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Hello:

After being on antidepressants for nearly 9 years now (with periods of discontinuation) and having recently slipped into a minor depressive episode, despite exercise, prozac, therapy, and social support...I'm tiring of western medicine.

Especially given the numerous recent studies finding that up to 50% of the drug trials negative findings have been supressed....or this article which suggest AD work on the placebo effect in minor episodes.

some links:

http://medicine.plosjournals.org/perlserv/...al.pmed.0050045

http://www.timesonline.co.uk/tol/life_and_...icle3434486.ece

So after trying to increase my dosage of prozac by 10 milligrams and experiencing MORE anxiety...I decided against taking more antidepressant. Instead I'm giving eastern medicine a try. Of course, I'll discuss this with my pdoc, who I see tomorrow.

I live in a wonderfully progressive city, and found an accupunture place that works on a sliding scale in an effort to offer eastern medicine to anyone who wants it. It's relatively cheap (less than my copay to see pdoc).

I've already had one round of accupunture and they want me to try some chinese herbs.

Wondering if anyone has any experiences...

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Accupuncture was great for me! I can honestly say that it staved off some of my mood problems - especially mild depression (which is not why I went in the first place, just an added benefit). I love it for all sorts of things - you can even get an accupuncture "face lift", which totally works too! You know, if you're feeling vain that day...lol.

Just a warning, some of the herbs can be rather foul...I could not choke down the ones they gave me for eczema...they were just horrible (I had to make a tea from them - my entire apt would stink for 2 days!). If they are giving you things in pill form, it's much better. You may also want to looking into learning Tai Chi as a supplement to accupuncture...it keeps the chi flowing along the meridiens and the center should be able to talk to you about this and guide you...they should also talk to you about dietary changes too...too complicated to go into here.

I found the Tai Chi and food changes very helpful for me and my eczema almost completely disappeared after only 4 weeks of doing it half-assed. I'm starting a new program again on March 5th. If you do decide to do it, I wish you good health and a pleasant journey!

The only thing I will say is this: the changes are very subtle...and you shouldn't expect miracles. In the end, you may still need some sort of help from the big bad pharaceutical companies...

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Especially given the numerous recent studies finding that up to 50% of the drug trials negative findings have been supressed....or this article which suggest AD work on the placebo effect in minor episodes.

The analysis, singular, didn't look at all antidepressants or even all classes of antidepressants, only fluoxetine, venlafaxine (an SSRI below 200 mg/day, with some of the most horrendous discontinuation effects if you miss a dose), nefazodone (discontinued in the US by the manufacturer in 2003), and paroxetine, after throwing out the data retrieved for sertraline and citalopram (itself being replaced by escitalopram.)

It is being ASSUMED that the results are inherently representative of all antidepressants regardless of FDA approval procedures before or after 1987-1999, regardless of other methods of action for the many medications approved before or since, and including a drug that was pulled from the market for making some people dangerously sick.

Even then the study DID NOT prove that all ADs work on the placebo effect, it showed that the SSRI/SNRIs studied when averaged as a group do not work significantly better than placebo for moderate depression.

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After being on antidepressants for nearly 9 years now (with periods of discontinuation) and having recently slipped into a minor depressive episode, despite exercise, prozac, therapy, and social support...I'm tiring of western medicine.

There's more to "Western medicine" than Prozac and placebo.

I've already had one round of acupunture and they want me to try some chinese herbs.

The idea behind placebo is that it is inherently harmless, and that the benefits/drawbacks are psychologically-driven. If you can't name the herb(s), we can't tell you it's harmless.

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A friend can trace his pretty serious mental health issues to when he tried to treat mild/moderate depression with chinese herbs. Now he's got some kind of psychosis/sz/bipolar and can hardly leave his flat or cook for himself, and is semi-incoherant when I talk to him on the phone. During the "depression" he was able to complete a degree at Cambridge university.

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A friend can trace his pretty serious mental health issues to when he tried to treat mild/moderate depression with chinese herbs. Now he's got some kind of psychosis/sz/bipolar and can hardly leave his flat or cook for himself, and is semi-incoherant when I talk to him on the phone. During the "depression" he was able to complete a degree at Cambridge university.

That is the sort of situation where I'd wonder if it weren't the delay in more aggressive treatment that nailed your friend more than the herbs. Although there are a few herbs that could send sz/bipolar straight into psychosis/mania, and some people do go downhill fast once they're triggered, I would think the effect would wear off once the offending prep was discontinued.

In this case I'm just guessing, because there are some pretty wicked things that people have been known to consume.

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Regarding the report that AD's aren't any better than placebo, the President of the AMA pointed out that these studies were looking at a single AD as the sole treatment. And in fact the average patient settles on the third AD. [and gets some success!!!!] So much of that report was media hype of the worst kind. We KNOW that the meds help. Pdocs use them every day and SEE the positive results.

There are over 35 meds that can be used successfully for depression treatment. If you have been on only one or two, then you cannot consider that you have any sort of thorough treatment.

Does your pdoc know how low and desperate you feel? Are you completely honest and open, or do you just slide in and slide out of appointments in order to avoid any problems or conflict.

Get in to see your pdoc soon. Print out your post and hand it to him. Tell him that you are gravely concerned about your lack of relief and about the need to take agressive action. If you don't get a wide eyed and earnest response from your pdoc, then consider changing pdocs.

As far as chinese medicine...

Acupuncture has shown only modest improvements in just a handful of illnesses. Mental illness is not one of them. Acupuncture is not some secret cure. It has been used and studied extensively in the West since the early 1970's and has NOT proven to be any better than placebo in general. If you get a sense of relaxation from the appointments then fine. You might also consider massage therapy as well. We would all probably benefit from the dedicated quiet time and manipulation.

Eastern medicines sold in the US are a complete unknown. They are not regulated and no one knows what is really in them. In one FDA study last year they found 50% of the medicines/herbs were contaminated with chemicals or Western pharmaceuticals (probably to enhance the effect). People have died from contaminated herbs. Take a good multivitamin with minerals and some Omega fish oils, and you'll be safer and better off.

Here's hoping things look up soon!

a.m.

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A friend can trace his pretty serious mental health issues to when he tried to treat mild/moderate depression with chinese herbs. Now he's got some kind of psychosis/sz/bipolar and can hardly leave his flat or cook for himself, and is semi-incoherant when I talk to him on the phone. During the "depression" he was able to complete a degree at Cambridge university.

That is the sort of situation where I'd wonder if it weren't the delay in more aggressive treatment that nailed your friend more than the herbs. Although there are a few herbs that could send sz/bipolar straight into psychosis/mania, and some people do go downhill fast once they're triggered, I would think the effect would wear off once the offending prep was discontinued.

To be fair he'd shown some extreme behaviour before trying the chinese stuff - one of the reasons we became friends was a love of sabotaging soundsystems in bars where we didn't approve of the music, and he did a lot worse besides. Then one of the herbs was yohimbe, which he took for "increased energy" not knowing it was a powerful sexual stimulant. He's been very cagey about it's effects but it definitely triggered an unhealthy erotic obsession. Another contained steroids that made one arm grow longer than the other. However I'd guess he's a classic unmedicated bipolar (he refuses all conventional meds after claiming that seroquel made him much worse) and there were definitely signs before he started going completely off the rails. He was simply of an age (early-20s) to develop the illness in full-blown form and maybe the herbs were simply a catalyst for something that was inevitable. I wish I could get him to try meds but he acts incredbily insulted whenever I mention it. He's extremely intelligent and what makes it worse is that his (very good) degree specialised in neuropharmacology, which when fed into his (what I think are) delusions means he always knows better and will get angry when people argue against him. Oh well, let him be and hope for the best I guess.. I'm certainly not the type to force pills on anyone.

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I was nearly sexually abused by an acupuncturist, who said he was treating me for depression. The acupuncture didn't do a damn thing, but dealing with the guy trying to get me to take my pants off induced homicidal urges that still linger to this day.

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Thanks for the input. First...so sorry to hear about your unfortunate experience mad_genius. That is awful.

I understand the comments about the placebo effect...however, the New England Journal of Medicine is a very reputable, hard to get published in journal...and the most recent article revealing that up to 50% of the FDA drug trials do not get published because the results are not positive...well that's something I'm going to pay attention to, and I don't think that is something to take lightly.

I'm not trying to say western medicine is bad or wrong...I'm not trying to convince anyone to quit taking their medication...I'm just trying to be open minded and explore the other options that are available.

A bit more info on my situation:

The herbs they want me to take are: gui pi tang and he huan pi.

I am not going to rely on Eastern Medicine as monotherapy for depression. I am still in therapy, still seeing a pdoc, and still taking the prozac.

My pdoc knows about this and has granted her blessings. While she was a little hesitant about the herbs, she said it is worth a try if I don't experience any adverse reactions. And I haven't so far...I have been drinking the herbs in a peppermint tea form....if anything this help seeking behavior could just be the placebo effect that I needed....

Eastern medicine looks to treat the body as a whole and not focusing only on your brain. Which I find appealing.

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Of course, I'll discuss this with my pdoc, who I see tomorrow.

I was wondering how the pdoc visit went and then I typed a lengthy reply to ask and then saw that you posted about it, so I deleted it...and I'm glad that she gave the A-OK for you to go ahead with it. I'm really excited to hear how it goes for you - I wish you much success in your new journey!

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As long as you keep taking your meds and got the pdocs blessing, great!

Eastern medicine looks to treat the body as a whole and not focusing only on your brain. Which I find appealing

We haven't had too many discussions about Eastern medicine, so I just surprised myself on reading your comment. It's an axiom that Eastern medicine is holistic and Western medicine isn't.

However I just realized that psychiatry at it's best is holistic.

Consider what we tell people:

Take your meds

Do talk therapy

get exercise

take a multivitamin & omega oil

Be with people who make you happy

Get a good nites sleep

avoid alcohol and street drugs

How much more holistic can you get? ;) "Go to church or meditate" is about the only thing left.

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Keep in mind that the most recent article reviewed almost exclusively trials that were six weeks or less in length. There are two issues here:

1) antidepressants can take up to six weeks to work

2) placebo effects can diminish over time...but as far as I can tell, we don't know how much time. Is six weeks long enough for an antidepressant placebo effect to go away? Maybe.

A friend who was reviewing the article and responses to it told me that apparently the placebo effect for antidepressants has been increasing for a number of years, presumably reflecting our increased confidence in medication's ability to treat depression.

(Maybe the best thing is a combined antidepressant+placebo approach? I haven't heard anyone suggest that yet in response to this article...)

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(Maybe the best thing is a combined antidepressant+placebo approach? I haven't heard anyone suggest that yet in response to this article...)

That was in the pedantic half of my response I dropped because it was a little boring and I don't have numbers to back up the argument better. Basically, if the antidepressant's effect can be assumed to be separate from that of placebo, and both are effective over a random but evenly-distributed population:

For 1,000 people:

- Let's then say that SSRI that provides significant improvement for 70% of your population. 700 do better.

- If placebo is 80% as effective as the SSRI on a similar scale, 560 people should improve (This is rotten odds for trusting placebo alone)

- The two are independent, so combining the two give 392 a blended response, but 168 will see improvement from the combination because of the added placebo, for 868 people improving out of 1000. (This is better odds of improvement that either monotherapy would get you.)

It may be an open question if placebo and therapy, both relying on psychological effects, would be entirely independent when considered across a depressed population. In the worst common case, placebo medication, psychotherapy, prayer, or even Magick, should mix with an effective medication for overall strongly effective treatment.

An herb, which may have real physiologic effects, may be more effective than placebo even as a placebo - or less effective - depending on the mix of benefits and side effects.

Nothing's perfect though: even with a hundred approaches, over a large population some folks are going to be left as bad or worse than they started.

Like I said, pedantic and a bit boring.

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The herbs they want me to take are: gui pi tang and he huan pi.

Talk about "witches' brew": gui pi tang has quite a few herbs in it, including astralagus and licorice root. I think one of the angelicas is also in it. As one component of several and only drunk as a tea, licorice root may not be too dangerous - by itself and in quantity, it can jack cortisol levels. The web page I linked mentions using it as herbs for chicken soup, and that's probably worth trying.

he huan pi is mimosa tree bark. Luckily, the Chinese herbal species - Albizia julibrissin -is NOT Mimosa hostilis, which, in combination with an MAOI, is used as an entheogen. It's reputed in TCM to be useful as a calming agent, but there doesn't seem to be a lot of research on it (probably drowned out on the search engines by the more entertaining mimosas)

There's nothing that really screams out "don't mix with a liver isoenzyme inhibitor" and nearly every herb in gui pi tang is being researched for non-psych uses.

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A friend who was reviewing the article and responses to it told me that apparently the placebo effect for antidepressants has been increasing for a number of years, presumably reflecting our increased confidence in medication's ability to treat depression.

(Maybe the best thing is a combined antidepressant+placebo approach? I haven't heard anyone suggest that yet in response to this article...)

My tdoc tells me that placebos always work on me...maybe these people need to study me :) ...well, for a little while, anyway...then I get wise to those damned placebos... ;) ...sounds like I'd be a perfect candidate. I'm all about donating my body and mind to science - take me now.

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It's an axiom that Eastern medicine is holistic and Western medicine isn't.

Was thinking more along the lines of Eastern medicine seeing all of the parts of the body as being connected and not just treating one particular area of the body of which the symptoms are coming from.

While I do acknowledge the medical model, I do not think major depressive disorder is as simple as serotonin being deficient in the brain (or any other combination of neurotransmitters).

I think we as humans, are bigger than that. We are more than just chemical reactions. That being said, I don't think medicine, in general, should view any dis-ease in isolation.

The mind is more than just the brain.

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hi,

themind - ive been thinking along the same lines regarding our bodies. i dont think MI is just an odd chemical reaction that affects some people but not others. however, i dont have the "brain" to think clearly on the subject right now.

the frustration of finding the right combo to treat our MI is also a biggie. add in all the side effects - and im quite surprised most of us are still alive!!!

Yeah for us!!!

db

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