Question:

I was wondering if anyone could help me.  My best friend has asthma, and got it as a reaction to the whooping cough vaccine when he was 3. His doctors put him on steroids when he was 16, which really messed up his metabolism.  He is currently on Flovent and Berotec.  He has been overweight ever since.  This situation, besides other factors, is really getting him down.  I don’t have asthma, and don’t have this weight problem.  Can anyone give any hints as to how to support him?   I want to be his friend, but it gets difficult at times to understand his feeling so worthless when he is such a nice guy. I appreciate any comments!! Lisa L.

Lisa Sometimes, it’s hard for us asthmatics to cope with the condition – it seems so unjust that we can’t control our breathing, something which is so fundamental, and something which other people take for granted. What doesn’t help is that some people find asthma funny – I’ve lost count of the times people have started laughing because I needed to use my inhaler in public. Honestly, you’d think I was about to relieve myself in the street, the way some people looked at me !! I don’t let it upset me now – the inhaler’s there for my benefit, not their entertainment. As I put it in a previous posting: DON’T LET OTHER IGNORANT BASTARDS CONTROL YOUR LIFE BY MAKING YOU FEEL UNCOMFORTABLE OR EMBARASSED ABOUT IT.

If they can’t accept that I am an asthmatic, and that I have to use regular meds to stabilise my condition, that’s their problem, not mine. I can sympathise with him about being overweight – my asthma is mainly exercise-induced, and I’ve never found a conventional or alternative treatment (breathing exercises included !) that can keep it under decent control whilst exercising. How to support him ? * Try to learn more about the condition, and treatments available.   By posting here, you’ve made a good start. The FAQ’s were posted   earlier this week, so you should have copies. If not, see the HTML   version at http://www.radix.net/~mwg/asthma-gen.html * Don’t wrap him up in cotton wool !!!   Most us don’t want sympathy, we just want to be better understood. * Don’t make an issue of his weight.   That’s the worst thing you can do.   My folks do that, even though they know the difficulties I have   with exercise, and it is SO annoying ! * Be there for him when he’s feeling down.   Let him know that you care – don’t assume that he knows that.   Being unable to breathe can be extremely distressing, if he has   an attack while you’re around, try to help him stay calm. Obviously, I can’t provide any medical advice, but it may be worth asking your own doctor for more information on the condition generally – that way, you might have a better idea of what he’s going through. It sounds like you really do care about your friend, especially as you’re making an effort to try to understand his condition. I hope that what I’ve said, and what I’m sure that other people will say, will be of some use to you. Feel free to mail me if you’ve got any further questions. Good luck ! Chris — Chris King               | Advice given here should NOT be used as a substitute

Response:

I was wondering if anyone could help me.  My best friend has asthma, and got it as a reaction to the whooping cough vaccine when he was 3.   His doctors put him on steroids when he was 16, which really messed up his metabolism.  He is currently on Flovent and Berotec.  He has been overweight ever since.  This situation, besides other factors, is really getting him down.  I don’t have asthma, and don’t have this weight problem.  Can anyone give any hints as to how to support him?   I want to be his friend, but it gets difficult at times to understand his feeling so worthless when he is such a nice guy. I appreciate any comments!! Lisa L.

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Question:

- Hide quoted text — Show quoted text -I’ve been taking Serevent 2 puffs twice a day and Flovent two puffs twice a day for about 6 months with amazing results.  I’ve gotten to the point that I rarely use my Proventil which is almost a miracle to me. In the last week or so I’ve started having anxiety-like attacks in the evening. I don’t have racing hearbeat but I feel extremely anxious and weird.  Kinda like I took too much Theo-Dur, if any of you know that feeling.  It is very intense.  The only thing I can link it to is the evening dose of Serevent. Has anyone else had this? Maybe I only need to take the Serevent in the a.m.?  I’m going to see my doc but thought I would ask here just in case he tries to tell me I’m nuts (G). Thanks for your help. CarolR

Saw my doctor today and he said the Serevent can cause the anxiety problems. He suggested I try 1 puff twice a day, or 2 puffs in the a.m. and 1 at night to see if that would work.  Also told me to use my peak flow meter to see if I even needed to the Serevent to open the airways.  I had been using to open it up so the Flovent would work.  So…we shall see how it goes. Thanks for all your notes. CarolR

Response:

I’ve been taking Serevent 2 puffs twice a day and Flovent two puffs twice a day for about 6 months with amazing results.  I’ve gotten to the point that I rarely use my Proventil which is almost a miracle to me. In the last week or so I’ve started having anxiety-like attacks in the evening.  I don’t have racing hearbeat but I feel extremely anxious and weird.  Kinda like I took too much Theo-Dur, if any of you know that feeling.  It is very intense.  The only thing I can link it to is the evening dose of Serevent.  Has anyone else had this? Maybe I only need to take the Serevent in the a.m.?  I’m going to see my doc but thought I would ask here just in case he tries to tell me I’m nuts (G). Thanks for your help. CarolR

Response:

You are not nuts. I had the same experience and had to eventually cut out the Serevent due to the anxiety attacks. I know I am very sensitive to medications, and even one puff once a day was too much for me. I am feeling alot better as far as the anxiety goes since stopping Serevent. Hope this helps.

Response:

You are not nuts. I had the same experience and had to eventually cut out the Serevent due to the anxiety attacks. I know I am very sensitive to medications, and even one puff once a day was too much for me. I am feeling alot better as far as the anxiety goes since stopping Serevent. Hope this helps.

It helps a lot.  At least I know I’m not the only one this has happened to! What’s weird is that it doesn’t happen witht he morning dose but just the evening dose.  Maybe I can only take 1 dose a day now? I didn’t take it this morning and I found I really needed it.   Is nothing simple anymore?? (G) CarolR

Response:

Hello: This is EXACTLY why I stopped taking serevent. The exact same symptoms you have. You know, I don’t know why there is so much emphasis on using serevent to get off of a shorter acting type of albuterol. In my opinion, serevent has more severe side effects. I’d talk to your doctor about stopping the serevent. The flovent for me made a HUGE difference. Mabye up that if it gets worse when you go off the serevent. On 12 Aug 1999, – Hide quoted text — Show quoted text – I’ve been taking Serevent 2 puffs twice a day and Flovent two puffs twice a day for about 6 months with amazing results.  I’ve gotten to the point that I rarely use my Proventil which is almost a miracle to me. In the last week or so I’ve started having anxiety-like attacks in the evening.  I don’t have racing hearbeat but I feel extremely anxious and weird.  Kinda like I took too much Theo-Dur, if any of you know that feeling.  It is very intense.  The only thing I can link it to is the evening dose of Serevent.  Has anyone else had this? Maybe I only need to take the Serevent in the a.m.?  I’m going to see my doc but thought I would ask here just in case he tries to tell me I’m nuts (G). Thanks for your help. CarolR

Jennifer Gerbi                          http://www.students.uiuc.edu/~gerbi Univ. of Illinois at Urbana-Champaign   1-113 ESB             (217)244-0332

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Question:

My 2 yr old has developed a rash on his face and eye lids. HAs anyone heard of Pulmicort doing that. Ron

Response:

My 2 yr old has developed a rash on his face and eye lids. HAs anyone heard of Pulmicort doing that. Ron

Its possible. Be sure to wash his face after face mask is removed. (I assume you use a face mask, whether using the Turbuhaler with AeroChamber & facemask, or the nebulizer with face mask). Here’s a link on the Pulmicort Turbuhaler: http://www.rxmed.com/monographs/pulmico2.html Excerpt Adverse Effects: No major side effects attributable to the use of budesonide, in all dosage forms, have been reported. During clinical trials, the frequency of subjectively reported side effects was low. The most common side effects were cough, throat irritation, and  hoarseness (2 to 4%). Bad taste, headache, nausea and dryness of the  throat were reported less frequently. Other side effects reported on  occasion during budesonide treatment were tiredness, thirst and  diarrhea. Skin reactions (urticaria, rash, dermatitis,  etc.) may, in rare cases, occur in association with local  corticosteroid therapy." Here is a link for the nebulized version (not available in US): http://www.rxmed.com/monographs/pulmico.html Excerpt: "Adverse Effects: During clinical trials, the most common side effects were  cough, throat irritation and hoarseness (2 to 4%). Bad taste, headache,  nausea and dryness of the throat were reported less frequently. Other side  effects reported on occasion during budesonide treatment were tiredness, thirst and diarrhea.  Facial skin irritation has occurred in a few cases when a nebulizer with a  face mask has been used. To prevent irritation, the facial skin should be  washed after use of the face mask. Skin reactions (urticaria, rash,  dermatitis, etc.) may, in rare cases, occur in association with local  corticosteroid therapy." Ellis

Response:

My 2 yr old has developed a rash on his face and eye lids. HAs anyone heard of Pulmicort doing that. Its possible. Be sure to wash his face after face mask is removed. (I assume you use a face mask, whether using the Turbuhaler with AeroChamber & facemask, or the nebulizer with face mask).

It is not possible to use a Turbuhaler with an Aerochamber/mask. However, there is an MDI version of Pulmicort, which can be used with an aerochamber.  There is also, as you say, the nebulizer version. The original poster may also want to investigate to see if something has changed in their child’s environment [e.g. new foods] to see if perhaps that is the cause of the rash. SW. THIS IS IN NO WAY PROFESSIONAL ADVICE.   Starwind UNSOLICITED COMMERCIAL EMAIL IS NOT WELCOME AT THIS ADDRESS OR VARIATIONS OF IT.

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My 2 yr old has developed a rash on his face and eye lids. HAs anyone heard of Pulmicort doing that. Its possible. Be sure to wash his face after face mask is removed. (I assume you use a face mask, whether using the Turbuhaler with AeroChamber & facemask, or the nebulizer with face mask). It is not possible to use a Turbuhaler with an Aerochamber/mask. However, there is an MDI version of Pulmicort, which can be used with an aerochamber.  There is also, as you say, the nebulizer version.

Whoops, I forgot you can’t use an AeroChamber with a DPI. The original poster did email me; said his son doesn’t use a mask, just breathes thru the tube; so I don’t know if he was using the Turbuhaler version, the MDI version, or the nebulizer version. I told him any such effects would be dose-dependent; perhaps he could reduce the Pulmicort dose and use some steroid-sparing meds, like Intal, Tilade, TheoDur, Proventil tabs. Food allergies (eczema) are certainly a possibility. Ellis – Hide quoted text — Show quoted text – The original poster may also want to investigate to see if something has changed in their child’s environment [e.g. new foods] to see if perhaps that is the cause of the rash. SW.

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Question:

Dear Iris, The best way to avoid this problem is to use a preventive inhaler that reduces your need for bronchodilator.  How often do you use the bronchodilator? Ken – Hide quoted text — Show quoted text -Any advice on how to deal with the temporary jitters you get from BD’s?  I get jittery, my hands tremble slightly.  It lasts for about 20 minutes to a half hour but it drives me crazy.  I avoid taking my BD unless I absolutely have to, but when my chest is congested and I break down and take it, I can really cough up lots of stuff and clear everything out.  I do feel better afterward. What does one do to get through the jitters? Iris —

Response:

Any advice on how to deal with the temporary jitters you get from BD’s?  I get jittery, my hands tremble slightly.  It lasts for about 20 minutes to a half hour but it drives me crazy.  I avoid taking my BD unless I absolutely have to, but when my chest is congested and I break down and take it, I can really cough up lots of stuff and clear everything out.  I do feel better afterward.

I have found that using a spacer helps.  When I am at home I always use an ‘Optihaler’ spacer with my BD.  Otherwise my already poor handwriting becomes totally unreadable.

Response:

Dear Iris, The best way to avoid this problem is to use a preventive inhaler that reduces your need for bronchodilator.  How often do you use the bronchodilator? Ken

Hi Ken: I’m also on Pulmicort and since I’ve only been on these meds a little over two weeks I have noticed I need the BD less and less.  But it still gives me the jitters and I still need it before I exericise in very hot or very cold weather so that’s at least 4-5x/week right now. This morning was the first morning in about 5 days that I woke up and felt I needed the BD.  It was also the most humid and hot mornign we’ve had so far this year, so I guess there’s a connection. Iris – Hide quoted text — Show quoted text – Any advice on how to deal with the temporary jitters you get from BD’s?  I get jittery, my hands tremble slightly.  It lasts for about 20 minutes to a half hour but it drives me crazy.  I avoid taking my BD unless I absolutely have to, but when my chest is congested and I break down and take it, I can really cough up lots of stuff and clear everything out.  I do feel better afterward. What does one do to get through the jitters? Iris —

–

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- Hide quoted text — Show quoted text – Any advice on how to deal with the temporary jitters you get from BD’s?  I get jittery, my hands tremble slightly.  It lasts for about 20 minutes to a half hour but it drives me crazy.  I avoid taking my BD unless I absolutely have to, but when my chest is congested and I break down and take it, I can really cough up lots of stuff and clear everything out.  I do feel better afterward. What does one do to get through the jitters? Iris

Well, if ya can’t stop the jitters, at least have fun with them: 1. Hold a glass of milk and ice cream in your hand.  Use your BD, and in a few minutes, you have a milkshake 2. Pretend you’re on the Comedy Central show Dr. Katz. 3. Take your BD.  Go to work, and complain about the job stress.  Mention that you have a subscription to Soldier of Fortune.  When you are shaking the most, ask your boss for a vacation. 4.  Two words:  Human vibrator. 5.  Clean the house.  You’ll get it done twice as fast. 6.  Scare people on the subway.  This won’t work if you live in New York though.  They’re used to everything. The scary thing is, I’m so used to the jitters, I can write neatly while shaking like a jumping bean.   Woodinat Joel: What do you want for Christmas, Crow? Crow: I wanna decide who lives and who dies Joel: Oh, I don’t know…

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ROFLMAO & PMP!  If you can’t laugh at it, you’re sunk! -Joopie

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I can only reiterate that Tornalate is a good beta agonist inhaler for me.  I have rarely gotten the jitters on it.  When I was in the hospital, the respiratory therapists knew it and exclaimed it was a superior product.  It comes in MDI, and solution for nebulizer, and I have used it both ways.  Don’t need it very often these days, but always carry it, in case.  Made by Dura, I have no connection with them, but don’t understand why I seem to be the only one using it.  I want to make sure they stay in business, in case…  See if you can get a sample, that’s how I discovered it, and a good thing it was, ’cause I had to bring my sample to the hospital until they could order some for their pharmacy.  It seems I’m allergic to albuterol. I have seen it listed in the FAQ for this group, wherever that is now. Good luck,

Any advice on how to deal with the temporary jitters you get from BD’s?  I

get jittery, my hands tremble slightly.  It lasts for about 20 minutes to a half hour but it drives me crazy.  I avoid taking my BD unless I absolutely have to, but when my chest is congested and I break down and take it, I can really cough up lots of stuff and clear everything out.  I do feel better afterward. What does one do to get through the jitters? Iris<< — Sue M.

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Any advice on how to deal with the temporary jitters you get from BD’s?  

I never got jitters from my BD’s until my 50th .. now the non-jittery periods are what’s temporary. get jittery, my hands tremble slightly.  It lasts for about 20 minutes to a half hour but it drives me crazy.  I avoid taking my BD unless I absolutely have to, but when my chest is congested and I break down and take it, I can really cough up lots of stuff and clear everything out.  I do feel better afterward.

Oh, you didn’t mean birthdays? Never mind. What does one do to get through the jitters? Iris Well, if ya can’t stop the jitters, at least have fun with them:

May I ask you’re credentials for prescribing such radical therapy? 1. Hold a glass of milk and ice cream in your hand.  Use your BD, and in a few minutes, you have a milkshake

How do you know she isn’t allergic to milk proteins or lactose?  Such an irresponsible suggestion may actually precipitate an attack. 2. Pretend you’re on the Comedy Central show Dr. Katz.

Is that M.D. or jsut a Ph.D.? 4.  Two words:  Human vibrator.

Take your smut to an alt.sex. channel prevert! 5.  Clean the house.  You’ll get it done twice as fast.

another irresponsible suggestion! — she’ll probably raise twice as much dust and dust mite dander and end up in the ER. 6.  Scare people on the subway.  This won’t work if you live in New York though.  They’re used to everything.

Is this just speculation or can you cite relevant articles? The scary thing is, I’m so used to the jitters, I can write neatly while shaking like a jumping bean.

However, your normal penmanship is probably completely illegible. You MUST be a doctor.

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- Hide quoted text — Show quoted text – Any advice on how to deal with the temporary jitters you get from BD’s?   I never got jitters from my BD’s until my 50th .. now the non-jittery periods are what’s temporary. get jittery, my hands tremble slightly.  It lasts for about 20 minutes to a half hour but it drives me crazy.  I avoid taking my BD unless I absolutely have to, but when my chest is congested and I break down and take it, I can really cough up lots of stuff and clear everything out.  I do feel better afterward. Oh, you didn’t mean birthdays? Never mind. What does one do to get through the jitters? Iris Well, if ya can’t stop the jitters, at least have fun with them: May I ask you’re credentials for prescribing such radical therapy? 1. Hold a glass of milk and ice cream in your hand.  Use your BD, and in a few minutes, you have a milkshake How do you know she isn’t allergic to milk proteins or lactose?  Such an irresponsible suggestion may actually precipitate an attack. 2. Pretend you’re on the Comedy Central show Dr. Katz. Is that M.D. or jsut a Ph.D.? 4.  Two words:  Human vibrator. Take your smut to an alt.sex. channel prevert! 5.  Clean the house.  You’ll get it done twice as fast. another irresponsible suggestion! — she’ll probably raise twice as much dust and dust mite dander and end up in the ER. 6.  Scare people on the subway.  This won’t work if you live in New York though.  They’re used to everything. Is this just speculation or can you cite relevant articles? The scary thing is, I’m so used to the jitters, I can write neatly while shaking like a jumping bean. However, your normal penmanship is probably completely illegible. You MUST be a doctor.

Hey, you out ‘natted the Small Woodinat Creature!  Congrats! Woodinat Joel: What do you want for Christmas, Crow? Crow: I wanna decide who lives and who dies Joel: Oh, I don’t know…

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Any advice on how to deal with the temporary jitters you get from BD’s?  I get jittery, my hands tremble slightly.  It lasts for about 20 minutes to a half hour but it drives me crazy.  I avoid taking my BD unless I absolutely have to, but when my chest is congested and I break down and take it, I can really cough up lots of stuff and clear everything out.  I do feel better afterward. What does one do to get through the jitters?

Read a book.  Take a bubble bath.  Meditate.  Pick the relaxer of your choice, and go to it. Chris Owens

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Any advice on how to deal with the temporary jitters you get from BD’s?  I get jittery, my hands tremble slightly.  It lasts for about 20 minutes to a half hour but it drives me crazy.  I avoid taking my BD unless I absolutely have to, but when my chest is congested and I break down and take it, I can really cough up lots of stuff and clear everything out.  I do feel better afterward. What does one do to get through the jitters? Iris —

Response:

I believe that some BDs will have more effect on you than others.  The dose will probably also make a difference. If you are having problems with unacceptable (to you) side effects I suggest you go back to your MD (US speak) or GP (UK speak).  If you are having to use your BD often (e.g. most days or several times a day) it may indicate the need to review the rest of your treatment. Since I started inhaled steroids I’ve needed the BD maybe 10 times, in as many months, and 1 puff instead of the 2 at a time I was using before.  The usual cause is that I used to get ‘caught short’ getting another steroid inhaler when the current one ran out, and so my inhaled steroid dose got reduced.  A few days later I would get a bit ‘clogged up’.  Now I have a spare – one on, one clean and one in the wash (the repeat prescription request form!) so to speak. At my level of use I’m not bothered about the jitters and they are less since it’s only 1 puff.  For the very few weeks when the BD was my only medicine I was not happy about the prospect at all.  I suspect my workmates wern’t either! Any advice on how to deal with the temporary jitters you get from BD’s?  I get jittery, my hands tremble slightly.  It lasts for about 20 minutes to a half hour but it drives me crazy.  I avoid taking my BD unless I absolutely have to, but when my chest is congested and I break down and take it, I can really cough up lots of stuff and clear everything out.  I do feel better afterward. What does one do to get through the jitters? Iris

– Surfer! http://www.nevis-vieww.demon.co.uk http://www.nevis-vieww.demon.co.uk/flash Hopeful anti-spam: alter double ‘w’ to single ‘w’ to view site & send Email.

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Question:

Frank can’t help it folks, poor thing.

– Hide quoted text — Show quoted text – I can answer these for you (A) What is a chiropractic subluxation? The potential injury caused by unnecessary spinal manipulation. (B) Can you identify one on a radiograph?  If not, what methods do you use to detect them?  How reliable are these methods? Only after a significant trauma.  Spiral CT scan is a very sensitive for delineating the extent of injury. (C) Can a subluxation cause visceral disease (a la Meric chart)? No (D) Can colic be treated chiropractically? No (E) Can a correcting a subluxation help in childhood ear infections? Not really

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Kirk, sham manipulation is fatally flawed.

How can you be certain the sham manipulation is not having an effect by accident. If sham manipulation can be so successful then

why go to a chiropractor and pay good money? Why go to college to study this if anybody can

do it? The issue is knowing were and when to adjust. If the chiropractor understands what he is

doing then he must be able to make a sham treatment. If he doesn’t understand what he is doing then

why go to a chiropractor? Chris Noble

A key is whether or not the subject knows if it is a sham adjustment if one wishes to incorporate a placebo study. Before you buy.

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 A sham could have some different effect that would blow the whole thing. Not very hard to understand.

– Hide quoted text — Show quoted text – Kirk, sham manipulation is fatally flawed.   How can you be certain the sham manipulation is not having an effect by accident. If sham manipulation can be so successful then why go to a chiropractor and pay good money? Why go to college to study this if anybody can do it? If the chiropractor understands what he is doing then he must be able to make a sham treatment. If he doesn’t understand what he is doing then why go to a chiropractor? Chris Noble

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Kirk, sham manipulation is fatally flawed.   How can you be certain the sham manipulation is not having an effect by accident.

If sham manipulation can be so successful then why go to a chiropractor and pay good money? Why go to college to study this if anybody can do it? If the chiropractor understands what he is doing then he must be able to make a sham treatment. If he doesn’t understand what he is doing then why go to a chiropractor? Chris Noble

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    Kirk, sham manipulation is fatally flawed.   How can you be certain the    sham manipulation is not having an effect by accident. If sham manipulation can be so successful then why go to a chiropractor and pay good money? Why go to college to study this if anybody can do it?

Chiro’s have developed techniques that work.   Their patients attest to this. Your sham treatment is neither defined or tested If the chiropractor understands what he is doing then he must be able to make a sham treatment.

 But no-one understands everything about any treatment.   He understands what he is doing works and he understands the basic philosophy behind it.   But he cannot guarantee that his approach is the only one that will work and that your sham treatment cannot possibly work. You want to use a sham treatment?   Prove it is ineffective first. If he doesn’t understand what he is doing then why go to a chiropractor?

Because they have developed successful treatments.   People go through it and say ‘It worked for me’ Until valid studies are done that is all we have to go on. You want a study?   Randomly select patients to consult MD’s or Chiro’s. Blindly evaluate the results.   Which group has a better response? If it’s the MD’s, then I’ll be quite happy to go to an MD first, and if that doesn’t work, go to the Chiro. If it’s the Chiro, then vice versa If it’s the same, then I’ll go to the one with the prettiest receptionist first<g Best wishes — John Bain UK TV Sound Director, magnotherapy user & distributor http://members.aol.com/JBainSI/Magnotherapy.html Surround Sound for Television

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John I have to agree with your post and only wished that I was eloquent enough to have written it. — Dr. Roland R. Hicks Doctor of Chiropractic All good things come from above-down-inside-out Natural Alternative to Celebrex/Vioxx: http://drhicks.joint-pain.com/ Internet Marketing to Win: http://www.aboutimw.com/drhicks.html Nutrition Products and Information: http://freelife.com/Sites/drhicks/redir.cfm?page=/info/welcome/welcom… fm toll free (877) 791-8686

– Hide quoted text — Show quoted text –     Kirk, sham manipulation is fatally flawed.   How can you be certain the    sham manipulation is not having an effect by accident. Not really.  Because the intent of the sham arm of the intervention is to essentially keep the parents blinded, and mimic the conditions of the experimental intervention MINUS the part being investigated.  One could in ensure that a real manipulation is not performed, as long as the parents can’t tell. Not at all.   Just because the patients cannot tell the real treatment from the sham does not mean that the sham is ineffective. It’s like running a test on asprin and using paracetamol as a control. The patients might not be able to tell whether they had the treatment or the control, but the control would never be a placebo.     Comparitive studies are the only way to go until you can develop benchmarks    for the treatment. This, too, is not the case.  With a mere comparison study the conclusions that can be drawn are more prone to being erroneous. To determine if an adjustment (rather than just time spent with the patients, expectation bias, etc) is having an effect, a properly designed sham comparison is the only way to go.  Otherwise we are left with essentially useless studies like the one we are discussing now. Your studies are also useless.   Your controls are invalid.   You have no idea what effect the sham treatment might be having. Randomised comparison studies will show which treatment is more effective, as practised, on a random subject.   I don’t care about the mechanism at this stage, I just want to know which treatment is more effective.   This study will tell me.   It needs to be repeated with a range of practitioners to eliminate charismatic effects, but the results are meaningful.   It gives the odds of a successful outcome for any patient attending either of the two treatments. Controlled studies give us much more useful information than comparisons studies. Not when you do not know whether the sham has any effect.   And you don’t. Your anti-sham philosophy is simply yet another attempt to thwart scientific investigation of alternative modalities (like your arguments against sham acupuncture).  Should we now throw out all negative placebo controlled trials because we can never know if the inert placebo is having some magical, homeopathic, or unknown effect? This is essentially what you are saying if you extend your argument. Not in the slightest.   Unless you can say you totally understand how the therapy works, you cannot say whether the sham treatment has any effect. It must contain enough elements of the treatment to fool the subjects. Inert placebos can be varied to see if there is any difference.   Completely different issue. If you wish to use a sham treatment as a placebo, you must first prove it is ineffective.   How are you going to do that?   Try it against another sham treatment and choose the least effective? No, sham treatments have their place, but cannot be used to prove or disprove a therapy.   All it can prove is that the real treatment is not significantly better than the sham.   Now prove that the sham treatment is ineffective and I’ll listen. Best wishes — John Bain UK TV Sound Director, magnotherapy user & distributor http://members.aol.com/JBainSI/Magnotherapy.html Surround Sound for Television

Response:

    Kirk, sham manipulation is fatally flawed.   How can you be certain the    sham manipulation is not having an effect by accident. Not really.  Because the intent of the sham arm of the intervention is to essentially keep the parents blinded, and mimic the conditions of the experimental intervention MINUS the part being investigated.  One could in ensure that a real manipulation is not performed, as long as the parents can’t tell.  

Not at all.   Just because the patients cannot tell the real treatment from the sham does not mean that the sham is ineffective. It’s like running a test on asprin and using paracetamol as a control.   The patients might not be able to tell whether they had the treatment or the control, but the control would never be a placebo.     Comparitive studies are the only way to go until you can develop benchmarks    for the treatment. This, too, is not the case.  With a mere comparison study the conclusions that can be drawn are more prone to being erroneous. To determine if an adjustment (rather than just time spent with the patients, expectation bias, etc) is having an effect, a properly designed sham comparison is the only way to go.  Otherwise we are left with essentially useless studies like the one we are discussing now.

Your studies are also useless.   Your controls are invalid.   You have no idea what effect the sham treatment might be having. Randomised comparison studies will show which treatment is more effective, as practised, on a random subject.   I don’t care about the mechanism at this stage, I just want to know which treatment is more effective.   This study will tell me.   It needs to be repeated with a range of practitioners to eliminate charismatic effects, but the results are meaningful.   It gives the odds of a successful outcome for any patient attending either of the two treatments. Controlled studies give us much more useful information than comparisons studies.

Not when you do not know whether the sham has any effect.   And you don’t. Your anti-sham philosophy is simply yet another attempt to thwart scientific investigation of alternative modalities (like your arguments against sham acupuncture).  Should we now throw out all negative placebo controlled trials because we can never know if the inert placebo is having some magical, homeopathic, or unknown effect? This is essentially what you are saying if you extend your argument.

Not in the slightest.   Unless you can say you totally understand how the therapy works, you cannot say whether the sham treatment has any effect.   It must contain enough elements of the treatment to fool the subjects.   Inert placebos can be varied to see if there is any difference.   Completely different issue. If you wish to use a sham treatment as a placebo, you must first prove it is ineffective.   How are you going to do that?   Try it against another sham treatment and choose the least effective? No, sham treatments have their place, but cannot be used to prove or disprove a therapy.   All it can prove is that the real treatment is not significantly better than the sham.   Now prove that the sham treatment is ineffective and I’ll listen. Best wishes — John Bain UK TV Sound Director, magnotherapy user & distributor http://members.aol.com/JBainSI/Magnotherapy.html Surround Sound for Television

Response:

Suppose it is simply the child’s karma to be (eventually) free of Colic.  How can we be sure the adjustment, sham adjustment, or other method is not stealing the credit owed to Karma.

Why Andrew, have you done more reading about Karma and are prepared to discuss it now? Here’s the question you kept avoiding all those months ago. Given 100 subjects for a trial,  can we assume that each carries the same Karmic burden Yes or No. If yes, please give your reasons.  When you answer this we can go onto the next question. Best wishes — John Bain UK TV Sound Director, magnotherapy user & distributor http://members.aol.com/JBainSI/Magnotherapy.html Surround Sound for Television

Response:

I understand the need to control variables and the attempted use of sham adjustments to control those variables AMAP. The question of variables does not just enter the control side but also the treatment side of a study.  For example, are all the patients treated with manipulation going to get the same adjustment or the adjustment that is determined to be necessary to correct the dysfunction(subluxation/fixation/restriction).  The reason I bring up this point is because if there is a rotational fixation of the joint then a lateral flexion impulse may or may not correct the fixation and therefore may skew the results to the side of ineffectiveness of the procedure. When it comes to testing a physical medicine the variables are endless.  Not to say that testing should not be done but there must be a global understanding that there are multiple variables that can not be controlled. — Dr. Roland R. Hicks Doctor of Chiropractic All good things come from above-down-inside-out Natural Alternative to Celebrex/Vioxx: http://drhicks.joint-pain.com/ Internet Marketing to Win: http://www.aboutimw.com/drhicks.html Nutrition Products and Information: http://freelife.com/Sites/drhicks/redir.cfm?page=/info/welcome/welcom… fm toll free (877) 791-8686

– Hide quoted text — Show quoted text – Might not be a bad idea to look at all such trials, and shine today’s knowledge on them. I think one might find many old truths to no longer be so. And some to be so. There is much info out there which strongly suggests that we are effected on many subtle levels. By not taking that into account, we can only have faulty or inaccurate information. Surly someone would try to eliminate as many variables as possible. To not do so would, at best , be not worthy of trust. The problem was that the study design compared chiropractic manipulation to administration of a drug.  This is not a true controlled trial, but rather a comparison trial (although JMPT still referred to it as placebo controlled and single blinded). The investigators should have had a manipulation group and a sham group. Kirk, sham manipulation is fatally flawed.   How can you be certain the sham manipulation is not having an effect by accident. Not really.  Because the intent of the sham arm of the intervention is to essentially keep the parents blinded, and mimic the conditions of the experimental intervention MINUS the part being investigated.  One could in ensure that a real manipulation is not performed, as long as the parents can’t tell. Comparitive studies are the only way to go until you can develop benchmarks for the treatment. This, too, is not the case.  With a mere comparison study the conclusions that can be drawn are more prone to being erroneous. To determine if an adjustment (rather than just time spent with the patients, expectation bias, etc) is having an effect, a properly designed sham comparison is the only way to go.  Otherwise we are left with essentially useless studies like the one we are discussing now. Controlled studies give us much more useful information than comparisons studies.  Your anti-sham philosophy is simply yet another attempt to thwart scientific investigation of alternative modalities (like your arguments against sham acupuncture).  Should we now throw out all negative placebo controlled trials because we can never know if the inert placebo is having some magical, homeopathic, or unknown effect? This is essentially what you are saying if you extend your argument. — Kirk Kolas Ontario Veterinary College Class of 2002

Response:

I am not sold on the art of "sham" adjustments.  If there is any joint movement it will have some affect on the joint complex. — Dr. Roland R. Hicks Doctor of Chiropractic All good things come from above-down-inside-out Natural Alternative to Celebrex/Vioxx: http://drhicks.joint-pain.com/ Internet Marketing to Win: http://www.aboutimw.com/drhicks.html Nutrition Products and Information: http://freelife.com/Sites/drhicks/redir.cfm?page=/info/welcome/welcom… fm toll free (877) 791-8686

– Hide quoted text — Show quoted text – "The one study did show that there was a reported improvement but since it was the mothers who reported the improvement the research was not definitive. Who should you ask if a baby’s colic is better?  I think the study is flawed since the measurement is strictly subjective and I hope that they can come up with a more structured study.  Colic is not easily quantified or classified." —- The problem with the design of this study was not really a problem with the measurement of "hours of crying".  This is a reasonable outcome measure, considering "colic" is operationally defined as increased hours of crying. The problem was that the study design compared chiropractic manipulation to administration of a drug.  This is not a true controlled trial, but rather a comparison trial (although JMPT still referred to it as placebo controlled and single blinded). The investigators should have had a manipulation group and a sham group. This way, the parents could be kept in the dark with respect to whether or not their child truly received an adjustment.  By comparing the outcomes of these two groups, the investigators could control for all those other factors that may be at play (e.g. expectation bias, handling of the child, increased time with the parents, etc…) I found it curious that JMPT also referred to the study as single blinded.  In my view it was not even single blinded because the "blinding" referred to the person evaluating the colic diary.  The outcome measure was simply total hours crying, so the diary evaluator, I presume, is simply adding up some numbers.  Blinding this individual is advantageous, but nothing to write home about.  Blinding the evaluators (the parents) is paramount. Nevertheless I have seen this rather poorly designed study touted in some forums.  I’d like to see it done properly with sham manipulation. I have never seen infant adjustments in person, but the couple of instances I have seen it on video, the "adjustments" were so subtle that I fear the investigators would have a hard time devising a convincing "sham" manipulation without actually replicating the adjustment arm of the study. And to end on a completely biased note: most pediatric adjustments look like sham adjustments to me in the first place. — Kirk Kolas Ontario Veterinary College Class of 2002

Response:

The problem was that the study design compared chiropractic manipulation to administration of a drug.  This is not a true controlled trial, but rather a comparison trial (although JMPT still referred to it as placebo controlled and single blinded). The investigators should have had a manipulation group and a sham group. Kirk, sham manipulation is fatally flawed.   How can you be certain the sham manipulation is not having an effect by accident.

Not really.  Because the intent of the sham arm of the intervention is to essentially keep the parents blinded, and mimic the conditions of the experimental intervention MINUS the part being investigated.  One could in ensure that a real manipulation is not performed, as long as the parents can’t tell.   Comparitive studies are the only way to go until you can develop benchmarks for the treatment.

This, too, is not the case.  With a mere comparison study the conclusions that can be drawn are more prone to being erroneous. To determine if an adjustment (rather than just time spent with the patients, expectation bias, etc) is having an effect, a properly designed sham comparison is the only way to go.  Otherwise we are left with essentially useless studies like the one we are discussing now. Controlled studies give us much more useful information than comparisons studies.  Your anti-sham philosophy is simply yet another attempt to thwart scientific investigation of alternative modalities (like your arguments against sham acupuncture).  Should we now throw out all negative placebo controlled trials because we can never know if the inert placebo is having some magical, homeopathic, or unknown effect? This is essentially what you are saying if you extend your argument. — Kirk Kolas Ontario Veterinary College Class of 2002

Response:

 Might not be a bad idea to look at all such trials, and shine today’s knowledge on them. I think one might find many old truths to no longer be so. And some to be so. There is much info out there which strongly suggests that we are effected on many subtle levels. By not taking that into account, we can only have faulty or inaccurate information. Surly someone would try to eliminate as many variables as possible. To not do so would, at best , be not worthy of trust.

– Hide quoted text — Show quoted text – The problem was that the study design compared chiropractic manipulation to administration of a drug.  This is not a true controlled trial, but rather a comparison trial (although JMPT still referred to it as placebo controlled and single blinded). The investigators should have had a manipulation group and a sham group. Kirk, sham manipulation is fatally flawed.   How can you be certain the sham manipulation is not having an effect by accident. Not really.  Because the intent of the sham arm of the intervention is to essentially keep the parents blinded, and mimic the conditions of the experimental intervention MINUS the part being investigated.  One could in ensure that a real manipulation is not performed, as long as the parents can’t tell. Comparitive studies are the only way to go until you can develop benchmarks for the treatment. This, too, is not the case.  With a mere comparison study the conclusions that can be drawn are more prone to being erroneous. To determine if an adjustment (rather than just time spent with the patients, expectation bias, etc) is having an effect, a properly designed sham comparison is the only way to go.  Otherwise we are left with essentially useless studies like the one we are discussing now. Controlled studies give us much more useful information than comparisons studies.  Your anti-sham philosophy is simply yet another attempt to thwart scientific investigation of alternative modalities (like your arguments against sham acupuncture).  Should we now throw out all negative placebo controlled trials because we can never know if the inert placebo is having some magical, homeopathic, or unknown effect? This is essentially what you are saying if you extend your argument. — Kirk Kolas Ontario Veterinary College Class of 2002

Response:

The problem was that the study design compared chiropractic manipulation to administration of a drug.  This is not a true controlled trial, but rather a comparison trial (although JMPT still referred to it as placebo controlled and single blinded).   The investigators should have had a manipulation group and a sham group.

Kirk, sham manipulation is fatally flawed.   How can you be certain the sham manipulation is not having an effect by accident. It’s like using a random drug off the shelves as a placebo, you have no idea what its effects will be on the participants in this study. Comparitive studies are the only way to go until you can develop benchmarks for the treatment. Best wishes — John Bain UK TV Sound Director, magnotherapy user & distributor http://members.aol.com/JBainSI/Magnotherapy.html Surround Sound for Television

Response:

John, Suppose it is simply the child’s karma to be (eventually) free of Colic.  How can we be sure the adjustment, sham adjustment, or other method is not stealing the credit owed to Karma. – Hide quoted text — Show quoted text – The problem was that the study design compared chiropractic manipulation to administration of a drug.  This is not a true controlled trial, but rather a comparison trial (although JMPT still referred to it as placebo controlled and single blinded). The investigators should have had a manipulation group and a sham group. Kirk, sham manipulation is fatally flawed.   How can you be certain the sham manipulation is not having an effect by accident. It’s like using a random drug off the shelves as a placebo, you have no idea what its effects will be on the participants in this study. Comparitive studies are the only way to go until you can develop benchmarks for the treatment. Best wishes — John Bain UK TV Sound Director, magnotherapy user & distributor http://members.aol.com/JBainSI/Magnotherapy.html Surround Sound for Television

Before you buy.

Response:

"The one study did show that there was a reported improvement but since it was the mothers who reported the improvement the research was not definitive. Who should you ask if a baby’s colic is better?  I think the study is flawed since the measurement is strictly subjective and I hope that they can come up with a more structured study.  Colic is not easily quantified or classified."   —- The problem with the design of this study was not really a problem with the measurement of "hours of crying".  This is a reasonable outcome measure, considering "colic" is operationally defined as increased hours of crying. The problem was that the study design compared chiropractic manipulation to administration of a drug.  This is not a true controlled trial, but rather a comparison trial (although JMPT still referred to it as placebo controlled and single blinded).   The investigators should have had a manipulation group and a sham group. This way, the parents could be kept in the dark with respect to whether or not their child truly received an adjustment.  By comparing the outcomes of these two groups, the investigators could control for all those other factors that may be at play (e.g. expectation bias, handling of the child, increased time with the parents, etc…) I found it curious that JMPT also referred to the study as single blinded.  In my view it was not even single blinded because the "blinding" referred to the person evaluating the colic diary.  The outcome measure was simply total hours crying, so the diary evaluator, I presume, is simply adding up some numbers.  Blinding this individual is advantageous, but nothing to write home about.  Blinding the evaluators (the parents) is paramount. Nevertheless I have seen this rather poorly designed study touted in some forums.  I’d like to see it done properly with sham manipulation. I have never seen infant adjustments in person, but the couple of instances I have seen it on video, the "adjustments" were so subtle that I fear the investigators would have a hard time devising a convincing "sham" manipulation without actually replicating the adjustment arm of the study. And to end on a completely biased note: most pediatric adjustments look like sham adjustments to me in the first place.   — Kirk Kolas Ontario Veterinary College Class of 2002

Response:

"Chiropractors are nervous system specialists with a focus on orthopedics. In other words, chiropractors are concerned with mechanical stressors on the nervous system. The nervous system controls all of the blood vessels in the body (via the sympathetic division of the autonomic nervous system). Every tissue in the body needs a healthy blood supply (for nourishment and waste removal). This blood supply is predicated upon having blood vessels functioning properly. Sympathetic innervation causes vasoconstriction (narrows arteries and arterioles), and thus diminishes the blood supply to an area. Profound reduction in blood supply results in hypoxia (decreased oxygen supply). This results in an ischemic condition, resulting in cellular death, and possible necrosis of the tissue. And thus, the functional integrity of the tissue is compromised." "A man may be a fool and not know it – but not if he is married." H.L. Mencken http://www.lifehousemusic.com/lh_music.html catchytune. says me.

Response:

– Dr. Roland R. Hicks Doctor of Chiropractic All good things come from above-down-inside-out Natural Alternative to Celebrex/Vioxx: http://drhicks.joint-pain.com/ Internet Marketing to Win: http://www.aboutimw.com/drhicks.html Nutrition Products and Information: http://freelife.com/Sites/drhicks/redir.cfm?page=/info/welcome/welcom… fm toll free (877) 791-8686

Here are some starter questions: (A) What is a chiropractic subluxation?

Atlas gave a good explanation, however I like to use common language to describet a subluxtion.  It is first and foremost the main object of a theory which attempts to explain what a chiropractor treats.  It is not proven for if it was it would not be a theory.  A subluxation in chiropractic terms is an abnormal positon or movement of the spinal bones/joints which cause a change in the function of the nervous system and to the extent that the nervous system is affected so the subjects health is affected.  Simply put a subluxation is anything which can cause negative effects on the nervous system and related to the structure of the body.  As Atlas stated that there are many causes of subluxations from injury, stress, metabolic, ect. (B) Can you identify one on a radiograph?  If not, what methods do you use to detect them?  How reliable are these methods?

There are instances in which the structural facet of a subluxation may be viewed on xray.  Since a subluxation is biomechanical, structural and neurological in origin one can not see the neurological or biomechanical aspects of a subluxation on a xray. Just as one cannot see the funtion of the sciatic nerve on a pelvic xray.  I propose a scenario to better understand the above explanation.  In my practice, I have the opportunity to see patients with disc degeneration on a daily basis.  These people come in with discs that have degenerated and thinned.  When the disc thins the bones(vertebrae) come closer together.  This caused the facet joints in the back of the spine to also come closer together(imburcate).  When these joints come closer together their biomechanics change and they are prone to Jamming upon extension movements or movements which cause an increase in the normal lumbar curve(lordosis).  Can you see these changes in the normal static Xrays?  yes Can you see the biomechanical changes on the xray? no biomechanical findings cannot be seen on a static test. Can you correlate your findings to the history and examination and predict the outcome of care? yes (C) Can a subluxation cause visceral disease (a la Meric chart)?

What is the Meric chart? A person can have a viscerosomatic reflex like having an upset stomach cause overall body weakness and malaise. A person can have a somatovisceral reflex like having hit one’s thumb with a hammer can cause stomach upset. A person can have a psychosomatic reflex in which they think they are sick and therefore they feel general muscle weakness and malaise. A person can have a somatopsychologica reflex in which the are hurt physically and it sets up the flight/fight reaction. This is the long way of answering the question asked.  Yes, a subluxation can be a cause of a visceral disease/condition/symptom.  The reverse is also part of the "subluxation theory" a visceral condition can reflex to the spine and cause pain and subluxation symptoms of the spine.  Ie. gall bladder causing pain in the right intrascapular region.  Cramping and lumbar muscle spasms and pain associated with painful menses in women are good examples of viscerosomatic reflexes.  The nerves travel both ways. (D) Can colic be treated chiropractically?

There is some clinical evidence that spinal manipulation can reduce the severity of colic however I believe the jury is still out on that one and more studies should be performed.  The one study did show that there was a reported improvement but since it was the mothers who reported the improvement the research was not definitive. Who should you ask if a baby’s colic is better?  I think the study is flawed since the measurement is strictly subjective and I hope that they can come up with a more structured study.  Colic is not easily quantified or classified.  Plus those little rug rats can’t comunicate other than crying or not crying.  My boy was diagnosed with a viral syndrome(possibly meningitis) when he was two months old.  We were up all night and went to the ER at 4AM due to his condition.  The only thing that would calm him was gentle motion of his hips and sacrum. Why? GOT ME.  The lumbar puncture was inconclusive.  I was explained by our pediatrician that just because you dip your hand into a barrel of pickles and don’t grab a pickle doesn’t mean that there are not pickles in there. We had to assume that the child had meningitis and treat it as such. (E) Can a correcting a subluxation help in childhood ear infections?

In my clinical experience, I would have to say emphatically YES.  Does it cure infections? NO I have treated approximately 20-30 children with chronic ear infections over the past 10 years and of those treated, in my observation 80-90% showed improvement in their condition.  Was it just the adjustments?  I doubt it.  I make sure that my patients keep on the medicinal regimine recommended by their medical doctor and simply try to improve the function of the cervical spine. I also try to make dietary changes for the child.  Do I understand the exact mechanism? NO  What my treatments are designed to do is increase drainage of the sinuses and aid in the drainage of the eustacian tube.  If there is restriction of motion in the upper neck causing reduce lymphatic drainage then this may be a factor in the condition.  My son has had chronic ear infections since he was one year old.  He has allergies and that plays a big role in his chronic infections.  I do gentle neck adjustments and skull craniopathy to aid in his congestion to clear his sinuses and have him on antibiotics only when an infection is present. The explanations provided are in no way complete and are for the purposes of presenting my experience.  If you have questions about the areas discussed or are unclear of what I was attempting to explain please ask me to clarify those areas. – Hide quoted text — Show quoted text – I have heard different chiropractors answer these questions differently.  We all know how a "Straight" chiropractor would answer them.  What do you think? — Kirk Kolas Ontario Veterinary College Class of 2002

Response:

If you have a question about chiropractic ask away.  I am not the ultimate expert but I may be able to help you none the less. If you had been to a chiropractor and had a question about the visit, rumors, theory, testing or even the question that you think others will think you are stupid to ask.  I’m on this newsgroup for enjoyment and if I can help another while I’m having fun then I’ve killed two birds with one stone. — Dr. Roland R. Hicks Doctor of Chiropractic All good things come from above-down-inside-out Natural Alternative to Celebrex/Vioxx: http://drhicks.joint-pain.com/ Internet Marketing to Win: http://www.aboutimw.com/drhicks.html Nutrition Products and Information http://freelife.com/Sites/drhicks/redir.cfm?page=/info/welcome/welcom… fm toll free (877) 791-8686

Response:

If you have a question about chiropractic ask away.  I am not the ultimate expert but I may be able to help you none the less.

Here are some starter questions: (A) What is a chiropractic subluxation? (B) Can you identify one on a radiograph?  If not, what methods do you use to detect them?  How reliable are these methods? (C) Can a subluxation cause visceral disease (a la Meric chart)? (D) Can colic be treated chiropractically? (E) Can a correcting a subluxation help in childhood ear infections? I have heard different chiropractors answer these questions differently.  We all know how a "Straight" chiropractor would answer them.  What do you think? — Kirk Kolas Ontario Veterinary College Class of 2002

Response:

I can answer these for you (A) What is a chiropractic subluxation?

The potential injury caused by unnecessary spinal manipulation. (B) Can you identify one on a radiograph?  If not, what methods do you use to detect them?  How reliable are these methods?

Only after a significant trauma.  Spiral CT scan is a very sensitive for delineating the extent of injury. (C) Can a subluxation cause visceral disease (a la Meric chart)?

No (D) Can colic be treated chiropractically?

No (E) Can a correcting a subluxation help in childhood ear infections?

Not really

Response:

(A) What is a chiropractic subluxation?

If you asked a medical doctor and a chiropractor to define a subluxation, you would get two different answers. The medical profession defines a subluxation as: "A partial or incomplete dislocation."  (From Taber’s Cyclopedic Medical Dictionary).      The Chiropractic profession has a different definition (and thus – meaning) for a subluxation. Specifically, a subluxation is an articular lesion which has the following components: 1. Abnormal movement or position of a bone. (Kinesiopathology). In the spine, this could be at the intersegmental level (meaning one vertebra and the vertebra above and below it). Or it could be at the global level (meaning the posture). 2. Abnormal tissue. (Histopathology):  This includes nerves, muscle, ligaments, tendons, adipose tissue, fascia, lymphatics, blood vessels, etc.      Kinesiopathology is composed of rotations and translations. Histopathology is caused by deformations of the tissues [Davis' Law of soft tissues, Wolff's Law of hard tissues]. What causes a subluxation? Subluxations are caused by one of three things:      1. Trauma (Physical stress)      2. Thoughts (Emotional stress)      3. Toxins (Chemical stress) Is a Subluxation the cause of all disease?      There is no one cause for all disease.  If there was, we would have probably found it by now. There are numerous causes for disease. One thing which needs to be stressed at this point is that the human body was designed to be healthy. The body has an innate ability to repair itself from injury, and to fight off pathogens. We were not designed to have to rely on pills, potions, and powders to resolve the majority of our problems.      Chiropractors are nervous system specialists with a focus on orthopedics. In other words, chiropractors are concerned with mechanical stressors on the nervous system. The nervous system controls all of the blood vessels in the body (via the sympathetic division of the autonomic nervous system). Every tissue in the body needs a healthy blood supply (for nourishment and waste removal). This blood supply is predicated upon having blood vessels functioning properly. Sympathetic innervation causes vasoconstriction (narrows arteries and arterioles), and thus diminishes the blood supply to an area. Profound reduction in blood supply results in hypoxia (decreased oxygen supply). This results in an ischemic condition, resulting in cellular death, and possible necrosis of the tissue. And thus, the functional integrity of the tissue is compromised.      Chiropractors do not treat disease. They find and remove subluxations. However, if the subluxation is the cause of the disease, then by removing the subluxation, you are effectively resolving the problem. (B) Can you identify one on a radiograph?  If not, what methods do you use to detect them?  How reliable are these methods?

        The Chiropractic definition of a subluxation involves mechanical, biochemical, and neurophysiological components. Of these, the mechanical component is visible on an x-ray. The neurological, and physiological components are not visible on an x-ray. Chiropractors study x-ray films with line drawing analysis. And with these, they can take precise measurements to determine if the bone(s) are subluxated.      Your chiropractor will only order an x-ray if he/she feels it is necessary. Precautions are used to ensure that you are exposed to the absolutely minimum possible radioation dose. These include lead shielding, high speed films, collimation, and screens. (C) Can a subluxation cause visceral disease (a la Meric chart)?

        Chiropractic has but one purpose. And that is to find and remove subluxations. If the subluxation is the cause of the dis-ease in the body, then it logically follows that by removing the subluxation (the cause), then you’re going to remove the dis-ease (the effect).      However, the subluxation is not the root of every health care problem. There are many reasons why people get sick. Interestingly enough, Chiropractic could help boost the immune system of the patient, so that their own innate immunity is stronger, and the body is better able to rid itself of the disease process. See: http://www.geocities.com/cbpdoc/neuroimmune.html (D) Can colic be treated chiropractically?

        Only if the colic is caused by vertebral subluxation. (E) Can a correcting a subluxation help in childhood ear infections?

        Only if the ear infections are caused by vertebral subluxation. I have heard different chiropractors answer these questions differently.  We all know how a "Straight" chiropractor would answer them.  What do you think?

        Now you know.

Response:

Question:

Hello,     Went to the doctor’s and he has increased my dosage of Paxil from 20 mg to 40 mg. I did not realize there was going to be a yoyo effect from not taking amitriptilene. I am looking forward to a normal night’s sleep (for me 6 or 7 hours) whenever that will occur, I cannot say, but I am trying to optimistic. Many thanks to all for the moral support.

Dear Mike, Please don`t increase your Paxil dose by 20 mgs, that is a huge increase at one time and there is a chance you will experience really uncomfortable side-effects. People with anxiety disorders need to start at a low dose and wean slowly. It is best to increase your dose in 5mg increments. It took me 6 weeks to go from 5 mgs to 20 mgs on Paxil, I can`t imagine a 20mg increase at one time Take care!! Jackie

Response:

- Hide quoted text — Show quoted text – Hello,     Went to the doctor’s and he has increased my dosage of Paxil from 20 mg to 40 mg. I did not realize there was going to be a yoyo effect from not taking amitriptilene. I am looking forward to a normal night’s sleep (for me 6 or 7 hours) whenever that will occur, I cannot say, but I am trying to optimistic. Many thanks to all for the moral support. Dear Mike, Please don`t increase your Paxil dose by 20 mgs, that is a huge increase at one time and there is a chance you will experience really uncomfortable side-effects. People with anxiety disorders need to start at a low dose and wean slowly. It is best to increase your dose in 5mg increments. It took me 6 weeks to go from 5 mgs to 20 mgs on Paxil, I can`t imagine a 20mg increase at one time Take care!! Jackie

Jackie, as usual, is quite right here! Philip

Response:

Mike, I agree with the other replies, don’t initially take the full 20 mgs.  If nothing else, at least cut it in half.  I hope you are able to get some sleep… smiles, elise

– Hide quoted text — Show quoted text – Hello,     Went to the doctor’s and he has increased my dosage of Paxil from 20 mg to 40 mg. I did not realize there was going to be a yoyo effect from not taking amitriptilene. I am looking forward to a normal night’s sleep (for me 6 or 7 hours) whenever that will occur, I cannot say, but I am trying to optimistic. Many thanks to all for the moral support. Cheers, Mike Mike, Hope your appt goes well and do let us know how it goes… smiles, elise     Many thanks for the info. I am going to the doctor today. For reasons which I cannot relate here I am not able to take benzos. I feel so tightly wound up, that I cannot relax at all. I have become so jumpy, too. I do not dare drink any coffee, for obvious reasons. When the doctor said that it was all right to just stop taking amitriptilene, I had no idea that I would feel this badly. I have always been tightly wound up, even as a child. It was nice while I did not feel so wound up, until recently. All of this anxiety is making it impossible for me to exercise, (I usually ride a bicycle to and from work) I live in Brooklyn, and I normally ride into Manhattan every day. But, the last 5 months of all this anxiety has made it impossible. I used to ride 30 miles a day. I try to take a walk every evening, just a few miles, to help burn off my nervous energy. I will let you know how I make out at the doctors, and my thanks to those who answered my query, and to those who have had good thoughts for me. Cheers, Mike one supposed to feel like shit, a week and half after not taking Amitriptilene? yes if you abruptly stopped-it takes a week to leave your system -taking both paxil and amitriptyline together is bad medicine imo-they compete quite viruntly for specific receptor sites there are other tca ssri combos that are safer-so you now are feeling the full brunt of the paxil and the abrupt ceasation of the ami-get another doc-btw paxil is less effective in treating ibs then the sedating tca’s even though it may be the most sedating ssri and certainly the most anticholinergic it still doesn’t equate to ami your ami dose was low and buttricing it with a benzo may have provided better relief even now a benzo would do wonders LM

Response:

Hi All,     I have been taking Paxil for about a month and a half, and have a good started taking Paxil, I was taking 75mg of Amitriptilene for a number of months before I started taking Paxil. I was taking Amitriptilene for IBS, but my symptoms had gotten so bad, that the doctor put me on Paxil, and a few weeks later told me it was all right to stop taking the Amitriptilene. There was no tapering down, or anything. Last week, I started waking at night for no reason, and then the symptoms got so bad. I now have a feeling of "impending doom" and I am so fatigued, irritable, etc. Is this normal? Is one supposed to feel like shit, a week and half after not taking Amitriptilene? I would expect some minor discomfort, for a few days, and that is a maybe, but these feelings are horrible. Any ideas? Should I wait a few more days, before caling the doctor? Many thanks in advance. Cheers, Mike

Response:

– Hide quoted text — Show quoted text – Hi All,     I have been taking Paxil for about a month and a half, and have a good started taking Paxil, I was taking 75mg of Amitriptilene for a number of months before I started taking Paxil. I was taking Amitriptilene for IBS, but my symptoms had gotten so bad, that the doctor put me on Paxil, and a few weeks later told me it was all right to stop taking the Amitriptilene. There was no tapering down, or anything. Last week, I started waking at night for no reason, and then the symptoms got so bad. I now have a feeling of "impending doom" and I am so fatigued, irritable, etc. Is this normal? Is one supposed to feel like shit, a week and half after not taking Amitriptilene? I would expect some minor discomfort, for a few days, and that is a maybe, but these feelings are horrible. Any ideas? Should I wait a few more days, before caling the doctor? Many thanks in advance. Cheers, Mike

I’d call your doc today, and try to get some relief. Chip

Response:

one supposed to feel like shit, a week and half after not taking Amitriptilene?

yes if you abruptly stopped-it takes a week to leave your system -taking both paxil and amitriptyline together is bad medicine imo-they compete quite viruntly for specific receptor sites there are other tca ssri combos that are safer-so you now are feeling the full brunt of the paxil and the abrupt ceasation of the ami-get another doc-btw paxil is less effective in treating ibs then the sedating tca’s even though it may be the most sedating ssri and certainly the most anticholinergic it still doesn’t equate to ami your ami dose was low and buttricing it with a benzo may have provided better relief even now a benzo would do wonders LM

Response:

    Many thanks for the info. I am going to the doctor today. For reasons which I cannot relate here I am not able to take benzos. I feel so tightly wound up, that I cannot relax at all. I have become so jumpy, too. I do not dare drink any coffee, for obvious reasons. When the doctor said that it was all right to just stop taking amitriptilene, I had no idea that I would feel this badly. I have always been tightly wound up, even as a child. It was nice while I did not feel so wound up, until recently. All of this anxiety is making it impossible for me to exercise, (I usually ride a bicycle to and from work) I live in Brooklyn, and I normally ride into Manhattan every day. But, the last 5 months of all this anxiety has made it impossible. I used to ride 30 miles a day. I try to take a walk every evening, just a few miles, to help burn off my nervous energy. I will let you know how I make out at the doctors, and my thanks to those who answered my query, and to those who have had good thoughts for me. Cheers, Mike

– Hide quoted text — Show quoted text – one supposed to feel like shit, a week and half after not taking Amitriptilene? yes if you abruptly stopped-it takes a week to leave your system -taking both paxil and amitriptyline together is bad medicine imo-they compete quite viruntly for specific receptor sites there are other tca ssri combos that are safer-so you now are feeling the full brunt of the paxil and the abrupt ceasation of the ami-get another doc-btw paxil is less effective in treating ibs then the sedating tca’s even though it may be the most sedating ssri and certainly the most anticholinergic it still doesn’t equate to ami your ami dose was low and buttricing it with a benzo may have provided better relief even now a benzo would do wonders LM

Response:

Mike, Hope your appt goes well and do let us know how it goes… smiles, elise

– Hide quoted text — Show quoted text –     Many thanks for the info. I am going to the doctor today. For reasons which I cannot relate here I am not able to take benzos. I feel so tightly wound up, that I cannot relax at all. I have become so jumpy, too. I do not dare drink any coffee, for obvious reasons. When the doctor said that it was all right to just stop taking amitriptilene, I had no idea that I would feel this badly. I have always been tightly wound up, even as a child. It was nice while I did not feel so wound up, until recently. All of this anxiety is making it impossible for me to exercise, (I usually ride a bicycle to and from work) I live in Brooklyn, and I normally ride into Manhattan every day. But, the last 5 months of all this anxiety has made it impossible. I used to ride 30 miles a day. I try to take a walk every evening, just a few miles, to help burn off my nervous energy. I will let you know how I make out at the doctors, and my thanks to those who answered my query, and to those who have had good thoughts for me. Cheers, Mike one supposed to feel like shit, a week and half after not taking Amitriptilene? yes if you abruptly stopped-it takes a week to leave your system -taking both paxil and amitriptyline together is bad medicine imo-they compete quite viruntly for specific receptor sites there are other tca ssri combos that are safer-so you now are feeling the full brunt of the paxil and the abrupt ceasation of the ami-get another doc-btw paxil is less effective in treating ibs then the sedating tca’s even though it may be the most sedating ssri and certainly the most anticholinergic it still doesn’t equate to ami your ami dose was low and buttricing it with a benzo may have provided better relief even now a benzo would do wonders LM

Response:

Hello,     Went to the doctor’s and he has increased my dosage of Paxil from 20 mg to 40 mg. I did not realize there was going to be a yoyo effect from not taking amitriptilene. I am looking forward to a normal night’s sleep (for me 6 or 7 hours) whenever that will occur, I cannot say, but I am trying to optimistic. Many thanks to all for the moral support. Cheers, Mike

– Hide quoted text — Show quoted text – Mike, Hope your appt goes well and do let us know how it goes… smiles, elise     Many thanks for the info. I am going to the doctor today. For reasons which I cannot relate here I am not able to take benzos. I feel so tightly wound up, that I cannot relax at all. I have become so jumpy, too. I do not dare drink any coffee, for obvious reasons. When the doctor said that it was all right to just stop taking amitriptilene, I had no idea that I would feel this badly. I have always been tightly wound up, even as a child. It was nice while I did not feel so wound up, until recently. All of this anxiety is making it impossible for me to exercise, (I usually ride a bicycle to and from work) I live in Brooklyn, and I normally ride into Manhattan every day. But, the last 5 months of all this anxiety has made it impossible. I used to ride 30 miles a day. I try to take a walk every evening, just a few miles, to help burn off my nervous energy. I will let you know how I make out at the doctors, and my thanks to those who answered my query, and to those who have had good thoughts for me. Cheers, Mike one supposed to feel like shit, a week and half after not taking Amitriptilene? yes if you abruptly stopped-it takes a week to leave your system -taking both paxil and amitriptyline together is bad medicine imo-they compete quite viruntly for specific receptor sites there are other tca ssri combos that are safer-so you now are feeling the full brunt of the paxil and the abrupt ceasation of the ami-get another doc-btw paxil is less effective in treating ibs then the sedating tca’s even though it may be the most sedating ssri and certainly the most anticholinergic it still doesn’t equate to ami your ami dose was low and buttricing it with a benzo may have provided better relief even now a benzo would do wonders LM

Response:

For reasons which I cannot relate here I am not able to take benzos.

Mike, you already do.  Diazepam (Valium) and other benzodiazepine type chemicals are in every mouthful of food you eat. Ian

Response:

I took Zoloft for 2 days, I had very little sleep and completely horrifying dreams when I did get to sleep. I felt really shaky and nervous as well. I thought I would be nuts in a week if I would have stayed on. It affects people very differently!

– Hide quoted text — Show quoted text – Hi everyone.I’m on my 2nd dose of Zoloft,25 mgs,my first day I had extreme nausea.On the 2nd day my husband took me to the hospital.I completely zoned out.It was very scary.I plan on completing my treatment because over-coming this awful way of life is important to me.What I’m asking is,was this normal? Should I just lower my dosage?Thanks in advance. Hi Julie! I wish I could help you with the Zoloft question.  I just wanted to welcome you to a very caring group!!! Hugs, Di

Response:

Hi everyone.I’m on my 2nd dose of Zoloft,25 mgs,my first day I had extreme nausea.On the 2nd day my husband took me to the hospital.I completely zoned out.It was very scary.I plan on completing my treatment because over-coming this awful way of life is important to me.What I’m asking is,was this normal? Should I just lower my dosage?Thanks in advance. Got questions?  Get answers over the phone at Keen.com. Up to 100 minutes free! http://www.keen.com

Response:

HI Julie, Call your prescribing doctor but I don’t see what it would hurt weaning on at say 12.5 for a few days then upping the dose. Sometimes the side effects are just increased anxiety over taking the med. What do you mean by Zoned out? Hope you are feeling better. Hugs Charla —

– Hide quoted text — Show quoted text – Hi everyone.I’m on my 2nd dose of Zoloft,25 mgs,my first day I had extreme nausea.On the 2nd day my husband took me to the hospital.I completely zoned out.It was very scary.I plan on completing my treatment because over-coming this awful way of life is important to me.What I’m asking is,was this normal? Should I just lower my dosage?Thanks in advance. Got questions?  Get answers over the phone at Keen.com. Up to 100 minutes free! http://www.keen.com

Response:

Hi everyone.I’m on my 2nd dose of Zoloft,25 mgs,my first day I had extreme nausea.On the 2nd day my husband took me to the hospital.I completely zoned out.It was very scary.I plan on completing my treatment because over-coming this awful way of life is important to me.What I’m asking is,was this normal? Should I just lower my dosage?Thanks in advance.

It’s best to start at 12.5mg with Z if you have anxiety problems.  It’s difficult to know what to say about your side effects, though.  It can cause nausea, but I’m not sure what you mean by "zoned out" though it must have been serious to go to the hospital.  Make sure you describe in detail what happened to your psychiatrist.  If you give the ng better details on the side effects you may get better advice. Best of luck to you, Matt

Response:

Thanks!It really helps to know there are people here who can relate to how I feel.Well after only 3 days my dr. took me off Zoloft.My body couldn’t handle the side-effects.I feel really disappointed because I’ve heard others have good results from this.He said we would try something different in about a week.Any ideas on something that may be better for me? Got questions?  Get answers over the phone at Keen.com. Up to 100 minutes free! http://www.keen.com

Response:

Thanks!It really helps to know there are people here who can relate to how I feel.Well after only 3 days my dr. took me off Zoloft.My body couldn’t handle the side-effects.I feel really disappointed because I’ve heard others have good results from this.He said we would try something different in about a week.Any ideas on something that may be better for me?

There are lots of possibilities. Another SSRI like Celexa would be a possibility. If one SSRI doesn’t work another might. It may be augmented by a benzo like (preferably IMO) Xanax. But if you try Celexa start at *5 mg* and no more. I am not totally convinced that you wouldn’t be able to benefit from Zoloft if it had been administered in the right low dose but Celexa works as well and supposedly has a lower side effect profile. There are many other possibilites: a TCA like imipramine, desipramine etc. preferably in a combo with a benzo, or newer AD’s like especially Effexor. Etc.etc. Philip – Hide quoted text — Show quoted text – Got questions?  Get answers over the phone at Keen.com. Up to 100 minutes free! http://www.keen.com

Response:

Hi everyone.I’m on my 2nd dose of Zoloft,25 mgs,my first day I had extreme nausea.On the 2nd day my husband took me to the hospital.I completely zoned out.It was very scary.I plan on completing my treatment because over-coming this awful way of life is important to me.What I’m asking is,was this normal? Should I just lower my dosage?Thanks in advance.

Hi Julie! I wish I could help you with the Zoloft question.  I just wanted to welcome you to a very caring group!!! Hugs, Di

Response:

You shouldn’t take Zoloft on an empty stomach.  Actually you shouldn’t take an pills (e.g. vitamins) on an empty stomach unless the pharmacist tells you to do so.

Actually since taking Z (though Z is somewhat unique in this) on a full stomach increases absorption of the med, if she wanted an even smaller effect than 12.5 mg would give her she could try it on an empty stomach. Matt

Response:

In the UK, my doctor said that there is no dosage less than 50mg. And so I had bad stuff hapening to me. Which included nausea, I assume you were not sick tho. I would have carried on but I had to work and so I stopped after two days, the side effects are ment to go away.

In the US we have scored 25mg tablets.  You could get a pill cutter which would would take the 50mg, if scored, down to 12.5mg.  (But I suppose this is a little after the fact.) Matt

Response:

After what I experienced I would be terrified to take 50mgs! I’m hoping to do better on a low dosage. Got questions?  Get answers over the phone at Keen.com. Up to 100 minutes free! http://www.keen.com

Response:

In the UK, my doctor said that there is no dosage less than 50mg. And so I had bad stuff hapening to me. Which included nausea, I assume you were not sick tho. I would have carried on but I had to work and so I stopped after two days, the side effects are ment to go away. — If I could start again. A million milles away I would keep myself. I would find a way. It’s a damn mad world. And It will get madder before it ends. – Hide quoted text — Show quoted text – Hi everyone.I’m on my 2nd dose of Zoloft,25 mgs,my first day I had extreme nausea.On the 2nd day my husband took me to the hospital.I completely zoned out.It was very scary.I plan on completing my treatment because over-coming this awful way of life is important to me.What I’m asking is,was this normal? Should I just lower my dosage?Thanks in advance. Got questions?  Get answers over the phone at Keen.com. Up to 100 minutes free! http://www.keen.com

Response:

Thanks everyone for the advice.This was really a scary reaction I had.It’s hard to explain what happened.I’m seeing my dr. tomorrow.The hospital gave me benadryl for the reaction,it helped.I’m thinking maybe I started at too high a dose,my body wasn’t ready.I intend to continue my treatment.I will be 40 this month,it seems like I’ve lived most of my life in fear. Maybe with the help of my dr. and people who understand what this is like,I will find a successful treatment.Thanks All! Got questions?  Get answers over the phone at Keen.com. Up to 100 minutes free! http://www.keen.com

Response:

Hi everyone.I’m on my 2nd dose of Zoloft,25 mgs,my first day I had extreme nausea.On the 2nd day my husband took me to the hospital.I completely zoned out.It was very scary.I plan on completing my treatment because over-coming this awful way of life is important to me.What I’m asking is,was this normal? Should I just lower my dosage?Thanks in advance.

Nausea and feeling zoned out are common initial side effects of Zoloft but it seems you had a really bad reaction. It is advisable IMO to start Zoloft at 12,5 mgs, stay there for a week and then raise the dose in increments of 12,5 mgs every week or at whatever pace is comfortable for you. *Starting low & going slow* will minimize the initial side effects. Moreover this could be helped by taking a benzo like Xanax on the side *as needed*, at least during the time you are weaning on Zoloft. You should give Zoloft a 6-8 week trial to be able to properly assess its effect but it’s likely that you will feel better much earlier. What does your doctor say? Philip – Hide quoted text — Show quoted text – Got questions?  Get answers over the phone at Keen.com. Up to 100 minutes free! http://www.keen.com

Response:

Julie, Sorry I can’t help you with the zoloft question because I don’t take that, but just wanted to say I hope everything goes well for you and you can get back to a more normal life. smiles, elise

– Hide quoted text — Show quoted text – Hi everyone.I’m on my 2nd dose of Zoloft,25 mgs,my first day I had extreme nausea.On the 2nd day my husband took me to the hospital.I completely zoned out.It was very scary.I plan on completing my treatment because over-coming this awful way of life is important to me.What I’m asking is,was this normal? Should I just lower my dosage?Thanks in advance. Got questions?  Get answers over the phone at Keen.com. Up to 100 minutes free! http://www.keen.com

Response:

I don’t know where you live but do you think that it ia normal, to give somebody shock treatment for anxiety and panic??

NO! It is something like a last resort for depression but there is no evidence AFAIK that it works for PAD. No ECT! I don’t think so, maybe for people who  have only depression. but that I am depri is because of the fakt that I have try’d now so many med; and the only one who helpt me was Remeron. But the side effect where so bad that I had to stop.

But we know now that those side effects were from the fillers. You found that out yourself! And soon Remeron will be available in loquid form and your troubles may be over…. they may be over earlier when the Dutonin (Serzone) will start to work…. I am optimistic…. love Diana.

Philip – Hide quoted text — Show quoted text – Is it normal that I feel very depri? When I was in Ireland I had not a very good time, I had than for med; selexa and clonazepam. I felt very depri. Now I am back for 14 days and I have other med; Dutonin( serzone) but I feel more and more depri. I know the new med need it’s time. But this is something that  is for me well known. I had this feeling before and it’s make’s me afraid, not for myself because I wish that I had the opportunitie to……. But for not my family. I am so tired from al this, every 8 weeks other med; sometimes less than 4 weeks. because I have sometimes very bad side effects, and than I have to stop. this is now going on for 18 mounths and I am fed up with all this. I don’t want no more, I had it. Before I went to Ireland I brought all the pills that I had safe’t to my gp. That was not a very good idea from me, so I start over again. the first I have already, I don’t know anymore for this moment what to do.everything that I try is going wrong. WHY, I feel my self worthless that I can get myself under control. Love Diana. Please no answer on my pc. {{{Diana}}} You are *not* worthless. You just feel that way because you are depressed. It is a symptom of depression. Give the Serzone some more time to work. If no med is able to help your depression, there is shock treatment as a last resort. Love, Chip Before you buy.

Response:

Dear Diana, Yes I would say it is very normal to feel depressed and frustrated after 18 months of trying so many different drugs and sometimes feeling worse. This can be a very long road. I am doing the same thing but thankful when the good days DO come, and they will! Sorry you are having such a hard time. I am just sticking with the Klonopin and no more antidepressants. None of them helped me – too many side effects – and life is OK most of the time. I hope the Serzone starts to help you soon. Is it giving you side effects?? Love,

Response:

Is it normal that I feel very depri? When I was in Ireland I had not a very good time, I had than for med; selexa and clonazepam. I felt very depri. Now I am back for 14 days and I have other med; Dutonin( serzone) but I feel more and more depri. I know the new med need it’s time. But this is something that  is for me well known. I had this feeling before and it’s make’s me afraid, not for myself because I wish that I had the opportunitie to……. But for not my family. I am so tired from al this, every 8 weeks other med; sometimes less than 4 weeks. because I have sometimes very bad side effects, and than I have to stop. this is now going on for 18 mounths and I am fed up with all this. I don’t want no more, I had it. Before I went to Ireland I brought all the pills that I had safe’t to my gp. That was not a very good idea from me, so I start over again. the first I have already, I don’t know anymore for this moment what to do.everything that I try is going wrong. WHY, I feel my self worthless that I can get myself under control. Love Diana. Please no answer on my pc.

Response:

– Hide quoted text — Show quoted text – Is it normal that I feel very depri? When I was in Ireland I had not a very good time, I had than for med; selexa and clonazepam. I felt very depri. Now I am back for 14 days and I have other med; Dutonin( serzone) but I feel more and more depri. I know the new med need it’s time. But this is something that  is for me well known. I had this feeling before and it’s make’s me afraid, not for myself because I wish that I had the opportunitie to……. But for not my family. I am so tired from al this, every 8 weeks other med; sometimes less than 4 weeks. because I have sometimes very bad side effects, and than I have to stop. this is now going on for 18 mounths and I am fed up with all this. I don’t want no more, I had it. Before I went to Ireland I brought all the pills that I had safe’t to my gp. That was not a very good idea from me, so I start over again. the first I have already, I don’t know anymore for this moment what to do.everything that I try is going wrong. WHY, I feel my self worthless that I can get myself under control. Love Diana. Please no answer on my pc.

{{{Diana}}} You are *not* worthless. You just feel that way because you are depressed. It is a symptom of depression. Give the Serzone some more time to work. If no med is able to help your depression, there is shock treatment as a last resort. Love, Chip Before you buy.

Response:

I don’t know where you live but do you think that it ia normal, to give somebody shock treatment for anxiety and panic?? I don’t think so, maybe for people who  have only depression. but that I am depri is because of the fakt that I have try’d now so many med; and the only one who helpt me was Remeron. But the side effect where so bad that I had to stop. love Diana. – Hide quoted text — Show quoted text – Is it normal that I feel very depri? When I was in Ireland I had not a very good time, I had than for med; selexa and clonazepam. I felt very depri. Now I am back for 14 days and I have other med; Dutonin( serzone) but I feel more and more depri. I know the new med need it’s time. But this is something that  is for me well known. I had this feeling before and it’s make’s me afraid, not for myself because I wish that I had the opportunitie to……. But for not my family. I am so tired from al this, every 8 weeks other med; sometimes less than 4 weeks. because I have sometimes very bad side effects, and than I have to stop. this is now going on for 18 mounths and I am fed up with all this. I don’t want no more, I had it. Before I went to Ireland I brought all the pills that I had safe’t to my gp. That was not a very good idea from me, so I start over again. the first I have already, I don’t know anymore for this moment what to do.everything that I try is going wrong. WHY, I feel my self worthless that I can get myself under control. Love Diana. Please no answer on my pc. {{{Diana}}} You are *not* worthless. You just feel that way because you are depressed. It is a symptom of depression. Give the Serzone some more time to work. If no med is able to help your depression, there is shock treatment as a last resort. Love, Chip Before you buy.

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– Hide quoted text — Show quoted text – Is it normal that I feel very depri? When I was in Ireland I had not a very good time, I had than for med; selexa and clonazepam. I felt very depri. Now I am back for 14 days and I have other med; Dutonin( serzone) but I feel more and more depri. I know the new med need it’s time. But this is something that  is for me well known. I had this feeling before and it’s make’s me afraid, not for myself because I wish that I had the opportunitie to……. But for not my family. I am so tired from al this, every 8 weeks other med; sometimes less than 4 weeks. because I have sometimes very bad side effects, and than I have to stop. this is now going on for 18 mounths and I am fed up with all this. I don’t want no more, I had it. Before I went to Ireland I brought all the pills that I had safe’t to my gp. That was not a very good idea from me, so I start over again. the first I have already, I don’t know anymore for this moment what to do.everything that I try is going wrong. WHY, I feel my self worthless that I can get myself under control. Love Diana. Please no answer on my pc.

Hi Diana! I feel so bad for you!  You are depressed and I’ve been depressed lately.  Just in the last day or two I’ve been feeling a little better.  The doc raised the Desipramine over the weekend and it made me more depressed.  I’m not taking the extra anymore and I feel better.  Please keep calling your doctor to see what else he can do and hang in there.  It has to get better for you and I believe it will!   {{{{{{{Diana}}}}}}} Diane

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I’ve been on an antidepressant (Effexor) for about six months now. It has been remarkably effective for the depression, but is affecting the quality of my sleep.  I’ve tried taking it at different times if the day, but still have problems.  One thing I notice in particular is that I often wake up after about five hours of sleep and feel tired, but mentally alert.  If I go ahead and go into the office to work super-early, my production is outstanding for about half the day. I get to feeling  very run down after lunch though.   If I go back to bed after waking up alert like this, I am usually able to drift off for another 1-2 hours of sleep.  Unfortunately, after sleeping an extra hour or two,  I FIND IT ALMOST IMPOSSIBLE TO GET UP. Even after loading up on coffee, no-doz, etc., I feel groggy all day.  I guess I don’t understand sleep cycles. How can I be more tired from sleeping two extra hours?  Does this have anything to do with which sleep cycle I’m in when the alarm goes off?  Any ideas on this will be appreciated.

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Hello, DGA – Have you ever been tested for a sleep disorder?  For years doctors tried to tell me that I was suffering from depression because I was sleepy all of the time.  Finally I was diagnosed first with sleep apnea and five years with narcolepsy.  I don’t know how long I had apnea before it was diagnosed, but I had had the narcolepsy for 37 years!  Having untreated sleep disorders can depress anyone! Kent Taylor (Mongo) – Hide quoted text — Show quoted text -DGA wrote in message …

I’ve been on an antidepressant (Effexor) for about six months now. It has been remarkably effective for the depression, but is affecting the quality of my sleep.  I’ve tried taking it at different times if the day, but still have problems.  One thing I notice in particular is that I often wake up after about five hours of sleep and feel tired, but mentally alert.  If I go ahead and go into the office to work super-early, my production is outstanding for about half the day. I get to feeling  very run down after lunch though.   If I go back to bed after waking up alert like this, I am usually able to drift off for another 1-2 hours of sleep.  Unfortunately, after sleeping an extra hour or two,  I FIND IT ALMOST IMPOSSIBLE TO GET UP. Even after loading up on coffee, no-doz, etc., I feel groggy all day.  I guess I don’t understand sleep cycles. How can I be more tired from sleeping two extra hours?  Does this have anything to do with which sleep cycle I’m in when the alarm goes off?  Any ideas on this will be appreciated.

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On Wed, 04 Aug 1999 19:16:58 GMT, "DGA" <davea…@flash.net

wrote: I’ve been on an antidepressant (Effexor) for about six months now. It has been remarkably effective for the depression, but is affecting the quality of my sleep.  I’ve tried taking it at different times if the day, but still have problems.  One thing I notice in particular is that I often wake up after about five hours of sleep and feel tired, but mentally alert.  If I go ahead and go into the office to work super-early, my production is outstanding for about half the day. I get to feeling  very run down after lunch though.   If I go back to bed after waking up alert like this, I am usually able to drift off for another 1-2 hours of sleep.  Unfortunately, after sleeping an extra hour or two,  I FIND IT ALMOST IMPOSSIBLE TO GET UP. Even after loading up on coffee, no-doz, etc., I feel groggy all day.  I guess I don’t understand sleep cycles. How can I be more tired from sleeping two extra hours?  Does this have anything to do with which sleep cycle I’m in when the alarm goes off?  Any ideas on this will be appreciated.

Try setting an alarm to limit your nap to 20-30 minutes.  Most people will be somewhat refreshed by that without having the body go into the "very groggy" state you describe. When you go to sleep, there are a lot of things that slow down – not just heartrate, many other body systems do this.  By going to sleep for 1-2 hours you give your body time to completely shut down – and you’ve seen how hard it is to get it started again.  By taking a short nap you don’t give your body time to completely shut down, so starting up again is a lot easier. In college I pulled a few long nights now and again.  I found that if I finished early enough to get 3 or more hours of sleep it was worth going to bed.  If I was going to get 1-2 hours (just as you describe) it did the same thing for me it is doing to you – made me really groggy the next day.  So if there was only time for 1-2 hours I just stayed awake (hadn’t been told about short naps then).

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DGA wrote:

I’ve been on an antidepressant (Effexor) for about six months now. It has been remarkably effective for the depression, but is affecting the quality of my sleep.

Greetings!  You’ve definitely come the right spot to talk about sleep problems.  Just remember that most of us here are not medical professionals. We can offer our own experience, and that of others, but it’s just that … our own thoughts and opinions, not a medical training!

One thing I notice in particular is that I often wake up after about five hours of sleep and feel tired, but mentally alert.  …

You might want to check out the patient information for this drug.  You can search for it at http://www.rxlist.com/ where I found indications that this drug for a small percentage of people slightly (very slightly) increased the incidence of insomnia and somnolence. You might want to discuss this with your doctor.  Additionally as Kent pointed out, your depression might well be connnected to sleep problems. Also, (and remember this is my own experience only) you might want to change the time you sleep to 1.5 hours instead of 2 hours.  I find that I feel more rested when I get a multiple of 90 minutes of sleep. Regards, =jbf= John B. Fisher

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I was on Effexor for depression but went off of it. I am very groggy when I get up my resting heartbeat is faster than it should be. and I am always in alot of pains. ie. lower back, etc. among other stress and the like.

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DGA wrote:

I’ve been on an antidepressant (Effexor) for about six months now. I guess I don’t understand sleep cycles. How can I be more tired from sleeping two extra hours?  Does this have anything to do with which sleep cycle I’m in when the alarm goes off?  Any ideas on this will be appreciated.

I’ve been on Effexor for 5 years.  It has caused two sleep related problems for me.  The first is called Rem Behavioral Disorder.  This is a condition where you "act out" your dreams, and it makes your sleep non-restful.  The second is called "Periodic Leg Movement Disorder."  I had a related problem (called Restless Leg Syndrome) before I went on Effexor, but SSRIs can make it much worse.  If you have PLMD without RLS, then you probably don’t even know you have it, and Effexor can make it get much worse.  PLMD means you kick your legs every minute or two, all night long.  (except when you are dreaming) The kicks cause you to stay in a less-restful stage of sleep, and keep you from getting enough of the deep sleep you need in order to get real rest. I have noticed over the years on Effexor that if I wake up naturally, then go back to sleep, I will end up sleeping for up to a whole DAY before I can manage to get myself back out of bed.  (Unless something scares me awake, or my wife physically drags my butt out of bed.) I haven’t ever heard about this before, and I always assumed it was because the meds I take for sleep wear off by morning time.  But you are right, it doesn’t seem to make a lot of sense.  I’ll ask my psychiatrist about it, and see if I can find anything about it on the net. One thing you might want to consider is the VERY short halflife of Effexor.  Do you usually take it in the morning?  If you take it when you get up, but you put off getting up, then that _might_ make it so that you start to experience the very mild beginnings of withdrawal.  Effexor withdrawal can be VERY nasty, and it generally involves migraine headaches, _massive_ periods of fragmented sleep where you often can’t clearly distinguish between being awake and being asleep, and vertigo/balance problems.  I’m on Effexor XR, so that I can get by with only one dose per day.  With normal Effexor, I had to take it twice a day, and if I was more than an hour or two late for the dose, I’d start having the headaches, dizziness, etc. About your weird problems when going back to sleep though, with ME, it seems like I stay in a sleep which is kind of like the sleep I have when I’m going through Effexor withdrawal.  I’m 1/2 awake, and 1/2 asleep, and it is impossible to tell if I’m dreaming or not. Any time I experience that "weird sleep," I usually end up not being able to get out of bed for a long time, and I always end up being exhausted for at least 12 hours or so afterwards.  It’s probably some weird sleep problem caused by Effexor, which someone will end up "discovering" in 10 years.  :) Anyway, my best suggestion is to just get up after 5 hours, and try to stick it out til your normal bedtime the next night.  If you need more than 5 hours sleep per night, then eventually the sleep deficit should help you sleep later.  I don’t have ANY idea what to do about the weird grogginess after going back to sleep.  I never even really gave it much thought as being a problem separate from my OTHER sleep problems until I read your post.  Thanks for the info.  :) -Bret Wood -bretw…@cs.uoregon.edu

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I’ve been off the stuff for about 3 days now..can’t really say I feel that bad…I actually feel BETTER….my body feel so much less sluggish and I want to DO stuff and I don’t feel uneven or unstable by any stretch of the imagination. I just feel good because this is actually turhing out to be an "up" week for me.  Maybe I don’t need the meds…  I dunno….things are on an upward curve for me at eh moment.  I feel great….great great great…..not upity, but just plain old great. i think.

dear spacegurl, i’ve done what you’ve done so many times…hell, i’m not on any mood stabilizers right now (shhh!) actually, i’m going to my doctor to trade my (rash-inducing…but that was just me…) tegretol for what i’m guessing will be neurontin, since i’ve tried most others. my summary of life without meds: short term, i felt fine. long term, i never have really gotten better. i haven’t had any unusual catastrophes, but i’ve just never been able to really "heal." my mood/neuro-issues still interfere with my life. it’s cyclical, so somtimes i think i’ll be fine without… in fact, i stayed off meds for seven years. but i am coming back to try again. i haven’t been able to produce much artwork (except for my website) or hold a job for long, i feel alternately sad and without energy or frightened/agitated, and my boyfriend and i are increasingly socially isolated due to my having a panic attack half of the times we try to go out. note: i also haven’t been able to stick to an exercise schedule of any kind when depressed! this seems pathetic to me, as i used to take ballet, race bikes, etc. so i am urging you to try different meds instead- and on your terms. my first time on lithium, i gained a ton of weight and consequently felt so betrayed by my doctors, who didn’t even warn me…and i’ve also tried depakote. neither worked for me anyway… I do’nt see how any meds that make you gain weight can make you happy.  At least not for me.

i really do agree. as i’ve said before (on this newsgroup,) every med i try is a gamble- it may help, it may not. whereas i *k*n*o*w* that the more weight i gain, the more depressed i’ll get. it’s just common sense to be unwilling to take a drug that makes me depressed via weight gain when i’m taking it to alleviate depression in the first place! call it vanity if you wish, but that’s my philosophy. I know, I need to change my views on this, but hey…I am doing what I need to do.

i know- believe me. but before you leave the mystical world of psychopharmacology, i really wanted to show you this: – Hide quoted text — Show quoted text – Ask the Expert – Mood Disorder Meds Weigh In Q. What mood disorder medications are most likely/least likely to cause weight gain? Information on both bipolar and unipolar drug therapy would be appreciated. A. The following is a basic summary of the effects of various mood medications, and their usual effect on weight: Key +++ weight gain very likely, often exceeding 8 lbs ++ weight gain sometimes seen, usually modest (5-6 lbs) + weight gain uncommon (less than 5% of patients) and usually less than 5 lbs. Antidepressants Fluoxetine (Prozac), Sertraline (Zoloft), Paroxetine (Paxil) + Bupropion (Wellbutrin) + Venlafaxine (Effexor) + Tricyclics Elavil, Tofranil, Doxepin and others +++ Mood stabilizers Lithium +++ (average weight gain=9 lbs) Valproate (Depakote) ++ Carbamazepine (Tegretol) + Note: Some elderly patients actually lose weight while taking Prozac. These figures are based on the literature, and my own experience. Patients vary greatly in their responses, however, and there are always patients who gain weight when they weren’t supposed to on a given agent.

i’m admittedly not sure where i got this.. it was a well-established website that i found easily by entering "weight" and "bipolar" into a search engine. spacegurl, i just want to let you know that not all drugs cause fattening. some even encourage loss (wellbutrin has been known to cause a loss of over 5 pounds in about 25% of the people who take it, for example. i wouldn’t really recommend  it as the most effective drug out there, but your results may differ.) i haven’t seen most of your posts leading up to this, but if you’re really quitting meds over the weight issue alone, you still have a range of options you could try (tegretol, neurontin…) love and luck, selene

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Well,  I just thought I’d check in with you guyus and first of all thanks you all sooooooo much for your e-mails and responses on here.  they really did help me.  I know you guys think that I am drilling a hole in my foot doing what i"M doin, but I can’t think of any other way.  I’ve been off the stuff for about 3 days now..can’t really say I feel that bad…I actually feel BETTER….my body feel so much less sluggish and I want to DO stuff and I don’t feel uneven or unstable by any stretch of the imagination. I just feel good because this is actually turhing out to be an "up" week for me.  Maybe I don’t need the meds…  I dunno….things are on an upward curve for me at eh moment.  I feel great….great great great…..not upity, but just plain old great. i think. But the weight thing was just a pisser for me.  I do’nt see how any meds that make you gain weight can make you happy.  At least not for me.  I know, I need to change my views on this, but hey…I am doing what I need to do. I think it is great that people out there are able to get help w/ the medication.  I won’t ever go backk on the stuff….i won’t. never ever ever…yuck. So, just thought I"d let you all know I am doing excellent w/ out the meds! — For more information about this service, send e-mail to:

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Oh Blue, this is so true…. I was perfectly sane (cough cough cough) much however.  I would give my life for him… With Metta & Blessings,  Jehanne "It is good to have an end to journey toward;   but it is the journey that matters, in the end"             Ursula Le Guin

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says… you know, money tends to run in families. Maybe that’s biological too, like there’s a money gene or something. ..Don’t laugh, that’s the way these researchers think. On the lighter side, did you know that having children tends to run in families? If your parents didn’t have children, chances are you won’t either.

Did you know that insanity is hereditary?  You get it from your children. Bluebird oh, is *that* where it came from?

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you know, money tends to run in families. Maybe that’s biological too, like there’s a money gene or something. ..Don’t laugh, that’s the way these researchers think. On the lighter side, did you know that having children tends to run in families? If your parents didn’t have children, chances are you won’t either.

doh… Leslie — Mom always told me I could be whatever I wanted to be when I grew up, "within reason."  When I asked her what she meant by "within reason," she said, "You ask a lot of questions for a garbage man." – Jack Handey Visit My Website! http://www.flex.net/users/tuesday

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it’s CATCHING!!!!!!!

for *real* well, i don’t suppose i’ve ever actually *driven* someone to depression, but i know it’s *really* hard to live with a depressive person, specially someone who wants to prove how unlovable they are. anna xxx

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Owlgirl, Thanks for confirming something I long suspected!  lol Thanks for the chuckle. Brenda

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you know, money tends to run in families. Maybe that’s biological too, like there’s a money gene or something. ..Don’t laugh, that’s the way these researchers think. On the lighter side, did you know that having children tends to run in families? If your parents didn’t have children, chances are you won’t either.

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you know…both my parents (who, nb, are NOT my biologial parents) have depression and are on medication. Same with my ex-de facto, my uncle and aunt, and 3 close rl friends. I could never relate to it, but now, i’ve finally succumbed myself. aaaaaaaaaaaaaaaaaaaaaaaaaarrrrrrrrrrrrrrrrggggggghhhhhhhhhhh! this can only mean one thing: it’s CATCHING!!!!!!! warn all your friends and family….. owlgirl – who had a shitty aftyernoon, thanx to zoloft withdrawal, but who feels good cos you are all here, and is especially grateful for the posts from Cris/z, Eva Marisa, and kdaly. Thanx.  :)

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– Hide quoted text — Show quoted text – Doea anyone know if there is an effect on arthritis if you are in that time of your life when estrogen levels are behaving like the latest roller coaster from hell.  I know I read somewhere that this could impact one’s immune system and arthritis and Ijsut wondered if going on the birth control pill might even it out.  I am not yet menopausal but at 43 I am heading down that road soon. I know they will not start you on HRT until you are not having your period for at least 6 months.  I woul like to talk with someone who may have experienced this.  Thanks for your help! Nan

I am on HRT and I am menopausal.  Prior to menopause, my arthritis ebbed and flowed with the level of my estrogen.  As the estrogen dropped, the pain increased.  As you probably know, it’s the drop in estrogen–that brings on a period every month. For me, it also brought on pain. Four months ago, I started HRT. I would take Premarin (estrogen) for 25 days and Provera (progestin) for the last 9 of those 25 days.  Then nothing for 5 days.  As soon as I would start the progestin, I would get a killer flare. The gyn adjusted the Premarin dose (up) and I’ve been great since…no flare, more energy…not such a crab ass. Carol                 Human beings are flawed individuals…the cosmic bakers took us out a little too early.  That’s why we’re as crazy as we are—Jimmy Buffett

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 I know they will not start you on HRT until you are not having your period for  at least 6 months.

I didn’t know this,is it standard procedure? Shel – Hide quoted text — Show quoted text –

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Doea anyone know if there is an effect on arthritis if you are in that time of  your life when estrogen levels are behaving like the latest roller coaster  from hell.  I know I read somewhere that this could impact one’s immune system  and arthritis and Ijsut wondered if going on the birth control pill might even  it out.  I am not yet menopausal but at 43 I am heading down that road soon.  I know they will not start you on HRT until you are not having your period for  at least 6 months.  I woul like to talk with someone who may have experienced  this.  Thanks for your help! Nan

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Doea anyone know if there is an effect on arthritis if you are in that time of  your life when estrogen levels are behaving like the latest roller coaster  from hell.  I know I read somewhere that this could impact one’s immune system  and arthritis and Ijsut wondered if going on the birth control pill might even  it out.  I am not yet menopausal but at 43 I am heading down that road soon.  I know they will not start you on HRT until you are not having your period for  at least 6 months.  I woul like to talk with someone who may have experienced  this.  Thanks for your help!

Well, I’m perimenopausal, I have severe RA, and yep, fluctuations in hormone levels *do* have an effect.  In my case, I’ve always had a worsening of my symptoms during the pre-menstrual period, when estro- gen levels spike.  These days, I’m experiencing out-of-cycle spikes, with the same worsening in joint pain, swelling, and length of morn- ing stiffness. I’ve discussed the problem with both my RD and my gyn, but there’s been no mention of using birth-control pills to level out the effect. Actually, I wouldn’t use them if they did have this effect; I still remember vividly the surge in well-being I experienced when I stop- ped using Lo-Ovral years ago (this was a low-dose combination pill). My gyn has recommended evening primrose oil, on the basis of what other patients have told him — he believes it to be safe, and did not think it would conflict with my other medications.  I’ve done some checking on the web and I believe this is probably true, but I’m waiting to check with my RD before I start.  According to the abstracts available through Medline, trials of evening primrose oil both for RA and for menopausal flushing have shown no significant benefit, but neither did they report any significant difficulties. Stacy Scott

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Hi Nan and group, – Hide quoted text — Show quoted text – Doea anyone know if there is an effect on arthritis if you are in that time of your life when estrogen levels are behaving like the latest roller coaster from hell.  I know I read somewhere that this could impact one’s immune system and arthritis and Ijsut wondered if going on the birth control pill might even it out.  I am not yet menopausal but at 43 I am heading down that road soon. I know they will not start you on HRT until you are not having your period for at least 6 months.  I woul like to talk with someone who may have experienced this.  Thanks for your help! Nan

      I’m not perimenopausal but I did think that there might have been a  connection between my overall increase in disease activity in the last year,  year and a half and my going off the pill.  My gyn/RD said it would be worth a  shot, so I’m back on the pill now for about 4-5 months.  Can’t say there’s  been any noticable change as yet and I’ve also added sulfasalzine to the mix  in the last month, so I’m hedging my bets, I guess.        I’m sure if you did a search on Medline, you’d get some info.  A friend  sent me the following abstract after hearing of my decision to get back on the  pill and I’m sure there’s lots more. Best wishes, Denise Sex hormones and rheumatoid arthritis: cause or effect relationships in a complex pathophysiology? Abstract: Sex hormones are believed to contribute to the risk of rheumatoid  arthritis (RA) because of the disease’s female preponderance, especially during the child-bearing  years, and because of the dramatic improvements seen during pregnancy. Available controlled data on serum dehydroepiandrosterone sulfate (DHEAS), testosterone (T) and estradiol (E2) in  RA patients not treated with glucocorticoids are summarized. Hypotheses of sex hormone  contributions to RA are tested by judgemental criteria for the causes or determinants of disease.  Available data support hypoandrogenicity in RA patients, especially among premenopausal females and  males. Limited prospective studies in women and therapeutic trials of testosterone therapy in  men further support a role of sex hormones in RA. Interactions of sex hormones and glucocorticoids  are also believed to be important and deserve priority in future research. Author: Masi AT Address: University of Illinois College of Medicine at Peoria (UICOM-P) 61605,  USA. Abbreviated Journal Title: Clin Exp Rheumatol Date Of Publication: 1995 Mar-Apr Journal Volume: 13 Page Numbers: 227 through 240 Number of References: 105 Country of Publication: ITALY Language of Article: Eng Issue/Part/Supplement: 2 ISSN: 0392-856X MESH Headings: Animal Arthritis, Rheumatoid (Central Concept) Disease Models, Animal Female Gout Human Immunity Male Pregnancy Risk Factors Sex Hormones (Central Concept) Steroids Support, Non-U.S. Gov’t Chemical Abstract Service Registry Number: 0 (Sex Hormones) 0 (Steroids) Article ID: 95385254

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Before I developed the RA I was the study coordinator for PMS and Preimenapause  studies at the University of Pennsylvania Medical Center.  I agree, nono of  our data supports more than a placebo response from eveing primrose oil.  It  has some diaretic properties, so some women troubled with fluid retention may  experience some relief of that symptom only.   If you are taking an SSRI (Prozac, Zoloft, etc.) you may find that increasing  your dose during the premenstrual time decreases your symptoms.  Our research  showed strong evidence that PMS and preimenapausal symptoms could be reduced  by mid-cycle dosing, or mid-cycle increase.  I have seen good results during  studies, and I have good results increasing  my own Zoloft dose from 50 mg to  100mg pre-menstrually.  Good results meaning no increase in RD symptoms at  that time — not a reduction in overall symptoms. We were just doing some DHEA studies when I left, and I think that it an  interesting idea.  Be careful with DHEA from health food stores.  As DHEA is  not yet FDA approved except for research proposes as a medicine, it is not  regulated by the FDA for safety or efficacy.  Health Food store preparations  are regulated as a food, and purity and dose may vary widely. Donah Zack Crawford

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