Monday, August 06, 2007

In the Mail

I often get books that bloggers and/or authors send me to read. I was pleasantly surprised to get an interesting book entitled Medicines for Mental Health by Nom dePlume, who is physicist with an interest in medical treatments for mental illness. The book examines psychotropic medications and their side effects; there is even a section on antidepressant drugs and sexual dysfunction. The book is offered to read for free at www.mentalmeds.org if you wish to take a look at it. I haven't read it yet but you can't beat the price!

34 Comments:

Anonymous Anonymous said...

Helen sez:
but you can't beat the price!

Eh. You get what you pay for usually.

7:11 PM, August 06, 2007  
Anonymous DRJ said...

Nom dePlume?

Really?

8:48 PM, August 06, 2007  
Anonymous DRJ said...

Dr. H,

If possible, please correct the link in my last comment:

http://www.bartleby.com/61/14/N0131400.html

Thanks.

8:50 PM, August 06, 2007  
Anonymous Nom dePlume, Ph.D. said...

Much thanks to Dr. Helen for the kind words. "Nom dePlume" is of course my pen name, as the astute drj indicates (and as the "About the author" section in the book states).

As for the comment by Mr. (or Ms.) anonymous of 7:11 PM, I am not the only author to provide a free download of a book for preview purposes, or for online reading supplementary to the printed copy. I wrote the book primarily for patients who need to understand their medications, and secondarily for medical professionals who do not specialize in psychiatric medication. I hope that most people who preview the book will purchase a copy, but my priority is to make the information available, not to force people to buy the book.

NdP

10:30 PM, August 06, 2007  
Anonymous DRJ said...

Nom PhD,

Your pen name is clever and you are kind for gently pointing out the "About the Author" section which confirms your book is written under a pen name. I should read more before commenting.

This is an important topic and you are to be commended for making your book available, free and online.

11:28 PM, August 06, 2007  
Anonymous Anonymous said...

I think it would be more valuable if you actually signed your name to your work though.

Free advice from anonymous people about heavy drugs in an already overprescribed industry... thanks, but no thanks.

I'll let dr.j do the fawning on behalf of all these online dr's in what must be a growing industry. All that drug money to be made off the vulnerables and all :)

6:46 AM, August 07, 2007  
Blogger Eleanor Deakin said...

Anonymous said...

I think it would be more valuable if you actually signed your name to your work though.


lol

I do agree though, "Nom dePlume" is rather off-putting and sounds silly.

8:38 AM, August 07, 2007  
Anonymous DRJ said...

Anonymous,

You should take your own advice and identify yourself when you comment online. Following your logic, your thoughts would be so much more valuable.

11:57 AM, August 07, 2007  
Anonymous Nom dePlume, Ph.D. said...

Mr. Anonymous: If you have not yet developed the capacity to look at information critically and evaluate it on its merits, now would be a good time to start. Read at least part of my book, and then come back and speak to the content. You can do this for free, after all; this is why I provide a downloadable review copy. Yet all you have done is make flip comments regarding my choice of pen name and exploitative doctors. I see little value in this behavior, unless it serves to provide you with entertainment.

Ms. Deakin: One can argue the merits of pen names. I grant that it is relatively uncommon to publish non-fiction under a pen name, but when it comes to technical material, the principal reason for using a real name is because the author has a formal background to display, which lends credence to the material. In my case, I have no such background, and do not claim any, so using my real name provides no such value.

I have chosen to use a pen name partly for reasons of privacy, and partly because my pen name is already well known in some circles, and provides a degree of "brand recognition." As for the choice of this particular pen name, I chose it partly to make it obvious that it was a pen name, so that there would be no confusion on the point. Perhaps I could have chosen a different name, but all have limits.

Dr. Helen was kind enough to mention my book, for the sake of people who might find it helpful. I hope that further comments in this thread might actually address the purpose and content of the book. I think that would be more useful.

2:09 PM, August 07, 2007  
Anonymous Anonymous said...


You should take your own advice and identify yourself when you comment online. Following your logic, your thoughts would be so much more valuable.


I'm not schilling anything. For free either. :)

Look, read my comment or not. I'm just observing that anonymous free drug advice is not going to appeal to that many non-vulnerable people these days is all. We're a bit skeptical of what we consume, which is a good thing to me ... lonely anonymous me. Funny how you'all can be so convinced by a made up name though...

~Jake Tapper (how's that?)

2:39 PM, August 07, 2007  
Anonymous Anonymous said...

Read at least part of my book, and then come back and speak to the content. You can do this for free, after all; this is why I provide a downloadable review copy. Yet all you have done is make flip comments regarding my choice of pen name and exploitative doctors. I see little value in this behavior, unless it serves to provide you with entertainment.

Thanks.
I full up to here with anonymous drug advice, so no thanks on your sample packet for me. Good luck with the marketing though -- blogs like this can be used to push a lot of things: did helen's husband link to this thread?

2:41 PM, August 07, 2007  
Anonymous DRJ said...

Jake,

It's much easier to discuss a topic with "Jake" than trying to sift through multiple anonymous comments to decipher whether they are from the same author. Thank you for providing clarity on that.

I certainly agree that people shouldn't base medical decisions on random internet advice but in general there is a poor interface between doctors and pharmacists in the US. Lots of mistakes happen in this area and once answer is for patients to be more involved, more educated, and more aware.

I don't know if Nom dePlume's book is reliable but I'm smart enough (and I'm sure you are, too) to gauge the information s/he provides and use it as a springboard to discuss issues with my doctor. It might be different if we could each prescribe for ourselves but since we can't, I want to err on giving people too much information rather than too little.

I confess, however, that your hostility toward this subject and/or Dr. Helen is surprising and I'm interested in why that is so.

2:49 PM, August 07, 2007  
Anonymous DRJ said...

Good point, Nom dePlume, and I'll take you up on your generous offer to discuss your book here. I've reviewed your book, especially the section on ADHD, and I have a question that might also be helpful to a few others.

My spouse and I are the parents of a profoundly autistic male teenager. Many of the medications prescribed for ADHD are used with autistics, in part because autistics have many ADD-like features but also because we are learning that these conditions may be part of the same spectrum of disorders.

We have never had much luck with these products but our son is also immune-compromised. Thus, it's not surprising that he reacts differently to these and other medications. In general, we have had more success with milder, purer, and/or single component medications and OTC/herbal supplements.

Do you have any thoughts about use of these prescriptions with immune-compromised individuals and/or alternative products?

2:50 PM, August 07, 2007  
Anonymous Anonymous said...

I confess, however, that your hostility toward this subject and/or Dr. Helen is surprising and I'm interested in why that is so.

I don't mind when the insta's push grills, or sci fi books, or whatever free products they choose to schill here.

It's wrong to push a book, by an anonymous author, on medical drugs for vulnerables. If it's worthy, let anony sign their name -- they make money off the purchases, and it's medical related, but you need a name from me to comment anonymously and further the discussion??

Sorry if you don't get it, but to me it crosses a line hawking pill books nobody's taking credit for -- in an industry where what's pushed today is killing you tomorrow. I suspect helen gets it, hence all the hedging she's done in helping push this one. The book is offered to read for free at www.mentalmeds.org if you wish to take a look at it. I haven't read it yet but you can't beat the price!

I suspect this is going to appeal to the vulnerables with $$ ("the market") who will now stroll into their doc's offices with drug preferences/shopping lists. Sad. Sad. Sad. Couple this with the "free choice" thread and you wonder why doctors like helen are getting rich, yet kids in the country are experiencing poorer and poorer health. ("No healthy meal tonight -- Mommy's tired. No need to exercise either -- just take this pill.") It's a cheap and easy way out, and it's becoming more and more common to commodify life like this. Not everywhere, thank god.

3:21 PM, August 07, 2007  
Blogger br549 said...

I see posters on this thread have been introduced to this blogs own private troll.

As you can tell from her current rash of postings (throughout the blog)in the passed couple days, she should know a lot about meds.

4:52 PM, August 07, 2007  
Anonymous Anonymous said...

br549:

Lol. Nope, not a pill popper myself hon. Not a pusher either. I don't make any money off that industry, not that there's anything wrong with that...

Say, is there some kind of maximum comments allowed per thread here? Funny how these rules spring up out of nowhere when you start to get an honest response going. Funny, it's like you don't trust dr. helen's blog to capably support her own assertations ... wonder why that might be, eh?

I confess, however, that your hostility toward this subject and/or Dr. Helen is surprising and I'm interested in why that is so.

4:57 PM, August 07, 2007  
Anonymous Anonymous said...

Do you have any thoughts about use of these prescriptions with immune-compromised individuals and/or alternative products?

Maybe you're overloading the child's system with synthethic pills thus further compromising the child's immune system?

Have you done an exhaustive dietary/nutritional analysis to find out what is missing in your child's diet? That's the first step. If you're in over your head relying on anonymous internet advice, do the kid a favor and start to wean him from the meds until he is of age and can best make his own medical decisions or get better medical advice than you can secure from him on this blog.

Just some thoughts from somebody not making money diagnosing online illnesses.

5:04 PM, August 07, 2007  
Anonymous Nom dePlume, Ph.D. said...

Anonymous's interest in psychiatric medications appears to start and end with the belief that people shouldn't take them, and shouldn't be exposed to information about them because they might want more of them. It is not an attitude I share, or that I will spend further time addressing. My firm belief is that the more information people have available, the more likely they are to make good decisions.

Drj, I'm very sorry about your son's situation, and the difficulty you all must have in dealing with it. Autism is not something I know very much about. As for ADHD, it appears to involve subnormal levels of dopamine chemistry in the brain, as shown in MRI scans of children with and without ADHD.

Dopamine chemistry is complex. Dopamine is a neurotransmitter involved in movement, mood, and the ability to feel pleasure (see, for example, the discussion on dopamine pathways in my book). Dopamine deficiencies can cause cause movement disorders (e.g., Parkinson's disease), ahnedonia (the inability to feel pleasure), loss of libido, and fatigue.

Dopamine is metabolized into norepinephrine, a neurotransmitter associated with energy and the ability to focus (concentration).

The usual medications for ADHD are stimulants (Dexedrine, Ritalin) and Strattera, in the US. Stimulants increase the rate at which dopamine and norepinephrine are emitted by neurons, producing all the benefits listed above. The drawback is that they are addictive and tightly controlled. For people (mostly children) who have ADHD, they can work wonders, and are worthwhile.

Strattera is a norepinephrine reuptake inhibitor that increases norepinephrine concentration only. The fact that it works on ADHD suggests to me that norepinephrine in particularly is more the key to ADHD, since Strattera does not increase dopamine levels.

I don't know what you've tried for your son, but stimulants and norepinephrine reuptake inhibitors are the most common choices. If they have not proven satisfactory, there is no obvious next choice. There are, however, other things that increase dopamine (and therefore norepinephrine) concentration:

- Mucuna Pruriens and fava beans, which contain the dopamine precursor, levodopa. I've seen claims that Mucuna Pruriens also stimulates growth hormone emission, but do not know for a fact if that is the case.

- The prescription medications selegiline and rasagiline, which are inhibitors of the enzyme monoamine oxidase B (MAO-B). These medications also increase dopamine and norepinephrine concentration, but in a fashion completely different from the way stimulants do it.

I have not read about the use of any of these for ADHD, but perhaps this will at least give you some avenues to explore. Obviously you should discuss these ideas with your son's doctor.

I hope this helps!

Nom

P.S. I'm male, by the way.

5:39 PM, August 07, 2007  
Anonymous DRJ said...

Anonymous,

I appreciate your advice even though I don't think it was offered sincerely. I do, however, believe you are well-meaning and I continue to agree that it's good to be cautious about our health and the medicines we take. As for our son's condition, we do limit what we give him. Given his immune-compromised condition, he may be the least medicated person of his type on the planet, so you are preaching to the choir on this issue.

Now here's my point: Just because there are people in the world who abuse or misuse information they get on the internet, that doesn't mean I want my access to information limited in an effort to protect those who you've decided might be less intelligent or competent.

5:39 PM, August 07, 2007  
Anonymous DRJ said...

Nom,

Thank you for your response. You've given us a lot to think about - some of which we already knew but all of which we need to revisit from time to time. Our son is in the unusual position of having many excellent and cautious doctors who are sometimes more willing to prescribe medicines than we want to try. So we parents are the gatekeepers on this issue and we want to focus on choices that the doctors and we agree offer the best promise. Our limited experience in this area is primarily with stimulants so I'm glad to know there are other options to consider. Thanks again.

5:49 PM, August 07, 2007  
Anonymous Anonymous said...

shouldn't be exposed to information about them because they might want more of them.

No.
I'm saying sign your name to the "information" you're pushing. If you stand by it, why hide? Are you afraid that what you espouse today might catch up to you tomorrow? Do you generally publish anonymously and expect to be taken seriously? What are you hiding by refusing to put name credibility behind your work?

If your pills are so good, if this information is so valuable, then put your name behind it.

Again, you get what you pay for. And this is an anonymous freebie folks.

6:02 PM, August 07, 2007  
Anonymous Anonymous said...

Kinda like those free samples the pretty drug reps who visit the doctor's offices dish up.

Of course, they require those pretty drug reps to wear a namebadge upon entering the medical facilities, you know.

6:02 PM, August 07, 2007  
Blogger br549 said...

I do hate waiting for the doctor. My appointment is at 8:30, and I am finally seen at 9:45. Drug reps popping in and out the whole time. With people who are really sick and in much discomfort in the waiting area.

Close the office one half day per week, and have all the drug reps come in and wait for each other. Don't make people in need of assistance wait any more than absolutely necessary. It's rude, and appears priorities are misplaced.

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