5 ms·

"Mood stabilizer" is a quite accurate description of the usual function of the drug - in bipolar patients like me, it reduces the magnitude and stabilizes the p

"Mood stabilizer" is a quite accurate description of the usual function of the drug - in bipolar patients like me, it reduces the magnitude and stabilizes the period of mood swings. Mood stabilizers also tend to be anti-seizure meds, and have all kinds of off-label uses because of neurological phenomena we don't understand, but the label is a very useful one. Same for antidepressants - often the same drugs (especially SSRIs) are both antidepressants and anxiolytics, but both labels are useful descriptions of the meds' common effects. Antidepressants in particular happen to be fantastically idiosyncratic drugs, but on average they do what they say on the label. Part of the problem is that, due to the ill-understood nature of the brain, good psychiatrists need to know strange drug interactions and ill-studied minority reactions in order to serve the full range of their patients. This edges on art rather than science, which is always a recipe for cognitive biases to gain control.

LyndsySimon 8y ago
I think what the parent was trying to say was that "antibiotic" describes the drugs' method of action, while "antidepressant" describes the drugs' intended affect. > due to the ill-understood nature of the brain, I think this is exactly the problem. We have a bunch of drugs that seem to work, and we think we know how and why they work, but we're not able to directly measure the problem in those terms. If someone has a bacterial infection, we can culture it and prescribe the correct antibiotic. If someone has a mental health condition, we almost always have to consider the way that it's presenting and make an educated guess as to which drug is going to be effective. It's not at all uncommon for that first guess to be incorrect, which leads to either iteration or a "cascade" depending on the practitioner.
- deleted 8y ago
  [deleted]
- deleted 8y ago
  [deleted]
fraudsyndrome 8y ago
I have a close friend with paranoid schizophrenia and also bipolar who, after an episode, underwent ECT. The medication that stopped him from hearing voices pre ECT/episode started again after ECT. After a year, the Psychiatrist is still trying to find the right combination of medication to stop it - they've (I think) more than tripled his current dosage of lithium along with others that I'm not aware of but it's unpredictable how much time the medication change actually takes effect, could be anywhere from 2 weeks to 2 months. I don't know where I was going with this, just sad to see him like this.
- tcj_phx 8y ago
  Sometimes less treatment is better than more treatment. If your friend will let you go to his appointments, maybe you can advocate on your friend's behalf. If he's ordered to submit to involuntary mental health treatment, you can probably request judicial review on his behalf. This would be to let the court know that your friend was doing better before the ECT treatment, and that you are concerned that some of his problems are now caused by the treatment itself. Edit: I commented on lithium a few weeks ago: https://news.ycombinator.com/item?id=19299137 https://news.ycombinator.com/item?id=19299137
  - fraudsyndrome 8y ago
    Thanks for the reply How can I, advocate on my friend's behalf against a Psychiatrist who has been working with him for years when I have no expertise in the field? Do I trust that his Psychiatrist has already thought the same thing? Maybe I can leak some info to him (like those articles) so he can think for himself and talk to his Psychiatrist about it. Technically he was doing better pre-ECT, but stress got to him and when comparing to when he had his episode (lasted a while before deciding on ECT), technically he's doing better post-ECT than during that phase. I'll take a look at that thread, thanks
    - tcj_phx 8y ago
      You've been a passive observer for a long time. Psychiatrists usually see their patients for a few minutes when they're at their worst, and have no perspective on how the patient actually does on a day-to-day basis. They haven't observed the patient between 'episodes'. You can help fill in the gaps in the psychiatrist's profile of your friend. > but stress got to him and when comparing to when he had his episode Stress is the major factor in most of these conditions. My recent comment about the Quakers and their asylums [0] is relevant: most of their patients got better with nothing more than 4 meals a day and the expectation that they could recover if given appropriate support. Malnourishment is the other major factor. My friend's involuntary treatment provider eventually did a genetic test that found she can't turn folic acid into folate. Getting supplemental folate has made a big difference for her misdiagnosed "mental" condition. B-vitamins... eggs... more coconut oil, less vegetable oil... fewer grains, more fruit (juice, apples, etc). [0] https://news.ycombinator.com/item?id=19243417 https://news.ycombinator.com/item?id=19243417

LyndsySimon 8y ago

I think what the parent was trying to say was that "antibiotic" describes the drugs' method of action, while "antidepressant" describes the drugs' intended affect. > due to the ill-understood nature of the brain, I think this is exactly the problem. We have a bunch of drugs that seem to work, and we think we know how and why they work, but we're not able to directly measure the problem in those terms. If someone has a bacterial infection, we can culture it and prescribe the correct antibiotic. If someone has a mental health condition, we almost always have to consider the way that it's presenting and make an educated guess as to which drug is going to be effective. It's not at all uncommon for that first guess to be incorrect, which leads to either iteration or a "cascade" depending on the practitioner.

deleted 8y ago
[deleted]
deleted 8y ago
[deleted]

fraudsyndrome 8y ago

I have a close friend with paranoid schizophrenia and also bipolar who, after an episode, underwent ECT. The medication that stopped him from hearing voices pre ECT/episode started again after ECT. After a year, the Psychiatrist is still trying to find the right combination of medication to stop it - they've (I think) more than tripled his current dosage of lithium along with others that I'm not aware of but it's unpredictable how much time the medication change actually takes effect, could be anywhere from 2 weeks to 2 months. I don't know where I was going with this, just sad to see him like this.

tcj_phx 8y ago
Sometimes less treatment is better than more treatment. If your friend will let you go to his appointments, maybe you can advocate on your friend's behalf. If he's ordered to submit to involuntary mental health treatment, you can probably request judicial review on his behalf. This would be to let the court know that your friend was doing better before the ECT treatment, and that you are concerned that some of his problems are now caused by the treatment itself. Edit: I commented on lithium a few weeks ago: https://news.ycombinator.com/item?id=19299137 https://news.ycombinator.com/item?id=19299137
- fraudsyndrome 8y ago
  Thanks for the reply How can I, advocate on my friend's behalf against a Psychiatrist who has been working with him for years when I have no expertise in the field? Do I trust that his Psychiatrist has already thought the same thing? Maybe I can leak some info to him (like those articles) so he can think for himself and talk to his Psychiatrist about it. Technically he was doing better pre-ECT, but stress got to him and when comparing to when he had his episode (lasted a while before deciding on ECT), technically he's doing better post-ECT than during that phase. I'll take a look at that thread, thanks
  - tcj_phx 8y ago
    You've been a passive observer for a long time. Psychiatrists usually see their patients for a few minutes when they're at their worst, and have no perspective on how the patient actually does on a day-to-day basis. They haven't observed the patient between 'episodes'. You can help fill in the gaps in the psychiatrist's profile of your friend. > but stress got to him and when comparing to when he had his episode Stress is the major factor in most of these conditions. My recent comment about the Quakers and their asylums [0] is relevant: most of their patients got better with nothing more than 4 meals a day and the expectation that they could recover if given appropriate support. Malnourishment is the other major factor. My friend's involuntary treatment provider eventually did a genetic test that found she can't turn folic acid into folate. Getting supplemental folate has made a big difference for her misdiagnosed "mental" condition. B-vitamins... eggs... more coconut oil, less vegetable oil... fewer grains, more fruit (juice, apples, etc). [0] https://news.ycombinator.com/item?id=19243417 https://news.ycombinator.com/item?id=19243417