Ritalin: Stimulant. I am not clear as to how it works, but it appears to allow more neurotransmitters needed for attention-demanding tasks. It is a common drug used in children with confirmed ADHD, but it is a tightly controlled med, needing a new perscription each time a user needs a refill. Potential for abuse is very, very high.
Sylert: No longer available in the US. Central nervous system stimulant. Was pulled from the US market because of hepatic failure, and should not be considered as first line treatment for ADHD.
Zoloft: Antidepressant, SSRI catagory. Used primarily for depression, anxiety. Can also be used for OCD, PTSD.
Paxil: Anti-depressant, SSRI catagory. Used primarily for depression, but can be used to treat OCD, anxiety, and agitation, PTSD, and PMMD (obviously not with JAG - pre menstrual mood disorder)
Tegretol: anti-seizure med primarily (used often with epilepsy). Can be used to sedate when hypermania exists. Interacts with Wellbutrin. Can also be used to control neuropathy (a certain kind of pain), and headaches (cluster, migraine, severe).
Impripramine: tricyclic antidepressant. Used for depression; enuresis (bedwetting). It is an uncommon drug, and only is effective with people who have clinical depression (an imbalance in neurotransmitters), but does not affect someone who has normal levels of seratonin, dopamine, and histamines. Use with caution.
Wellbutrin: antidepressant, SSRI. Used for depression. Use with caution in treating bi-polar, as some evidence points to triggers of a manic phase. Common s/e are anxiety, suicidal ideations, and other psychotic episodic events.
One thing which struck me is that there aren't any noted meds for bi-polar. I was looking for meds like lithium, risperdal, depakene/depakote, lamictil, zyprexa, abilify...but those weren't mentioned. There is a note which indicates that JAG took 18 meds, so obviously the list in the probation report is not complete. But I still would've thought I'd've seen at least one bi-polar med if his bi-polar diagnosis was a true one.
Bi polar is often misdiagnosed as depression. People seek help when they're depressed, not when they are manic (for the most part). Most of the time when a patient comes in to (my) the hospital and they are diagnosed as bi-polar, it's because they're in the midst of a significant manic episode, which can include cessation of sleep, speeding /racing thoughts, tangentiality, inability to care for self, grandiose thoughts and behaviors, and so on. It's not too difficult to spot a person in a manic episode, once you've seen it...but if a person is having a 'sub-acute' episode (meaning, it's not bad enough to affect one's ability to take care of oneself), it's really hard to spot.
So most folks don't get diagnosed in the manic stage, but do get given a diagnosis of depression; and are subsequently treated as a depressive rather than a bi-polar sufferer.
Bearing that in mind, I find it utterly fascinating that the majority of his meds were addressing depression; something he was not diagnosed with (or at least it's not been alluded to in anything I've read; I could've missed it). Depression also tends to not kill other people, but does kill the sufferer via suicide. It's not often there's a homicidal aspect to depression, at least not a serial one (homicidal/suicidal instances together are, sadly, fairly common); if there is one, it's often 'incidental' and/or in the course of the act of suicide.
And it was stated that he has been off all meds from the time he was 16.
So.
Dr. Carroll was unable to give an axis 1 disorder. Which tells me, we're dealing solely with an axis 2 disorder, and that it is more than likely it's BPD and/or antisocial (it's possible to have all 'cluster' disorders at once).
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