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gray matter decline following mania and depression


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A German doctor, Thomas Schleapfer, has done loads of research into the neurodegeneration of brain tissue during depression. What he concludes is that because of the duel action of lower absorption of both seratonin and norepinephran, brain cells don't regenerate at their normal rate. They don't stop completely and you aren't actually losing so much that you suddenly become an idiot. They just don't replace themselves as they normally do. Even a mild SSRI can put a stop to that.

Don't panic!

There is a load of pharma company money going into this research because it boosts sales. It's rather full of hype and the media is going to turn it into a black and white, do or die story as always.

What's more worrying is the fact that after years of being on psychomeds, you're brain is likely to get used to the work being done for it and when/if you go off it will have gotten lazy and takes some time to get back in the swing of taking care of those dead cells.

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That's really interesting and it's slightly different than what I'd thought about depression (I'm assuming this is the hippocampal shrinkage stuff?), that the problem was a loss of cells, not a failure to regenerate. I'll have to look his stuff up.

That is interesting about the rebound effect as well. Is Schleapfer doing that research as well? Did he find it for all antidepressants, and for other meds than antidepressants?

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Any psychoactive substance, logically, will cause lasting changes to synapses and eventually neural topology (aka structural brain "damage") which will then change the way the brain behaves without the substance. This reviews the many studies that have shown this effect, and suggest that much chronic mental illness is the result of such changes in response to medications which are poorly understood.

http://psychrights.org/Articles/EHPPPsychD...c(Whitaker).pdf

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I don't believe I asserted anything about the initial post. Did you read the study I posted?

Just FYI, I don't expect the majority of people here to listen to me. I'm not trolling. I don't really care that you all accept the pseudo-science of psychiatry. I'm just passing along info for those interested in actual science, who are able to discern things for themselves.

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The full article mentioned in this post has not been made public via the internet; I was only able to find the abstract. The abstract makes no mention of having controlled for the effects of medications, and in fact the sample size is so small that I find it hard to believe this would have been statistically possible to determine. In fact, as they did not report anything to the contrary, I would fully assume that all 20 bipolar patients were indeed medicated, since no non-medicated bipolar group was built into the methods at all (where do you even dig up diagnosed bipolars who are not on meds?). Ergo, any discrimination between the effects of the disorder vs. the effects of medications could not have been determined in this study.

This point was made eloquently on the empircalinsanity blog in resonance's sig (*cough*):

http://empiricalinsanity.wordpress.com/200...polar-disorder/

If someone has the full text, with evidence to the contrary, I'm all ears. If they actually did build this into the methods of the study, someone ought to teach them how to write a proper abstract.

This same claim has been made now for ADD, depression, bipolar, and psychosis. In all cases, those pointing out the lack of *any* studies showing these effects but controlling for unmedicated sufferers have been published and then ignored completely. It's called confirmation bias and economic pressures manufacturing consent. We could all argue these dynamics forever, which is why it makes more sense to argue the hard science. You can all label me a troll or a Scientologist, but if you aren't arguing on scientific merit, I am not really hearing you.

Here's the abstract relating to the article referred to by the original poster:

Background

Structural brain abnormalities of the medial temporal lobe have been found in people with bipolar disorder (BPD). It is not known whether these abnormalities progress over the course of the illness or how they relate to neuropsychologic functioning. We sought to address these uncertainties in a prospective cohort study of people with bipolar I disorder.

Methods

Twenty patients with bipolar I disorder and 21 control subjects were recruited from the community. Participants were group matched for age, sex, and premorbid IQ. Longitudinal change in gray matter density was assessed using magnetic resonance imaging and evaluated using the technique of tensor-based morphometry with SPM2 software. Changes in gray and white matter density were estimated and compared with changes in cognitive function and clinical outcome.

Results

Patients with BPD showed a larger decline in hippocampal, fusiform, and cerebellar gray matter density over 4 years than control subjects. No significant changes in white matter density were found. Reductions in temporal lobe gray matter correlated with decline in intellectual function and with the number of intervening mood episodes over the follow-up period.

Conclusions

Patients with BPD lose hippocampal, fusiform and cerebellar gray matter at an accelerated rate compared with healthy control subjects. This tissue loss is associated with deterioration in cognitive function and illness course.

And for fun, since it's apropos, here's a former drug rep describing exactly the toxic, brain damaging effects of SSRIs that can lead to falsely diagnosed bipolar conditions, which happened to me personally, and which we now know the drug companies knew about but did not disclose to regulatory bodies like the FDA, for obvious reasons:

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wow, that article jemini posted was so interesting. i only skimmed it, will read later, it's late. It really is kind of disturbing in that many of us have wondered if the medication has made us worse... and the thought that we may only be making ourselves crazier...that's really alarming. I'm not sure which is worse. Life before meds, the debilitating moods, the awesome irritability. Or the long-term med-crippled brain. I've never taken SSRI's. (except for 2 looney days on 5mg of lexapro. lol). no benzos. but i do take a small dose of an AP.

Has there been any mention of mood stabilizers like lamictal or lithium making people crazier?

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psychrights.org is a propaganda site. The article is from a fringe journal dedicated to debunking the medical view of mental illness. The fact that atribution is given to author with only a place of residence following his name typicaly indicates that he has degree in medicine or a mental health care field.

This is really all you need to know about the journal that came from:

Founding Editors and Consultants:

Peter R. Breggin, MD, and Ginger Ross Breggin

Some info on Breggin from quackwatch:

http://www.quackwatch.org/04ConsumerEducat...BR/breggin.html

http://www.quackwatch.org/11Ind/breggin.html

Breggin's resum
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VE is exhibiting his characteristic intellectual dishonesty. I'm sure he won't mind my making a counter-point:

The study I posted was not written by Peter Breggin. This is stated pretty clearly on page 1, as well as in the title of the PDF file. It was written by Robert Whitaker. Also, the study cites *numerous* studies on which it is based. I've read many of them. VE undoubtedly has not.

Seriously VE, you can't pick and choose, readily accepting all the minimal evidence presented by studies run or funded by Big Pharma as proof the meds are the Cure, and dismissing actual data in all other cases as obviously from flawed sham sources.

Here's some more reading for people, since VE has chosen to divert the issue into quality of sources.

A well-researched, honest look at the distortion of facts and scientific method used to promote psychiatry:

http://www.amazon.com/Blaming-Brain-Truth-...h/dp/068484964X

About the author:

http://sitemaker.umich.edu/elliot.valenstein/home

Books about the brain damaging effects of SSRIs, the research behind this (some of which was quelled by the drug companies as early as the late 80s), and how to safely get off these drugs, by Harvard (practicing) psychiatrist Joe Glenmullen:

http://www.prozacbacklash.com/

The latter books each have an entire first chapter online; both are excellent reads and eye-opening. The first isn't online, but some of the reader reviews are very thorough in outlining the book's talking points.

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Also, just to say, VE also is not board certified to practice psychiatry, nor has he gone to med school, nor as I can tell did he even study pre-med science including biopsychology. You could use his argument dismissing Breggin (who has been speaking and writing on the issue of psychiatry for many decades) to dismiss any studies or arguments VE makes. I *don't* do this, as I understand it does not require a license to practice psychiatry to be interested and capable of investigating the underlying science. However I also don't run a board where I pretend I am an expert and actively censor or ban dissenting viewpoints claiming this interferes with the local residents' treatment plans.

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Hi All:

Jemini wrote:

Seriously VE, you can't pick and choose, readily accepting all the minimal evidence presented by studies run or funded by Big Pharma as proof the meds are the Cure, and dismissing actual data in all other cases as obviously from flawed sham sources.

meds for mental illness are the cure? when did this happen? and what meds are the cure? I'd love not to be bipolar & anxious.

db

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Any psychoactive substance, logically, will cause lasting changes to synapses and eventually neural topology (aka structural brain "damage") which will then change the way the brain behaves without the substance. This reviews the many studies that have shown this effect, and suggest that much chronic mental illness is the result of such changes in response to medications which are poorly understood.

http://psychrights.org/Articles/EHPPPsychD...c(Whitaker).pdf

I figured I would get my shovel and do a little fact checking. ** I need a bulldozer to move all the bullshit ** I don't have enough time in one day to expose all the lies.

The Author

Robert Whitaker was a science writer for the Albany JournalTimes Union [edit]. He made a name by exposing some excesses in the pharmaceutical industry and on poorly trained student surgeons. He founded Center Watch a for profit clinical trials tracking website and later sold his shares. He appears to have no education or employment in science, medicine or research. He published a paperback book in 2003 Mad In America: Bad Science, Bad Medicine, and The Enduring Mistreatment of the Mentally Ill which is already out of print. Its premise is that Schizophrenic patients are worse off now than they were twenty years ago. It spends a significant amount of time detailing psychiatric horror stories from the 40's thru 1970's.

The Journal

This article was published in "Ethical Human Psychology and Psychiatry" the official publication of the International Center for Study of Psychiatry and Psychology (ISCPP), founded and advised by.... Peter Breggin, MD. The ISCPP claims to be peer reviewed, but only one editor of twelve is an MD. Of over 30 editorial reviewers only 8 are psychiatrists. This publication is so unimportant from a scientific perspective that it is not indexed on Pubmed/Medline.

The Article

I just can't spend enough time to address more than a tiny portion of Whitakers article. True to form from his book, he opens with "shocking" stories of drug failures.......from the late 1960's and early 1970's. Most of the drugs referenced are no longer primary or even secondary drugs! He distorts the truth here by deliberately implying that patients on meds relapsed more than those not on drugs. On close reading we find that those on meds relapsed because they STOPPED the meds. Not that meds CAUSED the relapse. Any medical doctor will agree that stopping any sort of medication for any acute condition will likely result in relapse.

It just goes downhill from there. Can you understand why no reputable journal will publish this tripe? Over half of Whitakers references are 20, 30, 40 years old. Most use medications that are no longer common and thus not directly relevant. He references other peoples books (!?), and unpublished manuscripts. A college freshman would not be allowed to submit a term paper with such shoddy references.

One thing I am thankful for being exposed to, yet stunned by, is the number of gullible people sucked into the conspiracy fantasies.

a.m.

p.s. The ex pharma rep is really a pathetic example isn't she. She can throw around a few acronyms and conflates a bad reaction into a general indictment of all psych meds under the care of a GP, then refuses expert psychiatric care because she "knows that once I get in there, I will be on their meds for the rest of my life". Riiight. Just like Dracula's bite.

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Firstly, I want to point out that I am responding to AM *because* he is being more or less respectful, stating facts and logical arguments, and is not simply resorting to childish name-calling and smearing to get his point across, and this has not been the norm on these boards when discussing these issues. I hope it will likewise be noted that I am responding in kind, addressing points rationally. As I've said before, when people fall back on personal attacks or step away from logical arguments they cannot rebut in favor of discrediting the source, I tend to feel I'm debating with cretins.

That said, I don't appreciate the shoveling bullshit lead-in.

Regarding Whitaker -- I respect the points made about his not being a psychiatrist, but also respectfully point out that if only other practicing psychiatrists are allowed to comment on *actual research data* and be taken seriously, then of course only the psychiatric viewpoint is going to be accepted. The research he cites has been cited by others, and where it is older research it is A) not therefore invalidated by the passage of time, and B) is older specifically *because* it reflects earlier tendencies in prescribing and points to an overall pattern that is the point of his study, which is that time and time again, a new class of drugs has been heavily pushed, the evidence that the drugs were causing serious, often long-term damage was marginalized and ridiculed by the establishment, and then eventually these effects became more widely known, resulting in a shift to a new class of drugs. This began with Thorazine and the original neuroleptics, where concerns of damage were *actively* dismissed (as in, pushed out of publications, smeared by doctors, etc) until major class action suits in the early 80s brought more attention to the research indicating as many as 40% of users of these drugs developed life-long permanent tardive dyskinesia and related brain damage. This continued with the so-called "minor tranquilizers", now banned in many countries for their debilitating dependencies and long-term effects, and most recently, the SSRIs that came out of the "prozac revolution", enjoyed a good 15 year run, and we are now starting to see the buried research data emerging that these drugs too cause TD and related neurological problems, as well as highly publicized increases in violence and suicidal behavior, and so the field is moving on, as they always have, the the new "atypical anti-psychotics", which yet again, have a lot research indicating long-term damage. My point is that you can smear the author all you want, but he is citing FACTS. For more recent facts, check out those writing about the more recent drugs, like Joe Glenmullen.

As for bias on the editorial staff of a journal, while I am glad to hear these facts (which I did not know) about that particular journal, and yes, accept the indication of bias in publishing, I find it rather disingenuous of you not to concede that the pharmaceutical industry has members on the review boards of many prominent journals, and infamously more than half of the committee members that designed the last DSM edition (IV) were on the payroll of pharmaceutical companies. Many books have hit the shelves in the past few years describing these influences, showing data as to how doctors' diagnosing, prescribing, and beliefs about what science has and has not shown are clearly influenced by the direct monetary gifts of pharmaceutical companies. By point is simply: don't tell me any research opposing the drug-model is invalid simply because it is biased, when the entire case for the drug-model is extremely biased and widely known to be so. Let's try to stick to the actual facts. (I cannot help notice no one has bothered to look into the studies I've linked and argue the actual data or scientific methods.)

As for why no "reputable" journal will print anti-drug "tripe" -- this has also been written about quite a bit, and I just touched on it.

I will finally point out, that whenever people on these boards have requested I post studies backing up my claims, and I do so, the claims are sometimes deleted by the ***s in charge, sometimes dismissed as the ravings of outsiders, sometimes ignored, and most frequently just ridiculed and mocked under the axiom that anyone who things drugs are harmful and/or not actually helpful in the long-term is by definition crazy. I also have been banned a few times, and attacked for posting too much anti-psych "propaganda". It is for these reasons that I tend to be hesitant about posting "further evidence". I recently sent VE, at his request, some studies including one from this year showing that medicated schizophrenics in a 15 year longitudinal study are substantially significantly less functional than those not medicated. He never replied, though he pointed out some rather disturbing things about his own sources of bias.

The ex-pharma rep is correctly pointing out what I have now read from several licenced, practicing, fully respectable psychiatrists: the drugs on the market by and large have numerous damaging effects that drug companies' own studies have shown; such studies are actively withheld from the FDA and the public until repeated anecdotal evidence from individual prescribing doctors leads to investigation and uncovery of the issues, and even then the issues are marginalized and typically not added to the PDR, drug inserts, or any other commonly shared source of drug info unless required by a legal ruling of a law suit against the drug company. She correctly describes the akathisia reaction from SSRIs (which I have now experienced 3 times), how this reaction is commonly attributed to an "underlying" bipolar condition which the drug "revealed", and she is correct that this has been covered up by drug companies and sold to a huge majority of prescribing doctors (the majority of which, VE, are not certified psychiatrists but rather general practitioners). Having lived through the same experience, I understand precisely what she is talking about. I find it difficult to find doctors willing to understand that I cannot, even according to the DSM, be diagnosed as bipolar when the only manic experiences I've ever had were always while taking serotonergic drugs and always subsided after removing the drug. I am now forced with doctors and insurance companies to accept the role of "non-compliant" bipolar forever. Because of these drugs. And the research is all there for anyone genuinely interested to review. Again I recommend Joe Glenmullen's book Prozac Backlash, with the first chapter online: http://www.prozacbacklash.com/

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Dr. Glenmullen doesn't conclude that patients should not be treated with SSRI's. Rather he indicates that SSRI"s should be used judiciously at the lowest level required:

Often the dose needed to maintain the effects of these drugs once they are working is much lower than the dose required for start-up. In my experience consulting to patients who have been treated with these drugs, about 75% are able to dramatically reduce their dose or eliminate the drug altogether.

The good doctor regularly compares SSRI's against the side effects of traditional AP's (he calls major tranquilizers, a now dated term) which are well known to cause TD, yet he does not call for the cessation of their use either.

I find his first chapter very readable and that contains some thoughtful comparison and hypothesis. I can relate to a number of the symptoms he discribes. Hopefully someone is doing careful research into this hypothesis. Again, Dr. Glenmullen openly states that he is merely making observational comparisons and has not facts showing that SSRI"s actually cause any brain damage.

a.m.

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Blaming the Brain

Jemini: "A well-researched, honest look at the distortion of facts and scientific method used to promote psychiatry:"

http://www.amazon.com/Blaming-Brain-Truth-...h/dp/068484964X

About the author:

http://sitemaker.umich.edu/elliot.valenstein/home

Well, it IS refreshing to see an author with a decent, or more than decent credentials, Elliot Valenstein. Valenstein is a professor emeritus (e.g. retired) of psychology and neurology. He has a unique perspective of having been involved in the physiology of the brain prior to the introduction of psychotropic meds thru the initial introduction of SSRI's and some anti epileptics.

Let us note that this book is now 10 years old, and the the professor was already elderly and retired when it was published. Further Dr. Valenstein states upfront that he is NOT OPPOSED TO MEDICATION, PSYCHIATRY OR TALK THERAPY.

Contrary to Jemini's statement, he does NOT expose any shocking distortion of facts or scientific methods! His does emphasize that the brain and mind are incredibly complex and that we do not have either a deep or comprehensive understanding of the factors controlling mental illness. His tone is calm and the material is presented as one speaking to collegues in a relaxed discussion. I think this book would really only be of interest in the nuts and bolts of medication and neuropsychology research.

Jemini often makes use of the basic point of Valensteins book: We don't have a comprehensive theory of the mind, mental illness and meds. SO WHAT? The roller coaster designer has no flippin' idea of how gravity works at the sub atomic level (nor does a single physicist), yet he is able to observe the effect and use it to his purpose!

This book does not support Jemini's case against medication and psychiatry.

a.m.

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