Compulsive Behavior Side Effects?

More often than not we hear or read about me discussing taking personal responsibility and being personally held accountable for our words and actions. This post won’t be any different. I found it humorous that I was sent the link to the below information and shortly after reading it I heard a damn commercial for the same thing. Odd what we hear on the radio @ 02:30 am while driving my happy ass to work. Anyone, I would assume, who watches television or listens to the radio has seen or heard at least one Ambilify commercial. True or not? Having a son who suffers from mild bipolar disorder we have been bombarded with samples and prescription answers which will somehow magically transform behavior. I tell you from my personal experience, we don’t use my son for a testing ground so big pharmaceuticals can make their billions at the cost of my son’s mental well-being. So, when I saw this bullshit about the lawsuit towards the makers of Ambilify I merely smiled to myself because we all know there is not one single perfect medication with no side effects. While my son has never taken Ambilify, we did research it extensively, just as we have done with many others.

But why are we here right now? But why did I choose to write about it right now? It’s simple, this is another example of people who cannot be responsible for their own actions. It’s about people who blame someone else for their own behavior because they acted without self control. It’s because people want the quick fix. It’s about people who choose to not read the small print or they choose to ignore the small print. Yes, I find this lawsuit as being fucking stupid because people made bad choices but don’t want to take responsibility for their own decisions. But then we know in our society nobody is forced to be held accountable, it’s always somebody else at fault. Bullshit! If we fuck up we just sue someone because we can profit from our lack of responsibility. Or have we forgot that coffee from a fast food joint is extremely hot and will burn the fuck out out your crotch if you spill it? People are dumbasses. Let this be yet just one more example.

The following information was originally found here and provided by a leading contributor to The Scorpion Army. I don’t have any express or otherwise permissions to copy this story from the above linked website or to use it on my blog as part of a post which includes my personal opinion. Hopefully they understand I do not support the lawsuit efforts but do not hold the above website responsible for posting this story. In the end, if they wish that I remove it in part or completely it will happen swiftly and immediately. The two pictures were borrowed from the internet using Google. Remember, I neither gain or loose anything by sharing the following information, it’s just being shared because I found it truly interesting.

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Abilify has been linked to compulsive behavior side effects, such as pathological gambling, binge eating and hypersexuality. These behaviors are thought to be triggered by the neurotransmitters dopamine and serotonin.

One of the most popular treatments for a variety of mental disorders like depression, schizophrenia and bipolar disorder,  makes billions for Bristol-Myers Squibb and the Otsuka Pharmaceutical Company. It was the top-selling drug in the U.S. in 2013 with sales of over $6.4 billion. The drug works by either increasing or decreasing dopamine or serotonin in the brain when there is an imbalance, and this makes it useful for a variety of approved and unapproved uses.

However, the drug is also linked to disturbing compulsive behavior side effects that can wreak havoc on the lives of patients and their families.

Among these side effects, compulsive or pathological gambling can be financially crippling, and it can destroy lives. People in the grip of compulsive behaviors will do anything they can to continue the chosen activity, even if it means ignoring the rest of their lives and withdrawing from friends and family.

This side effect in particular may lead to lawsuits against Bristol-Myers and Otsuka America, claiming the companies did not properly warn patients and doctors of this serious side effect.

In addition, reports of other side effects include compulsive eating, shopping and even sex addiction.

How Abilify Causes Compulsive Behavior

While doctors aren’t exactly sure how Abilify (aripiprazole) works, they believe it acts on receptors in the brain for chemicals that regulate mood and behavior. These chemicals are neurotransmitters called dopamine and serotonin.

handful of medications

When the dopamine system is stimulated in response to a particular activity, people will feel a high from it or a feeling of pleasure. This reward system normally ensures that we continue to eat and do other things we need to do to survive. In people with mental disorders, these systems are stimulated excessively, or not enough.

Researchers think Abilify may over-stimulate dopamine reward receptors in the brain – called dopamine 3 (D3) receptors – and trigger compulsive behavior.

Compulsive Gambling

Several case studies focused on a connection between aripiprazole and compulsive behavior, also called pathological behavior, especially in the case of gambling. One French study published in 2013 by Gaboriau, et al., examined several people who checked into a clinic because of their compulsive gambling behaviors. Study authors looked at eight individuals who took Abilify as part of ongoing medical treatment. Researchers found the drug caused seven of the eight patients to lose control of their gambling habits.

After discontinuing the drug or greatly reducing the dose, patients regained control of their compulsive behaviors, researchers wrote.

Another 2011 case study by Cohen, et al. found similar results in patients treated for schizophrenia. No patients in this study had a history of pathological gambling. Soon after taking the drug, they began gambling uncontrollably.

Similarly, a 2011 British study conducted by the National Problem Gambling Clinic found a relationship between Abilify and the drive to gamble in some patients. Doctors described one case in which a patient took the antipsychotic and “was preoccupied with thoughts of gambling and his gambling activity became both impulsive and involved extensive planning in obtaining funds to gamble, including the use of crime.”

Another patient said gambling became “a reason to live” after he took the drug.

In all cases, gambling problems resolved after discontinuing Abilify and switching to another drug.

Gabapentin (Neurontin) Addiction

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When I was originally diagnosed with diabetic peripheral neuropathy I was prescribed Gabapentin which was still a newish drug to treat the nerve pain in my feet. Within weeks myself and my family really started noticing changes in me we didn’t like. Changes like heavy mood swings, feeling like the walking dead, nauseous always, and much more. I discussed this with my doctor and I was told my body has to get used to the very potent medication and I needed to give it time. After about 6 months I did get used to it I guess you could say, it became a crutch to say the very least. At about that same six month period is when I began using VA medical facilities and I had yet another discussion with another doctor who couldn’t prescribe Gabapentin because the VA didn’t offer it so I was switched to Lyrica. After trying it out for a few months I made the choice to stop taking either of the medications because to me the extreme pain was better than the way on felt taking them. Those of you out there with diabetic
peripheral neuropathy and the associated pain know what it’s like and how its a game changer in one’s overall lifestyle. It’s been 15 months almost to the day since I stopped taking them and I can still say the pain is still better than the side effects. In my own experience, neither worked well for me and the pain I felt while taking the either drug was reduced very little. After some digging I found an article my mother forwarded to me a couple of years back because I was talking with another family member who was recently prescribed Gabapentin and was telling me how it really wasn’t working out for her either. It all got me thinking this morning that I wanted to share with y’all what was once shared with me. I copied and pasted the article but you can find a link to it at the very bottom. Please feel free to share more information or your personal stories in the comments.

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When Neurontin was the new drug on the block, physicians believed that they had found a real breakthrough drug to help patients with all kinds of nerve pain.  The drug had fewer side effects and drug interactions than current ones on the market and was classified as non-addictive, which meant you did not have to keep extensive records on it every time you prescribed it.[i] Soon Neurontin was generating over $4 billion a year in sales.[ii]

Then the trouble began.  A whistle-blower from the drug’s manufacturer claimed the company was spinning data on the drug’s effectiveness and using illegal means to promote its off-label uses among physicians.  When the dust settled from civil and criminal lawsuits, Pfizer paid out $572 million to claimants.[iii]  But not to worry. As soon as Neurontin became a cheap drug available generically, Pfizer marketed a close cousin of it named Lyrica, which today generates $3 billion a year in sales.[iv]

What is Gabapentin?

Gabapentin is an analog of gamma-aminobutyric acid (GABA), a neurotransmitter that slows down the activity of nerve cells in the brain. This means that gabapentin has a similar structure and is made up of similar chemicals as GABA, although its effect on the body is not the same. The scientists who developed gabapentin were deliberately trying to mimic GABA.

Gabapentin does not convert into GABA, does not inhibit it, does not alter the uptake of dopamine, and does not interact with GABA receptor cells.[v]  How gabapentin works and how it relieves pain and suppresses seizures is unknown.  One theory is that it increases the level of GABA by increasing the activity of glutamic acid decarboxylase, an enzyme responsible for the synthesis of GABA.[vi]

The chemical name for gabapentin is 2-[1-(aminomethyl) cyclohexyl]acetic acid and its molecule looks like this:

Gabapentin is not a Controlled Substance, that is, one that the United States federal government classifies as having potential for addiction and regulates under the Comprehensive Drug Abuse and Control Act of 1970. However, gabapentin shares characteristics of addictive drugs in that it produces a withdrawal syndrome and certain psychoactive effects.  Its cousin drug, pregabalin, is a Schedule V Controlled Substance.

What are the Medical Uses of Gabapentin?

The United States Food and Drug Administration approved Neurontin for the treatment of seizures in adults and children, especially as a supplemental drug used for the same purpose. In 2002, the FDA approved it for treatment for pain from shingles. Horizant and Gralise are extended release versions of gabapentin that were approved for shingles pain in 2012.[vii] Gabapentin was also approved for restless leg syndrome in 2011.[viii]

When gabapentin was first introduced, doctors were excited about it because it had few side effects and drug interactions compared to competing remedies, and because it was not metabolized through the liver but rather excreted through the kidneys.[ix]  Physicians began to prescribe it off-label for various conditions, including hot flashes during menopause, pain from fibromyalgia, bi-polar disorder, pain after polio, neuropathic pain, complex regional pain syndrome, trigeminal neuralgia, migraines, alcohol and drug withdrawal seizures, and diabetic neuropathy.[x] Later it was proven that the manufacturers of this drug had exaggerated claims about its effectiveness for various conditions.[xi]  Pregabalin, commonly sold as Lyrica, is a newer drug now prescribed for nerve pain, epilepsy and fibromyalgia, and it has largely replaced gabapentin.[xii]

The usual dose for people over 12 years old who have epilepsy is 300mg three times a day. This can be increased to 1800mg a day. Doctors prescribe the drug to children with epilepsy based on their body weights.[xiii]

For post-herpetic neuralgia (shingles), the dose is the same as for epilepsy. For adults with restless leg syndrome, the dose is 600mg taken at five o’clock in the evening.[xiv]

Dosages for people with kidney problems may be different than these.[xv]

If you break a gabapentin tablet in order to take just half, you need to use the rest of the pill as your next dosage or else discard it.[xvi]

One unusual aspect of gabapentin is that its bioavailability decreases with the dose.  For example, if you take 900mg, 60% is available to your body, but if you take 4800mg, that drops to only 27%.[xvii]

What are the Side Effects of Gabapentin?

The most common side effects of gabapentin are drowsiness, unsteadiness, sleepiness, loss of coordination, clumsiness, vision changes, and dry mouth.[xviii]  Some people report the following rare side effects:  edema, weight gain, swollen hands and feet, headaches, diarrhea, trouble thinking, abnormal thoughts, suicidal thoughts, fever, ataxia, diplopia, flu symptoms, shortness of breath, chest pain, mouth sores, chills, nausea, coughing, tremor, and other cold symptoms.

If you experience certain symptoms, you should call your doctor immediately because they can be a sign of a serious health condition. These can be black tarry stools, dark urine, tiredness, chest pain, suicidal mood, swollen glands, unusual bruising, rashes, or signs of an infection such as fever, cough and sore throat.[xix]

Children react to gabapentin differently than adults.  They may experience behavioral changes, moodiness, hyperactivity, overly emotional states, and restlessness.[xx]

What Drugs Interact with Gabapentin?

In general, you should not take gabapentin products with medicines that slow down the central nervous system and make you drowsy. These may be anti-histamines, narcotic painkillers, sleeping pills, muscle relaxants, anti-anxiety medications, and drugs for depression and seizures.[xxi] Gabapentin products will react with drugs used during surgeries, even dental procedures.[xxii] Do not take gabapentin products with morphine (Kadian, MS Contin), naproxen (Aleve) or hydrocodone (Lortab, Vicodin).[xxiii]

Drugs containing gabapentin will interact with ketorolac, aluminum carbonate, aluminum hydroxide, aluminum phosphate, dihydroxyaluminum amino acetate, dihydroxyaluminum sodium carbonate, ginkgo, magaldrate, magnesium carbonate, magnesium hydroxide, magnesium trislicate, and morphine sulfate liposome. If you combine gabapentin with tobacco and alcohol and then take certain other drugs, you may cause an unpleasant or difficult reaction.[xxiv]

If you take any common antacids like Maalox and Di-Gel that contain aluminum or magnesium, you need to wait two hours before taking gabapentin.[xxv]

Which People Should not Take Gabapentin?

Gabapentin products have not been determined safe for pregnant or breast-feeding women or children, even though doctors sometimes prescribe it for children with epilepsy.  People with histories of depression, mood or mental disorders, and kidney diseases usually do not take gabapentin because it can make these conditions worse.[xxvi]  These drugs are used with caution for people with liver or heart diseases.[xxvii]

What Lawsuits Have Ensued Over Gabapentin?

At first the United States Food and Drug Administration approved Neurontin for only for epilepsy but by the year 2000, 78% of prescriptions that doctors wrote for Neurontin were for conditions other than seizure disorders. The new drug was widely prescribed “off label” for more than a dozen conditions, including fibromyalgia, nerve pain, migraines, menopausal symptoms, bipolar disorder, and even attention deficit disorder in children.[xxviii] Between 2000 and 2004, Neurontin was generating $1 to $4 billion in sales a year for its manufacturers, which were first Warner-Lambert and later Pfizer drug companies.[xxix]

In 2002, Dr. David Franklin, an employee of Warner-Lambert, went to authorities to report that his company was promoting Neurontin for uses not approved by the FDA. While it is not illegal for doctors to prescribe drugs for unapproved uses, it is illegal for a drug company to advertise and promote them for unapproved uses. [xxx] Dr. Franklin testified that Warner-Lambert paid to doctors to present themselves as authors of studies written by non-doctors employed by the company. He said that the company also paid doctors to speak to other doctors about the off-label uses of Neurontin, and offered physicians expensive retreats and dinners at expensive restaurants to promote the drug.[xxxi]

As criminal and civil lawsuits were filed against the company, more negative information came out. Pfizer had apparently delayed or suppressed publication of studies that were negative or neutral about Neurontin, and exaggerated any positive claims. For example, three double-blind studies showed that Neurontin did not improve the symptoms of bipolar patients any better than sugar pills, but the company manipulated the studies and how symptoms were defined in evaluating the success of Neurontin. Of the 12 studies of the drug’s effect on migraine headaches, two negative ones went unpublished, and some of the positive studies involved only patients who had taken 2400mg or more of the drug.[xxxii] In other studies, patients could easily figure out that they were not in the placebo group, and ordinarily this would have meant that the study could not be published. Company spokespeople denied all the charges, but Pfizer ended up paying out $430 million in claims to states enrolled in the Medicaid program.[xxxiii] In 2011, Judge Patti Saris of the U.S. District Court in Boston ordered Pfizer to pay Kaiser Health $142.1 million for duping the company into prescribing Neurontin for migraines and bipolar disorder.[xxxiv]

In 2004, gabapentin became available as a cheap generic drug,[xxxv] which drastically reduced its value as a money-maker for Pfizer. Pfizer introduced a similar but more potent drug called Lyrica, which was approved by the FDA in December 2004. Lyrica was approved for seizure disorders and pain from fibromyalgia, but it is now prescribed for many other conditions “off-label,” especially all kinds of chronic pain. Today Lyrica ranks 19th among all prescription drugs, and generates more than $3 billion a year for Pfizer.[xxxvi]

What are the Risks of Taking Gabapentin?

Gabapentin doubles the risk for suicidal thoughts and behaviors, but the risk is still low.  In one study of 27,863 patients on Neurontin and 16,029 on a placebo, 0.43% of the ones on the real drug became suicidal compared to 0.24% on the sugar pill.[xxxvii]

Gabapentin has some potential for abuse because it has psychoactive effects.   Once you have been on it for a while, you may experience a difficult withdrawal syndrome when you try to stop taking it.

Gabapentin causes drowsiness and incoordination, which means that you are at an increased risk for accidents, and probably should not drive when you take this medication.[xxxviii]

Gabapentin increases the risk for sudden death after seizures in patients who have epilepsy.  It can cause certain dangerous and sometimes even fatal reactions. Symptoms of this condition can be fever, rash, painful lymph glands in the neck and armpit, unusual bleeding, and yellow eyes and skin.[xxxix] Both of these reactions are extremely rare.

Gabapentin may slightly increase your risk for cancer.[xl]

Does Gabapentin Show up on Urine Tests?

Gabapentin has a half-life of about five to seven hours, which means it should completely clear the body within 38 hours. Standard urine tests do not test for it because it is not a controlled substance.

What is a Gabapentin Overdose?

Symptoms of a gabapentin overdose may be appearing drunk and disoriented, with slurred speech and double vision.[xli]  Such overdoses are very rare.

What is Gabapentin Withdrawal or Discontinuation Syndrome?

When gabapentin was first introduced, scientists believed that it could not cause a withdrawal syndrome.  Since that time, there have been many case studies of people who experienced such difficult symptoms when they tried to stop using the drug that many had to go back on it.  For example, one 81 year old woman with bipolar disorder took Neurontin for five years, and developed severe cold symptoms when she stopped. On the tenth day after stopping Neurontin in a gradual way, she had terrible chest pain, hypertension, and mental changes that were difficult to manage. She was back to normal within one day of taking the drug again.[xlii]

In another case study, a 53-year-old woman vomited a black substance like coffee grounds and developed abdominal pain and black stools after stopping gabapentin.  By days four and five, she developed restlessness, anxiety, agitation, disorientation, confusion, headaches, and extreme sensitivity to light.  When her doctor administered gabapentin again, she was calm and normal within a day.[xliii] Another such study found that a 41-year-old male developed insomnia, headaches, heart palpitations, and excessive sweating after stopping Neurontin, but his symptoms went away when he went back on it.[xliv]

It has now been proven that gabapentin can build up in the body and cause a severe withdrawal syndrome similar to the ones for benzodiazepines and alcohol. The syndrome can last for weeks and even months, depending on the levels you took the drug and for how long you took it.  Symptoms are agitation, confusion, disorientation, sensitivity to light, headaches, heart palpitations, and hypertension, chest pain.  If you were taking gabapentin for epilepsy, your seizures will probably come back.  Some people develop seizures during withdrawal even if they never had one before.[xlv]

What is Gabapentin Addiction?

In theory, gabapentin should not be addictive because it has no affinity for the nerve receptors associated with addictions to marijuana, benzodiazepines or opiates.  It was marketed as non-addictive, but post-marketing studies showed that some people were abusing it.  In the early 2000s, the drug was being sold to thousands of people with sales were over a billion dollars a year.  Some of these patients were asking their doctors to increase their amounts (self-escalation) as they developed physical dependencies on Neurontin.  When they tried to quit, they entered a withdrawal syndrome that caused them to go back to the drug.  The new conclusion about gabapentin, as one expert put it, “The dependence and abuse potential for gabapentin has not been evaluated in human studies.”[xlvi]

The United States Drug Enforcement Agency does not list gabapentin as a drug of concern, even though it is being sold on the Internet illegally. Its street name is “morontin” because it makes you “dopey.”

What Treatments are Available for Gabapentin Addiction?

Because the withdrawal syndrome for this drug can produce unpleasant and even dangerous symptoms, you need to consult your doctor or an addiction specialist at a drug rehabilitation clinic about how you can safely stop taking the drug. The usual method is to wean a patient from the drug by gradually lowering the dosage, but this does not always prevent the withdrawal syndrome.[xlvii]  If you have tried unsuccessfully to quit taking gabapentin, you should seek professional help.

The state-of-the-art treatment for drug addiction is to enter a residential treatment center where your withdrawal can be done under medical supervision.  If you are addicted to other drugs or alcohol as well as gabapentin, your detoxification process will become even more complicated.

Once you have completed detoxification and your body is completely clear of drugs, you need to remain at the center for a few weeks or more so that you can undergo therapy to learn to live a drug-free life.  You will work one-on-one with a therapist who can help you with any psychological problems you may have that contribute to your drug abuse.  You may learn how to deal stress through non-pharmaceutical means such as running or other sports, yoga, meditation, journaling and so forth.  You may have classes in the chemistry of drugs and why they can get such a hold on people’s lives.  You will learn how to avoid relapsing into drug abuse or alcoholism, even if you have a genetic tendency or long family history of such problems.  Most drug rehab programs offer activities that are fun to do as well as ways of self-exploration, such as social gatherings, sightseeing, outdoor sports, and participating in art, drama and music. Once you return home, you usually remain in support meetings in your community and in individual and family counseling to help you stay on track.

How Can I Tell if I am Addicted to Gabapentin?

If you can answer yes to any of these questions, you may want to consider talking to your family physician or an addiction specialist at a residential treatment center about your concerns with gabapentin.

Are you taking gabapentin without a doctor’s prescription? Do you ask your doctor to keep increasing your dose?Do you buy gabapentin from the Internet or other illegal sources? Do you experience withdrawal symptoms when you stop taking gabapentin? Have you tried to quit taking gabapentin on your own but failed? Do you consider yourself to be someone who abuses drugs or alcohol?Do you use gabapentin along with alcohol or other drugs as a way of treating emotional pain? Are you taking gabapentin even though you experience unpleasant side effects and even though you are unsure if it is effective for you? If money were no object, would you enter an intense program to help you deal with drug problems? Do your friends or family members criticize you because of your drug abuse? Do you feel guilty about how you use drugs? Are you trying to cut down on your use of gabapentin or other drugs?

[i]  Tran, K. T., Hranicky, D., Lark, T., & Jacob, N. J. (2005). Gabapentin withdrawal syndrome in the presence of a taper. Bipolar Disorders, 7(3), 302-304.

[ii] Peterson, Melody. “Whistle-Blower Says Marketers Broke the Rules To Push a Drug,” The New York Times, March 14, 2002; and Saul, Stephanie, “Experts Conclude Pfizer Manipulated Studies,” the New York Times, October 8, 2008.

[iii] “Pfizer Told to Pay $142.1 Million Over Marketing of Epilepsy Drug,” New York Times, January 28, 2011.

[iv] “U.S. Pharmaceutical Sales  2013,” The United States Food and Drug Administration, see http://www.drugs.com/stats/top100/2013/q1/sales

[v] “Neurontin,” the RX List, see http://www.rxlist.com/neurontin-drug.htm

[vi] Hellwig, T., Hammerquist, R., & Termaat, J. (2010). Withdrawal symptoms after gabapentin discontinuation. American Journal of Health-System Pharmacy, 67(11), 910-912.

[vii] See articles on FDA approvals and clinical trials of Gabapentin at Center Watch, http://www.centerwatch.com/

[viii] “Neurontin (Gabapentin),” The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR600709

[ix] Tran, K. T., Hranicky, D., Lark, T., & Jacob, N. J. (2005). Gabapentin withdrawal syndrome in the presence of a taper. Bipolar Disorders, 7(3), 302-304.

[x] Mack, Alicia (Ph Pharm). Examination of the Off Label Uses of Gabapentin, The Academy of Managed Care Pharmacy,  see http://www.amcp.org/data/jmcp/Contemporary%20Subject-559-568.pdf

[xi] Peterson, Melody. “Whistle-Blower Says Marketers Broke the Rules To Push a Drug,” The New York Times, March 14, 2002; and Saul, Stephanie, “Experts Conclude Pfizer Manipulated Studies,” the New York Times, October 8, 2008.

[xii] “Neurontin (Gabapentin),” The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR600709

[xiii] “Gabapentin,” Medline, Information from the National Institutes of Health, see http://www.nlm.nih.gov/medlineplus/druginfo/meds/a694007.html

[xiv] Ibid, see also “Neurontin,” the RX List, see http://www.rxlist.com/neurontin-drug.htm

[xv] Ibid.

[xvi] “Neurontin,” the RX List, see http://www.rxlist.com/neurontin-drug.htm

[xvii] “Gabapentin,” Medline, Information from the National Institutes of Health, see http://www.nlm.nih.gov/medlineplus/druginfo/meds/a694007.html

[xviii] “Neurontin (Gabapentin),” The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR600709. See also “Neurontin,” the RX List, see http://www.rxlist.com/neurontin-drug.htm

[xix] “Neurontin,” the RX List, see http://www.rxlist.com/neurontin-drug.htm

[xx] “Neurontin (Gabapentin),” The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR600709

[xxi] “Gabapentin,” Official Information from the United States Food and Drug Administration, Drugs.com, see http://www.drugs.com/gabapentin.html

[xxii] “Gabapentin,” Medline, Information from the National Institutes of Health, see http://www.nlm.nih.gov/medlineplus/druginfo/meds/a694007.html

[xxiii] “Gabapentin,” Official Information from the United States Food and Drug Administration, Drugs.com, see http://www.drugs.com/gabapentin.html

[xxiv] “Neurontin (Gabapentin),” The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR600709

[xxv] Ibid.

[xxvi] Ibid.

[xxvii] “Gabapentin,” Official Information from the United States Food and Drug Administration, Drugs.com, see http://www.drugs.com/gabapentin.html

[xxviii] Saul, Stephanie, “Experts Conclude Pfizer Manipulated Studies,” the New York Times, October 8, 2008.

[xxix] Ibid.

[xxx] Peterson, Melody. “Whistle-Blower Says Marketers Broke the Rules To Push a Drug,” The New York Times, March 14, 2002.

[xxxi] Saul, Stephanie, “Experts Conclude Pfizer Manipulated Studies,” the New York Times, October 8, 2008.

[xxxii] “Pfizer’s Headache,” Newsweek Magazine, October 7, 2008.

[xxxiii] Winstein, K. J.  “Suit alleges Pfizer spun unfavorable drug studies.” Wall Street Journal. October 8, 2008.

[xxxiv] “Pfizer Told to Pay $142.1 Million Over Marketing of Epilepsy Drug,” New York Times, January 28, 2011.

[xxxv] Saul, Stephanie, “Experts Conclude Pfizer Manipulated Studies,” the New York Times, October 8, 2008.

[xxxvi] “U.S. Pharmaceutical Sales  2013,” The United States Food and Drug Administration, see http://www.drugs.com/stats/top100/2013/q1/sales

[xxxvii] “Neurontin,” the RX List, see http://www.rxlist.com/neurontin-drug.htm

[xxxviii] “Neurontin (Gabapentin),” The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR600709

[xxxix]Ibid.

[xl] “Neurontin,” the RX List, see http://www.rxlist.com/neurontin-drug.htm

[xli] “Gabapentin,” Medline, Information from the National Institutes of Health, see http://www.nlm.nih.gov/medlineplus/druginfo/meds/a694007.html

[xlii] Tran, K. T., Hranicky, D., Lark, T., & Jacob, N. J. (2005). Gabapentin withdrawal syndrome in the presence of a taper. Bipolar Disorders, 7(3), 302-304.

[xliii] Hellwig, T., Hammerquist, R., & Termaat, J. (2010). Withdrawal symptoms after gabapentin discontinuation. American Journal of Health-System Pharmacy, 67(11), 910-912.

[xliv] Finch, C., Eason, J., & Usery, J. (2010). Gabapentin Withdrawal Syndrome in a Post–Liver Transplant Patient. Journal of Pain & Palliative Care Pharmacotherapy, 24(3), 236-238.

[xlv] “Neurontin,” the RX List, see http://www.rxlist.com/neurontin-drug.htm

[xlvi] Ibid.

[xlvii] Tran, K. T., Hranicky, D., Lark, T., & Jacob, N. J. (2005). Gabapentin withdrawal syndrome in the presence of a taper. Bipolar Disorders, 7(3), 302-304.

Original Article

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Every Beginning Ends

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I was once told, for a reason I can’t remember, the every beginning is the result of another beginnings end. I don’t know why I am thinking of that today other than I realized that I prefer privatized healthcare over being a part of the VA healthcare system. Its almost like moving backwards instead of forwards when it comes down to my health concerns. I have, in my own personal opinion, two that give me the greatest concerns. Those being my knee and my diabetes. Care and or treatment for both have turned into an absolute clusterfuck if you were to ask me. If I want to talk to a dumbass fucktard I can go to Walmart, however, when discussing my health with a healthcare “professional” I do expect that you know more than me. So far, I am fully disappointed with most of what I have experienced with the VA healthcare system. Not to be confused with the VA who have accommodated me since day one all the way back in 1999 when it was decided that exiting the Air Force was in my best interest. A decision made for me but as I look back it was probably still the best decision because I wasn’t sure if what I did is what I wanted to be doing any longer anyway. Maybe I will get into that soon as it would seem I have been doing quite a bit of reflecting on my life here the last few months.

Now, one would think that one could trust the VA medical to do its part in ensuring that when they make changes in ones medications that they hold up their end of the deal and ship them out to you as promised in a timely manner. I suppose I am the dumbass for assuming that would be the case. In grand anticipation of the changes I seemed to overlook one thing, I way overestimated what I thought should be a timely manner. Why? On 25 March 2014 I saw a diabetic specialist who prescribed me a different insulin because the VA doesn’t offer the dial a unit pen version. I needed a refil so it go changed so I could accommodate the way they do business. Fair enough I guess. However, after ten days (the allotted wait time) I received all of my refils with the exception of a few, one that was back ordered (indefinitely), and two that were never ordered, my glucose test meter and my insulin. After inquiring and getting the cock and bullshit story I was reassured that it was now done. Oh, and by the way, we will go ahead and order the syringes you will be needing as well. I made this call on 09 April 2014. Yesterday, yes the 16th, I received my syringes, but nothing else. I called to inquire again and was told it was all mailed on the 14th so give it another 7-10 days before any concern can be given. Really? Good goddamn thing I got friends in low places (I.e. doctors) who made sure I received a loaded pen of my old insulin to carry me to the big switch event. I want to be done fucking around and being fucked around by the VA medical. I see now why they have a well deserved reputation of being a literal joke. But wait, there’s more.

Today I saw an orthopedic specialist for my knee. The same knee that has had eight surgeries on it and nobody wants to replace it with a shiny new one. As well, this doctor, in his best opinion, believes that there is nothing he can do to better the way it feels, moves, or functions. Do know how hard it is to explain to another human being what “pain” is to you? Now, try doing that same explanation to a doctor, now do that with a VA doctor. Do you know what the result is? There is no result. None. There are predetermined answers which much be given to downplay what one is feeling. So, I get to be made out to feel like shit because my knee, once again, is shredding to utter pieces. Yes, I did xrays and some other imaging about three weeks ago. Yes, he reviewed them in front of me, yes he cringed a little when he saw all the screws, bolts, and other artificial bullshit that showed up plain as the nose on your face. However, even though he commented that the hardware had shifted and I have a screw backing out that this fact has nothing to do with what “appears” to be my ACL ligament being ruptured yet again. Oh really? I tossed out my yellow bullshit flag and called for a time out why we reviewed his credentials. No diploma on the wall but he has a real cool badge. The long and short of it is that I was given a cortisone shot and a prescription for antiinflammatory medication which I should get in 7-10 business days. I won’t hold my breath. I got a better exam from my son who explained to me that if something hurt to do then just don’t do it. Well, shit, that solves everything, I will just stop walking and standing from this point forward. On a patient/doctor statisfication rating of 1-10 I give this a 1 with my middle finger being then one I choose to show how happy I am right this second. Oh, I get to go back in the end of July to see if I have improved at all. I can make a prediction on how that appointment will go, y’all probably can as well.

If this hasn’t been fun enough, I registered with the “my healthcare.VA.gov” website only to find out that to access any of my records I have to go to the main facility with a government form in hand to be verified in person with proof of I.d. so they known its me on-line. This is so much fun I couldnjustnshitnrazor blades in rejoice. I know, sounds like allot of whining, complaining, and bitching for no real reason. Well, if it helps y’all, in feel the reasons are pretty valid. For the first time in my life I imagined how good it would feel to choke the life out of someone giving me grief for no special reason. Is this karma sneaking up non me to let me know that it is finally time to be rewarded for all the years I have been an asshole? I should be careful who I ask that. Anyway, appearantly the adventure (my life) continues on yet for another day, whether I like it or not, I can be happy about that I suppose.

Note To Self: Just Breathe

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The absolute worst time to have an anxiety panic attack is while you are sitting in a chair with a needle mere millimeters from the vein it is about to puncture. How do I know this? I know this from first hand experience this morning. But, before I get into that and what happened next, y’all might need to catch up a bit by reading “An Attack Of Aichmophobia” which was written by me on 19 December 2013 and can explain a little more why I was having blood drawn in the first place. The blood was to serve a two fold purpose, one to do my Hemoglobin A1C panel for diabetic medication prescription renewals and also to see if I had anything weird going on which might explain me really freaking out around needles. I know, made no sense to me either. Why stick someone with a needle that has been freaking out about being stuck with needles here lately. Needless to say, the blood could not be drawn as requested because I threatened to stick the needle where the sun don’t shine to the technician. I ended up back in my doctor’s office where I was introduced to Klonopin or at least the doctor thought he was introducing us for the first time. I’m real aware of this drug as it is one of the drugs my son takes to try to “control” episodes he has because of being bipolar. I have tried to use some humor in the last post because it has been my way of dealing with the fact that I’m pretty fucking scared at this point in my life. I mean, ask yourself, how can a diabetic get away from sharp objects?

Meanwhile, while sitting in the doctor’s chair, figiting and sweating like a whore in a Catholic confessional, the doctor went over my “symptoms” and any known allergies. By this point I’m agitated, I want to go home, I want to get the hell away from all of this to sort it out. The doctor offered me a small pill and a small sip of water in a very small paper cup. He said to take it so we could continue our conversation. So, I complied, I took the pill. Within a few minutes my mind was clearing up, my focus was coming back, and it seemed like I just might be coming back to my senses. A quick check of my pulse, my blood pressure, and a tiny flashlight in my eye revealed to the doctor that my anxiety attack has come to it’s conclusion. Wow, now that was impressive, it worked almost as well as the calming effects my wife’s cold hands have when she places them on my neck when comforting me. He went on to explain that what I had just taken was 2mg of Klonopin. Within a few minutes I was back in the lab chair with a needle in my arm drawing blood and I could really care less. The only thing I could think of is where is my pain, where is my fear, am I dead. I’m a very firm believer that fear and pain are two very basic elements that ensure our safety and remind us that we are indeed still alive. I felt neither but I did feel scared. I imagine how my son must feel, what must be going on inside his brain as he watches what happens around him. Does it have the same effect on him.

That is that. A short walk down the hallway to meet my wife in her office. After seeing she was in there alone I walked thru the door, closing it behind me, where I sat down in one of the chairs at the front of her desk, all I wanted to do is just breathe. She made no comments about what had happened. If I know her the way I think I know her then nothing will ever be said. She did mention that she would pick up my new prescription on her way home with all the instructions. I leaned in to give her a kiss, not saying a word, and I left. I got into my car and found myself going to work. I have spoken to her since because she called to check up on me. She tried to explain that from now on I will need to take this medication prior to testing and prior injecting until I feel it is all under control like it once was. Will it ever get back under control? Will it ever be the same again? Have I lost what I thought I had control of just days before? I have come to the point that I really have grown to dislike this whole diabetes thing. Seems everyone has a way to kick it’s ass. I wish I could find my way to kick diabetes square in the ass and right out the door. Is this the part when someone tells me that we reap what we sew? Unfortunately I can’t go back in time, nor do I want to either, tomorrow is another day, to be dealt with like any other day I suppose. I just need to remember to breathe.

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