Lamictal and Abilify: Back on Medication

Images from rxlist.com & drugs.com

After 2 years of not being on medication, I am back to a daily regimen of lamotrigine (Lamictal) and aripiprazole (Abilify) with lorazepam (Ativan) as needed.

Many of you may know, or may not know, what I decided to taper off of medication so that I could get pregnant. Well, that hasn’t happened. And my thoughts got to a point where it became life and death again. I didn’t want to go back to the psych hospital so I asked my psychiatrist for help.

My psychiatrist (God bless him) is a very conservative psychiatrist. He was the one who helped me off of medication 2 years ago, and he’s the one titrating my dosages up now. Lamotrigine is for long-term maintenance of the bipolar disorder, aripiprazole is for short-term maintenance of bipolar disorder and SAD (seasonal affective disorder), and lorazepam assists with severe anxiety as needed. I started taking the medication four weeks ago, and I’m only on 50 mg of lamotrigine and 5 mg of Abilify. There will be no increase on Abilify and I titrate up on lamotrigine every 2 weeks. My next big jump is 100 mg.

My psychiatrist expects me to come off of aripiprazole within the next few months (hopefully by December). If not, I will have to get regular blood sugar and cholesterol tests performed. He will adjust all medications as necessary in the event that I am pregnant. He’s a great psychiatrist; he’s willing to work with me based on my situation rather than him throwing drugs at me. He allows me to have complete control over my treatment regimen, which is something I like and respect.

In the past, I may have come off as anti-medication, but really, I’m not. I advocate for use of medication in a necessary, responsible manner. In 2010, 253 million prescriptions were written for antidepressants.¹ (Keep in mind that the U.S. is estimated to have 307 million people in the country.² That’s about 82.4% of the population taking antidepressants.) This is not responsible; this is too much. In the comments, people have rightly corrected me in the assumption that 1 person can get multiple prescriptions in a year; I failed to remember that.

Let’s assume a person is on 1 antidepressant (the majority of people take 1). Beginning in January, that person gets 5 refills for 30 days. By May, the person will need another 5 refills. Then another prescription is dispensed in October. That’s 3 prescriptions per person. Of course, this can vary depending on how often the doctor will see a patient so let’s generalize and say 5 prescriptions per person per year. My calculations for prescriptions per American mean that nearly 20 percent (about 17%) of the population is on antidepressants. Sure, it’s not my original ridiculous number of 82.4%, but I still think this is pretty high. (By the way, feel free to correct my stats in the comments if necessary; I don’t claim to be a math wizard.)

While I am not on an antidepressant, I am one of the millions of Americans who is on medication for mental illness. For 2 years, honestly, I’d forgotten I had anything relating to mental illness. It was nice to wake up and be myself without thinking about me plus bipolar disorder. Every morning and every evening, it’s now me plus bipolar disorder plus SAD plus anxiety. These are all real symptoms that need to be managed. I don’t want to be dependent on this medication forever, but I may have to. If it helps me manage my suicidal thoughts and function with people in life, then it’s worth it.

Your turn: What do you think about taking psychotropic medication? Do the symptoms outweigh the risks for you? What’s been your experience in taking (or not taking) psych meds?

Notes:

1. Shirley S. Wang, “Antidepressants Given More Widely,” The Wall Street Journal. Published on August 4, 2011. Available at: http://online.wsj.com/article/SB10001424053111903885604576486294087849246.html. Accessed October 20, 2011.
2. Google Public Data Explorer. Population in the U.S. Last updated: July 28, 2011. Available at: http://www.google.com/publicdata/explore?ds=kf7tgg1uo9ude_&met_y=population&tdim=true&dl=en&hl=en&q=us+population. Accessed October 20, 2011.

Should psych drugs be avoided at ALL costs?

My brain isn’t functioning today quite honestly so my apologies if the following makes no sense whatsoever. It’s long and I ended up rambling.


Lately, I’ve been thinking about whether there are any benefits to using pharmaceutical drugs. I have blogger friends who are very much anti-pharmaceuticals anything, try to avoid drugs as much as possible but take them if necessary, or think pharmaceutical drugs are a Godsend.

I’m still trying to figure out where I stand.

Pharmaceutical companies are in the business of making money. It is not to their advantage to put out completely shoddy products that do not work. I’m sure many of them bury negative data and findings that do not shed a positive light on their drugs but if something works overall, they’ll put it out there. I don’t believe the doctors who are involved in these trials are all dirty, rotten sell-outs. Some of them are very well-meaning and honest who work to make these drugs as effective as possible. Call me naïve if you like but I just can’t bring myself to believe there are more greedy docs who skew results than there are those who are concerned with advancement.

I don’t think twice about popping Excedrin Migraine when I’ve got a painful, debilitating migraine; I have no problem taking naproxen (aka Aleve) when I’ve got menstrual cramps, and taking ibuprofen isn’t an issue if I have severe muscle pain. I don’t question the safety of these drugs. I’ve used them for so long, they’ve proven to be relatively safe for me (not everyone can tolerate those drugs) and efficacious. The safety risk of taking Excedrin Migraine sometimes outweighs the benefits of not taking it. (Note: I only speak of adults in terms of ingesting this kind of medication.I don’t believe developing bodies, such as youngsters, are able to handle medication that can significantly affect mood.)

When it comes to psych meds, I am not anti-medication. Psych meds should be taken on a case-by-case basis. There are some people who consider these meds to be a life-saver while others complain that it has made them miserable and worsened their lives. This is the gamble people take when choosing to ingest a psych med—most people don’t know that. Trouble is, most people don’t know when the stakes are high enough to take that risk.

I shouldn’t be in a position to judge anyone but when I hear people taking antidepressants based on circumstances—a job loss, failed relationship, loss of a life—I worry that it’s unnecessary. We are becoming a nation that is more reliant on “quick fixes” rather than developing coping mechanisms. It’s easier to pop a pill and dull your emotions than it is to face problems, tackle issues head on, and learn to work your way through it. Case in point: rising unemployment hasn’t slowed sales of antidepressants or sleeping pills.

  • I have an aunt who was a violent paranoid-schizophrenic. She was placed in a mental institution and drugged up the wazoo. Now, she’s basically existing; the lights are on but no one’s home. The drugs have killed her. She’s alive but not really.
  • My father was a non-violent paranoid-schizophrenic. It got to the point where we needed to medicate him to get him on track. The medication helped him to function “normally” but his thought processes and physical ability was significantly slowed. He once told me that he felt useless because my mother was busting her butt at work to pay for my college and he was basically an invalid because his mental illness had prevented him from being able to work. He died 4 months later. A few days after the funeral, my mom began to find his psych meds hidden all around the house. I often wonder if the drugs killed him.
  • Another aunt (this is all on the paternal side of the family) also became a paranoid-schizophrenic. She was a brilliant woman who was basically reduced to moving from place to place to the point where she eventually became homeless and could not hold down a job. She disappeared for a while but during one cold winter, was found and brought into a homeless shelter. She was placed on meds and her cognitive functions returned despite the fact that her speech was sometimes garbled. She traveled the world, went on cruises and various excursions. The change was remarkable. Psych meds improved her life and saved her—the benefits of the drugs outweighed the side effects.

As I withdraw from Lamictal, I am curious to see who I am without this drug. Will my creative juices flow freely once again or are they now somewhat hindered? Will my cognitive functioning correct itself or will I forever suffer from problems? Will my short-term memory loss issues smooth out or will I still suffer from intermittent forgetfulness? I have some side effects that may remain with me for a while or perhaps forever (though I hope not) but seeing others fully recover after taking drugs for 10 times longer than I have gives me hope.

I feel the majority of my progress has come from intensive counseling and being infused with the truths as laid out in the Bible. I’d say 90% of my progress has been due to counseling. I give the meds 10%. You can tell I don’t place much stock in them. But they’ve helped to cut down on the mixed episodes.

So far, I haven’t had any suicidal thoughts are behaviors that are out of the ordinary. (Thank GOD.) I’ve been dealing with a mild depression but that stems from basing my worth based off of my career rather than any biological imbalances. The last time I suffered a severe depression, I was on Lexapro (if that tells you anything).

I’ve gotten a lot of resistance and concern from family members who question my decision to come off of the medication. They’ve seen a miraculous change in me and attribute it to being on meds. Meds aren’t a cure-all. They don’t see the counseling and shifting of thought processes going on that has helped me to develop coping mechanisms. Meds may help people “cope” but they don’t develop the tools needed to cope.

I’ve decided that I’ll probably give that Christian psychiatrist a call. My counselor recommended him and she said that he’s very neutral on meds and doesn’t shove them on anyone. I mentioned that I wasn’t sure if anyone would accept me as a patient only to lose me in the end—she insisted he wouldn’t mind. The intake cost is hefty but since I was able to temp a few days for my job this week—I’m not permanently returning, I can swing it.

Which brings me back to my position on psych meds: I said it earlier but I think it’s a case-by-case basis. In my personal life, I’ve seen the benefits outweigh the side effects and I’ve seen the side effects outweigh the benefits. And I’ve seen benefits (not necessarily beneficial) as a result of side effects. Psychiatry is the biggest medical guessing game of all medical specialties. There are no certainties, and there’s no one medication that works best for everyone. Pharmaceutical companies make it a point to put the disclaimer on the patient information sheet that they’re not exactly sure HOW these drugs work. All that stuff about serotonin, dopamine, and neurotransmitters is pure speculation when it comes to depression. You’ll have me convinced about chemical imbalances once I can get a MRI and blood test done. Until then, it’s all trial-and-error.

So if I do suffer from relapses while withdrawing from this medication and it gets to the point where I may need to be hospitalized, I’m not averse to remaining on the drug. Better to be alive and on a psych drug than dead because I was determined not to use it at risk to my safety. If I end up having to stay on the drug, the future of giving birth to children will seem a bit more uncertain.

Antidepressant rankings: Zoloft and Lexapro considered best overall

A number of antidepressants were recently ranked in different surveys:

Zoloft and Lexapro came in first for a combination of effectiveness and fewer side effects, followed by Prozac (fluoxetine), Paxil (paroxetine), Cymbalta, and Luvox among others.

The first was efficacy — or how likely patients were to experience the desired effects of the drug.

Efficacy:

1. Remeron (Mirtazapine)
2. Lexapro (Escitalopram)
3. Effexor (Venlafaxine)
4. Zoloft (Sertraline)
5. Celexa (Citalopram)
6. Wellbutrin (Buproprion)
7. Paxil (Paroxetine)
8. Savella (Milnacipran)
9. Prozac (Fluoxetine)
10. Cymbalta (Duloxetine)
11. Luvox (Fluvoxamine)
12. Vestra (Reboxetine)

The second was acceptability — the likelihood that a patient would continue using a drug for the duration of the study (it is generally assumed that a high ratio of patients dropping out indicates the presence of undesirable side effects for a drug).

Acceptability:

1. Zoloft (Sertraline)
2. Lexapro (Escitalopram)
3. Wellbutrin (Buproprion)
4. Celexa (Citalopram)
5. Prozac (Fluoxetine)
6. Savella (Milnacipran)
7.
Remeron (Mirtazapine)
8. Effexor (Venlafaxine)
9. Paxil (Paroxetine)
10. Cymbalta (Duloxetine)
11. Luvox (Fluvoxamine)
12. Vestra (Reboxetine)

antidepressantsMy experience with Lexapro was a disaster and I’ve written about Zoloft’s connection with irritability and rage. Paxil’s side effects are especially rough (see Bob Fiddaman’s Seroxat page) while Effexor’s withdrawal effects proved to be significantly challgenging. Although Prozac offset Effexor’s withdrawal symptoms, it causes severe somnolence that can impair cognitive functioning. And last but not least, Cymbalta contributed to the unfortunate death of Traci Johnson who had no history of depression.

These drugs may be effective for many people but it’s still a guessing game. Dr. Mark I. Levy, quoted in ABC News’s article on the rankings, mentioned that while psychiatrists may not have much use for the rankings, he sees them as beneficial for primary care physicians. And Dr. Harold G. Koenig, a professor at Duke University Medical Center, adds:

“I would be likely to start patients on either Zoloft [because it’s cheaper] or Lexapro … Unfortunately, that is almost none of my patients. By the time they get to me [a psychiatrist], the primary-care doctors have tried Zoloft and other antidepressants, so my patient are not the “new to medication” kind of patients,” he said.

I won’t rehash my thoughts on PCPs prescribing antidepressants and other psych meds. You can read about them here.

Christian counseling: Nouthetic vs. Biblical

Last night, I spent some time on the phone with my husband’s friend’s sister (aka my former pastor’s sister). We’ll call her Natalie.

Natalie was very sweet and kind, really encouraging and strengthening me by sharing her testimony of faith in God. She suffers from anxiety and panic attacks, which has led her to take Paxil (on and off) for the past 7 years. She says the drug has helped her tremendously and who am I to knock the drug (knowing what I know about Paxil/Seroxat) when she has seen the wonders that it has worked in her life?

I briefly explained my story of depression, history of suicide, and diagnosis of bipolar disorder. Although she couldn’t fully relate, she was very sympathetic and understanding. In fact, our conversation was so fruitful, I ended up taking notes!

Jay AdamsWe briefly touched on the issue of Nouthetic counseling (NC). She has undergone the course and simply needs to be certified. The counselor I currently see is associated with the Christian Counseling Education Foundation (CCEF), which has roots in NC and was founded by the man—Jay Adams—who developed the method. However, CCEF is now known for what is called biblical counseling. The organization has since moved away from pure Nouthetic methods and become more a bit more varied, taking bits and pieces of psychology (and perhaps psychiatry) that line up with the Bible. Adams, disagreeing with the organization’s approach, founded the Institute for Nouthetic Studies and uses the Bible as the sole counseling textbook. According to the wiki entry on Nouthetic counseling, Adams developed the word Nouthetic based on the “New Testament Greek word noutheteō (νουθετέω), which can be variously translated as ‘admonish,’ ‘warn,’ ‘correct,’ ‘exhort,’ or ‘instruct.'”

NC was developed back in the ’70s as a response to the popularity of psychology/psychiatry. Many Christians reject some of the teachings of such popular psychologists as Freud, Jung, Adler, Maslow, etc. Adams’ highly successful book, Competent to Counsel, criticizes the psychology industry and counters its teaching with a Nouthetic approach.

But NC has its Christian critics.

Read the rest of this entry »

Loose Screws Mental Health News

John Grohol at PsychCentral reports that the fate of the mental health parity bill is uncertain as its main champion, Sen. Ted Kennedy, takes a leave of absence to focus on treatment of his brain tumor. I echo John’s thoughts in hoping to see that other senators are willing to carry the torch and pass this important piece of legislation.


I came across a post from Kalea Chapman at pasadena therapist in which she linked to a WSJ article on whether veterans suffering from PTSD should be awarded the Purple Heart.

Supporters of awarding the Purple Heart to veterans with PTSD believe the move would reduce the stigma that surrounds the disorder and spur more soldiers and Marines to seek help without fear of limiting their careers.

Opponents argue that the Purple Heart should be reserved for physical injuries, as has been the case since the medal was reinstituted by Congress in 1932.

I side with the opponents. The Purple Heart should be awarded to be people who have visible evidence of bravery. With the rising number of PTSD prevalence, I’m afraid that the award would be handed out like candy. The rising number of veterans with PTSD on disability has caused enough of an issue that a Texas VA facility wanted mental health officials to stop diagnosing veterans with the condition.


Jordan Burnham, an 18-year-old student who survived a nine-story jump from a building, plans on walking at his graduation with the assistance of two canes. A family who used to attend my church knows this family and put him on my church’s prayer list. It’s a small world, after all.


Finally, it looks like expecting moms should have no fear of causing birth defects in their baby while taking antidepressants, according to a study being published in the British Journal of Psychiatry.

A research team from Montreal University studied more than 2000 pregnant women on antidepressants and discovered the drugs did not present any adverse effects. However, it sounds like they only oversaw the women while they were pregnant in their first trimester. I haven’t seen the actual study but it doesn’t seem to mention whether the women discontinued the antidepressants after the first trimester.

Thoughts on Bipolar Overawareness Week: Part I

I finally sat down and read all those posts that I linked to about Bipolar Overawareness Week. I mentioned in my previous post that I feel like I had a contrarian view. Well, I do. Somewhat. Although it’s probably not as contrarian as I’d think.

Let’s take my experience, for example.

Read the rest of this entry »

Wyeth reps no like Pristiq

Oof. I'm just starting to read The Carlat Psychiatry Blog and stumbled upon this post about Wyeth drug reps trashing Pristiq. Wow. Carlat pulled an excerpt of a Wyeth rep mocking Pristiq's new marketing slogan: "People, Passion, Performance… Pristiq!"

"PEOPLE – 1/2 of you will be gone in less than 27 days

PASSION – There is no passion now, but for those that remain with Wyeth, we will bribe the passion out of you by taking you to Vegas for 4 days.

PERFORMANCE – You thought it was hard to reach your performance incentive before? Wait until 2nd quarter

PRISTIQ – Good luck selling both Effexor XR and Pristiq at the same time. So Dr., would you like to hear about my antidepressant that has been around for 12 years, with proven efficacy with the ability to titrate the dose as need to better care for each patient's needs that will have generic competition in 4 months, or would you like to hear about my brand new antidepressant with one dose, less indications and less evidence of efficacy? You want me to choose, let me check with my bonus plan to see which one pays more."

Carlat:

If this is the typical attitude within the Pristiq sales force, Wyeth may end up a little shy of the blockbuster they were hoping for!

I couldn't have said it better myself.

NYTimes

“The drugs save lives, and we often have no choice but to use them — even if we have questions about their long-term use. But the questions are big ones, and we owe it to our patients to try to answer them.”

Richard FriedmanDr. Richard Friedman, a frequent mental health columnist for the New York Times, has written a piece that questions the use of antidepressants and how dependent patients have become on them. I’ve read Friedman’s previous columns and appreciate his realistic take on the psychiatric and psychological field. His most recent piece is worth reading.

The Zoloft-rage/violence connection

[This post is quite lengthy so I suggest you grab a cup of coffee or tea and sit down and read it. The following is not for the faint of heart (or those with a lack of time).]

It’s been amazing to me that I’ve received numerous comments on Zoloft inducing rage. I’m humbled by having a Pittman supporter visit my site and post some comments from the ChristopherPittman.org forums. Read the following:

In my senior year in high school I was diagnosed as being severely depressed and put on medication. The first medication that I was on I took for 5 months and it made me really aggressive. My friends and family noticed the change and I told my doctor about it and she changed my meds. After that I was fine. I am normally a very passive person and will let just about anything fly. But the medication made me really aggravated and aggressive toward my friends and family and it seemed that I wasn’t overcoming my depression. I just got done watching the 48 hours investigation on the Discovery Times Channel and felt a connection with Chris. I felt that I had to write this to let you know that Chris is not the only one out there that had these side effects. I think there should be a study done to see how many people that take antidepressants have increased aggression. The problem is that the pharmaceutical industry has deep pockets and many lobbyists. I hope this helps in some way.

And another:

I remember the case when it happened.

At the time I thought, “Zoloft right”.

Let me tell you my physician put me on Zoloft and it took about three weeks for my to become psychotic and I’m a 50 year old woman.

I have three children and I don’t make a lot of money but please let me know if I can do anything for the Pittman boy.

The jury should have been placed on Zoloft before they made they decision. Unless you’ve experience it you simply cannot believe its’ effect.

Brynn and Phil HartmanI did a bit of quick reading/research into Zoloft triggering violence in people who otherwise would have never been violent and it seems that are a few stories out there to support the assertion. I found a few comments on depressionblog.com that mentioned a link between Zoloft and rage fits. A Salon.com article published a story antidepressants inducing rage in 1999. Apparently, Brynn Hartman, the wife of famous comedian Phil Hartman, killed herself and her husband while taking Zoloft. While close friends attribute the sudden behavior on the antidepressant, others attribute it to a combination of the medication with cocaine and alcohol in her system. (Zoloft does have a warning against alcohol use in conjunction with the drug.)

One interesting thing I learned from the article is that this kind of behavior is often labeled under the name akathisia on patient safety guides. Most – if not all – of the major antidepressants list akathisia as a side effect. Here’s the initial description of this condition from Wikipedia:

Akathisia, or acathisia, is an unpleasant subjective sensation of “inner” restlessness that manifests itself with an inability to sit still or remain motionless… Its most common cause is as a side effect of medications, mainly neuroleptic antipsychotics especially the phenothiazines (such as perphenazine and chlorpromazine), thioxanthenes (such as flupenthixol and zuclopenthixol) and butyrophenones (such as haloperidol (Haldol)), and rarely, antidepressants.

Akathisia may range in intensity from a mild sense of disquiet or anxiety (which may be easily overlooked) to a total inability to sit still, accompanied by overwhelming anxiety, malaise, and severe dysphoria (manifesting as an almost indescribable sense of terror and doom).

No real mention of extreme anger or irritability mentioned there. But if you read on…

The 2006 U.K. study by Healy, Herxheimer, and Menkes observed that akathisia is often miscoded in antidepressant clinical trials as “agitation, emotional lability, and hyperkinesis (overactivity)”. The study further points out that misdiagnosis of akathisia as simple motor restlessness occurs, but that this is more properly classed as dyskinesia. Healy, et. al., further show links between antidepressant-induced akathisia and violence, including suicide, as akathisia can “exacerbate psychopathology.” The study goes on to state that there is extensive clinical evidence correlating akathisia with SSRI use, showing that approximately ten times as many patients on SSRIs as those on placebos showed symptoms severe enough to drop out of a trial (5.0% compared to 0.5%).

Read the rest of this entry »

Loose Screws Mental Health News

Let’s start off small and build up, shall we?

A blog I came upon, Providentia, has a post on the suicide rate in Kentucky over a 10-year period. Male schizophrenics have the highest rate of suicide. The leading methods of suicide in the state are firearm use, overdose, and hanging.


Mary WinklerMary Winkler, the preacher’s wife who killed her husband, has been moved from jail to a mental health facility, where she will serve the remainder of her three-year sentence.


East meadow, a poster on the drugs.com message board, asks about Lexapro’s correlation to suicide. Her sister committed suicide while on Lexapro and questions whether the Lexapro might have affected her in that way. As a former Lexapro user, I can empathize with the change in her sister’s behavior.


The Depression Calculator: see how much depression is costing your company and see if treatment is worth your while. I went through it for kicks and basically, I walked away feeling like it cost too much to hire someone with depression, especially if I were running a small business. Blah.


Apparently, bipolar disorder is covered under the Americans with Disabilities Act (ADA). Starbucks is settling an $85,000 lawsuit with Christine Drake, a former Starbucks employee who suffers from bipolar disorder. It seems that Drake’s first manager was willing to work with her “psychiatric impairment” and allow her to gain “extra training and support.” Then, get this:

“But, during her third year, new management told her she was “not Starbucks material,” refused to continue the accommodation and ultimately fired her for discriminatory reasons, the agency alleged.”

Starbucks probably put up one helluva fight, but in the end, they’ve tried to put a good face and good spin on the situation:

Starbucks agreed to pay Drake $75,000 and donate another $10,000 to the Disability Rights Legal Center, which provides legal representation for low-income people with disabilities facing discrimination, as part of the settlement.

“The facts of this case illustrate how relatively minor accommodations are often all that disabled people need to be productive members of the work force,” said the EEOC’s San Francisco district office director, Joan Ehrlich. “It is important that all of Starbucks’ managers understand their legal duties regarding disabled employees and provide them with the tools necessary to succeed. This is in everyone’s best interest.”

Ms. Drake, who seems to be more than capable of handling a job well, has probably eeked out several years of a barista’s salary from the Starbucks suit.


I’m amused, but it’s not necessarily a good thing.

RisperdalJohnson & Johnson is gearing up to put Risperdal for children on the market. I’m sure other blogs have beat me to the punch on this, but I just came across this info and found it absolutely retarded. (But what do drug companies care?)

The FDA has approved “expanded use” for Risperdal in teenagers who suffer from schizophrenia and the short-term treatment of bipolar mania in kids ages 10-17. I’m leery enough about antidepressants in kids let alone antipsychotics.

“J&J said the agency has not requested the company perform any additional studies, implying that it need only agree with the FDA on acceptable labeling for the expanded uses in order to gain final approval.”

I wasn’t sure what “expanded use” was so I looked it up. This was the best I could come up with:

“Applications for a new or expanded use, often representing important new treatment options, are formally called “efficacy supplements” to the original new drug application.”

Well, I didn’t know what efficacy supplements were so I looked that up too:

“The legislative history indicates that this provision was directed at certain types of efficacy supplements (i.e., supplemental applications proposing to add a new use of an approved drug to the product labeling).”

So – correct me if I’m wrong – it sounds like the studies performed that led up to this “expanded use” are not as rigorously evaluated by the FDA as the initial studies that allowed the drug to be released on the market in the first place. It just seems like a company and the FDA simply need to agree on “acceptable labeling.” So if we’re following the theory that I’m still correct, the FDA doesn’t follow up on the clinical trials performed on these children, they just agree with J&J on the “acceptable labeling.” Doesn’t that thought make you feel all warm and fuzzy inside about your health?


Christopher PittmanOn the subject of children and psychotropic medications, 12-year-old Christopher Pittman shot and killed his grandparents and then set their house on fire in November 2001 all while on an adult dosage of Zoloft. It looks like the drama is still playing out in June 2007.

According to CourtTV.com, Pittman suffered from hallucinations while on the 200 mg dose and while in jail, displayed symptoms of mania.

“Three years after the killings, Pittman was tried in adult court and convicted of murder. He was sentenced to 30 years in prison. He was then 15 years of age.”

No doubt Pittman should be held responsible for what occurred, especially if he admitted to the killings (which he did). However, the situation raises a few questions. First of all, why was he on 200 mg of Zoloft when he was TWELVE? Why wasn’t he considered mentally ill and placed in a mental health facility? I could go on and on. While Pittman “did the crime and needs to do the time,” why isn’t the doctor who prescribed this not present in any of the reported stories? If this incident was 2001, it can only be worse for antidepressants and other psych meds today.

Mean behavior isn't always mental illness

OK – I continue my streak of NYTimesing (lookee! A verb!) and post a link to an essay by Dr. Richard Friedman about how chronically "mean" people may not have a mental illness. They are just… well, mean.

Friedman raises an interesting point about how psychiatry and psychology try to explain away so much of people’s behaviors via diagnosis that people aren’t left any room to be "normal." Mean people don’t need to be lumped into a category of "anger disorder" or some crazy nonsense like that. Perhaps there are people who have extreme issues with anger and need to learn behavioral techniques to get it under control. But other people at their very core like to hurt, manipulate, and demean others. This is not a mental illness. This is a human, sinful nature.

Mind Over Matter, Pt. 2

Perhaps I've written about this previously. Perhaps I haven't. Regardless, I'll tackle it anyway.

Some people with a mental illness who hear what I'm about to say will tell me I'm crazy. Perhaps I'd get "partially correct."

Read the rest of this entry »

Babies and toddlers are mentally ill

The new fad? Diagnosing young children with mental illness.

Oh and I mean young.

Originally, I’d written about how psychiatrists are diagnosing mental illness in infants. Mental health blogs now are all over the Rebecca Riley case and rightly so.  She was a 2½-­year-old toddler diagnosed with ADHD and bipolar disorder. How a psychiatrist can diagnose a child that young is beyond me.

intueri has written a brilliant post about the case and diagnosing children that young:

“We need to stop labeling behavior as pathological just because it causes us inconvenience. We also need to stop using diagnoses as means of absolving us of our responsibilities (”it was the bipolar that made me say those mean things to you; it wasn’t me”). We, as providers, need to stop colluding in these goals: We need to stop the belief that a pill will always cure everything.”

(linkage attribution: Furious Seasons)

Loose Screws Mental Health News

Yeah – the copy editor in me wants to try “Loose Screws News.” For now.

Clinical Psychology and Psychiatry is among many of my favorite blogs to read. In this particular post, he rips on Eli Lilly’s zyprexafacts.com, which was set up in response to NYT articles that alleged Lilly drug reps pushed Zyprexa to physicians for off-label uses. I hope to just have a stupid ol’ time and rip on each Eli Lilly press release in response to each NYT article, but we’ll see what happens. I’ve already got one lined up with notes scribbled on the printout; I just need to transfer it into electronic form. (Oh, the joys of being a transit commuter.)

Liz Spikol linked to an article originally published in bp magazine about how difficult marriages are when one spouse suffers from bipolar disorder. The saddest statistic I’ve ever read:

“In the United States and Canada, at least 40 percent of all marriages fail. But the statistics for marriages involving a person who has bipolar disorder are especially sobering—an estimated 90 percent of these end in divorce, according to a November 2003 article, ‘Managing Bipolar Disorder,’ in Psychology Today.”

Um, joy considering that I’m I suffer from bipolar and have been married for just over a year now. This strikes incredible fear in my heart. It’s not that we don’t love and care for each other, but I can only imagine how much a spouse who doesn’t suffer from bipd can take. I hate to say it, but I keep waiting for my husband to walk out on me. Not because I’m pessimistic (OK, I am, but that’s beside the point), but because I fear that he’ll reach a point where he’ll say, “I can’t take anymore of this! I’ve dealt with this for 10 years and nothing’s changed, nothing’s getting better. I’m sorry, but I can’t be married to you and deal with this anymore.” Just waiting.

Kelly Osborne Retarded celebrity story of the day: Kelly Osborne suffers from depression because she’s so privileged. But hey! — she’ll pose for Playboy and get photoshopped so she can feel better. *gags*

If you’re mentally ill and fired for it, don’t bother suing. It looks like the mentally ill don’t have a case unless there’s a physical illness to somehow “prove” it:

“Sixteen years after Congress enacted the Americans with Disabilities Act (ADA), people with psychiatric disabilities are faring worse in court cases against employers for discrimination than are people with physical disabilities, researchers have found in a national study.

‘People with psychiatric disabilities were less likely to receive a monetary award or job-related benefit, more likely to feel as though they were not treated fairly during the legal proceedings and more likely to believe they received less respect in court,’ said Jeffrey Swanson, Ph.D., a study investigator and an associate professor of psychiatry at Duke University Medical Center.”

I’m not sure how to solve this problem. Psychiatric disabilities are less tangible and harder to prove than a physical disability. It’s easier to wage war against a company if you suffer from a bad back vs. if you suffer from depression. (Whether or not the bad back is a fictional illness is up to you.)

Another oy moment. (The Long Islander in me is coming back full force.) Got a pet that’s misbehaving? Put him or her on an antidepressant. Double oy.

New Zealand is being introduced to lamotrigine (trade name Lamictal in the U.S.). Good luck, bipolar New Zealanders. Best wishes.

And finally, a study has discovered that about half of patients who suffer from some kind of severe burn suffer from clinical depression. (Shouldn’t someone diagnose this as PTSD? That’s pretty traumatic, if you ask me.) While the finding isn’t surprising, the study highlights the need not only to treat the physical ailment, but also to address the mental healing necessary to overcome stress from the injury.

Just another day: Part II

Originally written October 16, 2006 (Updated edits in bold red)

On the heels of discussing my cynicism about pharmaceutics and pharmaceutical companies (namely, psychiatric-related), I have a few questions regarding the approach of psychiatric evalutations:

1. Why aren’t people tested for biochemical imbalances?
2. Is there a way to determine from blood work or an MRI what kind of mental illness a person is suffering from (in conjunction with the patient’s psychiatric assessment)?
3. How do doctors know the appropriate dosage for a patient? Does s/he start a patient off on what is considered “normal” for an average person and then increase or reduce the dosage based on reactions and side effects?
4. How does a doctor know when to increase a dosage? (Figuring out when to reduce a dosage SHOULD be much easier.)


Psychiatry is an inexact science. For the most part, I think much of it — regarding medication, Freud, and now, the pharmaceutical industry — is a crock.

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Just another day

Originally written October 16, 2006 (Updated edits in bold red)

“So sad / so sad / sometimes she feels so sad” ~ Paul McCartney, “Another Day”

I’m finishing up my third full day in the psych hospital and I’m accomplishing things totally unrelated to my “treatment.”

I’ve gotten through 100 pages of Mark Twain’s The Adventures of Tom Sawyer. It’s an interesting book — never read it before – and reading about Tom’s mischevous ways takes me away from the dreariness of a psych hospital. I have a mind to read Huck Finn afterward.

Your Drug May Be Your ProblemI’m reading several books at once, however. (I’ve got ADD when it comes to books; sometimes I finish them, sometimes I don’t.) I’m finally reading my Bible again and trying to plow through Your Drug May Be Your Problem. It’s an interesting book but most of it is alarming. The authors, Breggin and Cohen, argue against psychiatric drugs completely. The books raises some awareness about the use of psychiatric drugs but I think the authors are mostly crying “Fire!” about an unattended candle. The only time I somewhat took them seriously was their discussion about lithium. I’ve already heard — and now seen — its effects. I think lithium is a drug that really shouldn’t be used any more. Are the therapeutic effects of lithium really worth risking a patient to possible toxic levels?

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Pharmaceutical cynicism

seroquelA mental health blog I’ve recently started reading, Furious Seasons written by P. Dawdy, has been blogging about Seroquel, a medication that has normally been used for acute mania in bipolar disorder. Now, Seroquel is being pushed for depression in bipolar disorder. In one of his older posts, he wrote: “So my hunch is that there must be money for researchers in going after BP, and Pharma companies must be willing to foot the bill. Yes, I am cynical.”

This has been my thinking for sometime now and I’m glad that someone had the gumption to say so. I’m highly cynical of pharmaceutical companies. Pharmaceutical companies don’t care about whether medications help people as long as they don’t kill anybody, which detracts from their profits in the form of class-action lawsuits. (See the Vioxx case with Merck.)

Dawdy also writes: “We are the only group in the psych business that matters. But our interests are not well served in the current power arrangment, in which we don’t even have much of a share or a voice. That is also bullshit and must change.”

I often feel disconnected from the pharmaceutical industry and the world of psychiatry. I am being told things and diagnosed left and right and I don’t understand much of what I’m being told by anybody. My concern is that clinical trial data is being fudged by doctors who receive funding from pharmaceutical companies but fail to disclose their ties. This area needs government regulation and a higher standard of ethical practice. Perhaps the APA should form a bureaucratic board of ethics specifically to overseen the relation between doctors working with (and often for) pharmaceutical companies.

Mood: 4