![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Bob on December 5, 2005, at 21:07:06
Is there any hard evidence, as in a suggestive study, that too many med trials and too much fooling with combos and doses can destroy your health in the long run (meaning after years and years)? I remember way back when I started meds there was this "kindling" theory floating around stating that if you caused your condition to ebb and flow it would get worse and worse.
Posted by med_empowered on December 6, 2005, at 0:43:51
In reply to Self-sabatoge?, posted by Bob on December 5, 2005, at 21:07:06
Some disorders involve a lot of trial and error, and alot of adjustment even after the correct medications are selected--bipolar disorder, for instance, is a tricky problem to treat. My guess would be that since those who have the most medication trials tend to be either more severely ill OR suffer from more side effect than other groups, you might find that, as a group, those who do a lot of trial-and-error tend to have not-so-good outcomes (maybe higher relapse rates or suicide rates, for instance). As for ruining your health...medications can cause problems, so I can see how exposing yoursellf to a wide assortment of psychotropics could cause some problems. That said...trial-and-error may be better than inadequate treatment or dealing with very bad side effects (ex: it may be better to a new medication if one causes akathisia or EPS). This seems like something that would be hard to study on the group level, though.
In my own experience, I've found that sometimes its best to sit down and ask what you *really* expect from drug treatment. For bipolar, this might mean getting rid of *extreme* mania, *extreme* depression and any disabling anxiety/insomnia, while still leaving milder depressive episodes and hypomania. Its also a good idea, if you can get talk therapy, to do so; once the extremes of any disorder are taken care of (ex: crippling phobias, psychosis, extreme depression), then talk therapy can real help you manage everything else.
As for kindling..its an interesting idea, but I dont know how well proven it is. There are some signs that it could happen--people with cyclothymia tend to develop BP I or II, people with BP II sometimes go on to develop BP I, and people with all bipolar disorders tend to get worse, not better, over time--but this is just suggestive of some sort of kindling..it doesn't real prove that something is happening, or even explain what it is thats causing symptoms to worsen. Also, if you look at schizophrenia, you often see the opposit of kindling; even in patients who aren't treated or are treated for short times or at very low doses, there's a trend to return to pre-schizophrenic functioning over 5 years (although there are also patients who get worse over this same period, both on and off medication). Long-term, there are apparently a lot of patients who more or less recover from schizophrenia with or without medication (sometimes with very low doses or occasional use of antipsychotics to deal with crippling symptoms). So..there you go. Its a pretty mixed picture.
Good luck!
Posted by summerflowers on December 7, 2005, at 3:21:29
In reply to Re: Self-sabatoge?, posted by med_empowered on December 6, 2005, at 0:43:51
interesting med_empowered I didnt know that about schizophrenia.From what psyc docs tell people it is lifelong and permanant well thats not giving them much hope is it!!!!!and hope to get better is what everybody NEEDS. Regarding self sabotage,I remember reading somewhere about concern about how complex and unknown the brain is,and how everything connects in this and that way and that forcing it to do things chemically is unknown territory.Maybe one day we will all be healed from these things naturally.Like they will discover some short term medicine that will repair the brain similar to a wound repairing itself with the help of antibiotics.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.