Brief update on Singulair-suicide link

Merck issued a press release today responding to the FDA’s investigation. Along with the standard "we didn’t know about this problem until after it the market" disclaimer, the PR mentioned:

In a cumulative analysis recently provided to the FDA of Merck’s randomized, double-blind, placebo-controlled clinical trials, which included over 11,000 adults and children in over 40 studies who were treated with SINGULAIR, there were no reports of suicidal thoughts or actions and no completed suicides in the patients who received SINGULAIR.

Additionally, in a cumulative analysis recently provided to the FDA of Merck’s randomized, double-blind, clinical trials that compared SINGULAIR with other active agents to treat asthma (which included over 3,900 adults and children who were treated with SINGULAIR and over 3,400 who were treated with other asthma therapies), there was 1 patient who attempted suicide who received SINGULAIR, and there were 3 patients who attempted suicide who received other asthma therapies (including inhaled corticosteroids and long-acting beta-agonists).  These studies were not designed to compare the rate of suicide in patients taking SINGULAIR with the rate of suicide in patients taking these other asthma agents.

Did Merck report that one suicidal attempt when compared to "other active agents to treat asthma"? It doesn’t say anything in their patient safety or prescribing information when I checked. Perhaps someone can find out whether they reported this in their clinical trials?

In the meantime, the Singulair section of medications.com is ablaze with parents who are now expressing concern over their children’s well-being on the drug. Apparently, issues have cropped up with the drug even before the FDA announced their investigation.

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Singulair and Suicidal Behavior

SingulairIn a particularly odd link, the FDA is looking into Singulair, the asthma and allergy drug and its correlation with suicidal behavior. I’ve taken Singulair in the past and not once did it ever occur to me to think about an allergy medication being linked to suicidal behavior. The FDA also says that it could cause mood and behavior changes. The situation that alerted the FDA to this possibility is the story of 15-year-old Cody Miller who killed himself 17 days after switching from allergy medication Allegra to Singulair. Miller’s mother, Kate, approached his medication switch with extreme caution and informed herself of the possible side effects:

She checked the Merck website and the information sheet she got from the pharmacist on Singulair and found no red flags, so they were stumped when Cody started acting out of character.

I have to hand it to Merck: Once the Millers reported Cody’s death, they immediately updated Singulair’s warnings to include suicidal thoughts and actions. However, Cody died on August 4, 2007. Merck updated their information two months later. As of February 29, 2008, the FDA still hadn’t taken any action. Despite the updated warnings, however, doctors and pharmacists were unaware of the new information.

The Singulair website carries the updated side effects, but you have to search it out in the patient information PDF on the fourth of five pages.

If you check with the FDA, you’ll find nothing. That’s because they admit they haven’t updated their website on Singulair since 2001.

According to the FDA’s MedWatch safety information, they have only begun their investigation today. They say it will take 9 months for them to “complete their investigation.” We may not hear of the FDA’s conclusions until early 2009. If this is a single, isolated incident, the FDA may just say the results are inconclusive and allow Merck rip the warning off their patient safety information. It is also important to note, however, that Singulair has also been linked to depression and anxiety.

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Celebrity Sensitivity: J.K. Rowling

J. K. RowlingFamed author of the “Harry Potter” series, J.K. Rowling admits that she suffered from suicidal thoughts after the breakdown of her first marriage when she was in her mid-20s. She attributes her recovery to “invaluable” counseling. There was no mention of her overcoming depression with medication in the article.

Another post on Celebrity Sensitivity either later or tomorrow…

Is EVERYTHING a mental illness?

PEOPLE who send excessive texts and emails may have a mental illness, according to an article in a leading psychiatric journal.

As more people leave the office computer, only to log on as soon as they get home, the American Journal of Psychiatry has found addiction to text messaging and emailing could be another form of mental illness.

I kid you freakin’ not. That’s an actual finding by Dr. Jerald Block  as reported by news.com.au. Here are the four symptoms to classify people into this mentally ill group:

  • suffering from feelings of withdrawal when a computer cannot be accessed;
  • an increased need for better equipment;
  • need for more time to use it;
  • experiencing the negative repercussions of their addiction.

textingDr. Brock considers text messaging to be a part of this category because it’s a form of electronic communication. The article uses a female sales consultant as an example of someone who “suffers” from this “debilitating” illness. She explains that she’s on the computer for work all day and then comes home and simply has to browse Facebook, eBay, and other entertainment sites.

Dr Robert Kaplan, a forensic psychiatrist at the Graduate School of Medicine, University of Wollongong, said he first saw a case of internet addiction in 1998.

“I think in general it’s escalating,” Dr Kaplan said. “We now all live in an internet world, and it brings with it a range of problems.”

Someone please tell me this is an early April Fool’s joke. If not, I’ll cry golden tears if pharma companies put out medication for this.

God and mental illness

Thanks to Gianna for sending me a link to an ABC News article about the relationship between religious faith and depression. The article analyzes whether faith can help or exacerbate a mental illness. The exacerbation, as referred to in the article, mostly comes from the stigma of mental illness within the religious community.

“You might be shocked to find out there are some denominations that do harm to people,” said Patricia Murphy, chaplain and assistant professor of psychiatry at Rush University. “Some congregations teach that depression is a sin … that’s the reaction they get when they turn to their pastor.”

Being punished by your religious leader for an unavoidable disorder sounds bad enough — yet it’s often compounded with tacit warnings against leaving the condemning sect.

“Studies have shown that faith leaders are least supportive [with mental health problems],” said Gregg-Schroeder. “There’s this attitude that if you pray harder, you’ll be able to pull yourself out of it. I’ve gone to funerals of people who were told to just pray to Jesus and stop taking your meds.”

praying dogI’ve been told that I suffer from depression because I didn’t pray enough or I wasn’t “right with God.” When I was admitted to a psychiatric hospital after my high school graduation, I found my pastor and church noticeably absent even though they were aware of the situation. When I was depressed, I’d get verses like Proverbs 15:13, “A merry heart doeth good like a medicine.” Great. That’s helpful. Especially when I don’t have a “merry heart.”

When I was forced to leave a fundie conservative Christian college midyear because of my depression, my pastor at the time was clearly disappointed with my decision not to return the following year. I decided that attending a college close to home as a commuter student would be better for my mental health. There was no need to scare more roommates with my occasional mixed episodes. I felt like I’d failed my pastor, my church, and my God. God more so than anyone else. I convinced myself that He must be upset with me – disappointed in me. It’s not easy to recover from depression when you feel like the One who dangles your life from His fingers is pretty pissed at you.

(Image from AP via Yahoo! News)

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Home bipolar test? What. In. The. World.

DNA strand

I stumbled upon an AP article on Yahoo! News titled, “Home bipolar disorder test causes stirs.” No kidding.

I read the article trying to figure out how this company, Psynomics, is able to genetically figure out who is more predisposed to what.

To take the test, patients receive by mail a plastic cup that they spit into, seal and send back to Psynomics. The company analyzes DNA in the saliva.

Psynomics will send patients’ test results only to their doctors to avoid the risk of self-diagnosis.

Here’s a sample report located on the Web site (PDF file).

Are you interested? If you’re anyone other than a white person of Northern European ancestry who shows some bipolar symptoms and has at least one other bipolar family member, then you don’t meet the criteria for this testing. Even if you do, save your money and buy something else – the test costs a steep $399 and the results aren’t entirely certain. In fact, researchers and doctors say there is very little data at the moment to support testing DNA for bipolar disorder or other mental illnesses.

[Dr. John] Kelsoe, 52, acknowledges that bipolar disorder probably results from a combination of genetic factors and life experiences, and that the presence of these gene variations does not at all mean that someone will, in fact, develop the disease. He admits, too, that his findings about the genetic basis of the illness are far from complete.

“The goal of this is to try and help doctors make an accurate diagnosis more quickly so the patient can be treated appropriately,” Kelsoe said. “Anything is going to help, even if it just helps a little bit.”

I’m worried that people are going to think that they have bipolar disorder, fork over the money for gene testing, and be told when that they have bipolar disorder when they really don’t. Why manufacture a mental illness for a person that may not exist?

In coming months, at least two other startups led by genetic researchers are set to release their own psychiatric genetic tests. One test claims to predict the risk of developing schizophrenia. The other is designed to forecast the likelihood that some medications for major depression could heighten suicidal thoughts in patients.

As much as I’m not a fan of psychiatrists and there’s always the chance for misdiagnosis, I call this company a scam designed to prey upon people’s insecurities. (Perhaps bipolar people would purchase this in the midst of a spending spree?) Regardless, some people are buying into this product that even the maker admits isn’t entirely accurate.

Psynomics has sold only a few tests so far but is projecting sales of 1,800 tests in 2008 and 30,000 in the next five years.

Considering that it now has major media coverage, it’s likely to take off even more.
(Image sciam.com)

Generic drugs are not exactly like brand names

Gianna at Bipolar Blast stumbled upon an article at the LA Times that outlines the FDA’s standard for generics:

In almost all cases, the FDA permits a generic drug to release 80% to
125% of an active ingredient into the bloodstream, compared to that
released in a single dose of the original medication.

Gianna makes a good point for tapering down on brand-name meds then switching to generics:

And definately too broad when I’ve been cutting down my only 10% at a
time. If the drug is 80% of what I’m taking that is a 20% cut without
intending a reduction. It of course can work the other way and make
coming off the drug a longer task and more difficult if it’s actually
125% of the brand name.

eek – that’s something to think about.

Loose Screws Mental Health News

I recently wrote about the MOTHERS Act and the unnecessary scare tactics surrounding it. A Dallas-Fort Worth TV station picked up on the story and provided a short one-sided view of the issue, continuing to purport that the bill is solely about drugging new moms. I don’t discount Ms. Philo’s terrible experience with her medication. In fact, I’d be against the act if its sole purpose was to force treatment on pregnant women – medicated or not. Again, I’d like to reiterate that the bill’s purpose is to educate moms about postpartum depression and postpartum psychosis – not to shove unnecessary pills down women’s throats.

If you have sleep apnea, your CPAP (Continuous Positive Airway Pressure) machine may alleviate depression symptoms. My husband has sleep apnea and hasn’t been able to use the CPAP machine because of sinus problems. When he doesn’t use it (he hasn’t for a while), he’s noticeably moodier and prone to depressive symptoms. But then again, anyone who doesn’t get good sleep for several days is pretty moody.

Seroquel XRAstraZeneca (AZ) is going after Teva Pharmaceutical Industries and Novartis AG’s Sandoz unit after the two companies applied to make cheaper version of Seroquel available. AZ’s patent on Seroquel expires in 2011. The trial date for patent litigation is August 11. In the meantime, according to the Bloomberg report, the FDA is considering approval of Seroquel XR for bipolar depression and bipolar mania.

What is it about the U.K. that they seem to take pharma’s power more seriously than the U.S.? The UK Medicines and Healthcare products Regulatory Agency (MHRA) charged GlaxoSmithKline (GSK), the maker of Seroxat (Paxil in the U.S.), with not fully disclosing their clinical trial data that downplayed serious side effects such as increasing suicidal tendencies among those 18 years and younger. The MHRA also asserts that Seroxat didn’t alleviate depression as much as GSK’s initial data showed. GSK, of course, denied manipulating the data to show favorable results:

GSK denies withholding data, claiming the risks did not come to light until the results of nine studies were pooled.

The UK minister of public health, Dawn Primarilo, promised to address the issue of Big Pharma hiding negative clinical trial data.

“Notwithstanding the limitations that may exist in the law, pharmaceutical companies should disclose any information they have that would have a bearing on the protection of health,” she says.

In other news, I shouldn’t be a successful writer or novelist. The correlation between creative writers and suicide is ridiculously high. More than 70 well-known writers and poets have successfully committed suicide. How much more “unknown” writers and poets have as well?

(Image from Monthly Prescribing Reference)

Are Big Pharma murderers?

An book review in the NYTimes today focuses on Melody Petersen, a former reporter of the Times, who has written a book against  Big Pharma's marketing tactics called Our Daily Meds: How the Pharmaceutical Companies Transformed Themselves Into Slick Marketing Machines and Hooked the Nation on Prescription Drugs. In the book, she asks:

“Could drugs be killing people but escaping all blame, leaving them to harm even more Americans until someone, finally, catches on?” Ms. Petersen asks.

Few of us have. Most of America hasn't. Petersen outlines in great detail – the point of repetition according to Janet Maslin's review – Big Pharma's propensity for skewing clinical trial results so that their drugs perform better than placebo, the increased and ubiquitous DTC marketing, and the "payola-dispensing drug company representatives."

(“Hotel too cold inside,” one said, in an evaluation of a June 1998
drug company program, adding, “Resort places preferred.” From a
different doctor, miffed at the lack of a chauffeur at another event:
“Hired car would have been much preferable.”

Petersen also covers Big Pharma's tactic of fixing side effects of medications by creating medications to fix the side effects leading to medication on medication.

And when the side effects of sleeping pills or antidepressants mean
more elderly people fall down, the solution is not likely to be the
scaling back of such prescriptions. “Instead,” she writes, “the
companies have used the statistics on falls to create a new blockbuster
pharmaceutical market for drugs they claim will reduce the chances of
breaking a bone.”

According to the Maslin's review, the book calls for non-government watchdog agencies and closer oversight on published studies, which Petersen says are ghostwritten by pharma spokespeople. Overall, Petersen's book sounds like a must-read for anyone who is skeptical of Big Pharma's activities. However, I doubt her book will get much press or coverage considering that you can't read any major publication without turning the page and seeing a drug ad then the required 2-page side effect warning that everyone skips over. If anyone reads the book, I'd like to know your thoughts about it.

Sorry if this post sounds hastily written. I'm off to an interview to freelance for a company.

Loose Screws Mental Health News

In Deutsches Arzteblatt International, a medical health online journal, two researchers contend that depression in children can be manifested through “weeping, irritability, or defiance.” Professor Claudia Mehler-Wex and Dr. Michael Kolch point out the ways to spot depression in children of various ages:

The signs of depression in infants are often screaming, restlessness, and weeping attacks for no clear reason. Preschool children may behave irritably and aggressively, while schoolchildren may be listless and apathetic. The symptoms in adolescents become similar to those in adults.

I’m no professor, doctor, researcher, scientist or expert but here’s what I can tell you: Much of this behavior is normal for children. Infants scream, become restless, and weep because they want attention. Preschoolers can be irritable and aggressive because they didn’t get their nap time. Schoolchildren may be “listless and apathetic” because they don’t like school or they don’t get to play as often. Adolescents are a bit trickier – they’re basically young adults at this point and it’s difficult to tell whether they’re enduring teenage angst or true depression.

But the point of the article is how depression in children is different than that of adults. It is estimated that nearly “3.5% of children and 9% of adolescents in industrial countries are depressive.” It’s scary to think that INFANTS are included in the 3.5% figure.


Golden Gate Bridge Phone: Out of ServiceA man jumped from the Golden Gate Bridge in a suicide attempt and survived. Apparently, the GGB is a popular place for people to commit suicide:

Last summer, Marin County Coroner Ken Holmes released findings from a 10-year study on suicide trends from the Golden Gate Bridge. In his report, Holmes found that 206 people plunged to their deaths from 1997 to 2007, including 59 San Francisco residents, a group that formed the largest percentage — 29.6 — of the jumpers.

Check out the photo to the left. I think it’s incredibly helpful how the government keeps things running these days.

(Image from SFist)

Mental health parity bill

I haven’t posted anything on legislation that relates to mental health care so it’s about time I did.

On March 6, the House approved the Paul Wellstone Mental Health and Addiction Equity Act, a mental health parity bill that will require most medical insurance companies to provide better treatment for mental illnesses akin to what they do for physical illnesses. This is a significant move considering that insurers who cover mental health treatment can currently do one of two things: make patients pay for the bulk of the cost or place limits on treatment. The Senate also passed a similar bill in September 2007. Here’s what both pieces of legislation would do:

Both bills would outlaw health insurance practices that set lower
limits on treatment or higher co-payments for mental health services
than for other medical care.

Typical annual limits include 30 visits to a doctor or 30 days of
hospital care for treatment of a mental disorder. Such limits would no
longer be allowed if the insurer had no limits on treatment of
conditions like cancer, heart disease and diabetes.

As a result, the cost of group health insurance premiums likely will go up. However, the bills do not apply to businesses with 50 employees or less or individual insurance.

According to the NYTimes, President Bush initially endorsed mental health parity but came out opposing the current bill because it “would effectively mandate coverage of a broad range of diseases.” Technically, he’s right.

Under the bill, if an insurer chooses to provide mental health
coverage, it must “include benefits” for any mental health condition
listed in the latest edition of the Diagnostic and Statistical Manual
of Mental Disorders, published by the American Psychiatric Association.

The protections of the House bill apply to people who need treatment for alcohol and drug abuse, as well as mental illness.

Covering a broad range of conditions is a step forward, but I realize if group insurers are forced to pay for all conditions listed in the DSM, I can see why premiums would go up. It wouldn’t surprise me if costs increased significantly. No one likes to hear this but if people want better mental health coverage, they need to be willing to pay for it. For those who suffer with mental illnesses, it’s certainly worth the cost.

(By the way, only 47 Republicans joined the 221 Democrats in helping to pass the measure. It has nothing to do with the overall importance of the bill but it was a little annoyance that I had to throw in here. Grr.)

Alaska's "clinical" trial of Eli Lilly over Zyprexa

Since I've been gone, a trial has begun in Alaska against Eli Lilly because of its off-label drug marketing of Zyprexa. Then, Connecticut recently decided to join a growing list of states going after Lilly as a result of the Zyprexa deal. There is so much going on with this case I can't even keep up.

But that's what we keep Philip Dawdy around for. 🙂

Pregnancy is NOT a mental illness

I stumbled upon Yankee Cowgirl’s blog that mentioned Congress is working on the MOTHERS (Mom’s Opportunity to Access Health, Education, Research, and Support for Postpartum Depression) Act which would “strongly encourage pregnant women into mental health programs – that means drugs – to combat even mild depression during or after giving birth.”

She links to a column written by Byron J. Richards on newswithviews.com. He writes:

The Mothers Act is pending legislation that will indoctrinate hundreds of thousands of mothers into taking dangerous psych drugs.

He goes on to slam Big Pharma about how they control Congress and how mothers don’t need psych drugs for a natural birth process.

The Mothers Act (S. 1375: Mom’s Opportunity to Access Health, Education, Research, and Support for Postpartum Depression Act) has the net affect of reclassifying the natural process of pregnancy and birth as a mental disorder that requires the use of unproven and extremely dangerous psychotropic medications (which can also easily harm the child).

These are some serious accusations. I got pretty riled up myself and decided to see what Congress said in the bill.

Read the rest of this entry »

For the Christians with bipolar disorder

If you haven’t found it already, I’ve stumbled upon My Life with Bipolar Disorder written by Nancie Koo in Singapore. She’s a born again Christian who writes about her struggles but remains steadfast in her faith. I started my blog nearly two years ago in the hopes that I could provide encouragement and information to other Christians suffering from mental illness. It’s good to see that many blogs have come along since then to fill the void.

Celebrity Sensitivity: Steve-O

I’ve never watched the show Jackass but apparently the big star from the show, Steve-O, is on suicide watch. Steve-O (real name: Stephen Glover) was recently charged with cocaine possession by LA police so it’s likely that he was under the influence of drugs when threatened to take his own life. He also is said to suffer from bipolar disorder. (I told you it’s the hip mental illness!) PerezHilton.com quotes Star magazine that first broke the story:

"Steve is stabilized on meds at this point," the source says. "He was also treated for burns on his skin as if he had been putting cigarettes out on his own body."

"Right now he’s in his extreme mania," a family member tells the mag. "His concerned friends and family are hoping he’ll seek treatment. He doesn’t need jail, he needs therapy. We’re just really hoping that this will be the wake-up call that gets him back to himself."

This is another celebrity’s antics we can take seriously. Steve-O left suicide notes for friends and family. While his drug charges shouldn’t be dismissed just because he’s famous, this family member is right; he needs treatment. If you want to see a disturbing photo that could be seen as a foreshadowing of this incident, see this post at PerezHilton.com.

Mental health treatment for minorities substandard

Speaking of race, I stumbled upon Ephphatha, a blog from an African American woman looking to raise awareness of mental health in the African American community.

She linked to two News & Notes series on npr that focus on the lack of appropriate care to Blacks in the mental health community. This gets me thinking: If Blacks, how much more so other racial/ethnic minorities, e.g. Hispanics, Asians, Native Americans, Indians, etc. Is it really true that Caucasians a.k.a. white Americans receive better mental health treatment than other races and ethnicities?

It appears so
.

Blood test for efficacy of antidepressants in the future?

Scientists have found that a biomarker for depression could show whether a person's antidepressant is working. The discovery could lead to something everyone in the psych world has been waiting for: a blood test of some kind.

The researchers looked at the interaction of neurotransmitters and a protein called Gs alpha. In brain cells, the protein acts like a kind of butler, passing messages from neurotransmitters on the outside and amplifying their messages, [study co-author Mark] Rasenick explained.

When the protein is working properly, it's like a butler whose "hands are just flying, cooking and cleaning at the same time," he said. But when the brain is depressed, "it just sits there in the corner."

That's an interesting observation. This might finally explain the difference between "depressed" brain activity and normal brain activity on an MRI. (By the way, has anyone had an MRI performed for depression?)

Researchers compared the proteins in the brains of people who committed suicide as a result of depression to those who did not. "They found the protein would have worked less effectively in the brain cells of the suicide victims."

Dr. Gregory Simon conceded that doctors cannot determine which antidepressant will work for which person.

"There's a long history of research using patterns of symptoms or biological measures — chemicals measured in blood or spinal fluid — to predict response to a particular antidepressant. None of those hoped-for predictors have significant value.

[Genetic tests] would not eliminate trial-and-error, but it would reduce the waiting time with each trial. But it's a long way from a study like this one to a test that's useful to patients and doctors."

Good news for the skeptics about this research study: It was funded by the U.S. Public Health Service and the American Foundation for Suicide Prevention. But a test simply to see if an antidepressant is working has the smell of pharma somewhere on it.

(Hat tip: Ephphatha)

Bipolar & the Workplace

I was surprised to see an ABC News article on bipolar disorder. Bipolar disorder is the “hip” mental illness these days — especially when used to characterize someone with extreme mood swings. One section addressed admitting to bipolar disorder in a work environment:

One day, he let it slip.

“I just blurted it out. ‘I’m sorry I’m getting shock treatments. I can’t remember anything,'” Steve said. His colleagues’ reactions were less than encouraging, he recalled.

“I would say that they were afraid of me,” Steve said. “They stopped referring their clients to me.”

Steve said that eventually his colleagues’ attitudes forced him to leave his job.

I admitted my problem to three people at my job: my managing editor at my last job and three of my coworkers (one with whom I am still friendly).

  • The managing editor, who had picked on me mercilessly, finally backed off. As far as I know, she didn’t tell anyone which I appreciated.
  • One of my coworkers admitted she had depression to me first before I told her I had bipolar disorder. It’s understood between us that we won’t go around and talk about these things.
  • The other coworker also told me about her journey through depression and her treatment afterward. I then revealed my struggle with bipolar disorder. We are friends outside of work now.
  • I’d told the last coworker about this shortly after I received my diagnosis after being released from the psych hospital. As far as I know, she didn’t tell anyone. But in the end, she’s the one who said the hurtful things about me in the e-mail I inadvertently received. It’s anyone’s guess if she told other coworkers or if she completely forgot.

From Bipolar Journey:

My experience is: work is work.  Outside of work is where one gains support for any illness they struggle with.  Acknowledging my response is skewed on the basis of recent events, I can’t recommend telling anyone you work with about one’s illness.  I should have kept to my Psychology professor’s advice:  “Never tell anyone you work with about your illness, trust me when I tell you:  they will treat you differently.”

I attended an outpatient group in late October 2006 after my hospitalization. One lady said that one of her coworkers admitted she was bipolar; since then, the coworker was teased and verbally abused by her supervisor and other coworkers. I’m not positive but I think the person might have even gotten fired lest her disorder interfere with her ability to do her job. (She cleaned pools.)

People with the disorder often have trouble keeping a job and are 40 percent less likely to be employed than the average person, said Ronald Kessler, a public health researcher at Harvard University.

On the other hand, Kessler said, if treated properly, they can be creative and invaluable individuals. Many highly successful authors, artists and professionals have the disorder.

I’ve seen statistics like this before and they worry me. I constantly wonder whether I’ll ever be able to hold down a full-time job for a long period of time. I’m currently unemployed and – to my disbelief – enjoying it. I’m afraid I’ll get lazy and never go back to work. I’m afraid that I’ll start to go in and out of jobs like a revolving door. One of my psychotherapists in college flat out told me that I’d never be able to hold down a job.

As I try to venture into editorial freelancing, I’m afraid of a host of things: outdated skills, inexperience, lack of confidence, failure, libel, confrontation, socializing, networking, creating expectations (of myself) that I never live up to. My counselor told me to just jump in and do it first then worry about the details later. [deep breath]

failureI fear failure the most. Failure that I’ve forgotten my editorial skills because they haven’t been used daily since 2005. Failure that editors will write me off because I’m a 26-year-old with unimpressive clips like “Bees Infest Dorm Hall” (yawn), “Student Organization Rallies Youth to Vote” (so cliche), and “Penn State Strikes Deal with Napster on File-Sharing” (Nov. 2003 = old). Failure that I’ll write an article, misinterpret the facts, and then get the publication slapped with a lawsuit. Failure that I’ll have to be “pleasantly persistent” in calling up editors, asking for prompt payment of my freelance services. Failure that I will intentionally avoid things that would otherwise propel my career: attending social mixers, networking, doing all the social things that makes my blood run cold because I hate meeting new people (in person). Failure that I’ll look at past awards I’ve received and then never live up to the reason why I received them in the first place. I don’t want to blame bipolar disorder from holding me back but sometimes, I can’t help but think where I’d be in my professional career without it.

(Image from gobears.wordpress.com)

Politics

Politics is a dangerous territory to discuss. Especially since there’s much emotion and fervor regarding this presidential race. I don’t normally discuss politics on this blog but this is something that has been bugging me as of late. I’d like to share my view with my readers so people can get a black woman’s perspective on this issue. By the way, I said “black” intentionally.

At this time, Senator John McCain is (pretty much) the Republican nominee. The Democratic nomination could go to either Senator Hillary Clinton or Senator Barack Obama. (I personally think Obama will end up winning the Democratic nomination, but that’s beside my point.)

This post addresses the highly popularized contest for the Democratic nomination between Clinton and Obama. In recent news, Geraldine Ferraro, the first woman to ever run for vice president, said the following:

“If Obama was a white man, he would not be in this position. And if he was a woman of any color, he would not be in this position. He happens to be very lucky to be who he is. And the country is caught up in the concept.”

Here’s my brief disclaimer: If you are so passionate about politics that my opinion might cause you to stop reading this blog, I suggest you don’t read any further. I also don’t plan on engaging in long debates about politics either; it’s too much of a merry-go-round. But, since you’re human, you’re probably going to click the link below anyway.

Read the rest of this entry »

Loose Screws Mental Health News

An article in the NYTimes addresses the issue of diagnosing mental health in developing countries. A startling fact:

Depression and anxiety have long been seen as Western afflictions, diseases of the affluent. But new studies find that they are just as common in poor countries, with rates up to 20 percent in a given year.

emoIn India, as in much of the developing world, depression and anxiety are rarely diagnosed or treated. With a population of more than one billion, India has fewer than 4,000 psychiatrists, one-tenth the United States total. Because most psychiatrists are clustered in a few urban areas, the problem is much worse elsewhere.

Looks like depression is really more than just a whiny rich American kid who chooses to be upset because he’s got nothing better to do. That’s “emo” for those who aren’t hip-to-the-jive. 😉


On The Elite Agenda, Dr. Fred Baughman mentions Swedish writer Janne Larson who asserts that “over 80 percent of persons killing themselves were treated with psychiatric drugs.” Thank God for FOIA that provides the docs to back this up:

According to data received via a Freedom of Information Act request, more than 80 percent of the 367 suicides had been receiving psychiatric medications. More than half of these were receiving antidepressants, while more than 60 percent were receiving either antidepressants or antipsychotics. There is no mention of this either in the NBHW paper or in major Swedish media reports about the health care suicides.

I guess Sweden isn’t the only country in the world that wants to sweep unfavorable mental health coverage under the rug. By the way, Sweden also is considered to be the seventh happiest country in the world.

While the FDA has recognized that antidepressants can cause an increase in suicidal behavior (as indicated by the “black box warning”), antipsychotics seem to have fallen under the radar. In fact in 2002, Clozaril was approved to combat suicidal behavior in schizophrenic patients. Since then, research has shown that antipsychotics can increase suicidal behavior in schizophrenic patients twenty-fold.

Akathisia – a serious side effect that has occurred for nearly all psych drugs in clinical trials – has been found to be linked to suicidal behavior with not only antidepressants but also in conjunction with antipsychotics.

Finally, Baughman closes with this:

It is important to note that nearly every school shooting that has happened in the United States over the last decade has been conducted by young males who were taking antidepressant drugs. The drugs not only cause suicidal behavior, they also seem to promote extreme violence towards other individuals. In most school shooting cases, the young men committing the violence also committed suicide after killing classmates and teachers. These are classic signs of antidepressant use.

I don’t know if that’s wholly true but it’s a trend I’ve seen with Cho, Kazmierczak, and Eric Harris of Columbine. Since 1996, there have been 55 major school shootings all around the world; 43 of them occurred in the U.S. Makes you wonder how many of these gunmen were on a psychotropic drug – prescribed or not – of some kind.

(Image from Style Hair Magazine)

Celebrity Sensitivity: Courtney Love & Heather Locklear

Courtney Love Sheesh. Talk about sensitivity on this one. Rumors have been flying around that Courtney Love (widow of Nirvana singer Kurt Cobain) is bipolar. Love goes ballistic refuting those speculations on her MySpace page:

and i hear now i am “Bi Polar” uhhhh…thats more nuts than I will ever be. I may be Eccentric, i certainly speak my mind and am slow to put out a record i need to mean the world to ME, and im sure i am quite Nuerotic (sic) but “Bi Polar” . Thats just slander.I shoot straight from the hip and spellcheck has NOTHING to do with REALITY.

Ok, Love is just crazy in general. I can respect that.

In other celeb somewhat-mental-health-related news, paramedics responded to a suicide call that police believed was from Heather Locklear. However, police soon found out it was a hoax and the call didn’t even originate from her house. Someone’s tryin’ to mess with Sammy Jo… (There’s a throwback for ya.)

Clarification on Mobile, Alabama high school suicide

Prester John left this comment:

"an 18-year-old high school student in Mobile, Alabama walked into a high school gym and shot himself in front of classmates on Thursday" The kid had some problems. He’d been suspended from school the day before, but they won’t say why. He had been arrested recently for his part in three armed robberies. (Incidentally, one of his accomplices is the son of a prominent local judge.) He was also homeless, which may very well explain the robberies. (Maybe even the other kid’s part in them. Helping out his bud, so to speak. Kids are so dumb, or at least I was.) Anyway, it’s a terrible tragedy. I’m not sure what it says about this town, state, and country that an 18 year old kid can be homeless but I am sure it’s not good.

The circumstances surrounding this suicide have just made me sadder.

Today's lesson: Paxil and Lexapro are not great antidepressants

Dawdy at Furious Seasons wrote a post on an editorial in the LA Times by Summer Beretsky’s experience with Paxil. After reading her editorial, I’m reminded that my own experience with one antidepressant wasn’t all that unique. Her drug was Paxil for panic attacks; mine was Lexapro for depression following a 3-month (on-and-off) stint with Paxil. I’m struck by the similarity of our experiences; not only did the same thing happened to me but I was also a communications major in college as well.

Paxil had one pretty undesirable effect on me: I started to lose interest in just about everything. I stopped initiating social activities (who needs that sort of thing?) and was no longer motivated to perform well academically.

My emotions had flat-lined: I hadn’t cried in months, nor had I proverbially jumped for joy. I felt — nothing.

I can still remember sleeping in bed at home on a weekday when I should have been at class. It was 2 in the afternoon, around the time my copy editing class was to begin. My boyfriend at the time (now my husband) lived in Kentucky while I attended college in New York. He planned to visit me that weekend but was getting fed up with my depression and listlessness. He called from work to tell me to get up and go to class. I mumbled on the phone, half-confused, and said no. He demanded, “Why not?” I said quite plainly, “Because I don’t care.” He said, “If you don’t get up and go to class, I won’t visit you this weekend.”

I replied, “I don’t care.”

Read the rest of this entry »

Distorted Thinking

A Google Alert for a post from My Journey Through Bipolar came to my inbox. I read it and feel that it expresses many of the thoughts that I’ve had and still have today. Here are the snippets that really spoke to me:

My thinking has been so terribly distorted lately.  I can hear it but
it is like I am watching it on TV and I can’t make the actors say
different lines.  “You just don’t understand me so I am not going to
talk to you anymore.”  “I am worthless and just taking up too much
space.  I would rather die then to put you all through this agony
anymore.”  “I have no friends.  No one loves me.  I am unlovable.  I
hate myself.  I HATE ME!!!”


And it all makes so much sense to me.  I really believe it.  I really
do feel like there is no reason to go on.  That I should just die.
That I am a waste of space.


And like the viewer watching TV I can see how ridiculous this story
is.  Of course she is loved.  Look at the supporting cast.  She doesn’t
actually want to die.  Look at her children worshiping her at her feet,
begging her to come play with them and give them kisses.  Who wouldn’t
want to stick around to foster that?  And a waste of space?  She
created this space.  She cooks and cleans in this space.  She bore her
children in this space.  She makes love to her incredible husband in
this space.  She isn’t a waste of space.  The space would be empty
without her.


And does she really hate herself?  I believe she hates the one that she
thinks she is.  That distorted her.  But if she saw herself as a
separate person she would love her.  She would see that other self and
think, what a great person.  She has it all.  The husband, house, kids,
cats, beauty, security, love all around.  A deep faith, a rich
community, arts and a strong soul of a warrior.  She would want to be
just like that other person.


I want to be just like I am.  I just want to be happy while I am being me.

Read the entire post here.

I hate to brag, but…

I hate to brag, but…

February 28, 2007
Pristiq's FDA Chances: Depression – Yea; Menopause – Nay

It wouldn't surprise me if they said yea to antidepressant use and nay to vasomotor use because of lack of evidence in improved symptoms.

April 19, 2007
Wyeth looking for Pristiq's FDA approval in 2008

I'll follow Pristiq as the information continues to trickle out but don't expect to hear much about it until next year when Wyeth becomes the proud papa of a brand new (and approved) product.

This is one of the few times I can actually say I was right. (Teenage-like "squee!" goes here.)

More recent posts from:

Blogs around the way

I’m catching up on reading my fellow bloggers’ posts (see Blogroll to the right), so if you’re not reading their site already, I’d encourage you to do so. Below  are some posts that caught my attention. Some might be a little dated.

Gianna at Bipolar Blast: Has a video up of Gwen Olsen, an ex-pharma rep who says that pharmaceutical companies aren’t in the  business of curing but in the business of "disease maintenance and symptom management." It’s nothing new but here are two quotes that caught my attention:

"And what I’m saying is provable is that the pharmaceutical industry doesn’t want to cure people. You need to understand specifically when we’re talking about psychiatric drugs in particular that these are drugs that encourage people to remain customers of the pharmaceutical industry. In fact, you will be told if you’re given a drug such as an anxiolytic, or an antidepressant, or an antipsychotic drug, that you may be on the drug for the rest of your life. And very frequently, people find that they are on the drug for a very long period of time, if not permanently, because they’re almost impossible to get off of. Some of them can have very serious withdrawal symptoms – most of them can have extremely serious withdrawal symptoms if they’re stopped cold turkey – but some people experience even withdrawal symptoms when they try to titrate or they try to eliminate the drug little by little, day after day."

"We have got to start making the pharmaceutical industry accountable for their actions and for the defective products they’re putting on the market. It won’t be long before every American is affected by this disaster and we need to be aware of what the differences are between diseases between disorders and between syndromes. Because if it doesn’t have to be scientifically proven, if there are no tests, if there are no blood tests, CAT scans, urine tests, MRIs – if there is nothing to document that you have disease, then you in fact, do not have a disease, you have a disorder and it has been given and has been diagnosed pretentiously and you need to get yourself educated and understand that there are options and those options are much more effective than drugs."

I’ve always wondered why doctors don’t run tests to diagnose any psychiatric disorders. From NIMH:

Research indicates that depressive illnesses are disorders of the brain. Brain-imaging technologies, such as magnetic resonance imaging (MRI), have shown that the brains of people who have depression look different than those of people without depression. The parts of the brain responsible for regulating mood, thinking, sleep, appetite and behavior appear to function abnormally. In addition, important neurotransmitters–chemicals that brain cells use to communicate–appear to be out of balance. But these images do not reveal why the depression has occurred.

If MRIs have shown that the people with depression have a part of the brain that functions abnormally then why isn’t it standard for all people diagnosed with depression to have an MRI done to confirm this? I have one of two hypotheses:  it’s too expensive to get an MRI done for each person and that insurance won’t pay for it or the abnormal functioning cannot be detected in the brain of every depressed person.  Therefore, is major depressive disorder really a made-up diagnosis?

Read the rest of this entry »

Pristiq receives approval from FDA

PristiqMore than a year ago, I promised to keep tabs on Wyeth’s new (renamed, rather) drug Pristiq. So I’m living up to it.

On February 29, 2008, the FDA granted Wyeth approval to move forward with putting the drug out on the market.

Wyeth said the company planned a big sales effort to introduce the product to psychiatrists and primary care doctors.

There’s a problem with that sentence. I’ll give you a second to figure out what’s wrong with it. Haven’t got it yet?

Primary care doctors. PCP should not be in the business of prescribing or providing psych meds. I’ve gone on and on about it at length before, but I’ll mention it again. PCPs are trained to treat overall conditions that have no need of referral to specialists. Think about it this way: If your psychiatrist prescribed anti-inflammatory medication because you mentioned that you’ve been having problems with your foot, you’d be taken aback, right? If a dermatologist prescribed heartburn medication after a patient mentioned he’d been having heartburn trouble, that would seem almost illogical, wouldn’t it?

(Pristiq logo from Pristiq.com)

Read the rest of this entry »

Loose Screws Mental Health News Rises From the Ashes

It’s good to be back.


A study for the U of Vermont concludes that anorexics have the highest rates of suicide. Researchers previously thought that their deaths resulted from their emaciated states. The actual article can be read at Time.com.

Anorexia has the highest mortality rate of any psychiatric disorder. But psychologists previously believed that those high rates of death were due to patients’ already deteriorated physical state. The hypothesis was that these are people already on the verge of death — they were so malnourished and underweight that even the slightest suicide attempt could easily lead to death.

Anorexia is usually seen as an illness rather than a psychiatric disorder. It’s good to see Time shedding some light on the link between anorexia and suicide. Making this kind of information widespread will definitely save  some lives that otherwise would have been lost.


On the topic of suicides, an 18-year-old high school student in Mobile, Alabama walked into a high school gym and shot himself in front of classmates on Thursday. There’s not much information surrounding this story but it just saddened me to read that a young man, perhaps with a good life ahead of him, took his own life away. While he didn’t shoot his classmates – he fired one shot up at the ceiling before shooting himself, I continue to remain dismayed at the trend of school shootings. No one is ever happy about suicides or homicides of any age but I think there’s something about school shootings that really speaks to adults. We like to think of kids – wow, I’m no longer a kid in comparison to them – as innocent and with a bright future ahead of them. There’s something about a school shooting that strikes a chord within all of us. The idea of school is equated with the notion of learning, growth, and development. It implies that students (for the most part) are not quite adults yet. JaJuan Holmes may have been a legal adult, but it seems that his unresolved issues were still viewed through a minor’s eyes.


laughterSeoul National University Hospital in South Korea is providing sessions on laughing your depression away. Many of the patients – if not all – suffer with depression stemming from their bout with cancer. For Americans and maybe even the British, the concept of laughing depression away seems ridiculous. However in South Korea’s culture, laughter outside of the home is deemed inappropriate, mainly for women.

“It was awkward at first. Yes, smiling is a good thing, but you know, I’m a little conservative. I sometimes still think laughing out loud is a bit low class,” [Jung-Oak Lee] said.

I’ve taken laughter for granted. I don’t know what I’d do if I was looked down upon for laughing out loud in public. That’s the last thing I want to worry about in a social atmosphere.

(Image courtesy Olson Center For Wellness)

Celebrity Sensitivity – it's back!

Because I’ve fallen off track with blogging for so long, I completely forgot what I called my celebrity feature. (My husband happily chimed in to remind me.)

Lily AllenRight now, the depressed celeb of the moment is singer Lily Allen. The New Zealand Weekend Herald reports that Ms. Allen checked into a London clinic after she suffered a miscarriage and broke up with the baby’s father.

If that isn’t enough to make anyone depressed, I don’t know what would. I usually rail on celebrities who shroud themselves with the cloak of depression but hearing the circumstances surrounding Allen’s depressive episode is certainly understandable. I’m glad she was cognizant enough to recognize that she needed treatment.

(Image courtesy Musichead)

The New Little Button

UPDATE: Please donate to Furious Seasons first. I reread his blog thoroughly today and it really struck me that if he didn’t make enough during his fund-raiser, he was going to scale back writing on the site.  He’s one of the main reasons that this blog continues to go on. He certainly inspires me and I know he’s an inspiration to a lot of bloggers as well. I think his fund-raising season is over but I know he’d still appreciate anything he gets. Heck, I’m going to dig up some pennies myself and throw them his way. But if you have $1 left over, that’ll do just fine.

I’ve joined the likes of Furious Seasons and The Last Psychiatrist and placed a PayPal donate button on my site. I’m currently unemployed and would like to get at least $12 a month to pay for my use of this site. I might mention the little button every now and then but there’s no pressure to donate really. But if you like my blog enough and have a dollar or so that you’d like to spare, please feel free. Google AdSense didn’t work out for me because of "invalid clicks" so I’ll have to look to other forms of ad revenue to keep me going. (Others have had trouble with it too.) I signed up with Typepad’s links a while ago but nothing ever came of that. I’ll try it again and see if I have better luck with it this time around. Otherwise, I hope  $12  per month isn’t too steep of a cost. Thanks in advance for any pennies that are thrown my way.

Depression: Theory or fact?

UPI has an article on a study which finds that the media presents depression's "chemical imbalance" as a fact instead of a theory. According to Jeffrey Lacasse and Jonathan Leo, the DSM says "the cause of depression and anxiety is unknown." Lacasse and Leo asked members of the media to submit evidence that supports chemical imbalance as a fact but no one did. This finding comes after the near-damning U of Hull study that asserts antidepressants don't work much better than a placebo on the majority of depressed patients. If the efficacy of antidepressants are this dubious, how much more are antipsychotics?

This article gets me thinking about the idea of media responsibility. I feel like what we call "news" has reverted to the days of yellow journalism. Sometimes, even worse than that. While the majority of publications strive to adhere to ethical practices and accuracy, many major publications will resort to printing anything that sells — even if it's libelous. But I'm getting off track here.

I can't wholly blame the media for sensationalism on certain topics like depression.  Most of them aren't scientists or research experts – they only report what they're told. Take NIMH's explanation of the way medication works for depression:

Antidepressants work to normalize naturally occurring brain chemicals called neurotransmitters, notably serotonin and norepinephrine. Other antidepressants work on the neurotransmitter dopamine. Scientists studying depression have found that these particular chemicals are involved in regulating mood, but they are unsure of the exact ways in which they work.

NIMH isn't presenting the way antidepressants work as a theory. It's an authoritative paragraph that sounds as though it's fact. If the chemical imbalance that causes depression is only theory then one must conclude the way antidepressants work as a theory as well, no? The NIMH has a section that explains what causes depression:

There is no single known cause of depression. Rather, it likely
results from a combination of genetic, biochemical, environmental, and
psychological factors.

"Likely results" leaves the door open to interpret the sentence as "maybe it's a combination of…" However, most people aren't scrutinizing words that carefully. Most people see this: "Rather, it results from a combination of…" Yes, I'm being nitpicky but the word "likely" still strikes me with a more authoritative connotation than maybe or perhaps. Here's a quote from a recent report from a local news station News 8 Austin:

Depression is more than just a negative state of mind. There are physical changes that occur in the brain that disrupt that natural balance of chemicals called neurotransmitters. (emphasis mine)

There is no single factor that causes depression. In fact, many experts believe most cases
[sic] of depression are a result of several sources. (emphasis mine)  

Again, I'm being nitpicky. "There are" is an authoritative phrase. People are unlikely to argue with a statement that includes the verb "are." Take for example, "There are people outside" or "There are five cats at the door." There's no question in the speaker's mind about whether people exist outside or the number of cats at the door. With subjects like depression that involve psychiatry and neuroscience, the majority of people aren't going to question these assertions either. I'm surprised that second paragraph didn't read, "many experts say …" Unless you're an expert yourself, you'd be unlikely to argue on what an expert says versus what the expert believes.

While I appreciate Lacasse and Leo's study on the inaccurate way depression is presented in the media, the "authoritative" sources on the issue would be loathe to correct it. Right now,  the big picture of raising awareness about depression is more important than to correct a trivial thing about the chemical imbalance being a theory. Pharmaceutical companies don't like correcting minor nuisances like theories.

To sum it up, I think the idea of a chemical imbalance causing depression is a theory. That's not a dubious statement. Unless it depends on your definition of what is is. 

Loose Screws Mental Health News

The AP has reported that a new Army mental health study says soldiers in Afghanistan have been suffering from an increase in depression in correlation with an increase in violence. It’s interesting that the focus is turning to Afghanistan now that violence has decreased in Iraq.

“The annual battlefield study found once again that soldiers on their third and fourth tours of duty had sharply greater rates of mental health problems than those on their first or second deployments, according to several officials familiar with the report.”

It seems that the more soldiers are exposed to combat, the higher the risk of depression and other mental health illnesses. A 2004 study indicates that about one in 10 soldiers have a serious mental health illlness that requires treatment. The AP article mainly focuses on depression but also mentions the rates of anxiety and PTSD are similar to the rates found in soldiers in Iraq last year. Thankfully, the number of troops who sought treatment has decreased to 29 percent from 34 percent in 2006.


TwinsOn a happy note (pun intended), a study published in Psychological Science has discovered that happiness can be genetic. Researchers studied about 1,000 identical and fraternal twins and found that their genes control about half of the traits that make people happy. The other half is control by circumstances.

“People who are sociable, active, stable, hardworking and conscientious tend to be happier, the researchers reported in the journal Psychological Science.

People with positive inherited personality traits may, in effect, also have a reserve of happiness to draw on in stressful times, [Tim Bates, a researcher at the University of Edinburgh who led the study] said.

“An important implication is that personality traits of being outgoing, calm and reliable provide a resource, we called it ‘affective reserve,’ that drives future happiness” Bates said.”

Basically, if you have none of those traits, you’ll just have to suffer through unhappiness like the rest of us. [sarcasm]


Finally, for those of you married men out there, here’s a tip to be a happier husband: Do more around the house, get more sex. ‘Nuff said.

(Image from Jupiter Images)

I'm officially unemployed

As of this past Monday, I currently own the title of "resident housewife." I made the big jump, at my husband's behest, and now find myself doing domestic things like housework and running errands. (I can't tell you how many times I washed dishes yesterday.) Oddly enough, I don't seem to mind except my feet hurt. I'd like a part-time job but the likelihood of obtaining a job where I wouldn't work weekends is highly unlikely. I have a friend, however, who's willing to pay me $10 an hour to help take care of her kids on Mondays, Wednesdays, and Fridays. She's currently having carpal tunnel problems so I'll likely take advantage of that offer whenever I can.

During the next coming weeks, I'm also going to try and freelance write. We'll see how that works out for me. I also wouldn't mind picking up some editing and proofreading jobs so I might have to re-interview with creative staffing services like Aquent and Boss Staffing. If anyone knows of any other creative staffing services like that in the Philadelphia area, please let me know. They specialize in placing people in "creative" jobs like editing, copy writing, proofreading, desktop publishing, web design, etc.

So that's my update. I can't promise multiple posts a day but I hope to write about mental health issues for a few publications so the potential for frequent posts and scouring other blogs for information in the next few weeks could be high. We'll see. I'm not sure about a market on writing about mental illness but it's one of the few topics I have a significant interest in.

As a result of leaving my job, the excellent medical  insurance that covered my husband and I has expired. We'll be moving to his health care insurance (which isn't awful but not as great as mine was). After a cursory search, however, we noticed that my psychiatrist isn't included under his plan. I'm reluctant to go to another doctor because I've already established a rapport with my current one. He's allowed me to have control over my own treatment and dictate the medication that I choose to use. I'm afraid another psychiatrist would try to shove Abilify down my throat if I mention passing suicidal thoughts. A few months ago, I went down to 100 mg of Lamictal in an attempt to slowly come off of it. I've been decreasing my dosages by about 25-50 mg every three months. I had a recurrence of frequent suicidal thoughts so I upped my dosage back to 150 mg. I was hoping that perhaps I had tricked myself into feeling better in conjunction with my counseling, but my suicidal thoughts have significantly decreased on the increased dose. It never ceases to scare me how much medication influences my mind.