Shown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by spike4848 on January 20, 2002, at 23:12:21
Hey Guys/Gals,
Anyone ever been treated by the famous Dr. Goldberg? How was his suggestions? How much does he cost? I am here in NYC and thinking about it.
(Sometimes I think Elizabeth, Cam, IsoM, OldSchool and the rest of the pbabble members have just as much or more information than any overpriced psychopharmacologist!)
Thanks
Spike
Posted by IsoM on January 20, 2002, at 23:52:15
In reply to Dr. Ivan Goldberg, posted by spike4848 on January 20, 2002, at 23:12:21
Nice improvement in the intro, Spike! So, you think we're as good perhaps? And much cheaper - I mean, how much cheaper can you get than free? And some of us are pretty good on the psychotherapy part too. But sorry to say, I just get treated by the local help. Never got anyone fancy like Dr. Goldberg.
> Hey Guys/Gals,
>
> Anyone ever been treated by the famous Dr. Goldberg? How was his suggestions? How much does he cost? I am here in NYC and thinking about it.
>
> (Sometimes I think Elizabeth, Cam, IsoM, OldSchool and the rest of the pbabble members have just as much or more information than any overpriced psychopharmacologist!)
>
> Thanks
> Spike
Posted by IsoM on January 21, 2002, at 1:58:26
In reply to Dr. Ivan Goldberg, posted by spike4848 on January 20, 2002, at 23:12:21
Spike, I've been to Dr. Goldberg's website to check on articles before & just went back tonight to see something. I'd never clicked on one link before (seeing I live in Canada) but here's a link in his site on the best practising psychiatrists in the US, specialising in treatment-resistant depression. Why not take a look?
Posted by OldSchool on January 21, 2002, at 9:38:30
In reply to Dr. Ivan Goldberg, posted by spike4848 on January 20, 2002, at 23:12:21
> Hey Guys/Gals,
>
> Anyone ever been treated by the famous Dr. Goldberg? How was his suggestions? How much does he cost? I am here in NYC and thinking about it.
>
> (Sometimes I think Elizabeth, Cam, IsoM, OldSchool and the rest of the pbabble members have just as much or more information than any overpriced psychopharmacologist!)
>
> Thanks
> SpikeIve been impressed by Dr. Goldberg's knowledge as well. One thing Ive observed about him, at least thru stuff he has posted on the Internet is that he seems very direct and straightforward. No bull...cut thru the crap. I appreciate that A LOT in this screwed up world we call psychiatry.
I like the way he writes. Very concrete and tangible writing style. No psychology BS. To Dr. Goldberg you have a mood disorder, which is a medical condition treated by drugs.
Id also like to say that if I had not become a self educated patient like Ive done, I would probably be dead by now.Old School
Posted by spike4848 on January 21, 2002, at 10:33:39
In reply to Re: Dr. Ivan Goldberg, posted by OldSchool on January 21, 2002, at 9:38:30
> Id also like to say that if I had not become a self educated patient like Ive done, I would probably be dead by now.
>Old School
Yes .... I agree .... I would have give up hope years ago if I didn't keep up to date current knowledge. The problem is so much of the literature is crap! Sorry. So much of the literature is bias by big pharmaceutical drug companies and physicians publishing questionable data in order to further their career, it gets hard to decipher.
That is why I think some of the best info come from p-babble. We are just individuals fighting a disease. We come together to trade ideas and experiences to improve our health. So the quality of material maybe better here than from any journal or pdoc. The difference between us and pdocs .... we live our illness/we have taken the medications/we know the results/we live with the side effects!
Spike
Posted by OldSchool on January 21, 2002, at 11:13:50
In reply to Re: Dr. Ivan Goldberg » OldSchool, posted by spike4848 on January 21, 2002, at 10:33:39
> > Id also like to say that if I had not become a self educated patient like Ive done, I would probably be dead by now.
>
> >Old School
>
> Yes .... I agree .... I would have give up hope years ago if I didn't keep up to date current knowledge. The problem is so much of the literature is crap! Sorry. So much of the literature is bias by big pharmaceutical drug companies and physicians publishing questionable data in order to further their career, it gets hard to decipher.Yes I totally agree that much of the info provided by the pharmaceutical companies is pure, unadulterated crap. I dont listen to everything I read or hear about psych meds. I make my own decisions and I think independently.
I personally believe the pharmaceutical industry is holding back a lot of good potential new ideas and research in psychiatry. For example I wouldnt be surprised at all if this new Selegiline MAOI patch gets blocked by the FDA for commercial and political reasons. Such as I bet you that the companies that market SSRIs will try to block the MAOI patch as this patch might end up being BIG competition for the SSRIs. Because it will probably be a much better antidepressant, more likely to create full remission, etc. etc.
Im very skeptical the MAOI patch will be FDA approved here anytime soon. If at all. For basically the same reason Moclobemide is not marketed in the USA. Moclobemide which is a "safe" RIMA MAOI, while certainly not as robust or effective as the older irreversible MAOIs, it certainly has some potential to fight TRD. Moclobemide is a good general antidepressant and frankly it would provide a good deal of competition to the SSRIs, which are HUGE moneymakers for the drug companies.
>
> That is why I think some of the best info come from p-babble. We are just individuals fighting a disease. We come together to trade ideas and experiences to improve our health. So the quality of material maybe better here than from any journal or pdoc. The difference between us and pdocs .... we live our illness/we have taken the medications/we know the results/we live with the side effects!I just have a general bad attitude towards psychiatry in general. I dont like it basically. All I can say is if I had not made it my goal to learn about this stuff on my own, well Id probably be gone a long time ago.
Old School
Posted by Bekka H. on January 21, 2002, at 13:21:11
In reply to Dr. Ivan Goldberg, posted by spike4848 on January 20, 2002, at 23:12:21
> Hey Guys/Gals,
>
> Anyone ever been treated by the famous Dr. Goldberg? How was his suggestions? How much does he cost? I am here in NYC and thinking about it.
>
> (Sometimes I think Elizabeth, Cam, IsoM, OldSchool and the rest of the pbabble members have just as much or more information than any overpriced psychopharmacologist!)
>
> Thanks
> Spike
*************************************************
Hi Spike. Some time ago I contacted Goldberg because I wanted to schedule a consultation. His initial fee was quite expensive (at least $500.00, and that was several years ago), and what really put me off was that he wanted to be paid HALF of the initial consult fee BEFORE I ever saw him. I'm sorry, but I come from a medical family, and that's not the way the doctors in my family do things. My grandfather (an old fashioned GP) used to treat poor people for free or nearly nothing. While I don't expect Goldberg or anyone else to work for free in this day and age, I certainly do not expect to pay in advance either. I have to say that Goldberg's website is excellent, but the question is, does an excellent website mean that he is excellent? Perhaps it does, or perhaps he pays some hard working research assistants $5.00 an hour to put his website together for him? If I had had better experiences with psychopharmacologists in the past, or if I had never had some of the huge disappointments I've had with psychopharmacologists, I probably would have been less cynical about Goldberg and would have gone ahead and scheduled an appointment; however, given the vast amount of information available online (thanks in part to Goldberg) and given the high level of discourse available on Psychobabble, in addition to my own interest in the field, I feel I can go to a much less costly psychopharmacologist and make up my own mind WITHOUT being taken to the cleaners.
Posted by Bekka H. on January 21, 2002, at 13:40:03
In reply to Re: Dr. Ivan Goldberg, posted by OldSchool on January 21, 2002, at 11:13:50
> > > Id also like to say that if I had not become a self educated patient like Ive done, I would probably be dead by now.
> >
> > >Old School
The problem is so much of the literature is crap! Sorry. So much of the literature is bias by big pharmaceutical drug companies and physicians publishing questionable data in order to further their career, it gets hard to decipher.
>
> Yes I totally agree that much of the info provided by the pharmaceutical companies is pure, unadulterated crap. I dont listen to everything I read or hear about psych meds. I make my own decisions and I think independently.
>
> I personally believe the pharmaceutical industry is holding back a lot of good potential new ideas and research in psychiatry.
*************************************************In my experience, everything above is absolutely true. I have worked on a number of clinical studies, and the pressure on reseachers to "publish or perish" is immense, and often forces even the honest ones into unethical behavior. Just this week on Medscape, there is an article about investigations into fraud in Britain. AT LEAST 5% of all drug trials in Britain are plagued with fraud, and I imagine that figure is just as high or higher here in the U.S. Two summers ago, I learned from a similar article about clinical trials in the U.S. that at least 50% of all doctors who are involved pharmaceutical research receive money from the drug companies for their research. Now, are the pharmaceutical companies really going to keep doctors who speak the truth on the payroll?
Posted by spike4848 on January 21, 2002, at 14:38:27
In reply to Re: Dr. Ivan Goldberg, posted by Bekka H. on January 21, 2002, at 13:40:03
Two summers ago, I learned from a similar article about clinical trials in the U.S. that at least 50% of all doctors who are involved pharmaceutical research receive money from the drug companies for their research. Now, are the pharmaceutical companies really going to keep doctors who speak the truth on the payroll?
Hey There,
Yes .... I get taken out by drug representatives alot. They take you to nice dinner .... give you alot of free samples and toys for the office .... all the while pushing their drug and trashing the opponents drug.
If a medication is useful .... I will use it. Why do drug companies need to pay individuals(drug representatives=cheerleaders) to convince you there product is superior? Probable because in reality, their drug is inferior. It is a shame .... medications that affect the quality of people's lives .... all caught up in marketing schemes. Why ... so the president of the drug company can make his payments on the second house in the Hamptons. Health care shouldn't be like this.
I refuse to speak to drug representatives.
Sorry about the ranting and raving.
Spike
Posted by bob on January 21, 2002, at 14:45:43
In reply to Re: Dr. Ivan Goldberg, posted by Bekka H. on January 21, 2002, at 13:21:11
500 dollars? Not bad.
Try a consultation at Hopkins: 700 dollars. At least they don't make you pay before you even go. They do want payment immediately when services are rendered, however.
Out of desperation, I've done this consultation twice in the last 7 years. They tend to stick to proven treatments. If SSRIs don't work for you, they suggest tricyclics, MAOIs, etc. They stick with Lithium, and Carbamazapine for the anticonvulsants. They seem to be on board with Lamictal. It's hard to say whether it's worth 700 dollars. I think I have a reasonably good psychiatrist who is willing to try many things, so for me Hopkins was not that groundbreaking. It could be different for others though. The desperation always keeps me looking for that magical idea nobody had before though; I guess that's why I went back again. I will say they pronounced me "well informed", and they didn't suggest a single thing I haven't come across before right here on this board. That was a little bit of a disappointment. It was another input however from people who are studying this stuff everyday, but I don't think there's any way around trial and error.
Posted by bob on January 21, 2002, at 14:50:24
In reply to Drug Representatives=Cheerleaders? » Bekka H., posted by spike4848 on January 21, 2002, at 14:38:27
I'm confused, Spike. You said you get taken out to dinner and receive tiny favors/bribes all the time from drug reps, but at the end of the message you state that you don't talk to them.
Posted by OldSchool on January 21, 2002, at 15:02:42
In reply to Drug Representatives=Cheerleaders? » Bekka H., posted by spike4848 on January 21, 2002, at 14:38:27
> Two summers ago, I learned from a similar article about clinical trials in the U.S. that at least 50% of all doctors who are involved pharmaceutical research receive money from the drug companies for their research. Now, are the pharmaceutical companies really going to keep doctors who speak the truth on the payroll?
>
> Hey There,
>
> Yes .... I get taken out by drug representatives alot. They take you to nice dinner .... give you alot of free samples and toys for the office .... all the while pushing their drug and trashing the opponents drug.
>
> If a medication is useful .... I will use it. Why do drug companies need to pay individuals(drug representatives=cheerleaders) to convince you there product is superior? Probable because in reality, their drug is inferior. It is a shame .... medications that affect the quality of people's lives .... all caught up in marketing schemes. Why ... so the president of the drug company can make his payments on the second house in the Hamptons. Health care shouldn't be like this.
>
> I refuse to speak to drug representatives.
>
> Sorry about the ranting and raving.
>
> SpikeWhenever I see these drug reps in my doctors office, Ive noticed quite oftentimes, more often than not they are very attractive women. LOL I wonder if the drug companies intentionally hire attractive women to talk to male doctors about their drugs? LOL You know, send in a nice looking female drug rep, professional acting and all in order to kiss the doctor's ass a lot and convince the doc to use "their" drug.
Hey...Im serious here. Many of these drug reps ARE quite attractive young ladies. Is their a reason why that is?
BS abounds in medicine IMO.
Old School
Posted by OldSchool on January 21, 2002, at 15:06:19
In reply to Re: Dr. Ivan Goldberg » Bekka H., posted by bob on January 21, 2002, at 14:45:43
> 500 dollars? Not bad.
>
> Try a consultation at Hopkins: 700 dollars. At least they don't make you pay before you even go. They do want payment immediately when services are rendered, however.
>
> Out of desperation, I've done this consultation twice in the last 7 years. They tend to stick to proven treatments. If SSRIs don't work for you, they suggest tricyclics, MAOIs, etc. They stick with Lithium, and Carbamazapine for the anticonvulsants. They seem to be on board with Lamictal. It's hard to say whether it's worth 700 dollars. I think I have a reasonably good psychiatrist who is willing to try many things, so for me Hopkins was not that groundbreaking. It could be different for others though. The desperation always keeps me looking for that magical idea nobody had before though; I guess that's why I went back again. I will say they pronounced me "well informed", and they didn't suggest a single thing I haven't come across before right here on this board. That was a little bit of a disappointment. It was another input however from people who are studying this stuff everyday, but I don't think there's any way around trial and error.
Im lucky in that my psychiatrist will let me try anything I want. All I have to do is tell him about some depression treatment I read about and voila I have the prescription. I bet he'd let me try an opiate if I wanted, even bupe. I dont want to try that but I bet he'd let me do it.Im not paying some high falutin idiot "psychopharmacologist" $500 to $700 for a consultation when I can read about stuff elsewhere and get it from a plain old psychiatrist.
Old School
Posted by bob on January 21, 2002, at 15:12:53
In reply to Re: Dr. Ivan Goldberg, posted by OldSchool on January 21, 2002, at 15:06:19
> Im not paying some high falutin idiot "psychopharmacologist" $500 to $700 for a consultation when I can read about stuff elsewhere and get it from a plain old psychiatrist.
>
> Old School
Old School:I don't think you, or the regular members of this board are typical of the general population. Many of us are very proactive in our treatments. Most people want to be told what to do, and that's it. We have a high desire to be informed, many people don't. You are essentially talking about treating yourself, which if you're up to it, is fantastic. Most people aren't.
It has often been said, by med professionals, as well as some on this board that only the complainers and severely TRD people post to this board. That may be partially true, but we are also a portion of the population who is computer literate, have internet access, and are extremely proactive in our own care. I think this is often overlooked.
Posted by bob on January 21, 2002, at 15:30:22
In reply to Re: Drug Representatives=Cheerleaders?, posted by OldSchool on January 21, 2002, at 15:02:42
You're DAMN right they're attractive! I've seen them too. I've had the "privelege" of knowing one or two. It is a job that often attracts young, outgoing, attractive people, and is obviously more suited to gals than guys, even though there are plenty of guys doing it. Think of the frat set from college, or the popular bar going set from any era of your life... pick out the most attractive people from that group. Bias it 80-20 women to men, and you've got yourself one hell of a drug bribing team. The job is not technically challenging at all, and there are many, many perks: travel, free meals, free events, and most importantly - you get to hang out with other attractive people! Who wouldn't like that job? I was friends with someone who's wife was a drug rep. She was put off with the fact that when they went out to their yearly meeting in Hawaii, everybody started sleeping with everybody else, even though many were married. This, to me, doesn't sound like the kind of people that are studying up on the technical aspects of pharmacology. I've often wanted to be a fly on the wall when one of these modelesque women sashays into my pdoc's office. I can't imagine what she's telling him about the drugs. They're often pushing drugs that have been around for years, such as Effexor. What in the world is this young girl going to say to my doctor about Effexor that will override what he's learned in his extensive practice? Oh... I forgot, she can give him little gifts, offer him tickets to exclusive events, and take him out to dinners.
We are not talking about medecine or even pharmacy at this level, we are talking about marketing. Marketing is characterized by this with practically any product you are selling. Doctors are human, and often male. Sex sells: it always has, and always will, no matter whether we like it or not. Look at commercials on tv - if you watch carefully, you will see attractive women associated with some of the most unlikely things. It is extremely pervasive. Heck, tv uses attractive people as much as they can: attractive people = ratings. In life, attractive people have unconcious effects on us.
Sorry about the rant, but BS like this really gets me going. The fact that when you boil it down to brass tacks... they're selling drugs with crass marketing schemes, almost like beer commercials.
Posted by spike4848 on January 21, 2002, at 16:39:43
In reply to Re: Drug Representatives=Cheerleaders? » spike4848, posted by bob on January 21, 2002, at 14:50:24
> I'm confused, Spike. You said you get taken out to dinner and receive tiny favors/bribes all the time from drug reps, but at the end of the message you state that you don't talk to them.
Sorry .... I *use to* go out to lunch/dinner .... not any more.
Spike
Posted by spike4848 on January 21, 2002, at 16:42:46
In reply to Re: Drug Representatives=Cheerleaders?, posted by OldSchool on January 21, 2002, at 15:02:42
> Hey...Im serious here. Many of these drug reps ARE quite attractive young ladies. Is their a reason why that is?
>
> Old SchoolHere is the answer .... just what you said, "You know, send in a nice looking female drug rep, professional acting and all in order to kiss the doctor's ass a lot and convince the doc to use "their" drug."
Spike
Posted by Dr. Bob on January 21, 2002, at 18:39:51
In reply to Re: Drug Representatives=Cheerleaders? » OldSchool, posted by spike4848 on January 21, 2002, at 16:42:46
> > Hey...Im serious here. Many of these drug reps ARE quite attractive young ladies...
I'd like any further discussion of drug company representatives to continue at Psycho-Social-Babble, thanks.
Bob
PS: And any discussion of posting policies to take place at Psycho-Babble Administration.
Posted by jane d on January 21, 2002, at 22:27:19
In reply to Re: Dr. Ivan Goldberg, posted by OldSchool on January 21, 2002, at 15:06:19
> Im not paying some
... "psychopharmacologist" $500 to $700 for a consultation when I can read about stuff elsewhere and get it from a plain old psychiatrist.
>
> Old SchoolOld School,
I don't know about you but one of the first and best "elsewheres" I found to read about stuff was Goldberg's web site. Free.
You might also want to take a look at the source of the psychopharmacology tips elsewhere on THIS site.
If there's any one here who hasn't seen Dr Goldberg's web site yet you really should:
http://www.psycom.net/depression.central.htmlJane
Posted by OldSchool on January 22, 2002, at 9:49:33
In reply to Re: Dr. Ivan Goldberg » OldSchool, posted by jane d on January 21, 2002, at 22:27:19
> > Im not paying some
> ... "psychopharmacologist" $500 to $700 for a consultation when I can read about stuff elsewhere and get it from a plain old psychiatrist.
> >
> > Old School
>
> Old School,
>
> I don't know about you but one of the first and best "elsewheres" I found to read about stuff was Goldberg's web site. Free.
>
> You might also want to take a look at the source of the psychopharmacology tips elsewhere on THIS site.
>
> If there's any one here who hasn't seen Dr Goldberg's web site yet you really should:
> http://www.psycom.net/depression.central.html
>
> Jane
Hi Jane, yes I have read the tips on this site as well as Depression Central. Ive known about Goldberg's site for years. I first began reading it several years ago when I first became treatment resistant and was literally desperate for a treatment that would work. If nothing else, the site gave me some hope that somewhere, somehow there would be something that would blast me out of depression. I would go into my psychiatrist's office asking about stuff I read on the Internet and half the time my psychiatrist had never even heard of it.Old School
Posted by Elizabeth on January 23, 2002, at 14:43:20
In reply to Re: Dr. Ivan Goldberg, posted by OldSchool on January 21, 2002, at 15:06:19
> Im lucky in that my psychiatrist will let me try anything I want. All I have to do is tell him about some depression treatment I read about and voila I have the prescription. I bet he'd let me try an opiate if I wanted, even bupe. I dont want to try that but I bet he'd let me do it.
Heh. Yeah, it's sad, but it often seems like we can do better finding out what the right thing for us is by ourselves and then convincing our doctors to try it (and often, having to educate them about it!).
What are you on now, BTW? I hope you find something that works for you and that you don't have to resort to opioids. I think they should be reserved for cases when regular antidepressants and other treatments have failed (although I still think opioids should be tried before ECT).
I'm glad to hear you've found a doctor you can work with. As for me, I'm still looking (and getting meds from my pdoc in another state in the meantime). I'm not convinced that there *is* a pdoc in NC who will prescribe buprenorphine (maybe yours would, I dunno). I've often thought that maybe I should just go to a pain clinic instead and ask for it (since I do have chronic pain and buprenorphine does relieve it -- no tolerance to that effect either, interestingly). Lots of people with chronic pain take OxyContin or Duragesic -- buprenorphine shouldn't be a problem (in theory, at least).
-elizabeth
Posted by OldSchool on January 23, 2002, at 17:56:39
In reply to Re: pdocs » OldSchool, posted by Elizabeth on January 23, 2002, at 14:43:20
> > Im lucky in that my psychiatrist will let me try anything I want. All I have to do is tell him about some depression treatment I read about and voila I have the prescription. I bet he'd let me try an opiate if I wanted, even bupe. I dont want to try that but I bet he'd let me do it.
>
> Heh. Yeah, it's sad, but it often seems like we can do better finding out what the right thing for us is by ourselves and then convincing our doctors to try it (and often, having to educate them about it!).
>
> What are you on now, BTW? I hope you find something that works for you and that you don't have to resort to opioids. I think they should be reserved for cases when regular antidepressants and other treatments have failed (although I still think opioids should be tried before ECT).
>
> I'm glad to hear you've found a doctor you can work with. As for me, I'm still looking (and getting meds from my pdoc in another state in the meantime). I'm not convinced that there *is* a pdoc in NC who will prescribe buprenorphine (maybe yours would, I dunno). I've often thought that maybe I should just go to a pain clinic instead and ask for it (since I do have chronic pain and buprenorphine does relieve it -- no tolerance to that effect either, interestingly). Lots of people with chronic pain take OxyContin or Duragesic -- buprenorphine shouldn't be a problem (in theory, at least).
>
> -elizabethAll I am on right now is 50 mg Zoloft and an Ace Inhibitor. My psychiatrist would like to push my dosage up like the old days, but that just spikes my BP nowadays. I just got done trying Amantadine for Seroquel induced EPS. The Amantadine had some good things about it, it made me feel better physically. I found that many of the aches and pains and somatic complaints Ive had for years dramatically improved on Amantadine. However mentally it made me feel f*cked up overall after a few days.
As for my psychiatrist, he is very laid back and listens pretty good. He is not a dictatorial psychiatrist at all. He is not local though, he is down in Charlotte. I know he prescribes MAOIs if asked for, and when I first went to him years ago he told me "we could try amphetamines or dopamine agonists if I wanted" but then he found out who I am (hehehe) and changed his mind. But for the average TRD person, if you came across as responsible Im sure he'd prescribe amphetamines or dopamine agonists.
I actually have a feeling I could talk my Pdoc into bupe if I really wanted it, but I dont. I just have a way with him where I can talk to him and he says Im an "educated patient." However, I do not think he would prescribe regular opiates to me, in fact I know he wouldnt...no way he would rx vicodin or percocet or anything like that. But I think I could talk him into bupe though. Probably all Id have to do is bring in some Medline stuff showing bupe for refractory depression and I bet I could talk him into it. I might be wrong though.
Getting mirapex from him would be easy. Or selegiline. Whatever I wanted pretty much, except pure opiates.
He also likes ECT.
Old School
Posted by bob on January 23, 2002, at 19:24:36
In reply to Re: pdocs, posted by OldSchool on January 23, 2002, at 17:56:39
I like the way you put that, Old School:
"He also likes ECT."
It made me laugh, because I imagined a personal ad, where someone might say... "I enjoy movies, music, fishing, and watching football. Oh, and I also like ECT."
This is the end of the thread.
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