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A lot of our information comes from direct personal experience, along with that of our friends, and that of the many people who posted all the incarnations of Crazy Talk: the Crazymeds forum various online support groups, consumer review sites, and the like - what’s known in the trade as anecdotal evidence. I had thought that all sites about meds skewed negative, but this study found that sites run by medical professionals were more neutral-to-positive about meds, so that makes me feel a lot better about the data I’ve gathered from them1. As I also gather data from sites that have nothing to do with medication and medical conditions, I’m pretty confident about both the size and spectrum of any online sampling I do. Most of them are not random sites either, but are targeted based on demographic data I’ve collected since I noticed people with certain brain cooties tend to participate in similar activities or have similar interests, and that some sites about those activities/interests have an off-topic area dedicated to the specific mental health issue (depression, anxiety, etc.), or migraines, epilepsy, whatever. Of course anyone with some other form of brain cooties would post something in that area, but you get the idea. I’d give some examples, but since Big Pharma refuses to buy any ads because I am, in the words of one Big Pharma ad buyer, “too unpredictable,” I’m not going to give them any leads to a shitload of potential customers for free.
Just the Facts
We also sit on our asses all day long and do a bunch of research. We find a study that is of interest and we put a link to it or an article about it within the page on the med in question. So there are many specific articles and studies that we’ve referenced throughout this site, either by direct link to the source (when available online) or by quaint footnotes (when we read it in something not available online). However there are a few works that we’ve built upon as a foundation, and that we also reference to check on certain things. This isn’t a static list. Paper is by far the superior medium, expensive though it may be.
Here are the key books, papers, and sites that comprise the foundation of what we know about neuropsychopharmacology.
Putting the Mental in “Reading is Fundamental”Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications (Essential Psychopharmacology Series) Third edition by Stephen M. Stahl © 2008 Published by Cambridge University Press. Primer of Drug Action 12th edition by Robert M. Julien Ph.D, Claire D. Advokat, Joseph Comaty © 2011 Published by Worth Publishers. The Prescriber’s Guide (Essential Psychopharmacology Series) Third edition by Stephen Stahl © 2009 Published by Cambridge University Press. Clinical Handbook of Psychotropic Drugs 18th edition Adil S. Virani, K. Bezchlibnyk-Butler, J. Jeffries © 2009 Published by Hogrefe & Huber Publishers. Essential Neuropharmacology: The Prescriber’s Guide Stephen D. Silberstein, Michael J. Marmura © 2010 Published by Cambridge University Press. Mosby’s Drug Consult 2007 (Generic Prescription Physician’s Reference Book Series) © 2007 An imprint of Elsevier. Also the 2004 edition, but only on pages that haven’t been fully updated yet. Evidence-based Psychopharmacology Dan Stein, Bernard Lerer, Stephen Stahl © 2005 Published by Cambridge University Press. Antiepileptic Drugs René H. Levy, Richard H. Mattson, Brian S. Meldrum, Emilio Perucca © 2003 Instant Psychopharmacology 2nd Edition Ronald J. Diamond MD © 2002. Published by W.W. Norton Pharmacotherapy for Mood, Anxiety, and Cognitive Disorders Stuart A. Montgomery, Halbreich Uriel © 2000 Published by American Psychiatric Publishing The Complete Guide to Psychiatric Drugs Edward Drummond, MD © 2000. Published by John Wiley & Sons, Inc. PDR: Physicians’ Desk Reference 2010 64th edition back through to 53rd edition of 1999. Old copies of the PDR come in handy for PI sheets that are no longer available and difficult to find, as well as to track the changes in both indications and adverse effects. The Bipolar Disorder Survival Guide David J. Miklowitz, Ph.D © 2002. Published by The Guilford Press. Handbook of Affective Disorders edited by Eugene S. Paykel, MD FRCPsych Living Well with Depression and Bipolar Disorder: What Your Doctor Doesn’t Tell You…That You Need to Know John McManamy Clinical Neurology for Psychiatrists David Myland Kaufman MD © 2001 W.B. Saunders Company. An imprint of Elsevier The New Chemotherapy in Mental Illness edited by Hirsch L. Gordon MD, Ph.D, FAPA © 1958 Philosophical Library, Inc. Published by Philosophical Library
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If you’re more of a cheapskate than I am, here are some awesome online resources.
Neurotransmitter.net Tons of information and research on psychiatric and neurological conditions, the drugs that treat them, and the rating scales used to measure the efficacy of said drugs. All neatly indexed and categorized to make it easy to make sense of a bunch of diverse information. I had no idea how much research was being done on hangovers until I hit this site. I knew doctors liked to party (considering that my stepfather is a vascular surgeon I had a first-hand look at how much doctors liked to party), but who knew they were getting grant money for it? A key site for patients, students and, most importantly, doctors of all stripes, shapes and sizes.
Sheldon Preskorn’s Applied Clinical Psychopharmacology Dr. Preskorn has authored over 300 scientific and professional articles, and many of them are available at this site, which is full of useful psychopharmacological data involving drug-drug interactions, methods of actions, clinical efficacies, pharmacokinetics and more written in a fairly accessible way. Dr. Preskorn has received continuous grant funding since 1978 for studies in the areas of psychopharmacology, neuroscience, and psychiatric illnesses. While most of the articles are at least ten years old, Dr. Preskorn is still publishing papers, so we might be seeing new material eventually. Regardless, he covers the basics of psychopharmacology in a way that makes sense, and the basics haven’t changed much.
PubMed You want studies, they got studies. Over 14 million citations covering 50 years of research. You’ll find the majority of my online cites reference a Pub Med URL. Especially helpful is PubMed Central, the repository of full-text articles and online books that are available free of charge. These are your tax dollars at work, people, make good use of them.
PLoS Medicine. The Public Library of Science is another great repository of free, peer-reviewed articles.
Google Scholar. For anything that may have slipped through the cracks of PubMed and PLoS. As with PubMed (but not PubMed Central or PLoS), not everything listed as a free full-text article is. Unlike PubMed, sometimes there are free full-text versions when it looks as if there isn’t. Whenever you see an option for “All # Versions”, click it, as there may be a link to a full-text version that didn’t make the main page for some reason. And if that link to a full-text version was a bait’n’switch job, maybe one of the other versions has the full text for free for real.The PDSP Ki database All Ki values, all the time. These are the raw numbers used to determine the potency of certain aspects of the freebase form (E.g.: paroxetine, but what is actually in a pill of Paxil is paroxetine HCl; while Tegretol is full of freebase carbamazepine) such as neurotransmitter reuptake inhibition. Potency has nothing to do with efficacy. Neuroscience Online, the Open-Access Neuroscience Electronic Textbook From the University of Texas, one of the best places on the planet for the study of psychiatric and neurological conditions. Making this combination text book and lecture series available for free is as awesome as its contents.
Global RPh - I don’t know if they have everything you need to pass the MCATs and get you through medical school, but it sure seems that way.Genetic Basis of Drug Metabolism Is low antiepileptic drug dose effective in long-term seizure-free patients? Tânia A.M.O. Cardoso; Fernando Cendes; Carlos A.M. Guerreiro Arquivos de Neuro-Psiquiatria vol.61 no.3A Sept. 2003 Monoamine depletion by reuptake inhibitors Marty Hinz; Alvin Stein; Thomas Uncini Drug, Healthcare and Patient Safety, October 2011 - Dove Press
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Pictures Worth Millions of Words
To give you an idea of what the Crazymeds library looks like, on the left is the primary Crazymeds library. Note all the journals on the lower shelves. Some of my articles will have references to papers with no links. Now you see why. I don’t like to link to the abstract as I, and other people without subscriptions to online services, will use abstracts alone as source material. I try to avoid that, but sometimes everything I need is in the abstract. So if I read it in a journal and it’s not available online, I don’t link to the abstract. That’s Bes on top of the bookcase. Here’s a little more about Bes.
On the right is a shot of some of the older material I used and most of the old medical texts I’ve collected. Those really battered ones are versions of the PDR from the late 19th century, when everything was just ingredients and all pharmacies were compounding pharmacies. The two small books next to The United States Dispensatory 23rd edition (1943) are formularies from 1904 and 1922. Not a list of meds 100-year-old insurance plans covered, but the actual recipes for treatments of different conditions. What did they give people for mania in 1922? One treatment is a mix of potassium bromide (one of the few working AEDs of its time, and one still used today to treat epilepsy in animals, and people in countries where phenobarbital is reserved for the rich) and a tincture of cannabis (which far too many of the bipolar self-medicate with). I guess things haven’t changed all that much.
You think your side effects are bad today? Some of the bromides make leprosy look good. Little wonder why many epileptics chose the accepted the alternative therapy of the day: bland foods, lukewarm baths, isolation from society, and celibacy2 instead of the available meds. Just like the ketogenic diet it supposedly worked better the younger one began. Now how many monks and nuns had religious visions? That’s Ek Balam, Bes’ sibling, on top of the bookcase.
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1 And I feel so…Fox News when a study that uses Crazymeds as a major source of its data proves me wrong.
2 Wait a minute, I'm on a highly restrictive diet, I live on the fringes of civilization, I'll not interact with another person - even over teh interwebs - for weeks at a time, I'll soak in the tub for a couple of hours, and I haven't been laid in… what year is this? W. was still President and the economy hadn't tanked the last time I had any fun, and I haven't been in anything close to a relationship with regular congress since 2004. It's not perfect - if my Topamax levels get hosed by a funky generic sometimes I'll have an aura first thing in the morning or wake up with a seizure hangover - but both my seizure control and bipolar symptoms have been a lot better. Jackson knew his shit.
Crazymeds’ General Bibliography by Jerod Poore is copyright © 2011 Jerod Poore
|Last modified on Monday, 24 March, 2014 at 16:05:04 by JerodPoore||Page Author: Jerod Poore||Date created: 31 January 2011|
All drug names are the trademarks of someone else. Look on the appropriate PI sheets or ask Google who the owners are. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of any trademarks may have changed without my noticing.
Page design and explanatory material by Jerod Poore, copyright © 2004 - 2014. All rights reserved.
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Almost all of the material on this site is by Jerod Poore and is copyright © 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, and 2014 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.
All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else.
Know your sources!
Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained through our personal experience and the experiences family, friends, what people have reported on various reputable sites all over teh intergoogles, the medications’ product information / summary of product characteristic (PI/SPC) sheets, and from sources that are referenced throughout the site. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or patient information leaflet (PIL) that comes with your medications and never ever throw them away.
Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
All brand names of the drugs listed in this site are the trademarks of the companies named on the PI/SPC sheet associated with the medication, sometimes on the pages about the drugs, even though those companies may have been acquired by other companies who may or may not be listed in this site by the time you read this. Or the rights to the drug were sold to another company. And any or all of the companies involved may have changed their names.
Crazymeds is optimized for the browser you’re not using on the platform you wish you had. Between you and me, it all looks a lot cleaner using Safari or Chrome, although more than half of the visitors to this site use either Safari or Internet Explorer, so I’m doing my best to make things look nice for IE as well. I’m using Firefox and running Windows 72. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazymeds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazymeds is not responsible for whatever weird shit your browser does or does not do when you read this site3.
No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this website. Use only as directed. Void where prohibited. Contains nuts. Certain restrictions may apply. All data are subject to availability. Not available on all mobile devices, in the 12 Galaxies Guiltied to a Zegnatronic Rocket Society, or in all dimensions of reality. Hail Xenu!
‘Everything is true, nothing is permitted.’ - Jerod Poore
1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.
2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.
3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?
[begin rant] I rent a dedicated server for Crazymeds. It’s sitting on a rack somewhere in Southern California along with a bunch of other servers that other people have rented. The hardware is identical, but no two machines have exactly the same operating systems. I don’t even need to see what is on any of the others to know this. If somebody got their server at the exact same time, with the exact same features as I did, I’m confident that there would be noticeable differences in some aspects of the operating systems. So what does this mean? For one thing it means that no two computers in the same office of a single company have the same operating system, and the techs can spend hours figuring out what the fuck the problem could be based on that alone. It also means that application software like IP board that runs the forum here has to have so many fucking user-configurable bells and whistles that even when I read the manual I can’t find every setting, or every location that every flag needs to be set in order for a feature to run the way I want it to run. And in the real world it means you can get an MBA not only with an emphasis on resource planning, but with an emphasis on using SAP - a piece of software so complex there are now college programs on how to use it. You might think, “But don’t people learn how to use Photoshop or Adobe Illustrator in college?” Sure, in order to create stuff. And in a way you’re creating stuff with SAP. But do you get a Bachelor of Fine Arts degree with an emphasis on Photoshop?
Back in the Big Iron Age the operating systems were proprietary, and every computer that took up an entire room with a raised floor and HVAC system, and had less storage and processing power than an iPhone, had the same operating system as every other one, give or take a release level. But when a company bought application software like SAP, they also got the source code, which was usually documented and written in a way to make it easy to modify the hell out of it. Why? Because accounting principles may be the same the world over, and tax laws the same across each country and state, but no two companies have the same format for their reports, invoices, purchase orders and so forth. Standards existed and were universally ignored. If something went wrong it went wrong the same way for everyone, and was easy to track down. People didn’t need to take a college course to learn how to use a piece of software.
I’m not against the open source concept entirely. Back then all the programmers read the same magazines, so we all had the same homebrew utilities. We even had a forerunner of QR Code to scan the longer source code. Software vendors and computer manufacturers sponsored conventions so we could, among other things, swap recipes for such add-ons and utilities. While those things would make our lives easier, they had nothing to do with critical functions of the operating system. Unless badly implemented they would rarely cause key application software to crash and burn. Whereas today, with open source everything, who the hell knows what could be responsible some part of a system failing. [/end rant]