Blog Archives

More Hard Issues: Homicidality, SUICIDALITY and the Imperfect world of psychiatric medications

1/24/2024

Val's Take

Sometimes we think serious, potentially catastrophic mental illness is not in the middle and upper middle class suburbs --- but it is.
That was seemingly proven once again by the killing of a father by his thirty-something son with "schizophrenia" in Highlands Ranch.
One of the ideas that the parents seemingly had and that clinicians have historically had and even advocates had in the beginnings of the MENTAL HEALTH MOVEMENT ----- "JUST TAKE THE DAMN MEDICATION."
So if people find the medication helpful --- they generally are taking it, and they are generally lobbying to ensure access to the medication at a reasonable price.
One of the places you see this is for people where the GENERIC is NOT going to be an ADEQUATE SUBSTITUTE.
In some ways, the current Activist Mental Health Movement is made up of a significant percentage of people in which the medication didn't work that well or made things worse.
In addition to that, sometimes Executive Functioning may be so impaired that adhering to a medication regime is not realistic.
While I think it was idiosyncratic mental health patients that have pushed this issue, Clinicians are more and more sophisticated about this issue as well --- and will do genetic testing if it is available for that particular medication and are on the lookout for side effects that would indicate the discontinuation of that particular medication.

TedTalk --- David Anderson of Cal-Tech
Most Psychiatric Medications work on the Brain -- Globally --- NOT SPECIFIC NEURAL CIRCUITS -- that can do more harm than good.

Pharmacogenetic Information & News
How Does Genetic Testing for Psychiatric Medication Work? (2017)

BUT what if --- you don't have a current medication or treatment that will bring the person into a RANGE in which the person can function without being a danger to others, themselves or "gravely disabled"?

TWO THINGS:

We need some place safe for that person to live
- For some people that is a Secure Placement.
- It is not for most people
Even if it is a Secure Placement, it needs to be comfortable and the person needs to have the ability to work with Clinicians and Peers to develop their "STRENGTHS" which often are IDIOSYNCRATIC -- and accommodations and workarounds for Executive Functioning Issues.

Not acknowledging the complexity of psychiatric medication in 2024 and failure to provide "contingency planning" if the medication:

Doesn't work for the person or well enough
Makes things worse
The person can't manage the administration
It's not clear what treatment would work
Etc.

IS MAKING US LESS SAFE.

Neuro-Diversity, Metabolism, Diet and the Need for Precision Medicine

1/20/2024

So to me the important thing about "Maternal Immune Activation" is "DYSREGULATION" of MULTIPLE SYSTEMS OF THE BODY.

And one of the BIG KEYS to that is "MITOCHONDRIA."

Down Syndrome based on research from the University of Colorado School of Medicine is now being conceptualized as an IMMUNE DISORDER. See also Mayo Clinic on general Down Syndrome information.

Nobody is expecting Down Syndrome to be REVERSED by "DIET" alone.

High IQ Developmental Difference/Disorder --- the reality of that is not something we're really willing to accept. I'm not saying we should "ACCEPT IT and DO NOTHING" ---

But there can be much more of looking for a "QUICK FIX" --- that may in fact help --- may even be LIFE SAVING
Even as the Developmental Aspects are shrugged off, ignored or never appreciated in the first place.

October 25, 2023

Metabolomic Biomarker Signatures for Bipolar and Unipolar Depression

Maternal Inflammation During Pregnancy and Offspring Brain Development:

The Role of Mitochondria

"The association between maternal immune activation (MIA) during pregnancy and risk for offspring neuropsychiatric disorders has been increasingly recognized over the past several years. "

Critical role of dysfunctional mitochondria and defective mitophagy in autism spectrum disorders (2021)

Affiliations

Hengyang Key Laboratory of Neurodegeneration and Cognitive Impairment & Institute of Neuroscience, Hengyang Medical College, University of South China, Hengyang, Hunan, 421001, People's Republic of China; Lhasa Guangsheng Hospital, Lhasa, People's Republic of China.

Translational Neuroscience:
Toward New Therapies

Chapter 3
Psychotic Disorders and the Neurodevelopmental Continuum

Michael J. Owen

"EMBO" stands for Excellence in the Life Sciences in Europe and Around the World

Metabolic Mind: Interview with Dr. Chris Palmer at Harvard.

One of the current big ideas in PSYCHIATRIC DISORDERS is around METABOLISM and a KETOGENIC DIET.

This is being promoted by a number of academics and organizations including METABOLIC MIND.

Above is an interview with Dr. Chris Palmer at Harvard. I find SOME of Dr. Palmer's ideas very interesting --- I am concerned that there is not an appreciation of some of the DEVELOPMENTAL ASPECTS of this.

Mental Illness & Metabolism

What are the basic rules for keto?

Keto basics

"The ketogenic diet is a very low carb, high fat diet that shares many similarities with the Atkins and low carb diets.

"It involves drastically reducing carbohydrate intake and replacing it with fat. This reduction in carbs puts your body into a metabolic state called ketosis.

"When this happens, your body becomes incredibly efficient at burning fat for energy. It also turns fat into ketones in the liver, which can supply energy for the brain (6Trusted Source).

"Ketogenic diets can cause significant reductions in blood sugar and insulin levels. This, along with the increased ketones, has some health benefits."

A DSM 5 Classification System that Isn't Good Enough

1/16/2024

Our current classification system contained in the DSM 5 is not supported by the research.

What is supported by the research is something much more DEVELOPMENTAL in which diagnostic categories are not fixed..
That has clinical, legal and policy ramifications.

Neurodevelopmental disorders (NDD) without boundaries: research and interventions beyond classifications (2023)

"Both genetic and environmental factors, along with clinical and imaging features, argue toward a continnum between NDD (Neuro-Developmental Disorders) but also with adult psychiatric presentations.

"This new paradigm could modify the therapeutic strategy, with the development of large-spectrum treatments or new psychotherapies addressing co-occuring symptoms."

December 12, 2023

The Ups and Downs of Bipolar Disorder

National Institute of Mental Health feature story on Josh Santana who was academically gifted, had ADHD and Bipolar Disorder.

King's College London
Thinking Twice About ADHD and Autism Spectrum Disorder (2019)

Autism and Beyond: Unveiling Overlapping Neurotypes

January 24, 2024

Key Facts:

The study found a substantial overlap in neurodivergence, with 76.2% of autistic children displaying traits of other neurotypes, including ADHD.

Over 55% of children assessed for autism might also meet the diagnostic threshold for ADHD, highlighting the necessity of holistic neurotype assessments.

Despite the clinical overlap, only 26% of children with additional traits were investigated for an underlying diagnosis, stressing the need for more comprehensive evaluation methods.

Source: University of Glasgow

Affiliations

1 GHU-Paris Psychiatrie et Neurosciences, Paris, France.
2 Excellence Centre for Autism and Neuro-Developmental Disorders, Child and Adolescent Psychiatry Department, Robert Debré Hospital, Paris Cité University, Paris, France.
3 Immunology, Immunopathology, Immunotherapy, INSERM U959, Sorbonne University, Paris, France.
4 Université de Paris, INSERM U1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France.
5 Child and Adolescent Psychiatry Department, Saint-Etienne University Hospital and CNRS UMR 5229, Institute of Cognitive Neuroscience Marc Jeannerod, University Lyon 1, Bron, France.
6 Child Mind Institute, New York, USA.
7 Univ. Bordeaux, INRAE, Bordeaux INP, NutriNeuro, UMR 1286, Bordeaux, France.
8 CHU Montpellier-Saint Eloi Hospital, University of Montpellier, Unit of Child and Adolescent Psychiatry (MPEA1), Montpellier, France.
9 Center for Research in Epidemiology and Population Health (CESP), INSERM U 1018, Paris-Saclay University, Villejuif, France.
10 Department of Pediatrics, Sainte Justine Hospital Research Center, University of Montreal, Montreal, QC, H4A3J1, Canada.
11 INSERM-UMR1163, Université Paris Cité, Institut Imagine, Paris, France.
12 Faculty of Medicine, University of Tours, Tours, France.
13 Autism and NDD GIS (GIS Autisme et Troubles du Neurodéveloppement), Paris, France.
14 Autism and NDD GIS (GIS Autisme et Troubles du Neurodéveloppement), Paris, France. paul.olivier2@inserm.fr.
15 Department of Psychiatry, McGill University, Montreal, Canada.

Science Up

Shared Genes & Psychiatric Disorders

Mirror Neurons innately tuned to aggression

1/5/2024

med.stanford.edu ›

mirror-neurons-aggression

Scientists discover mirror neurons in mice and find they’re ...

Feb 15, 2023 · The researchers found also that these mirror neurons seemed innately tuned to aggression, even in mice that had never witnessed or engaged in aggressive behavior. They did

BUT . . .

Unlocking Anger’s Potential:

A Surprising Key to Goal Achievement

Alice Merton -- No Roots
"A thousand times I've seen this road. A thousand times."

Dec. 5, 2023
Cerebellar Glia Influence Aggression Level

Mirror Neurons & Aggression

Does a Mirror-Trap reactivate aggression-mirroring neurons?

We used a genetically encoded mirror-TRAP strategy to functionally interrogate these aggression-mirroring neurons. We find that their activity is essential for fighting and that forced activation of these cells triggers aggressive displays by mice, even toward their mirror image.

Hypothalamic neurons that mirror aggression - PubMed

Translational Medicine Friday