Some books I read in the (Chinese) Lunar Year of 2016

Students Who Drive You Crazy. (2009) Corwin Press.

  • It is a good book despite the somewhat negative title. Authors are rather self-reflective and helped me relook my time when I was teaching in the civil service
  • I borrowed it (no surprises) from NLB Singapore

Miracle on the 17th Green. James Patterson. (The crime/thriller writer, yes)

  • Main character Travis gets sacked and goes on to revive a past flame of playing professional golf; saving his marriage in the process
  • Most memorable idea? A man who hates his job would not be an attractive man
  • Cue NLB : )

Happy Lunar New Year!


Epilepsy (Singapore): Case Studies and Medications

Choong Chew Thye, Michael Chee Wei Liang, Diana Koh Hwee Hoon, Sherman Goh Keng Hwee (Editors).(2013). Seizures in the city: a collection of writings on epilepsy. Singapore. Candid Creation Publishing for Epilepsy Care Group.

Perhaps the old me would have gone through the book like a train. But these are not just writings. These are peoples’ lives…

This post is split into two parts, it opens with treatment then it follows with a few life experiences.


Professor Michael Chee Wei Liang at the time of writing was a neuroscientist (with the Duke-NUS Graduate Medical School) and was a former clinician (active medical doctor). He wrote the chapter on the development of epilepsy care. I shall focus on the medications specifically coined – anticonvulsants.

In Professor Chee’s analysis, an approximate 50% of epilepsy sufferers have well controlled epilepsy via medication. (With further research elsewhere or reading through the book, some undergo surgery as remedy.) To side track, some ‘psychogenic seizures’ may appear to be epilepsy but they are not so. (I do recall I hearing about this back when I attended a talk during my healthcare sector days.) Thus, this presents greater challenges for correct and accurate diagnosis.

[Do note that the year now is 2017. Things may have changed. Further, it is critical to seek qualified medical advice on the issue. If needed, seek a second or even a third opinion. The medication list below is not exhaustive. I have selectively highlighted some side effects and put them in italics. The trade/brand name of the drugs on the market most likely differ from the names provided.]

There are two groups categorised by age. The prior/elder generation of drugs include:

  • Phenytoin
  • Sodium Valproate
  • Phenobarbitone (risks of inducing sleepiness/has sedative effects)

The more recent/younger group comprise:

  • Lamotrigine (rashes)
  • Topiramate (cognitive decline in areas like word finding; falling weight)
  • Gabapentin (limited side effects but not very useful)

Resident Accounts and related issues

Tony Loh Kia Hiang – seizures hit him at age 35 (complicated by sleep apnea if my memory serves me right).

Fan Yew Meng – left store with unpaid merchandise: ‘did not have clarity of mind’; charged with theft and acquitted.

Tan Pek Ann – seizures from age 7 post severe fever; was able to get married; supportive work environment with colleagues who know ‘what simple steps should be taken when I have a seizure.’

Discrimination faced by some at work and in leisure because of their epileptic condition.

Epilepsy may intertwine with depression given the (potential) job losses; sense of helplessness; and relationship rejection. The flow on risk is suicide. Hence, carers and families or friends need to take precautions as required.

OCD – Medications

OCD is termed as Obsessive-Compulsive disorder. It is a mental illness that revolves around obsessions and compulsions. The desire to rid oneself of the obsessions may lead to compulsive behaviour while for others it may remain at the obsession level (not that this is necessarily less distressing). People with OCD may similarly suffer from depression.

For some definitions see the entry from Mayo Clinic (US) – dated 17 Sep 2016; or Institute of Mental Health (Singapore) – not dated.

Apart from therapy, medications often form the other arm of treatment.

One type of medication described by psychologist Patrick B. McGrath (below) is the SSRI (Selective serotonin re-uptake inhibitors). It basically allows more serotonin to remain in the brain ecosystem. Consequently, more neurons may come into contact with serotonin. Resultantly, OCD symptoms could decline. The 2007 book (below) suggests that SSRIs ‘appear to be the safest’ among the various types of medications. Negative effects take the guise of headaches, nausea, insomnia, agitation and sex-related issues. Brand/Trade names of SSRIs include Prozac, Luvox, Wellbutrin, Paxil, Celexa, Zoloft and Lexapro.

Benzodiazepines like (brands) Xanax, Ativan, Valium and Klonopin pump up the effects of GABA (gamma-aminobutyric acid) an inhibitory neurotransmitter. (See Anxiety Neurotransmitters. The Brain from the Top. It appears the source hails from McGill University, Canada.) This brings tranquility to the patient. Unfortunately, there is potential for addiction and abuse.

One other group are the Monoamine oxidase inhibitors (MAOIs). As of 8 June 2016, a the Mayo Clinc article, describes that the drug class has ‘…generally been replaced by antidepressants that are safer and cause fewer side effects.’ So it does seem that this type of medication as a ‘last resort’ (opined by McGrath) still holds true. A sample of brands:

  • Isocarboxazid (Marplan)
  • Phenelzine (Nardil)
  • Selegiline (Emsam)
  • Tranylcypromine (Parnate)

[Please note that this exposition on OCD medications is non-exhaustive and is not a substitute for advice from a medical/qualified professional.]

Book reference:

Patrick B. McGrath. (2007). The OCD Answerbook. Naperville. Sourcebooks.

Coaching/Peer Tutoring (ADHD)

We often speak about SMART (Specific, Measurable, Attainable, Realistic, Timely/Timebound) goal setting.

But for people dealing with ADHD or dyslexia,  it is wise to bring up the idea of short term goals as precursor. Thus, if one needs to write a 3000 word essay – formative goals may include (a) improving one’s grammar; (b) writing organised paragraphs; (c) research etc. In one case study, an electronic planner with an alarm was utilised to help the student keep track of timespan (with the guidance of a coach).

A related method (from 1988) is called Classwide Peer Tutoring (CWPT). In a space of 20 minutes, a class is split in half. Each half further divide themselves into pairs. They are called to tackle preset questions. The student who tutors is given ‘academic scripts’, these include answers. The teacher supervises the process and provides positive reinforcement where applicable. Outcomes of greater ‘engagement’ and better assessment scores were found for elementary (primary level in the Singaporean context) students.


Likewise, CWPT is arguably suited for others who are not afflicted by ADHD.

Sometimes though goal setting can go very awry… See <When Goal Setting Goes Bad> Harvard Business School Working Knowledge. (2 Mar 2009).

Silverman, Stephan M.; Iseman, Jacqueline S.; Jeweler, Sue. (2009). School Success for Kids with ADHD. Waco.  Prufrock Press. [Unfortunately, I am unable to utilise the strategies from other teachers. I felt that the information from Chapter 6 was too lean such that I was unable to understand how things were executed or what they meant in the first place…]