SSRIs and mood disorder

[Guest guest]

Dear Misty and list members,

 

I am going to respond to the points in your previous letter. I hope that

this is clear.

 

<< But I do understand ALL information is susceptible to manipulation. >>

 

Yes, I agree, including and especially information from the

pharmaceutical industry. They notorious for manipulating data, omitting

and not publishing unfavorable data, eliminating patients from studies in

order to get favorable results, etc. etc., therefore biasing perceptions.

 

" Perhaps you will take a look and tell me what you think? "

 

Re citations in your second post, again there is no hard evidence in any

of these articles or any link between antidepressant medication and cancer.

 

" But whether we can find out if there is a link or not, I would personally

want to exhaust all natural & holistic solutions before taking a prescription

such as a SSRI. "

 

I absolutely agree if depression were mild to moderate and clearly

related to stress and there were no medical reasons for depression (e.g.

treatable medical condition such as thyroid disorder, anemia, etc.). For

example, energy psychology, homeopathy, talk therapy, and St. John's Wort,

phototherapy are good examples of interventions with little or no

complications or side effects.

 

However, bipolar disorder often presents as depression and is often

misdiagnosed as a unipolar depression. The average time of diagnosis from

onset of symptoms (usually depression) to diagnosis of bipolar disorder is

eight years. Evidence indicates that the longer bipolar disorder is not

treated with medication, the more difficult and resistant it becomes to

subsequent treatment of any kind as the neurophysiological dysfunction

becomes more " set " in the central nervous system. Therefore in this case if

more time were lost because of ineffective non pharmaceutical treatment, the

prognosis becomes potentially worse. Lost time with ineffective approaches

has the consequence of increase morbidity and mortality - with increased

risks of suicide, loss of job, loss of marriage, comorbid drug/alcohol

dependence and abuse which are all clearly associated with bipolar disorder.

This not only has a devastating impact on the individuals and their family,

but also on society with loss of work productivity, costs of hospitalization

and further medical treatment, etc.

 

An individual with mood disorder that is obviously a reaction to an acute

stress and in which there is no family history of mood disorder or

alcohol/drug dependence, with no significant prior history of depression and

no current medical disorder which may contribute to depression has time to

try a non pharmaceutical approach. In this case I agree that non

pharmaceutical approaches might well be exhausted before trying psychotropic

medications.

 

Each individual's personal preferences for Rx should be respected.

Health care providers should educate clients/patients as to the risks and/or

benefits of intervening or not treating (pharmaceutical or non

pharmaceutical.) Then it is up to the individual to decide what make sense

to them in view of the information presented.

 

Pharmaceutical Rx (not only SSRIs) is not to be taken lightly. Cancer is

usually our last concern (if considered at all) regarding adverse medication

reactions. The plethora of potential side effects from GI distress, sexual

dysfunction, weight gain/loss, potentially serious allergic reactions,

changes in blood electrolytes, and blood pressure, sedation, insomnia, etc.

(the list is almost endless) are more common and troublesome.

 

Last, but not least, non pharmaceutical preparations in the processed

forms are not always benign. Some examples - ginko biloba causes impaired

clotting and should be discontinued before surgery, Kava Kava has been

withdrawn in Europe because of liver toxicity, ephedra may cause serious

cardiovascular reactions.

 

Best regards,

 

 

Phil Milstein, MD

Adult Psychiatry/Psychopharmacology

Santa Fe, NM

[Guest guest]

Hi Dr. Milstein, Yes, the herbs you have mentioned have caused problems, but in

most cases after the person taking them had abused them in a really bad, bad

way... You might be interested in checking out homeopathy in relationship to

psychology and psychiatry. There are wonderful remedies for all sorts of

different mood disorders- what ever the label might be. For example, Aurum

Metallicum is ideal for those suffering from deep, deep depression- even

suicidal depression. I have seen homeopathic remedies work in situations that

were conventionally thought of as untreatable/incurable- including the disorders

you mentioned. I feel these are valid avenues of exploration, which deserve a

chance before trying more drastic (and dangerous) protocols such as SSRI's. This

is a site for just such an exploration and for the people who wish to

participate in such an exploration. If you have suggestions on how to explore

these alternative options more fully/effectively, please feel free to share your

wisdom with us. I trust that you are a very knowledgeable and open-minded MD.

If however your perception is deeply rooted in allopathic medicine, I respect

and honor that, and suggest perhaps a different, more allopathic site as being

appropriate. Be Well,Mistyhttp://www..com

 

MidbarNM wrote:Dear Misty and list members,

 

I am going to respond to the points in your previous letter. I hope that

this is clear.

 

<< But I do understand ALL information is susceptible to manipulation. >>

 

Yes, I agree, including and especially information from the

pharmaceutical industry. They notorious for manipulating data, omitting

and not publishing unfavorable data, eliminating patients from studies in

order to get favorable results, etc. etc., therefore biasing perceptions.

 

" Perhaps you will take a look and tell me what you think? "

 

Re citations in your second post, again there is no hard evidence in any

of these articles or any link between antidepressant medication and cancer.

 

" But whether we can find out if there is a link or not, I would personally

want to exhaust all natural & holistic solutions before taking a prescription

such as a SSRI. "

 

I absolutely agree if depression were mild to moderate and clearly

related to stress and there were no medical reasons for depression (e.g.

treatable medical condition such as thyroid disorder, anemia, etc.). For

example, energy psychology, homeopathy, talk therapy, and St. John's Wort,

phototherapy are good examples of interventions with little or no

complications or side effects.

 

However, bipolar disorder often presents as depression and is often

misdiagnosed as a unipolar depression. The average time of diagnosis from

onset of symptoms (usually depression) to diagnosis of bipolar disorder is

eight years. Evidence indicates that the longer bipolar disorder is not

treated with medication, the more difficult and resistant it becomes to

subsequent treatment of any kind as the neurophysiological dysfunction

becomes more " set " in the central nervous system. Therefore in this case if

more time were lost because of ineffective non pharmaceutical treatment, the

prognosis becomes potentially worse. Lost time with ineffective approaches

has the consequence of increase morbidity and mortality - with increased

risks of suicide, loss of job, loss of marriage, comorbid drug/alcohol

dependence and abuse which are all clearly associated with bipolar disorder.

This not only has a devastating impact on the individuals and their family,

but also on society with loss of work productivity, costs of hospitalization

and further medical treatment, etc.

 

An individual with mood disorder that is obviously a reaction to an acute

stress and in which there is no family history of mood disorder or

alcohol/drug dependence, with no significant prior history of depression and

no current medical disorder which may contribute to depression has time to

try a non pharmaceutical approach. In this case I agree that non

pharmaceutical approaches might well be exhausted before trying psychotropic

medications.

 

Each individual's personal preferences for Rx should be respected.

Health care providers should educate clients/patients as to the risks and/or

benefits of intervening or not treating (pharmaceutical or non

pharmaceutical.) Then it is up to the individual to decide what make sense

to them in view of the information presented.

 

Pharmaceutical Rx (not only SSRIs) is not to be taken lightly. Cancer is

usually our last concern (if considered at all) regarding adverse medication

reactions. The plethora of potential side effects from GI distress, sexual

dysfunction, weight gain/loss, potentially serious allergic reactions,

changes in blood electrolytes, and blood pressure, sedation, insomnia, etc.

(the list is almost endless) are more common and troublesome.

 

Last, but not least, non pharmaceutical preparations in the processed

forms are not always benign. Some examples - ginko biloba causes impaired

clotting and should be discontinued before surgery, Kava Kava has been

withdrawn in Europe because of liver toxicity, ephedra may cause serious

cardiovascular reactions.

 

Best regards,

 

 

Phil Milstein, MD

Adult Psychiatry/Psychopharmacology

Santa Fe, NM