Why the depression?

I have just recently switched from Prozac/Fluoxetine to Ciprimil/
Citalopram. Of the Prozac I was taking 20mg. The Doctor put me on 40mg
of Citalopram. It was a straight swope. Now I'm suffering mild
depression. I thought one SSRI would take straight over from another.
Or does the waiting period apply when changing meds? I changed meds
due to ongoing anxiety/panic attacks. These seem to have subsided,
although I can only report strange feelings and mil depression. I
guess my brain needs to re-adjust?

On 2007-04-02, ChrisC <chrispche@googlemail.com> wrote:
> I have just recently switched from Prozac/Fluoxetine to Ciprimil/
> Citalopram. Of the Prozac I was taking 20mg. The Doctor put me on 40mg
> of Citalopram. It was a straight swope. Now I'm suffering mild
> depression. I thought one SSRI would take straight over from another.
> Or does the waiting period apply when changing meds? I changed meds
> due to ongoing anxiety/panic attacks. These seem to have subsided,
> although I can only report strange feelings and mil depression. I
> guess my brain needs to re-adjust?

In my experience, there is always a period of adjustment when changing
from one AD to another. Both 'withdrawal symptoms' from the old one and a
delay before the new one's effects settle down.

--
-- ^^^^^^^^^^
-- Whiskers
-- ~~~~~~~~~~

tony@riddler.co.uk

i am cool


"ChrisC" <chrispche@googlemail.com> wrote in message
news:1175512569.982758.320940@b75g2000hsg.googlegr oups.com...
>I have just recently switched from Prozac/Fluoxetine to Ciprimil/
> Citalopram. Of the Prozac I was taking 20mg. The Doctor put me on 40mg
> of Citalopram. It was a straight swope. Now I'm suffering mild
> depression. I thought one SSRI would take straight over from another.
> Or does the waiting period apply when changing meds? I changed meds
> due to ongoing anxiety/panic attacks. These seem to have subsided,
> although I can only report strange feelings and mil depression. I
> guess my brain needs to re-adjust?
>

ChrisC <chrispche@googlemail.com> wrote:

> I have just recently switched from Prozac/Fluoxetine to Ciprimil/
> Citalopram. Of the Prozac I was taking 20mg. The Doctor put me on 40mg
> of Citalopram. It was a straight swope. Now I'm suffering mild
> depression. I thought one SSRI would take straight over from another.
> Or does the waiting period apply when changing meds?

It depends on which drug you have been on and which one you're going to
switch to. Your GP probably hasn't a clue about what the issues are and
what, if any, `off' period is advisable for most combinations of
antidepressants.

I've got a table published by the manufacturer of Mirtazapine which says
that when you switch from fluoxetine to citalopram:

`Serotinin syndrome possible, specific care needed'

- but with `++' next to the note, indicating that it's not just possible
(no +), not just likely (one +), but bloody likely.

In other words, you should have been under observation if nothing else
to see if you had any adverse reactions - your doctor's being negligent
with respect to your care..

> I changed meds
> due to ongoing anxiety/panic attacks. These seem to have subsided,
> although I can only report strange feelings and mil depression. I
> guess my brain needs to re-adjust?

Your doctor shouldn't have been such a fuckwit, that's the problem.

Medical ignorance causes folk like us a lot of problems. The quacks
just haven't a clue about psychotropic medication on the whole.

Rowland.


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Whiskers <catwheezel@operamail.com> wrote:

> On 2007-04-02, ChrisC <chrispche@googlemail.com> wrote:
> > I have just recently switched from Prozac/Fluoxetine to Ciprimil/
> > Citalopram. Of the Prozac I was taking 20mg. The Doctor put me on 40mg
> > of Citalopram. It was a straight swope. Now I'm suffering mild
> > depression. I thought one SSRI would take straight over from another.
> > Or does the waiting period apply when changing meds? I changed meds
> > due to ongoing anxiety/panic attacks. These seem to have subsided,
> > although I can only report strange feelings and mil depression. I
> > guess my brain needs to re-adjust?
>
> In my experience, there is always a period of adjustment when changing
> from one AD to another. Both 'withdrawal symptoms' from the old one and a
> delay before the new one's effects settle down.

Plenty of these drugs interact with each other. The interactions that
occur when you change over can cause evil problems, and potentially
death (but death is a worry only when you've got really unlucky and
MAOIs are involved as far as I can tell).

I've got a table here from a drug firm that indicates what you need to
watch out for and what `off' period you need between drugs.

Rowland.

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On 2007-04-02, Rowland McDonnell <real-address-in-sig@flur.bltigibbet> wrote:
> Whiskers <catwheezel@operamail.com> wrote:
>
>> On 2007-04-02, ChrisC <chrispche@googlemail.com> wrote:
>> > I have just recently switched from Prozac/Fluoxetine to Ciprimil/
>> > Citalopram. Of the Prozac I was taking 20mg. The Doctor put me on 40mg
>> > of Citalopram. It was a straight swope. Now I'm suffering mild
>> > depression. I thought one SSRI would take straight over from another.
>> > Or does the waiting period apply when changing meds? I changed meds
>> > due to ongoing anxiety/panic attacks. These seem to have subsided,
>> > although I can only report strange feelings and mil depression. I
>> > guess my brain needs to re-adjust?
>>
>> In my experience, there is always a period of adjustment when changing
>> from one AD to another. Both 'withdrawal symptoms' from the old one and a
>> delay before the new one's effects settle down.
>
> Plenty of these drugs interact with each other. The interactions that
> occur when you change over can cause evil problems, and potentially
> death (but death is a worry only when you've got really unlucky and
> MAOIs are involved as far as I can tell).
>
> I've got a table here from a drug firm that indicates what you need to
> watch out for and what `off' period you need between drugs.
>
> Rowland.

On the other hand, I've only taken a break when changing on one occasion,
and that was weaning slowly off something that didn't agree with me very
well - I forget which one that was. I've also forgotten how many
different ADs I've used.

--
-- ^^^^^^^^^^
-- Whiskers
-- ~~~~~~~~~~

"ChrisC" <chrispche@googlemail.com> wrote in message
news:1175512569.982758.320940@b75g2000hsg.googlegr oups.com...
>I have just recently switched from Prozac/Fluoxetine to Ciprimil/
> Citalopram. Of the Prozac I was taking 20mg. The Doctor put me on 40mg
> of Citalopram. It was a straight swope. Now I'm suffering mild
> depression. I thought one SSRI would take straight over from another.
> Or does the waiting period apply when changing meds? I changed meds
> due to ongoing anxiety/panic attacks. These seem to have subsided,
> although I can only report strange feelings and mil depression. I
> guess my brain needs to re-adjust?
>

I had fun switching from Mirtazapine to Clomipramine. Hallucinations,
feeling very unreal, hearing two songs going through my head at once, waking
up at 6am and writing 5 songs one after the other. If I hadn't been ill
with depression at same the time I wouldve enjoyed it.
As long as you're not on an MAOI or switching to one, then a straight swap
doesn't usually cause problems, but it is worth speaking to the doctor if
you're concerned about any effects you are getting. Mind you, Prozac does
take a while to wash out of your system because of its long metabolic half
life, so it might have been wise for the doc to have waited a while before
prescribing the replacement.

> "ChrisC" <chrispche@googlemail.com> wrote in message
> news:1175512569.982758.320940@b75g2000hsg.googlegr oups.com...
>>I have just recently switched from Prozac/Fluoxetine to Ciprimil/
>> Citalopram. Of the Prozac I was taking 20mg. The Doctor put me on 40mg
>> of Citalopram. It was a straight swope. Now I'm suffering mild
>> depression. I thought one SSRI would take straight over from another.
>> Or does the waiting period apply when changing meds? I changed meds
>> due to ongoing anxiety/panic attacks. These seem to have subsided,
>> although I can only report strange feelings and mil depression. I
>> guess my brain needs to re-adjust?
>>
>


I switched from Prozac to Citalopram a while back (med-free at the mo), and
I recall Doc telling me to expect the usual 3 weeks or so before
'kicking-in'. Can't remember much about how I felt at the time now, but the
switch was made because anxiety was a big problem, and it did help
eventually.

Whiskers schreef:
> On 2007-04-02, ChrisC <chrispche@googlemail.com> wrote:
>> I have just recently switched from Prozac/Fluoxetine to Ciprimil/
>> Citalopram. Of the Prozac I was taking 20mg. The Doctor put me on 40mg
>> of Citalopram. It was a straight swope. Now I'm suffering mild
>> depression. I thought one SSRI would take straight over from another.
>> Or does the waiting period apply when changing meds? I changed meds
>> due to ongoing anxiety/panic attacks. These seem to have subsided,
>> although I can only report strange feelings and mil depression. I
>> guess my brain needs to re-adjust?
>
> In my experience, there is always a period of adjustment when changing
> from one AD to another. Both 'withdrawal symptoms' from the old one and a
> delay before the new one's effects settle down.




IMO it would have been better to wean on Cipramil while weaning off of
Prozac. That's the smoothest way.

Philip
>

Rowland McDonnell schreef:
> ChrisC <chrispche@googlemail.com> wrote:
>
>> I have just recently switched from Prozac/Fluoxetine to Ciprimil/
>> Citalopram. Of the Prozac I was taking 20mg. The Doctor put me on 40mg
>> of Citalopram. It was a straight swope. Now I'm suffering mild
>> depression. I thought one SSRI would take straight over from another.
>> Or does the waiting period apply when changing meds?
>
> It depends on which drug you have been on and which one you're going to
> switch to. Your GP probably hasn't a clue about what the issues are and
> what, if any, `off' period is advisable for most combinations of
> antidepressants.




SSRI's are cross-tolerant and no 'off' period is needed while switching.
However, weaning on the new one whiole tapering off of the old one is
usually a smoother ride than switching overnight.
>

> I've got a table published by the manufacturer of Mirtazapine which says
> that when you switch from fluoxetine to citalopram:
>
> `Serotinin syndrome possible, specific care needed'
>
> - but with `++' next to the note, indicating that it's not just possible
> (no +), not just likely (one +), but bloody likely.
>
> In other words, you should have been under observation if nothing else
> to see if you had any adverse reactions - your doctor's being negligent
> with respect to your care..



I beg to differ. If the total amount of SSRI in the system isn't changed
there will be no problems with serotonin syndrome which essentially
implies an *overdose* of serotonin in a manner of speaking. One may also
wonder why the manufacturer of a rivalling (and much less effective) AD
should publish things pertaining to other ADs.

Philip


>

Whiskers <catwheezel@operamail.com> wrote:

[snip]

> On the other hand, I've only taken a break when changing on one occasion,
> and that was weaning slowly off something that didn't agree with me very
> well - I forget which one that was. I've also forgotten how many
> different ADs I've used.

Me too - but there are definitely risks involved. Not everyone gets
bitten by 'em, that's all.

Rowland.

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Philip Peters <philip@p-peters.demon.nl> wrote:

> Rowland McDonnell schreef:
> > ChrisC <chrispche@googlemail.com> wrote:
> >
> >> I have just recently switched from Prozac/Fluoxetine to Ciprimil/
> >> Citalopram. Of the Prozac I was taking 20mg. The Doctor put me on 40mg
> >> of Citalopram. It was a straight swope. Now I'm suffering mild
> >> depression. I thought one SSRI would take straight over from another.
> >> Or does the waiting period apply when changing meds?
> >
> > It depends on which drug you have been on and which one you're going to
> > switch to. Your GP probably hasn't a clue about what the issues are and
> > what, if any, `off' period is advisable for most combinations of
> > antidepressants.
>
> SSRI's are cross-tolerant and no 'off' period is needed while switching.

That is not the case with all combinations - there is a risk of
serotonin syndrome when switching between some combinations of SSRI
according to the medical chart I have here.

[snip]

> > I've got a table published by the manufacturer of Mirtazapine which says
> > that when you switch from fluoxetine to citalopram:
> >
> > `Serotinin syndrome possible, specific care needed'
> >
> > - but with `++' next to the note, indicating that it's not just possible
> > (no +), not just likely (one +), but bloody likely.
> >
> > In other words, you should have been under observation if nothing else
> > to see if you had any adverse reactions - your doctor's being negligent
> > with respect to your care..
>
> I beg to differ.

What is your qualification?

Are you a pharmacist or a doctor, or working from a reliable reference
source?

If not, what validity does your opinion have?

I am not expressing *my* opinion on the matter of these drugs - I'm
forwarding some information from a reliable source.

I got my information from a chart from a drug company printed for
doctors entitled `A guide to switching antidepressants' (the doctor
concerned had several for some reason - I asked for one, and got it).

[snip]

Rowland.


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Rowland McDonnell, wrote:

>I am not expressing *my* opinion on the matter of these drugs - I'm
>forwarding some information from a reliable source.
>
>I got my information from a chart from a drug company

lol now THAT is a reliable source ;o>

I think Philip is correct re: weaning of one while slowly increasing
dose of another is a safe way to go. Switching abruptly shouldn't be
too bad as well, but, as Whiskers pointed out, some adjustment is
often necessary. Serotonin syndrome doesn't usually involve feeling
mildly depressed, instead there are a lot of weird physical symptoms.
On the other hand, there is a "prozac poop-out" effect. Some research
also suggests that for people who took a number of antidepressants in
their life, every next one can be less effective than the one
before.

Yan

I would have to politely disagree. Because of the very long half-life
of Prozac, and the very potent nature of Citalopram, going right from
the one to the other does present (during the first week or so) some
risk of having one's serotonin level go up too high. On the other
hand, to be fair, I haven't seen serotonin syndrome happen an awful
lot.

As I'm sure you're aware, being on more than one SSRI does increase
the risk of going into a serotonin syndrome. As Prozac leaves the
body so slowly, the first week of being on Celexa is essentially like
being on both, because so little of the Prozac has been metabolized
out.

At this point, if it hasn't taken place, it (serotonin syndrome) isn't
likely to, so it's probably a non-issue. If the OP has been on
multiple anti's, perhaps it's time to start looking at the other
aspects of effect on the affect, and treatment alternatives. Always
discuss with your physician prior to changing any medication or
dosage.

G

<yanleykin@gmail.com> wrote:

> I think Philip is correct re: weaning of one while slowly increasing
> dose of another is a safe way to go.

What do you think you are doing, providing dangerous misinformation?

Do you have any qualifications in the field that give you any authority
to make that statement?

Are you a doctor or a pharmacist? Do you have *any* expertise in the
field? A reliable medical reference to hand?

I think you're just talking off the top of your head and you've no
personal expertise and no medical references.

I *DO* have proper official printed information from pukka medical
experts doing their level best to provide accurate information.

Based on my comparison of what you think with what the medical experts
think, I think you're wrong.

> Switching abruptly shouldn't be
> too bad as well,

It can cause a risk of death if you switch from an MAOI to `pretty much
anything else' without a gap.

The recommended gap switching from any MAOI to anything else is a
fortnight. From fluoxetine (Prozac - a long `half-life' drug) to an
MAOI, a five week gap is recommended by the official medical references.

What's your expertise? I don't have any in this field, and I'm not
pretending that I do - but I've got a reference work here published for
doctors, and I'm inclined to trust it.

[snip]

Rowland.

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Rowland McDonnell schreef:
> Philip Peters <philip@p-peters.demon.nl> wrote:
>
>> Rowland McDonnell schreef:
>>> ChrisC <chrispche@googlemail.com> wrote:
>>>
>>>> I have just recently switched from Prozac/Fluoxetine to Ciprimil/
>>>> Citalopram. Of the Prozac I was taking 20mg. The Doctor put me on 40mg
>>>> of Citalopram. It was a straight swope. Now I'm suffering mild
>>>> depression. I thought one SSRI would take straight over from another.
>>>> Or does the waiting period apply when changing meds?
>>> It depends on which drug you have been on and which one you're going to
>>> switch to. Your GP probably hasn't a clue about what the issues are and
>>> what, if any, `off' period is advisable for most combinations of
>>> antidepressants.
>> SSRI's are cross-tolerant and no 'off' period is needed while switching.
>
> That is not the case with all combinations - there is a risk of
> serotonin syndrome when switching between some combinations of SSRI
> according to the medical chart I have here.
>
> [snip]
>
>>> I've got a table published by the manufacturer of Mirtazapine which says
>>> that when you switch from fluoxetine to citalopram:
>>>
>>> `Serotinin syndrome possible, specific care needed'
>>>
>>> - but with `++' next to the note, indicating that it's not just possible
>>> (no +), not just likely (one +), but bloody likely.
>>>
>>> In other words, you should have been under observation if nothing else
>>> to see if you had any adverse reactions - your doctor's being negligent
>>> with respect to your care..
>> I beg to differ.
>
> What is your qualification?
>
> Are you a pharmacist or a doctor, or working from a reliable reference
> source?
>
> If not, what validity does your opinion have?
>
> I am not expressing *my* opinion on the matter of these drugs - I'm
> forwarding some information from a reliable source.
>
> I got my information from a chart from a drug company printed for
> doctors entitled `A guide to switching antidepressants' (the doctor
> concerned had several for some reason - I asked for one, and got it).
>
> [snip]
>
> Rowland.




I would be very interested to read it. Can you post it here?
No, I'm not a doctor (but I know a lot of them ;-) Although I never
heard about this - having talked to hundreds of people many of whom
including myself switched ADs by tapering off one and weaning on another
one simultaneously - there may be some truth in it although I'm not
inclined to take anything given out by Big Pharma to promote their own
drug as gospel. Prozac having a long half life the weaning process
should maybe be slower than with other SSRI's but I *never* heard of
anyone developing serotonin syndrome from this. But I have no
qualifications to pretend what I say is gospel either ;-)

Philip

Hi Rowland,

Here are a couple of references. By the way -- I agree re: MAOIs, but
he is switching from one SSRI to another.

http://www.patientcareonline.com/pat....jsp?id=133654
http://patients.uptodate.com/topic.a...=psychiat/5069
http://www.parkhurstexchange.com/qa/.../2005-02-02.qa

However, this chart seems to agree with you -- maybe the same one you
have?
http://www.gpnotebook.co.uk/cache/1651179592.htm

As a compromise, here's one review showing mixed results from various
switchings.
http://www.ptcommunity.com/ptJournal...PTJ3012740.pdf

I think it might come down to a compromise between going medication
free for a while, and risking some side effects. Depending on the
dose and the drug, risk of SE can be small, and the risk of relapse
due to being med-free is high. Either way, mild depression, as Chris
seems to have, is not a symptom of serotonin syndrome, as far as I
know, and he didn't mention having an fever, tremors, hypertension,
etc.

As Gary pointed out, with Prozac a more careful tapering off may be
warranted, due to the longer life of flouxetine. I do recall reading
something about it.

Best,
Yan

On Apr 3, 5:52 am, real-address-in-...@flur.bltigibbet (Rowland
McDonnell) wrote:
> <yanley...@gmail.com> wrote:
> > I think Philip is correct re: weaning of one while slowly increasing
> > dose of another is a safe way to go.
>
> What do you think you are doing, providing dangerous misinformation?
>
> Do you have any qualifications in the field that give you any authority
> to make that statement?
>
> Are you a doctor or a pharmacist? Do you have *any* expertise in the
> field? A reliable medical reference to hand?
>
> I think you're just talking off the top of your head and you've no
> personal expertise and no medical references.
>
> I *DO* have proper official printed information from pukka medical
> experts doing their level best to provide accurate information.
>
> Based on my comparison of what you think with what the medical experts
> think, I think you're wrong.
>
> > Switching abruptly shouldn't be
> > too bad as well,
>
> It can cause a risk of death if you switch from an MAOI to `pretty much
> anything else' without a gap.
>
> The recommended gap switching from any MAOI to anything else is a
> fortnight. From fluoxetine (Prozac - a long `half-life' drug) to an
> MAOI, a five week gap is recommended by the official medical references.
>
> What's your expertise? I don't have any in this field, and I'm not
> pretending that I do - but I've got a reference work here published for
> doctors, and I'm inclined to trust it.
>
> [snip]
>
> Rowland.
>
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Philip Peters <philip@p-peters.demon.nl> wrote:

> Rowland McDonnell schreef:
> > Philip Peters <philip@p-peters.demon.nl> wrote:
[snip]

> >>> I've got a table published by the manufacturer of Mirtazapine which
> >>> says that when you switch from fluoxetine to citalopram:
> >>>
> >>> `Serotinin syndrome possible, specific care needed'
> >>>
> >>> - but with `++' next to the note, indicating that it's not just
> >>> possible (no +), not just likely (one +), but bloody likely.
> >>>
> >>> In other words, you should have been under observation if nothing else
> >>> to see if you had any adverse reactions - your doctor's being
> >>> negligent with respect to your care..
> >> I beg to differ.
> >
> > What is your qualification?
> >
> > Are you a pharmacist or a doctor, or working from a reliable reference
> > source?
> >
> > If not, what validity does your opinion have?
> >
> > I am not expressing *my* opinion on the matter of these drugs - I'm
> > forwarding some information from a reliable source.
> >
> > I got my information from a chart from a drug company printed for
> > doctors entitled `A guide to switching antidepressants' (the doctor
> > concerned had several for some reason - I asked for one, and got it).
[snip]

> I would be very interested to read it. Can you post it here?

Well, it's an A4 wall chart - I extracted the information from the it
that applied to the particular case being asked about.

Rendering the whole of it on Usenet wouldn't be trivial - I can't see
the OCR software doing a very good job with it, for example (lots of
colours, layout, and printing in both black and white).

> No, I'm not a doctor (but I know a lot of them ;-) Although I never
> heard about this

Are you sure that no-one you've come across has ever suffered from
sweating, diarrhoea, myoclonus, shivering, hyper-reflexia, or tremor
upon switching antidepressants? (the symptoms of serotinin syndrome)

I know I'm not.

>- having talked to hundreds of people many of whom
> including myself switched ADs by tapering off one and weaning on another
> one simultaneously

Anecdotal evidence can only take you so far - which is a point that
doctors don't seem to understand themselves.

> - there may be some truth in it although I'm not
> inclined to take anything given out by Big Pharma to promote their own
> drug as gospel.

It's a medical reference chart. If a drug firm gave out something like
that in the UK and it was wrong, they'd suffer badly. One can be
confident that the information supplied on it was identical to the
standard medical references of the time - although new evidence might
have come along by now.

I once knew a drug pusher as it happens (worked for Pharmax, but gave it
up in disgust and went into homoeopathy) - he explained just how
*insanely* careful they have to be when putting together any sort of
material at all that refers to medical anything. That's why I'm sure
the information matches what the standard medical references of the time
said.

Of course, one of the problems is that the standard references rely in
large part on drug company test results - but you can't have everything,
can you?

> Prozac having a long half life the weaning process
> should maybe be slower than with other SSRI's

Why guess? Why not look up a drug reference? I wouldn't guess about
this sort of thing.

>but I *never* heard of
> anyone developing serotonin syndrome from this. But I have no
> qualifications to pretend what I say is gospel either ;-)

I've never heard of anyone specific getting it either - but note I'm not
sure I'd've remembered or even been told about the symptoms, and the
evidence I have here convinces me that there's a very real risk.


Rowland.

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<yanleykin@gmail.com> wrote:

> Hi Rowland,
>
> Here are a couple of references. By the way -- I agree re: MAOIs, but
> he is switching from one SSRI to another.

Yes, I know - and what qualifies you to offer a personal opinion on any
part of this matter? Are you a pharmacist or a doctor or someone else
with reliable, detailed information in your brain?

I'm not offering a personal opinion: I'm just relaying some information
from a reliable source.

[snip]

> However, this chart seems to agree with you -- maybe the same one you
> have?
> http://www.gpnotebook.co.uk/cache/1651179592.htm

Er, no, as I said, I have a proper doctor's wallchart.

[snip]

Rowland.

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On Apr 3, 7:49 pm, real-address-in-...@flur.bltigibbet (Rowland
McDonnell) wrote:
> <yanley...@gmail.com> wrote:
> > Hi Rowland,
>
> > Here are a couple of references. By the way -- I agree re: MAOIs, but
> > he is switching from one SSRI to another.
>
> Yes, I know - and what qualifies you to offer a personal opinion on any
> part of this matter? Are you a pharmacist or a doctor or someone else
> with reliable, detailed information in your brain?
>
> I'm not offering a personal opinion: I'm just relaying some information
> from a reliable source.
>

Well, in this case I also wasn't offering a personal opinion, just
relaying some information from the links I posted. Unfortunately,
almost no information in my brain is either reliable or detailed,
therefore I have to refer to other people's work (which I posted).

Best,
Yan

<yanleykin@gmail.com> wrote:

> (Rowland McDonnell) wrote:
> > <yanley...@gmail.com> wrote:
> > > Hi Rowland,
> >
> > > Here are a couple of references. By the way -- I agree re: MAOIs, but
> > > he is switching from one SSRI to another.
> >
> > Yes, I know - and what qualifies you to offer a personal opinion on any
> > part of this matter? Are you a pharmacist or a doctor or someone else
> > with reliable, detailed information in your brain?
> >
> > I'm not offering a personal opinion: I'm just relaying some information
> > from a reliable source.
> >
>
> Well, in this case I also wasn't offering a personal opinion,

So when you said `I agree', that was in what way not offering a personal
opinion?

> just
> relaying some information from the links I posted. Unfortunately,
> almost no information in my brain is either reliable or detailed,
> therefore I have to refer to other people's work (which I posted).

Hmm - but is any of what you posted reliable? I don't see any
particular reason to trust it.

Rowland.

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>
> So when you said `I agree', that was in what way not offering a personal
> opinion?

We already had a conversation about semantics, word usage, etc --
remember?


>
> Hmm - but is any of what you posted reliable? I don't see any
> particular reason to trust it.
>

The review article seemed pretty good -- balanced. By the way, at
least I post my references when I offer "opinions" -- where are
yours?

Yan

<yanleykin@gmail.com> wrote:

> > So when you said `I agree', that was in what way not offering a personal
> > opinion?
>
> We already had a conversation about semantics, word usage, etc --
> remember?

I haven't the faintest idea what you are talking about.

The point is that you were offering a personal opinion, then claimed
that you were not.

> > Hmm - but is any of what you posted reliable? I don't see any
> > particular reason to trust it.
>
> The review article seemed pretty good -- balanced.

So what? I've read plenty of `balanced' sounding things that are just
plain wrong.

> By the way, at
> least I post my references when I offer "opinions" -- where are
> yours?

I've not offered a personal opinion.

What is your point, exactly?

Rowland.

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> > We already had a conversation about semantics, word usage, etc --
> > remember?
>
> I haven't the faintest idea what you are talking about.

I'm the grad student that posted request for participants a few months
ago. You advised me to read Korzybski -- remember?


> The point is that you were offering a personal opinion, then claimed
> that you were not.

Ok, fine, it was a personal opinion, based on my understanding of the
literature, as well as some knowledge of the practices that goes on
clinics.


> So what? I've read plenty of `balanced' sounding things that are just
> plain wrong.
>

Published in a reasonably good peer-reviewed journal, seems relatively
un-biased. Of course, every one decides for themselves what he or she
trusts. You have your chart, other people refer to other things.

Yan

<yanleykin@gmail.com> wrote:

> > > We already had a conversation about semantics, word usage, etc --
> > > remember?
> >
> > I haven't the faintest idea what you are talking about.
>
> I'm the grad student that posted request for participants a few months
> ago. You advised me to read Korzybski -- remember?

Quite, but I still haven't a clue what you're talking about.

> > The point is that you were offering a personal opinion, then claimed
> > that you were not.
>
> Ok, fine, it was a personal opinion, based on my understanding of the
> literature, as well as some knowledge of the practices that goes on
> clinics.

Right - but you're not actually qualified in any way to have a reliable
personal opinion in this matter, though? You're not, are you?

I have my personal opinions on this subject, also based on my
understanding of the literature, as well as quite a lot of knowledge of
current medical practice and current official guidelines and research
results.

I've not presented those opinions. Why? Because I'm not adequately
well informed, despite the fact that I probably know as much as you.
Neither of us well enough informed to offer a personal opinion on this.
So I'm not; but you are.

> > So what? I've read plenty of `balanced' sounding things that are just
> > plain wrong.
>
> Published in a reasonably good peer-reviewed journal, seems relatively
> un-biased. Of course, every one decides for themselves what he or she
> trusts. You have your chart, other people refer to other things.

It's not mine: it's a doctor's chart.

You're being dishonest when you call it my chart: it's an underhand
attempt on your part to belittle my claim.

Where did this chart I have been referring to come from? Well, unlike
what you're trying to imply with your underhand wording, my source is a
confirmed reliable source - much more so than a single article in a peer
reviewed journal, and much more so than the Web.

Why is it more reliable? Because it's a drug company freebie for
doctors providing medical information.

Now, I know a bit about how these things are compiled and what
environment they are distributed in.

And these are the facts: the chart I have is a distillation of the
`contemporary consensus view as published in all the literature and
reviewed by the profession at large'. It has to be: if it weren't, the
drug company would have been sued.

The only *legitimate* concern you might raise is about that chart is
when it was published - 1999. New data comes along; I would expect, for
example, for there to be some warnings about switching to/from
mirtazapine by now (the drug the chart was created to market - it's one
of the two drugs that's got no specific problems reported when switching
except in the case of MAOIs; the other one is reboxetine (ditto re:
MAOIs)).

Rowland.

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On Apr 5, 2:39 pm, real-address-in-...@flur.bltigibbet (Rowland
McDonnell) wrote:
> <yanley...@gmail.com> wrote:
> > > > We already had a conversation about semantics, word usage, etc --
> > > > remember?
>
> > > I haven't the faintest idea what you are talking about.
>
> > I'm the grad student that posted request for participants a few months
> > ago. You advised me to read Korzybski -- remember?
>
> Quite, but I still haven't a clue what you're talking about.
>
> > > The point is that you were offering a personal opinion, then claimed
> > > that you were not.
>
> > Ok, fine, it was a personal opinion, based on my understanding of the
> > literature, as well as some knowledge of the practices that goes on
> > clinics.
>
> Right - but you're not actually qualified in any way to have a reliable
> personal opinion in this matter, though? You're not, are you?
>
> I have my personal opinions on this subject, also based on my
> understanding of the literature, as well as quite a lot of knowledge of
> current medical practice and current official guidelines and research
> results.
>
> I've not presented those opinions. Why? Because I'm not adequately
> well informed, despite the fact that I probably know as much as you.
> Neither of us well enough informed to offer a personal opinion on this.
> So I'm not; but you are.
>
> > > So what? I've read plenty of `balanced' sounding things that are just
> > > plain wrong.
>
> > Published in a reasonably good peer-reviewed journal, seems relatively
> > un-biased. Of course, every one decides for themselves what he or she
> > trusts. You have your chart, other people refer to other things.
>
> It's not mine: it's a doctor's chart.
>
> You're being dishonest when you call it my chart: it's an underhand
> attempt on your part to belittle my claim.
>
> Where did this chart I have been referring to come from? Well, unlike
> what you're trying to imply with your underhand wording, my source is a
> confirmed reliable source - much more so than a single article in a peer
> reviewed journal, and much more so than the Web.
>
> Why is it more reliable? Because it's a drug company freebie for
> doctors providing medical information.
>
> Now, I know a bit about how these things are compiled and what
> environment they are distributed in.
>
> And these are the facts: the chart I have is a distillation of the
> `contemporary consensus view as published in all the literature and
> reviewed by the profession at large'. It has to be: if it weren't, the
> drug company would have been sued.
>
> The only *legitimate* concern you might raise is about that chart is
> when it was published - 1999. New data comes along; I would expect, for
> example, for there to be some warnings about switching to/from
> mirtazapine by now (the drug the chart was created to market - it's one
> of the two drugs that's got no specific problems reported when switching
> except in the case of MAOIs; the other one is reboxetine (ditto re:
> MAOIs)).
>
> Rowland.
>
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> Remove the animal for email address: rowland.mcdonn...@dog.physics.org
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As I've said, each of us gets to choose what we believe based on the
best information available to us. On the basis of this, we get to
choose what information we pass on to others. You have your (surely
extremely reliable) sources, and I (while fully acknowledging your
extremely reliable sources) pointed out a few others. We both passed
along information from our sources, even though, as you point out,
neither of us is fully qualified to do so. Others can look at the
chart that you have in your possession (or at least your description
of it) and at some of the things that I posted above and decide for
themselves. Neither of us are in possession of the ultimate truth, as
far as I know.

Yan

<yanleykin@gmail.com> wrote:

[snip]

> As I've said, each of us gets to choose what we believe based on the
> best information available to us.

But you are wrong. And you are still being dishonest.

I am not operating on `belief'. I've never had any time for that.
There's clearly no point in trying to have a discussion with you: you're
just a belittler who's not interested in trying to understand, just
pushing your personal beliefs on others.

[snip]

Rowland.

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On Apr 5, 4:14 pm, real-address-in-...@flur.bltigibbet (Rowland
McDonnell) wrote:
> <yanley...@gmail.com> wrote:
>
> [snip]
>
> > As I've said, each of us gets to choose what we believe based on the
> > best information available to us.
>
> But you are wrong. And you are still being dishonest.
>
> I am not operating on `belief'. I've never had any time for that.
> There's clearly no point in trying to have a discussion with you: you're
> just a belittler who's not interested in trying to understand, just
> pushing your personal beliefs on others.

And it is your choice to believe that about me as well.

Best,
Yan

Rowland McDonnell, wrote:

>I am not operating on `belief'. I've never had any time for that.

lol you have no time to form your own beliefs and belief system?

you must be one very busy dude. how do you make decisions if you have no
beliefs?

good grief!

you really are a bore to me. that's my opinion. i even believe you are a bore
to many. it's just a belief and it didn't take much time at all to form ;o>

the schmuck won't see this i guess, seeing as he's posting from the uk
depression group.

bear doesn't cross post
http://www.youtube.com/watch?v=7_VlVckrUgY