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Depression

Lyme Update: New Neuroscience Evidence

by Dr Charles Parker on July 5, 2010 · 1 comment

The blacklegged tick (Ixodes scapularis), the ...

Black-legged Tick - Image via Wikipedia

Lyme Testing Details Are Changing: MyLyme ID, The New Standard
Why should we become very interested in Lyme? Why should those with psychiatric concerns even think about this odd presentation often relegated to infectious disease docs? Simple: Lyme Disease is the Great Imitator, and regularly shows clinically with significant psychiatric presentations from dementia, to depression, to our old friend here at CorePsych Blog: ADHD.

Lyme and Psychiatric Diagnosis
Lyme, in fact, again confirms my underlying proposition that ADHD symptoms often imply more than simple appearances. See the emotional and behavioral implications in this NPLDA Lyme Assessment Form from Robert C. Bransfield, M.D. [Information from patients with late stage neuropsychiatric Lyme disease (NPLD) was entered into a database to serve as a reference point for diagnosis and tracking the patient's status after diagnosis. - Also see this excellent Psychiatric Times article on Lyme and Neuropsychiatric Disorders]

And Dr Bransfield [see his article here on cognitive impairments with Lyme] goes on to say:

All involved with late state Lyme disease agree there is a large amount
of inaccurate information on this subject. This disagreement exists at every
level – journals, scientific meetings, clinical practice, media outlets,
etc. (17,18,19) Some of this disagreement can best be viewed as the normal
difference of opinion seen when scientists approach a very complex problem
from a very different perspective. To fuel the intensity of these disputes,
some approach these issues with a significant bias. The full recognition of
this illness has implications, which could effect tourism, real estate
values, disability, insurance company/managed care liability, workman’s
compensation cases, motor vehicle issues, some criminal cases, and political
issues. Bias issues can adversely effect patient care, research funding, and
medical regulatory issues. Some of those previously impacted by bias now
have difficulty approaching this disease with full-unhampered objectivity.

Lyme disease is clearly a very complex disease. When considering a
similar spirochete disease, syphilis, it has been said, “To know syphilis is
to know medicine.” However, to know Lyme disease is not only to know
medicine but also neurology, psychiatry, politics, economics, and law
.

And from Wikipedia:

Diffuse white matter pathology can disrupt these ubiquitous gray matter connections and could account for deficits in attention, memory, visuospatial ability, complex cognition, and emotional status. (Did I leave anything out? – And see this Wiki link also for SPECT imaging implications diagnostically.)

Other Excellent Lyme Resources:
Dr Kenneth Singleton: the Lyme Disease Solution – see page 58 for psychiatric conditions.
Check out this website for the Lyme Disease Association.
International Lyme and Associated Diseases Society website.

New NeuroScience testing with MyLyme ID The first comprehensive laboratory assessment tool.
Now we have to get more serious, for those already deeply into the long-term implications of less comprehensive testing.

The combination of B. burgdorferi (Lyme) specific memory T cell response and cytokine analysis, in conjunction with standard western blot, provides both cellular and humoral [blood] immune response, as well as patient inflammatory response assessment.  This comprehensive assessment provides the most complete clinical analysis of infection status and immune response that can be utilized to guide therapeutic intervention protocols. Review this relevant reference on LLT-MELISA Lyme from ScienceDirect June ‘06.

MY Lyme Immune I.D.™ Comprehensive Assessment (#5652) Includes:
1. —- Immune Tolerance Test® (ITT®)
Identifies memory T cell response specific for B. burgdorferi (Lyme) antigens, even “hidden” or low levels.
Includes a panel of B. burgdorferi (Lyme) specific antigens that offer early and late stage identification.

The specific antigens:
OspC     – Early antigen appears shortly after tick bite or transfer of the spirochete
p41        – Early and late antigen that provides mobility to the spirochete
VlsE-1   – Late antigen appears after spirochete infection
p100     – Late stage antigen
DbpA    – Essential protein needed for overall virulence

2. —- Cytokine Analysis
Analysis of B. burgdorferi (Lyme) antigen specific inflammatory immune response in patients.
Provides guidance for effective intervention protocols.
Assessment includes cytokines, chemokines, and immune growth factors:
IL-1β        IL-6        IL-8        IL-10        G-CSF        IFN-g        TNF-α

3. —- Western Blot Analysis (IgG and IgM)
Western Blot is the industry standard methodology – already frequently used.

It appears that this new level of testing will bring more clear evidence to the diagnostic table. Interestingly, the opportunity for application of even more comprehensive neurotransmitter and hormonal testing will add more interventions to the clinical treatment process.

Do drop a comment and share the details of your take on this new MyLyme testing – or your take on testing in general!

Do take a look at this video on the problem of missed Lyme and the Lyme movie Under Our Skin here on You Tube.
cp

Make sure you take a look at these pages!
ADHD Medication Rules Purchase
“Rules” Affiliate Link
Neuroscience Details


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Psychiatric Diagnosis and DSM 5: Maps to Nowhere

by Dr Charles Parker on February 13, 2010 · 25 comments

Diagnostic Bible? Scientific Heresy

Diagnostic Bible: Scientific Heresy

If you are lost, forget being found with this bible.
You may be thinking the new, long awaited DSM5 psychiatric diagnostic manual would herald pointed improvements in the evolution of psychiatric science – …like new information, new perspectives, new treatment strategies. Don’t be worried, you won’t have to change anything you are doing… it’s the same old 19th Century stuff, trimmed up to tweak the descriptive language, with no improvements there for patient care, and no new science. Boring. But Freud is happy.

The DSM5 is not categorically ineffective
On a brief positive note you will appreciate this NPR review of the diagnostic evolution with childhood bipolar diagnosis – a significant problem addressed repeatedly here at CorePsych Blog as kids are regularly, automatically slammed with atypical antipsychotics rather than considering the biologic underpinnings of emotional explosions. Been there, done that.

Labels, not science, still prevail
See this brief description in the LA Times and you will catch the drift and controversy on these new, already outdated diagnostic maps. Our books are outdated simply because we aren’t learning how to read the brain images and the lab reports. All the names will change when we recognize gluten sensitivity, bowel dysfunction, and the abundance of metabolic imbalances that effect brain function.

The Earth is Flat! DSM 5 Points at the Tips of Icebergs – Only What You See.
The tip-toe progress with these new superficial labels for office appearances misses altogether the complexity of new brain and body science. Neuroscience evidence is easily available, often paid for by insurance, and remains almost completely ignored by psychiatry. Real facts, not labels, will foretell the changes necessary for psychiatric practice, for treatment strategies to evolve with the rapidly evolving new science.

Neuroscience evidence changes thinking.
Yes, these refined descriptions may help some talk about psychiatric matters with a bit less confusion, but the new DSM5 conclusions are based almost completely upon 19th century vertical thinking, insufficient feedback with patients in the office, and questions that ignore modern neurophysiology and metabolism.

Psychiatrists will remain speculative with dreams and fantasies, while hard evidence from molecular and cellular physiology remains in the closet – frequently derided as quackery. Interestingly, psychiatry is held to a different standard on evidence than the rest of medicine, as SPECT brain imaging and the measurement of neurotransmitter biomarkers is still derided as non-specific, while patently non-specific biomarkers, such as cholesterol screening, are accepted uniformly in general medicine. It’s time for diagnostic change – but DSM5 is already old news.

Your Comments Count
Let’s see what you think… please comment here and weigh in on your views of psychiatric diagnosis – look forward to hearing from you!
cp

Make sure you take a look at these pages!
ADHD Medication Rules Purchase
“Rules” Affiliate Link
Neuroscience Details


Bookmark and Share

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Intuniv for ADHD: Metabolic Challenges

February 1, 2010 Autism Spectrum

This post is the fifth, with four others, documenting Intuniv Overview, Dosing Details, Drug Interactions and Addiction Indications. Please review all of these posts for more informed use of Intuniv

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Vitamin D3: Swine Flu, Depression, Autism

September 24, 2009 Blog

Vitamin D3 Needs Attention On Several Levels – Just take the time to go through these many Vitamin D3 links, and do watch this video by Dr John Cannell. We have been hearing about the importance of D3 with depression for years, and know that it is directly connected with good thyroid function – now think D3 and Swine Flu

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Pristiq For Major Depression – Clinical Details on CorePsych Radio

July 8, 2009 Bipolar

Some think that Pristiq is just another Effexor XR – but they aren’t thinking about the details.

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Depression and ADHD: Jim Carrey on Neurotransmitters

May 25, 2009 Beyond ADHD

Yes, Jim Carrey is using neurotransmitter precursors to help him with depression, – and what he is saying often makes office sense – we have regularly witnessed burnout from SSRIs – live on Larry King.

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ADHD Medications with Depression: Seven Significant Problems

March 30, 2009 Beyond ADHD

Depression and ADHD: Often Confusing – Listen on CorePsych Radio -handout for the program at this link, medications specifically recommended

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Vitamin D3 – Easy to Measure and Important to Correct

January 5, 2009 Brain/Body Evidence

At every first psychiatric interview, especially here in the middle of northern hemisphere winter, – and if you or your client is African American always ask the SAD [seasonal affective disorder] question:

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Grumpy Outed: ADD and Depression For A Lifetime

November 27, 2008 Beyond ADHD

Holiday Case Report – Grumpy was one of the Seven Dwarfs in the classic Disney film Snow White. This week I met his alter ego. In fact, Grumpy came to my office and we found a new role for him at ~ 50 years old

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ADD/ADHD: Book Review, Beyond Meds – The Exercised Brain

September 1, 2008 Autism Spectrum

Help for ADD/ADHD Beyond Medications: Many want to change their brain, and also want non-medication alternatives for ADD/ADHD treatment. So many ask for comprehensive brain fixes that work for a lifetime – this one is a keeper. Ratey has done it again.

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