, irritable and decreased memory. When a bipolar person takes lithium and reports depression or memory difficulties, they are told they are coming off their "high". Hmmmm.
Posted by Krazy Kat on May 20, 2002, at 17:46:31
In reply to Why is it considered Manic For Us?, posted by Bubba on May 19, 2002, at 15:14:40
I love your name. I believe there is still a lot of controversy re: this. Hopefully someone who understands how these meds work better than I, will answer.
Posted by crepuscular on May 21, 2002, at 17:12:55
In reply to Why is it considered Manic For Us?, posted by Bubba on May 19, 2002, at 15:14:40
Hmm. i'm not sure disinhibition behaviors should be assumed to be manic by anybody - a good p-doc should recognize the difference.
mania has so many flavors across different people, and indeed for the same person. most "normal" people generally do not become clinically manic (or hypomanic) on these drugs. i can say from personal experience that neurontin did not cause euphoria for me and was far more debilitating than lithium in terms of mental acuity. yuck!
so i don't know. labels can be bad, but getting the bipolar label is a significant step up from GAD or garder variety depression. it may be both over-diagnosed in person already inside the mental health system, and under-diagnosed outside the system.
for my epistemological dollar, similar symptom clusters may have different etiological origins and respond to very different medications - for no good reason other than people are such unique critters. perhaps sub-threshold schizophrenia sometimes shows up as bipolar or depressive symptomology, and for those people, the atypicals are actually getting to the root of something that "shouldn't" work.
same goes for other symptom clusters...
;)
Posted by James on May 23, 2002, at 1:46:09
In reply to Re: Why is it considered Manic For Us?, posted by crepuscular on May 21, 2002, at 17:12:55
speaking of symptom clusters, that reminded me of something that has bothered me for a while. Whats the deal with the concept of the comorbidity of different disorders ? For example, I think now there is a debate about whether bipolar is under-diagnosed in children and mistaken for ADHD, or whether there is no such thing as childhood BP. Joe Biederman and Jill Wozniak at I think Harvard are of the former opinion, and some other person is of the latter (I forget who--but in my opinion mistaken). I also agree with you 150% about the idiocy of labels. They say that in children in Boston have a 70% chance of being diagnosed as bipolar./
--James
This is the end of the thread.
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