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Dr. Bob is Robert Hsiung, MD,
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Posted by Squiggles on March 25, 2007, at 4:34:59
In reply to Re: Orothomolecular treatment for bipolar disorder » Squiggles, posted by Larry Hoover on March 22, 2007, at 14:05:53
> > So, even if preliminary clinical trials on drugs, nutrients, and minerals are too early to yield valid results, eventually, after some years, it should become obvious that vitamins and amino acids, for example ARE or ARE NOT efficient in *correctly* diagnosed psychoses. I think the major mental illnesses are too hard-wired to confuse with the placebo effect, unlike say, situational anxiety and stress.
> >
> > So, we should know by now whether bipolar disorder can be cured by vitamin B or amino acids. If someone claims to be able to cure orthomolecularly, then either the subject is not bipolar, or not enough time has elapsed to see the illness recur. This is assuming that we know that vitamin B or amino acid X do not work.
>
> I disagree with your basic premise. You assume homogeneity of diagnosis can be determined a priori.----I do?:-) Sorry, you are educated in statistics it seems. I am way behind you. I wouldn't say that diagnosis can be made *a priori* unless there is an established medical history of symptomatology, such as in cancer for example. I think medicine is desperately working towards that in mental illness but it has not been exclusively established yet-- just some MRIs that show similarities. The rest is many years of medical history and research. But that is a problem that goes for any treatment program, including orthomolecular.
In fact, the currently observed clinical/statistical failure of any specific intervention to cure all subjects pretty convincingly argues for broad heterogeneity with convergent symptomotology/phenotypy, within any currently defined psychiatric diagnosis.
>
> Let's assume, for argument's sake, that bipolar really exists as five different dysfunctions (genotypy),
----(by dysfunctions i think you mean such things as damage to frontal lobe, euphoria, catatonic depression, uric acid excretion, thyroid disorder, right?)each expressing in a similar way (phenotypy). However, we cannot yet tell one from the other.
----It look like you're stacking the deck here;
We diagnose by symptoms alone. We may have found the perfect treatment for one of the dysfunctions, according to our biochemical investigations, but when we gather a collection of subjects together and blindly treat them, our success falls well short of our expectations, statistically. Yet, for individuals, some are "cured". Others might be helped a bit. And others yet, are cursing the cost/lost time/side effects, absent any benefit.
----Well, that is the miraculous thing about bipolar disorder, unlike the depressive illnesses-- once you give lithium for example, ALL the diverse symptoms disappear. Infact, it is astounding how lithium targets both the severe depression, and the mania at the same time. It is a magic bullet, and regarding the symptomatology of this illness, by the fruits of the treatment you can know it.
>
> Some treatments work for some people, but not for others. Orthomolecular treatments do work. But not predictably so.
----Then I think it is not science, right;
You still have to do the experiments. The only scientific way to demonstrate absence of benefit from orthomolecular treatment is to never try. All the rest is statistics, with all attendent fallacies (type 1/type 2 error, sampling bias, blah blah blah).----You could say that about every molecule on the planet given to a bipolar or a depressive. If that is how research is done, we would have an infinite number of possible cures. You have to have a hypothesis, or a model, or bump into a lucky discovery.
Squiggles
Posted by Phillipa on March 25, 2007, at 4:34:59
In reply to Re: Orothomolecular treatment for bipolar disorder » Squiggles, posted by Larry Hoover on March 22, 2007, at 14:05:53
Lar I agree and have found some supplements to be superior to meds. What about Vita C? If I don't take it I bruise and yes I know that long term use can cause it if you stop it.But when on a supplement I believe will help anxiety or something simple like that it will. Love Phillipa
Posted by KayeBaby on March 25, 2007, at 4:34:59
In reply to Re: Orothomolecular treatment for bipolar disorder » Squiggles, posted by Larry Hoover on March 22, 2007, at 14:05:53
I agree, Larry.
I have been reading everything I can get my hands on about this subject for a couple of months now.The appeal of it is obvious. The premise, logical.
It makes sense to optimize nutrition and check for deficits when a person is experiencing any sort of unwellness before loading them up on heavy duty medications.
I have added B-6 and zinc (in safe amounts)and it helps me. In fact after discontinuing the two while leaving everything else the same for about 5 days I just added it back in just today. I felt worse off of it and noticably better on it.
The improvement I experienced when adding B6 and zinc to my supplement regime was unmistakable and sustained. I felt distinctly less well off of it, especially the last couple of days.
I played around with higher doses of V-C. 2-12g and had no ill effects besides gas. One very noticable positive and repeatable effect of 10g V-C was the disappearance of some pretty awful upper airway wheezing. I believe it has some anti-histamine properties so perhaps that is what did it.
I really believe that a large portion of the sustained improvements in my anxiety, fatigue and depression have come from time and nutrition.
I am also grateful for the medications that have enabled me to fuction when my symptoms are at their worse. This is what helped me to survive while I rested, researched and healed.
Peace,
Kaye
Posted by med_empowered on March 25, 2007, at 4:34:59
In reply to Re: Orothomolecular treatment for bipolar disorder » Squiggles, posted by Larry Hoover on March 22, 2007, at 14:05:53
I'm personally interested in orthomolecular psychiatry, and have been looking for someone locally. The ideas are pretty sound, I think: vitamins/minerals cal alleviate mental distress, with fewer side effects than psychotropics. Lithium, after all, is a mineral; this is not a concept entirely foreign to psychiatry.
I don't want to play the conspiracy card, but...you can't patent vitamins/minerals, and Big Pharma dictates the direction of a lot of research. To claim otherwise would be naive. So I think part of the problem is that there isn't funding for orthomolecular research, and the psychiatric establishment is too in love with $$$ pharmaceuticals to really think about, say, niacin therapy. Plus, science moves by revolution, not evolution. 40 years ago, psychoanalysis was popular. Now its the bio-bio-biopsychiatric model. In 30 years, it could well turn back to more psychosocial models of distress. Point it, within our current paradigm, I don't think there's a lot of room for vitamin therapy, and there may not be for a while--that doesn't mean it doesn't work.
Posted by Squiggles on March 25, 2007, at 4:34:59
In reply to Give it a whirl..., posted by med_empowered on March 23, 2007, at 2:29:41
I think I'll stick with the lithium.
Squiggles
Posted by Larry Hoover on March 25, 2007, at 4:34:59
In reply to Re: Give it a whirl..., posted by Squiggles on March 23, 2007, at 7:55:13
> I think I'll stick with the lithium.
>
> SquigglesYou don't have to give up lithium to test orthomolecular approaches, Squig. It's not either/or. Orthomolecular means "the right molecule". Why have you stopped looking for other correct fits with your own biochemistry?
Lar
Posted by Squiggles on March 25, 2007, at 4:35:00
In reply to Re: Give it a whirl... » Squiggles, posted by Larry Hoover on March 23, 2007, at 8:39:30
Experimentation with non-mainstream
medicine is dangerous to your health.
As a project for human guinea pigs it
may be worthwhile for those who volunteer
and the researchers who get results.Squiggles
Posted by Larry Hoover on March 25, 2007, at 4:35:00
In reply to Re: Give it a whirl..., posted by Squiggles on March 23, 2007, at 8:44:23
> Experimentation with non-mainstream
> medicine is dangerous to your health.????
Classic non sequitur. It is equally possible that the failure to do so is dangerous to one's health.
Your use of lithium arises from non-mainstream medicine. Moreover, it is a classic example of orthomolecular medicine, and megadose mineral therapy specifically.
I think I finally figured out why I have such a struggle with you, while in debate. I suspect that you think in terms of black and white, all or nothing. No shades of grey. No conditional arguments/boundary conditions are accepted. Yet, that's about all I consider, there being so few absolutes.
Lar
Posted by Squiggles on March 25, 2007, at 4:35:00
In reply to Re: Give it a whirl... » Squiggles, posted by Larry Hoover on March 23, 2007, at 8:57:21
I'm just scared of the unproven. It took a while to perfect lithium treatment. At the same time I envy those who have a better quality of life by
trying alternatives that work. So, kudos to you
and your cohorts.Squiggles
Posted by KayeBaby on March 25, 2007, at 4:35:00
In reply to Re: Give it a whirl..., posted by Squiggles on March 23, 2007, at 9:33:04
I researched the known margins of safety before my foray into orthomolecular type therapies.
I figured I would try a few things and if I saw any benefit then I would delve a little deeper.
I really didn't get any benefit from niacin at higher doses (didn't hurt either)but even at no more that 100 mg B6 (both forms) and 30-50 zinc I benefitted. Now I will get the urine test for pyroluria. This is where the rubber meets the road. I have an indication that there may be something to this particular theory for me.
I have exposed myself to no danger of any account and have been rewarded by my expirimentation.
Squiggles, you are smart and capable of exploring your options while keeping yourself safe.
I'll tell you what. This endeavor, for me, has proven much more safe and beneficial than say, my decision to experiment with peanut butter brands which resulted in weeks of illness due to salmonella poisoniing.
Compared to the risks I have taken with psychotrophic medications and the side effects they have caused a little self medication with higher than RDA of nutrients seems oh-so-tame and practical.
Take Care,
Kaye
Posted by Squiggles on March 25, 2007, at 4:35:00
In reply to Re: Give it a whirl..., posted by KayeBaby on March 23, 2007, at 14:46:53
What is pylourea? Does a doctor test for that?
Squiggles
Posted by Phillipa on March 25, 2007, at 4:35:00
In reply to Re: Orothomolecular treatment for bipolar disorder, posted by KayeBaby on March 23, 2007, at 0:36:04
B6 also acts as a mild diuretic had a wise OB-GYN who used it for PMS water retention it works . I think I took 50mg? Love Phillipa
Posted by KayeBaby on March 25, 2007, at 4:35:00
In reply to Re: Give it a whirl..., posted by Squiggles on March 23, 2007, at 14:51:48
Here is an explanation.
http://www.drkaslow.com/html/pyroluria.html
The end result of it being over-excretion of zinc and b6.
I do not know of any Dr.'s who test for this disorder except for the orthomolecular medicine practitioners. You can order the test from a few places online for about 40.00 dollars.
My M.D./naturopath was not even familiar with the condition.
Zinc also opposes copper and copper excess is known to cause all sorts of mental and nervous system problems. It is possible that this is why I see benefit from the zinc.
It sure would be nice to know so that I could apply nutrients in a more targeted manner.
It is difficult to find help in this area and it is treated as though it is voodoo or something. nutrition based medicine is legitimate and it seems suspect that it is not being utilized more.
I suspect the reason is that it is just not a huge money maker for the medical industry. I also believe that it is an untapped gold mine and it will soon catch on.
Peace,
Kaye
Posted by KayeBaby on March 25, 2007, at 4:35:00
In reply to Re: Give it a whirl..., posted by Squiggles on March 23, 2007, at 14:51:48
Here is a fascinating blog written by a man stricken with schizophrenia and his experience with using the principles of orthomolecular medicine as his method for healing.
This blog is so touching and informative-I cannot recommend it highly enough.
Posted by KayeBaby on March 25, 2007, at 4:35:00
In reply to Re: Orothomolecular treatment for bipolar disorder » KayeBaby, posted by Phillipa on March 23, 2007, at 19:19:28
> B6 also acts as a mild diuretic had a wise OB-GYN who used it for PMS water retention it works . I think I took 50mg? Love Phillipa
Phillipa,
It also gave me back my fun, sweet dreams which had been absent for so long I had forgotten what joy they were!
I also think that the B6 is somewhat energizing.
Peace,
Kaye
Posted by Squiggles on March 25, 2007, at 4:35:00
In reply to Re: Give it a whirl..., posted by KayeBaby on March 23, 2007, at 19:36:35
I'll try to keep an open mind on this subject
and read up on it. The broad application of orthomolecular treatments ranging from psyhiatric disturbance to cancer is rather disturbing and smacks of snake-oil panacea. However, i have not seen the statistics, nor read all the literature. I'm willing to follow its development as it seems to have become quite a hot avenue of "research".Certainly, it has not been recommended to me as a medical alternative to lithium by any of my doctors, though i did have a nagging, disturbing doubt at one point when i was tested for magnesium after K-induced seizure and stroke. I would have thought that hospital care would have been a better option. But i did recover in my own bed after a month of excruciating headache and blood pressure swings, and vertigo, and incontinence. I felt as if i was run over by a truck. It seemed so obvious to me that the convulsions/stroke from withdrawal were the cause, and not a magnesium problem. I may just not understand the test and confuse it with orthomolecular medicine.
Squiggles
Posted by KayeBaby on March 25, 2007, at 4:35:00
In reply to Re: Give it a whirl..., posted by Squiggles on March 24, 2007, at 8:18:48
> I'll try to keep an open mind on this subject
> and read up on it. The broad application of orthomolecular treatments ranging from psyhiatric disturbance to cancer is rather disturbing and smacks of snake-oil panacea. However, i have not seen the statistics, nor read all the literature. I'm willing to follow its development as it seems to have become quite a hot avenue of "research".
>
> Certainly, it has not been recommended to me as a medical alternative to lithium by any of my doctors, though i did have a nagging, disturbing doubt at one point when i was tested for magnesium after K-induced seizure and stroke. I would have thought that hospital care would have been a better option. But i did recover in my own bed after a month of excruciating headache and blood pressure swings, and vertigo, and incontinence. I felt as if i was run over by a truck. It seemed so obvious to me that the convulsions/stroke from withdrawal were the cause, and not a magnesium problem. I may just not understand the test and confuse it with orthomolecular medicine.
>
> Squiggles
Squiggles,
The magnesium test that you had isn't really an application of orthomolecular medicine. This is a guess but mineral/electrlyte imbalances or deficiencies are often checked because and imbalance gives rise to many life threatening conditions.Which, of course, begs the question that if it is accepted that Vitamin/mineral imbalances or deficiencies can have profound negative consequences (such as death) them why should it be such a leap to assume that it could cause more subtle dysfuctions?
My mother-in-law had an episode of acute psychosis in her late 60's. She was admitted and was found to have pernicious anemia (b-12) high copper and a few other imbalances. She was put on a short course of anti-psychotics and given b-12 shots and other corrective supplements and she is now in her mid 80's and well.
She was treated by a garden variety psych. so this must be something that they look for as a matter of course. More likely, she had an older Dr. that attended to first things first.
It might be intersting to look up info on some of the known and mainstream medical accpted disease states produced by nutrient deficiencies and see the wide range of physical AND mental symptoms they present.
Pellegra, Scurvy, Pernicious Anemia, BeriBeri(which I believe means 'I cannot, I cannot' if memory serves me)
Take Care,
kaye
Posted by Squiggles on March 25, 2007, at 4:35:00
In reply to Re: Give it a whirl... » Squiggles, posted by KayeBaby on March 24, 2007, at 17:13:29
OK - thanks for that post-- and for the magnesium explanation. What you say
about various mineral and vitamin deficiencies
causing illness is of course true and well-known.
It is a far more complex thing to unravel and
may not be consistent with the present neurophysiological research being done. But you must admit that neuropsychopharmacology and its attendant drugs are far ahead of orthomolecular medicine, for now anyway.Squiggles
Posted by KayeBaby on March 25, 2007, at 4:35:01
In reply to Re: Give it a whirl..., posted by Squiggles on March 24, 2007, at 17:58:50
If you need something to make a fast, impressive impact, neuropsychiatric meds are indeed the way to go.
I like to view psych-meds as a way to stop the bleeding and nutrition therapy as a method to heal the wound.
I do not think orthomolecular or nutrition based therapies will heal everyone. Optimization of ones nutritional status, however, cannot hurt.
Peace,
Kaye
Posted by Phillipa on March 25, 2007, at 4:35:01
In reply to Re: Give it a whirl..., posted by KayeBaby on March 24, 2007, at 18:52:59
Kaye agree l00% with you. Love Phillipa
Posted by nolvas on March 25, 2007, at 15:38:03
In reply to Re: Orothomolecular treatment for bipolar disorder, posted by Klavot on March 22, 2007, at 12:42:30
"Linus Pauling, the pioneer of orthomolecular medicine, claimed that cancer could be cured by taking huge quantities of vitamin C. Ironically, Pauling himself eventually died of cancer."
You can claim ironically that he died of cancer, which is true, it was prostate cancer. However he was aged 93! when he died. How many of us will reach that age? It's still an exceeding good lifespan for anyone to hope for.
Posted by madhatter on March 25, 2007, at 18:31:14
In reply to Re: Orthomolecular treatment for bipolar disorder, posted by Squiggles on March 22, 2007, at 14:44:07
>
> ----Well, that is the miraculous thing about bipolar disorder, unlike the depressive illnesses-- once you give lithium for example, ALL the diverse symptoms disappear. Infact, it is astounding how lithium targets both the severe depression, and the mania at the same time. It is a magic bullet, and regarding the symptomatology of this illness, by the fruits of the treatment you can know it.
>
>
> >
> > Some treatments work for some people, but not for others. Orthomolecular treatments do work. But not predictably so.
>
>
> ----Then I think it is not science, right;
>
>
> You still have to do the experiments. The only scientific way to demonstrate absence of benefit from orthomolecular treatment is to never try. All the rest is statistics, with all attendent fallacies (type 1/type 2 error, sampling bias, blah blah blah).
>
> Squiggles
>Well for someone who claims to take a scientific approach, you make some pretty unscientific claims here, Squiggles. Lithium is not a cure but a treatment and it certainly is not a magic bullet. It only works for some people and not others. I'm glad it works for you, it did not for me. It can also have serious side effects when used long term and has a narrow toxicity range.
Used as a maintenance treatment for preventative purposes there is good evidence for it being useful for preventing manic episodes (in people with classic euphoric mania)but not for preventing depressive episodes (Lamatrogine has the best research basis for preventing depressive episodes).
My manic phases tend to be mixed and/or dysphoric in nature, and according to the research lithium os not so great for people with this symptom profile.Perhaps that is why I had breakthrough manic episodes while on lithium despite having blood levels within the therepeutic range.
I have been managing bipolar disorder for many years. when lithium didn't work, I was trialed on other stuff such as sodium valporate, carbanazapine and also had breakthrough episodes on these. When it became obvious that none of these were doing what they were supposed to do my shrink put me on zyprexa for maintenance, which within six months had me 30 kilos heavier and borderline diabetic (interesting that Ely Lilly's second most profitable drug after zyprexa is for diabetes!)Then she switched me to rispiradone which made me lactate and still kept the weight increase going.
These meds the docs are experimenting with, and many people are on multiple combinations of drugs which have NO long term scientific research to back them up and serious long term side-effects. We are experimental guinea pigs. Mainstream med approaches ALSO do not work consistantly for all people, so in your terms it is not science.
Some people have been effectively so brainwashed that it is impossible to seperate the placebo effect from the treatment effect, and your grandiose claims for lithium as the magic bullet reek of manic symptomology.
Posted by madhatter on March 25, 2007, at 19:17:28
In reply to Re: Orthomolecular treatment for bipolar disorder, posted by madhatter on March 25, 2007, at 18:31:14
This is an attempt to deconstruct the evidence for the use of psychotropic drugs as a life time maintenance treatment for bipolar disorder and monitor what level of risk I am taking by being non-compliant with medication. It is not meant to encourage anyone to do as I am doing, but to review the literature and interpret my own non-compliance in terms of the risks involved.
Geddes at al (2004) conducted a systematic review and meta-analysis of randomized controlled trials of the use of lithium for long term therapy for bipolar disorder.
Despite the fact that lithium has been used for over 50 years, only 5 randomized control studies met the criteria for inclusion, giving a total sample of 770 people covered by the trials.The overall relapse rate indicated that the risk of relapse was 60% for placebo and 40% for lithium (this is considered statistically significant) For depressive relapse there was no statistically significant difference in relapse rates (25% on lithium vs. 30% for placebo). For manic relapse the risk of relapse was 14% on lithium vs 24% on placebo ( statistically significant). This supports the common belief that lithium is better for preventing mania than it is for depression.
The main adverse events for lithium were somnolence, nausea and diarrhea.These trials were conducted with followup periods ranging from 11 months to four years. There is no research on longer term use that I have found on the use of lithium for a lifetime.
I remember having read an article on differential responses to lithium indicating that people experiencing dysphoric mania (irritable ratbags like me) are more likely to relapse on lithium than those who experience classic elated mania., but having been disorganized I have not got the reference at the moment.
So based on this stuff, and treating my alternative diet, supplements, CBT , meditation as a placebo, there is a 24% risk of me having a manic episode and being forcibly hospitalized by relying on my placebo. There is a 14% risk it would happen if i WAS taking lithium, so the actual risk that I am taking it will happen is 10% more likely than being on lithium.It’s a risk I’m willing to take, as I have found alternative ways of controlling the depressive symptoms.
Ref: http://ajp.psychiatryonline.org/cgi/content/full/161/2/217
Posted by linkadge on March 27, 2007, at 19:17:43
In reply to Re: Limited evidence for long term lithium, posted by madhatter on March 25, 2007, at 19:17:28
For me, lithium works well for the first few weeks and then everything just gets really grey.
>mania (irritable ratbags like me) are more >likely to relapse on lithium than those who >experience classic elated mania.,
I can attest to this too. Lithium is proconvulsant, and is no good for epileptics.
I guess it can agrivate certain kindling type emotional disorders.Ocassionally, lithium has induced rage reactions in myself, esp with an AD.
Linkadge
Posted by Ed O`Flaherty on March 30, 2007, at 13:54:26
In reply to Re: Orothomolecular treatment for bipolar disorder, posted by KayeBaby on March 23, 2007, at 0:36:04
The Pfeiffer Center in Chicago (www.hriptc.org) does a lot of useful work-both research and treatment- in psychiatric conditions,including bipolar. My own experience with it in Ireland is that it results in a significant improvement in the mental health of more than half of the bipolar patients I treat. I have some details in www.omega3.20megsfree.com
This is the end of the thread.
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