Dr. Feelgood
September 29, 2005 11:19 AM Subscribe

Strattera could make you commit suicide. Earlier today it was announced that Paxil could cause cause birth defects (scroll down). Now Strattera (an ADHD drug) is on the list of "wonder drugs" that could have serious consequences. Is it really worth it to visit Dr. Feelgood just to find out later that it really did more damage than good?
posted by Guerilla (103 comments total) 1 user marked this as a favorite

"could cause cause birth defects"

Shucks! I forgot to take my Strattera.
posted by Guerilla at 11:22 AM on September 29, 2005

Feeling down? Ask your doctor about Strattera™! You'll either end wandering through life in a giddy, drug-addled haze, or hang yourself in the bathroom. Either way, problem solved.
posted by ToasT at 11:31 AM on September 29, 2005

As you traverse the minefield that is having a child (or two) these days, you quickly learn that there are a whole lot of avoidable things you can do to screw up your kids, from drinking/improper medication during pregnancy to massive Thimerisol-laced vaccine dosages all at once.

The trick is, if you trust someone else to make that choice for you, or if you trust that the current knowledge that exists about something is both accurate and complete, you can easily end up making a small choice that has huge consequences.

As my wife and I go through this (7-week-old twins), we are rapidly discovering that the safest solution is to do nothing at all unless there is a genuine problem that needs immediate solving (for example, an eye infection), then to do as much research as possible -- but at some point, you've still got to take a leap of faith.

Something worth noting: I wish I could find the link (my wife dug it up months ago), but there's a very good study showing a link between regular exposure to television in the first two years of a baby's life and ADHD. Part of our diligence as a parent might someday be weighing the risk/reward ratio of a drug like Strattera to treat ADHD, but it's also keeping them away from the television for the first few years to decrease the odds that we'll need to medicate them for ADHD in the first place.

Then again, tomorrow it may come out that television actually prevents ADHD. Hence the leap of faith part.
posted by davejay at 11:33 AM on September 29, 2005

Last year my autism specialist was suggesting Ritalin to help with a focusing aspect of my Aspergers Syndrome, but our goddamn family doctor said he didn't think it was safe and gave me Strattera! This is a guy in Austin who we thought was smart, somewhat holistic, and did some work on Indian reservations. When I got home I researched Straterra on Usenet and saw enough to chuck it. I am sick of running in with an endless succession of doctors who seem to be nothing but shills for the pharmaceutical companies, and are putting my life on the line like that.
posted by rolypolyman at 11:36 AM on September 29, 2005

If you bother to read the article the FPP links to, you'll notice that there are no known cases of anyone actually committing suicide while taking Strattera, and only one known suicide attempt. The reason for the warning is because of a "small, but statistically significant" increase in suicidal thoughts among those taking the drug.

The FDA is clearly taking action on the "better safe than sorry" theory, otherwise known as CYA.
posted by cerebus19 at 11:51 AM on September 29, 2005

massive Thimerisol-laced vaccine dosages... the safest solution is to do nothing at all unless there is a genuine problem that needs immediate solving

I really hope you're not planning on letting your children free-ride.
posted by Kwantsar at 11:51 AM on September 29, 2005

I took Strattera for awhile and was fine. (I'm an adult so I suppose that might make some difference.)

The truth is that anything you can ingest is not guaranteed to be risk free. Any time you take something that tampers with brain chemistry you really do need to be diligent to watch for any negative effects. If ever there was a case of YMMV this is it. My take is that the benefits MUST outweigh the risks, and again, one needs to be monitored carefully at the start of ANY drug regimen. Period.

I take a drug that rarely has the side effect of giving one a skin rash that can KILL you. However for me it is a Wonder Drug and works just fine. Altho always cautious when starting such a med, the benefit it is to me vastly outweighs the risk I could have a problem (which again, with careful observation can be caught early enough to do some good.)
posted by konolia at 11:54 AM on September 29, 2005

I take strattera, as does my wife.

The warning is specifically related to Kids and Adolescents.

That doesn't make it okay, but it's not an "OHNOES STOP TAKING STRATTERA" just yet..

For me the pro's outweight the side effects. And it's better than the other adhd stuff i've taken.
posted by Lord_Pall at 11:55 AM on September 29, 2005

massive Thimerisol-laced vaccine dosages all at once

the safest solution is to do nothing at all unless there is a genuine problem that needs immediate solving

The problem is that if you wait until your child gets measles or rubella, or even polio, there isn't a whole lot that you can do to "solve" it.
posted by cerebus19 at 11:55 AM on September 29, 2005

Drugs have side-effects, yes. Of course, they have benefits, too. Anti-depressants have saved more lives than taken.
posted by callmejay at 11:55 AM on September 29, 2005

davejay, that mirrors my own experience with our two daughters (now 3 and 6). The only thing I'll add is that you'll often hear that you should be your child's "best advocate", but anytime you try to do so (question a doctor's prescription for example) you're treated like a big pain in the a$$ at best and a nut job at worst. "Oh, you researched it on the Internet?" [Doctor rolls eyes, hands you glossy literature from drug rep who brings him donuts once a week and screws him once a month].

[/rant]
posted by Outlawyr at 11:56 AM on September 29, 2005

I am taking Strattera. Before I took it I was suicidal, but kept finding myself on my fire escape with a rope and thinking it would be really cool to build a zipline. Now I know why I am out there.

Really, though, really on Strattera. And it's been helping me -- however, I could see how it might have negative effects. My dumbass joke above is kinda along those lines -- what if distraction, constant distraction, kept you from examining parts of your life too closely? So now you closely, don't like it, and don't act, but you can't ignore it as easily as before.
posted by kingfisher, his musclebound cat at 11:59 AM on September 29, 2005

Has anyone ever thought that maybe so many people are depresed because the world is going to shit? i really dont think we should be medicating everyone into a super happy state, instead we should be working to make the world better so more people are not so sad. also maybe adhd is an adaptive prosses to a world full of a million inputs at once. the adhd kids will eventualy many generations down the line be perfectly adapted to handling a million things at once.... just something to think about.
posted by stilgar at 12:00 PM on September 29, 2005

"So now you look closely . . ."
posted by kingfisher, his musclebound cat at 12:00 PM on September 29, 2005

One way to make things a little better...
posted by stilgar at 12:01 PM on September 29, 2005

instead we should be working to make the world better so more people are not so sad.

Depression is not sadness. However, yes, we should be working to make the world better so more people are not depressed. It's not mutually exclusive with medications, though.
posted by callmejay at 12:02 PM on September 29, 2005

my autism specialist was suggesting Ritalin to help with a focusing aspect of my Aspergers Syndrome, but our goddamn family doctor said he didn't think it was safe and gave me Strattera!

I've heard people say similar things about the Vioxx debacle -- that opioids like OxyContin would have been safer and more effective for some of the patients on Vioxx, but doctors wouldn't prescribe them because of the stigma and fear attached to them. Ritalin certainly provokes the same kind of less-than-rational reactions, at least among nondoctors.
posted by transona5 at 12:07 PM on September 29, 2005

I wonder what Tom Cruise thinks about all this?
posted by spilon at 12:09 PM on September 29, 2005

I think that we're getting into a tricky area when we talk about depression. The reason is that we essentially have two phenomena with similar symptoms: sadness and clinical depression. Sadness is caused by personal problems, whereas depression is an actual chemical imbalance that needs to be addressed by drugs like Strattera. People often confuse the two. When people see sadness as depression, they give drugs when what they should be giving is love and support. When people see depression as sadness, they tend to give hurtful advice like "cheer up", and "you don't need those drugs", when what is needed is a correction of a serious chemical imbalance.
posted by unreason at 12:11 PM on September 29, 2005

I've been diagnosed with ADHD, took meds for a few years, never really accomplished anything through them. Now my appetite's back and I sleep better.
posted by Mach3avelli at 12:17 PM on September 29, 2005

One of the problems, IMO is that Drug companies need to keep comming up with new drugs that do the same thing, because their patents run out. Is Strattera really any better then Ritaln? Is Welbutren really better then Prozac? But they have to keep making and promoting new drugs in order to make new money.

Weak.
posted by delmoi at 12:17 PM on September 29, 2005

Is it really worth it to visit Dr. Feelgood just to find out later that it really did more damage than good?

Agenda-filter? Troll? Troll with agenda-filter?

I am someone who has the choice of (a) taking medication and dealing with some less than pleasant side effects so that I can be more or less functional or (b) not taking medication and being a raging mess of a human being whose inner chaos drives her to the brink of self-destruction and wreaks havoc on the lives of her friends and loved ones. Whatever physical damage I'm risking is mitigated by the very real damage I would have sustained to date had I not chosen to treat my illness with medication.

All medication have risks that are best assessed by weighing them against the risk of not treating the illness in question.
posted by echolalia67 at 12:21 PM on September 29, 2005

Is Strattera really any better then Ritaln? Is Welbutren really better then Prozac?

Well, Strattera isn't a stimulant, which could make it better for people who can't handle stimulants. At least it's a very different drug, and having more options is usually better. Also, isn't Wellbutrin older than Prozac?
posted by transona5 at 12:25 PM on September 29, 2005

Free ride, Kwantsar? You edited out the "all at once", not the "at all, ever"--which of course wasn't there.
posted by hototogisu at 12:27 PM on September 29, 2005

Oh, let's see: I could take brain meds that may or may not have side-effects, which I may or may not suffer. Or I could kill myself.

I think I'll keep my pills, thanks.
posted by five fresh fish at 12:36 PM on September 29, 2005 [1 favorite]

What a crappily worded sensationalist post. Do you think your editorializing is going to help people or potentially make them feel unsure or uncomfortable or scared? Are you trying to demonstrate that you care or that you can generate controversy and rip out a cool baiting FPP screed? Oy.

Peacay - I think you're over analyzing... I'm not a writer/editorialist so take it for what it is. I do care because I've tried several medications over the past four years that mostly have had negative effects for me (Prozac, Effexor, Paxil, Strattera, and most recently Cymbalta). I think everyone has a different chemical make-up and I'm one of the few that is somehow adversely affected. Cymbalta was the most recent experiment in my "alpha-testing" and all it did was make me tired all day, wide awake at night, and feeling like I had the flu - generally making me feel like shit all the time. I know I should be taking something for my symptoms, I just have no idea what, and obviously the doctors don't either.
posted by Guerilla at 12:38 PM on September 29, 2005 [1 favorite]

One way to make things a little better...

We're not supposed to link to our own pages stilgar, it's a no-no around here
posted by poppo at 12:38 PM on September 29, 2005

If you doubt your doc's objectivity, you can also talk to your pharmacist. Most people don't realize how much training it takes to be a pharmacist - the PharmD degree is a fairly grueling 4 yrs during which you learn an obscene amount of detail about the chemical structures of drugs, their side effects, etc., etc. Your local pharmacist has probably been standing on his/her feet all day filling prescriptions and would love the chance to put their training to use answering questions. Plus, pharmacists can't prescribe, so drug companies don't bother marketing to them as much as to the doctors.
posted by selfmedicating at 12:40 PM on September 29, 2005

Note: I use the words "grueling" and "obscene" b/c I'm in the middle of a pharmacy program right now and should be studying for my test tomorrow.
posted by selfmedicating at 12:42 PM on September 29, 2005

Stattera is pretty much Effexor with a new marketing twist.
posted by StickyCarpet at 12:42 PM on September 29, 2005

And while Effexor is not a stimulant per se it does have "activating" effects.
posted by StickyCarpet at 12:44 PM on September 29, 2005

Guerilla, I only referred to your wording. It's not analysis really, it's just reading. And it's tabloidesque when the subject is very sensitive and serious. If you don't see that you could/should have worded that differently then I will continue to question your level of care for other people. You voiced your opinion in a sensationalist fashion and I don't believe you considered how it would read. Crap wording - still stands. But I wish you well with your struggles nonetheless.
/derail.
posted by peacay at 12:45 PM on September 29, 2005

"Is Welbutren really better then Prozac?"

It works very differently on the neurotransmitters and so, for some people, the answer is "yes". It's a different class of antidepressants and for that reason you could hardly have chosen a worse example. But even within the same class, such as the SSRIs that Prozac belongs to, people report different effectiveness with different drugs.

Your general point is correct, however. Drug companies do research new things that they can patent when their old patents are running out, and then they promote them furiously even when the older drug is just as—or more—effective.

Here's an interesting note: for my severe osteoarthritis, I've taken a variety of meds over the years. I've mostly been uninsured and am self-paying, which has been a problem sometimes. I can always take large quantities of over-the-counter ibuprofen, but it doesn't work that well and is hard on my kidneys. Vioxx worked very well for me, but was hard on my stomach. Celebrex didn't work as well, but it helped and was easier on my stomach so that's what I had been taking the last several years. But because of the possible heart problems related to Celebrex (and knowing that all drugs have risks), I asked my doctor to switch me to something else. So he tried an older anti-inflammatory, indomethacin. It's worked better for me than anything else! (But I'm also supplementing with hydrocodone.) Because it's old, it's also cheap. (Even at Walgreens if you're self-paying; but I just discovered that Walgreens charges 4x as much as Costco for hydrocodone, at least if you're self-paying.) None of my other family with this disease can take indomethacin because, for them, it's too hard on their stomachs.

So, the lesson is that sometimes older drugs can be better, and they're certainly cheaper, but different people get different results. If you're going to be taking something a long time you should find something that works best for you with the least side-effects.

With regard to antidepressants, fluoxetine (Prozac) works well for me, but I have to take a high dosage. I supplement with buproprion (Wellbutrin). Celexa worked quite well for me, but was too expensive. None of the older antidepressants did much for me at all.
posted by Ethereal Bligh at 12:45 PM on September 29, 2005

StickyCarpet, no offense, but you are full of it.

Sarafem and prozac, same thing. Welbutrin and Zyban, same thing. Effexor and Strattera, two totally different meds. Effexor is the antidepressant that is notorious for being hard to wean off of. Strattera is an ADHD drug (nonstimulant) that is occasionally being used offlabel for bipolar depression.
posted by konolia at 12:49 PM on September 29, 2005

Stattera is pretty much Effexor with a new marketing twist.

Well if it is just do a search on "+Effexor +Suicide"... or check this out.
posted by Guerilla at 12:49 PM on September 29, 2005

Is it really worth it to visit Dr. Feelgood just to find out later that it really did more damage than good?

ah...this old chestnut.

everyone has a personal responsibility to find their path to happiness and to enjoy their life. i know that sounds a little hippy, but it is the first thing i think of when people start taking potshots at psychotherapeutic meds in general. if you have a problem, then you, (and your doctor), need to figure out a way past it.... nobody else (ie tom cruise).

you can talk about Brave New World and Prozac Nation, but i feel like most of these critiques come from an old-school "you have to earn happiness" puritan type thing...and the resultant schadenfreude in these drugs failures.
posted by cgs at 12:54 PM on September 29, 2005

A) Strattera is an SNRI--the same class of drugs as Effexor.

B) Don't get medical advice on the internet, especially from me.
posted by StickyCarpet at 12:55 PM on September 29, 2005

StickyCarpet, Effexor is a serotoninnorepinephrine reuptake inhibitor. Strattera is a selective norepinephrine reuptake inhibitor. They're two different things.
posted by veronica sawyer at 1:04 PM on September 29, 2005 [1 favorite]

See: B)

I have seen several web articles near-equating them.
posted by StickyCarpet at 1:10 PM on September 29, 2005

Two things struck me about this discussion:
1) some folks seem to be under the misaprehension that medications, and antidepressants "make you happy" or produce some sort of drugged out euphoria. The euphoria merely masks underlying problems. This implies that the rationale for taking them is akin to the reason an alcoholic drinks. In most cases, if the medication is appropriate, the medications simply keep one's mind from the irrationally negative. From my experience taking Prozac, I can tell y'all that one still feels a full range of emotion, to the point where something really shitty can still make you cry. The difference is you have the stability and focus necessary to pull yourself together and move on, rather than wallowing in it.
2) I've got to wonder how one could plausibly argue that anyone's depressed because "the world's going to shit." Um, when, exactly, was the world so much better? Sure, we've got climate change and chimpy to deal with, but more people are living longer healthier lives than ever before. Remember those peasants in the Holy Grail? Its hyperbole, but that image should highlight how the world's changed. Also, how bout things like the civil rights movement? Women getting the vote? I think being told by the state that you're not trusted to make decisions about your country's future is pretty depressing.

/rant
posted by pieisexactlythree at 1:16 PM on September 29, 2005

Oh and, veronica, excuse me for a minute. I'm off to edit those wikipedia pages.
posted by StickyCarpet at 1:23 PM on September 29, 2005

Amazing. It would seem that just about everyone here is one drugs. I would be shocked if I wasn't saddened.

Better living through chemistry indeed.

I've often wondered how many people have actually gone through the proper ADHD testing procedures or if they've just walked into their doctors and said "I think I have ADHD" and the doctor just said "OK, here's your drugs". And by proper testing procedures I mean the full 48 hour mental ward tests, not just some survey at the doctors office with an Eli Lily copyright at the bottom.

My parents thought I had something wrong with me at one point. Took me to the shrink, did the full testing, turns out I was just an little spoiled bastard. Shrink told them so. So instead of looking to chemicals to try and force my brain to "behave" they were told to follow a few simple guidelines for "good mental health". Discipline, focus, reward. Goals make people happy. We all say to ourselves "if I just had x, I'd be happy". Well, go and do x, and you won't be happy. As soon as you have x, you'll need x+1. This is the fun little trick our brains play on us. It's good to have goals. Achieving goals makes us happy, not the goal itself. There is even a scientific study that illustrates this theory. Check this out.

Yeah, I'm a dick and insensative. But I also know that most people who are "chemically depressed" also can't tell you of a goal they want to achieve. The lack of focus and direction in their lives is what they end up running away from. kingfisher pointed out earlier " what if distraction, constant distraction, kept you from examining parts of your life too closely? So now you closely, don't like it, and don't act, but you can't ignore it as easily as before"; this is kind of what I'm talking about.

Thank you for letting me indulge in my personal goal, destroying the lives of others.
posted by daq at 1:31 PM on September 29, 2005

At least he know's he's a dick.
posted by mr_roboto at 1:40 PM on September 29, 2005 [1 favorite]

Discipline, focus, reward. Goals make people happy. We all say to ourselves "if I just had x, I'd be happy".

Oh yes the old "bootstrap" theory of mental health. What crap.

Medication for me means that I go to to "I don't have 'Y'. To get 'Y', I need to do 'Z + X'. Failing to do so means I don't get 'Y' and is my own damn fault", instead of "I don't have 'Y' because I am a loathsome waste of flesh who never should have been born and if I had any guts I'd do the world a favor and kill myself."

For me medication makes "discipline, focus, reward" possible. It doesn't make it easy by any means, but at least my problems are a little clearer identify, address, and solve.
posted by echolalia67 at 1:44 PM on September 29, 2005

daq, you're a duchebag. I suggest some Marijuana.
posted by delmoi at 1:48 PM on September 29, 2005

But I also know that most people who are "chemically depressed" also can't tell you of a goal they want to achieve.

And what medical school did you graduate from, Doctor?
posted by veronica sawyer at 1:55 PM on September 29, 2005

I have seen several web articles near-equating them.

Well, effexor is a total bitch to try to wean off of, and strattera-well, I went cold turkey and had no problem atall.

But I also know that most people who are "chemically depressed" also can't tell you of a goal they want to achieve

Cart before horse, hon. Not being able to be motivated is a SYMPTOM of depression. FWIW I do have goals but when not medicated (bipolar type two here) I can't even drag myself to do the dishes. Or sometimes, even bathe. Too much effort...like trying to climb a mountain. These sorts of depressions suck the life out of you not just emotionally but physically as well. When I am down even my workout is harder-I can lift less weight, my spin class is twice as hard, and all around it just sucks. When I am normal or up, my workout goes very well. And we are talking about a mood cycle that could simply be a matter of days between one state and another.

I spent decades unmedicated trying to focus and "suck it up." During those years, not only did it not work BUT my illness progressed -got worse-BECAUSE I was untreated, and now my illness is harder to treat than it would be if I had dealt with it earlier. For unipolars, if they are treated for their first major depression, sometimes they can actually be cured.

So yes, dear, you were a bit richardist in your post.
posted by konolia at 1:57 PM on September 29, 2005

It is possible to suffer from some of these conditions (even multiple conditions) and cope and / or thrive without magic pills... Of course, severity has a lot to do with that too... No doubts about that.

But in the less extreme cases, I think we could all do with less pills and more due diligence... I cope every day with my own issues and have done quite well without assistance. Granted, I'm most certainly on the lower side of the afflictions, but they don't seem insignificant to me. at times they seem quite overwhelming.
posted by DuffStone at 2:15 PM on September 29, 2005

delmoi, kine or just some shake from the bag? It's been a little dry in my neck of the woods. That, with a little lysergic, maybe some mesc, a few tabs of the old blue, and a couple of bottles of valium. The latest thing was shrooms, but man those were way too harsh on the old travel channels. Ended up puking while up was lost (how many of you actually know what it means when you cannot figure out which way is "up"?). Was not the best way to adjust to the ceiling. Probably should have smoked the bowl first, would have prevented the nausea.

For those not familiar with the phrase "better living through chemistry", it is a tacit alliteration to the idea of using drugs to run away from problems rather than look for real answers.

The study from the NPR story I linked to had a lot of very good data about the way the brain processes happiness. It is tangental to the subject of mood altering substances.

An echolalia67, I never said there are not people who actually need some kind of medication. I was referring, specifically to those who said "I asked my doctor to put me on x drug of the week because I read the published literature on it". Well, hoorah for bonzo, but that doesn't quite cut it for me, kids. And I appreciate that you did not take my statements as an attack on your personal mental state or necessity for medication.

And yes, I am a douche because I would rather people take responsability for their lives and actions rather than just run around in circles gobbling up whatever is marketed to them as the solution for their percieved failings, whether real or irrational. You know, the same crap they expect from me. That whole social contract thing that being a human tends to encompass. We're all in this together, eh? All the plebians in the same boat, revelling against the evil patricians and their plutocracy. Just because you don't agree with my assessment of how the current situation of the pharmacutical marketing machine and the doctors work in collusion and inhumanely ignore real problems that people have and decide to go the "simple" route of dosing everyone to keep them "happy" does not mean I don't understand mental illness or have a very deep appreciation for those with true mental disorders. Most of them are my clientelle (read, gee I'm in the goth/industrial scene, and yes, the stereotypes are pretty true, we have a lot of depressed people who hate themselves and their lives and gather in groups every week at clubs around the country to bitch about how much thier lives suck more than everyone elses. It's like a knitting circle, only they have to one up each other on how much drama they have to deal with. Most of it they themselves create, but that's a whole different sub-subject).

ADHD is not a mental disorder. It is a behavioral disorder. That means it is the result of something that requires behavioral control to "cure". Drugs such as Aderol, Ritalin, and other whacked out drugs, hile having the side effect of allowing you to "focus" better, are just "speed". Yes, they help. So does methadrine. I tend to organize my sock drawer when on speed. This usually takes several hours. It's a behavioral side effect. Classic story. Class geek, known for having outbursts through out his school career, finally gets prescribed Ritalin. He calms down. Goes off to college. Since he'll be a poor college student, they get him one of the mega-huge bottles to last him the whole semester. Goes out to a party. Takes a few pills with him. The local drug monkey, learning of said drug, pays him $10 a pop for each pill. The party lasts until the next week. Welcome to tweaker country, kids. Your local douchebag, open for business.
posted by daq at 2:24 PM on September 29, 2005

I'm also very full of myself at the moment, so please feel free to rip it all apart.

No, I am not a doctor. Yes, I only study drugs in order to understand what effects they have on the active mental state. There are very good reasons for people with true mental conditions to seek treatment and make use of drugs for the effects as necessary. But there is also a need for less dependancy on the corporate teat, as it were.

Oh, my anetdote about the college kid is not a first person personal experience, however it is a story that I've heard repeated through several generations. Mind you, to actively study this phenomena, I'd need a grant of several thousand dollars and to finish my pre-med courses(veronica sawyer = it would have been MCV, but I never made it out of VCU, so for what it's worth, meh), which I refuse to do currently (well, that and I can't afford to). But no, there is no reason to believe that what I have observed is universal or more than just someone sharing their own knowledge about something. You know, like you kids with your drugs.
posted by daq at 2:33 PM on September 29, 2005

And yes, I am a douche because I would rather people take responsability for their lives and actions rather than just run around in circles gobbling up whatever is marketed to them as the solution for their percieved failings, whether real or irrational.

Yes.

You know, the same crap they expect from me. That whole social contract thing that being a human tends to encompass.

I don't remember signing anything like that. Social contracts deal with how you interact with others, now how you deal with yourself. I don't know of any social contract theory that requires people suffer because not suffrering would irritate scientologists.

ADHD is not a mental disorder. It is a behavioral disorder. That means it is the result of something that requires behavioral control to "cure". Drugs such as Aderol, Ritalin, and other whacked out drugs, hile having the side effect of allowing you to "focus" better, are just "speed". Yes, they help. So does methadrine.

OK, Tom Cruse.
posted by delmoi at 2:37 PM on September 29, 2005

I'm with Daq, in theory. There are a few children out there who have such disciplinary problems that it might be necessary to dope them up until they develop more brain cells. Such drugs should exist, for their sake. But those children are relatively few and far between.

The underlying problem here is that there are far too many kids (and adults) being "diagnosed" as ADHD and given drugs when it would be fully possible for them to deal with it themselves. That they are very likely, in fact, just going through their own mental development processes and their brains NEED that time of relative insanity for whatever reason.

It's like a kid going through the "no" phase or the "why" phase. No child psychologist is going to say those should be suppressed - they are a very important part of a child's developmental process! So why do we assume that any behavioral problems past the age of 5 must be treated with medicines rather than allowed to run their course?

And I say this as someone who is "ADHD" and loves it. Thank the gods that my parents never drugged me up. I was a real bastard when I was in middle school. By forcing me to deal with my inability to focus on my own, what I ended up developing were some (if I do say so) truly great multiasking abilities. And looking back on my development, I know for certain that these came from my ADHDness as a child. (in short, I kept myself under control by training my mind to do multiple things at once)

And EVERY SINGLE TIME I hear about some parents drugging their kid up because he (gasp) daydreams in class! or WORSE he *ASKS TOO MANY QUESTIONS!*... I just want to slap them. Because there's a kid who could grow up to be exceptional... but will be drugged into mediocrity.
posted by InnocentBystander at 2:38 PM on September 29, 2005

Daq: given your writing style, I think you're parents neurologist may have made a big mistake with that diagnosis.
posted by delmoi at 2:40 PM on September 29, 2005

Just to be clear, I don't favor medicated Overactive kids, but I think adults should be able to take whatever drugs they want.
posted by delmoi at 2:42 PM on September 29, 2005

delmoi: my writing style is a little frantic today, seeing as I haven't slept in 3 days now (no, it's not the drugs, it's because I've been a little too busy lately, damn scheduling overlaps and all that jazz), and the fact that I write how I think. You know, with several layers going at once and connections to one thought leading off on tangents (hence the embedded comments, like this one). This is also why I do not fit into mainstream society and kind of like that fact.
posted by daq at 2:45 PM on September 29, 2005

OK, sorry for getting ranty. It's just that it really, REALLY bugs me when I see parents do that. I've benefitted so much in my life from being able to multitask like I do, it kills me to see that being forcibly taken away from someone else.

To clarify - I do not doubt there are children in this world who need medication. But I think on the whole, unless the child's behavior crosses the line from "distracting" to "self-destructive," the child should be allowed to grow up naturally, without his brain getting saturated with chemicals.

Non-medicative therapy and\or counseling is a better alternative as well. I think, actually, a ADHD therapy based on teaching the kid to UTILIZE his hyperactivity, rather than to suppress it, could be a hugely good thing.

Assuming you can get the kid to pay attention. ;-)
posted by InnocentBystander at 2:46 PM on September 29, 2005

InnocentBystander: watch it, I'm toxic today. Might want to save your praise until I'm done vomiting in peoples corn flakes.
But yes, you do seem to get it. At least part of it.

back to delmoi: adults taking whatever drugs they want? sure, just as long as they don't take them at work, or if they work in some kind of critical position, you know, like doctor, or policeman, or fireman, air traffic controller, you know, that whole responsible directory for the lives of others thing, that they are a) aware of the full effects of the drugs they are taking, b) are given enough time for the effects to be either constistant or for the effects to have worn off before they go off and, oh, I don't know, shoot someone because they were tweaked and felt paranoid because that dog just wouldn't shut up. Let freedom ring and all that, just not in my house, at 4AM, while I'm trying to sleep. Because I am probably drunk. And you'll wake up my cats. Wait, nevermind, they've slept through earthquakes. Lazy damn cats.

I like the imagery of vomiting in someone's cornflakes.
posted by daq at 2:51 PM on September 29, 2005

It's sad too see how fucking ignorant some folks still are about mental health issues.
posted by teece at 2:51 PM on September 29, 2005

Daq - I agree with you for the most part about personal responsibility. But I think more studies need to be done into the "chicken and egg" relationship between actions and brain chemistry.

Fundamentally, I don't believe that "brain chemistry" is the sole cause of psychological problems. In the sense, that is, that if I'm depressed over someone dying, handing me happy pills in JUST the right doses will make everything OK again.

But I don't stand hard and fast to that belief. If someone could scientifically document brain chemistry as being the prime mover in human behavior, then I'd have to accept it and re-evaluate some of my beliefs.

In the meantime, though, I believe medical science most definately has jumped too quickly onto that particular bandwagon, with far too little actual experimental data supporting their viewpoints. It seems frightningly plausible that, in 30 years, we're going to end up with an entire *generation* that's psychologically broken because they weren't allowed to develop emotionally as children. The problem is that "happiness in a pill" is so darn easy to market, the ones advising caution are getting run over by the bandwagon.
posted by InnocentBystander at 2:59 PM on September 29, 2005

Gah, also, I don't agree with Tom Cruise at all. Hence my previous comment about actual psychological tests versus "I think I need some drugs".

Wait, no, I do agree with one thing Tom Cruise said. Pharmacutical companies market drugs to the public and doctors give them to people instead of prescribing a treatment based on the individuals actual problems. This, I see, is a problem. It's also something the insurance companies really, really don't like. Though it seems that Ralph Nader (ew) seems to have something to say as well. It's a PDF, but it's one of those scholarly study things.

I don't agree with Cruise's "assessment" that it's all lies. The 1952 study by Charles Savage on the effect of LSD on depression were awesome. So Eli Lily did something right. At least for a while. Once. And it was a long time ago.

That's also a really wierd strawman. Because I don't like today's, what was it, Prozac Nation(?), I am immediately condemned as some kind of loon who believes aliens are inhabiting my bad thoughts and I need to give my money to "the foundation"? Um, keep smoking that gange, baby, maybe those conspiracy theories will make a good book one day. And they already know about the fluoride in the water thing.
posted by daq at 3:05 PM on September 29, 2005

Could someone pass me that last donut while I finish up with this drug-rep...

*zips fly, wipes away powdered sugar from mouth*
posted by docpops at 3:12 PM on September 29, 2005

Re: Effexor vs. Strattera...

Having taken both, I can categorically say that they are NOT the same thing by any stretch of the imagination. There are specific chemical reasons why this is the case (they're not even in the same class of drugs), but ... WOW. Seriously, that's like saying that caffeine and cocaine are the same thing because they're both stimulants.
posted by spiderwire at 3:29 PM on September 29, 2005

Full disclosure: I have a business relationship with one of the Big Pharma companies discussed in this discussion. I can not make direct categorizations about the motives of the said company because
1. I am under an NDA
2. I am a very small cog in a very big machine. (i.e. I don't have access to the supposed high level decisions about risks vs. benefits.)

That being said, I have never worked anywhere else where so much effort is spent on following both the letter and the spirit of the law as it applies to our business.

I am bipolar and I have Adult ADD. I have taken many drugs, and only now after 5 years of trying different medication in different doses have I found a combination of medications that helps me to lay the groundwork for living a normal life. That is not to say that I am hoping for the "magic bullet" that will cause me to be perfectly normal. I don't think that that will every happen. Now I just hope for a combination of medications that will let me compete on a level playing field.
posted by SteveTheRed at 3:45 PM on September 29, 2005 [1 favorite]

I was diagnosed with adult ADD years ago. I was offered drugs by my doctor but listened (thank god) to a friend of mine. She told me to stop drinking booze and stop eating refined sugar of any kind. I tried it for a month. Symptoms gone. Totally changed my life. Been two years and havn't looked back.
posted by Bighappyfunhouse at 4:17 PM on September 29, 2005

I've been surprised at how many are taking medications here as well. I'm no less guilty. Initial diagnosis: ADD, take Paxil and Dexedrine. Dr. bows out, leaving me hanging with no means to obtain needed meds. Withdrawal symptoms for a month (disorientation, auditory and visual hallucinations (mild, just images wavering is if a bad signal on a TV set, auditory issues; sounds fading in and out quickly.) Then some time down the road, job induced depression; Paxil again, lose job (where is it? It was around here *somewhere*) and again, cut off from meds, withdrawal symptoms for a month, and further erosion of faith in our deeply flawed and onerous medical system.
So, in the future I will just drink a fifth of whiskey and amputate my leg or do whatever, but my days of believing in a solution through meds is pretty much over.
I understand that a lot of you have found redemption and solutions with the therapies that you are following and I am happy for you and wish you much success in the future in discovering a 'normal' life, as for me I quit. I just quit. I have decided that rather than sacrifice my pay and pay out of pocket fees of up to $80.00 per week as well as missing hours at work with resultant decreases in my paycheck that I will just cope. Somewhere in there I was also diagnosed with Social Anxiety Disorder, and now undiagnosed Asperger's Syndrome (this from a friend who's cousin has suffered from this from his entire life, so I think he's a pretty good judge, also read 'Songs of a Gorilla Nation' and it was spot on to my experiences).
Conclusion: Screw it, I'll deal with my issues and find a way to experience happiness without interacting with 'normals'. It would be nice, but too damn painfully frustrating. Too damn frustrating.
posted by mk1gti at 5:06 PM on September 29, 2005

i really dont think we should be medicating everyone into a super happy state, instead we should be working to make the world better so more people are not so sad.

It blows my mind how many people still regard antidepressants as "happy pills," or "magic drugs," or anything of the sort. As if there's some government conspiracy to drug the nation into a drooling stupor. In reality, if you want a truly unmotivated populace, take AWAY the antidepressants. Then you'll have the thousands of people who through medication are able to live a normal life, including working for a better world, instead in a state of vegetative numbness.

Just because they make sad people feel better doesn't mean they're soma.
posted by granted at 6:41 PM on September 29, 2005

"In most cases, if the medication is appropriate, the medications simply keep one's mind from the irrationally negative."

This has been exactly my experience. My anecdote:

After a long time being very wary of these meds, I've just recently started on Wellbutrin. It's helping me. All it does is keep me from going down the unhappy depression spiral to seriously bummed out thoughts. I've never gone so far as to contemplate suicide, but I get down into that inconsolable misery and it takes a lot for me to pull myself out. With the Wellbutrin, even if I think about things that normally take me down the spiral, I just don't go down so far. It's like a mood limiter, keeping me from bottoming out. Otherwise I feel completely normal, with the exception that with my mind not getting caught up in depressing thoughts, I can get things done and get some enjoyment from just plain ol' simple life things.

daq said: "So instead of looking to chemicals to try and force my brain to "behave" they were told to follow a few simple guidelines for "good mental health". Discipline, focus, reward. Goals make people happy. We all say to ourselves "if I just had x, I'd be happy". Well, go and do x, and you won't be happy. As soon as you have x, you'll need x+1. This is the fun little trick our brains play on us. It's good to have goals. Achieving goals makes us happy, not the goal itself."

Well, see, I had actually done all that, and I've gotten to a point where I just don't have anything to be depressed about, I've achieved a whole bunch of great stuff, and where I'm in a career that I love and am continually challenged at... but I still fall into these awful depressions, for no apparent reason.

Clearly all the positive things I was doing weren't enough to dig me out of the hole, so it seemed pretty likely that there was actually some kind of chemistry problem that I had little or no control over.

That's what made me decide to try something, at my doctor's recommendation, to see if it would change things, and happily it's working. As I said I'm not euphoric in any way, and I still even get sorta bummed sometimes - I just don't get so bummed that I look at everything I'm doing and say "what's the use" anymore. It's not handing me a happy life, but it's certainly making it a lot easier for me to find my own happy times.

And the doc says it's not a permanent thing, that the

daq also said: "And yes, I am a douche because I would rather people take responsability for their lives and actions rather than just run around in circles gobbling up whatever is marketed to them as the solution for their percieved failings, whether real or irrational."

Well, I agree about how people should take responsibility, and previous to now I would have agreed that people don't need these pills and should just haul themselves up by their bootstraps and do the hard work. But now that I've experienced my own problem even after doing all the hard work, and seen the effectiveness of this particular med for me, it seems pretty clear that a lot of people do actually need them. Sometimes all the work and enforced discipline and enforced focus just isn't enough.

That being said, I agree with stilgar that the world has a lot of depressing things going on in it, and fixing them would probably help everyone have a better, saner, happier life.

Every little bit helps.

mk1gti: "I've been surprised at how many are taking medications here as well."

I'm not surprised at all. Most folks here seem to be highly intelligent, well-educated people who don't generally conform to societal norms. A friend of mine offered me the thought not long ago that this world is currently set up not so exceptionally bright, creative people can be happy and successful, but so that people of average intelligence, ability and creativity can be happy and achieve success. A group of relatively bright people, as I think most MeFites are, are certain to have trouble being happy trying to stay afloat in a world full of "regular folks." There's certainly enough frustration expressed here on a daily basis with all the stuff going on in the world to display that.

Just a thought folks, I'm no authority, just offering that to chew on.
posted by zoogleplex at 7:14 PM on September 29, 2005 [1 favorite]

Konolia: Darlin', you just showed us two great big honking red flags for mania. (Actually three, if you ask me, not that you did.)

Let's see...
"...seeing as I haven't slept in 3 days now (no, it's not the drugs, it's because I've been a little too busy lately, damn scheduling overlaps and all that jazz)"

1) not sleeping
2) overactivity

Seriously, there are "scheduling overlaps" and there is not sleeping for 3 frikkin' days!

"I write how I think. You know, with several layers going at once and connections to one thought leading off on tangents..."

3) Flight of Ideas

Definitely three signs.

Well, either you're doing way too much meth and/or speed or it's entirely possible that you're a wee little bit manic at the moment. Either way it's not good. Get some sleep, fer krissakes, and while you're at it, get some food into you.

/mom

Getting back to the topic at hand, yes I think that people with signifigant mental health issues can manage without medication...how well that works out, that's an entirely different matter. Many of the people that I've met who are going the drug free route work their asses off trying to maintain some equilibrium and their efforts are only partially successful. Others have no insight whatsover and are in a complete freefall. Very, very few are pulling it off. Sadly, I know that I fall somewhere in the two first groups and are nowhere near the latter one.
posted by echolalia67 at 7:33 PM on September 29, 2005

without meds, that is.
posted by echolalia67 at 7:34 PM on September 29, 2005

Just because they make sad people feel better doesn't mean they're soma.

There is a stark difference between being sad and being depressed. Please do not muddy the waters by using imprecise language. We put up with enough shit without our friends and "supporters" write this off as mere "sadness." Sad people cry, they don't fucking suicide.

Gah!
posted by five fresh fish at 7:47 PM on September 29, 2005

Just a thought folks, I'm no authority, just offering that to chew on.

I'm going to think on this one. I think I might learn something important from it. Thank you, zoogleplex.
posted by five fresh fish at 7:51 PM on September 29, 2005

I would rather people take responsability for their lives and actions

Seeking mental health care and appropriate treatment *is* taking responsibility for their lives and actions. To say otherwise reveals a deep misunderstanding of mental illness and treatment.
posted by jesourie at 7:54 PM on September 29, 2005 [1 favorite]

Is Welbutren really better then Prozac?

For me it was worlds better. When I started wellbutrin in 2003, I got my life back. I turned a corner and things just kept getting better and better.

However, today everything fell apart so I need a med readjustment of some sort.

You folk who think we should just "stick it out" and "take responsibility" have zero idea what it is that we go through. Be glad you don't know what it feels like when all the joy is suddenly sucked out of your world and nothing feels good anymore, not even food (and forget about being interested in sex). In fact, how *dare* you judge us from your lofty perch, lucky enough to be born with a brain chemistry that works right. We deserve to have a decent life, too, you assholes, and if it's pills that get us there, so be it.

Look, clearly these drugs are marketed at a much huger portion of the population than they are *truly* beneficial for. There is a problem here, but this does not mean that those for whom the various drugs *are* a good (or at least good enough) solution are being victimized or taking the "easy" way out.

I'm still really livid at some of the attitudes on display here, but today has been a really awful day for me and I'd better shut up before I get myself into trouble.
posted by beth at 8:22 PM on September 29, 2005 [1 favorite]

I'm going to think on this one. I think I might learn something important from it. Thank you, zoogleplex.

I've learned a tremendous amount just by checking back on this post all day. This discussion has shed some light on a lot of different things for me most definitely. I'm at a loss as to keep trying to find the answer to my dilemmas, or if I ever will for that matter.
posted by Guerilla at 8:25 PM on September 29, 2005

Every one of these threads brings out those kinds of opinions, beth. I don't really try to argue with them. Somehow, it feels like one of those topics where there is such a huge gulf that it's almost not possible. What's funny is that I think a lot of us feel the same way you do--that antidepressants are probably overprescribed--but the anti-meds crowd don't seem to leave much room for agreement.

Anyway, I know how I feel about it, but even after many years of thought, I'm not entirely sure what my rational judgment is. In theory, I certainly don't like the idea of psychoactive drugs being misused in the way that the anti-meds crowd thinks they are. I read a science fiction novel a few years ago where one character had had all of their self-doubt and shame thoughts purged from their brain; they had incredible self-esteem. The result was the character was a sociopath. Then, on the other side, I think back on the history of medicine and particularly anasthesia where there was a resistance to it because it was thought it immoral to not feel the pain. I hear resonances of that in the anti-med crowd's words.

Part of why I haven't decided what I think about this is because I haven't even decided what I think about the question of human happiness. Putting metaphysics aside, is there any reason to believe that it's really possible for us to be "happy" the way that we wish? After all, the desire for happiness is a fundamental motivation--why should it ever be achieved? The universe could simply be fundamentally unfair in this respect to we humans. So all the philosophical/social issues thoughts lead to questions of what it means to be human. Good luck on any of us answering that any time soon.

But on a practical level, my own experience is like yours and the other people's in this thread: antidepressants don't make me "happy", they keep me from being insanely unhappy for no goddam reason. Like zoogleplex, I first started antidepressants during a time in my life when I was happy, situationally. Everything in my life was great, I was happy with everything. And I still was getting crazily, suicidally depressed. I was sincerely baffled. That's when it finally occured to me that, hey, maybe it's not just all about me getting my psyche in order. And, like many other people, particularly creative people, I found that antidepressants did dull me a little. After all, the mood swings and all the drama drove a bunch of my creative impulse, which I think is true for many people. And I regretted losing (mostly) that. But the alternative, seriously, would be death. Suicide and depression run in my family. So it's still an easy choice for me to make. I prefer to live.
posted by Ethereal Bligh at 8:42 PM on September 29, 2005 [1 favorite]

zoogleplex
Well said about the normal end of things, I wonder if persons like Richard Feynman, Freeman Dyson, Albert Einstein and other great minds would have found as much success as they did then in today's world. It's all about conform, conform, conform and that kind of thing just bores me to tears. Aspiring to Mediocrity.
I go into my job every day and there's an advertisement poster for some of the products our company sells. Prominently displayed right in the middle of the board as if to mock us is something called 'Frownies'. I am not making this up. Of course everyone there wanders around in their own little 'I'm to busy to relate to others in a caring, empathetic way' busybusybusybacksoon way and I just wander through it all and laugh to myself. I'm one of the most productive ones there by the way, part of my 'disability' is to have a higher than normal ability to concentrate and when I'm at my desk doing my work an earthquake could happen and I probably wouldn't notice.
Like Feynman would say 'Dont' Bug Me, Man!'
And Ethereal, a tip 'o the hat to you and all the rest who are getting benefit from the meds, don't let some well-meaning ignorant bumbler convince you to 'just straighten up and fly right'. That kind of garbage irritates the hell out of me at least as much as I'm sure it does you, if not more. If one is not professionally qualified to comment on such things, don't open your flapping piehole.
posted by mk1gti at 9:15 PM on September 29, 2005 [1 favorite]

wow...i've really enjoyed this thread, even though it saddens me that so many people are having such hard times.

my anecdote (brief): i feel like i'm right in the middle on all of this... i have family members who swear by their meds, and they are better on them (one sis is off right now, trying to get pregnant, is totally miserable). i've been in talk therapy in the past for depression, and it has helped...but i've definitely spent the latter half of my 29 years "bootstrapping" it with varying degrees of success (much as echolalia described).

and i sympathize with some of what daq and his bunch are saying. i don't want to be tied to a med, or deal with wierd side effects. but you know what chills me more? spending the next thirty years slogging along only to realize that i could have stopped "keeping my chin up" and put that energy towards living my life.

which gets back to my earlier post: only you can make that decision, and to hell with everyone else.

frankly, i don't see why people get so upset at what others do. if everyone is doping themselves into drooling zombies, well, then you'll just be that much more creative, won't you? (re: frownies)
posted by cgs at 9:45 PM on September 29, 2005 [1 favorite]

well said, cgs, only the individual can make the choice of whether they do or do not need the medication and the best way to make that decision is to do the research and obtain the advice of a professional, one who isn't just going to say 'take this pill, now go away' but someone who is able to provide therapy as well as medication.
posted by mk1gti at 10:36 PM on September 29, 2005

Aw shucks... well thanks back to y'all, fff and mk1. Us looners needs to he'p each other out. :)

Again on the "normal" angle - which I think really means "conformist" angle - I work in the entertainment biz now (video games), and I have to say that pretty much all my friends and acquaintances in the biz (both in games and other media) are on some sort of antidepressant. The few that aren't are "conformists" in the showbiz sense - you know, THOSE showbiz types, type A personalities, producers... or more of the smarmy schmoozer type. Of course those folks are not creators in any way, they are business people and bureaucrats - not so different from corporate office drones, just functioning in a different milieu where the language and methods of "conformity" are very different.

Most creative people seem to be forced to be harnessed by non-creative people for the purpose of creating things that make the non-creatives rich. This is true in pretty much every creative and scientific discipline. We create or research because we can't NOT do it; we get very unhappy if we don't or if we are thwarted in some way. Artists MUST draw or paint or sculpt, or we go nuts. The best scientists are all people who MUST investigate the universe and satisfy their intense curiosity, driven from the inside. We would and will all do what we do, for the most part, without regard for fame or monetary compensation. Of course, that doesn't pay the bills, does it... so it's rather impractical. Very few creators are fortunate enough to just create whatever they want and have that also support them materially; most of us need to get some kind of job. And that means, generally, working for non-creative people and having our work generate a great deal of money that we never see - even if we're getting paid very well on a scale relative to most people (and that's assuming we even can get some kind of job using our creativity; lots of us are working 'normal' jobs and not creating anything). And of course, the non-creatives generally insist upon and impose "creative control" on our work.

All of which drives most creative people nuts, literally. We're really not "accepted" by the "normals," except in that we provide their entertainment, or their income if we work for them. Ask anyone who's been an artist at Disney the last 10 years how much fun it is to have some fatuous "suit" tell you how you should make your film. Guh.

Heh, and don't even get me started about actors... whoo boy, they are a mess.

Anyway, yeah, I think that people who are aspiring to something other than mediocrity or manipulative dominance over the mediocre are just not treated well by the mediocre and especially the manipulators, and that causes a lot of depression. When you know you're under someone's whip just because of who you are and the things that drive you inside, that's a serious gut-twister. It's no wonder a high percentage of creatives and free-thinkers are somewhat unbalanced emotionally and have a high rate of depression and thus use of anti-depressants - "conformist" people rarely hesitate to make them think they're freaks.

Feynman, Einstein, Dyson... these are extraordinary minds with extraordinary visions, people who have literally changed our world and everyone's lives, doing things far beyond anything even most bright people out there are capable of, certainly way past anything I can do. I can't imagine how these guys look at and think about the rest of humanity, when just commuting to work can drive me batty...
posted by zoogleplex at 11:00 PM on September 29, 2005

"Anyway, yeah, I think that people who are aspiring to something other than mediocrity or manipulative dominance over the mediocre are just not treated well by the mediocre and especially the manipulators, and that causes a lot of depression."

It is of course certain that outliers are going to fit in less well with the rest of society than most. But this sentiment you're expressing above has long rubbed me the wrong way. I am exceptional in a variety of ways. And my childhood education failed me in most ways and I am bitter about that. Even so, this way of thinking strikes me as both self-pitying and snobbish—a very unpleasant combination.

For the sake of argument, let's assume you're correct. If so, then I might well say that a lot of people don't like me on MetaFilter because I'm smarter than most. Now, how does that statement strike you? Doesn't sound so good when you're on the other end of it, does it? Instead, it sounds incredibly self-serving and egotistical.

And, again, let's say you're right, even if it's an unpleasant truth for some. So those of us that are "special" don't fit in with a world that can't stand our failure to be mediocre. Oh, how terribly sad is that? I mean, of all the crosses to bear, that's gotta be among the worst, right? As opposed to being a 8-year-old child starving to death in Sudan. Or a mentally handicapped person ridiculed by his/her peers as a child and pitied by adults. Oh, woe are we who are cursed—cursed—I tell you, by being gifted creatively or intellectually or, worse, both.

Personally, the way I see it is that I have two unusual handicaps that have made my life very difficult: my crippling bone disease, and depression. Other than that, though, I was born a white male in the US in an era where, for example, joint replacements are common. More importantly, for some reason, apparently, I was born brighter than most (whatever that means) and because of this I've had opportunities and created opportunities that someone not blessed as I have been blessed would not. If not fitting in that well among most people is the price I have to pay for this gift, and all the other ways I'm advantaged, it's a bargain.

Besides which, if you have any sense at all, and maybe some experience, you'll have learned that geniuses are a dime a dozen. Big whoop.
posted by Ethereal Bligh at 4:34 AM on September 30, 2005

I hate to damage the generally friendly tone of this thread and I'm not happy to so strongly disagree with zoogleplex. But I feel very strongly and negatively about this sentiment. I've heard it from a lot of people I've known and it's just wrong.
posted by Ethereal Bligh at 4:42 AM on September 30, 2005

Ethereal Bligh writes "So, the lesson is that sometimes older drugs can be better, and they're certainly cheaper, but different people get different results. If you're going to be taking something a long time you should find something that works best for you with the least side-effects."

This is exactly correct, and bears repeating. Many drugs, especially in mental health, are touted as being newer and better, almost magical in their abilities. We now know, however, that they work only about as well as the older drugs. This is true for SSRIs (Paxil, Prozac, etc) which have now been shown to only work as well as older anti-depressants, and no more safely, and has now been shown true by the CATIE study for anti-psychotics (NYT link from 9/20).

Medications work well for some people some of the time. The problem is not in the drugs as a possible part of a health care solution, but in the marketing (which doctors tend to buy too readily) of meds (or a specific med) as the only solution. This is especially true because studies show that meds work no better nor worse, overall, than competent psychotherapy for many mental illnesses.
posted by OmieWise at 5:38 AM on September 30, 2005

The one thing I've seen over and over, and which there seems to be much agreement upon, is that a combination of meds and talk therapy is more effective than either alone. Speaking from personal experience, even if I were to assume that all my problems with depression were purely an abnormal biochemistry, it's the case that living with depression becomes something that much of my psyche was built around. If meds by themselves are very effective at restoring a healthier mental balance, it's the case that there's a lifetime of coping mechanisms that in the context of a biochemically healthy person are no longer functional coping mechanisms and are, rather, counterproductive. Not to mention that shifting from a predominantly depressed person to a more normal person is a big life change that is confusing in itself.

With all chronic illnesses, physical or mental, a big portion of the sufferer's life is built around the illness and, in many or most cases, is distorted as a result. For whatever reasons, my joint disease doesn't identify me in my own self-image nor has it distorted much of my life. Yes, in the last five years it has, as I've become extremely disabled. But in contrast to the case with my sister, it doesn't really define me. It does define much of her and her life and, I believe, not in good ways.

In my case, however, depression has formed a core, maybe the core, of my identity. Until I was 25, I fought extreme depression on a regular basis, experienced deep crisis periods every two months or so. After I'd been on the meds for a while, it became apparent that I was undergoing a huge transition. A difficult one, actually, as I struggled with leaving behind my entire identity defined by depression. I didn't realize this was the case at first, and then once I did realize it I didn't want to give it up because it was who I was. Depression and manic-depression are, in my opinion, particularly tenacious in that they are perversely attractive. The tortured soul struggling through life to some possible heroic victory is a seductive image. It's cliched, but it's easy to mythologize these illnesses into something tragically noble. Even if your depression/manic-depression is purely biochemical, you still may be "in love" with it and, if so, you're not going to get better because you will continue to choose to live a certain kind of life. Or, if you're not really "in love" with it, you still may cling to it because it's familiar, it's what you know. Talk therapy is absolutely necessary for all these reasons.
posted by Ethereal Bligh at 6:33 AM on September 30, 2005

I can't stress enough how important it is to me that people get treatment for their mental problems. If treatment works, it works, and that's what matters. It's also important, though, in these days of med ads on TV, to know that therapy is just as effective (even for severe depression) as meds are. That doesn't mean I think anyone should stop taking their meds, just that there are other alternatives as well. This article details a study that shows CBT is equivalent to meds, even for severe depression, and it recommends changing treatment guidelines in order to use psychotherpy as the first line treatment, which seems wise given the possible side-effects of meds. The last two paragraphs explain that although the study is about CBT it should be applicable to other mainstream therapies, a position supported in Bruce Wampold's rigorous The Great Psychotherapy Debate.
posted by OmieWise at 7:30 AM on September 30, 2005

EB What you describe is the same as is said of alcoholics who stop drinking. They continue in coping behaviors learned while drinking. Makes sense to me.

Therapy: That therapy is as effective as meds sounds like it could be valid, but what does this do to the notion that these various conditions are chemical in nature, rather than psychological? Of course there is also the additional issue of time and expense.
posted by Goofyy at 7:52 AM on September 30, 2005

ADHD is not a mental disorder. It is a behavioral disorder. That means it is the result of something that requires behavioral control to "cure". Drugs such as Aderol, Ritalin, and other whacked out drugs, hile having the side effect of allowing you to "focus" better, are just "speed". Yes, they help. So does methadrine.

Jesus, that is just so uninformed. It is a neurological disorder. This is fact, not opinion. People with ADHD have a problem with dopamine production and their neurotransmitters. Hence their being distracted by every single thing around them.

I was diagnosed with ADHD about 4 years ago, and yes, I went through a battery of tests to make sure. I went on medication but found out that the side effects for me were too brutal to continue. So now I compensate by keeping refined foods out of my diet, keep my headphones on at work, exercise, take Omega-3s through flax seed, and pop L-Tyrosine three times a day. Oh, and mega loads of caffiene.

I do however, have lots of friends on a couple ADHD boards who have had great success with meds (Adderal, Ritalin, etc). And lousy experiences with Strattera. Strattera is strictly for those who cannot take stimulants. My shrink refused to prescribe it, saying it causes far more problems than it cures.

Oh, and fuck Tom Cruise.
posted by Ber at 8:41 AM on September 30, 2005

My, what an interesting thread. Especially OmieWise's post which got me wondering how genital torture was connected with ADHD. By the way, on a semantic note - there is no such thing as "Adult ADD," it is not a separate disorder. Also, the clinical term is ADHD rather than ADD; ADHD comes in Predominantly Hyperactive, Predominantly Inattentive, and Combined types.

Now for a little bit about me and where I'm coming from. I was diagnosed with ADHD close to 20 years ago. I've been medicated for 13 years; the first 10 were on Dexedrine and now I am on Strattera. Yes, I received the "full battery" of tests - which, for the record, has nothing to do with 48 hours in a mental ward - although that means nothing and my own personal history means everything. To give you an idea of how severe my ADHD is, a few years ago I was approved for state-funded Vocational Rehabilitation because of it.

Anybody who says ADHD doesn't exist (many people do think this) is full of crap. Anybody who says "you should be able to manage without drugs" is also full of crap. ADHD is a very individual thing, just like depression. I have not had behavioral or talk therapy relating to my ADHD, my sole treatment has been medication. And it's damned effective for me. My friends and family have always been able to tell when I miss my meds; there is a marked difference in my behavior, personality, and attitude.

Back to the original topic - the supposed dangers of Strattera - many posters here seem to be of the opinion that Strattera makes you happy. Not at all - Strattera is an ADHD medication, not an anti-depressant. Non-stimulant medications for ADHD are actually quite new, so there's not much to say about that, but even stimulants have a different effect on people who genuinely have ADHD. I've always placed it on a scale of -10 to +10. At either end of the scale is inattention and hyperactivity; the "normal" state is 0. Most people start at 0, so when they take a stimulant they go up on the scale. Patients with ADHD start at -10 and also go up the scale when on stimulants - which is closer to normal.
posted by etoile at 9:06 AM on September 30, 2005

The underlying problem here is that there are far too many kids (and adults) being "diagnosed" as ADHD and given drugs when it would be fully possible for them to deal with it themselves. That they are very likely, in fact, just going through their own mental development processes and their brains NEED that time of relative insanity for whatever reason.

InnocentBystander, you're dead-on with this one. That's a great way of putting it. There are definitely individuals who, like myself, do have a neurological disorder - but I don't think the numbers are as high as they seem based on actual diagnoses.

Unfortunately, until we have an actual test, like the kind that checks for allergies (definitive based on visible response) or the kind that checks for anemia (definitive based on chemical properties) we will continue to see ADHD getting overdiagnosed in both children and adults.
posted by etoile at 9:10 AM on September 30, 2005

etoile writes "Especially OmieWise's post which got me wondering how genital torture was connected with ADHD."

Um, I'm sorry, WHAT?
posted by OmieWise at 9:20 AM on September 30, 2005

Sorry about that, OmieWise - it was a joke based on the acronym CBT, which can mean Cognitive Behavioral Therapy but also Cock and Ball Torture. It wasn't meant in a negative way, and I apologize.
posted by etoile at 10:19 AM on September 30, 2005

Thanks etoile. No apology necessary, your clarification is more than enough. I was somehow worried I'd unconsciously been a jerk, when I've got all the trouble I can handle trying to control myself from consciously being a jerk. Perhaps I do need CBT (type to be determined).
posted by OmieWise at 10:25 AM on September 30, 2005

I think there are some of us pill people who would be glad to add or try therapy for our ailments, however insurance doesn't always cover this. We take the type of help we can get because paying out of pocket for therapy is not within our means.

Then of course there is the lame therapist phenomena, which I have encountered myself. The county mental health system that was taking care of me for a few years gave me vouchers to see a therapist for a little while. Mine wouldn't stop talking about her bout with depression and how she got over it. That's very nice for her and all, but I was there to talk about my issues and there really wasn't much focus on that. My point is just that not all therapy is necessarily all that beneficial.
posted by beth at 10:54 AM on September 30, 2005

EB, it's okay to disagree with me. I'm not advancing what I typed as something I really believe in, but just as an idea of why perhaps so many people who are identified as or who self-identify as creative or "brighter than most" might feel alienated from other people, and thus perhaps become depressed. I don't know any people of any sort who enjoy being shunned or mistreated by others, being told directly or indirectly that they are unwelcome, strange, or only tolerated because who they are and what they do is something exploitable. These things aren't good for the self-image, and constantly feeling this way is certainly a contribution to depression.

And yeah, it can be self-pitying and snobbish, which are certainly emotions that depressed people get caught up in. I guess I'm just saying that for some people, the advantages of being bright and creative and having that set of opportunities sometimes (or often) pale in comparison to the social disadvantages.
posted by zoogleplex at 11:22 AM on September 30, 2005

It appears that some people here don't realize that brains don't have "bootstraps." If you have a chemical imbalance, merely "cowboying up" doesn't work, because you're not processing the chemicals that will allow yourself do it.

Forget it. I can't even dumb it down enough. Read a goddamn book.

And yes, weaning yourself off Effexor is a bitch. I'm doing it right now. Vertigo. I feel like someone's playing a theramin in my ear canal. ooooWEEEEoooo!
posted by Kloryne at 8:20 PM on September 30, 2005

"It appears that some people here don't realize that brains don't have "bootstraps." If you have a chemical imbalance, merely "cowboying up" doesn't work, because you're not processing the chemicals that will allow yourself do it. "

Actually, I disagree with this a little bit. That is, I feel pretty certain that there's a synergistic relationship between what we call the "mind" and the brain and altering one will alter the other. (Of course, I reject the dualist perspective outright, but it's a convenient way for me to make this point.)

But I agree with your sentiment. Even if I'm right about the synergy, there are obvious limits.
posted by Ethereal Bligh at 8:28 PM on September 30, 2005

Well, yes, I agree it's all one loop -- as has been stated above, talking therapy is just as important as drug therapy. However, if your brain is simply inable of creating those "get up and go" (I can't think of any more analogies!) chemicals on its own, you must have a the correct chemical balance (pill form for now) before you can actually attempt the talking therapy to make the rest of the cycle complete and, hence, get the old bootstraps out (I'm going to launch into The Gambler in any moment, now).

I apologize for lack of finesse in discussing this. I've honestly been trying to NOT talk about it for about 20 years (therapy aside).
posted by Kloryne at 8:39 PM on September 30, 2005

the dr. feelgood link is superb! thank you, thank you.
posted by brandz at 8:43 PM on September 30, 2005

And yes, weaning yourself off Effexor is a bitch. I'm doing it right now. Vertigo. I feel like someone's playing a theramin in my ear canal. ooooWEEEEoooo!

Been there, done that - Celexa in my case. Yeeesh, blegh. You know that first day of the flu when you are not only achey, nauseous, and congested but you also feel weird electrical shocks going through your body? That's what it was like on and off for a few months. Talk to your doctor, see if there is a way to taper off it a little more gradually - titrating down very slowly was the only way I could do it without feeling sick all of the time.

That being said, the physical discomfort of drug side-effects are, for me, trivial compared with the horror show that goes on in my head when I'm unmedicated. I say this as I am slowly weaning myself off of medications in preparation for pregnancy. Frankly, I'm terrified.
posted by echolalia67 at 10:48 PM on September 30, 2005

my autism specialist was suggesting Ritalin to help with a focusing aspect of my Aspergers Syndrome, but our goddamn family doctor said he didn't think it was safe and gave me Strattera!

God for-FUCKING-fend that an overworked doc, specialist in nothing, should have the unmitigated GALL to use his own judgment when confronted with an angry, mentally disturbed patient demanding a highly addictive medicine that's been proven to cause heart attacks, tachyarrhythmias, strokes, and cerebral hemorrhage.

How DARE he?

The sad part, to my way of thinking, is that he prescribed Strattera instead. I don't think that medicine's safe either, and I think we're well on the road to finding it out. The FDA is completely outgunned by Big Pharma.

Drug companies today recall the example of Coca-Cola in its early days. Put cocaine in a drink, and, imagine that - people just keep on buying it.

On the other hand, Novartis bought me a nice steak and a couple glasses of Syrah last night, so maybe I should just shut up and eat.
posted by ikkyu2 at 10:43 AM on October 1, 2005 [1 favorite]

echolalia67: Talk to your doctor, see if there is a way to taper off it a little more gradually - titrating down very slowly was the only way I could do it without feeling sick all of the time.

Just wanted to say thanks for the advice. I am doing it with my doctor's help, taking a little of the time-release balls out at a time; much better than it could be, I know. I stupidly did the "cold turkey" thing many years ago -- bad idea. Also, good luck to you and your meds-free pregnancy. And way to go! My man and I were discussing that very thing last night, and how challenging (OK, scary) it must be for expecting mammas.
posted by Kloryne at 2:02 PM on October 1, 2005

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