tag:blogger.com,1999:blog-4683970826895755480.post2623665416861389661..comments2024-03-28T00:17:55.823+00:00Comments on Bruce Charlton's Notions: Classifying psychiatric drugs: Corrective, Symptomatic, Counter-pathologicalBruce Charltonhttp://www.blogger.com/profile/09615189090601688535noreply@blogger.comBlogger15125tag:blogger.com,1999:blog-4683970826895755480.post-15973899101708822132012-09-29T05:43:01.529+01:002012-09-29T05:43:01.529+01:00@Ariston
Thanks for pointing out my slip of the p...@Ariston<br /><br />Thanks for pointing out my slip of the pen with Lamotrigine - I meant anticonvulsant (*not* antipsychotic).<br /><br />From a psychiatry point of view - Lamotrigine is promoted as a 'mood stabilizer' - but that concept is bogus. <br /><br />Lamotrigine may - apparently - have uses as an antidepressant (in line with what you say above). It may have stimulant properties (increasing energy and motivation, rather like amphetamine).<br /><br />I agree that people seem to like taking L. - whereas they dislike most of the other anticonvulsants, unless they appreciate sedation. <br /><br />I have deleted my comment, to avoid propagating error - which does make you comment in response look rather strange - sorry! Bruce Charltonhttps://www.blogger.com/profile/09615189090601688535noreply@blogger.comtag:blogger.com,1999:blog-4683970826895755480.post-11546291313194091792012-09-29T03:32:47.158+01:002012-09-29T03:32:47.158+01:00The link you sent me was dead, but I found it here...The link you sent me was dead, but I found it <a href="http://www.hedweb.com/bgcharlton/subtypes-depression.pdf" rel="nofollow">here</a>. Very interesting. I've noticed that European (including the UK) doctors tend to be more bullish on St John's Wort than American ones; a friend of mine doing her residency says the negative interactions are very emphasized in medical school. I know a number of persons who take it, but mostly for SAD.<br /><br />It's interesting that you call lamotrigine an antipsychotic; most of what I've seen on it has defined it as an atypical antidepressant, but that has not jived with my impression the phenomenal side of the literature describing patient response. (I'm a hobbyist reader of medical literature— a strange way to pass time, I know.) I have wondered if its description as such has been to make it more palpable to patients; it's a lot easier to sell to a patient that they need an atypical antidepressant than an antipsychotic.Aristonhttps://www.blogger.com/profile/05941177388074392732noreply@blogger.comtag:blogger.com,1999:blog-4683970826895755480.post-81712630300774848112012-09-28T13:36:04.744+01:002012-09-28T13:36:04.744+01:00This comment has been removed by the author.Bruce Charltonhttps://www.blogger.com/profile/09615189090601688535noreply@blogger.comtag:blogger.com,1999:blog-4683970826895755480.post-61295632204926254012012-09-27T23:29:58.861+01:002012-09-27T23:29:58.861+01:00Where would you place the use of the anticonvulsan...Where would you place the use of the anticonvulsant lamotrigine in this classification? It seems (by comparison to lithium, at least) that it would be placed in category three, but testimony has given me the idea that it does not result in the blunting effects lithium or SSRIs tend to.<br /><br />It strikes me that one of the biggest problems with drug regimens is the desire to create easily definable classes rather than analyzing particular cases and allowing the patient (if intelligent enough) to self–experiment with differing psychopharma to a degree. I worked as a technician in a pharmacy during college, and the amount of persons on SSRIs was terrifying— especially among women over 35.<br /><br />(Even more terrifying is the wide use of anti–psychotics amongst children from families poor enough to be on the free governmental health care in the US— obviously the successor to amphetamines in attempting to deal with their behavior.)Aristonhttps://www.blogger.com/profile/05941177388074392732noreply@blogger.comtag:blogger.com,1999:blog-4683970826895755480.post-31465390305125514132012-09-26T15:14:24.610+01:002012-09-26T15:14:24.610+01:00FROM JOHN DOUGLAS
Rather a lot of "it probab...FROM JOHN DOUGLAS<br /><br />Rather a lot of "it probably works by...."<br /><br />...and in conjunction with your comment-<br /><br />"You must understand that almost all modern medical research is corrupt, and systematically dishonest"<br /><br />makes me wonder about the efficacy of pills as panaceas. Does anybody really understand how these pills work.<br /><br />I asked my doctor what effect my levetiracetam tablets would have on my body if I didn't need them and she replied 'probably none'<br />There's that word again - probably. Makes me nervous hearing words like that.<br /><br />Do I need them?<br />I sometimes wonder if there isn't a better way.<br />======================<br />By the way, I didn't know you had been 'sacked' - the internet is a strange world with a mind of its own :)<br />regards<br />John Douglas<br />http://nourishingobscurity.com/category/jd/Bruce Charltonhttps://www.blogger.com/profile/09615189090601688535noreply@blogger.comtag:blogger.com,1999:blog-4683970826895755480.post-42956038798944986072012-09-26T07:37:55.255+01:002012-09-26T07:37:55.255+01:00@FHL - Not usually. But yes, they could. And not j...@FHL - Not usually. But yes, they could. And not just psychoactive drugs, but various agents. <br /><br />Neurotoxicity is one mechanism - poisoning nerve cells so that they are permanently impaired or killed. It happens with a number of agents - for example Alchohol, Carbon monoxide; and from trauma (e.g. punch drunk syndrome) - as well as drugs.<br /><br />The fact that some drugs have such a different effect in first dose from ever after implies that some changes may occur with the first dose and last a lifetime. Bruce Charltonhttps://www.blogger.com/profile/09615189090601688535noreply@blogger.comtag:blogger.com,1999:blog-4683970826895755480.post-27202418241155866512012-09-26T04:11:29.298+01:002012-09-26T04:11:29.298+01:00I have a quick question: can psychoactive drugs pe...I have a quick question: can psychoactive drugs permanently alter thinking patterns? I'm not talking about the simple effect of withdrawal and addiction. I mean: can taking a psychoactive drug change the way a person processes reality and logic in such a way that his thinking is permanently altered even after the drug has completely left his system, even years later- possibly for the rest of the person's life? Would/could this change personality? Can certain drugs reroute neurons?FHLnoreply@blogger.comtag:blogger.com,1999:blog-4683970826895755480.post-46752448038386105432012-09-25T15:03:06.646+01:002012-09-25T15:03:06.646+01:00@d - not sure about these particular examples - bu...@d - not sure about these particular examples - but some of the out-of-the-blue suicides (e.g of famous people) will probably due to SSRIs; and some of the weirdly horribly violent explosive murders we see in the news are probably due to anabolic steroids (which are extraordinarily widely used, illegally).<br /><br />@CHris - but antidepressants begin to work in hours or a few days (i.e. after they have been absorbed, or when they later reach therapeutic levels), not after a few weeks - so there is nothing to explain. <br /><br />(There is no drug which takes weeks to start working - the slowest are probably drugs that affect cell turnover like cytotoxics - but even they work in days.)<br /><br />(Look at my (online) book Psychiatry and the Human Condition - http://www.hedweb.com/bgcharlton/<br />psychhuman.html <br />for a discussion of this point.) <br /><br />You must understand that almost all modern medical research is corrupt, and systematically dishonest - rotten from top to bottom. The people involved are not even trying to be honest - surely you have heardthem speaking? <br /><br />It is a matter of working from a few sources of evidence that can be trusted.Bruce Charltonhttps://www.blogger.com/profile/09615189090601688535noreply@blogger.comtag:blogger.com,1999:blog-4683970826895755480.post-48870411364204582242012-09-25T12:19:07.760+01:002012-09-25T12:19:07.760+01:00A long shot but: the short-tempered cabinet minist...A long shot but: the short-tempered cabinet minister who ranted at the policemen the other day - would it be legitimate to wonder what he's on, or is "he's always been a twat" explanation enough?deariemenoreply@blogger.comtag:blogger.com,1999:blog-4683970826895755480.post-60994809285166321702012-09-25T12:15:33.459+01:002012-09-25T12:15:33.459+01:00That sounds very gloomy. Whenever my wife sees ap...That sounds very gloomy. Whenever my wife sees appalling driving, be it recklessness or incompetence, she wonders out loud about the driver being on drugs. Must we now wonder whether they are on prescribed drugs?deariemenoreply@blogger.comtag:blogger.com,1999:blog-4683970826895755480.post-57928261320182950462012-09-25T11:51:33.449+01:002012-09-25T11:51:33.449+01:00Bruce, you really need to go and read the current ...Bruce, you really need to go and read the current work from the Australians on neuroglial pathways and neurogenesis. <br /><br />It explains some clinical findings, such as why antidepressants and antipsychotics do not work for a week to fortnight (they hit steady state and alter receptor saturation within a day or so).<br /><br />And it blows your classification to smithereens.CHrishttp://blog.pukeko.net.nznoreply@blogger.comtag:blogger.com,1999:blog-4683970826895755480.post-4464313564572675352012-09-25T11:00:04.973+01:002012-09-25T11:00:04.973+01:00@d - no not necessarily, under the circumstances y...@d - no not necessarily, under the circumstances you outline and so long as the side effects are not worse than the problem being treated.<br /><br />Indeed almost all drugs create dependence to some extent (the higher doe for longer period the greater the dependence) - and all psychoactive drugs without exception create dependence.<br /><br />Luckily many/ most people can get through the withdrawal process OK (especially if they are expecting it) and come off the drugs if necessary or beneficial to do so. <br /><br />But many psychiatric problems are self-limiting (e.g. most cases of mania and endogenous depression, and many cases of catatonia and apparent schizophrenia - although these may be permanent with or without treatment) and some drugs - like the neuroleptics/ antipsychotics - make people feel bad. <br /><br />Probably hundreds of thousands/ millions of people who suffered an acute, one-off, short-term, psychotic breakdown have been made permanently dependent on neuroleptics which make them feel bad, look bad (blank face, tremor, tardive dyskinesia etc) and function badly - but which they cannot stop taking without proking a psychotic break. <br /><br />Indeed, nowadays the situation may be worse, since these are being given to children, teens and non-psychotic people under the pretense that they are preventive of more serious problems in the future - but actually creating innumerable impaired lifetime clients for Big Pharma who are the only beneficiaries of the process.Bruce Charltonhttps://www.blogger.com/profile/09615189090601688535noreply@blogger.comtag:blogger.com,1999:blog-4683970826895755480.post-80807238893450359722012-09-25T09:44:19.230+01:002012-09-25T09:44:19.230+01:00Is addiction necessarily much of a problem? If yo...Is addiction necessarily much of a problem? If you expected to need a drug for the rest of your life, would it matter that you might become addicted to it? <br />(I ask from profound ignorance of this whole field.)deariemenoreply@blogger.comtag:blogger.com,1999:blog-4683970826895755480.post-62013101977399264042012-09-25T08:02:14.236+01:002012-09-25T08:02:14.236+01:00@The - yes, I agree.
But it was significant that...@The - yes, I agree. <br /><br />But it was significant that SSRIs are the characteristic drugs of the present era of bureaucratic conformity. Although there are signs that neuroleptic/ antipsychotics are taking-over - being given increasingly to children and teens, and they are dependence producing.<br /><br />This is seriously sinister since these were the drugs given to Soviet dissidents; because they demotivate people and make them placidly compliant (and less productive). The perfect Leftist drugs, in fact... Bruce Charltonhttps://www.blogger.com/profile/09615189090601688535noreply@blogger.comtag:blogger.com,1999:blog-4683970826895755480.post-25708639711032221902012-09-25T07:16:41.649+01:002012-09-25T07:16:41.649+01:00If you are correct about lithium and SSRIs then th...If you are correct about lithium and SSRIs then they really might tend to diminish genius, or at least artistic genius. However, I wonder if they still might in some circumstances actually help a genius produce more and better work, if his emotional instability is getting in the way of actually getting the work done.Thursdayhttps://www.blogger.com/profile/13002311410445623799noreply@blogger.com