Random thoughts on a Sunday
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Loading ...I’m telling you, I’m in blog weirdo-land right now. I was refreshing my newsreader, and I started reading some blogs I usually don’t get to, but I also have found myself commenting on certain sites that I usually don’t comment on. I then realized there were quite a few sites that I read far more often but don’t comment on with the same frequency. All in all, I’ve been writing on others’ sites more than my own. That has to stop if I’m gonna keep a blog. I don’t have that much time!
I’ve been really, really disorganized lately. Everything’s fine, no real complaints except for work, which has been as hellishly complex as the worst subjects of studying. If any of you grok what LDAP is, you can imagine the complexity and hassle of trying to migrate a major state university’s worth of data over the last 5 or so years (>100,000 people and associated computing resource entries over the time period) from 10-year-old software to something current. I’m not going to waste space on the specifics, but trying to “fit” bandaged-up crap that’s beyond aging, full of “custom” fixes, to something standard and current is a nightmare. When I was last there 3 years ago, this was the final thing I was working on, and I’m sad to say no real progress has been made. Hell, I don’t think they’ve even filled my old position yet.
So, I’ve decided to get back on an anti-depressant. I won’t tell you which one because of HIPAA and all, but also because it makes no damn bit of difference anyway. I was commenting on Shrinkrap about the fact it’s all a crapshoot anyway. A doctor can have the right reasons to choose antidepressant A over antidepressant B, including side effect profiles, etc., but it makes squat difference in reality that a person will react in a predictable fashion vs. another. Different people will respond to different degrees given a certain medication, but if you block beta-1 receptors, your heart rate/blood pressure will go down, guaran-damn-teed. You give someone Adderall (assuming they’re not already a jaded meth addict), they will be pharmacologically stimulated. Moreover, in both these cases, you can use an independent, objective measurement like blood pressure to monitor the [side] effects of the drugs and know if changes need to be made.
Contrast that with a patient starting SSRI therapy, they might feel better after 2-3 weeks, might not. They might feel worse. Repeat for SSRI, choice 2: “Meh, I feel something, but it’s not like I feel worlds better.” Repeat again. If you could, in theory, measure the 5-HT/NE reuptake blockade to prove an antidepressant was working, it would have no predictable correlation to how the patient feels, which is my main point. Psychiatrists really have their hands full with complex psychoses, criminal disorders, etc., so I’m not disparaging them at all. It’s just that for people who just need the “fine-tune” knob adjusted to their personal, subjective liking, roll the dice because at that point, it’s craploads more luck than science.
Like many things, it could be my expectations are little high. I am just not feeling as good as I thought I would be at this point being out of school and concentrating on me and family. I have not started in earnest my exercise plan, and although nobody is making me feel “under the gun,” I know myself well enough to know that I need to nip this stuff in the bud before I look back and wonder where the time went. Not gonna happen this time.
Blogging/Web2.0, Medical and Health, Personal | enrico | 
September 23, 2007 1:01 pm
By Deb, September 24, 2007 @ 2:04 pm
You are right, there is a lot of variability in the antidepressant treatments.
By Roy from Shrink Rap, September 30, 2007 @ 10:18 am
I love random thoughts posts (my specialty, lol). On th whole predictable response theme, not so much. There are some reports of betablockers causing tachycardia (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=9659206) and I have certainly seen people who become sedated on Adderall. I have also ran into at least 6-8 patients who insist that Tylenol (acetaminophen) gives them an intoxicated feeling.
My point: never say “always” (or “never”).
By enrico, September 30, 2007 @ 1:05 pm
Roy: Point well taken; I’ll never say “never” again. LOL! I’m well aware of paradoxical sedation of amphetamines, but as far as I know, in spite of being drowsy, lethargic, etc. they are still physiologically stimulated (increased BP/HR)–I should have said that instead of “pharmacologically” above. Thanks for stopping by!