SSRIs

Question:

all good and all usefull!  :) thanks. mainly because i think of all the times i myself tried to "come off" a med ..lol. what do you think about two antidepressants used together? if it works what is the harm? harpy

Response:

>all good and all usefull!  :) >thanks. >mainly because i think of all the times i myself tried to "come off" a med >..lol. >what do you think about two antidepressants used together? >if it works what is the harm? >harpy

I think it’s pretty common to use 2 ADs together. like Prozac + Wellbutrin or Prozac + Trazadone. Wouldn’t make much sense to use 2 SSRIs together like Prozac + Zoloft…but then again, it’s what works that counts… What’s wrong with Fred (Viscount)? Click here for answers: http://x53.deja.com/[ST_rn=ps]/getdoc.xp?AN=683691056&CONTEXT=972383963.717291529&hitnum=24 You can also click on this link about psychopaths and observe how well it describes Fred: http://www.geocities.com/lycium7/

Response:

I think many of us are already taking two AD’s, so its kind of a moot question… but yeah… if it works, do it. Linda – Hide quoted text — Show quoted text ->all good and all usefull!  :) >thanks. >mainly because i think of all the times i myself tried to "come off" a med >..lol. >what do you think about two antidepressants used together? >if it works what is the harm? >harpy

Response:

informed me of this: :> What’s wrong with Fred (Viscount)? Click here for answers: :> : :The above link is not taking me to a site. It merely opens :a format to send an e mail.  I would like to see it, although :I already know what’s wrong with fred. : :Mark : Mark, this link should take you to a section of a post that Keith put out titled " more on Fred as a Psychopath". If you browser asks, tell it that this link is a message ID and not an email address. I don’t know how outlook express works with this.

Response:

- Hide quoted text — Show quoted text – >informed me of this: >:> What’s wrong with Fred (Viscount)? Click here for answers: >:> >: >:The above link is not taking me to a site. It merely opens >:a format to send an e mail.  I would like to see it, although >:I already know what’s wrong with fred. >: >:Mark >: >Mark, this link should take you to a section of a post that Keith put >out titled " more on Fred as a Psychopath". If you browser asks, tell >it that this link is a message ID and not an email address. I don’t >know how outlook express works with this.

I fixed it to go to the Deja archives, that should work better. What’s wrong with Fred (Viscount)? Paste this link into your browser for answers: http://x53.deja.com/[ST_rn=ps]/getdoc.xp?AN=683691056&CONTEXT=972383963.717291529&hitnum=24 You can also click on this link about psychopaths and observe how well it describes Fred: http://www.geocities.com/lycium7/

Response:

Geez Bikerboy  When you get done worrying about whats wrong with Fred try and figure out whats wrong with Mark. – Hide quoted text — Show quoted text -> What’s wrong with Fred (Viscount)? Click here for answers: > The above link is not taking me to a site. It merely opens > a format to send an e mail.  I would like to see it, although > I already know what’s wrong with fred. > Mark

Response:

Dos Do educate the patient on the proper use of an antidepressant to increase compliance. Do "start low and go slow" to minimize side effects. Start the antidepressant at a low dose and gradually increase the dose of medication as tolerated. Do use pharmacologic antidotes when necessary to minimize antidepressant-induced side effects. Do consider targeting all 3 neurotransmitters when treating depression: serotonin, norepinephrine, and dopamine. When switching antidepressants, do consider both the neurochemical effect as well as side effects. Do consider, when choosing an antidepressant, which side effects would be particularly detrimental to the patient — for example, weight gain in an obese patient or sedation in a patient with psychomotor retardation. Do consider augmenting with other antidepressants, mood stabilizers, or stimulants for partial responders. Do consider drug-drug interactions when choosing an antidepressant. Do prevent antidepressant discontinuation syndrome by slowly tapering the medication. Avoid abruptly reducing and/or discontinuing antidepressants. Do educate the patient that they should not stop taking the medication because they feel better. They should always consult with their physician first. Don’ts Don’t stop a medication before a patient has received an adequate trial of any antidepressant intervention. An adequate treatment trial includes an adequate dose for an adequate duration. Don’t ignore a patient’s complaints of side effects because you this may compromise compliance. Don’t forget to consider comorbid medical or psychiatric illnesses that can interfere with an adequate treatment response. Don’t be satisfied with a partial response. Aim to induce remission and prevent relapse. Don’t underestimate the importance of the doctor-patient therapeutic alliance. http://www.medscape.com/Medscape/psychiatry/TreatmentUpdate/2000/tu04… What’s wrong with Fred (Viscount)? Click here for answers:

Response:

Do’s and don’ts for Tinyfright. 1)  Do get a life. 2)   Do return to asdm-m 3)   Do learn something about bipolar disorder. 4)  Do stop whing about how Carol cleaned your clock in court. 5)   Do go outdoors and get some sun. 6)   Do get treatment for IAD 7)   Do have your momma hide the matches from you.                    Don’ts Don’t pretend to be Mr. Nice Guy who’s trying to save usenet from trolls. Don’t take advantage of mentally ill, vulerable women and then brag about it in e-mails to your hero, Viscount. More later… Viscount of ASDM – Hide quoted text — Show quoted text – > Dos > Do educate the patient on the proper use of an antidepressant to > increase compliance. > Do "start low and go slow" to minimize side effects. Start the > antidepressant at a low dose and gradually increase the dose of > medication as tolerated. > Do use pharmacologic antidotes when necessary to minimize > antidepressant-induced side effects. > Do consider targeting all 3 neurotransmitters when treating > depression: serotonin, norepinephrine, and dopamine. When switching > antidepressants, do consider both the neurochemical effect as well as > side effects. > Do consider, when choosing an antidepressant, which side effects would > be particularly detrimental to the patient — for example, weight gain > in an obese patient or sedation in a patient with psychomotor > retardation. > Do consider augmenting with other antidepressants, mood stabilizers, > or stimulants for partial responders. > Do consider drug-drug interactions when choosing an antidepressant. > Do prevent antidepressant discontinuation syndrome by slowly tapering > the medication. Avoid abruptly reducing and/or discontinuing > antidepressants. > Do educate the patient that they should not stop taking the medication > because they feel better. They should always consult with their > physician first. > Don’ts > Don’t stop a medication before a patient has received an adequate > trial of any antidepressant intervention. An adequate treatment trial > includes an adequate dose for an adequate duration. > Don’t ignore a patient’s complaints of side effects because you this > may compromise compliance. > Don’t forget to consider comorbid medical or psychiatric illnesses > that can interfere with an adequate treatment response. > Don’t be satisfied with a partial response. Aim to induce remission > and prevent relapse. > Don’t underestimate the importance of the doctor-patient therapeutic > alliance. > http://www.medscape.com/Medscape/psychiatry/TreatmentUpdate/2000/tu04… > What’s wrong with Fred (Viscount)? Click here for answers:

Response:

– Hide quoted text — Show quoted text – >Do’s and don’ts for Tinyfright. >1)  Do get a life. >2)   Do return to asdm-m >3)   Do learn something about bipolar disorder. >4)  Do stop whing about how Carol cleaned your clock in court. >5)   Do go outdoors and get some sun. >6)   Do get treatment for IAD >7)   Do have your momma hide the matches from you. >                   Don’ts >Don’t pretend to be Mr. Nice Guy who’s trying to save usenet from trolls. >Don’t take advantage of mentally ill, vulerable women and then brag about it in e-mails >to your hero, Viscount.

Unlike Fred, I have never had to pretend to be nice. What’s wrong with Fred (Viscount)? Click here for answers:

Response:

> What’s wrong with Fred (Viscount)? Click here for answers:

The above link is not taking me to a site. It merely opens a format to send an e mail.  I would like to see it, although I already know what’s wrong with fred. Mark

Response:

>> What’s wrong with Fred (Viscount)? Click here for answers:

>The above link is not taking me to a site. It merely opens >a format to send an e mail.  I would like to see it, although >I already know what’s wrong with fred. >Mark

Web Page at: www.robertpo.com For email replies remove the ****

Response:

>>> What’s wrong with Fred (Viscount)? Click here for answers:

sigh didn’t work either Web Page at: www.robertpo.com For email replies remove the ****

Response:

hey Keith, I would add a few little things here. –Don’t assume that just because some responses to medications happen rarely, or very rarely, that one of your patients isn’t gonna be a rare person!! –Do be aware that allergic reactions do happen to medications and they can not be predicted.  Do stop all meds immediately if an allergic reaction does occur and deal with the resulting effects of this appropriately! otherwise, I say we print this out and give to our pdocs! Leslie J.

– Hide quoted text — Show quoted text -> Dos > Do educate the patient on the proper use of an antidepressant to > increase compliance. > Do "start low and go slow" to minimize side effects. Start the > antidepressant at a low dose and gradually increase the dose of > medication as tolerated. > Do use pharmacologic antidotes when necessary to minimize > antidepressant-induced side effects. > Do consider targeting all 3 neurotransmitters when treating > depression: serotonin, norepinephrine, and dopamine. When switching > antidepressants, do consider both the neurochemical effect as well as > side effects. > Do consider, when choosing an antidepressant, which side effects would > be particularly detrimental to the patient — for example, weight gain > in an obese patient or sedation in a patient with psychomotor > retardation. > Do consider augmenting with other antidepressants, mood stabilizers, > or stimulants for partial responders. > Do consider drug-drug interactions when choosing an antidepressant. > Do prevent antidepressant discontinuation syndrome by slowly tapering > the medication. Avoid abruptly reducing and/or discontinuing > antidepressants. > Do educate the patient that they should not stop taking the medication > because they feel better. They should always consult with their > physician first. > Don’ts > Don’t stop a medication before a patient has received an adequate > trial of any antidepressant intervention. An adequate treatment trial > includes an adequate dose for an adequate duration. > Don’t ignore a patient’s complaints of side effects because you this > may compromise compliance. > Don’t forget to consider comorbid medical or psychiatric illnesses > that can interfere with an adequate treatment response. > Don’t be satisfied with a partial response. Aim to induce remission > and prevent relapse. > Don’t underestimate the importance of the doctor-patient therapeutic > alliance.

http://www.medscape.com/Medscape/psychiatry/TreatmentUpdate/2000/tu04… u04.html – Hide quoted text — Show quoted text – > What’s wrong with Fred (Viscount)? Click here for answers:

Response:

– Hide quoted text — Show quoted text ->>> What’s wrong with Fred (Viscount)? Click here for answers: >sigh didn’t work either >Web Page at: www.robertpo.com >For email replies remove the ****

The link is to the message I previously posted about Fred as a psychopath. Mark, your newsreader is misinterpreting it as an email front of the message ID…I’m using Agent too and it works fine for url (I have "Make an educated guess".) Sigh…I wasn’t expecting any problems until the original post began to expire from people’s news servers, at which time I was going to post it again and update my sig file… Here it is again: Fred’s own words give him away. He has said many times, both on this group and in emails, that he doesn’t care about anyone on the group. He knows that all the posters are real people, and he knows that he hurts them…he doesn’t care. http://www.geocities.com/lycium7/ (Excerpts) These psychopaths often think of themselves as special, and deserving of special privileges, even if unsaid. They can be found in all echelons of society, from low-class to high-class backgrounds, but they are never insane or crazy, rather, more like "morally insane." Tim Field, a noted author and webmaster of Bully OnLine, believes that the psychopath picks out people who can see through him: "A bully’s (sociopath) apparent self-esteem and self-confidence is actually arrogance, an unsustainable belief of invulnerability honed from his willingness to act outside the bounds of society to ensure their survival. Targets (or victims) are people who can see through the arrogance to perceive the empty shell behind it – and bullies can sense who can see through them, furthering the target’s elimination." [Bully OnLine]. This usually happens in the workplace, and in situations where the psychopath has let his mask drop, realizing that you’ve seen what he’s really made of. In the workplace, this can mean your very doom if the psychopath happens to be your boss. (I see through you Fred. Best of luck.) The cruelty of the psychopath is something almost unexplicable. The psychopath has a callous, remorseless, and unempathetic attitude towards his victims, or targets. He relates to others on a basis of power rather than affection. Like the narcissist, he has an arrogant, disdainful, and patronizing attitude. Most people will be able to identify this arrogance, although it can often be misinterpreted as an overhealthy self-esteem. Psychopaths do not form real attachments, and they enjoy their image of autonomy. They have a grandiose self-structure which demands "a scornful and detached devaluation of others" [Gacon et al 1992], in order to ward off envy toward the good perceived in people. They react towards perceived or existing attachment capacities with ambivalence and often aggression. Most of them transfer the attachment to "hard objects" such as weapons, knives, etc. The grandiose self is represented onto the weapon or object and is a projection of themselves. (Fred’s "hard object" is his computer.) The fact of the matter is, if we paid closer attention, the psychopath may be able to be discerned. There is something "off" about them — larger than life, almost as if they’re playing a role. It’s hard to describe unless you’ve experienced it (as one individual commented, "I don’t know how to describe pornography, but I sure know what it is when I see it.") In the end, however, you might find out what their true colors are, for they are extremely arrogant, not to mention pugnacious, and are often called obnoxious personalities; however, oftentimes their means of hurting or destroying someone be more subtle. Psychopaths are often witty and articulate. They can be "amusing and entertaining conversationalists, ready with a quick and clever comeback, and can tell unlikely but convincing stories…They can be very effective in presenting themselves well and are often very likeable and charming. To some people, however, they seem too slick and smooth, too obviously insincere and superficial. Astute observers often get the impression that psychopaths are play-acting, mechanically "reading their lines." [Hare, 35]. The psychopathic personality can also be very convincing. They use their moods to manipulate others. Oftentimes they are overbearingly magnetic whenever the purpose suits them, but otherwise can be repugnant and downright mean. It all depends on what they want. They may "ramble and tell stories that seem unlikely in light of what is known about them. Typically, they attempt to appear familiar with sociology, psychiatry, medicine, psychology, philosophy, poetry, literature, art, or law. A signpost to this trait is often a smooth lack of concern at being found out." [Hare, 35]. One psychopathic individual I knew claimed that he had a genius IQ and that he was studying several different majors at college. "When I found out I had a genius IQ, that’s when all my trouble started" he said. I asked him, "Why?" He replied, "’Cause I’m too smart for my own good." In the end I found out these were lies because he was, in fact, a high-school drop-out. Despite their failures, psychopaths have a very "narcissistic and grossly inflated view of their self-worth and importance, a truly astounding egocentricity and sense of entitlement, and see themselves as the center of the universe, as superior beings who are justified in living according to their own rules." [Hare, 38]. They often come across as "arrogant, shameless braggarts–self-assured, opinionated, domineering, and cocky. They love to have power and control over others and seem unable to believe that people have valid opinions different from theirs. They appear charismatic or ‘electrifying’ to some people." [Hare, 38]. I know exactly what Hare means when I recall one person I used to know (who had been diagnosed); he always seemed to be charming everyone around him, although in the end every woman who fell for him ended up becoming hostile when they realized all he had been doing was leading each one on simultaneously. . They know exactly how to appeal to one