The article does note one plus of all this, a plus that should not be discounted: it reduced the stigma of mental illness & made it a discussable topic. Even the ludicrous phrase, "chemical imbalance," _as a phrase_, was of enormous help to a large number of people. It really is easier to say, "My girl friend has a chemical imbalance in her brain" (direct quote of a freshman talking to me in conference many years ago) than to say -- What? The girl friend was had the symptoms labeled bipoalr. I don't know what effect (positive or negative) of the meds she took: the label was of considerable comfort.
Experience varies on getting off the drugs. I was taking the maximum dosage (I forget the SSRI's name), decided it was for shit, and quit cold. For a couple of months I felt somewhat elated, with more energy, but no other apparent effect.
Now when I started ADx, with amitriptylene ("Elavil") the immediate effect (clicking in 5 days after I reached a dosage of 100 mg.) was dramatic. The day before, 10 minutes into a class, my voice suddenly started to space out like one of the old fashioned record players when the vbatteries wore out. I dismissed class. The next morning, I was sitting in my office 5 minutes before a 9am class, wondering how I would get through it, and click, I had my mind back and could think. The drug became ineffective after a year or two, and no other med ever helped me. (Incidentally amitriptylene is a great sleeping pill: it doesn't interfere with rem sleep as do most . I still take 50mg every night to help me get back to sleep when I awaken in the middle of the night. The other night I was lying fully awake at around 3am, when it struck me: I had not taken my nightly meds. I never need them to get to sleep, but as an old man I wake up two or three times every night, and that is when insomnia is apt to hit without amitriptylene.
Of course most modern drugs are dangerous. I take 100 mg of celebrex every morning. (The alternative is hip surgery to replace my 'old' plastic & hip joint.) Celebrex is a close cousin of a drug that was taken off the market because it was killing people. But before I started it I had to have Jan put on my socks and shoes -- couldn't bend far enough to do it myself -- and was inconstant serious pain. I prefer to gamble with Celebrex rather than with major surgery.
And then there is Xanaflex. It's a muscle relaxant, but I take it to prevent migraine. In the sprint of '99 I developed headaches which at first seemed non-migraine, but they became worse and worse until about every five days I would wake up around 2am with incredible head pain as well as unstoppable nausea (dry heaves). I would head for the ER to be put on morphine & an anti-nausea drub by an IV. Get home around later afternoon.Not fun. And then one day my neurologist mused, "Tension headaches shouldn't come on in the middle of the night. Perhaps its atypical migraine. Before taking Xanaflex I had to have a heart test on a treadmill, then work up to an effective dose slowly. It stopped the headaches completely. So I take 12mgs of it a day. And flomax, which doesn't seem to work as I still get up 3 times or more a night. (The alternative there is prostate surgery.) It's probable that that many different meds will create some kind of undesirable synergy, but so far not.
On 6/16/2011 4:53 PM, shag carpet bomb wrote:
> One of the books in the review is about the scandalous way in which
> people came to buy the claim that depression and other disorders are
> about a "chemical imbalance" in the brain - which, IIRC, was a
> marketing ploy promoted by Prozac. As the authors under review points
> out, this was based on ludicrous scientific reasoning:
> "When it was found that psychoactive drugs affect neurotransmitter
> levels in the brain, as evidenced mainly by the levels of their
> breakdown products in the spinal fluid, the theory arose that the
> cause of mental illness is an abnormality in the brain’s concentration
> of these chemicals that is specifically countered by the appropriate
> drug. ... Thus, instead of developing a drug to treat an abnormality,
> an abnormality was postulated to fit a drug."
> Additionally, it turns out that psychoactive drugs are having
> long-lasting changes on the brain that may be worse than the original
> symptoms for which they were prescribed:
> With long-term use of psychoactive drugs, the result is, in the words
> of Steve Hyman, a former director of the NIMH and until recently
> provost of Harvard University, “substantial and long-lasting
> alterations in neural function.” As quoted by Whitaker, the brain,
> Hyman wrote, begins to function in a manner “qualitatively as well as
> quantitatively different from the normal state.” After several weeks
> on psychoactive drugs, the brain’s compensatory efforts begin to fail,
> and side effects emerge that reflect the mechanism of action of the
> drugs. For example, the SSRIs may cause episodes of mania, because of
> the excess of serotonin. Antipsychotics cause side effects that
> resemble Parkinson’s disease, because of the depletion of dopamine
> (which is also depleted in Parkinson’s disease). ...
> [snipping bit about pre-frontal cortex atrophying....]
> Getting off the drugs is exceedingly difficult, according to Whitaker,
> because when they are withdrawn the compensatory mechanisms are left
> unopposed. When Celexa is withdrawn, serotonin levels fall
> precipitously because the presynaptic neurons are not releasing normal
> amounts and the postsynaptic neurons no longer have enough receptors
> for it. Similarly, when an antipsychotic is withdrawn, dopamine levels
> may skyrocket. The symptoms produced by withdrawing psychoactive drugs
> are often confused with relapses of the original disorder, which can
> lead psychiatrists to resume drug treatment, perhaps at higher doses."
>> In an exchange in the NRB years ago Lewontin forced a physician to
>> vigorously that he had claimed that germs caused TB.
>> TB only occurs, of course, in the 'presence' of a bacillus; but its
>> _causes_ Lewontin argued were social. I don't think one can assert a
>> particular cause of mental illness --or even assert it exists: that
>> remains to be clearly established. My symptoms certainly existed, but
>> whether they constituted a definable "illness" or not remains to be
>> established by future research. And Doug must have had his tongue in
>> corner of his mouth when he typed, "what about the possibility." That
>> hardly gets us anyplace. The answer to such a suggestion is always the
>> same, Sure, but who knows.
>> ays to kill a CEO)