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Neurology (Expert Forum)
3 Conditions? Or One?
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3 Conditions? Or One?
by Ruth__0__0, Dec 30, 1998 12:00AM
Hello,
I am being, or have been, treated for 3 different conditions, the medications for which all seem to involve neurotransmitter regulation,
namely, migraine (Imitrex), depression (not currently on medication, but
have taken Prozac & Zoloft in the past) and obesity. I have noticed that these 3 different conditions (& treatments therefore) really do seem to interact with one another to a great extent. In fact I'd say they are intimately intertwined (eg, I gained 90 lbs on elavil which was once prescribed for depression, and which I see is now being used for migraine
prevention; another example: when I need to use Imitrex, it
very clearly has an effect on my depression, too, if I happen to
be suffering from a bout of depression at that time). The one medication
I have ever used that seemed to control *all three* conditions
at once was fenfluramine, which was prescribed by an obesity specialist (I lost weight, was not depressed, and had NO migraines while I was on the medication). But then of course that medication was taken off the market.
I am starting to have a theory about these 3 conditions, ie,
that it is not 3 *different* problems, but rather that there
is one single underlying problem (with the brain neurotransmitter
regulating mechanism??), which, if that ONE problem were
adequately addressed, all the various manifestations of it
(obesity, depression, migraine) would resolve. The problem
is that I have 4 different drs involved (psychiatrist for
depression (who I only see once/yr), obesity specialist for obesity, neurologist for migraine, and my primary care physician who is a family
practice specialist) and none of them are really interested in the problems that supposedly fall under the "venue" of one of the other specialists. (ie, neurologist not interested in obesity; bariatric specialist not interested in migraine; etc., etc., etc.) - and my primary care physician just keeps referring me back to the various specialists. This all
seems too fragmented to me. And its Frustrating!
What kind of dr (a neurologist? that's my best guess) would be
interested in possibly looking into the possibility that these
are not 3 *different* disorders, but maybe ONE underlying
disorder that precipitates "symptoms" from all 3 of these
allegedly different areas of specialization?
I was SOOOOOO disappointed when they took fenfluramine off the
market. Although all my various specialists have tried various
different medications & lifestyle modification recommendations,
etc., etc., I have never (either before or since) in my adult
life had all 3 of these conditions under control at once, as I
did when on that medication. But now that I know that it is
POSSIBLE to have all 3 of them under control at once, I want
very much to achieve that again, somehow. I'm just at a loss
for what kind of dr would be the right kind of dr to see who would
be interested in the whole total picture & not just their own one little
part of it.
Thank you very much for your response; I really appreciate it.
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Thanaks for the question. It is always possible that the diet medication may be brought back on the market although I have seen nothing yet. I have heard reports that the cardiac complications may have been overestimated? So you may have some luck in that regard. Interstingly the disease processes you discuss have mostly to do with the serotonergic system and I'm sure that an interaction exists between the three problems. The fenfluramine was thought to act by also affecting serotonin levels. How it put everything in homeostasis for you I am not sure. In terms of a doctor who can put this togeathert for you it will be a matter of finding someone who will take a holistic approach and it may require alittle searching around and discussion with friends. Good luck
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