Flutterby™! : Antidepressant info?

Antidepressant info?

2001-03-09 16:52:19+00 by Dan Lyke 8 comments

A request for help: I've got an adult friend who, after many years of therapy and alternative medicine to treat anxiety attacks and attention problems, has decided conventional treatment and drugs are in order. Because of the alternative medicine bent this is not a decision made lightly, and there's no health insurance so resources need to be spent wisely, so said friend wants to find someone who actually knows what's going on, and isn't just prescribing the drug-of-the-month to bored yuppie housewives. I'd heard Daniel G. Amen on the radio and was impressed, my friend found his Brain Place site, and is interested in going to the Fairfield branch of the Amen Clinic.

As usual I've been asked to be a guardian angel, to double-check decisions and references and do a little hand holding. Can any of y'all point me towards good resources on psychoactive drugs and treatment and horror and success stories?

comments in ascending chronological order (reverse):

#Comment made: 2002-02-21 05:31:17+00 by: topspin

I have only a coupla moments before vacation starts and I'll respond in depth (and probably privately to you, Dan) when I return. Buspar, from Dr. Amen's "post-ganglia" problems section, is a choice I'd consider for a med, but the related therapy.... reprogramming... inventorying... understanding/accepting anxiety attacks is the key, IMHO.

#Comment made: 2002-02-21 05:31:17+00 by: TheSHAD0W

I hate to tell you this... But even the best doctors don't know just what's going on w/ psychoactive drugs. Every antidepressant out there has potentially serious side effects and may or may not be effective, with results dependent on the patient's biochemistry. A drug you've heard horror stories about might wind up being the most effective and best tolerated by your friend. And yes, he will probably get the "drug-of-the-month" first, and it may not work well; at which point he'd be switched to something else. Eventually, hopefully (and likely) he'll find something he finds works for him, with no side-effects or ones he can live with. The trick is, once he finds that drug, to stop searching for something better and stick with it.

#Comment made: 2002-02-21 05:31:17+00 by: Dan Lyke

My impression is not that nobody knows, but that overprescription usually keeps the various parties happier than proper diagnosis. Certainly the people developing these drugs have some understanding to the processes involved, and the diagnostic equipment is available (albeit expensive), but the attitudes with which antidepressants are generally prescribed are pretty cavalier, "Feeling down? Here, have a Zoloft", the unsaid "if nothing else the placebo effect will work."

#Comment made: 2002-02-21 05:31:18+00 by: seitz

There's a good database of drug info at http://promini.medscape.com/drugdb/search.asp, but it's "official" info, and thus may lag some word of mouth (for the sake of verifiability).

When it comes to attention management (e.g. ADD), I've gotten the feeling that antidepressants get prescribed more often (first) than stimulants because the latter have gotten a bad rep (and are even sometimes hard to get filled, because not all pharmacies will even carry them). Amen's book, in which (on the basis of brain scans) identifies 6 different classes of ADD, looks interesting (have browsed but not yet bought).

#Comment made: 2001-03-15 11:29:19+00 by: monde [edit history]

You probably won't take this seriously, but I honestly mean what I am about to say.

In this day and age, in most cases with but a few scattered exceptions, any kinds of drugs that actually have the potential to make people feel good are not prescribed by doctors for any effective length of time - or sometimes not even at all, period.

Frankly, I have a terrible case of Fear of Aging, which is a complex mind-trip for me, but I recognize part of it is just my realization that unlike my parents, and their parents, when I start having lots of aches and pains, mental and physical, the doctors are going to give me Ibuprofen and so-called "antidepressants" which - in all my own experience AND in those of many of my friends I've known, do only one thing: decrease or eliminate sex drive or interest. I guess of not being able to get laid is the source of one's depression, that could help in that instance...but any other sort, and it seems to be taking away from, not improving, life quality.

Tell your friend that it's highly likely that a successful search for effective pharmaceutical relief of anxiety and depression will take him/her not to his shrink or physician, but to the dingier downtown areas - frequently shifting about from week to week - where the local "Open Air Pharmacy" will be found.

This is a frightening and just plain "not tenable" idea for most "normal folks" to even consider, I realize - but these are not the times we grew up in. These are desperate times which sometimes do call for desperate measures. Maybe you know some friends who can help and thus avoid the street buying scene, which would be MUCH better. But most don't.

One can find benzodiazepines (valium, klonopin and xanax) if they look hard enough. The pills are cheap and last for a day or so. I would advise not taking them for longer than a few days in a row without some time inbetween not taking them because they ARE addictive. (Most things that actually WORK, ARE.)

Cocaine and heroin might be offered, and while these might provide relief in the short term, their downsides pretty much mitigate any positive effects. Coke just has too short an action period. Heroin is just too compelling.

Amphetamines do help some people who have energy problems related to slow metabolism. But for other people, they cause nightmare psychotic behaviour. Tread this ground carefully - if ADD is part of the picture, your friend will probably not be psychotic from it, and may benefit from it.

Start any drug in small doses. Since you are your own doctor here, it's up to your friend to do their homework. Find out what sort of personality tendencies your friend has, and whether it's the benzos or the speed that might help...

Or if marijuana could be the best bet. It's the least dangerous of all the scheduled drugs - no one has ever died of an OD of it. Unfortunately it's actually easier to find crack than it is pot nowadays, because of the infernal, asinine neo-prohibition climate. Still, many, many, many people will attest to the healing potential of the "herb that heals the nations" - again, different minds = different pathways = different effects.

Experiment. Take charge of your own life. But be cautious - it is a jungle out there. The results may be disappointing or the best thing life ever showed you - or somewhere in between.

Don't waste time with doctors - unless they're known "croakers" they value their medical license more than your friend's happiness. They also frequently get bought off by pharmaceutical companies trying to push some "new treatment" - and do everything they can to make sure it's all you will be offered. That's $75.00 for a visit to a shrink who's really just a stooge, and even more for a bottle of some stupid SSRI or tricyclic antidepressant that will dry out the mouth and soften the penis.

Go renegade: it's at least got a chance of helping long enough for your friend to seriously self-analyze. Supervise if possible - especially if s/he's a total drug "newbie". Bad things DO happen when people get addicted, but they're grossly exaggerated by a (paid off) media.

I'm not joking about any of this. Really. My heart goes out to your friend, whatever they decide to do.

#Comment made: 2002-02-21 05:31:18+00 by: monde

You probably won't take this seriously, but I honestly mean what I am about to say. In this day and age, in most cases with but a few scattered exceptions, any kinds of drugs that actually have the potential to make people feel good are not prescribed by doctors for any effective length of time - or sometimes not even at all, period. Frankly, I have a terrible case of Fear of Aging, which is a complex mind-trip for me, but I recognize part of it is just my realization that unlike my parents, and their parents, when I start having lots of aches and pains, mental and physical, the doctors are going to give me Ibuprofen and so-called "antidepressants" which - in all my own experience AND in those of many of my friends I've known, do only one thing: decrease or eliminate sex drive or interest. I guess of not being able to get laid is the source of one's depression, that could help in that instance...but any other sort, and it seems to be taking away from, not improving, life quality. Tell your friend that it's highly likely that a successful search for effective pharmaceutical relief of anxiety and depression will take him/her not to his shrink or physician, but to the dingier downtown areas - frequently shifting about from week to week - where the local "Open Air Pharmacy" will be found. This is a frightening idea for most "normal folks" to even consider, I realize - but these are not the times we grew up in. These are desperate times which call for desperate measures. One can find benzodiazepines (valium, klonopin and xanax) if they look hard enough. The pills are cheap and last for a day or so. I would advise not taking them for longer than a few days in a row without some time inbetween not taking them because they ARE addictive. (Most things that actually WORK, ARE.) Cocaine and heroin might be offered, and while these might provide relief in the short term, their downsides pretty much mitigate any positive effects. Amphetamines do help some people who have energy problems related to slow metabolism. But for other people, they cause nightmare psychotic behaviour. Tread this ground carefully, and start any drug in small doses. Since you are your own doctor here, it's up to your friend to do their homework. Find out what sort of personality tendencies your friend has, and whether it's the benzos or the speed that might help. Or if marijuana could be the best bet. It's the least dangerous of all the scheduled drugs - no one has ever died of an OD of it. Unfortunately it's actually easier to find crack than it is pot nowadays, because of the infernal, asinine neo-prohibition climate. Don't waste time with doctors - unless they're known "croakers" they value their medical license more than your friend's happiness. They also frequently get bought off by pharmaceutical companies trying to push some "new treatment" - and do everything they can to make sure it's all you will be offered. That's $75.00 for a visit to a shrink who's really just a stooge, and even more for a bottle of some stupid SSRI or tricyclic antidepressant that will dry out the mouth and soften the penis. Go renegade: it's at least got a chance of helping long enough for your friend to seriously self-analyze. Supervise if possible - especially if s/he's a total drug "newbie". Bad things DO happen when people get addicted, but they're grossly exaggerated by a (paid off) media. I'm not joking about any of this. Really.

#Comment made: 2002-02-21 05:31:18+00 by: Dan Lyke

Monde, sorry about the problem with the duplicate post and bad formatting, I'm tweaking code as I look through this to make sure things work right. If you want to nuke one of those off I'd appreciate it,

This is Flutterby, and I live in Marin. Self-medication and alternatives to the standard medical and (especially) psychiatric establishment are the norm, not the exception.

My friend has been around the block a little bit. There have been some attempts at behavior modification through hallucinogens, a little bit of work with the traditional LSD, some better effects with Ecstacy, although none of them seem to "stick".

And a lower grade treatment rather than 8-12 hours where someone else has to be working with the "patient" to work on issues and goals would be preferable to those in the vicinity.

Marijuana has its place, but as a reaction to panic/anxiety, especially in the current political climate (even in Marin!) isn't the right solution. And given the nature of this friend's work (not computers), it's not something that can be turned to when the fear comes.

I don't know much about Klonopin and Xanax and the like, Topspin will hopefully be back in a few days, and in the mean-time I'll go poke through medline.

Amphetamines are a definite "out". Beyond my own general distrust of "uppers", my friend has some experience in the years gone by with amphetamine culture.

The big realization here, and the decision that it's probably taken decades to come to, is that this is most likely from some identifiable physiological imbalance, one that, because of the distrust of mainstream medicine, there hasn't yet been the chance to identify and even try to treat. The hope is that with a couple of thousand dollars spent on diagnosis and testing perhaps there's a way to get life back under control enough that there's a stable income stream to pay for regular treatment.

#Comment Re: made: 2012-08-12 16:03:20.69554+00 by: Dan Lyke

Just because Amen was mentioned in this: A Washington Post profile of Daniel Amen and his clinics, Via MeFi.