![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by MB on June 26, 2001, at 15:14:28
I need to hear some feedback from people who have been to the Amen Clinic For Behavioral Medicine. I am trying to decide whether or not to make an appointment to go there. I really feel like I need to be on some sort of medication, but the meds I've tried have made me feel worse, and feel like I'm being misdiagnosed, maybe. Has anyone on this board had any experience with this place?
Posted by MB on June 26, 2001, at 22:42:56
In reply to Amen Clinic, posted by MB on June 26, 2001, at 15:14:28
I think they are callng me tomorrow. Should I make an appointment? I need to know what to do. It's expensive, but would be worth it if I could get on the right meds! Does anybody have any experience with this place that does the SPECT scans?????
Posted by Lorraine on June 26, 2001, at 23:36:13
In reply to Does anybody know anything about this place?--help, posted by MB on June 26, 2001, at 22:42:56
> I think they are callng me tomorrow. Should I make an appointment? I need to know what to do. It's expensive, but would be worth it if I could get on the right meds! Does anybody have any experience with this place that does the SPECT scans?????
I'm sorry, I don't know anyone who has used them. I've read two of his books and like them quite a bit, but who knows things are still pretty experimental, I'd say. But, hey, I don't shy away from experimental. I'm doing neurofeedback at EEGSpectrum, which has a reputation for being one of the best places to do neurofeedback, which, like, scans, is just evolving.
I do see a neurologist who did a QEEG on me, performed a correlational analysis using a data base of 8,000 patients, and prescribed meds based on this. I really can't say if this was a useful approach. He told me that his data-base indicated that I should be on stimulants and mood stabilizers, which haven't really been fully satisfactory although I've had some response.
What I see Amen doing, especially in his latest book, which is on ADD is trying to use his scans to prescribe meds. In his book, he comes up with a number of different forms of ADD based on his scans. I think what he's really doing is saying that all of these DSM categories that we have been using are bumpkiss because they have no physiological underpinnings. That's what my pdoc says as well. I believe that these guys are onto something, but I don't know that they have enough experinece years or data behind them to make accurate predictions about med response.
Also, with my pdoc, it bothered me that once he took my QEEG and did his analysis, he never went back to see if his approach was affecting my brain waves the way he thought it should. The cost of redoing the QEEG was prohibitive so I declined that option. Then when I started doing this neurofeedback, they did a quick-and-dirty scan and I had them print it out so that I could take it to my pdoc. What it showed was that the "spiking" or subthreshold seizure activity that he had spotted originally was not being affected by the meds he prescribed. When I pointed this out to him, he said (you guessed it), "You're right!"
So--here's my long winded point--make sure that if he is prescribing meds based on scans that he has a way of getting feedback on his methodology without costing you and arm and a leg. I would also ask him a lot of questions before I committed, like: what is his success rate? can you talk with other patients who have your type of problems to see how happy they are?
Posted by MB on June 27, 2001, at 10:55:32
In reply to Re: Does anybody know anything about this place?--help » MB, posted by Lorraine on June 26, 2001, at 23:36:13
This is all good advice. I think a SPECT scan will cost (gulp!) $2000, which wouldn't be that bad if it guaranteed successful medication...but if it's going to cost an additional $2000 to get a follow up (to test medication) it's not worth it. I will grill them if they call today. I think followup will be my focus...if they just take people's money, prescribe, and then turn them loose, I will definitely steer clear.
Posted by stjames on June 27, 2001, at 12:29:08
In reply to Amen Clinic, posted by MB on June 26, 2001, at 15:14:28
Dr. Amen is the expert on ADD. A person on the ADD list went to get a consult. She found it to be very through, a whole day affair. I think Dr. Amen makes med and treatment recommendations, then you can continue with a local pdoc, based on his recommendations.
James
Posted by Elizabeth on June 27, 2001, at 23:02:08
In reply to Amen Clinic, posted by MB on June 26, 2001, at 15:14:28
No experience with them, but I do have a general idea of what they're about: using imaging studies to make predictions about medication response. I like the attitude they have about medication: very practical, use-what-works, with an emphasis on trying to figure out how to predict what that will be.
I'm sort of skeptical about the reliability of functional brain imaging in this area, although I'm open to the possibility that these folks have collected enough data over the years that they can use the technology to predict treatment response.
I had a SPECT scan lately, and to nobody's surprise, it showed some abnormalities that are typical of depression (I was off ADs at the time). I have thought about getting the hospital where I had it done to forward the records to the Amen Clinic or a similar facility for clinical correlation; I wonder if they'd do that.
-elizabeth
Posted by MB on June 28, 2001, at 1:47:22
In reply to Re: Amen Clinic » MB, posted by Elizabeth on June 27, 2001, at 23:02:08
I bet they would do that. I've heard of people having scans done at the University of Oregon in Eugene, having the scans sent to California for evaluation, and getting feedback from the clinic that way.
> I had a SPECT scan lately, and to nobody's surprise, it showed some abnormalities that are typical of depression (I was off ADs at the time). I have thought about getting the hospital where I had it done to forward the records to the Amen Clinic or a similar facility for clinical correlation; I wonder if they'd do that.
>
> -elizabeth
Posted by MB on June 28, 2001, at 1:55:20
In reply to Re: Amen Clinic, posted by stjames on June 27, 2001, at 12:29:08
I wonder if I should even take the time to go there. I highly doubt that I have ADD...most of my trouble has to do with inappropriate mood fluctuation. Antidepressants and stimulants make it *harder* for me to focus and sit still. I was hoping that with a SPECT scan they could tell me why, when I seem to have depression, SSRIs make me so freaky (racing thoughts, inability to focus, mental and physical tics, etc). The web site seemed ADD oriented, but I was hoping they could also treat mood disorders.
> Dr. Amen is the expert on ADD. A person on the ADD list went to get a consult. She found it to be very through, a whole day affair. I think Dr. Amen makes med and treatment recommendations, then you can continue with a local pdoc, based on his recommendations.
>
> James
Posted by Lorraine on June 28, 2001, at 10:29:56
In reply to Re: Amen Clinic, posted by MB on June 28, 2001, at 1:55:20
Look, you have to call and ask some of these questions, which are all good. You lose nothing in the phone call. Amen's first book is about all mood disorders and his second, although it's emphasis is on ADD discusses other mood disorders in this context--I think some of his subclassifications border on non-ADD diagnosis. Anyway, CALL. It's worth finding out. I don't think he's a fraud or anything like that.
Posted by Elizabeth on June 29, 2001, at 19:19:12
In reply to Re: Amen Clinic, posted by MB on June 28, 2001, at 1:55:20
> Antidepressants and stimulants make it *harder* for me to focus and sit still.
Have you tried anticonvulsants or lithium?
-elizabeth
Posted by Lorraine on July 1, 2001, at 11:18:51
In reply to Does anybody know anything about this place?--help, posted by MB on June 26, 2001, at 22:42:56
MB: Do keep us posted on this. I am VERY interested in what they say to your questions. We need trail blazers. I'm blazing away on neurofeedback. (The jury's still out, but the meter is definately running:-))
Posted by MB on July 2, 2001, at 17:25:54
In reply to Re: Amen Clinic, posted by Lorraine on June 28, 2001, at 10:29:56
Yeah, you're right, I should call them back. I was out when they called me, and I never returned the call...nervous, I guess.
Posted by MB on July 2, 2001, at 17:37:02
In reply to Re: Amen Clinic » MB, posted by Elizabeth on June 29, 2001, at 19:19:12
> Have you tried anticonvulsants or lithium?
>
> -elizabeth
I've taken Neurontin and Tegretol before, but not in a way that would be scientifically meaningful. I took Neurontin for a short time. It was prescribed experimentally by a neurologist whom I saw due to "restless leg syndrom" (or something that resembled it). It was like taking a sugar pill. I could take handfulls of it (the RLS was agonizing) and not even notice.When I took tegretol, it was only for a few days. I had checked myself into a detox program (I had been using alcohol and opiates to alleviate depression). They wouldn't let me have my Xanax (which I had been taking as prescribed for six months, and which I was *not* abusing) so they put me on tegretol so I wouldn't have seizures. Parenthetically, when I left that place, and asked for my bottle back, I found that the staff had been eating my Xanax.
Posted by Elizabeth on July 3, 2001, at 15:12:20
In reply to Re: Amen Clinic, posted by MB on July 2, 2001, at 17:37:02
> > Have you tried anticonvulsants or lithium?
>
> I've taken Neurontin and Tegretol before, but not in a way that would be scientifically meaningful. I took Neurontin for a short time. It was prescribed experimentally by a neurologist whom I saw due to "restless leg syndrom" (or something that resembled it). It was like taking a sugar pill. I could take handfulls of it (the RLS was agonizing) and not even notice.It's not so great for RLS, I guess! In that case, can I suggest giving it
> When I took tegretol, it was only for a few days. I had checked myself into a detox program (I had been using alcohol and opiates to alleviate depression).
A common story. (Unfortunately, "medically supervised detox" is a form of torture that's still accepted in the modern world, for some reason.)
> They wouldn't let me have my Xanax (which I had been taking as prescribed for six months, and which I was *not* abusing) so they put me on tegretol so I wouldn't have seizures.
It does help people get off benzos (at least by reducing the risk of seizures). But yanking someone off of Xanax cold-turkey is just *wrong*. (IMHO)
> Parenthetically, when I left that place, and asked for my bottle back, I found that the staff had been eating my Xanax.
Jeez. That's disgusting. When I was hospitalised (for coma and respiratory problems) in February-March, the paramedics asked my boyfriend for all my medications, supposedly so they would know what I was on. When I got them back, the benzos and Soma had mysteriously vanished. Take note, everyone.
-elizabeth
Posted by toluened on November 29, 2003, at 1:20:28
In reply to Re: Does anybody know anything about this place?--help, posted by MB on June 27, 2001, at 10:55:32
> This is all good advice. I think a SPECT scan will cost (gulp!) $2000, which wouldn't be that bad if it guaranteed successful medication...but if it's going to cost an additional $2000 to get a follow up (to test medication) it's not worth it. I will grill them if they call today. I think followup will be my focus...if they just take people's money, prescribe, and then turn them loose, I will definitely steer clear.
My experience at the Clinic has been excellent. They are all staffed by dedicated professionals. SPECT imaging has shown itself to be a useful, powerful and accurate tool. But the focus of treatment is the mental and physical health of the patient. As for prescribing meds, the doctors know what they are doing, and the application of medications, if any, is combined with skilled and well-trained psychotherapy where appropriate.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.