MRI's, Prophylactic use of Statins and Gingko Biloba

[ontherecord]

Dear Doctor

What do you make of the research indicating the protective effect of second-generation statins against Alzheimer's Disease? Do you think that elevated cholesterol levels increase levels of APOE4 or trigger pre-exisiting levels?

What do you make of the research indicating the protective effect (or helpful effect) of 120-240mgs of Ginkgo Biloba against Alzheimer's, based on the work already done? Effective? Promising? Worth taking at any age (I'm 26)? Does it work much like antioxidants?

I'm scheduled to have an MRI with and without contrast very soon, and I would like to know what serious conditions this would exlude for certain? My neurological exam was NORMAL, and my doctor didn't even think I needed one (for a mild head injury that I sustained almost a year ago, where there was no LOC, no PTA, no dizziness/nausea or headaches, but which seems to have knocked some unquantifiable level of intelligence out of me, which he attributes to pre-existing depression.  The depression is being addressed with antidepressants).  

Can you detect APOE4 or neurofibrilliary tangles/plaques, or microscopic brain injury on MRI? Would it be possible to talk to the radiologist right after for a summary?

I know you've said that the MRI is test of structure, not function, but at 26, IF the MRI comes back normal, combined with a normal neurological exam and no symptoms besides this self-described (but honest belief) loss of intellgence, would you feel comfortable that enough was done and that there is nothing serious to worry about?

Thanks again for your time.

[CCF-Neuro-M.D.-CS]

The evidence for use of statins in patients with AD is not complete. There are reports for and against using statins. The formal studies to answers these questions are being completed now (randomized double blind placebo controlled). I can not speculate as to whether these medications will ultimately be used to help AD patients.

The same can be said for Ginko. Again there are studies in the literature on both sides of the debate. There was one double blind placebo trial which suggested a benefit with Ginko, but the study used non-standard measures for the endpoints. I know it is used heavily in Europe for various conditions. One of the problems in the U.S. is that these agents are not controlled in regards to manufacturing and cotent. Therefore, the various products on the market can have varying levels of the active agent. Also, ginko can interact with other medications, and therefore, I tell all patients to inform their doctors so that known drug interactions can be avoided. Regarding it's use in young patients, I believe there is no evidence to support its use at this time.

The unltrastructural changes you are mentioning can not be seen on MRI scans. The MRI helps to exclude mass lesions, vascular disease, diseases of the white matter (such as MS), and looks for atrophy. Certain patterns of cortical atrophy may suggest one diagnosis over another. In patients with documented dementia occasionally a PET scan (studies how the brain uses radioactive glucose) is helpful. This tests more of the function of the brain. Regarding the interpretation by the radiologist, it is typically performed minutes to hours after the scan is completed. I am not sure if you can speak to the radiologist, but you should be able to review the results with your neurologist.

It seems that you are receiving a good evaluation. Without personally seeing you I can not tell you if the evaluation is complete. The only other test that may be of help is a neuropsychological test. It may reveal areas of cognition which are not working properly. If specific areas are identified, then strategies and skills to adress this area may be of some benefit. I hope this answers your question, and good luck. Sorry for the delay, I wanted to check on a few sources.

[Algernon71]

Dude, you need a (new) hobby.

Do you actually expect to get a helpful answer to this question on this board? Have you read the other responses? Maybe 1 out of 10 is information you couldn't just get off of Google.

If you think a busy neurologist is going to take the time to answer this question in-depth, you're not paying attention.

Myself I have a Visual Evoked Response Report, as yet uninterpreted by the doctor, and it would be real helpful to be able to post it and get an interpretation. The stuff you are posting will be helpful to no one.

Even to you, because apparently no one thinks there is anything wrong with you!

[Algernon71]

Oh, and one final point. From your posts on here it is obvious you aren't stupid and that you have some knowldege of neurology. If you are worried about lack of intelligence, ** get a a neuropsych exam **. You know that already.

And be aware that antidepressants can have wide and diverse effects on different individuals, and there have been reports of cognitive dysfunction, frontal-lobe syndrome, etc,. from antidepressants. You should really be off that stuff if you want an honest assessment of your brain.

Finally, nowhere in psychiatry (that I am aware of) is "lack of intelligence" a sign of depression, nor are antidepressants approved, marketed, or even clinically tested for such a condition. The kook that gave them to you is probably trying to get you to shut up and go away. Antidepressants ARE good for doctors in that way!

Consider reading "Prozac Backlash" by Joseph Glenmullen.

[LT CAGE]

Obviously, you have to come to this and other sites to feel important and try to throw out some artificial intelligence to make yourself feel better. I believe you have a social disorder and should be looking for answers in the mental health area of this discussion board. ( I am not slamming anyone with mental health issues, as I have them myself.) I am just very tired of seeing you post to people comments only to be ignored because of your inability to realize that people do not want to hear form you. They want to hear from people who are going through the same health issues they are and from the professional who answers to this board.

Only a reliable competent doctor should be giving any advice to patients. They come here for answers, ideas, and advice for a direction on their suffering and they don't need an arrogant want to be trying to give them help off of something you may have read on another sight and then try to pass it on to them.

On behalf of the people who would really like to use this sight and donate to use this sight, I ask you to find another sight that you can chat with other arrogant want to be hobbiests and let us post our sincere questions.

[Algernon71]

I'm in agreement. Ontherecord, perhaps you could volunteer in a hospital neurology department, take a class on neurology, or even get employment in a hospital- all of which would be preferable to your posting messages here as a "medical authority".

I wasn't kidding about the hobby thing. The only thing about your hobby, is, it has negative ramifications for people who actually want to reach the neurologist or exchange info with others who actually have neurological conditions.

Of course you have the RIGHT to post here, but be aware that many of us don't find it helpful and may actually find it annoying and counter-productive.

[ontherecord]

First, let me say that I don't appreciate the commnents of either of you two clowns.

Second, of course I have the RIGHT to post here, just like you have the right as well.  Algernon71: if you want answers to your tests, talk to your treating neurologist instead of venting your misdirected ire at me.  

LT: CAGE: if you've noticed, I haven't posted many commnents recently because I realized that I couldn't care less about you or anyone else, and I have my own problems to worry about.  

Since you've accused me of being arrogant, I feel I must respond.  I DO believe that I AM better than you.  I believe I have a right to be CONFIDENT (I don't call it arrogance).  I am 26 and have a law degree and an MBA from one of the finest institutions in the country and am admitted to practice law in two Northeastern states (NY and Massachusetts).  When you accomplish what I have, then come back and talk to me.

I take an interest in neurology for a variety of reasons, personal interest being one of them.  I will never get jerked around by doctors the way you two may, and you know why? Because doctors have a tremendous amount of respect for me and the knowledge I come in with.  Believe me, they'll go the extra mile with me, spend the extra time, and be more cordial with ME than they will be with YOU.  More often than not, their tone goes from paternalistic to supplicating in a New York minute within 5 minutes of the conversation, and I get the time and treatment I need, in large part because of my awareness.

Algernon71 once again: Neuropsychological testing is USELESS here because I do not want any subtle deficits (if any exist) revealed, because there is nothing we can do about them anyway.  As well, I DO have pre-existing depression that was exacerbated by my head injury, so the antidepressant prescription was good doctoring, as it has helped me regain my mental clarity, slowly but surely.  And my neurologist is board certified in neurology and psychiatry and has OVER a decade of experience, so he is not some "kook" as one of you clowns suggested.  In any event, the neuropsychiatric sequelae from mild head injury is sometimes persistent and often variable, and more complicated than you may think, or appreciate.

Finally, yes, much of the information is available on the internet, but I am asking about the PROPHYLACTIC USE of statins and Gingko Biloba, which HAS NOT been addressed by the literature.

In summation, you guys are entitled to your opinion, but I don't accord it much weight.  I will post whatever I want, whenever I want, because I owe you nothing and couldn't care less what two faceless clowns on the internet think about me.  You know why? Because I AM better than both you guys will EVER be.

[milmascara]

Go get `em !

[ontherecord]

And, by the way, since when were you appointed the spokesperson for all of the posters on this board? What makes you think you are entitled to voice any opinion outside of your own?

Furthermore, whether you are a real leiutenant or not is questionable, but whatever the case may be, your strongarming tactics carry no weight in the civilian world, where people are allowed to have ideas of their own.  So don't try to pull that nonsense on me.

[Algernon71]

If you are so important and your neurologist so interested in what you have to say, why are you asking questions here of THIS neurologist? Why don't you just call your neurologist and ask him these questions?

You have signs of a personality disorder. Ask your neuropsychiatrist about Narcisistic PD.

I have an advanced degree also and could list my resume, but I don't come here to impress others. You apparently do.

Qualifications mean nothing to me. My neurologist is **** and he has similar qualifications. If yours is so great and listens so closely to you, why are you posting questions on here?

As far as the antidepressant, since you're so smart and thorough and all, I'm just suggesting that you might want to investigate antidepressant treatment a little bit closer. Do so- or don't- I couldn't care less.  

Now, I have to go to work. That's why I've only posted on here rarely- I do other things with my time! It might be something for you to consider- if you're a lawyer, think of the billable time you are spending annoying us, when you could be earning!

All my best,

Algernon71

[LT CAGE]

I also have advanced degrees. Two as a matter of fact. I am now working on my Psychology degree. That is how I came up with the personality disorder. It's either that or you are a head injury.

I just don't agree with the way you post to other people. You are not a doctor. I don't care how much education or experience you may have. Let the other people post questions so they may move on in their life.

Your attempt to impress has failed. Like Algernon said, if you are so important why are you here and not doing your ambulance chasing lawyer thgs?

I am here because of a car accident and several surgeries that have left me disabled. There is very little information on the internet or through other sources about my condition and this neuro on this sight is the most honest and gives a direction for hope. That is why I would like to post a question but you are too busy trying to impress the world while you hide behind a computer somewhere else in the world. Sorry you have such a worthless petty life. I am done here for good.

As to the neuro, I appreciate what you have done on this sight. I guess I will just keep checking the archives for answers. If I wasn't so far away, I would love to come to your clinic.

[ontherecord]

For the record, unlike you two bozos, at least I NEVER hijacked someone else's thread in an attempt to assert the importance of my own problem in comparison to theirs.

Algernon71: you've already gotten through once, and received what seemed to be a sufficient response, so I don't know what you're complaining about.  

Lt Cage: your problems are your problems and mine are mine.  To me, my situation is more important, even though your situation is objectively (at least on paper) seemingly more serious.  Again, I owe you nothing. You have absolutely the same opportunity to post as I do.  And if you like my comments, ignore them.  No one is forcing you to read them.

To both you guys: if you look at the "purpose" of the forum, it's exactly to ask the questions like the ones I'm asking -- for GENERAL INFORMATION.  So my original question (before the thread was hijacked with diatribes and vilifications) is consistent with the purposes of the forum.

Since you're both self-appointed experts in psychology (and I majored in psychology in college, so I know all about it), you are both responsible for PROJECTION.  I'm sure you pysch gurus know all about it.

Finally, although my neurologist does take the time to answer my questions, he is a busy guy and has a lot of patients to manage, so he's not going to talk about prophylactic measures for Alzheimer's disease with a 26 year old when he's got 10 patients in the waiting room.  Here, the neurologist responds at his or her OWN time, and in any case, a Cleveland Clinic neurologist would probably be more up-to-date on these developments than a private practice neurologist.

Just remember, when it comes right down to it, you're essentially telling me that your problems are more important than mine and that I should yield to people like you.  I say screw you both, and best of luck, whatever you do.

[Algernon71]

Dude, for such a smart guy, you don't read well. Read the last response to you- it was succinct and wasn't a substantive answer. If you read it closely, it's pretty obvious that your post was annoying- even to the neurologist.

I don't envy you- I suspect that people react that way to you in general, not just on the Internet.

[ontherecord]

Who is misreading? You just said that my post was annoying even to the neurologist.  How do you know what this forum's neurologist is thinking? It's either this neurologist or my neurologist (highly suspect you were referring to this forum's neurologist) but unless you have telepathy, you're in no position to say what the neurologist is thinking.....

In any event, it's a recurring pattern with you: with another poster in the past, you told her to get off the internet for a couple of weeks and see if that helps.  Alright buddy, the world revolves around you and no one else.  Who is narcisstic NOW buddy? YOU.

[dont]

hey, will you read my post "question" and give me your opinion. I am more than happy to take it. You seem to have a lot of experience with your own neurologist and even though you are still 11 years younger than me maybe he has educated you on Parkinson's. I didn't do as much research as you before going in and although he didn't tell me he suspected it I didn't ask because while I as there I was mainly concerned with ALS and MS. But the shaking didn't start until about a week and half after the Wellbutrin which makes me wonder although maybe I was so caught up in my thoughts I didn't notice it when I visited the nuero in March. Both hands shake when my arms are rested on a armrest but with my hands hanging over it. If I totally relax my hand the shaking stops. I feel inner shaking too which is like a thump or something add like someone slapping my brain. I don't want to make another trip back to neuro because I think he already thinks I am a hypochondriac. Thanks for your opinion.

[funkser]

I cannot believe you want this guy to submit an opinion on a neurological problem.  He is a lawyer, not a neurologist.  For God's sake, find a second opinion on your matter from an actual neurologist.

To onthe record, why not get your medical degree and leave this forum for people who are suffering.  You can add the degree to your other scholastic achievements,and then use this forum to brag further.  When you become a neuro, do research on the above noted subject you asked about, and quit being a glutten on this forum.  Your name appears more often then the damn ccf neuro!

[funkser]

I cannot believe you want this guy to submit an opinion on a neurological problem.  He is a lawyer, not a neurologist.  For God's sake, find a second opinion on your matter from an actual neurologist.

To onthe record, why not get your medical degree and leave this forum for people who are suffering.  You can add the degree to your other scholastic achievements,and then use this forum to brag further.  When you become a neuro, do research on the above noted subject you asked about, and quit being a glutten on this forum.  Your name appears more often then the damn ccf neuro!

[funkser]

I cannot believe you want this guy to submit an opinion on a neurological problem.  He is a lawyer, not a neurologist.  For God's sake, find a second opinion on your matter from an actual neurologist.

To onthe record, why not get your medical degree and leave this forum for people who are suffering.  You can add the degree to your other scholastic achievements,and then use this forum to brag further.  When you become a neuro, do research on the above noted subject you asked about, and quit being a glutten on this forum.  Your name appears more often then the damn ccf neuro!

[dont]

He's not a doc but I know that from reading his posts he has educated himself in his condition which is something I wish I would have done more prior to going to my nuero. I went it immediately admitting to panic attacks and depression instead of being quipped with knowledge and I feel as if from the get go the doc wrote me off as a mental case. I plan to get a second opinion but here it takes months to see a neuro when you are a new patient. If you don't like what he has to say then don't read it.

[ontherecord]

Your post was pretty funny, but I don't think it was funny enough to post 3 times.  In any case, don't trivialize my suffering; there are different degrees of suffering and if you're suffering as much as some of the previous clowns (Algernon71 and Lt. Cage), go to the ER or your neurologist and quit your crying.

The board is open for everybody and sometimes you just get through.  I'm not going to sit there thinking "someone out there may just have bigger problems than I, so therefore I'll let someone else get through." If that's the case, YOU shouldn't be posting either.

Again, quit your crying and complaining, and don't tell me if I'm suffering or not.  You're not the one who is in MY head. You're not the one who sustained a mild head injury.  So you have no business to assess whether I'm suffering or not.  Matter of fact, since you're healthy enough to write a message and capable of clicking the "post" butting THREE times, I say YOU'RE NOT SUFFERING. How 'bout them apples?

[Algernon71]

I honestly don't know any lawyers that have this kind of time to spend on the Internet.

[ontherecord]

I'm in between jobs.  I have an interview tomorrow actually.  We'll see how it goes.  But you're right: when I was working, I didn't have the time or the inclination to check this board as much.  I still don't, and probably would have checked back in a few days if I hadn't been assaulted so brutally by you this fine AM.  In any event, I think you and I are done arguing.  You're not changing my behavior or opinions and I'm not changing yours.  So we'll just have to agree to disagree and go our separate ways.  Just remember though: you began this, see what I wrote to funkser, same goes for you.  I'll leave it at that, to avoid further verbal sparring.  I'll even be kind enough to let you have the last word, provided you don't directly insult me.

[Algernon71]

That's very kind of you.

Here's the last word: Employment.

[lmroswell]

Can't we all just get along...:)

[dawnrenata]

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[Roselady3]

Gheesh!! Isn't there a political forum for you to fight at?

Now as for helping this person.

Mild head injuries can cause difficiencies. If there is a leasion- it may show up on the MRI. It may have been so diffuse that it won't. The MRI is probabally being used to rule out other posibilities BEFORE exploring other avenues.

A Neurophysch testing can tell you the area's of the brain that might have been affected by your head injury. It CAN possibly help you in knowing what areas of cognition to work on. It is usually just used to PROVE brain injury & is most useful in lawsuits.

As for your other questions- why don't you write them down & take them to your Neuro when you go to discuss the results of the MRI. Shove the list under his face & don't let him rollerskate out of the room until you have your answers.

[ontherecord]

Thanks roselady.  Actually it happened while playing basketball and it was totally inadvertant and unable to be prevented (unless I never showed up to begin with).  From what I've read though, you're absolutely correct.  The neuropsych testing is usually used to prove some deficiencies where the MRI is normal.  Since there is no one to sue, I don't think I need a neuropsych test, since even if there are deficits, I can't do anything to "undo" them -- besides take Ginkgo Biloba of course, and thereby my question....  

Also, although not directly pertinent to a mild head injury, people with MODERATE to SEVERE head injuries have a 2-4 times greater chance of developing Alzheimer's disease than patients who didn't sustain a moderate to severe head injury; studies have shown that these people have greater levels of apolipoprotein 4 in their brains, and again, I'm just curious whether APOE 4 can be seen on imaging after a mild head injury (as compared to moderate or severe head injury).

Finally, on my doctor's behalf, he cares more about getting me back to 100% (or as close to 100% as possible) than talking about things which he believes aren't pertinent.  He wants to focus on the issues and not stray into academic dialogue about neuroprotective effects of Lipitor, Zocor, or Ginkgo Biloba.

Hence my question to the CCF Neuro M.D., which, although clearly isn't appreciated by other posters, will in the next decade CHANGE the way medicine is practiced and increase the understanding of Alzheimer's disease, or at least explore and clarify the relationship between APOE 4 and AD.....

[kwag]

I have read that statins have antifungal properties and that is how they help Alz.  Look into that.  There are many safe and natural products that do the same.  Alterations in diet help as well.  As far as all the other posting that has been going on............  I have come to learn that some of the best "knowledge" that I have received has not come from doctors but has come from "wise" people with experience.  I am not discrediting doctors but much of what we call educated knowledge is false.  One day eggs are bad, the next good then bad again and so on.  This goes for so many things.  I have come to believe that the knowledge that I learned in college is very faulty.  I now rely heavily rely on God's word for truth.  And what I don't understand, I pray for understanding and it comes.  I have many times read your comments and have apprediated them.  I have often wanted to post help to others but have with held for many reasons with the biggest being that I have grown weary.  Most everyone that I have tried to help refuse to alter their lifestyle to a quality that is suitable for good health.  We were created and given life for a reason.  We were given what we needed to stay healthy.  With each passing year, we get further and further away from the way we were intended to live.  Anyhow, enough of that.  I have found your posts informative and I pray that everyone gains the peace and health that they are seeking.  God Bless each and everyone and may God forgive us for we obviously can't possibly know what we do.

[ontherecord]

Thanks for your post.  It was informative and I agree with much of what you have to say.  I will look into the possible mechanism of action of statins as you suggested.  As for natural remedies, I'm glad you brought that up; studies have proved a beneficial effect of Ginkgo Biloba against Alz. disease and I think it's good to take, regardless of a person's age.  Second, I started this GNC Mega-Mens multivitamin: this thing has more than enough B-complex, minerals of all sorts, and plenty of vitamins A, C, and E.  I've felt better over the week that I've taken it.  In addition, I am eating healthier, drinking less coffee, and getting plenty of water (and much less diet coke).  I used to hit the bottle pretty heavily from time to time, but I have given that up (almost) altogether because 1 in 14 American adults is an alcoholic (and that's the ones who are reported).  I had no idea (like I do now) all the damage alcohol can have on the brain (atrophy, cerebellar degeneration, Wernicke-Korsakoff syndrome), the heart (cardiomyopathy), the liver (hepatitis and cirrohsis), and other stuff like neuropathy and a host of things I would rather not deal with.)   I'd rather not it become a problem in the future so I think I'm better off without it (maybe from time to time, on social occassions, I'll have 2 beers at one sitting).  I'm exercising (always have actually), and even taking some St. John's Wort (which is first-line therapy for depression in Germany and France, and proven to be just as effective as antidepressants for mild-to-moderate depression).  I take a very mild dose of Xanax daily, just because it mellows me out, but I'd like to get off of that too.  I'm very close to being EXACTLY where I want to be in life, and as soon as I'm there, I'm going to live even healthier.  But I've said all this because I do concur with you that most people do not take care of their one and only body, myself included in the past, but all that's changing.  

I do feel some sadness because I am reluctant to play competitive basketball anymore; I've played for 12 years and I sustained one shot in the head last year, and it's taken me a year (almost a year) to psychologically get past it.  As unlikely as a real head injury is in basketball (once in 12 years) I just don't want to take even a chance.  Unfortunately, I don't have the patience to run on a treadmill, so I have to figure out some other way of getting aerobic activity in.  

However, all this said, the one major lesson I have learned from all of this is that taking care of your health is EXTREMELY important at any age, and I will no longer mortgage my future in self-destructive behavior.  It has also taught me that you live life once, never take it for granted, and it has instilled a very hedonistic mentality, evinced by a sense of urgency of getting all that I want done, as soon as I can.  So all in all, we're getting there: like football, life is a game of INCHES (to take a line from Al Pacino in Any Given Sunday).  And since "the blood runs when the time comes" (taken from Things To Do In Denver When You're Dead) you may as well "get busy living, or get busy dying." (taken from The Shawshank Redemption).  I choose life as long as I have the choice.

[robertsb55]

i'm not sure you understand what apoe4 is.  this an apolipoprotein- a microscopic entity which plays a role in the metabolism of ldl cholesterol.  This clearly is not visible on an MRI which only identifies macroscopic structures.  There is clearly a link between people who are homozygous for apoe4 and alzheimers.  This link has been shown to be ameliorated by taking statins.  btw statins are not all good, they have side effects like myositis that are rare but do occur. in fact one statin, baycol, was removed from the mark for this very problem. I am sure you know about this based on your litiginous nature.  There is an interesting article by the head of the cardiology dept at cch dr. topol who notes due to pharmacogenomic differences amongst people that despite all the hoopla statins actually benefit very few people like 8 in a 100- just a thought

[Algernon71]

Hahahah.

On the record, I am sorry for my previous confrontational messages. I encourage you to post as much as you like, because I like entertainment.

"I used to hit the bottle pretty heavily from time to time, but I have given that up (almost) altogether because 1 in 14 American adults is an alcoholic (and that's the ones who are reported)."

This is a bizarre statement! Why the hell would anyone stop drinking just because 1 in 14 (supposedly) Americans is an alcoholic?

Personally, I'm not having sex anymore, because 1 in 4 Americans has genital herpes!

[Algernon71]

I really have found our exchange amusing. I'm a pretty sharp guy and I think I am smarter than you. And better looking.

[Algernon71]

One last comment: If you don't have the patience for a treadmill, try running down a trail or a street, OUTSIDE, like most people do. It's remarkably good exercise.

And I can dunk on you any day.

[ontherecord]

You've made me laugh more than Chris Rock in his most recent HBO special.  According to you, you're smarter, better-looking (I don't know how you could possibly determine this, never having seen me, although I am a good-looking guy, by any objective standard) and you believe you could "dunk on me." If you're ever in the New York area, we'll have to play a one on one, and see what's what.  We could also hit a bar, and see who performs better with the ladies.  Unlike you, I don't have to say I'm good-looking, because women know it.  I don't need to say I'm smart, because women sense it.  I don't need to say that I'm charismatic, because women feel it.  I don't think degrees are indicative of intelligence (my cousin is a freshman at an Ivy league school, and he's smarter than me), but it does serve as some barometer of ability and motivation, if not intelligence (which you haven't even disputed -- just thought I'd throw it in to preempt a counterargument).  

As for the drinking, alcohol is just too pervasive in society today for my taste.  Virtually every social activity revolves around booze, and if I go out on thursday, friday and saturday and stay out at a bar for an average of 3 hours, and drink one beer every thirty minutes, I'd have drank 18 beers in 3 nights, which promotes brain atrophy which could cause long-term cognitive impairment.  Who goes to a bar and drinks one beer anyway? So I figure I may as well abstain altogether.  Also, IF I go out three consecutive nights, then I'll feel a little uneasy during the Sunday night episode of Sopranos, and may feel the need to have a couple of shots of Jim Beam to mellow out.  So you see how it could BECOME a problem if it wasn't for my own early intervention.  I don't want to end up with self-inflicted damage from alcohol.  I remember being at a Hooters in Florida a while back, and I'm sitting there taking in the scenery and the pretty waitress sits there with a pretty smile, asking "can I get you another one." Well, of course you can my dear.  However, little does she know (and probably couldn't care less anyway) that she was contributing to my demise.  If I am going pursue women like that, I need to be a "have" and not a "have not" and most who have aren't egregious drinkers.  

In any event, I don't think the booze was ever a problem but in five or six years, at that pace, it may have been.  A good friend of mine once told me "the faster you live life, the faster things are taken away from you, regardless of your chronological age."

As always, it's been a pleasure.

[kwag]

Who has woe?    
Who has sorrow?
Who has contentions?
Who has complaints?
Who has wounds without cause?
Who has redness of eyes?
Those who linger long at the wine, Those who go in search of mixed wine.  
Do not look on the wine when it is red, When it sparkles in the cup,
When it swirls around smoothly:
At the last it bites like a serpent, and stings
like a viper.
Your eyes will see strange things, and your heart
will utter perverse things.
Yes, you will be like one who lies down in the midst
of the sea, Or like one who lies at the top
of the mast, saying:
"They have struck me, but I was not hurt;
They have beaten me, but I did not feel it.
When shall I awake, that I may seek another drink?" Proverbs 23:29

Wine is a mocker, Strong drink is a brawler, and whoever is led astray by it is not wise.  Proberbs 20:1

[Algernon71]

Dude,

This white boy CAN dunk on you...but...

I was *kidding* about all that, man. I can't really dunk, let alone while guarded. I'm a good looking guy and do fine with the ladies, but I was KIDDING.

Your long response is like a thermonuclear bomb of defensiveness and insecurity.

You might want to talk to someone about that at some point!

[lmroswell]

Sake anyone???  JK.  I believe everything in moderation.

[ontherecord]

Algernon71: I figured you were kidding, and all was in good fun, but I wasn't sure what to make of the Jekyll and Hyde 180 degree turn in your inflection between 4/28 and 4/30.  You may want to talk to your doctor about Multiple Personality Disorder:-)

Kidding aside, you know how health conditions can take a toll on the psyche.  I would bet the farm (if I had a farm to bet) that before you started dealing with some of these strange psot-viral/possible MS conditions, you were more or less an easy going, friendly guy and that all this waiting, runaround, and uncertainty over the visual evoked potentials, symptoms, etc, has made you less patient, easier to frustration, and just downright angry at times.  

When the body isn't 100%, the mind has a way to coming apart at the seams sometimes.  As we can both attest, it's much easier to vent on the internet than in the real world.

[dont]

Does anyone have an opinion and the negative effects of usisng anti-depressants and high doses of Xanax? I have found info on the net that talks about abnormal movement being cause by Xanax. I am on 3 .05 LONG ACTING at that. I have read that the "cure" can be worse than the illness and I am wondering if I am not going thru that now.I am calm in a weird sense but am wired at the same time if that makes sense. I had major major major attacks. I am beginning to wonder if I shouldn't throw out all the drugs. I'm also on Pamelor which strangely makes your heart race like a horse during the day but yet makes me sleep at night. So many of the dag gone things seem to make more anxious than to help. I am very medicine sensitive. I can't take OTC decongestants so maybe drugs are not the route for me. Typing this write now I'm shaking like a leaf. I feel like I have Parkinson's or something. My resting heart rate is 130 and I am not having a panic attack right now. What's yall's opinion???

[Algernon71]

On the record, I will have to write something to you later.

First, the question on Xanax:

This, I know something about. You should read the book, "Brain Disabiling Treatments in Psychiatry" by Peter Breggin- it is small medical textbook, and he is VERY critical of medications- but if you don't take that personally, he also lists pretty much all the negative side effects from all that stuff you are talking about. Highly recommended!

I have taken benzos, Xanax among them, and it resulted in abnormal jerks, nystagmus, all kinds of stuff. Actually for panic attacks and most psychiatric conditions, Xanax is really worse than the disease. If you want meds, low-dose zoloft or something like that may help, or, even better, panic attacks can usually be almost completely cured through behavioral and cognitive-behavioral therapy.

[dont]

Can you elaborate on the abnormal jerks you had? Also anyone really think it will cause a seizure if I quit cold turkey? I am down to two .05 long acting and half of one so I'm down to 2.5 down from 3-4. I am so sick of feeling like this and I really think it's the Xanax. I also think the Xanax is increasing the effects of the Pamelor. Thanks for the info

[ontherecord]

Like you requested, I read your post on you separate thread and am unable to offer any insight into your condition.  But, I too know something about xanax and antidepressants (as I am on both right now, and in the past took mild doses of xanax for about a year).  First, I know different people react differently to these medications, even on similar doses, but I have never taken more than .05 twice a day, and usually it was more like once a day.  On this dose, I had nothing but relief for the most part, except that it did affect my short-term memory a little bit.  That was my biggest immediate concern.  Now, this guy Peter Breggin, M.D. also wrote a book called Toxic Psychiatry in which he indirectly says that in the long-run, benzos can cause brain atrophy, or shrinkage of the brain.  My guess is that this is probably true, but clearly the risk is greater on higher doses as compared to lower doses, and I surmise long-term means over a period longer than a decade.  As of now, I take .5 mg once a day (regular, not sustained release) and would actually like to quit it altogether (unless I really need it) once my new antidepressant (lexapro) kicks in.  I wouldn't recommend quitting it cold turkey if you think you're on a high dose and I would work with my doctor if I were you on coming up with the right medication(s) and the right dose.  There are certain antidepressants that are FDA approved for Generalized Anxiety Disorder as well, and to my knowledge, Lexapro, Effexor XR, and Buspar are amongst these.  

Back to the xanax: some people have motor problems on the medications, and some may even develop nystagmus, but that really depends on the person.  What I would do (and it's been made abundantly clear on this thread that I'm not a doctor) is try to take as little as possible; this way, you minimize side effects, you minimize potential for tolerance, and you minimize dependence and withdrawal.  Also, try to clear up your situation with your neurologist if you can, and if you don't feel comfortable with your doctor, a second opinion never hurt, especially if it will give you peace of mind.