Abilify's chameleon-like behavior

Here's a scenario concerning the ever expanding market for neuroleptic medication. Perhaps some of you have ideas to contribute to this scenario.

Abilify originally was approved by the U.S. Food and Drug Administration as an antipsychotic, and rather quickly gained approval as a treatment for depression and autism. I am now thinking of Chris, if I have to use a label for him at all, as "depressed," and no longer "schizophrenic" thanks to Bristo-Myers-Squibb's (BMS) amazing Abilify trick, aided and abetted by its good friend, the FDA.

BMS has now freed us to pick and choose our label based on the many diagnoses its product is treating. Technically, since Chris is on Abilify only, he is not clinically depressed, because to meet this standard he would have to be also on an antidepressant, as Abilify is only approved for unipolar depression if used in conjunction in conjunction with an antidepressant. I could begin thinking of Chris as bipolar, since bipolar doesn't seem to carry the same stigma as "schizophrenia." I sincerely doubt Chris is autistic, so autism is a non-starter. I like the idea of "depressed" because anyone can start off on both Abilify and an antidepressant and then drop the antidepressant. Can Chris now go to his doctor and get his original diagnosis changed, given that he was once on an antidepressant and weaned himself off it? I think, judging from the Abilify, that this is a valid conclusion to draw. On what basis could a doctor refuse to change his original diagnosis?

But what does this mean for the BMS pipeline? The company is going to have to reposition schizophrenia, once again, as horrible, devastating, and, most importantly, "unique." Will it begin to trash Abilify as no longer useful for schizophrenia while simultaneously introducing a new improved drug, e.g. "Rehabilify" marketed only for schizophrenia?  What new "diseases" will replace schizophrenia market for Abilify?

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Aripiprazole (pronounced /ˌɛərɨˈpɪprəzoʊl/ AIR-i-PIP-rə-zohl; brand names: Abilify, Aripiprex) is an atypical antipsychotic and antidepressant used in the treatment of schizophrenia, bipolar disorder, and clinical depression. It was approved by the US Food and Drug Administration (FDA) for schizophrenia on November 15, 2002, for acute manic and mixed episodes associated with bipolar disorder on October 1, 2004, as an adjunct for major depressive disorder on November 20, 2007 and to treat irritability in children with autism on 20 November 2009.[1][2] Aripiprazole was developed by Otsuka in Japan, and in the United States, Otsuka America markets it jointly with Bristol-Myers Squibb. (Wikipedia)

My ashram

Chris and I attended our first Sahaja Yoga meditation last night. I couldn't help shaking my head; the venue was within spitting distance of where Chris spent two years attending a psychiatric outpatient program. Two words that come to mind about that program are "expensive and lame."  It looked upon psychic distress as mainly a medical problem, and of course, medication management was a big part of the curriculum. Impressive, if you judge these things by the number of staff with professional accreditations. The problem is, the cooking classes, the light ergotherapy exercises (bringing your knees to your chest while lying on the floor), the forty minute acting classes, just don't do the profound lifting needed to get to the root of psychosis.

If I were going to run a program, here's what I've have on the menu. Yoga classes, meditation, assemblage point shifters, Family Constellation sessions, music, etc. The emphasis would be on vibration. There were be classes on nutrition and vitamin support. The rented facilities would look more like an ashram and not at all like a hospital outpatient program. This kind of therapeutic outlet would be cheap because it wouldn't be professionalized. It would be staffed mainly by volunteers.

I'm not very familiar with meditation, having done it sporadically with different teachers over the past few years. Sahaja Yoga meditation is different to the other meditations I've done, which tended to be more like "imagine yourself walking through a peaceful green forest and you come upon a crystal stream . . ." The aim of Sahaja Yoga is to immediately awaken the kundalini, which, with practice, eventually leads to self-realization. The technique is simple to grasp and self-realization doesn't have to be attained after years of discipline. We're all expected to notice improvements rather quickly in our well-being.

I have always been uneasy about the awakened kundalini. I've read that it is such a powerful force that amateurs have no business playing with it. I also thought it was something that you just don't jump into. We jumped right into it last night. Chris and I went through our guided meditation in English in a separate room from the others who were carrying on in French. After we finished and our kundalinis were roused, we stepped into the main room where the rest of the group was busy fanning kundalinis and cleaning chakras. The air was flowing with kundalini arousal en masse.

Chris was enthusiastic about his experience. We both slept well.

Meditate instead of medicate

Chris got another "you've got to up your game" talk from me a couple of nights ago. This time, I strongly suggested yoga and meditation. My pushing yoga and meditation will come as no surprise to anybody reading my past two posts.

I'm getting a little tired suggesting things my twenty-seven year old son should already have thought about for himself, but there you are. I'm used to pushing and prodding, after all, I'm a wife. Lucky for me, Chris is usually appreciative of my motherly suggestions. Left to his own devices, he'd continue to read Marcel Pagnol in the original French, take voice lessons, cook our dinner, and be a generally fabulous and conscientious guy.  But, he has yet to earn a paycheck nor is he pursuing full time or part time studies. He's going to have to up his game.

To move him to the next level, to get the next breakthrough experience, (he's had several, all of which have upped his game in some way) I think introducing him to yoga and meditation is what is needed. We may not have to journey to Outer Mongolia for healing by shamans, we can take a mind and body journey right at home. Some of you might be offended that I would equate yoga and meditation to upping one's game, but what is underlying this is the wish that Chris's resilience continue to increase.

I gave Chris an assignment: Find three yoga courses that he might want to enroll in and check back with me by COB today. I told him I would take care of finding the meditation. On Sunday I went to a most interesting talk about a certain kind of meditation that made me realize that this may be what we are looking for. I'm going to a meditation tonight, and will see how it goes.

Sara Weber, party pooper*

I just reread the meditation article I posted yesterday. An extract appears below. I'm always suspicious, when I read things like meditation is good for everybody except the mentally unstable, that the people pushing this opinion are trying to keep schizophrenia under the paid protection of psychiatry. Before I wised up, I used to ask the opinion of Chris's psychiatrists as to different ideas that I would like to try with him, e.g. sound therapy, assemblage point shifts, or even vitamins for crying out loud, and what do you know, they were not in favor of him attempting these things. These things, after all, are not under their control. These kind of weird things, after all, might destabilize him. Well, Chris has tried these weird things, and they have had the opposite effect -- they have integrated him.

extract
But Sara Weber, the chairwoman of the Contemplative Studies Project of New York University’s postdoctoral program in psychotherapy and psychoanalysis, expressed some skepticism.

“Believe me, it’s a great relaxation and everyone needs to relax, and probably relaxing makes everyone feel better and promotes some of those things,” Dr. Weber said. “And some people can deal with what arises just by calming down. But other people who have been through trauma disassociate and go into a deadened space where they don’t feel. So what happens if that breaks down in the middle of one of those bliss sessions?”
 
In her experience, Dr. Weber said, the technique could even have adverse side effects. “Some people report falling apart,” she said. “They can have very intense and bad emotional experiences.

You might also like a real life example of this attitude.

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I'm getting sensitive about being "a square." Tell me that the word "party pooper" isn't hopelessly out-of-date. Please? I've never heard of Russell Brand, the comedian snuggling up to David Lynch in yesterday's photo. I have heard of David Lynch, though. He's more my age. The other night I asked my middle son Alex not to drive the car all over "Hell's half acre." He broke up laughing.

Look who's meditating now?

Today's post, Look Who's Meditating Now, is brought to you courtesy of the New York Times.

POSTER BOY Russell Brand with David Lynch at the December Met fundraiser for Mr. Lynch’s foundation, which promotes Transcendental Meditation.

There are so many kinds of meditation, I would like to know from readers what kind of meditation you recommend for people who have experienced extreme states, and what kind should be avoided.

Herbalism in Turkey

Interesting article from Today's Zaman.*

A prominent herbalist in Turkey, Şeref Menteşe, has lambasted drug companies, saying the side effects of commonly prescribed drugs have resulted in too many illnesses in the country, costing billions of dollars for the treatment of toxins released from the drugs.

The son of an immigrant worker in Germany, Menteşe pursued a degree in medicine but dropped out during his senior year after realizing how drug companies interact with future doctors and surgeons during their schooling. “One day, we were told experts from drug companies would brief us on how to write prescriptions for drugs. That was the day I realized there was a huge conflict of interest between doctors and big pharmaceutical companies. I said to myself this is not the way to go about healing patients under the influence and directives of drug lords,” he recalls.


Read the rest of the article here.
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About Today's Zaman
I welcome all our readers across the world who are keenly interested in developments in Turkey and its immediate geographic vicinity. The editorial staff and I are well aware of the fact that this paper, in both its print and Web editions, is being closely followed by a great number of people all over the world on a daily basis. The reason is simple yet also complex: Turkey stands at the world's geographic and political crossroads. In recent years it has become one of the most closely followed and frequently discussed countries.

The literary agent of my dreams

I've haven't blogged for a while and my posts will be infrequent over the next little while. It's good news. A literary agent contacted me out of the blue to send him my manuscript, thus bypassing my having to send him a proper query letter and chapter summaries. The manuscript is with an editor right now and I'm scrambling to keep up with all of the suggested changes. I've had to stall the agent while I work nights and week-ends to whip the memoir into better shape.

Of course, there is every possibility that the agent may not like what I send him, so I should stop daydreaming about seeing myself at the altar with him. We haven't even been out on a date.

Mick Jagger of literary world: Martin Amis credits Tina Brown with making him the man he is today

Read more: http://www.dailymail.co.uk/femail/article-1190271/Ex-girlfriend-reveals-lovers-affairs-literary-lothario-Martin-Amis.html#ixzz1GlMDZKGA

Weirdly well

Chris phoned me last night from the church. Could I come and pick him up? He wasn't feeling well. I immediately got excited. When I got there and he climbed into the car, I put my hand on his forehead and it felt feverish. This was a good sign. What part of you is sick? I asked him, but not expecting him to really be able to put his finger on it. You see, Chris, to my knowledge, has never been sick. He doesn't have the vocabulary because he has no reference point.

While his middle brother had perpetual ear aches and his youngest brother had an asthma like condition,  Chris has never been sick. Not a toothache, not an ear ache, no vomiting, nothing. He is supernaturally well. Dr. Abram Hoffer observed this abnormal good health in his patients who had been diagnosed with schizophrenia. They were never sick.

When Chris truly lives less in his mind and more in his body, he will get sick like the rest of us, or at least, that's my hope.

By the time we got home, Chris no longer seemed feverish. What he claimed he had was nausea. He went to bed immediately, and was up bright and early this morning as if nothing had happened.

EC buys same old chestnut

Thanks to Stephany for alerting me to this European Commission press release about EC approval of the latest injectable schizophrenia drug.

There is no new information in this release, the EC has bought the same tired justifications from doctors with ties to pharma about the need for adherence to schizophrenia medication. I'm bored already.

Also not new in this article is the figure of one in a hundred. Schizophrenia, apparently, is still occuring in the population at the rate of 1%, the same as always. Schizophrenia's identical twin, bipolar, is now as overexposed as Paris Hilton at a party, but good old schizophrenia doesn't budge in the rankings. This makes me wonder what's the matter with schizophrenia. If we believe that these so-called mental illnesses are being overprescribed, why isn't the rate of schizophrenia in the population reflecting this? What is going on?

Out in left field

Today's post is taken from the New York Times.

Handedness clearly runs in families. The 2007 paper by the group at Oxford identified a gene, LRRTM1, that they discovered in the course of studying children with dyslexia, and which turned out to be associated with the development of left-handedness.

Dr. Francks, who is now at the Max Planck Institute for Psycholinguistics in the Netherlands, recalls that the discovery made headlines and attracted a great deal of attention, the more so because this gene was also found disproportionately in people with schizophrenia, even though none of these connections are simple or well understood. “We’re not looking for a gene for handedness or a gene for schizophrenia,” he said. “We’re looking for subtle relationships.” The gene affects the ways that neurons communicate with one another, he said, but its mechanisms still need to be studied

I was the only person growing up in my family who is left handed (and immune compromised.) One of my sister's is right handed and dyslexic, or, I suppose I should say "has a diagnosis of dyslexia." Chris is right-handed. Our middle son, Alex, is left-handed. All of my husband's immediate family is right handed. The New York Times article deserves a read, but it doesn't add anything new to schizophrenia, that forever illusive "organic brain dysfunction" which tantalizing is linked to just about everything in life that involves being human.

None of it turns out to be simple. The idea of links to schizophrenia has been particularly persistent, but schizophrenia is a complicated and probably heterogeneous disorder, and studies of different populations show different patterns; last year, a study found no increased risk with non-right-handedness for schizophrenia or poorer neurocognition.

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On the Left Hand, There Are No Easy Answers, Perry Klass, MD, March 6, 2011

Inside Mongolian shamanism

I'm quite excited about my current bedside reading, The Horse Boy: A Father's Quest to Heal his Son, by Rupert Isaacson. It's the story of a father helping his five year old son overcome autism by travelling to Mongolia to ride horses and undergo shamanic ceremonies. I'm only part way through the book at the moment, and hope to do a more in depth review later. The book explains that shamanism was the ancient religion of Mongols until the Soviets tried to stamp it out. Following the break-up of the Soviet empire in the 1990s, shamanism has been slowly making a comeback. Today there is even an association of Mongol shamans. In fact, the word shaman is a Siberian word meaning "to see in the dark," referring to people who experience other realities.

What is especially gripping about this book is the in-depth documentation of what Isaacson, his wife and son experienced in Siberian and Mongolian healing ceremonies. I have written elsewhere in this blog about Olga Kharatidi's book, The Master of Lucid Dreams, about her journey to the shamans of Uzbekistan to heal trauma, but the healing ceremony was not as well explained as in the Isaacson book.

The thought that so-called mental illness is a gift, if properly embraced and chanelled, is not especially new in Western circles, but Isaacson's contribution is to anecdotally document how a specific problem (autism) can treated by aboriginal practices. The way these problems are viewed is similar to the Family Constellations that Chris and I went through. There is an ancestor element (a family curse) that needs atonement. Bert Hellinger, who popularized Family Constellations, drew on his work with the Zulus in Africa.

Several shamans questioned whether Isaacson's wife had an immediate female ancestor with a strange mind. (She did.) Instead of saying, "mentally ill" they wondered if she had an ancestor who was "like a shaman." The wife's grandmother became bipolar after the death of her eight year old son and was institutionalized towards the end of her life. The shamans referred to her as "like a shaman" because some shamans have mental problems before they start their training. The shamans see this as a sign that these people are destined to be shamans. 

Isaacson thought about the shamanic healers he had come into contact with over the years in his career as a journalist. They were odd, often spoke in riddles and were "away with the fairies." Isaacson notes, however, that it was interesting that they all had integral roles in their communities, rather than being marginalized as so often happens in industrialized societies.

The self-help community writes a good deal about how to treat people in their spiritual crisis, relying on shamanic beliefs, but here is an actual documented shamanic practice that makes fascinating reading. The family goes through the rituals meted out by nine shamans, who ask them to do some rather bizarre things like wash their more intimate parts with vodka, have vodka and curdled milk spat on their faces by the shamans, and be whipped (including the son).

At the end of the nine shaman ceremony, the son, who enjoyed it all immensely, walked over to a small Mongolian boy and declared him his "friend." His first friend ever. Perhaps seeing what his parents were willing to go through for him and accept on his behalf was part of this breakthrough.

The shaman ceremony reminds me of the breakthroughs that Chris had after the assemblage point shift and the Family Constellation. Within ten minutes of finishing the AP shift, he immediately started walking taller and the color flooded back into his pale facial skin. About three months after the Family Constellation Therapy, he began to be sociable with people. These results can be achieved rather quickly with shamanic ceremonies. Ritualistic ceremonies are essential rights of passage that have been largely forgotten by the people and too often denigrated and ignored by science.