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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 34. This is the beginning of the thread.
Posted by SLS on January 15, 2008, at 7:06:46
Re: Welcome! - Board name change. » Dr. Bob
Posted by SLS on January 15, 2008, at 6:21:23
In reply to Welcome!, posted by Dr. Bob on January 14, 2008, at 21:45:40
> Hi, everyone,
>
> Let's give this new board a try. I hope it doesn't make things too confusing!
>
> Bob
I think calling this board "neurotransmitters" is too limiting and simplistic. It doesn't take into consideration gene activity, second messengers, and brain circuitry. Scientists are discovering that affective disorders involves more than neurotransmitters and synaptic receptors.Perhaps "Neuroscience" would be a better name.
- Scott
Posted by gardenergirl on January 15, 2008, at 15:08:35
In reply to Board Name Change Neurotransmitters » Neuroscience, posted by SLS on January 15, 2008, at 7:06:46
Posted by AbbieNormal on January 15, 2008, at 17:24:41
In reply to Board Name Change Neurotransmitters » Neuroscience, posted by SLS on January 15, 2008, at 7:06:46
Wow. This should put a rest to all the shouting, picketing, a near riotous requests for this new board. The Admin board has been flooded with groveling appeals - I think they even beseeched.
I'm sure the hoards are grateful.
Abbie
Posted by SLS on January 15, 2008, at 22:59:56
In reply to New: Board Neurotransmitters, posted by AbbieNormal on January 15, 2008, at 17:24:41
> Wow. This should put a rest to all the shouting, picketing, a near riotous requests for this new board. The Admin board has been flooded with groveling appeals - I think they even beseeched.
>
> I'm sure the hoards are grateful.
>
> AbbieWhat a tough call it will be to try to separate posting on one board versus the other.
I think the "Medication" board should focus on clinical issues (specific therapeutic interventions). A clinical issue might indeed involve a discussion of the pharmacology of a particular drug to better understand how to use it or predict an outcome.
A "Neuroscience" board might better focus on pure research and theory without focusing on therapeutics.
I guess one way to judge posts is whether or not there are any issues regarding clinical therapeutics. One can address the pharmacology of drugs and the associated brain physiology affected and still be eligible for the "Medication" board.
"Neuroscience" might better address issues that do not include clinical therapeutics.Another way might be to distinguish between posts addressing the therapeutics related to the treatment of a specific person on the "Medication" board versus generalized neuroscience, hypotheticals, or theory as they relate to mental illness.
- Scott
Posted by Dr. Bob on January 16, 2008, at 0:58:36
In reply to Re: New: Board Neurotransmitters, posted by SLS on January 15, 2008, at 22:59:56
> What a tough call it will be to try to separate posting on one board versus the other.
I agree, and expect it'll evolve with time.
> I think the "Medication" board should focus on clinical issues (specific therapeutic interventions).
>
> A "Neuroscience" board might better focus on pure research and theory without focusing on therapeutics.That would be one way to do it, but clinical issues can be "advanced", too.
I'm open to changing the name, though. Any other suggestions?
Bob
Posted by SLS on January 16, 2008, at 5:54:44
In reply to Re: New: Board Neurotransmitters, posted by Dr. Bob on January 16, 2008, at 0:58:36
> > What a tough call it will be to try to separate posting on one board versus the other.
>
> I agree, and expect it'll evolve with time.
>
> > I think the "Medication" board should focus on clinical issues (specific therapeutic interventions).
> >
> > A "Neuroscience" board might better focus on pure research and theory without focusing on therapeutics.
>
> That would be one way to do it, but clinical issues can be "advanced", too.
>
> I'm open to changing the name, though. Any other suggestions?
------------------------------------------------
Hi doctor.I don't always like change. I have, for the most part, come to agree with a great many of your innovations. However, I think separating the "Medication" into simple versus complex drug regimes is both arbitrary and clinically irrelevant. In fact, I would guess that there would be fewer novel ideas synthesized aimed at getting people well if psychopharmacological ideas could not be shared in one place.
I haven't done a study, but it seems to me that the majority of people on the Psycho-Babble "Medication" board are treatment resistant. This will most likely indicate combination therapy. Besides not understanding the technical verbiage to appear on the "Neurotransmitter" board - which is really a combination treatment board - a treatment-resistant person new to the study of their own illness might be unable to look for clinical information would benefit them.
How many people take one antidepressant plus lithium? This is combination treatment and would thus be directed to an unnecessarily sophisticated correspondence. What about adding bethanecol to a TCA to treat delayed micturition. How do you foster continuity of threads involving therapeutics if its definition is determined by how many drugs one takes?
Do we still have a "Newbies" board? Let me check. Ah yes. What is this board supposed to be for? I like to think of it as an introduction to the basic operation and theme of the boards and the first questions one has as to where to initially look for information.
I think it is counterproductive to separate out posts such that people can no longer easily follow another's treatment history because the number of drugs they try constantly causes them to flip from one board or another.
"Medication" could be devoted to the clinical treatment of individuals, including relevant medical and neuroscience information.
A "Neuroscience" board might better serve conversations regarding pure science and theory such that it applies to psychiatry and people in general. Issues to be included might be things like clinical trials, receptor-ligand dynamics, upstream and downstream events, second messenger cascade events, gene regulation, brain circuitry, pathological morphology and processes, neuroendocrine function, etc.
I think all the people who are looking desperately only for information that might get them well using pharmacological intervention should interact on one board, regardless of the number of agents used or how aggressive the treatment.
The separation in theme that is currently being practiced with the appearance of the new "Neurotransmitter" board has the potential to deter education and mutual support.
- Scott
Posted by Phillipa on January 16, 2008, at 12:56:34
In reply to Re: New: Board Neurotransmitters » Dr. Bob, posted by SLS on January 16, 2008, at 5:54:44
Dr. Bob I agree with Scott I'm having a very hard time already as found some of my threads on neurotransmitters. I was hoping if that maybe teaching what they are? And then a simeple meds board that does follow a persons progress. Thanks Phillipa
Posted by Dr. Bob on January 16, 2008, at 21:52:39
In reply to Re: New: Board Neurotransmitters » Dr. Bob, posted by SLS on January 16, 2008, at 5:54:44
> I think separating the "Medication" into simple versus complex drug regimes is both arbitrary and clinically irrelevant. In fact, I would guess that there would be fewer novel ideas synthesized aimed at getting people well if psychopharmacological ideas could not be shared in one place.
It's arbitrary, that's true. But plenty of novel ideas could be generated at Neurotransmitters.
> I haven't done a study, but it seems to me that the majority of people on the Psycho-Babble "Medication" board are treatment resistant. This will most likely indicate combination therapy. Besides not understanding the technical verbiage to appear on the "Neurotransmitter" board - which is really a combination treatment board - a treatment-resistant person new to the study of their own illness might be unable to look for clinical information would benefit them.
People who aren't treatment-resistant go online to look for information, too. And posts on Neurotransmitters don't have to have a lot of technical verbiage.
> How do you foster continuity of threads involving therapeutics if its definition is determined by how many drugs one takes?
I'm not sure. But it's come up already.
> I think it is counterproductive to separate out posts such that people can no longer easily follow another's treatment history because the number of drugs they try constantly causes them to flip from one board or another.
That's another good point.
> The separation in theme that is currently being practiced with the appearance of the new "Neurotransmitter" board has the potential to deter education and mutual support.
It does, but the previous system did, too.
Bob
Posted by seldomseen on January 17, 2008, at 6:29:07
In reply to Re: New: Board Neurotransmitters, posted by Dr. Bob on January 16, 2008, at 21:52:39
I've noticed that a lot of posters on the medication board are interested in how these drugs work, how they interact with each other and how they are metabolized.
That is pure pharmacology.
Under the pharmacology heading we could talk about receptors, antagonists, agonist, partial agonists, drug distribution, half-life etc...
All of which are pretty advanced.
Note that pharmacology is uniquely different from one's own personal experience with a drug, advice on how to take a drug and potential side effects.
Just my take.
Seldom.
Posted by SLS on January 17, 2008, at 6:37:39
In reply to Re: New: Board Neurotransmitters, posted by Dr. Bob on January 16, 2008, at 21:52:39
Hi doctor.
Thanks for responding. I think I understand your motivation for splitting the boards. (Imagine me trying to read your mind - a CBT no-no). It might be to create a board that will address more people whose treatment is, perhaps, more conventional and to be able perhaps to establish the character of each drug individually.
It still makes me want vomit - or at least burp - whenever I see the word "Neurotransmitters" as the label for a clinical board. Even more vomitus is that the neurotransmitter theory of depression is ARCHAIC. It neglects everything that neuroscience has learned more recently. I detest the limitations that the word "neurotransmitters" places upon intercourse. It is an affront to my sensibilities. For the sake of redundancy, I would prefer to see a split in categories be:
1. clinical
2. research / theoryLet us not let Psycho-Babble demonstrate to the rest of the world our apparent naivety. Let us remain at least current, if not progressive.
Pretty-please.
:-)
- Scott
Posted by SLS on January 17, 2008, at 6:48:22
In reply to How about calling it the Pharmacology board » Dr. Bob, posted by seldomseen on January 17, 2008, at 6:29:07
Hi seldomseen.
Your idea has merit.
However, again, it neglects the morphology and function of the brain and other influential systems. I certainly don't think that describing the routing of impulses efferent from the hypothalamus on to the reticular formation has a place on a "pharmacology" board. Circuitry is at least as, or perhaps more important, than neurotransmitters when trying to understand the CNS.
"Neuroscience" is a more comprehensive and accurate categorization for what will be discussed or in my case, disgust, on the "Neurotransmitter" board. I have a theory about the mechanism of action of Lamictal that is, I believe, unique. In order to understand the theory, one must understand the anatomy and circuitry of the brain.
- Scott
-------------------------------------------------
> I've noticed that a lot of posters on the medication board are interested in how these drugs work, how they interact with each other and how they are metabolized.
>
> That is pure pharmacology.
>
> Under the pharmacology heading we could talk about receptors, antagonists, agonist, partial agonists, drug distribution, half-life etc...
>
> All of which are pretty advanced.
>
> Note that pharmacology is uniquely different from one's own personal experience with a drug, advice on how to take a drug and potential side effects.
>
> Just my take.
>
> Seldom.
Posted by seldomseen on January 17, 2008, at 11:38:42
In reply to Re: How about calling it the Pharmacology board » seldomseen, posted by SLS on January 17, 2008, at 6:48:22
Your take on pharmacology is interesting. It is quite a comprehensive field that does, in fact, take into account the fundamental anatomy and physiology of the body's various systems and the effect on, or manipulation of those systems by drugs.
A discussion of the "the routing of impulses efferent from the hypothalamus on to the reticular formation" would be quite a home on a pharmacology board, a pharmacology class or in the practice of clinical pharmacology....
You'll just have to trust me on this one ;)
But bottom line, I personally don't care what the board is called.
Just FYI
Posted by Jamal Spelling on January 17, 2008, at 11:48:51
In reply to Re: How about calling it the Pharmacology board » SLS, posted by seldomseen on January 17, 2008, at 11:38:42
"On the fundamental physiological and quasi-physiological interaction between, but not confined to, systems and subsystems of the human central nervous system, as they pertain to psychiatry, psychology, pharmacology, neurology, and related medical specialities."
Posted by Jamal Spelling on January 17, 2008, at 11:57:37
In reply to I propose the following name for the new board:, posted by Jamal Spelling on January 17, 2008, at 11:48:51
"Things to do with psychiatry and drugs and neurotransmitters and all, that do not belong on the Medication board."
Posted by MidnightBlue on January 17, 2008, at 21:32:39
In reply to Board Name Change Neurotransmitters » Neuroscience, posted by SLS on January 15, 2008, at 7:06:46
Just call them Meds 101 and Meds 301
Posted by SLS on January 18, 2008, at 8:06:32
In reply to Re: How about calling it the Pharmacology board » SLS, posted by seldomseen on January 17, 2008, at 11:38:42
Hi.
> Your take on pharmacology is interesting.
I don't have a take on pharmacology except that it would be included in the study of neuroscience.
> It is quite a comprehensive field that does, in fact, take into account the fundamental anatomy and physiology of the body's various systems and the effect on, or manipulation of those systems by drugs.
"A brain circuit has been discovererd that links the thalamus to the nucleus accumbens"
This is an example of pure neuroscience that does not state anything related to pharmacology except that it might later help understand the workings of the brain. Understanding this brain circuit routing might help to understand illness and how it may be treated, whether it be pharmacologically, or through rTMS, DBS, ECT, or VNS. In other words, the progress of pure neuroscience has indeed already produced non-pharmacological treatments.
> A discussion of the "the routing of impulses efferent from the hypothalamus on to the reticular formation" would be quite a home on a pharmacology board,As I have already demonstrated, the focus of study appearing in this quote indicates nothing regarding pharmacology, even though the new knowledge and understandings evolving from the study of pure neuroscience can produce new insights into the pharmacology of drugs.
> a pharmacology class or in the practice of clinical pharmacology....
> You'll just have to trust me on this one ;)
I'm sorry, but we don't yet know each other. I have no reason to trust you yet. Right now, I am more trusting in my own deliberation and conclusion.
> But bottom line, I personally don't care what the board is called.
Then why lobby for a name change to "Pharmacology"? I consider the name and categorization of this new posting board to be extremely important. I am still partial to my proposal of renaming it to "Neuroscience".
I can be quite stubborn. I'm working on it, though.
- Scott
Posted by Dr. Bob on January 19, 2008, at 11:46:44
In reply to Re: Board Name Change Neurotransmitters » SLS, posted by MidnightBlue on January 17, 2008, at 21:32:39
> Just call them Meds 101 and Meds 301
I just had that idea, too! Except I was thinking Medication would stay just Medication. Also, Psycho-Babble Medication 301 or just Psycho-Babble 301?
Bob
Posted by Dinah on January 19, 2008, at 12:03:55
In reply to Re: Board Name Change Meds 301, posted by Dr. Bob on January 19, 2008, at 11:46:44
I like Scott's name idea and division of posts much better.
And his rationale seems sound, so I won't comment further on that.
Posted by Phillipa on January 19, 2008, at 19:39:05
In reply to Re: Board Name Change Meds 301 » Dr. Bob, posted by Dinah on January 19, 2008, at 12:03:55
And I still wish there was some teaching. Neurotramitter of the week maybe? Phillipa
Posted by MidnightBlue on January 19, 2008, at 20:09:16
In reply to Re: Board Name Change Meds 301, posted by Dr. Bob on January 19, 2008, at 11:46:44
Dr. Bob,
I DO really like the 101 and 301. :-) The simple title "medicaion" sounds a little flat to me.
MB
Posted by Dr. Bob on January 20, 2008, at 4:01:20
In reply to Re: Board Name Change Meds 301 » Dr. Bob, posted by MidnightBlue on January 19, 2008, at 20:09:16
> The simple title "medicaion" sounds a little flat to me.
Well, one step at a time...
Bob
Posted by ShawnThomas on January 22, 2008, at 15:24:26
In reply to Board Name Change Neurotransmitters » Neuroscience, posted by SLS on January 15, 2008, at 7:06:46
As a person who has done much to promote the spread of web-based information related to neurotransmitters and their receptors, I must say that the negative connotations associated with the term "neurotransmitter" really concern me. A vast majority of the psychiatric drugs either on the market or in clinical trials directly affect one of the following:
A. *Neurotransmitter* receptors
B. *Neurotransmitter* transporters
C. *Neurotransmitter* concentrationsTrue, a few drugs only affect voltage-gated ion channels and don't directly affect neurotransmitters' receptors, transporters, or concentrations. Some of these drugs can, however, affect neurotransmitter release! I am sure that no one will hesitate to ask a question about a drug that affects ion channels on a board billed as more advanced. Neurotransmitters, gene activity, second messengers, and brain circuitry are all interrelated. Studying neurotransmitters can require one to consider information from several disciplines: neuroscience, pharmacology, psychiatry, psychology, control theory, biophysics, radiology, and many others. This is not a limited topic of discussion!
I do not believe that the name of the board was chosen with any intent to limit the scope of a more advanced discussion about the brain and drugs that affect it. In my opinion, the name of the board does not imply that simple theories of neurotransmitter "imbalance" are valid. It simply acknowledges the fact that many people are excited to learn about neurotransmitters and related topics. The board's users can help one another to gain a more realistic understanding of the role that neurotransmitters play in affective disorders. We can also welcome any comments or suggestions about neuroscience or neuropharmacology because they will probably involve a system(s) affected by a neurotransmitter in one way or another :)
What really matters is sharing information to give people the ability to make more informed choices. What matters to me is giving people hope. We need to make information about neurotransmitters and the many systems and processes related to them more easily accessible for people all over the world. I really believe that, and I commend Dr. Bob for his support of this very important effort to encourage advanced discussions about neurotransmitters, neuroscience, neuropharmacology, and related topics.
Shawn
Posted by Phillipa on January 22, 2008, at 20:19:21
In reply to Neurotransmitters: a broad + interesting topic, posted by ShawnThomas on January 22, 2008, at 15:24:26
Shawn where else can I learn ? I like it too with people like you willing to explain to those not knowledgeable like me. Thank-you again. Phillipa
Posted by SLS on January 27, 2008, at 6:22:52
In reply to Neurotransmitters: a broad + interesting topic, posted by ShawnThomas on January 22, 2008, at 15:24:26
Hi Shawn.
I am a bit taken back by your assertion that the study of the brain should be understood within the boundaries of studying neurotransmitters. Many investigations into brain function do not mention neurotransmitters, but rather, discuss anatomy, circuitry, neuron cell numbers, glial cell fraction, tissue mass, myelination, downstream cascades, blood flow, nuclear events, and a bunch more stuff - much of which you have already mentioned.
> As a person who has done much to promote the spread of web-based information related to neurotransmitters and their receptors, I must say that the negative connotations associated with the term "neurotransmitter" really concern me.
I have never heard of such a thing. What are these connotations, and where do you find them? I don't believe that this is a problem here.
> A vast majority of the psychiatric drugs either on the market or in clinical trials directly affect one of the following:
>
> A. *Neurotransmitter* receptors
> B. *Neurotransmitter* transporters
> C. *Neurotransmitter* concentrationsWhether or not this is true is not the issue. Why set limits unnecessarily?
Neuroscience is all-encompassing. It does not suffer from being what I regard as being a myopic perspective regarding the topics to be discussed. While it is true that the majority of current antidepressant drugs can be conceptualized as tropic upon your three neurotransmission inclusions, what of the future? I think it is too esoteric to reach for ways that describe the biology and treatment of mental illness as a study of neurotransmitter molecules. Is a hormone a neurotransmitter? It certainly can be defined as one if you want to. What about all the peptides that influence neuronal tone? Are there receptors for these molecules throughout the body, including the brain. Yes. A receptor is anything that accepts a ligand that changes some function.
Most everything can be regarded as related to neurotransmission in that physiological events can, through a flow diagram, be shown to be related to the messengers that facilitate the communication between brain cells, including glia - if you reach far enough. Why work so hard to make this connection? Why not simply make this new board a place where any topic related to the study of neuropsychobiology be nurtured? You never know when pure science will yield clinical applications.
I continue to like my idea as you do yours.
Respectfully,
- Scott
Posted by SLS on January 27, 2008, at 12:37:00
In reply to Re: Neurotransmitters: a broad + interesting topi » ShawnThomas, posted by SLS on January 27, 2008, at 6:22:52
Sorry...
"Neuroscience is all-encompassing. It does not suffer from being what I regard as being a myopic perspective regarding the topics to be discussed."
I didn't mean to say that you were myopic. Bad choice of diction.
- Scott
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