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David Healy's BMJ editorial getting wide coverage


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David Healy's recent editorial, "Serotonin and Depression: the Marketing of a Myth," in the British Medical Journal, has been picked up and commented upon by lots and lots of media outlets, many of them quite respectable (i.e. mainstream) and most of them quite respectful of his critique of SSRI hegemony. One thing he says in the editorial that I wasn't aware of is that theories of depression which included the role of cortisol were swept aside by the SSRI sales blitz. Also, in the mainstream media coverage, the defensiveness of some of his critics from within psychiatry was quite satisfying.

Diagnosed w/ ADD and minor depression in 1990. Fluoxetine 20 mg/day. Also methylphenidate, but hated it and quit after about a week. Quit fluoxetine cold turkey (ignorance) 18 January 2013. Experienced brain zaps, flu symptoms, heart palpitations. Nothing after August 2013. Mirtazapine 15 mg/day for sleep beginning around 1999. Began tapering August 2013.  As of March 2015 I'm off mirtazapine and antidepressant free. Don't sleep well after sunrise, feel anxious and sad some of the time, still have tinnitus. Still occasionally take lorazepam for anxiety but never more than 1 mg.  Prescribed metoprolol (beta blocker) for atrial fibrillation diagnosed June 2013. Medical  opinion (two cardiologists) is that it's not caused by fluoxetine w/drawal and is a dangerous, chronic condition requiring lifelong medication. As of Aug 2013 heart palpitations for the most part ceased. Tapered beta blocker and am off of it as of Jan 2015. No wd symptoms or recurring afib at all so far. Maybe it was wd after all, but doctors don't think so, surprise surprise. However, a small victory: the last doctor I related this to shrugged her shoulders. Getting lots of exercise, which has me physically pretty robust at age 71 in spite of persistence of mirt wd symptoms, mainly insomnia and anxiety, but also jaw-clenching annoyance at noises of a certain pitch and timbre. Incessant media fixation on the presidential campaign has ruined my disposition and my faith in the future. My Introduction.

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Hey, nice summation. The SMC experts were like an SNL skit.

 

also: Have you read the responses posted on BMJ after the article? A cortisol guy weighed in.

2009: Cancer hospital said I had adjustment disorder because I thought they were doing it wrong. Their headshrinker prescribed Effexor, and my life set on a new course. I didn't know what was ahead, like a passenger on Disneyland's Matterhorn, smiling and waving as it climbs...clink, clink, clink.

2010: Post surgical accidental Effexor discontinuation by nurses, masked by intravenous Dilaudid. (The car is balanced at the top of the track.) I get home, pop a Vicodin, and ...

Whooosh...down, down, down, down, down...goes the trajectory of my life, up goes my mood and tendency to think everything is a good idea.
2012: After the bipolar jig was up, now a walking bag of unrelated symptoms, I went crazy on Daytrana (the Ritalin skin patch by Noven), because ADHD was a perfect fit for a bag of unrelated symptoms. I was prescribed Effexor for the nervousness of it, and things got neurological. An EEG showed enough activity to warrant an epilepsy diagnosis rather than non-epileptic ("psychogenic") seizures.

:o 2013-2014: Quit everything and got worse. I probably went through DAWS: dopamine agonist withdrawal syndrome. I drank to not feel, but I felt a lot: dread, fear, regret, grief: an utter sense of total loss of everything worth breathing about, for almost two years.

I was not suicidal but I wanted to be dead, at least dead to the experience of my own brain and body.

2015: I  began to recover after adding virgin coconut oil and organic grass-fed fed butter to a cup of instant coffee in the morning.

I did it hoping for mental acuity and better memory. After ten days of that, I was much better, mood-wise. Approximately neutral.

And, I experienced drowsiness. I could sleep. Not exactly happy, I did 30 days on Wellbutrin, because it had done me no harm in the past. 

I don't have the DAWS mood or state of mind. It never feel like doing anything if it means standing up.

In fact, I don't especially like moving. I'm a brain with a beanbag body.   :unsure:

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Have you read the responses posted on BMJ after the article? A cortisol guy weighed in.

I hadn't but have now. Would have included the link to these comments if I'd known they were accessible to the public. Thanks.

Diagnosed w/ ADD and minor depression in 1990. Fluoxetine 20 mg/day. Also methylphenidate, but hated it and quit after about a week. Quit fluoxetine cold turkey (ignorance) 18 January 2013. Experienced brain zaps, flu symptoms, heart palpitations. Nothing after August 2013. Mirtazapine 15 mg/day for sleep beginning around 1999. Began tapering August 2013.  As of March 2015 I'm off mirtazapine and antidepressant free. Don't sleep well after sunrise, feel anxious and sad some of the time, still have tinnitus. Still occasionally take lorazepam for anxiety but never more than 1 mg.  Prescribed metoprolol (beta blocker) for atrial fibrillation diagnosed June 2013. Medical  opinion (two cardiologists) is that it's not caused by fluoxetine w/drawal and is a dangerous, chronic condition requiring lifelong medication. As of Aug 2013 heart palpitations for the most part ceased. Tapered beta blocker and am off of it as of Jan 2015. No wd symptoms or recurring afib at all so far. Maybe it was wd after all, but doctors don't think so, surprise surprise. However, a small victory: the last doctor I related this to shrugged her shoulders. Getting lots of exercise, which has me physically pretty robust at age 71 in spite of persistence of mirt wd symptoms, mainly insomnia and anxiety, but also jaw-clenching annoyance at noises of a certain pitch and timbre. Incessant media fixation on the presidential campaign has ruined my disposition and my faith in the future. My Introduction.

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Thanks for adding that link. I don't see the "cortisol guy" comment there. Sorry, and thanks for your charitable failure to mention that in your reply.

 

Wherever it is, the guy was Dr. Bernard Carroll, noted responder to people still dumb enough to rant about psychiatry on 1boringoldman.com and the rest of extant written material on earth. If anyone left a pamphlet about eczema on the moon I'd check that, too. I'm pretty sure there was something from the 1990s, which I'll add to the thread next time I happen across it. (When? Picture a dog chasing its tail near a cliff. I might be back in a few minutes, or it might be several months, after a "lengthy recuperation.")

 

He listed links like this, which is one of his publications.

http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=5011224

"Over 40% [of 60 patients] of the depressed patients had UFC excretions in the range seen in Cushing's disease, while only 6% [of 35 patients] of the other patients excreted such high amounts of Cortisol."

 

Cortisol mentioned by Shirwan Mirza, who said in a long, worthy comment that it's the only known biomarker for a DSM diagnosis.

http://www.bmj.com/content/350/bmj.h1771/rr-12

 

In sum, I went on quite the meander trying to find the BMJ response I was thinking of when I replied originally; if I'd followed every intriguing path I'd still be doing this tomorrow. This blog post has several new branch points.

http://davidhealy.org/theres-something-about-mary/

The relevance to cortisol is Dr. Healy, in a comment, saying the abandonment of cortisol/depression work is covered in Shorter & Fink's book, "Endocrine Psychiatry, Solving the Riddle of Melancholia." It's expensive, so it's worth branching off to find reviews and summations, but not for me at the moment. I'm going to look for the documentary by "Irene" in another comment. ;)

This is the S&F book:

https://global.oup.com/academic/product/endocrine-psychiatry-9780199737468?cc=us〈=en&

2009: Cancer hospital said I had adjustment disorder because I thought they were doing it wrong. Their headshrinker prescribed Effexor, and my life set on a new course. I didn't know what was ahead, like a passenger on Disneyland's Matterhorn, smiling and waving as it climbs...clink, clink, clink.

2010: Post surgical accidental Effexor discontinuation by nurses, masked by intravenous Dilaudid. (The car is balanced at the top of the track.) I get home, pop a Vicodin, and ...

Whooosh...down, down, down, down, down...goes the trajectory of my life, up goes my mood and tendency to think everything is a good idea.
2012: After the bipolar jig was up, now a walking bag of unrelated symptoms, I went crazy on Daytrana (the Ritalin skin patch by Noven), because ADHD was a perfect fit for a bag of unrelated symptoms. I was prescribed Effexor for the nervousness of it, and things got neurological. An EEG showed enough activity to warrant an epilepsy diagnosis rather than non-epileptic ("psychogenic") seizures.

:o 2013-2014: Quit everything and got worse. I probably went through DAWS: dopamine agonist withdrawal syndrome. I drank to not feel, but I felt a lot: dread, fear, regret, grief: an utter sense of total loss of everything worth breathing about, for almost two years.

I was not suicidal but I wanted to be dead, at least dead to the experience of my own brain and body.

2015: I  began to recover after adding virgin coconut oil and organic grass-fed fed butter to a cup of instant coffee in the morning.

I did it hoping for mental acuity and better memory. After ten days of that, I was much better, mood-wise. Approximately neutral.

And, I experienced drowsiness. I could sleep. Not exactly happy, I did 30 days on Wellbutrin, because it had done me no harm in the past. 

I don't have the DAWS mood or state of mind. It never feel like doing anything if it means standing up.

In fact, I don't especially like moving. I'm a brain with a beanbag body.   :unsure:

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Thanks very much for meandering, westcoast. My interest in cortisol is that it was suggested as a reason why, having taken my last AD a couple of months ago, I'm having trouble sleeping past dawn. Also very much hoping the SSRI paradigm is shifting. 

Diagnosed w/ ADD and minor depression in 1990. Fluoxetine 20 mg/day. Also methylphenidate, but hated it and quit after about a week. Quit fluoxetine cold turkey (ignorance) 18 January 2013. Experienced brain zaps, flu symptoms, heart palpitations. Nothing after August 2013. Mirtazapine 15 mg/day for sleep beginning around 1999. Began tapering August 2013.  As of March 2015 I'm off mirtazapine and antidepressant free. Don't sleep well after sunrise, feel anxious and sad some of the time, still have tinnitus. Still occasionally take lorazepam for anxiety but never more than 1 mg.  Prescribed metoprolol (beta blocker) for atrial fibrillation diagnosed June 2013. Medical  opinion (two cardiologists) is that it's not caused by fluoxetine w/drawal and is a dangerous, chronic condition requiring lifelong medication. As of Aug 2013 heart palpitations for the most part ceased. Tapered beta blocker and am off of it as of Jan 2015. No wd symptoms or recurring afib at all so far. Maybe it was wd after all, but doctors don't think so, surprise surprise. However, a small victory: the last doctor I related this to shrugged her shoulders. Getting lots of exercise, which has me physically pretty robust at age 71 in spite of persistence of mirt wd symptoms, mainly insomnia and anxiety, but also jaw-clenching annoyance at noises of a certain pitch and timbre. Incessant media fixation on the presidential campaign has ruined my disposition and my faith in the future. My Introduction.

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I and many others had that too. I'd wake up at 4 or 5 am having finally fallen asleep around 2 or 3am. Plus being in an inexplicable state or dread/terror/regret doom. No way to fall asleep. It went away after 2 years. I hope you don't have that! I'd never felt anything like it, not even during many months when my surviving a serious disease was unlikely. That was sadness and fear, or grief and terror. The WD thing is inhuman. People here think it has something to do with cortisol. I like "brain damage" because it covers everything.

 

Post back if you find anything in your own for ways, please. BTW I turned a corner 5-6 months ago. One day I noticed I hadn't felt the dread for a few days. Haven't felt it since. If there's an explain other than time it was MCGs, a kind of oil, I'd started that about ten days before the day I noticed the dread was gone. Magnesium and the other stuff people tout on this site made no difference for me.

 

http://survivingantidepressants.org/index.php?/topic/33-waking-with-panic-or-anxiety-managing-cortisol-spikes/

2009: Cancer hospital said I had adjustment disorder because I thought they were doing it wrong. Their headshrinker prescribed Effexor, and my life set on a new course. I didn't know what was ahead, like a passenger on Disneyland's Matterhorn, smiling and waving as it climbs...clink, clink, clink.

2010: Post surgical accidental Effexor discontinuation by nurses, masked by intravenous Dilaudid. (The car is balanced at the top of the track.) I get home, pop a Vicodin, and ...

Whooosh...down, down, down, down, down...goes the trajectory of my life, up goes my mood and tendency to think everything is a good idea.
2012: After the bipolar jig was up, now a walking bag of unrelated symptoms, I went crazy on Daytrana (the Ritalin skin patch by Noven), because ADHD was a perfect fit for a bag of unrelated symptoms. I was prescribed Effexor for the nervousness of it, and things got neurological. An EEG showed enough activity to warrant an epilepsy diagnosis rather than non-epileptic ("psychogenic") seizures.

:o 2013-2014: Quit everything and got worse. I probably went through DAWS: dopamine agonist withdrawal syndrome. I drank to not feel, but I felt a lot: dread, fear, regret, grief: an utter sense of total loss of everything worth breathing about, for almost two years.

I was not suicidal but I wanted to be dead, at least dead to the experience of my own brain and body.

2015: I  began to recover after adding virgin coconut oil and organic grass-fed fed butter to a cup of instant coffee in the morning.

I did it hoping for mental acuity and better memory. After ten days of that, I was much better, mood-wise. Approximately neutral.

And, I experienced drowsiness. I could sleep. Not exactly happy, I did 30 days on Wellbutrin, because it had done me no harm in the past. 

I don't have the DAWS mood or state of mind. It never feel like doing anything if it means standing up.

In fact, I don't especially like moving. I'm a brain with a beanbag body.   :unsure:

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The WD thing is inhuman. People here think it has something to do with cortisol. I like "brain damage" because it covers everything...BTW I turned a corner 5-6 months ago. One day I noticed I hadn't felt the dread for a few days. Haven't felt it since. If there's an explain other than time it was MCGs, a kind of oil, I'd started that about ten days before the day I noticed the dread was gone. Magnesium and the other stuff people tout on this site made no difference for me.

 

 

Glad you've kicked the dreads. My best thoughts to the westcoaster from the midwest. (I'm originally from both the Bay area and Wisconsin so I was glad to hear from you.)

 

I like "brain damage" too, but it has the ring of permanence so "withdrawal" is a more correct term, I think. -_- I'm knocking on wood as I tell you that I don't seem to have a bad case of dread, just run-of-the mill anxiety--at least not this week--but that may be because I have a 1 mg lorazepam-before-bed habit, which is my next and final taper, i.e. craziness is probably just around the corner.

 

Peace

Diagnosed w/ ADD and minor depression in 1990. Fluoxetine 20 mg/day. Also methylphenidate, but hated it and quit after about a week. Quit fluoxetine cold turkey (ignorance) 18 January 2013. Experienced brain zaps, flu symptoms, heart palpitations. Nothing after August 2013. Mirtazapine 15 mg/day for sleep beginning around 1999. Began tapering August 2013.  As of March 2015 I'm off mirtazapine and antidepressant free. Don't sleep well after sunrise, feel anxious and sad some of the time, still have tinnitus. Still occasionally take lorazepam for anxiety but never more than 1 mg.  Prescribed metoprolol (beta blocker) for atrial fibrillation diagnosed June 2013. Medical  opinion (two cardiologists) is that it's not caused by fluoxetine w/drawal and is a dangerous, chronic condition requiring lifelong medication. As of Aug 2013 heart palpitations for the most part ceased. Tapered beta blocker and am off of it as of Jan 2015. No wd symptoms or recurring afib at all so far. Maybe it was wd after all, but doctors don't think so, surprise surprise. However, a small victory: the last doctor I related this to shrugged her shoulders. Getting lots of exercise, which has me physically pretty robust at age 71 in spite of persistence of mirt wd symptoms, mainly insomnia and anxiety, but also jaw-clenching annoyance at noises of a certain pitch and timbre. Incessant media fixation on the presidential campaign has ruined my disposition and my faith in the future. My Introduction.

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benzos did work the odd time I got my mitts on any.

 

brain damage does sound permanent. how about maladaptive alterations to cerebral morphology of unknown duration?

2009: Cancer hospital said I had adjustment disorder because I thought they were doing it wrong. Their headshrinker prescribed Effexor, and my life set on a new course. I didn't know what was ahead, like a passenger on Disneyland's Matterhorn, smiling and waving as it climbs...clink, clink, clink.

2010: Post surgical accidental Effexor discontinuation by nurses, masked by intravenous Dilaudid. (The car is balanced at the top of the track.) I get home, pop a Vicodin, and ...

Whooosh...down, down, down, down, down...goes the trajectory of my life, up goes my mood and tendency to think everything is a good idea.
2012: After the bipolar jig was up, now a walking bag of unrelated symptoms, I went crazy on Daytrana (the Ritalin skin patch by Noven), because ADHD was a perfect fit for a bag of unrelated symptoms. I was prescribed Effexor for the nervousness of it, and things got neurological. An EEG showed enough activity to warrant an epilepsy diagnosis rather than non-epileptic ("psychogenic") seizures.

:o 2013-2014: Quit everything and got worse. I probably went through DAWS: dopamine agonist withdrawal syndrome. I drank to not feel, but I felt a lot: dread, fear, regret, grief: an utter sense of total loss of everything worth breathing about, for almost two years.

I was not suicidal but I wanted to be dead, at least dead to the experience of my own brain and body.

2015: I  began to recover after adding virgin coconut oil and organic grass-fed fed butter to a cup of instant coffee in the morning.

I did it hoping for mental acuity and better memory. After ten days of that, I was much better, mood-wise. Approximately neutral.

And, I experienced drowsiness. I could sleep. Not exactly happy, I did 30 days on Wellbutrin, because it had done me no harm in the past. 

I don't have the DAWS mood or state of mind. It never feel like doing anything if it means standing up.

In fact, I don't especially like moving. I'm a brain with a beanbag body.   :unsure:

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lol.  You left out the important buzzword though: maladaptive iatrogenic alterations...

Diagnosed w/ ADD and minor depression in 1990. Fluoxetine 20 mg/day. Also methylphenidate, but hated it and quit after about a week. Quit fluoxetine cold turkey (ignorance) 18 January 2013. Experienced brain zaps, flu symptoms, heart palpitations. Nothing after August 2013. Mirtazapine 15 mg/day for sleep beginning around 1999. Began tapering August 2013.  As of March 2015 I'm off mirtazapine and antidepressant free. Don't sleep well after sunrise, feel anxious and sad some of the time, still have tinnitus. Still occasionally take lorazepam for anxiety but never more than 1 mg.  Prescribed metoprolol (beta blocker) for atrial fibrillation diagnosed June 2013. Medical  opinion (two cardiologists) is that it's not caused by fluoxetine w/drawal and is a dangerous, chronic condition requiring lifelong medication. As of Aug 2013 heart palpitations for the most part ceased. Tapered beta blocker and am off of it as of Jan 2015. No wd symptoms or recurring afib at all so far. Maybe it was wd after all, but doctors don't think so, surprise surprise. However, a small victory: the last doctor I related this to shrugged her shoulders. Getting lots of exercise, which has me physically pretty robust at age 71 in spite of persistence of mirt wd symptoms, mainly insomnia and anxiety, but also jaw-clenching annoyance at noises of a certain pitch and timbre. Incessant media fixation on the presidential campaign has ruined my disposition and my faith in the future. My Introduction.

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Sorry. Brain damage.

2009: Cancer hospital said I had adjustment disorder because I thought they were doing it wrong. Their headshrinker prescribed Effexor, and my life set on a new course. I didn't know what was ahead, like a passenger on Disneyland's Matterhorn, smiling and waving as it climbs...clink, clink, clink.

2010: Post surgical accidental Effexor discontinuation by nurses, masked by intravenous Dilaudid. (The car is balanced at the top of the track.) I get home, pop a Vicodin, and ...

Whooosh...down, down, down, down, down...goes the trajectory of my life, up goes my mood and tendency to think everything is a good idea.
2012: After the bipolar jig was up, now a walking bag of unrelated symptoms, I went crazy on Daytrana (the Ritalin skin patch by Noven), because ADHD was a perfect fit for a bag of unrelated symptoms. I was prescribed Effexor for the nervousness of it, and things got neurological. An EEG showed enough activity to warrant an epilepsy diagnosis rather than non-epileptic ("psychogenic") seizures.

:o 2013-2014: Quit everything and got worse. I probably went through DAWS: dopamine agonist withdrawal syndrome. I drank to not feel, but I felt a lot: dread, fear, regret, grief: an utter sense of total loss of everything worth breathing about, for almost two years.

I was not suicidal but I wanted to be dead, at least dead to the experience of my own brain and body.

2015: I  began to recover after adding virgin coconut oil and organic grass-fed fed butter to a cup of instant coffee in the morning.

I did it hoping for mental acuity and better memory. After ten days of that, I was much better, mood-wise. Approximately neutral.

And, I experienced drowsiness. I could sleep. Not exactly happy, I did 30 days on Wellbutrin, because it had done me no harm in the past. 

I don't have the DAWS mood or state of mind. It never feel like doing anything if it means standing up.

In fact, I don't especially like moving. I'm a brain with a beanbag body.   :unsure:

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West coast can you provide any links for link oil you used please. I cannot find anything.

 

Thank you

2000 - sertraline for job anxiety low confidence (17 years old) ..which turned the next 16 years into nightmare!

 

On/off sertraline severe withdrawals every time. 2014 - felt better as reduced dose of sertraline no more inner restlessness. Doctor rushed off again. Hit severe withdrawal. Lost the little I had in life. Couldn't get stable again on 12.5mg. Was switched to prozac. Had severe reaction to prozac..came off in November 2015 at 6mg as felt more confused and damaged on it..Even more withdrawal ..rage, depression, dyphoria, near constant suicidal ideation, self harm impulses, doom, concrete block in head, unable to do much of anything with this feeling in head..went back on 6mg of sertraline to see if would alleviate anything. It didn't..reduced from December to June 2016 came off at 2.5mg sertraline as was hospitalised for the severe rage, suicidal impulses, and put on 50mg lofepramine which in 2nd week reduced all symptoms but gave insomnia which still have..psych stopped lofepramine cold turkey..no increased withdrawal symptoms new symptoms from lofepramine except persistant insomnia which has as side effect.

 

Taking Ativan for 8 months for the severe rage self harm impulses 1-3 times a week (mostly 2 times a week) at .5mg. Two months (I'm unsure exactly when the interdose started to happen) ago interdose withdrawal seemed to happen..2 days I think after the Ativan.

 

 

Nightmare that could have been avoided!

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Sorry. Brain damage.

HA! :-)

Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease". Long story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything. Amitryptiline, Prozac, bupropion, buspirone, flurazepam, diazepam, alprazolam, Paxil, citalopram, lamotrigine, gabapentin...probably more I've forgotten. 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

2/12/20             12                       0.045               0.007                   1 

May 2021            7                       0.01                  0.0037                1

Feb 2022            6                      0!!!                     0.00167               0.98                2.5 mg Ambien

Oct 2022       4.5 mg Lamictal    (off Celexa, off Xanax)   0.95 Valium    Ambien, 1/4 to 1/2 of a 5 mg tablet 

 

I'm not a doctor. Any advice I give is just my civilian opinion.

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