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Coronavirus and psychiatric drug tapering & withdrawal

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Colonial
1 hour ago, Onmyway said:

 

If you are in hospital with covid-19 statistics show that you have only a 50% chance of surviving it. If you are in ICU on a ventilator your chance of surviving is 15%

 

Luckily here in the USA, The Hospital discharge rate is already 40% CURRENTLY at 12,182 with 16,479 hospitalized and only 4,376 in ICU in New York City which has the highest percentage of cases and deaths, and the Ventilator survival rate is holding at about 50%.  Perhaps here people are not waiting until it's too late to go for help, compared to where perhaps the Statistics Your quoting are holding.  

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Onmyway
59 minutes ago, Colonial said:

 

Luckily here in the USA, The Hospital discharge rate is already 40% CURRENTLY at 12,182 with 16,479 hospitalized and only 4,376 in ICU in New York City which has the highest percentage of cases and deaths, and the Ventilator survival rate is holding at about 50%.  Perhaps here people are not waiting until it's too late to go for help, compared to where perhaps the Statistics Your quoting are holding.  

 

Actually, I had relied on newspapers for those numbers, so they are old and not necessarily correct. 

Below are the latest *correct* numbers from the UK: 

 

About 50% survive ICU.

About 1/3rd survive after needing ventilator support. (p.13 of report linked) - so not 15% but about 33%

 

 

These are not the same group as the 40% in the US numbers as US numbers seem to be hospital admissions, not necessarily ICU admissions as stated by @Colonial. Not all hospital admissions are as severe as the ICU admissions. 

 

*The numbers above are of people died divided by the number of people died+discharged (likely the mildest ICU cases and the most severe ICU clases, we don't know about the middle of the distrubition in terms of severity, for all we know they may all survive). Note that many people are still in hospital receiving treatment so we don't know how many of those will survive. These are the closed cases. 

 

Over 70 years old about 32% survive ICU, under 50 about 77% - these are ICU patients, not just those that received ventilator support. 

Note that these are data from when the hospitals have not yet reached capacity. As they do reach capacity, the percentage dead will likely change. 

 

This report has comparative data on Covid-19 and other viral pneumonias from previous years. So this will provide comparison to pneumonia from the flu and other viral diseases, for example. 

 

https://www.icnarc.org/About/Latest-News/2020/04/04/Report-On-2249-Patients-Critically-Ill-With-Covid-19

 

 

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Colonial

This is interesting in the smaller percent of disparity by sex, but seems to be a paradox that women seem to have more adverse reactions then men.

A little off topic, but shows that male "might" have a slightly lower risk reaction to the drug cocktail while also being the group more likely to need it:

 

https://www.washingtonpost.com/health/2020/04/04/coronavirus-men/

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Onmyway
1 hour ago, Colonial said:

 

True, but the jury is out as to why.

 

If, as the original articles indicate, the reason so many persons lungs are giving out is a combination of the virus and it's interacting with their Current drug regime,  It's questionable what throwing more drugs linked to concurrent morbidities could possibly do.

 

@Colonial, I don't know what original articles you are refering as you are not citing anything but I have not seen 'current drug regime'  (and I have reviewed over 1400 articles on Covid this weekend)  having an impact on covid with the potential exception of certain Hypertension drugs. 

 

The only drugs that might potentially threaten risk of getting covid-19 and risk of surviving it are some hypertension drugs - Angeotensin Receptor Blockers (drugs that end in -sartan like losartan) and potentially ACE inhibitors (drugs that end in -pril, e.g. isonopril). In vitro studies show that they may increase risk of covid-19 and survival but animal studies do not necessarily support that hypothesis. However, there is some evidence that they may impact the susceptibility and severity of disease. Some people claim that they may be protective but we don't yet have data and this may really be just a pharma hype.

 

If I were on those drugs, I'd try to switch to alternative hypertension drugs personally but if I could effectively social distance I would not change things as switches can be life threatening with those drugs when they are prescibed for heart failure especially when access to docs is hard and the change can't be easily monitored. There are no other drugs that I have heard of that increase susceptibility to covid. NSAIDs have been discouraged for treatment of all viral infections but there are no reports of them increasing susceptibilty. 

 

So if you are on psychiatric drugs we have no information one way or the other that they are beneficial or hurtful for covid-19 so no need to worry about it. 

 

Yes, drug interactions can be an issue but the likelyhood of that is low and if you have to be put on a drug regimen in hospital to treat covid-19, the cost benefit analysis likely would be skewed to survival over low insidence of side effects/interactions. Having said that, I would discourage the prophylactic use of drugs to prevent covid-19 especially with the little knowledge we have on effectiveness of the proposed regimens. That cost-benefit, at least for me, goes against new drugs. But it may be a different decision for people who are older or can't effectively social distance (live with grandchildren for example) or have underlying conditions. 

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Colonial
On 4/3/2020 at 12:51 PM, Shep said:

From the Rxisk.org site, dated April 2: 

 

Medications Compromising Covid Infections

 

A number of psychiatric drugs are included in this list, so please quarantine as much as possible, wash your hands, and stay safe. 

 

On 4/3/2020 at 12:51 PM, Shep said:

 

 

I didn't think i needed to re cite what was already in the thread.  @Onmyway

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Colonial
On 3/25/2020 at 4:43 PM, Colonial said:

 

Hydroxychloroquine, the malaria drug now being given to Covid-19 patients in NY hospitals since midnight, has 58 major drugs interactions, including:

Citalopram, Escitalopram and Haloperodol

 

It has 266 moderate warnings including Fluoxetine .

 

One person has already died by self administering this med out of their supply of Fish tank medications.

I'm not sure if it was because it interacted fatally with a med He was already on.

 

 

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Colonial
11 minutes ago, Onmyway said:

So if you are on psychiatric drugs we have no information one way or the other that they are beneficial or hurtful for covid-19 so no need to worry about it. 

 

Yes, we do, that was the entire point of those 2 articles, if your discussing adding the other meds to them

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Colonial
On 3/25/2020 at 4:43 PM, Colonial said:

Hydroxychloroquine, the malaria drug now being given to Covid-19 patients in NY hospitals since midnight, has 58 major drugs interactions, including:

Citalopram, Escitalopram and Haloperodol

 

It has 266 moderate warnings including Fluoxetine .

 

https://www.drugs.com/drug-interactions/hydroxychloroquine,plaquenil-index.html

 

all antipsychotics, and antidepressants have effects on the heart, as evidenced in lengthening Q-T intervals.[78] Azithromycin and hydroxychloroquine also prolong Q-T intervals and the addition of these drugs to prior treatment may accordingly cause problems.

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Onmyway

 

Hydroxychloroquine, the malaria drug now being given to Covid-19 patients in NY hospitals since midnight, has 58 major drugs interactions, including:

Citalopram, Escitalopram and Haloperodol

 

It has 266 moderate warnings including Fluoxetine .

 

One person has already died by self administering this med out of their supply of Fish tank medications.

I'm not sure if it was because it interacted fatally with a med He was already on.

 

 

@Colonial, please stop spreading misinformation and scaring people about their drug regimens! 

 

The couple who took their fish tank chemicals took chloroquine phosphate which is not the same as the chloroquine drugs. Fishtank chemicals are toxic. It has nothing to do with their other medicines and interaction with their other medicines. 

 

Covid medicine interacting with other medicines does not mean that they cause or worsen covid-19. Some of these interactions are small, some are worse. If it's a life saving situation, interaction comes second to survival for the vast majority of people. 

 

 

 

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Colonial
2 minutes ago, Onmyway said:

 

@Colonial, please stop spreading misinformation and scaring people about their drug regimens! 

 

Oh, he's really most sincerely dead alright, no misinformation there,

Or in the other 2 articles.

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Colonial

Your missing the point, that the article is claiming the reason the people are getting "that sick" to need a ventilator to begin with or another risky drug regime is because the drugs their ALREADY on have put them at the higher risk for respiratory failure.

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Onmyway
4 minutes ago, Colonial said:

 

Yes, we do, that was the entire point of those 2 articles, if your discussing adding the other meds to them

No we don't. That article said that some of these medicine may interact with other medicines. The majority of these interactions are rare. For example hydroxychloroquine can increase risk of arrythmias similar to citalopram so the effects may be additive. That side effect is rare for citalopram. If you are in an ICU where you'd get that drug, arrythmias can be managed - you're monitored. Given rarity and manageability vs non-survival, it's a straightforard decision if you get to that point. 

 

As far as I'm concerned (and I take citalopram) I am not worried about this a teeny tiny bit.

GIven how our anxiety can get out of hand and spiral on small issues in WD, I don't think that it is helpful to worry about this. 

 

Stay home and if you need intensive treatment, take the drugs that increase your chance of survival. If you want to survive that is. 

 

 

 

 

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Onmyway
7 minutes ago, Colonial said:

 

Oh, he's really most sincerely dead alright, no misinformation there,

Or in the other 2 articles.

The misinformation is that he took a DIFFERENT chemical, not the drug.

Nothing to do with interactions or with the drug we are talking about. 

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Colonial

No, the article said the medications prior to illness were the reasons they got so sick to begin with:

 

Medicines can increase the risk of pneumonia or pneumonitis by depressing immunity and other protective mechanisms (e.g., immunosuppressive agents, antipsychotic agents, some opioid analgesics, proton pump inhibitors), by causing sedation, which may increase the risk of aspiration, by depressing pulmonary ventilation and favouring the occurrence of atelectasis (e.g., opioid analgesics, anticholinergic drugs, psychotropic agents), or by a combination of these mechanisms.

 

https://rxisk.org/medications-compromising-covid-infections/?utm_source=COVID+%26+Meds&utm_campaign=March+News&utm_medium=email

 

 

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Colonial

 

We're having 2 different conversations.

Your discussing what's the best risk-reward once a person is already deathly sick.

 

I'm backing it up to say, if the reason your that sick to need a ventilator to begin with is because drugs suppressed your ability to fight the infection to begin with, the LAST thing that would help would be more drugs already known to cause interactions with those very drugs.

 

My other post was referring to how could we ever get to an understanding if those "rescue drugs"could work in a "control group" of patients not already under the influence of the original medications that made them so compromised to begin with.

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Onmyway
1 hour ago, Colonial said:

Your missing the point, that the article is claiming the reason the people are getting "that sick" to need a ventilator to begin with or another risky drug regime is because the drugs their ALREADY on have put them at the higher risk for respiratory failure.

 

And the solution that guy suggested was to pause taking psychiatric drugs. Tell me how that works for people like us because I have forgotten we are on a WD website. Since we can't do that, let's worry needlessly? Also, that guy cites how psychiatric+other drugs increase risk of pneumonia overall. We don't yet know that this is true of Covid-19 susceptibility or Covid-19 based pneumonia. 

 

I looked at all his cites to the literature - to show increased risk of pneumonia for many of these categories of drugs he cites one cohort based study only (per class of drugs). Cohort studies are the least reliable and the most prone to bias so you need many such studies to be able to draw definitive conclusions. I would need to see more evidence. For example, the study that he cites for SSRIs is on older adults with COPD. We don't know that it can be generalized to people without COPD. People on COPD are probably on many other drugs so it could be interaction between SSRI and other drugs rather than the SSRI drugs by themselves. The link between PPI use and pneumonia is based on the idea that when stomach juice is less acidic it allows more bacteria to grow. That would not necessarily apply to viral pneumonia. So the rxrisk aricle is a lot of hype and scare mongering but not enough solid evidence behind that.  

 

About gabapntinoids there is more evidence and about NSAIDs he is right and he is also right that treating fever, unless very high, is not necessarily beneficial. 

 

So again, no need to worry unnecessarily but stay home, wash hands and if you need treatment (which hopefully you won't need if you do the above) do the treatment. Your doctors are hopefully aware of your interactions. Non-psychiatrist doctors are more open to considering risks and interactions of drugs and ICU doctors I hope even more. 

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Colonial
48 minutes ago, Onmyway said:

And the solution that guy suggested was to pause taking psychiatric drugs

 

I see no recommendation to stop Psychiatric medications either Cold Turkey or Fast Taper because of a fear of Covid.

Your reading things into the material that isn't there. 

The article as Your clearly states is about a plethora of drugs, I don't know why your picking a fight on just one group and then "claim" we are over worrying about them.

 

And for supposed bad science that your touting about from Risk,, the supposed "use" of Hydro and Azirithmo was based on 6 cases.  SIX...

No mention of the other how many other attempts it was tried and either failed or left the person worse that before they were ill.

Classic drug company cherry picking of data.

 

The point of the articles was to warm people of the extra risk they do have so they knew they were in a "high risk" category for pneumonia complications.

It was not to tell anyone to panic and go off their meds or not choose a treatment later if they got sick and thought it was their only hope.

I have no idea where You picked that out.

You also conveniently ignored the Military article on the risks of these Malaria meds to otherwise healthy people, which could only compound neurological issues.

 

You seem to be under the impression that life needs to be sustained at ALL COSTS...

Even if that means to"cure" a person for them only to be more disabled cognitively and functionally.

 

There are things worse than death.  Perhaps Your issue is that You haven't come to terms with Your own Mortality and the grave that awaits us all.

But Your premise refuses to accept that, and in turn shouts reasonable discussion of what that "worse thing" might look like and just want to shoot it down as fear mongering. 

 

Part of good medicine is knowing when "enough is enough", and not living in fear of the inevitable.

It's not "touting" bad science based on a few random outcomes as "promising science" to give false hope to people who can't face mortality.

Which generally isn't the patient, it's the family.

 

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drugged
On 4/5/2020 at 5:47 AM, Shep said:

 

It may have been mefloquine. 

 

Malaria drug causes brain damage that mimics PTSD: case study

 

That same website recently put out an article raising concerns about the use of these kinds of drugs:

 

Drug Touted as COVID-19 Treatment Has Troubling Side Effects, Experts Say

 

 

My limited understanding is that at least some of the anti-malarials are quinolones.  Since it seems likely I've been harmed by taking fluoroquinolones in the past, use of quinolones would be contraindicated should I become sick enough to require hospitalization?  Correct?  The usefulness of anti-malarials against this virus seems questionable anyway so I don't see it ever being an issue for me where I live but I have instructed my PCP that I should not be given any fluoroquinolones in the case of a bacterial infection. 

 

The thing that does concern me is being in the middle of tapering a drug where I'm dividing the smallest tablet available into ever tinier pieces.  Is a hospital going to mess with that or will they either cold turkey me or bump the dose back up to the smallest available tablet?  Thinking about this question helped me decide to continue tapering the trazodone followed by the pregabalin rather than start on counting beads to taper the venlafaxine further.   

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Colonial

@drugged

 

That's a tough call, especially for those of us who've already been harmed by the quinolone family.  Some companies are starting to no longer produce them:

  02/26/2020 Sandoz Inc. has made a business decision to discontinue Levofloxacin Tablets.

 

It's good your doctor knows not to give them, but as you say the issue is what happens if you end up in bad shape in an E.R.?

It's why I've always told my Doctor I want him calling in to my Pharmacy the EXACT ridiculously small dose of meds I'm on, EACH MONTH because if I end up unconscious or in a coma, their going to dose Me by what my pharmacy records indicate I'm taking.

 

The best thing I can suggest to anyone, and this is something that we "should" have in place at any time, because you don't need a Pandemic to have though this through, is have a 2 weeks of meds ready to either take with you to the E.R., or that someone who knows Your situation can can bring down, say if your in a car accident, etc.

 

Regardless of WHY we're being admitted to the hospital, and especially BECAUSE we may not be able to speak for ourselves at that time, as much of these precautions should be handled ahead of time. It's why AS SOON as I make another med drop I notify my Doctor immediately to update the chart so if I'm non responsive, all the electronic info they pull up by insurance, doctor and pharmacy records match as close as possible.  Because if your just filling months worth of meds at a time, and nobody knows exactly WHAT your doing, or you NEVER TELL your doctor your  counting out beads of Cymbalta and he thinks Your still taking twice as much as You are, that's what their going to dose You at, God Forbid, Your in a Coma or something.  And then You get to start Your taper all over again because now they've got you "juiced" back up at what you were at 2 years ago and you have to start your taper all over again, just because Your electronic medical records didn't match or your doctor had no idea what the hell You were up to.

 

Can you "make" a few Weeks worth of med and put them in the capsules You can purchase?  Then at least you would have them already ready to take to the hospital.  And if your doctor can confirm to the E.R.:  "Yes, He's on a tiny amount of this, you'll be in better shape. 

 

It the best "harm reduction" protocol I've been able to put in place for myself, everyone being on the same page, Doctor, Pharmacy and Insurance.  It's a bit of a nuisance to have to go to "pick up" what amounts to only .25 mgs of liquid paxil a month, but it's better than nobody knowing what the hell my dose is in an emergency.

 

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Colonial
3 hours ago, drugged said:

Is a hospital going to mess with that or will they either cold turkey me or bump the dose back up to the smallest available tablet? 

 

In theory, they would have to compound the dose for you, but that could take a week to get that done, hence why I suggested having some to take with you or in a place your "next of kin" knows where to find them and bring them down to the hospital in an emergency.

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Onmyway
6 hours ago, Colonial said:

 

I see no recommendation to stop Psychiatric medications either Cold Turkey or Fast Taper because of a fear of Covid.

Your reading things into the material that isn't there. 

The article as Your clearly states is about a plethora of drugs, I don't know why your picking a fight on just one group and then "claim" we are over worrying about them.

 

And for supposed bad science that your touting about from Risk,, the supposed "use" of Hydro and Azirithmo was based on 6 cases.  SIX...

No mention of the other how many other attempts it was tried and either failed or left the person worse that before they were ill.

Classic drug company cherry picking of data.

 

The point of the articles was to warm people of the extra risk they do have so they knew they were in a "high risk" category for pneumonia complications.

It was not to tell anyone to panic and go off their meds or not choose a treatment later if they got sick and thought it was their only hope.

I have no idea where You picked that out.

You also conveniently ignored the Military article on the risks of these Malaria meds to otherwise healthy people, which could only compound neurological issues.

 

You seem to be under the impression that life needs to be sustained at ALL COSTS...

Even if that means to"cure" a person for them only to be more disabled cognitively and functionally.

 

There are things worse than death.  Perhaps Your issue is that You haven't come to terms with Your own Mortality and the grave that awaits us all.

But Your premise refuses to accept that, and in turn shouts reasonable discussion of what that "worse thing" might look like and just want to shoot it down as fear mongering. 

 

Part of good medicine is knowing when "enough is enough", and not living in fear of the inevitable.

It's not "touting" bad science based on a few random outcomes as "promising science" to give false hope to people who can't face mortality.

Which generally isn't the patient, it's the family.

 

 

Below is a quote from the article that you pointed to @ https://rxisk.org/medications-compromising-covid-infections/?utm_source=COVID+%26+Meds&utm_campaign=March+News&utm_medium=email 

It is at the end of the article. 

 

In the present situation of pandemia, unnecessary and harmful treatments should be reviewed and eventually stopped. It is urgent to review and in appropriate cases to pause psychotropic drugs (particularly antipsychotics), anticholinergic medicines and opioid analgesics and monitor the effects." "

 

That is horrible advice for people in our community. It is particularly bad because his evidence is so thin. 

 

@ColonialI have no desire to argue with you on whether life is worth living or not or at what cost life should be saved. It is up to every person to decide that. That is why we have DNR orders and advance directives. I assume that most people would like to live rather than die from covid-19 but I can't speak for everyone. I want to clarify only the facts - the side effects and interaction issues are existent but fairly rare and most non-life threatening.  I'll take a 1/1000 chance of PTSD over certain death. Bu that's me. YMMV. 

 

You are right - the evidence for hydroxyquine is not solid. But we are grasping at straws. There are many current clinical trials going on. And no, there is no conspiracy behind that drug - it is no longer protected by a patent and as such is cheap and produced by many manufacturers. That's why Trump is asking India to release it.  Hydroxychloroquine is a  TNF-a inhibitor and as such lowers the body's immune system. We don't know that this is the only way in which it works in Covid-19 but it is one of the presumed ways.  People die of Covid-19 often because their immune system goes into overdrive (Cytokine storm) and so some of the approaches are to tone that inflammation down as it starts attacking various organs. Thalidomide which is also a TNF-a inhibitor is also being trialed. Yes that is the same drug that causes.  malformations in fetuses. 

 

1. So, don't stop your psychiatric drugs because someone says it will increase your risk of covid-19 (evidence is thin for pneumonia except perhaps gabapentioids and evidence is non-existent specifically for Covid-19). 

2. Don't worry about your psychiatric drugs increasing your risk of covid-19. (evidence is thin)

3. If you are offered potential treatment in the ICU with risk of interacting with your current drugs and causing (fairly rare?) side effects, weigh the costs and benefits. Benefit of the proposed drug (benefits are still very much up in the air for most of these drugs) vs the risk of death or side effects. Ask your doctor, make up your own mind. I personally am taking hydroxyquine if offered if I am in the ICU for covid-19. 

4. Don't start taking prophylactically drugs such as hydroxychloroquine or  prevent Covid-19 (evidence is thin). 

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Onmyway
4 hours ago, drugged said:

My limited understanding is that at least some of the anti-malarials are quinolones.  Since it seems likely I've been harmed by taking fluoroquinolones in the past, use of quinolones would be contraindicated should I become sick enough to require hospitalization?  Correct?  The usefulness of anti-malarials against this virus seems questionable anyway so I don't see it ever being an issue for me where I live but I have instructed my PCP that I should not be given any fluoroquinolones in the case of a bacterial infection. 

 

The thing that does concern me is being in the middle of tapering a drug where I'm dividing the smallest tablet available into ever tinier pieces.  Is a hospital going to mess with that or will they either cold turkey me or bump the dose back up to the smallest available tablet?  Thinking about this question helped me decide to continue tapering the trazodone followed by the pregabalin rather than start on counting beads to taper the venlafaxine further.   

Hi @drugged, quinolones and quinine-derivative drugs are not related as far as I could ascertain. They just sound the same. So I would not worry about it. 

 

If you are worried about quinolones, you should put it as an allergy in your medical record. You might even want to get a bracelet with that if your reaction was that severe.

 

I don't know how good medical record sharing is in the US but most likely if you were admitted unconscious they would not know what drugs you were on so they would CT you. But if you had covid-19 and needed hospitalization you most likely wouldn't be unconscious by the time you ended up in a hospital. I'd carry a pill box with you. If you use a liquid solution you could use the little hotel honey jars to take multiple "portions". 

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Colonial
44 minutes ago, Onmyway said:

 

In the present situation of pandemia, unnecessary and harmful treatments should be reviewed and eventually stopped.

 

Yes, I agree, EVENTUALLY Stopped. Nobody panicking.

That poor couple who just died by Murder- suicide because He "thought" He had the Covid-19 and gave it to his wife....

To find out His test result was NEGATIVE.   God have Mercy.

 

I do also appreciate the part of the discussion that Elders in long term care facility are unfortunately "drugged"  at a higher percentage than those at home, in order to be more "compliant".  Thus putting them at a higher risk rate for complications and the very Deaths we are all trying to avoid.  It's a sad fact that we as a society would rather drug Our Elders if it's cheaper than hire the extra staff to take Proper care of them.

 

 " I'll take a 1/1000 chance of PTSD over certain death. Bu that's me. YMMV. "

 

I might too, if that was MY actual percentage rate.  But that is based mostly  on healthy young males with no preexisting conditions or current drug load.

What the % is for the rest of us already sensitized to drug kindling?  I'm afraid it would be far higher. 

Which is why I'm glad this forum exists, to help people get off meds responsibly and not in a panic, so as to not do more harm that they thought they were trying to avoid.

 

I enjoyed Our discussion, thanks for sharing with Me!  Have a great day! 🙂

 

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Onmyway
14 minutes ago, Colonial said:

 

Yes, I agree, EVENTUALLY Stopped. Nobody panicking.

That poor couple who just died by Murder- suicide because He "thought" He had the Covid-19 and gave it to his wife....

To find out His test result was NEGATIVE.   God have Mercy.

 

I do also appreciate the part of the discussion that Elders in long term care facility are unfortunately "drugged"  at a higher percentage than those at home, in order to be more "compliant".  It's a sad fact that we as a society would rather drug Our Elders if it's cheaper than hire the extra staff to take Proper care of them.

 

 " I'll take a 1/1000 chance of PTSD over certain death. Bu that's me. YMMV. "

 

I might too, if that was MY actual percentage rate.  But that is based mostly  on healthy young males with no preexisting conditions or current drug load.

What the % is for the rest of us already sensitized to drug kindling?  I'm afraid it would be far higher. 

Which is why I'm glad this forum exists, to help people get off meds responsibly and not in a panic, so as to not do more harm that they thought they were trying to avoid.

 

I enjoyed Our discussion, thanks for sharing with Me!  Have a great day! 🙂

 

I think you forgot to include the part of the quote where he says to pause these drugs during the epidemic which is what I was objecting to. Pause implies CT. That's dangerous.

 

It is urgent to review and in appropriate cases to pause psychotropic drugs (particularly antipsychotics), anticholinergic medicines and opioid analgesics and monitor the effects." "

 

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Colonial
8 minutes ago, Onmyway said:

I think you forgot to include the part of the quote where he says to pause these drugs during the epidemic which is what I was objecting to. Pause implies CT. That's dangerous.

 

It is urgent to review and in appropriate cases to pause psychotropic drugs (particularly antipsychotics), anticholinergic medicines and opioid analgesics and monitor the effects." "

 

He said, to review and IN APPROPRIATE CASES, to pause. 

Again, He and  I was referring to the entire list of drugs, opiods, PPI Inhibitors, anticholinerics, etc. Not just psych meds.

But by your OWN LOGIC of rather taking the risk of 1/1000 of getting PTSD by taking the Hydro, the VERY SAME logic could be for CT'ing any med, even psych, for a short period until the infection passed.  You just denied Your own reasoning there.

 

Again, I really don't think we're saying opposing things, I think we're just having 2 slightly different discussions.

Have a great day! 

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Onmyway

@Colonial, I don't think this discussion is productive as you keep ignoring what you see. He says to "pause psychotropic drugs (particularly antipsychotics)." He says where appropriate but what does that mean? Do people for whom CT-ing psychotropic drugs is appropriate somehow not get WD? How does he know ahead of time.

 

For our community here CTing will 100% lead to severe withdrawal symptoms. It's not the same as a 1/1000 or 1/10 chance of PTSD. It is certainty. I find his recommendations irresponsible. Nobody should be making any drastic medication changes now when health care is not easily available. Not when his evidence of risk is so thin. Not even for ARB and ACE inhibitor anti-hypertension drugs which potentially pose a much more significant covid-19 risk. 

 

I don't know what you are arguing but my arguments are: 

 

1. We should not be worrying/fear mongering about the risks that psych drugs might pose regarding catching covid-19 or developing serious disease from it until we have better evidence that they indeed increase risks. We especially should not be pausing or CT-ing such drugs because of worries that they may increase our risks. The evidence is extremely thin to non-existent that psych drugs increase risk and severity of covid-19.

2. We should not be worrying about potential drug drug interactions IF we are in critical situation in an ICU as the cost benefit is very diffrent there but again that cost-benefit may depend on how valuable your life is to you in comparison to how much you want to avoid rare side effects. If your heart is failing you may be less likely to worry about prolonged QT syndrome or potential PTSD but that may be just me. Some people will, for sure, choose differently. My goal is to clarify this choice rather than choose for people. 

3. We should not be frivolously taking unproven drugs as prophylaxis to prevent covid-19. The cost benefit analysis here may skew in the opposite direction. But that may also depend on your situation. (If you were a 68 yr old nurse exposed to covid-19 daily with multiple underlying diseases, you may choose to take an unproven drug as prophylaxis to prevent. But the vast majority of us are not in that situation.)

 

My goal is to allay anxieties which many people have and which can spiral in situations of social isolation, threat of severe disease and real uncertainty.

 

I am trying to work off of evidence as much as it exists. These recommendations may change in the future but right now this is the best that we know. They are not from some random website, they are not from Fox news, they are not from a snake-oil salesman. I gain nothing from making these recommendations and exposing the thin evidence of the rxrisk article. They are based on analysis and critical reading of the scientific evidence as much as is available right now (not that much unfortunately). This changes constantly. Trials are being run, new data becomes available. 

 

I don't think repeating this is helpful beyond this post. If people have questions, they are welcome to ask and I will answer to the best of my knowledge. Good luck to you @Colonial

 

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drugged
17 hours ago, Onmyway said:

Hi @drugged, quinolones and quinine-derivative drugs are not related as far as I could ascertain. They just sound the same. So I would not worry about it. 

 

Chloroquine and hydroxychloroquine belong to the quinolone family of drugs according to the medical literature.  I was floxed from repeated courses of cipro for recurrent UTIs so quinolones are in my medical history as a no-go antibiotic.  I can't take cephalosporins or sulfonamide antibiotics either.  Where I live the doctors don't seem interested in your previous medical records.

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Onmyway
3 hours ago, drugged said:

Chloroquine and hydroxychloroquine belong to the quinolone family of drugs according to the medical literature.  I was floxed from repeated courses of cipro for recurrent UTIs so quinolones are in my medical history as a no-go antibiotic.  I can't take cephalosporins or sulfonamide antibiotics either.  Where I live the doctors don't seem interested in your previous medical records.

You're right, it seems to be derived from quinolines. I suspect it is hard to get an allergy bracelet at this time. 

In the US the CDC is saying that hydroxychloroquine is being used in hospitalized covid-19 patients even though the evidence is only anecdotal and not based on RCTs though they are warning about patients with prolonged QT syndrome and interactions with drugs that cause QT issues. https://www.cdc.gov/coronavirus/2019-ncov/hcp/therapeutic-options.html

 

Let's hope that none of us ends up in the hospital with covid-19. I'm strictly self isolating thought I suppose that has to end at some point. 

 

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UnfoldingSky

I just learned today that a friend of my dad's (whom he hasn't been near in a long while) had the virus, tested positive, they are elderly and survived, no hospitalization needed.

 

A relative (whom I haven't seen in years) was also told he had it, however no test was given, he is in his fifties, he recovered as well from whatever it was he had. No hospitalization needed.

 

 

 

 

 

 

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drugged

I've not left the house other than to go for a walk in probably three months but my spouse works at a retail grocery/pharmacy store where he comes into contact with at least a couple hundred people everyday he works.  Since he's high risk due to his age he's been wearing disposable gloves since the beginning and just started wearing washable masks I managed to find online.  When he's home it's just us and our elderly cat.  I worry about his exposure a lot.  He's very healthy overall but he's also going to be 81 in a month.  

 

This has nothing directly to do with my tapering except the added anxiety and stress seem to magnify WD symptoms.  

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drugged
On 4/6/2020 at 11:41 AM, Onmyway said:

I don't know how good medical record sharing is in the US but most likely if you were admitted unconscious they would not know what drugs you were on so they would CT you

My experience is the medical record sharing here is virtually non-existent.  My current PCP (and the clinic I tried before her) actually specified that they did not want my previous records sent to them.  I've had several occasions when I had to change doctors for one reason or another and had the new doctor actively disparage everything the previous doctor said or did.  

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Colonial
3 hours ago, drugged said:

My experience is the medical record sharing here is virtually non-existent.  My current PCP (and the clinic I tried before her) actually specified that they did not want my previous records sent to them.  I've had several occasions when I had to change doctors for one reason or another and had the new doctor actively disparage everything the previous doctor said or did.  

 

That's horrible, not wanting records.  It never ceases to amaze me even though we're supposedly "one Nation", we 50 states really are all in Our own little worlds when it comes to how we do things.  I wonder how much of it has to do with Federal and State funding since parts of Iowa are so rural, if You have an "outbreak" of something it's not deemed an immediate "threat" to the rest of the nation.  I realize one Doctor or medical group has their own regulations on what they have to do or not do and they won't be "bound" per se by what a past doctor did if laws or protocols are changed but I would think they would like to at least know what drugs You were on, regardless of whether they agreed with the diagnosis.  Out here? When I show up in the emergency room the network is connected right into my recent pharmacy records.  They tell Me what I'm on and I confirm or not if I'm actually taking the meds that I actually picked up from the pharmacy. Of course, your dealing with "clinics" which might not be properly networked, but one would hope major hospitals in Your State would be.  I assume too, it would depend on what your insurance is, how well their collaborating.  Clinics are one thing, because your obviously conscious and can speak for Yourself.  Hospitals have a little more legally responsibility to "know", to the best of their network ability, to access Your records ASAP. When You come to the E.R. here now,  each time they scan your finger, so going forward your fingerprints are already in their system, so overtime their building up that data base so if you ever show up unconscious as a John or Jane Doe, hit by a car or something, your fingerprint is already on file and their right into your records: drug allergies and current regimen being their biggest concerns.  Of course, my luck, I'll come in missing the one finger they scanned. lol. 😊

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Superwoman
On 3/16/2020 at 7:05 PM, Dragon said:

Just further to that,  I think I may have had the C.virus myself already. I am on the 23rd day of a flu-like illness which had a high temperature, sore throat and cough. It felt like nothing else I have ever suffered from before, and I've had flu lots of times in my life. The time it started fits in with the Coronavirus epidemic, which brings us back to the question asked by @sunnysideup69, are we more vulnerable to catching this virus because we are in WD from ADs. Well we feel pretty ill and have some very bad symptoms but whether that translates to a weakened immune system, who knows.

 

My personal opinion is that it probably does make us more liable to catch things, but having said that, a positive frame of mind can probably help protect us from this as it can from many other things.

 

I'm isolating anyway, in case it wasn't that and I might therefore catch it and in case it was and I can still pass it on to someone else. lol

Dragon, How are you feeling now?  Are you still sick.  How high was your temperature?  How long did the high temperature last for?  My husband and I have had a slightly high temperature for 3 weeks.  We are quarantined because there is no way to know if we have it or not without getting a test.  Tests are in short supply here in the USA.  So most people are not able to get tested.  It is really weird because we don't really have any other symptoms aside from what I presume are withdrawal symptoms.  Neither of us really feel feverous and would not know anything is up if we had not taken our temperatures.  Our temperatures are ranging from 99.1 to 100.7 F.  We don't seem to be getting any worse, but the temperature is lingering.  I have been using a lot of natural medicine, so maybe that is holding it at bay.  I have never had anything like this before.    

 

I too have been wondering if WD from AD affects the immune system and could make us more vulnerable to catching this virus and recovering if we get it.  It makes me feel better that people say that they actually get sick less since tapering.  It might be hard for us to gauge if we are actually sick with a virus or if our symptoms are WD.  Headaches, fatigue, aches and temperature dysregulation and I think runny nose are all WD symptoms.  These things can also be signs of viral infections.  I don't think cough is a WD symptom.

 

It is a good idea to get a 3 month supply of medications if you can.  The WHO recommends having some extra medications on hand at all times, but especially now.  People might want to save their old medications that they no longer take after switching or discontinuing meds.  That way we can help each other out if someone can not get their medication because there is a shortage.            

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Dragon

What struck me about your post @Superwomanwas that you said you have never had anything like this before. That was exactly how we felt. We had someone visit to do an assessment for some building work. He stayed about an hour and was coughing and blowing. This was early February, before people were neurotic about such things. Four days later my husband became ill with a fever of 101.f and a cough, fatigue, achy limbs etc. He has never had flu at all before and was therefore quite alarmed ! I got ill about five days after that, with a fever of 102.f a very sore throat, no cough, but extreme fatigue and aches and pains. We both had to have some days in bed. The worst part lasted about 7-10 days (the fever about a week) but the illness has lingered on and I still don't feel well from it. My husband has recovered better. Tests for Coronavirus are limited in the UK aswell. Then the advice was just to stay home and wait and they only tested people who had to go to hospital. I'm not sure who is being tested now but I think it is NHS front line workers. They are trying to expand testing obviously. I would really like to get an antibody test (to see if we've had it) but I've read there are technical difficulties with those.

 

My husband and I are in the highish risk category for pneumonia from this virus, being in our late 60s. We are all in lockdown in the UK and neighbours, very kindly, shop for us.

 

I am now suffering from a very bad wave of WD symptoms just like I had in the beginning 10 months ago. I don't know if this is because I've been ill, would have happened anyway, or because of general anxiety over the C.virus situation and it's implications.

 

Do you have cases in your area of the US ?

 

I hope you feel better soon.xx

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UnfoldingSky

Not to interrupt the flow of conversation here but I thought people here may want to read this.

 

It's an article about the risks of taking hydroxychloroquine written by someone who purports to have taken it for rheumatoid arthritis:

 

https://www.theglobeandmail.com/opinion/article-what-do-you-have-to-lose-by-taking-hydroxychloroquine-for-covid-1/

 

The author of the article is saying among the adverse effects are paranoia, hallucinations and suicidal thoughts.

 

 

 

 

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Colonial

Thank you for sharing that story. 

Again, why treat the very people with a drug who are most susceptible to not have  good outcome?

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