Started the celexa for real...

And then that damn full moon causes me to get manic too so who knows.

It did effect you economically. You took tegretol for 7 years and paid for the doctor to write those rx's. If the tegretol affected you in other ways I don't know. Imagine if you (in an other life) had an episode of depression and were prescribed and AD. Maybe you never got over a moody adolescence or maybe there was series of tragedies in your life. ADs are great at helping you avoid the underlying issue. Who knows. Maybe that happens twice because it worked for you the first time. Now you go into a manic episode so the drs say you are "really bipolar". So now you enter a whole arena of meds. The first round makes you worse but instead of removing them they add drugs which only complicates matters. You chart says bipolar, something most label as "incurable" for the rest of your life. There are politicians who have admitted to going through an episode of depression. Who has admitted being diagnosed with bipolar? Before it meant no opportunity to get insurance on your own which usually translated into no small business. You could be an inventor. A brilliant artist but if you can afford healthcare starving artist is all you get. Until ACA is ingrained this is still an issue. Those drugs that are supposed to help "don't" so now you are on the newest "wonder" drugs thanks to the relationship between you dr and the insurance company. Note that those new drugs have 5 years testing at best and as little as two studies. The crazy moods you never had before lead to bad or no relationships, lower paying jobs and so on. All along those meds keep getting costlier and costlier because you start taking more or you run out of cheaper options and your salary decreases. They become a bigger and bigger part of your daily life.

You can't base it just on your experience. The example I just gave is a conglomeration of what happens everyday. What about Hellion? She said she hasn't been labeled BP up until now. If she ends up in a manic episode is she BP? Say it ain't so!

Self diagnosis... The bottom line is to be a partner in your care. If the doctor isn't going to work with me I am damn sure to go out and do my own research. I don't tell them what to "think". I pay them for their expertise. But I am not going to give up thinking for myself either I don't advise that of anyone.

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I agree we in general are way over prescribed and over diagnosed. A better example would be kids who get tagged ADD/ADHD and put on amphetamines at a young age. That is much more dangerous in my view.

Bi polar does have much more stigma attached to it then depression for sure.

I seriously doubt that Hellion is going to get a bi polar dx from having a wired reaction to Lexapro. Doesn't sound like mania it sounds like feeling wired and there is a big difference. But for the sake of argument if she had a full blown manic episode than that could very well indicate bi polar or "manic switching" that they are calling a form of bi polar I don't know. So little is really known.

As far as my own self diagnosis, I exaggerate. My pdoc was very very reluctant to let me go off of Tegretol. He was confident in my diagnosis and i was not. We talked about it at length before we both agreed to try it. I have not had a manic episode since but I do get hypo mania. So I was right and he was wrong. It can be a guessing game. I have always had very good partnerships with my pdocs. (except my last one in CA who I had and hated but he intimidated me, I should have fired him but when depressed my confidence is down). I am sure you and I are the exception in doing all the research we do. I have lived it and studied it my whole life and my pdocs respect that. I know you don't like the guessing game aspect of it but I am afraid that is the way it is. So little is known and we and are pdocs are stumbling in the dark in a lot of ways. Yes I base a lot of what I say on my own experience and it is a whole big world out there but it is what I have, plus the experience of those I know and the studying I have done.

Maybe where we might disagree is that I think that overall psyche meds have done much more good than harm. Look at schizophrenics who live on there own and do quite well because of meds. Off of them it is just horrible. That is a general statement and I know it doesn't apply to everyone. I told a story in another thread about one of my best friends when I was little. His mom was schizophrenic and he developed it as a teenager. I saw him on and off meds many times. On meds he could maintain a little apartment and do pretty good. Off meds there was the CIA and aliens and all that. No way he could function. Me and my friends were of no help to him because we didn't have a clue. I told the whole story in some other thread. The sad part to me and my friends is that we couldn't help him even though we tried in all our stupid ways. He hated taking meds and left an AIS home quit meds and ended up roaming the streets homeless. I don't know whatever happened to him. He is probably dead.

"I seriously doubt that Hellion is going to get a bi polar dx from having a wired reaction to Lexapro. Doesn't sound like mania it sounds like feeling wired and there is a big difference. But for the sake of argument if she had a full blown manic episode than that could very well indicate bi polar or "manic switching" that they are calling a form of bi polar I don't know. So little is really known."

The part in bold is where we disagree If (for the sake of argument) hellion had a full blown episode I would say get her off the med. I wouldn't say it is indicative of a bipolar diagnosis at all. If hellion then continued to have episodes on these meds I would continue to blame the meds. If she comes back in 6 months with a BP diag I will be really pissed. (She won't because she is more informed than most but for the sake of argument...)

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Yeah I highly doubt I'd get a diagnoses of bi-polar...doesn't mania usually involve a hardcore amount of motivation and drive to do things with a sort of uplifted mood and feeling of anything is possible? The closest I ever come to that is with adderall that I have taken in the past which made me want to clean, clean, clean listen to music, not sit still but that was clearly because of the adderall....if I get high energy in my natural state its more to do with anxiety and PTSD which is more fear based adrenaline reactions with no sort of uplifted mood and not really motivation but a lack of control over impulses if that makes sense. So essentially I am pretty sure any bi-polar like symptoms i have could be attributed to the PTSD combined with my other mental conditions.

I don't doubt a drug could make me experience a mania like state, but I doubt it could actually make me develop bi-polar disorder...those symptoms would probably go away when stopping the use of the drug causing it.

I do think it is interesting that people either go to sleep or are wired on celexa. Whatever your reaction is the opposite seems to be true on Zoloft. Nothing scientific there. It's just an observation I've had from this forum. Wellbutrin did make me manic (and it was great until they told me it wasn't ) but the celexa made me wired which was definitely different. I was really wired and rather sick. It was more like the symptoms of serotonin syndrome. I don't think either is good of course.

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I tool Celexa for a long time. It was one of the better ones for me (which means not that great but better than others for me), but I didn't get tired or wired on it. Wellbutrin, yes, way wired, couldn't handle it and quit cold turkey.

Michanne here is a real life example currently in my family.

My brother has a 14 year old son who is showing signs of depression. This started a year a go and they brought him to see a psychologist and psychiatrist. The pdoc was wise enough to only recommend a certain brand of fish oil and no meds. He only went to a couple of sessions with the T and quit taking the fish oil so they didn't really follow up. My nephew didn't want to see the T for understandable reasons. He didn't want to think something was wrong with him.

So this year he is showing symptoms again that are outside the normal range for a kid his age. My brother is concerned with all our family history, as he should be, so they are going to take him in again. This time the kid is willing to see the T and is kind of looking forward to it.

I will see my brother this weekend for Easter and my very strong recommendation will be to not let him go on meds. Maybe try some supplements. And I will strongly advise a lot of sessions with T. No one can be harmed an only helped by a T in my view. Even a totalally "normal" person can benefit for CBT.

So even though I am so pro med or seem to be we are on the same page in this case. However if he had attempted suicide or self harm I would recommend meds.

I look at it as a very healthy thing and early intervention because of the level of awareness my family has because of many years of going through the ringer and a lot of treatment. We are fortunate. I can point to a number of examples with the grand kids in the family, including my daughter, where their self awareness is much higher and early intervention in their teens has made a huge difference. My sister adopted two sons at a young age. The one from Russia has a huge attachment issue (I think it is called), she read up on it and found an expert and even flew to New York to mean with this expert. She is trying very hard to help him although it is difficult and we all see sociopathic tendencies in him. Scary. He is making alot of progress though. Only 8 years old. None of the grand kids are on meds. I call it breaking the chain of generational mental illness and addiction. I may suffer but my suffering helps the younger ones. Hey that just occured to me and gives me more meaning and purpose to my suffering. It brings tears to my eyes that they have a better shot at it.

For the sake of argument, not using anyone as an example, but someone has a full blown manic episode after starting an AD, the psychiatric community seems to look at this as a form of bi polar.
If someone is MDD and never had a full blown manic episode and then an AD triggers a full blown manic episode.....does this ever even happen?

I have experienced a lot of hypomania both after being on a med a long time and just starting a new med like has happened the last couple of weeks although it seems to be balancing out now. And sometimes I have rapid cycling. That is the main reason my pdoc suggested Lamictal was because of rapid cycling and also because it is supposed to help with plain MDD. Most pdocs would say I have bi polar II and I may very well have bi polar II. My pdoc and I really don't care that much because we care about my symptoms and how I am responding. i should probably get it changed to bi polar II because it does fit and it would help my disability case.

Here is a good article that discusses the issue.

?Switching? of Mood From Depression to Mania With Antidepressants | Psychiatric Times

I am suspect of the intentions of that blog. The business model is advertising. IOW, it isn't a blog that accepts advertising. It is an advertising site that includes content. Btw, this is where advertising sites are going because google's algorithm has been changing. It means we have to be more aware of who is paying for it. (I digress). They say this in the editorial statement. It's also pretty obvious who is paying I bet the board is filled with pharma execs. I didn't look. Though they say the writing is independent that quote you post says different. It suggests it is a diagnosis alone. Terrible, IMO.

In order to consider medication a criteria it has to be accompanied by other criteria and it has to be part of a specific group of criteria. On it's own it is exclusionary. It is not easy to understand, btw. One of the problems I have with DSM.

http://www.journalbipolardisorders.com/content/1/1/12

This is another article which is also based on somebody's personal experience. I am starting to see a pattern with celexa... Hmmmm. Maybe it is just so common. I think he questions whether he should have been given the drug at all or sought other treatment or simply allowed himself to work through it. I think, given his position and lifestyle it is expected that a 40 year old maintain a level of energy. I think there is a lot of pressure to take the drug in our society. It probably would have been a lot cheaper to meditate in India for a year

http://www.madinamerica.com/2013/02/...-definition-2/

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That's good. I would also consider inheritable "habits". What aspects of your diet are passed from generation to generations? My mothers gen was into canned veggies more often than fresh or frozen and very bland meals. A former friend of mine referred to the diet he grew up on as the "white box diet". He new it was a problem but it was a habit. It was pretty obvious to me why he would crash at 2pm almost like clockwork. Those kinds of habits are passed down to adopted children too. We know the benes of fresh veggies but I do not think we pay enough attention to the benes of herbs and spices in our diet. Turmeric, clove and ginger pop into my head but there are many more. It might be something less obvious too. This might be radical thinking but what about spending an hour with a specialist in aryvedic or naturopath?

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Well that base is kind of covered. His Mother is a registered Nutritionist and it is her job to consult and advise diabetes patients. At one time it was strictly native americans, but I think she just took another job at McLearan Health.

I can assure you she feeds her family a very healthy diet and is well aware of refined sugar and processed foods and all of that. So I think we can rule that out. I wish he would have stuck with the fish oil the first pdoc suggested.

The generational diet was definitely passed down to us but as a nutritionist she broke it and does use a lot of herbs and spices as well. My other sister in law is way more gung hoe and is a self educated organic gardener and herbalist. She also has the master gardener certificate. Her and my brother have an organic farm and it is a very long list of all the things she is into. Physical, emotional, spirtual. They are both pharmacists but sold their pharmacy and bought an organic farm. She is working on me and my Dad all the time trust me...with limited success. The generational thing is interesting because my grandmothers parents immigrated from Finland and homesteaded in northern Michigan. Tough life to carve out a living in northern michigan. True pioneers. But she grew up on a standard farm diet...so many more whole foods, what they could produce and store from the land. By the time it got to my parents and me it was the standard american diet.

And he also runs track and cross county so gets tons of exercise. Maybe even playing baseball this year. So that can be ruled out.

It is mainly about his moods and lack of friends, I am not sure what other symptoms and how much my brother will want to talk about it with me this weekend. Maybe nothing to worry about but my brother is worried about the genetic aspect and family history.

My other neice from the organic farming brother is starting to have some trouble at 21 but they can't figure out if it is just hormones and thydroid or what. Her parents are not worried about depression and think it is whacked hormones but she is because she experienced a couple weeks of all the symptoms of depression. Her comment was I will never judge anyone ever again for not being able to function or having depression like zinco because i have experienced it first hand.

Well it is a blog and I am also suspect about blogs in general. I did think that Psychiatric Times was a respected publication. I looked at a bunch of pages and I don't see any ads. It doesn't seem to be an ad based site because I don't see any ads. I know there is a lot of controversy on what goes into the DSM but it is very widely used and that is what it says in the 5th edition.

I don't know if it is an editorial it is based on a wide range of research. Why do you say it is not independent? I don't know who paid for it but i will list the authors and references below. If you want to say that McLean Hospital and Harvard are not independent I wouldn't agree. I don't think their money comes from big pharma. I didn't look up the authors. I will have to read your articles later. Just the name "mad in america" makes me suspect. I am not familiar with the site though. In fact the editorial statement says he makes no money from it and stopped taking honor aria (not money) from big pharma in 2008. He is from Samaritan Mental Health in OR., has a website that make no money for him or others. He wrote a book he makes money on but that in no way makes him biased. So I don't know where you are coming up with some of your statements or distrust of the article. I will post the statement at the bottom.

See now that might be something hellion could relate too (forgive me, hellion). I agree meds are an unjustified answer:

"It is mainly about his moods and lack of friends, "

I believe we do not have to be a slave to our genetics. In fact the study of epigenetics is proving this. When you talk about breaking the cycle altering the epi layer is part of it. Education effects epigenetics. A parent who treats their diabetes is less likely to have a kid that has diabetes. Not just the type 2 kind either. They believe there is a genetic switch that occurs.

In the case of your nephew I would teach him (and this is just my style and preference. I don't know the kid obviously.) that there are many ways to increase his esteem by making the most of his moods (within reason). I just watched the Steve jobs movie with Ashton Kutcher the other day. There is a person who learned to work with the fact that he was never going to be a "traditional employee". And he had personality issues his entire life but I am imaging he came to terms with it. I can't imagine where he would have been if he had listened to his teachers, bosses and even peer. Probably on meds . There are many examples of people like this and you can even meet them in places like colleges and nonprofits and start ups.

My cousin gets her kid involved in outside school activities precisely because he has trouble socializing but put him in a wilderness camp every year. He learns to work with kids outside the school peer group system which involves more competition and grades. Now he is actually building a group of friends outside the school system and keeps up with them on social media. He does participate in school activities but just not with the same success. He does have a somewhat difficult personality that is for sure. I bet by the time he reaches college he will have completely dumped those video games The thing is his grandmother is very mentally ill... My cousin was the parent growing up. She still is. She'd love to live in a different part if the country but won't because of her mother. My aunt was off and on antipsychotics and my parents denied it. I used to spend weekends and the mood would go from great to exhausting and stressful. Not a healthy situation. Other members of the family all exhibit some sort of mental illness. My cousin could have succumbed to the idea that he has inherited a genetic disposition. In fact we have had several discussions about putting him on adderal (which I disagree with and she is now wanting to take him off of due to recent studies adolescent males). But overall she has not bought into it. It's not even addressed very much though we do discuss it. Just not in those terms. He very well could exhibit MI symptoms at some point. (Let's not forget to give credit to dad in all of this either ) The other thing that she is doing is she went from major obesity to running in races. It has taken her many years and huge commitment from everybody but what better example of perseverance and resisting inherited example? For you, that would be the sort of example I would set for your nephew if don't get the opportunity to spend time with him I mean regarding your commitment to MH. You have your own way. That is just me.

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Maybe you have a problem with the DSM but one of the links you posted supports my view. (although fairly uninformed, but I like to debate and learn).

International Journal of Bipolar Disorders | Full text | Bipolar disorders in DSM-5: strengths, problems and perspectives

I don't understand how you don't see ads? Posting snapshots of what I see below.

Editing involves selecting what to publish. If you read the editorial statement they state they are an advertised based business model. They also state they disclose when an advertiser is a contributor. The bottom part with regard to comments says "In some instances, we might pay users to contribute to our sites." My big red flag, however, is how that particular author made it sound that you can diag somebody based on a reaction to medication. He never says it is a minor and supplementary part of the diag. That bothers me tremendously. Mad in America is definitely has specific POV but not without basis. From the about page:

"The bloggers on this site include people with lived experience, peer specialists, psychiatrists, psychologists, social workers, program managers, social activists, attorneys, and journalists. While their opinions naturally vary, they share a belief that our current system of psychiatric care needs to be vastly improved, and, many would argue, transformed."

Madinamerica.com does not host advertisements or sell any data about our readers. As such, our ongoing operations are funded entirely by the support of our readers. (For more about our legal organization, see “About Us.”)

Now I know you agree the system needs improvement




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I do have problems... Lots of them... With dsm. (Apparently they dropped the #). But the article's claim didn't make sense to me regardless. I honestly don't know how a dr with a full case load is supposed to absorb this but what-ev. The statement in your article is not in context and therefore misleading (I stand by that ). You can't diag somebody as bipolar based on a reaction to an AD. In fact it excludes a diag based on substance abuse altogether (your situation). You have to have 5 out of 9 criteria plus (emphasis mine)...

"Where DSM-IV required, as criterion A, the presence of one of the two mood symptoms (elation/euphoric or irritable mood), in DSM-5, ‘the mood change must be accompanied by persistently increased activity or energy levels’. This new rule is, of course, more restrictive and excludes all individuals who report only one of the three entry symptoms and those with both elated and irritable mood. Thus, for no apparent reason, DSM-5 classifies some patients as having subthreshold bipolar disorders who would formerly have been diagnosed with manic episodes or bipolar I or II disorders. This strict new rule is not based on data, indeed it contradicts available evidence. As the international Bridge Study of 5,635 patients seeking treatment for major depressive episodes demonstrated clearly, any of those three gate questions is valid on its own, according to the criteria established by Robins and Guze (1970) and Angst et al. (2012).

Exclusion criteria
One important and amply justified change in DSM-5 concerns the diagnosis of bipolar II disorder. In DSM-IV, the change of major depression into hypomania under antidepressant treatments (ADs) was in principle an exclusion criterion. In DSM-5, that change - provided it persists at fully syndromal level beyond the physiological effect of the treatment - is explicitly a criterion for bipolar II disorder. DSM-5, like DSM-IV, allows some scope for clinical judgment as to causality. In addition, DSM-5 provides new formal criteria for substance/medication-induced bipolar and related disorder."

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I don't know how old Hellion is our how much of this applies to her.

I totally agree that genetics is not some set of fixed phenotypes and characteristics. Genes are turned on and off all the time and affected my environment. Gene expression is happening all the time in all your cells. I totally agree. However it is a grey area. You cannot use CBT or diet or social activities to change your eyes from blue to brown. So which phenotypes can be changed and which one not? Very complex question.

In my case maybe it was to late. I was diagnosed and got clean and sober at 32. While all the work I did to stay clean and sober worked and maybe even changed my epi genetics, and probably did. But it didn't fix the depression despite all the meds and therapy and exercise and spiritual practice and on and on. Now that could be that a pattern had become so ingrained that it was just to late and I was treatment resistant. Or (my belief) that it is just so ingrained in me genetically that those switches and phenotypes whatever they are just could not be changed by environment just like I can't change my blue eyes to brown. I have worked so hard for so many years and here I sit.

Maybe it is possible that early intervention when I was 14 could have made a huge difference and avoided meds later in life. I was pretty open to counseling to some degree and even went a couple of times as a teenager at my mothers urging. We would have had to address the drug and alcohol issues first which is what my mom was trying address. She didn't have a clue about the depression even though she worked in mental health. I was not willing to address the drugs and alcohol at that point. But forget about me.

The grand kids and breaking the chain. My nephew from the organic farm family decided on his own (largely due to me and my brother having been sober for so many years) to get clean and sober at the age of 16. That's a young age but he had a good enough bottom for him. Drinking bottles of cough syrup, came real close to a suicide, all kinds of things. His parents sent him to a wilderness/ recovery type camp in Colorado. He says he found himself on that mountain and it was life changing. He has been gung ho AA ever since. He is 23 been sober ever since, is on no meds, about to graduate as an engineer and go on to get a masters. Very well adjusted and happy kid. An awesome early intervention success story.

My other nephew with the mild symptoms. Mood and lack of friends. i really don't know all the symptoms because by brother hasn't talked to me about it and I am not around him enough. I did spend a week with him last summer and he was very quiet and into reading and video games. He took a liking to me. I am sure knowing his parents and my brother, even though my brother was raised by a pharmacist as I was, that they very much want to avoid meds. I hope my brother reaches out to me because I am very much going to push the therapy no meds route with a therapist that specializes in teens. And all the other social things you suggest. I am very confident that with this early intervention he will adapt and figure out how to function and works best for him without meds even if he has a genetic pre disposition. As you said Steve Jobs was able to do. Those case are kind of special though. If he had attempted suicide or self harm or drug and alcohol issues then maybe a different intervention would be needed and maybe even meds. Or if his symptoms keep getting worse and worse into his 20's despite treatment that might be different. One thing he is gonna need if it is serious is a learning curve by his parents which is why I hope they reach out to me.

I hope some of this does help Hellion. I will have to read the part on your family again later.

Here is someone from this forum who posted in the Fetzima thread.

Current Diagnosis - Bi Polar with mixed mania
He blogged about it.

Http://livinginthewell.wordpress.com

You didn't provide a source for the above info. I am assuming mad in america.

Are we looking at the same website because I just surfed a ton of pages and have not seen an ad. Now most pages are diverting me to sign up for free. Maybe i have a pop up blocker or something else blocking the ads. i do have a few tools running. mainly a program called disconnect that blocks them from tracking me and is probably blocking the ads too. And i can't find an editorial statement. Anyways here is a link to the editorial board with financial disclosures. All from universities. You are suggesting they are purposely editing out evidence that would go against their theory. that is a strong charge given their credentials. they don't seem to be married to a theory but are writing and article based on gathered evidence. Experts from universities like Harvard carry alot of credibility with me. I must be blocking all those ads you are showing in your screen shots. Yes the site will lose a lot of credibility with me if it has all those ads. It look like it is owed my UBM Medica Network who owns a bunch of sites and they are probably who makes the money on the ads. I don't know if that ruins the credibility of the editorial board and content of the site. You say that is the new model. So maybe not a good source for me to point to.

Editorial Board | Psychiatric Times

Lets try this website which is the section editors website and says doesn't collect any info and doesn't make any money on it other than from his book. I haven't read it and it is only one doctor.

Bipolar II, Mood Swings without Mania; Brain Tours; Stress and Depression; Hormones and Mood; and more...

Regardless I am not the one arguing that taking an AD that triggers mania should be a sole criteria for a bi polar dx. I have never argued that. You are the one saying that AD's in someone who is truely MDD only can cause that person to develop bi polar. That AD's alone can cause bi polar in someone who never had it. I am arguing that that is not true. DSM 5 and the new distinctions are saying that if AD's trigger mania and along with that certain common symptoms of mania are present then that person belongs on a spectrum of bi polar or a sub diagnosis of bipolar. Bi Polar I, Bi Polar II, Switched Mania, Mixed Mania, somewhere on the lower side of the spectrum. I believe this is true. We both know that my initial meth withdrawal full blown mania and dx was totally wrong. They have sorted that out in the years since. Right now with my reaction to Fetzima to new DSM 5 would say I am switched mania. Looking over my history the most accurate dx for me is bi polar two. Now there labels matter in whether to prescribe a mood stabilizer or not.

So a pdoc would most likely add a mood stabilizer and not take the AD away. Which is exactly what happened to me recently because of rapid cycling. He didn't tell me what he was thinking for some reason and maybe he didn't want to add that label because it didn't really matter I was going to take the Lamictal anyway. I am going to have a talk with him about that. All I know is he read my mood journal, we talked about the rapid cycling i was having and right away he suggested Lamictal. I hadn't heard of it but at that point I was willing to go with his advice. Now I know what he was thinking. When i looked it up later I assumed it was for an AD augmenter which it is also being used for.

So its complicated and yes surely I would agree psychiatry needs improvement. I however have much more faith in the motives of those in the field. It is my nature to have faith in humanity in general. I don't believe docs are in the back pockets of pharma reps some are influenced by them and buy the latest line or are desperate for something new to come out to try because so many things don't work. My brother in law was a drug rep for Pfizer the giant for many years. We are very close and talked about it all the time. He was always pissed because about half the doctors in practice he could see refused to see any drug reps period. Just flat out refused. Those docs deserve credit. Then the gov outlawed a lot of the stuff that was going on. He could no longer set up big lunches for the doc and all the staff, couldn't hand out pens and gifts anymore, no doughnuts. And Pfizer has made huge cut backs in their drug reps and advertising. Yes it is true. They cut about half of their drug reps. He was the number one salesmen for many years and won all kinds of awards and trips and stuff and even he got cut and no longer works there. i am selling Viagra and Chantix pens on ebay and I have boxes and boxes of them because he couldn't hand them out anymore. Want some Viagra pens I will send you some. the Chantix ones i have are the best quality and nice pens, everyone wants them.

And i cannot believe that heads of psychiatry at hospitals and universities and researchers are all so corrupt. Call me naive but i think the vast majority of them are in search of truth and want to help people. There are cultures of corruption that run amock in fields for sure. Politics is the worse, wall street second......the sciences last. I just don't believe the whole field is in the back pocket of big pharma. Big pharma, hospitals, insurance companies, the AMA, this trade group and that trade group all have huge lobbies and influence in Washington. Researchers battle for NIH money. But the sciences are the least corrupt. NIH, NIMH, Large universities, university hospitals, private start ups, foundations, and yes even big pharma all do very good work. They are working to advance the body of knowledge in the medical sciences. It is not all greed, corruption, and alterial motives as you seem to believe. So we differ on our level of faith in the field primarily it would seem. So that is my rant and naive faith in humanity.

And another thing. My Dad is a pharmacist, by brother is a pharmacist, my sister in law is a pharmacist, and then there was that outcast brother in law who worked for pfizer. All my Dads friends were Docs when I was growing up. My brother and sister in law owned a pharmacy in a hospital. They are very involved in the medical community in their town. We talk about these issues ad nauseam. Most pharmacist and docs hate drug reps but they will take their pens and let them make their little speal. That's why I kid about my drug rep brother in law being an outcast. Sure they are influenced by this factor or that factor. Drug reps being a very small factor. I have known all these people my whole life, not just my family but all the docs my dad and brother know and all the conversations we have had. These are good and honorable people trying to do the right thing and sometimes stumbling in the dark with the rest of us. They are certainly not corrupt and actually try to take steps so as not to even appear to have a conflict of interest. My rant and my experience.

And I know Big Pharma's current strategy. They decided to stop targeting docs so much, which is why my brother in law, top regional salesmen for many years for pfizer got let go, and they decided to put their money into targeting consumers with direct ads. And a patient walks in and says I want abilify and that has an influence. A good doc won't let that influence them. I don't know how much influence it really has. Doctors are smarter than that.

I went into my pdoc in CA after I was already on albilfy and he told me if let everyone who walked and asked for ablilfy have it Kaiser would be broke. At 600 bucks a month they would be broke. So he was protecting his employer. The only reason he let me have it is because I was already on it. So he thought it unethical to take me off of it. Kaiser puts together a formulary based on a panel of experts who evaluate the safety and effectiveness of new drugs. They might say that cost doesn't play into the decision but it certainly does. That goes against big pharma. All the drug companies would love their newest drugs covered by all insurance companies. It doesn't happen that way. Maybe they negotiate for huge discounts and get them once they approve a drug for their formulary but I don't think big pharma has a big influence on that panel making that decision. I had Kaiser for many years and I really believe they want the best patient out comes. And of course costs play a role or they would be out of business. They are a non profit insurance medical provider all rolled into one.

Or take medicaid and medicare. Generics only baby. If you want brand names you pay big bucks. Medicare has four tiers, number one tier is generic and no copay. If you want tier 4 brand name you pay huge copay. So in spite of all the ads the incentives are to go with generics. With big pharmas huge lobby how is this true. If you pay out of pocket what are you gonna get? The latest and greatest brand name or a generic? Even if the brand name would work better for you. I may soon be screwed with Fetzima, the one drug has worked the best for me because of insurance and costs. That drug company will be SOL too.

Yes it is.


Those ads are chose based on your browsing history. If you are blocking tracking you get ads geared toward the primary audience. The primary target audience is other professionals and students (it's in the tag line). Thus college ads. They probably see me coming from psych central and identify me as a patient thus seroquel.

The financial disclosure for the founder and chief states over 10k in stock with forest laboratories... The maker of celexa and Lexapro. There is nothing wrong with using these sites as a source of information. It is important, IMO, to question who pays for it and the information provided. Questioning journalistic integrity is healthy, no?

Everybody has a POV and edits what they choose to publish based on it. The NYT is liberal bent. Fox is right leaning. They are pro med.


His intentions might be good but he is still pushing the chemical imbalance theory. Couple that with his misinterpretation of dsm and I don't have much faith in this guy. Please let's not go down the imbalance argument. That's not my intent. I am just saying I don't buy it and as such this guy isn't going to carry a lot of weight for me.


The first article implied it so I assumed that is what you are saying. That is the author of the link above too.

In my second post on the subject I said that was really a misnomer... Cause the "symptoms of bipolar". That is different. However I don't think we can say it doesn't. If you keep giving a person antidepressants and they keep having episodes they can have them on their own. This was discussed at a bipolar seminar I attended a few years ago at university of Colorado. This can happen when a patient fails to accurately share their complete history or the doc fails to ask. I advocate that people bring a friend or family member and this is one reason why. I still believe if we could make the connection definitively we would have the equivalent of a blood test.

I didn't say they are all corrupt. I find that statement to be unfair. Scientists often stick to their morals no matter who is paying. But marketing is very powerful and clever. What they choose to publish is controlled as much as they can. IOW, they have rules on what papers to publish but there is no oversight so they are broken all the time. A dr did data research on this. Pharma also decides what they fund. They are beholden to stockholders and stockholders aren't going to fund research in lavendula which grows wild in the fields. Schools are also tied to researching what they get funding for. Every grant comes with stipulations. So it isn't a matter of researchers doing corrupt things. It is a matter of what they are allowed to focus on. Even students have ambitions. Do they want to work for private or nonprofit? It very much effects what projects they take. It isn't cut and dry either. Some people work private so they can independently fund what they believe in.

If you read mad in America and if your read Whitaker's book you will see that not all people are looking to topple the system or discount what patients gain from the meds. They are looking to make the system work better not tear it down. I always find it odd how people who defend the system refuse to read books like anatomy of an epidemic so there is a challenge for you. What are you afraid of? A huge reference section is included. I looked quite a few of those up too

If you have been reading carefully you know I have not discounted the use of meds as a tool. I don't believe the world is black and white. I also am not going to accept the status quo or fail to draw my own conclusions and ideas simply because I lack the "proper credentials". I do think there are some bad apples and have even met some. Those people do a lot of damage to patients and the industry. If you want to get mad at somebody get mad at them.

Footnote on big pharma sales jobs. I have been to many Microsoft sponsored events over the years. I know how it is. You go to these things and you learn a ton about the products and benes at the exclusion of any information about oracle or wordpress. Free enterprise. It's pretty transparent. But pharma has strategically placed booths at the APA conferences. I can't imagine how doctors could not be influenced by those booths... Compliments and samples and free education. So on it goes...



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I'm surprised kaiser paid for abilify. They refused to even prescribe Lamictal and it was generic at the time. That's why I won't go back. Their formulary is all about cost. I didnt know they even denied that. But I don't completely disagree with the generic route. You can get a part d plan to cover branded drugs in fact there are classes of drugs where they are required to cover most of them. Psychotrophic drugs is one of those classes. That was a big controversy this year. Medicaid probably is all generic, idk. I just know about the part d controversy.

Insurance companies do pay for branded drugs just not that one. I wouldn't feel too bad for big pharma. They also make money off of generics and "me too" drugs. And there isn't a whole lot of research in antidepressants anymore so those new ones are just a tweak hear and there. It's all marketing. They use coupons to lure patients in. The problem is insurance co's never see what big pharma is covering so they can't properly budget the true cost of these drugs. The war between the two industries has been raging for a while.

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Kaiser only pays for abilify as an anti psychotic and not as an augmenter to an AD. the only reason I got it was because I was already on it. It seems from what I have heard Kaiser CA is better than in a lot of other areas of the country. I don't think their formulary is totally based on cost but is based largely on the best patient outcomes. They won't accept a brand new drug right away even if it might me beneficial because they will wait for more clinical data to come out. Or TMS. They won't adopt it until the clinical trials are done are there is a lot of evidence that it works. If it works they will adopt it.

I don't feel sorry for big pharma at all. My main point is that in the big picture with insurance companies making formularies, and medicaid, and medicare, and generics, and peoples pocket books involved that is a lot of force going against big pharma. Medicare may have to make name brands available but they are tier 4 and huge copay. That is part D. My parents have part D and they get all tier one generics except for a couple where they just have to have the tier two brand name. that is 50 bucks copay. the expensive brand names are tier 4 and a very big copay. so all the incentive is to go generic.

I am not defending big pharma at all. I am saying they do not have near the influence you seem to believe they do. I am defending researchers and doctors and hospitals and the integrity and good intentions of their research. Of course any researcher, or scientist, or editor has a point of view and will tend to ignore evidence to the contrary. It is human nature. If they follow proper scientific method they should be able to weed out their own bias.

I am saying that big institutions like NIH, NIMH, Mayo Clinic, John Hopkins, Harvard and the like I have a lot of respect for and is who I look to for research. NIMH grants and university research has worked very well and has served us well over all. As well as small start ups in genetics, and med delivery systems, and imaging techniques in silicon valley with venture capitalist. Very similar to the hey day of tech companies in silicon valley. Biotech companies are all over there and in the Santa Cruz mountains. Where did MRI's and Pet Scans and ultra sound and all those come from. Huge break troughs. We are going to see the same think in brain research and psychiatry and genetics and personalized medicine. I have great faith in our system. It is amazing in my view.

Of course there are problems and we should work to make it better. But we have to acknowledge it ain't all bad. I am not afraid to read material that points out problems in our system. I am not a huge fan of trial lawyers and class action law suits but they have their place.

I watched all the coast guard hearings on the BP oil spill. These were the hearings that got into all the nitty gritty detail and tons of witnesses. Hours and hours of it. It was all on C-Span and I watched it. BP took some big short cuts to stay on schedule because that rig was scheduled to move to another site. It was already behind schedule. The extra steps they should have taken were not that expensive but they were time consuming so they went without them and the concrete job that was supposed to seal the well didn't work and it blew. That simple and they are gonna pay through the *** for it.

Then the latest thing with GM sitting on info they had about a safety issue for two years because of whatever pressures they were under. The trial lawyers should go after them and GM is gonna pay big.

If a drug company sits on info they know would be harmful to patients then go after them.

But trial lawyers get over zealous and hurt the system too. A lot of law suits hurt the system as a whole. One example is mal practice insurance docs have to pay. They can barely have a private practice because of it. Most would rather go to a hospital and work so they don't have to worry about it. Overall the trial lawyers as far as doc mal practice have not served us well.

If I choose to take Klonopin knowing the risks full well and then five years later when I am almost dead with withdrawals should I be able to sue the manufacturer and win?

Or vaccines. They have saved millions and millions of lives over the years. But every time a certain number of a certain vaccine is administered a certain percentage of people is going to die. Does that mean the manufacturer should be sued and bankrupted. Or that we should not give vaccines.

I am sure there are bad apples and greedy people in the field who do a lot of damage. Blatant greed, corruption, and neglect and incompetence should be gone after. However the medical arts and especially mental health is a risky business and we as patients and society have to take on some risks and not cry and sue every time something goes wrong or there is an adverse effect or something happens that no one could have for seen.

Of course a stock holder owned company is not going to pursue research that isn't going to be profitable. That doesn't mean all their research is invalid. Even big pharma research over all has made a big contribution to the system. That is just one part of it. many miracle drugs came out of drug company research.
And if some researcher can write a grant proposal to NIH and make a good enough evidence based case to them on lavendula they may just get funded.

I think it will evolve for the better and yes we need to be agents of change.

Oh and the whole bi polar thing. I forgot where we were and I am tired but the truth is I don't know much about it. I just went with a gut reaction on why I didn't agree with the whole med causing a dx or symptoms. I don't know. I like to take opposing views for the sake of argument. It's educational and good debate. I don't think the people that have to come up with the DSM and wrangle with all those issues have any ill motives. They are stumbling around in the dark with the rest of us trying to find the right approach..........I am tired but I haven't given up yet.