From: egf48542@ucbeh.san.uc.edu
Newsgroups: sci.med
Subject: Re: Peter Breggin, _Toxic Psychiatry_ (Q)
Date: 11 Dec 92 06:46:55 GMT
Organization: Univ. of Cincinnati

In article <Bz29F5.Jvr@unx.sas.com>, sasghm@theseus.unx.sas.com (Gary Merrill) writes:
> And what about those patients who are perfectly happy about their
> "abnormal" behavior?  What about those patients who do not feel the
> need for treatment.  If you have not encountered a large number
> of case descriptions in which the patient is being treated at the behest
> of someone *else* (often under duress), you haven't read many cases.


    Let's make a deal.  I won't make ludicrous, absurd statements about the
SAS programming language-something I know nothing about-if you stop making
ludicrous, absurd statements about psychiatric treatment-something you
know absolutely, positively NOTHING about. 

In the meantime, do some reading.  On research.  "Advances in Neuropsychiatry"
-Schizophrenia Research (1991) edited by Carol Tamminga, M.D. and Charles
Schulz, M.D. would be a good start.  And if you reject overwhelming scientific
evidence, I will continue listing items for those persons who might be
interested.

	In the August 27th, 1992 "New England Journal of Medicine" there is a
small scale study (which needs to be replicated and confirmed) of 13 persons
with schizophrenia who underwent high-resolution MRI scans.  They had
previously been assessed for their degree of thought disorder.  The scans
revealed that all had brain tissue loss in as section of the left temporal
lobe.  The degree of tissue loss correlated DIRECTLY and STRONGLY with the
degree of thought disorder.  Some persons who have had temporal lobe
abnormalities such as temporal lobe epilepsy have symptoms that mimic
schizophrenia (visual and auditory hallucinations, etc.).

	PET (positive emmision tomography studies) in the past 10 years have
consistently revealed that persons with schizophrenia have reduced frontal lobe
activity and do poorly on psychiatric tests like the Wisconsin Card Sort Test.
	
	The September, 1992 of Discover Magazine has a nice article on a recent
finding that shows that the left predorsal frontal cortex fails to activate in
accordance with limbic structures failing to properly function in persons with
schizophrenia.

	NIMH research, led by Dan Weinberger, M.D. and Fuller Torrey, M.D. have
studied a large amount of twins, one twin with schizophrenia and one without
and have found in about 98% of cases the twin with schizophrenia has enlarged
cerebral ventricals, implying brain tissue loss.

	In the Schizophrenia research book, several findings are of note. 
First, negative symptoms of schizophrenia seem to be correlated with decreased
glucose metabolism of several areas immediately surrounding the limbic system.
Second, accumulating research points to the fact that schizophrenia is a
disease of the left side of the brain, specifically, a breakdown in connections 
between the hippocampus, temporal lobe, and frontal lobe area.  Third, it is
likely that a lesion-probably prenatal-affects the wiring of the limbic system,
particularly the hippocampus, since the hippocampus in virtually all persons
with schizophrenia is shrunken and "wired" in a disordered way.  Fourth,
gangliosides, agents used in brain damaged patients, seem to partially repair
hippocampul(sp?) disorganization. 

Clozapine is a recently marketed atypical antipsychotic which acts selectively
blocks D1 and D2 receptors, interacts with 5HT2 receptors and is an alpha-1
antagonist, as opposed to traditional antipsychotics which act on D1, D2 or a
combination of both receptors.  Atypical antipsychotics cause little or no EPS 
and reduced or very little chance of Tardive Dyskinesia, from preliminary
observation. It is predicted that early in the next century, these new atypical
antipsychotics will replace typical ones like Thorazine and Haldol.  

By the way, they work a lot better.  I've met several patients who had been
hearing voices for years (one person for 18 years), who stopped hearing them
after being put on clozapine (Clozaril). It doesn't work for everyone, but
others will come out that will work for those who don't respond to Clozaril,
hopefully.  And without the risk of agranulacytosis (fatal drop in white blood
cell count) that is protected against by weekly blood monitoring. 

Many persons with schizophenia deny they have an illness for various reasons,
including paranoia, distrust of physicians, bad experience with medications,
and other reasons. If you gain their trust, like I have, you will find out that
virtually NONE of them are HAPPY.  They tend to make bad judgements because
they have a malfunctioning limbic system, which involves our judging process. 
Most of them have at least a fraction of insight that something is wrong, but
many on the surface will deny it. What's wrong is called that they have a brain
disease which affects the ability to think logically.

Fortunately, at the pace research is going, the cause of schizophrenia will be
found before the year 2000.  Then any rational person will be able to conclude
that schizophrenia is a brain disease, no more and no less that Alzheimer's
disease or Multiple Sclerosis. An overwhelming amount of rational people know
that it is a brain disease, a small amount of idiots in North Carolina and
other places who never tried to help anyone with schizophrenia think they know
the truth, when all they know is how to sound foolish. 

Ed Francell
Univ. of Cincinnati
Newsgroups: sci.med