21–30 of 79 posts
The disease casually mentioned ( https://en.wikipedia.org/wiki/Encephalitis_lethargica ) in the article is worth looking into as well - a ?virus? that causes coma, that appeared, wreaked havoc (affected ~1M people and killed half) for a decade or so, then disappeared
The article describes its first subject as having been diagnosed with simply "depression", but describes their medication regime as including lithium and lamotrigine which in combination is strongly suggestive of treatment for bipolar depression in particular. Given that the described behavior sounds very much like a manic episode, the article should have explained this connection before attempting to focus the blame…
While I understand the rest of the article, as someone who has been through opioid-withdrawal induced RLS a few times in my life, this is really downplaying how horrible it is.
The RLS alone would stop me from sleeping for a week or more. You lose your mind. It’s horrific. I can understand why someone with a severe case might be willing to take that risk — though from the sounds of it, a lot of prescribers aren’t explaining that risk to their patients.
As an aside, for those who are unaware, RLS is induced by opioid withdrawal because chronic opioid use disorder/abuse down-regulates your dopamine receptors. Our dopamine pathways have wide reaching effects within our bodies and minds.
The article describes its first subject as having been diagnosed with simply "depression", but describes their medication regime as including lithium and lamotrigine which in combination is strongly suggestive of treatment for bipolar depression in particular. Given that the described behavior sounds very much like a manic episode, the article should have explained this connection before attempting to focus the blame…
You severely overestimate the quality of care you would receive in a psychiatrist's office when thinking that lithium and lamotrigine wouldn't be prescribed for no reason. Prescription of pramipexole should have given it away.
The article even says later that "[t]he state medical licensing board disciplined the psychiatrist", so I don't understand why people here are critiquing care that was literally censured by the board!
Quoted post unavailable.
The article describes its first subject as having been diagnosed with simply "depression", but describes their medication regime as including lithium and lamotrigine which in combination is strongly suggestive of treatment for bipolar depression in particular. Given that the described behavior sounds very much like a manic episode, the article should have explained this connection before attempting to focus the blame…
Quite possible, but both medications are actually used in unipolar depression treatment as well. They wouldn’t be first-line treatments, but it’s not uncommon to see one or both of these tried when the patient can’t tolerate SSRIs for some reason. They are also used to augment SSRIs in many cases.
Earlier quoted context omitted.
I agree about it sounding like a manic episode a lot. If I were to put up an opposing opinion -- some caveats here: cluster B disorders and autism both can include lithium (and symptoms not too dissimilar from mania), lamotrigine too on the BPD front. Mood stabilizers are prescribed in combination for a variety of conditions, I feel like it's a rather large jump to make. Also, Moda and a Benzodiazepine are going to d…
I omitted the Xanax entirely from my previous post because the polypharmacy here is such a mess, but I agree that it probably factors into disinhibition. I don't personally attribute much relevance to modafinil in this instance; while the wakefulness effects are often described mechanistically through dopamine, I have never seen anyone experience any traditional stimulant or dopamine agonist effects from modafinil. M…
What do you mean by traditional stimulant effects? I mean, modafinil is definitely stimulating, even if Wikipedia says it's an "eugeroic". Combines with caffeine pretty badly.
The article describes its first subject as having been diagnosed with simply "depression", but describes their medication regime as including lithium and lamotrigine which in combination is strongly suggestive of treatment for bipolar depression in particular. Given that the described behavior sounds very much like a manic episode, the article should have explained this connection before attempting to focus the blame…
You severely overestimate the quality of care you would receive in a psychiatrist's office when thinking that lithium and lamotrigine wouldn't be prescribed for no reason. Prescription of pramipexole should have given it away.
Earlier quoted context omitted.
I agree about it sounding like a manic episode a lot. If I were to put up an opposing opinion -- some caveats here: cluster B disorders and autism both can include lithium (and symptoms not too dissimilar from mania), lamotrigine too on the BPD front. Mood stabilizers are prescribed in combination for a variety of conditions, I feel like it's a rather large jump to make. Also, Moda and a Benzodiazepine are going to d…
I omitted the Xanax entirely from my previous post because the polypharmacy here is such a mess, but I agree that it probably factors into disinhibition. I don't personally attribute much relevance to modafinil in this instance; while the wakefulness effects are often described mechanistically through dopamine, I have never seen anyone experience any traditional stimulant or dopamine agonist effects from modafinil. M…
Earlier quoted context omitted.
I omitted the Xanax entirely from my previous post because the polypharmacy here is such a mess, but I agree that it probably factors into disinhibition. I don't personally attribute much relevance to modafinil in this instance; while the wakefulness effects are often described mechanistically through dopamine, I have never seen anyone experience any traditional stimulant or dopamine agonist effects from modafinil. M…
> I have never seen anyone experience any traditional stimulant or dopamine agonist effects from modafinil. What do you mean by traditional stimulant effects? I mean, modafinil is definitely stimulating, even if Wikipedia says it's an "eugeroic". Combines with caffeine pretty badly.