More Random Newsquibs

Now the Bipolar have Something Else to Whine About

Acetaminophen Blunts Evaluation Sensitivity to Both Negative and Positive Stimuli

Acetaminophen, an effective and popular over-the-counter pain reliever (e.g., the active ingredient in Tylenol), has recently been shown to blunt individuals’ reactivity to a range of negative stimuli in addition to physical pain.

Next time someone whines about a mood stabilizer working in terms of preventing hypomania, sorry, their emotions being all blunted and shit, and if anyone knows of a med that’s more “activating”, I now know where to point them.

This Explains So Fucking Much

Genetics and the placebo effect: the placebome

  • Predisposition to respond to placebo treatment may be in part a stable heritable trait.

  • Candidate placebo response pathways may interact with drugs to modify outcomes in both the placebo and drug treatment arms of clinical trials.

  • Genomic analysis of randomized placebo and no-treatment controlled trials are needed to fully realize the potential of the placebome.

Placebos are indispensable controls in randomized clinical trials (RCTs), and placebo responses significantly contribute to routine clinical outcomes. Recent neurophysiological studies reveal neurotransmitter pathways that mediate placebo effects.

First of all it’s another reason to require an active placebo (a med, usually an old one like Thorazine or desipramine, that is already approved to treat whatever the new med is being tested to treat).

Secondly, and more importantly, it explains why, when people who write about their bad experiences with meds and include anecdotes about that their parents and/or grandparents who were able to deal with their problems using vitamins or whatever, the placebos worked for said ancestors.

Hey, as long as it works.  Have a placebo party.  Good luck and find another site to rave about whatever you’re taking to fix whatever it is you think is wrong with you.

It’s a Start…

Anti-vax mom changes her tune as all 7 of her children come down with whooping cough

A Canadian woman who had declined to have her children immunized against pertussis, better known as whooping cough, has changed her position now that all seven of her children have come down with the disease.

I consider it a bit of misapplied karma for the antivaxxer parents whose kids gave my daughter pertussis – thanks to her birth family’s neglect regarding her booster shot, as it turns out – which subsequently developed into asthma.

I’m lucky to have had a booster shot about ten years prior to when that happened.  Influenza shots don’t do me a damn bit of good, but the pertussis vaccine works perfectly for me.

 

Brand vs. Generic Meds Updates

I’ve updated the Brand vs. Generic and FDA vs. Teva/Impax vs. Reality pages to reflect the bioequivalence testing data on Budeprion XL the FDA quietly released … however long ago they quietly released it … along with their somewhat more stringent standards for generic crazy meds.

At least the first couple of new generics for any given med. My money is on their still letting most of them get by on paperwork alone and no actual BA/BE testing.

http://www.crazymeds.us/…/Med…/BrandNameVsGenericMedications

Assorted Tidbits

Various news items.

 

From Reuters:

States ask U.S. Congress to launch inquiry of herbal supplements

A group of 14 state attorneys general on Thursday asked the U.S. Congress to investigate the herbal supplements industry after a New York probe of the products turned up ingredients that were not listed on labels and raised safety concerns.

The group, led by New York Attorney General Eric Schneiderman and Indiana Attorney General Greg Zoeller, also asked Congress to consider giving the U.S. Food and Drug Administration more oversight of herbal supplements.

Here’s the best part:

In February, four major retailers, GNC Holdings Inc, Target Corp, Walgreens and Wal Mart Stores Inc, halted sales of certain supplements after being subpoenaed by the New York attorney general. DNA tests had failed to detect plant materials listed on the majority of products tested.

On Monday, GNC reached an agreement with Schneiderman to adopt more stringent testing standards than the FDA requires, and began to resell the supplements.

A study found the products were within FDA guidelines, Schneiderman said. GNC said tests also showed its products were safe, pure, properly labeled and in full compliance.

The way I read it the problem was whatever was promised on the label wasn’t in the bottle, and not there was stuff in there that wasn’t on the label.  It doesn’t really matter which of the two happened, because, as I point out on the Meds and Supplements page, as long as the stuff isn’t toxic it’s legal.  GNC can sell you stale peppermint and call it St. John’s Wort and the FDA can’t do shit about it.  The FTC might, but I wouldn’t be surprised if their hands are tied.

On the subject of toxicity…

researchers also have found other problems, including high levels of lead, mercury and arsenic in certain supplements.

Yum!

Hippocampal Size May Predict ECT Response in Depression

Size matters.  And in this case smaller is better.

Hippocampal structure may be an important indicator of electroconvulsive therapy (ECT) outcome and, potentially, the outcomes of other treatments in patients with major depression, new research suggests.

Investigators at the University of California, Los Angeles (UCLA) found that patients who had smaller hippocampal volumes at baseline were more likely to show clinical improvement after the initial phase of ECT treatment.

“Smaller hippocampal volumes at baseline predict a more robust clinical response,” first author Shantanu H. Joshi, PhD, assistant professor of neurology at UCLA, said in a statement.

 

The Annual Cost of Mental Illness: 8,000,000 Lives

Results  For all-cause mortality, the pooled relative risk of mortality among those with mental disorders (from 148 studies) was 2.22 (95% CI, 2.12-2.33). Of these, 135 studies revealed that mortality was significantly higher among people with mental disorders than among the comparison population. A total of 67.3% of deaths among people with mental disorders were due to natural causes, 17.5% to unnatural causes, and the remainder to other or unknown causes. The median years of potential life lost was 10 years (n = 24 studies). We estimate that 14.3% of deaths worldwide, or approximately 8 million deaths each year, are attributable to mental disorders.

 

You’re Killing Me, AdSense

Seriously Google?  Three ads for Dunkin’ Donuts on the Wellbutrin page but only one on the Remeron page?

The third ad is further down the page, and is exactly the same as the 728×90 banner seen here just above Brand & Generic Names & Drug Class

Don’t you read what I write?

At any dosage it will make you crave doughnuts. Seriously. You will want to invest in Krispy Kreme stock (or maybe something along similar lines that isn’t tanking); as Remeron’s antagonism of the serotonin 5HT2C and H1 receptors gives you the munchies for carbohydrates and sugars like you were 16 and smoking the best pot ever in the parking lot of a strip mall with a 24-hour doughnut shop beckoning you with glazed and jelly-filled ecstasy. People dipping spoons into a bag of sugar and eating it as is – not unheard of when on Remeron. This stuff is nothing more than legal marijuana, and if I knew crap about biochemistry I could probably prove that crazy statement.

People who take Wellbutrin don’t want to eat anything. It’s the “happy, skinny, horny pill”, remember? People who take Remeron want to eat doughnuts all day long.

Sad MetaStat

I’ve updated the site stats page.  I managed to track down the source of something that has been bothering me: why is there such a big discrepancy between the numbers reported by Alexa, Google Analytics and Awstats?  I haven’t found out why, but at least I know where: the Crazy Talk forum (especially people using the Tapatalk app), and this blog.

The truly sad stat: the most popular page on this blog, the one that gets THREE TIMES as much traffic as the main / home / default page, is the admin panel login.  There are more annoying little 1337 4aX0rs trying to crack this piece of shit than there are people interested in reading it.

Why bother?

Offline Means Offline

Some bug in the forum software has allowed people to log onto the forum and read it while it was offline COMPLETELY DEFEATING THE PURPOSE OF TAKING IT OFFLINE TO SPEEDUP THE REBUILD!!!! THANKS LOADS, EVERYONE!!!

I’ve had to put in a hard restriction of the forum to my IP address.  Hence the 403 forbidden message.

No wonder the maintenance during some of the upgrades took for fucking ever.  That wasn’t cache weirdness I was seeing in the online users list.  Those were people logged on when I said not to be logged on.

Forum Software Upgrade

Since we’re doing maintenance, I may as well update the forum software.

This looks to be a somewhat major upgrade for a move from one 3.4.x version to another 3.4.x version, so I don’t know how long it will take. Both the forum and blogs will be offline Sunday, 21 March, from noonish Mountain I’m-not-on-Daylight-Insanity-Time (~1200 PDT, ~1900 GMT) until however long it takes.

That could be anywhere from 15 minutes to two hours.

Does Altitude Exacerbate Depression?

Back in September the Missoulian ran an article about suicide in Montana & the Rocky Mountain West.  It was the same old story: the focus was on stigma and cowboy culture,  along with the problems of social isolation, easy access to firearms, and a severe shrink shortage.  There was one thing that was new and caught my eye: a correlation between altitude and suicide rate.  OK, there’s a correlation, but that doesn’t mean causation.

Until now.  Perhaps.

In the article There’s a Suicide Epidemic in Utah — And One Neuroscientist Thinks He Knows Why we see how living in the Rockies can make the neurotypical feel happier, and those with mood disorders feel crappier.  And while few things involving the brain are quite that simple, that’s the gist of the hypothesis behind why a high altitude can be hazardous for your mental health.

I can tell you from my own experience that since I moved from sea level – where I had lived my entire life – to ~3,000 feet up, some things have improved and some things haven’t, or have steadily become worse.  But there have been many other changes over the last ten years, so it’s difficult to pin down exactly what may have caused what.  Could altitude be a positive or negative contributory factor?   Sure.  It could even be a little of each.

For my daughter, though, it was a big negative.  I didn’t think 3,000 feet was high enough to make a difference as far a migraines were concerned, and I certainly didn’t think anything below 8,000 feet would have an affect on mood disorders.  Altitude sickness usually doesn’t set in for someone with normal oxygen saturation until you’re that high up, and she had spectacular oxygen saturation.  But apparently it was enough of a difference.  She’s no more than 500 feet above sea level, and her headaches and interictal moodswings are much more under control than they were up here.

 

Someone Finally Gets It Right!

The article “Dangerous Cases:  Crime and Treatment“, by in the December 1st edition of Time, is the best damn thing I’ve ever read about violent crime and the mentally interesting.  I can’t remember reading anything in the mainstream press, other than the BBC’s website, the stats I’ve been quoting for the last 12 years:

People with a serious mental illness are also nearly 12 times as likely as the average person to be the victim of a violent crime, like rape, and as much as eight times as likely to commit suicide. People with symptoms of mental illness account for as much as 30% of the chronically homeless population.

She also dug into the same studies I’ve been throwing around every time I have to write the same damn essay in response to the same over-reaction to annual tragedies.  She’s the first sane reporter to see the light:

As a total population, the millions of Americans who suffer from a mental illness at some point in their lives are no more likely than anyone else to commit a crime. But narrow that population to only those with the most serious mental illnesses, like schizophrenia or bipolar disorder, who do not receive treatment, and it appears to be a different story. A widely cited 2005 study based on NIMH data found a violent-crime rate of 8.3% among those with a “major mental disorder,” compared with 2.1% among those without disorders. A 2008 peer-reviewed analysis that surveyed 31 academic studies found that 12% to 22% of inpatients and outpatients with serious mental illnesses “had perpetrated violence in the past six to 18 months.”

Only 3% to 5% of violent crimes in the U.S. can be attributed to mental illness, according to Duke medical sociologist Jeffrey Swanson. But such tragedies–like Cukor’s death or the 2007 Virginia Tech shooting, in which a student with a mental illness killed 33 people–tend to have a disproportionate impact. They earn headlines, anger the public and motivate politicians to action in a way that the mundane suffering of the homeless or convicted criminals does not.

I never liked the 2008 meta analysis to which she refers, but that’s just quibbling over dueling studies.  I think she gives her readers a bit too much credit by not pointing out that such events earn more headlines than when the dangerously sane do the same thing, but that would have been beyond the scope of the article.  Which is actually about the question of broadening the rules for involuntary commitment of the severely crazy.

On the article’s core issue – it’s well worth reading for that too.  It raises important questions.  If someone is unable to tell that they are ill (anosognosia – lack of insight – a condition about half of the schizophrenic and a third of the bipolar have, I think, because stats on this are hard to come by), thinks the meds are making them worse, or are pressured by the general stigma and/or their family to stop taking their meds, should they be forced to stay in a psych hospital before they wind up dead on the streets?  As someone who has been homeless due to brain cooties and in the locked ward of a psych hospital I’d much rather be locked up in a loony bin than living in an abandoned building and eating mystery meat or oatmeal soup at a church.  And I don’t think there are that many abandoned buildings left in which it’s safe to for a lone nutjob to be living, let alone something like the palace of a condemned thrift shop that I found over 30 years ago.  Trying to get someone with anosognosia to determine if they need to check themselves into a hospital, or even if they need to take meds and other treatments, is the same as telling someone with bipolar disorder to try really hard to not have mood swings.  Which, as we all should know, is the same as asking someone with type-1 diabetes to try really hard to produce the correct amount of insulin.  It’s basically Christian Science psychiatry.

I hate to quote a bunch of hippies, but “Freedom’s just another word for nothing left to lose.”

Lack of insight – easier to remember than anosognosia – is a physical condition you can see on a brain scan.  It looks the same in Alzheimer’s as it does in bipolar disorder and schizophrenia.  If we don’t expect someone with Alzheimer’s to decide for themself if they belong somewhere they don’t want to be, should we expect the same of someone with schizophrenia or bipolar who is similarly clueless?

Like lots of things in life there is no easy, simple answer.  Who determines how crazy someone needs to be to get checked into what sort of facility for how long?  What sort of treatment options will be available?  What prevents them from being gulags where  inconvenient, but not particularly crazy people are dumped?  Does everyone get a brain scan, or do we just rely on something like the Beck Cognitive Insight Scale?  What if someone knows they’re batshit crazy but just doesn’t want to take their meds?  What if the only thing that works has really bad quality-of-life, but not health-endangering side effects?

Whatever the answers are they need to be determined by people with real experience in the world of mental illness, not politicians.  And it needs to be done before the next over-publicized killing, not immediately after.  No matter what steps are taken nothing, absolutely nothing will prevent another mass killing by someone with a mental illness.  It certainly won’t prevent the ones carried out by the dangerously sane.  Designing something with calmer, clearer minds will be like the really good meds: it will work better and suck less.

Merry RxMas Cards and Gifts

Celebrate being mentally interesting and medicated while fulfilling holiday obligations. Crazymeds Merry ℞mas Cards and Gifts.

Merry RxMas Card: The Last Xmas Tree
The Last Xmas Tree from the Xmas Tree Lot

 

Merry RxMas Card: Isolated and Unbalanced
Feeling Isolated and Unbalanced

 

Merry RxMas Card: Snowed In and Running Out of Meds
Snowed In and Running Out of Meds – the prophecy.

 

Merry RxMas mug
When you want to wash down your meds with eggnog.

Cards come in the three different covers shown above with your choice of what’s inside:

  • Blank (AKA creative negative space)
  • Wishing You a Merry ℞mas and A Mentally Interesting New Year
  • A description of the Merry ℞mas scene depicted on the card

Mugs and magnets have Merry ℞mas – spelled out in a special holiday version of the Pill Font – on a white background.

All pictures on the cards are from in and around the glorified Unabomber shack where I live. I hope my gift of schadenfreude makes you feel a little happier.

The card with the idyllic winter scene of snow on top of a well has been available since 2013.  I now call it “Snowed In and Running Out of Meds” because for nine or ten days (I kind of lost track) in late February and early March 2014 I was completely snowed in and nearly ran out of a couple meds.  Even with a week’s supply that I keep on hand for this sort of thing I had to significantly lower my dosage of topiramate for a few days.

That well is fake.  It covers the access port to the septic tank.  Like my pickup it was completely buried.  Unlike my pickup it was where it belonged.  Cabin Fever blog entries.

 

 

 

New Merchandise on New Media

Some stuff I added some time ago but forgot to post here, and some recently added crap.

First the new stuff.   For your emotional baggage:

Batshit Crazy field bag
For your extended stay in the locked ward.

 

Mentally Interesting tote
Be the most styling bag-lady around.
Medicated For Your Protection messenger bag
If you take as many meds as I do, this is your bag.

 

Next, the old crap.  For your psychological hang-ups:

Meds Help framed tile
Yes. Yes they do help.

 

Breakfast of Champions! mini poster
Too cheap to wear it? Then put it on your wall for $7.

Epilepsy Is NOT Contagious. Nor is a lot of other stuff.

I don’t know why I totally miss the obvious.

New designs at Straitjacket T-Shirts! Assorted brain cooties aren’t contagious. Bipolar, depression, epilepsy, OCD, PTSD, and schizophrenia. Shirts and mugs. Buttons, magnets, and bumperstickers coming eventually.  I may even do a generic Mental Illness.

 

Epilepsy Is NOT Contagious shirt
Unlike the rabies and lycanthropy, you can’t catch my epilepsy if I bite you.

Like the Team Schizophrenia hoardables, Schizophrenia Is NOT Contagious merchandise is sold at cost.

Stigma as a Barrier to Getting and Adhering to Treatment

A big meta-analysis:

The Impact of Mental Illness Stigma on Seeking and Participating in Mental Health Care

Like a lot of meta-analyses it seems a bit “let’s just find everything that proves my hypothesis.”  And there’s a hell of a lot of extrapolation going on, but, in a way, there needs to be a hell of a lot of extrapolation.  Why?  If you were afraid of people finding out you had something, would you tell anyone you were behaving in a certain way out of fear?

Of course not.

While the study itself might be somewhat flawed, I still like it.  It agrees with what I’ve been posting lately, especially about things like the exacerbation of stigma caused by the stereotype of crazy=mass murderer.  Although they include higher rates of violence among the mentally interesting while omitting all the studies showing how the difference isn’t all that high after all while drunks and spouse/partner abusers are way more likely to kill a shitload of people than any of us crazies are.

Is this bad science?  Probably.  I honestly don’t know.

If the study itself if too dense, the press release is far more non-researcher friendly.

On being labelled “schizophrenic”, in the words of the diagnosed

The completely unsurprising results of a study have found that people diagnosed with schizophrenia have a hell of a time coming to terms with it.  The stigma is so bad that they won’t seek treatment.  One of the main problems?

 

Quote

the media’s role in propagating the violence-schizophrenia link

 

Since the interview was done with people getting help through Britain’s NHS, they are the ones who have come to terms with the diagnosis and are getting treated.  It begs the question, how many aren’t getting help due to stigma?

Thanks media.

Full article at BPS Research Digest.

Brain Food for the Mentally Interesting

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