Return Of The Scorpion, Reloaded

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Have y’all ever been awake in bed, staring at the ceiling about a million different things and in the midst of all your deep thoughts you find yourself wondering what it would look like with mirrors on the ceiling? Funny question, right? Not really. Not for me. As much as I looked forward to the return of The Sting of the Scorpion I found life kicking me in the balls with bigger things to worry about. In the end, at the end of each day, I find myself in bed unable to fall asleep because of suffering from a very busy brain.

I lay there wondering when life became so complicated. I’ll start with me, mine is the easiest to explain I suppose. Somewhere around the first of the year I went to the doctor because I was suffering from pain in my back that home remedies like ibuprofen and ice could no longer relieve. I was unaware of any injury to my back and figured it was age+work+fatigue+ I’m not 20 anymore= my pain. A series of tests, studies, and exams revealed that my L4 and L3 are ruptured along with my L2 on it way to oblivion. However, it not due to injury, it’s due to some degenerative disease I cannot spell or pronounce along with some pretty severe arthritis. In English, a+b+c= a severe deflection in 3 different directions accompanying the continued pressure on many nerves. After many doctors, a couple pain management specialists, and even some injections, the only answer I am given is to have corrective surgery. And at this stage, there isn’t any fundage to take care of that lovely deductable. So, that shits on hold.

My now 21 year old daughter is attempting to have children at a zero success rate. We, her and I, have been to the fertility clinic on more than one occasion and it was discovered she suffers from PCOS accompanied by a super high testosterone level. So, now she is on a “plan” to bring everything into alignment so eventually she can get pregnant. The challenge has been to keep her emotions in check but this has ramped her anxiety up a billion fold.

So, somewhere around early last month my wife and I were enjoying a very relaxing and romantic bubble bath together until I found she had a weird bump near the limph node of her left breast. The bubble bath ended. This started a series of appointments, exams, and consultations. Allot of fucking time had to pass while being in the dark, not knowing that answers we we seeking, and I cannot even imagine what this is doing to my wife on the inside emotionally. But, now we have news, there are masses, however not concerning masses, and all tests will be repeated in November this year.

As y’all can see, the last few months have been a fucking roller coaster from hell and we aren’t getting off just yet I’m afraid. So, I lay in bed next to my wife at night, staring at her sleeping and staring at my bare ceiling wondering what I look like staring into the abyss trying to empty out my mind so I can get some sleep. It’s hard enough having my problems I can’t get corrected and a thousand times harder watching time click by with the ones I love while they wonder about their own personal unknowns. So, have patience with me as I find time, energy, and the right mood to keep coming back, it will happen, but I have to take into account this thing I call my life.

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

Why Do Doctors Have Differing Opinions

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After a grueling fucking twenty minute conversation with my VA healthcare professional, a person whom I can barely understand much less say her name or even try to spell it, I made the choice to speak with her civilian counterpart in the sector of private medicine. I was solely looking for confirmation of the information I was given in regards to my diabetes and how the peripheral neuropathy in my feet is getting worse over time instead of better. I currently take Pregabalin (which is used to relieve neuropathic pain from damaged nerves that can occur in your arms, hands, fingers, legs, feet, or toes if you have diabetes. Pregabalin is in a class of medications called anticonvulsants. It works by decreasing the number of pain signals that are sent out by damaged nerves in the body.) after being prescribed two others which made me sick to my stomach and didn’t work for me personally. As of lately, the Pregabalin seems to have just stopped working with a considerable increase in the pain in my feet. I called for consultation to see if I had other options. But, as she read straight out of the “VA doctor to patient book of protocol bullshit”, she explained that this treatment prescribed by her IS working for me and any idea it isn’t working is just my imagination.

She don’t even know about my imagination first of all and I have spent less than fifteen minutes total in the three times I have been in her presence so how in the hell can she claim such bullshit. Yes, I understand they are busy doctoring and shit but the dirt under my fingernails has more bedside manner than she could ever hope to have. So, I phoned my civilian doctor, who tells me that no treatment is 100% foolproof and our bodies get nonreactive to most medication we take on a regular basis. No shit! How do I fix it? I hate the awkward silence that happens after an unexpected question or answer because I wonder if I crossed that all to visible line we’re never supposed to cross. Anyway. What my point? The conversation that I had with each doctor got me thinking about the below article I read not to long ago and I just wanted to explain WHY I was sharing it out of the blue like I am. It also made me think of the above sketch, because I do see doctors as “angels” and the serpents they battle within when confronted with doing the right thing or doing only how they are taught. No, I don’t think all doctors are quacks selling snake-oil remedies, but many get tied up in being a doctor before being a human being. I would love to hear your opinions if y’all don’t mind taking a minute.

Why Health Professionals Become Quacks

William T. Jarvis, Ph.D.

It is especially disappointing when an individual trained in the health sciences turns to promoting quackery. Friends and colleagues often wonder how this can happen. Some reasons appear to be:

Boredom

Daily practice can become humdrum. Pseudoscientific ideas can be exciting. The late Carl Sagan believed that the qualities that make pseudoscience appealing are the same that make scientific enterprises so fascinating. He said, “I make a distinction between those who perpetuate and promote borderline belief systems and those who accept them. The latter are often taken by the novelty of the systems, and the feeling of insight and grandeur they provide” [1] Sagan lamented the fact that so many are willing to settle for pseudoscience when true science offers so much to those willing to work at it.

Low professional esteem

Nonphysicians who don’t believe their professions is sufficiently appreciated sometimes compensate by making extravagant claims. Dental renegades have said “All diseases can be seen in a patient’s mouth.” Fringe podiatrists may claim to be able to judge health entirely by examining the feet. Iridologists point to the eye, chiropractors the spine, auriculotherapists the ear, Registered Nurses an alleged “human energy field,” and so on. Even physicians are not immune from raising their personal status by pretension. By claiming to cure cancer or to reverse heart disease without bypass surgery, general physicians can elevate themselves above the highly trained specialists in oncology or cardiology. By claiming to heal diseases that doctors cannot, faith healers advance above physicians on the social status chart (physicians are normally at the top of the chart while preachers have been slipping in modern times). Psychologists, physicians, actors, or others who become health gurus often become darlings of the popular press.

Paranormal tendencies

Many health systems are actually hygienic religions with deeply-held, emotionally significant beliefs about the nature of reality, salvation, and proper lifestyles. Vegetarianism, chiropractic, naturopathy, homeopathy, energy medicine, therapeutic touch, crystal healing, and many more are rooted in vitalism, which has been defined as “a doctrine that the functions of a living organism are due to a vital principle [“life force”] distinct from physicochemical forces” and “the theory that biological activities are directed by a supernatural force.” [2,3] Vitalists are not just nonscientific, they are antiscientific because they abhor the reductionism, materialism, and mechanistic causal processes of science. They prefer subjective experience to objective testing, and place intuitiveness above reason and logic. Vitalism is linked to the concept of an immortal human soul, which also links it to religious ideologies [4].

Paranoid mental state

Some people are prone to seeing conspiracies everywhere. Such people may readily believe that fluoridation is a conspiracy to poison America, that AIDS was invented and spread to destroy Africans or homosexuals, and that organized medicine is withholding the cure for cancer. Whereas individuals who complain about conspiracies directed toward themselves are likely to be regarded as mentally ill, those who perceive them as directed against a nation, culture, or way of life may seem more rational. Perceiving their political passions are unselfish and patriotic intensifies their feelings of righteousness and moral indignation [5]. Many such people belong to the world of American fascism, Holocaust deniers, tax rebels, the radical militia movement, and other anti-government extremists who would eliminate the FDA and other regulatory agencies that help protect consumers from health fraud. Liberty Lobby’s newspaper The Spotlight champions such causes and also promotes quack cancer cures and attacks fluoridation.

Reality shock

Everyone is vulnerable to death anxiety. Health personnel who regularly deal with terminally ill patients must make psychological adjustments. Some are simply not up to it. Investigation of quack cancer clinics have found physicians, nurses, and others who became disillusioned with standard care because of the harsh realities of the side effects or acknowledged limitations of proven therapies.

Beliefs encroachment

Science is limited to dealing with observable, measurable, and repeatable phenomena. Beliefs that transcend science fall into the realms of philosophy and religion. Some people allow such beliefs to encroach upon their practices. While one may exercise religious or philosophical values of compassion, generosity, mercy and integrity (which is the foundation of the scientific method’s search for objective truth), it is not appropriate for a health professional to permit metaphysical (supernatural) notions to displace or distort scientific diagnostic, prescriptive or therapeutic procedures. Individuals who wish to work in the area of religious belief should pursue a different career.

The profit motive

Quackery can be extremely lucrative. Claiming to have a “better mousetrap” can cause the world to beat a path to one’s door. Greed can motivate entrepreneurial practitioners to set ethical principles aside.

The prophet motive

Just as Old Testament prophets called for conversion and repentance, doctors have to “convert” patients away from smoking, obesity, stress, alcohol and other indulgences [6]. As prognosticators, doctors foretell what is going to happen if patients don’t change their way of life. The prophet role provides power over people. Some doctors consciously avoid it. They encourage patients to be self-reliant rather than dependent, but in doing so they may fail to meet important emotional needs. Quacks, on the other hand, revel in, encourage, and exploit this power. Egomania is commonly found among quacks. They enjoy the adulation and discipleship their pretense of superiority evokes.

Psychopathic tendencies

Studies of the psychopathic personality provide insight into the psychodynamics of quackery. Dr. Robert Hare who investigated for more than twenty years, states, “You find psychopaths in all professions. . . the shyster lawyer, the physician always on the verge of losing his license, the businessman with a string of deals where his partners always lost out.” [7] Hare describes psychopaths as lacking a capacity to feel compassion or pangs of conscience, and as exhibiting glibness, superficial charm, grandiosity, pathological lying, conning/manipulative behavior, lack of guilt, proneness to boredom, lack of empathy, and other traits often seen in quacks. According to Hare, such people suffer from a cognitive defect that prevents them from experiencing sympathy or remorse.

The conversion phenomenon

The “brainwashing” that North Koreans used on American prisoners of war involved stress to the point that it produced protective inhibition and dysfunction. In some cases, positive conditioning causes the victim to love what he had previously hated, and vice-versa; and in other cases, the brain stops computing critically the impressions received. Many individuals who become quacks undergo a midlife crisis, painful divorce, life-threatening disease, or another severely stressful experience. The conversion theory is supported by a study of why physicians had taken up “holistic” practices. By far the greatest reason given (51.7%) was “spiritual or religious experiences.” [8]

Many people ”including far too many health professionals, law enforcement officials, and judges’ exhibit a cavalier attitude toward quackery. Although most reject the idea that quackery is “worth a try” for a sick person [9], it is important to reinforce and mobilize those who understand quackery’s harmful potential.

References

Reid WH and others. Unmasking the Psychopath. New York: W.W. Norton and Company, 1986.Webster’s New Collegiate Dictionary.Dorland’s Illustrated Medical Dictionary, 25th Edition. Philadelphia: WB Saunders Co. 1974.Sarton G. A History of Science, Volume I. New York: W.W. Norton & Company, 1952, p.497.Hofstadter R. The Paranoid Style in American Politics and Other Essays. New York: Alfred A. Knopf, 1966.Dominian J. Doctor as prophet. British Medical Journal 287:1925-1927, 1983.Goleman D. Brain defect tied to utter amorality of the psychopath. The New York Times, July 7, 1987.Goldstein MS, Jaffe DT, Sutherland C. Physicians at a holistic medical conference: Who and why?” Health Values 10:3-13, Sept/Oct 1986.Morris LA, Gregory J D, Klimberg R. Focusing an advertising campaign to combat medical quackery. Journal of Pharmaceutical Marketing and Management 2:(1):83-96, 1987.

About the Author

William Jarvis, Ph.D, is a retired professor of public health and preventive medicine at the Loma Linda University School of Medicine. Jarvis is founder and president of the National Council Against Health Care Fraud and is co-author of a textbook, Consumer Health: A Guide to Intelligent Decisions, 7th Edition.

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Struggling With Dueling Personalities

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As my 18 year old daughter pushes through her second semester in college to become a RN she has come face to face with the fact that there are many psychology and sociology classes to attend. She knows the human brain really fascinates me and she knows I have my own out of the normal box way of thinking, meaning I question everything. Because of my age and personal experiences I tend to have a jaded opinion about my fellow human beings. It makes me hard to talk to at times because I don’t want to talk about “how” I got where I stand today because much of my personal past is still unknown to even the closest people in my life. Simply put, there are things I choose not to discuss, its just the way it is.

Anyway, she had a paper to write about personality disorders versus mental disorders. She didn’t know the “line” between them is often blurred, often confused, often misidentified, and very often a person gets mislabeled. Now, she is familiar with bipolar disorder since her brother struggles daily with it. She had to learn the “disorder” in order to live in peace with her brother in a comfortable manner for both of them. She thought she had this paper nailed until she asked me to review it. Its not that she had it all wrong, because she didn’t. But, because the terms are confusing, it makes the information available confusing. Jokingly, I told her that the specialists who study these and other disorders make it difficult to learn for job security, which is both true and false in every conceivable way. So, I gave her my interpretation, whether it helped or not we will have to see when she gets her grade. Below is how I see it.

Sometimes people confuse two mental disorders, only one of which could be referred to as “common” within the population which is bipolar disorder and then schizophrenia. This confusion has largely resulted from the common use of some of these names in popular media, and as short-hand by people referring to someone who is grappling with a mental health issue. The disorders, however, have little in common other than the fact that many who have them are still stigmatized by society.

Bipolar disorder is a fairly common mental disorder compared with the other two disorders. Bipolar disorder is also well-understood and readily treated by a combination of medications and psychotherapy. It is characterized by alternating moods of mania and depression, both of which usually last weeks or even months in most people who have the disorder. People who are manic have a high energy level and often irrational beliefs about the amount of work they can accomplish in a short amount of time. They sometimes take on a million different projects at once and finish none of them. Some people with mania talk at a faster rate and seem to the people around them to be constantly in motion.

After a manic mood, a person with bipolar disorder will often “crash” into a depressive mood, which is characterized by sadness, lethargy, and by a feeling that there’s not much point in doing anything. Problems with sleep occur during both types of mood. Bipolar disorder affects both men and women equally and can be first diagnosed throughout a person’s life.

Bipolar disorder can be challenging to treat because, while a person will take an antidepressant medication to help alleviate a depressed mood, they are less likely to remain on the medications which help reign in the manic mood. Those medications tend to make a person feel “like a zombie” or “emotionless,” which are feelings most people wouldn’t want to experience. So many people with bipolar disorder find it difficult to maintain treatment while in their manic phase. However, most people with bipolar disorder function relatively well in normal society and manage to cope with their mood swings, even if they don’t always keep on their prescribed medications.

However, schizophrenia is less common than bipolar disorder and is usually first diagnosed in a person’s late teens or early to late 20’s. More men than women receive a diagnosis of schizophrenia, which is characterized by having both hallucinations and delusions. Hallucinations are seeing or hearing things that aren’t there. Delusions are the belief in something that isn’t true. People who have delusions will continue with their delusions even when shown evidence that contradicts the delusion. That’s because, like hallucinations, delusions are “irrational”, the opposite of logic and reason. Since reason doesn’t apply to someone who has a schizophrenic delusion, arguing with it logically gets a person nowhere.

Schizophrenia is also challenging to treat mainly because people with this disorder don’t function as well in society and have difficulty maintaining the treatment regimen. Such treatment usually involves medications and psychotherapy, but can also involve a day program for people who have more severe or treatment-resistant forms of the disorder.

Because of the nature of the symptoms of schizophrenia, people with this disorder often find it difficult to interact with others, and conduct normal life activities, such as holding down a job. Many people with schizophrenia go off of treatment (sometimes, for instance, because a hallucination may tell them to do so), and end up homeless, without friends or family, and sometimes end their life as a plausible solution.

All people suffer, period. No person wants or needs to be a “lab rat” in the discovery of what ails them mentally. But, society dictates we label and judge others based on our opinions, ignorance, lack of understanding, and the pure lack of compassion. I know what y’all are thinking, and yes I do judge people myself in regards to stupidity and the utter lack of common sense. So, I do live the double standard in many ways, I ride that double edge sword like the evil bitch she is. Its one of many of my personal faults. I’m definitely not an expert on this topic, but in my defense I have read about and studied this topic for many, many years because the subject is very near and dear to me. Nor do I claim that what I have interpreted or formed my own opinion on is dead nuts accurate. As with all things, interpretation is the ultimate devil in the woodpile.

We can learn allot by paying attention and observing our fellow humans, but more often than not we choose to just ignore the people around us. We have become dependent on others to guide us in life for some fucked up reason. However, I do know two doctors, y’all know who you are, who take a different approach to medicine, they look at the person first, not the diagnosis. They take into consideration that we a people with feelings, emotions, and look at alternative ways to treat the various symptoms of life. I appreciate my two friends a great deal, one day I would like to shake the hands of Kris and Rexi because they have taken time out of their lives to include me into their lives. They are both amazing women in my opinion and anyone who has them in their daily lives are truly lucky.

Anyway, in closing, helping my daughter helps me more often than not because it gives me a chance to reevaluate the things I think I know well and opens my mind to the possibilities that there are other options. I get pretty set in my damn ways sometimes but my thirst for knowledge will never be quenched as long as I’m still breathing. My dad once told me, the summer he died, that people prey on the closed mind, they prey because the closed mind is that of a victim, and they begin with the upper hand because they know how defenseless a victim is. Is it true? I still challenge myself to this very day not to be a victim with a closed mind. Do you?

Now I’m Just A Little Fucking Pissed

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I hope the right motherfuckers are going to be reading this post because I have a message for you that you motherfuckers need to listen to and understand. I reference three physical letters of response I received yesterday after I spent hours, many of them months ago, filling out forms, questionnaire, social surveys, household income surveys, military background questionnaires, background checks, applications, and residency verification. Thanks for allowing me to waste my fucking time and your time. I look back now at the time it took y’all to process everything and see why people are frustrated with the fucking wait. Y’all fuckers want to know what is super fucked up? I qualified for the three services I applied for based on my income, employment status, and residency according to all three of the assistance organizations legal standards. I think I get the picture tho, because I really find it to be racial, because NO other reasons were given, unless “we’re sorry you were not qualified for assistance” is a reason. Is it because I’m white that assistance isn’t available? Since I’m white I shouldn’t be unemployed? Is that why we need me to list my race? Is that the first page y’all fucks look at?

Personally, now that a clear stance has been made, I’m beginning to understand what many people say these days, and that is that you need me to have a job because so many depend on my paycheck. I’ve been busting my ass working since I was 14, to include my time in the Air Force and the last fifteen years since I got out of the military. For what exactly? To be told by people who hide behind a form letter that because I’m white I don’t qualify for financial aid or any kind of anything, not even food stamps, nothing. That’s fucking great, I understand now that I am not allowed into the elite group because I’m not an alcoholic, drug dependant, I don’t have excess children with different last names, I’m legal to be in the United States, I’m white, I’m not a felon, I own my guns legally, I am a disabled veteran, and I’ve never received anything in any form of prior assistance. What exactly does it take for help for a white man when I’m in need? I could really do with less go fuck yourself letters!

But why should you give a flying fuck about me? Did I not donate to your political party? Do I not support the government your way? Is it because I speak English and don’t believe I need to push “1” for English? Why? Being white and speaking English seems to be holding me back. Oh, yea, btw, I appreciate all of my original paperwork y’all sent me to fill out being in Spanish, it was a real pleasure contacting your offices to have forms sent to me in English. I’m bet my German last name really fucking confused you fucktards. Or is it just the government standard to shotgun blast out Spanish forms in hopes of identifying potential illegal voters? Don’t worry, I’m not the only one that knows that even dead or fictional characters get to vote, receive government assistance, and are signed up for obamacare. But as long as there are politicians and government offices it is only going to get worse. But fuck, why do you care, you got a job, a paycheck, and get to fuck with people’s lives for entertainment. Yay you!

Sadly, like the voices of many legal American citizens, my voice remains muted. I’m the wrong color living in the wrong state to to quality for anything more than being on a mailing list. Let’s not forget, you overly arrogant motherfuckers, that y’all sent me the initial bullshit in the mail offering the assistance, I did not seek you out. Who would of thought sending shit to a person with a German last name would have result in that person being white? Do I think our system is fucking broke? Yes. Do I think this system is racist? Yes. Do I personally think it will ever change? Not in my fucking lifetime it won’t. So fuck you, that’s why, I will figure something out.