Antidepressant of the selective serotonin reuptake inhibitor (SSRI) class
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The NACE Journal Club with Dr. Neil Skolnik, provides review and analysis of recently published journal articles important to the practice of primary care medicine. In this episode Dr. Skolnik and guests review the following publications:1. Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction. Discussion by:Guest:Muthiah Vaduganathan, MDCo-Director of the Center for Cardiometabolic Implementation ScienceBrigham and Women's Hospital.2. A Cell-free DNA Blood-Based Test for Colorectal Cancer Screening– NEJM 2024. Discussion by:Guest:Mathew Clark, MD Clinical Professor at the Sidney Kimmel medical college of Thomas Jefferson UniversityAssociate Director Family Medicine Residency Program Jefferson Health - Abington3. Mindfulness Meditation vs Escitalopram for Treatment of Anxiety DisordersSecondary Analysis of a Randomized Clinical Trial. JAMA Network Open Discussion by:Guest:Kim Alfonzo, MD Resident– Family Medicine Residency ProgramJefferson Health – AbingtonMedical Director and Host, Neil Skolnik, MD, is an academic family physician who sees patients and teaches residents and medical students as professor of Family and Community Medicine at the Sidney Kimmel Medical College, Thomas Jefferson University and Associate Director, Family Medicine Residency Program at Abington Jefferson Health in Pennsylvania. Dr. Skolnik graduated from Emory University School of Medicine in Atlanta, Georgia, and did his residency training at Thomas Jefferson University Hospital in Philadelphia, PA. This Podcast Episode does not offer CME/CE Credit. Please visit http://naceonline.com to engage in more live and on demand CME/CE content.
La periodista Iratxe Etxebarria nos habla en su libro de su experiencia personal ya que '7.300 miligramos de escitalopram' es como un antidepresivo que sirve para aumentar la cantidad de serotonina en cuerpo, esa sustancia que permite mantener nuestro equilibrio mental....
In this episode, we explore a groundbreaking study on escitalopram's efficacy in treating generalized anxiety disorder in children and adolescents. We discuss its potential as the first FDA-approved medication for youth anxiety. How might this change our approach to pediatric anxiety treatment? Faculty: David Rosenberg, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.5 CMEs: CAP Smart Takes Vol. 18 The Role of Escitalopram in Treating Generalized Anxiety Disorder in Youth
Real Life Pharmacology - Pharmacology Education for Health Care Professionals
On this episode of the Real Life Pharmacology Podcast, I start my journey on summarizing the most highly testable pearls with the top 200 medications. I'm going through the top 200 medications, 5 drugs at a time, and sharing my experience and clinically relevant information about these medications. Escitalopram is an SSRI that can cause serotonin syndrome, sexual dysfunction, and SIADH. Simvastatin is a cholesterol medication that can cause myopathy and rhabdomyolysis. Levothyroxine is a thyroid hormone replacement medication that has numerous binding drug interactions. Vicodin is a brand name combination of hydrocodone and acetaminophen. It is an opioid combined with and OTC analgesic. Lisinopril is an ACE inhibitor used for hypertension that can cause a chronic dry cough and hyperkalemia.
My name is Kim Newlove, and I'm an Ohio-licensed pharmacist. Welcome to the 30th episode in my drug name pronunciation series. Today, we're talking about citalopram (Celexa) and escitalopram (Lexapro). In this episode, I divide all four drug names into syllables, tell you which syllables to emphasize, and share my sources. The written pronunciations can be helpful, so you can see them below and in the show notes on thepharmacistsvoice.com. Thank you for listening to episode 274 of The Pharmacist's Voice ® Podcast! To read the FULL show notes, visit https://www.thepharmacistsvoice.com. Click the Podcast tab, and select episode 274. Subscribe to or follow The Pharmacist's Voice ® Podcast to get each new episode delivered to your podcast player and YouTube every time a new one comes out! Apple Podcasts https://apple.co/42yqXOG Spotify https://spoti.fi/3qAk3uY Amazon/Audible https://adbl.co/43tM45P YouTube https://bit.ly/43Rnrjt Citalopram = si-TAL-uh-pram Emphasize TAL Source: clinical practice and popular opinion Celexa = se-lek-sa No emphasis is indicated by my source, but I emphasize LEX. Source: medication guide, FDA's website Escitalopram = ES-si-TAL-uh-pram Emphasize ES and TAL. TAL gets the most emphasis. Source: clinical practice and popular opinion Lexapro = leks-a-pro No emphasis is indicated by my source, but I emphasize LEX. Source: medication guide, FDA's website Thank for joining me to learn how to say citalopram, Celexa, escitalopram, and Lexapro. If you know someone who needs to learn how to say citalopram, Celexa, escitalopram, and Lexapro, please share this episode with them. Links from this episode Celexa medication guide - FDA Website Lexapro medication guide - FDA Website USP Dictionary Online (aka “USAN”) **Subscription-based resource USP Dictionary's (USAN) pronunciation guide (Free resource on the American Medical Association's website) The Pharmacist's Voice ® Podcast Episode 272, pronunciation series episode 29 (losartan) The Pharmacist's Voice Podcast Episode 269, pronunciation series episode 28 (tirzepatide) The Pharmacist's Voice Podcast Episode 267, pronunciation series episode 27 (atorvastatin) The Pharmacist's Voice Podcast Episode 265, pronunciation series episode 26 (omeprazole) The Pharmacist's Voice Podcast Episode 263, pronunciation series episode 25 (PDE-5 inhibitors) The Pharmacist's Voice Podcast Episode 259, pronunciation series episode 24 (ketorolac) The Pharmacist's Voice ® Podcast episode 254, pronunciation series episode 23 (Paxlovid) The Pharmacist's Voice ® Podcast episode 250, pronunciation series episode 22 (metformin/Glucophage) The Pharmacist's Voice Podcast ® episode 245, pronunciation series episode 21 (naltrexone/Vivitrol) The Pharmacist's Voice ® Podcast episode 240, pronunciation series episode 20 (levalbuterol) The Pharmacist's Voice ® Podcast episode 236, pronunciation series episode 19 (phentermine) The Pharmacist's Voice ® Podcast episode 228, pronunciation series episode 18 (ezetimibe) The Pharmacist's Voice ® Podcast episode 219, pronunciation series episode 17 (semaglutide) The Pharmacist's Voice ® Podcast episode 215, pronunciation series episode 16 (mifepristone and misoprostol) The Pharmacist's Voice ® Podcast episode 211, pronunciation series episode 15 (Humira®) The Pharmacist's Voice ® Podcast episode 202, pronunciation series episode 14 (SMZ-TMP) The Pharmacist's Voice ® Podcast episode 198, pronunciation series episode 13 (carisoprodol) The Pharmacist's Voice ® Podcast episode 194, pronunciation series episode 12 (tianeptine) The Pharmacist's Voice ® Podcast episode 188, pronunciation series episode 11 (insulin icodec) The Pharmacist's Voice ® Podcast episode 184, pronunciation series episode 10 (phenytoin and isotretinoin) The Pharmacist's Voice ® Podcast episode 180, pronunciation series episode 9 Apretude® (cabotegravir) The Pharmacist's Voice ® Podcast episode 177, pronunciation series episode 8 (metoprolol) The Pharmacist's Voice ® Podcast episode 164, pronunciation series episode 7 (levetiracetam) The Pharmacist's Voice ® Podcast episode 159, pronunciation series episode 6 (talimogene laherparepvec or T-VEC) The Pharmacist's Voice ® Podcast episode 155, pronunciation series episode 5 Trulicity® (dulaglutide) The Pharmacist's Voice ® Podcast episode 148, pronunciation series episode 4 Besponsa® (inotuzumab ozogamicin) The Pharmacist's Voice ® Podcast episode 142, pronunciation series episode 3 Zolmitriptan and Zokinvy The Pharmacist's Voice ® Podcast episode 138, pronunciation series episode 2 Molnupiravir and Taltz The Pharmacist's Voice ® Podcast episode 134, pronunciation series episode 1 Eszopiclone and Qulipta
Join us for a brief discussion on Lexapro (Escitalopram).
High Yield Psychiatric Medications Antidepressants Review for your PANCE, PANRE, Eor's and other Physician Assistant exams. Review includes SSRI's, SNRIs, TCAs, MAOIs, Atypical antidepressants, Serotonin modulators. TrueLearn PANCE/PANRE SmartBank:https://truelearn.referralrock.com/l/CRAMTHEPANCE/Discount code for 20% off: CRAMTHEPANCEIncluded in review: Citalopram, Escitalopram, Fluoxetine, Fluvoxamine, Paroxetine, Sertraline, Desvenlafaxine, Duloxetine, Levomilnacipran , Milnacipran, Venlafaxine, Amitriptyline, Clomipramine, Doxepin, Imipramine, Trimipramine, Desipramine, Nortriptyline, Protriptyline, Tranylcypromine, Isocarboxazid, Phenelzine Selegiline, Bupropion, Mirtazapine, Trazodone
We welcome back Kim Witczak, Consumer Representative on the FDA Advisory committee, to share her insights gained from 20-years of advocacy work and experience in advertising and marketing. Her extensive experience has not only honed her skills but also equipped her with the ability to connect the dots, revealing the complex relationships between Washington, the FDA, Big Pharma, Medical Schools and the healthcare system. Kim Witczak
Brooke Siem is a writer, speaker, and passionate advocate for the crucial practice of safe de-prescribing for psychiatric drugs. Her debut memoir, titled "MAY CAUSE SIDE EFFECTS," reveals the challenging journey of antidepressant withdrawal. Through her experiences, Brooke has become a devoted proponent of antidepressant withdrawal education, mental health healing, and the pursuit of happiness.Not only is Brooke deeply involved in the field of mental health, but she is also an accomplished and award-winning chef, boasting over fifteen years of experience in the culinary industry. In 2017, she even earned the prestigious title of Food Network's "Chopped" Champion. This is part 1 of a 2 part episode Brooke SiemMay Cause Side Effects: A Memoir: Siem, BrookeHappiness Is A Skill by Brooke Siem | Substack@BrookeSiem / Twitter@brookesiem | InstagramBrooke Siem | LinkedInIf you are in a crisis or think you have an emergency, call your doctor or 911. If you're considering suicide, call 1-800-273-TALK to speak with a skilled trained counselor.RADICALLY GENUINE PODCASTDr. Roger McFillin / Radically Genuine WebsiteYouTube @RadicallyGenuineTwitter: Roger K. McFillin, Psy.D., ABPPSubstack | Radically Genuine | Dr. Roger McFillinInstagram @radicallygenuineContact Radically Genuine—-----------FREE DOWNLOAD! DISTRESS TOLERANCE SKILLS—----------ADDITIONAL RESOURCES3:00 - A Multicenter Double-Blind, Placebo-Controlled Trial of Escitalopram in Children and Adolescents with Generalized Anxiety Disorder6:00 - Chocolate Obsession | Chopped | Food Network9:30 - Radically Genuine Podcast with Dr. Roger McFillin | 55. Post antidepressant sexual dysfunction31:00 - Radically Genuine Podcast with Dr. Roger McFillin | 31. Grief. You have 180 days to get over it.32:00 - Psychiatry.org - APA Offers Tips for Understanding Prolonged Grief Disorder49:00 - Incidences of Involuntary Psychiatric Detentions in 25 U.S. States
In this episode, David interviews Dr. Roberta Murphy: member of the Imperial Centre for Psychedelic Research and training medical psychotherapist. This is a rare impromptu podcast, recorded about a half hour after David heard Murphy speaking on a panel at UK's Breaking Convention conference. He asked her if she wanted to be on the podcast sometime, and before they knew it, they were recording. Fastest turnaround ever? She discusses her past research and what she's doing at Imperial College; her work on a psilocybin for depression trial; a psilocybin versus Escitalopram trial; her hopes for psychedelics treating people with Parkinson's; and her recent co-written paper on the ARC Framework (Access, Reciprocity and Conduct), where she will be focusing strongly on the Conduct aspect through her work at Imperial. She mostly talks about her other recent paper exploring the impact of one of the more important aspects of therapy: the therapeutic alliance on the psychedelic experience. How does the treatment dynamic between the therapist and the client impact the outcome (and course) of the therapy, and what determines whether it's neutral, negative, positive, or very positive? Click here to head to the show notes page.
Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Escitalopram Trade Name Lexapro Indication Major depressive disorder, anxiety disorder, PCD, PTSD, social phobia Action Increases the extracellular levels of serotonin in the synaptic cleft by selectively inhibiting its reuptake Therapeutic Class Antidepressant Pharmacologic Class SSRI Nursing Considerations • Contraindicated with MAOI • May cause suicidal thoughts, insomnia, drowsiness, diarrhea, nausea, serotonin syndrome • May cause QT prolongation with certain medications • Assess for sexual dysfunction • May take 4-6 weeks for full affect to take place • Monitor for serotonin syndrome (mental changes, NV, tachycardia, hyperthermia)
Gianni Glick is a psychiatry resident at Stanford. He earned his bachelor's from UC Berkeley in 2014 and his medical degree from Brown University in 2019. He is particularly interested in group therapy, psychoneuroimmunology, and the novel applications of psychedelic therapy. He teaches an "Introduction to Psychedelic Medicine" course at Stanford university and medical school. He is most recently the 2021 recipient of the Trainee Innovator Grant award from the Stanford Department of Psychiatry and Behavioral Science (2021). Host: Roy Collins, MD Guest: Giancarlo (Gianni) Glick, MD 0:46 - Introduction to Dr. Gianni Glick, Stanford Medicine Resident. 3:24 - Here, Dr. Glick defines “psychedelic therapy” and discusses some history of Psychedelics utilization. 4:41 - We define psychedelics and give some examples, including LSD, MDMA, Psilocybin, and ayahuasca 10:26 - Psilocybin has been shown to help treat depression, treatment-resistant depression, alcohol use d/o, smoking cessation, anxiety, and depression associated with terminal illnesses like cancer -MDMA is also being studied as a potential treatment for social anxiety and PTSD 11:36 - We discuss the results of a recently published study in the journal NATURE on the effects of psilocybin on patients using fMRI data 16:13 - We discuss “enhanced activation of neuroplasticity” as a mode of action in psychotherapy and potential similarities in psychedelic-assisted therapy 21:26 - We discuss a 2021 study that compared psilocybin to escitalopram, an anti-depressant, in treating depression—link to the paper in the references section (Trial of Psilocybin versus Escitalopram for Depression, 2021) 30:26 - We discuss the contrast between the controlled nature of research trial environments in psychedelic research compared to public use 32:46 - We discuss potential uses of psychedelics in athletics and anecdotal athlete experiences of enhanced performance with “micro-dosing.” We also define a “normal” dose v micro-dosing. Micro dosing is defined as 1/8th to 1/15th of a regular dose. References Stanford psychedelic science group: https://med.stanford.edu/spsg.html -Trial of Psilocybin versus Escitalopram for Depression (2021): https://www.nejm.org/doi/full/10.1056...
Piše: Miša Gams Bereta: Eva Longyka Marušič in Jure Franko Vsebino pesniške zbirke Marcella Potocco Odisej(ka) v labirintu na kratko povzemajo pesnikove besede pod posvetilom: “sprememba implicira strah, a pričakovanje strah raztaplja”. Zbirka je razdeljena na šest tematskih sklopov, ki se med seboj razlikujejo in dopolnjujejo tako po vsebini kot po stilistični zasnovi. V prvi z naslovom Kar je reči o shojenih stvareh se pesnik pozabava s strukturalističnim in fenomenološkim ustrojem sveta, z označevalci, imeni in pomeni, prostori in razmerji, ki jim pripadajo. Shojene stvari za sabo puščajo prostor, ki ga orje naš dialektični um ter omogoča prostor za poimenovanje, ozaveščanje tu-biti pa tudi drugega kot drugačnega. 33 poimenovanj za sneg (kot jih poznajo Eskimi), zapiše avtor, “… zadostuje za / razlikovanje snega. Zadostuje, samo če // se želiš, želiš brez razlike, obrniti / kot plug sredi razpomenjenega polja.” V pesmi Še nekaj o shojenih stvareh pa dodaja: “… Ne na triintrideset in plus različic / za smisel nečesa, česar ni. Ko bo, // bo. Ne da bi z izgovorjenim sneg / izpraznila snega. Temveč da bo nekaj, // v besedi, celo, postalo tu-bit-je.” V drugem sklopu Lekcije iz minljivosti se Potocco na eni strani poigrava s Heraklitovo tezo o minljivosti, po drugi strani pa trdi: “potrebuješ nekaj skromne popustljivosti – do dreves, do ljudi // in bivanja – in šele potem – šele potem se iz tega lahko rodi upor.” Pri tem s pomočjo metafor ponudi nekaj lekcij iz postkolonialistične zgodovine in indijanske mitologije. V tretjem sklopu z enakim naslovom, kot ga ima pesniška zbirka, se znova prizemlji v sedanjosti, ki jo naseljuje pričakovanje prihoda novega bitja. Rastoči nosečniški trebuh ga spomni na rast drevesa, oblika trebuha pa poraja številne asociacije na zaznavo geometrije prostora in porajajočega se bitja, ki vidi, čeprav v pesnikovem svetu še ni dejansko prisotno. V pesmi z naslovom Odisejka v labirintu, v katerem je že izražen tudi spol otroka, skicira prostor še nerojenega bitja: “Presek premic. Zaznavanje daljic / v labirintu, ki ga tvoriš v mestu. // Vijuge poti nad izvotljenimi okni / k očesu, ki te zagleda in ti ga ne vidiš.” Čeprav so priprave na rojstvo prikazane z opisom vrste dokumentov, ki jih kot oče potrebuje za pot v porodnišnico, življenje doma teče naprej svojo pot. Pesem z naslovom Drago dete nagovarja jokajočo novorojenčico ter hkrati izpostavlja problematiko, s katero se soočajo priseljenci v Evropi: “Ne joči, pridem kmalu, mimo migrantov – ljudi, za katere ne moreš najti prave strategije. Pisati o njih je pilatovsko umivanje rok, / ni rešitev. Tvoje modre oči ne razumejo niti besede. Dobiš joško / na vsaki dve uri – imaš posteljo tu, drugo, prenosno, za drugam, / imaš ogenj, ki ugaša v peči – imaš les, ki včasih zaškrta nad tabo.” Četrti sklop prinaša poigravanje z otroškimi pravljicami in izštevankami, kot so Ringa ringa raja, Volk in sedem kozličkov in Sneguljčica. O njej pesnik s pomočjo ponavljanja in personifikacije zapiše: “Ti za stolom, jaz za stolom, jaz tebi / o vzgoji, ti meni o tečnobi, jaz tebi o Sneguljčici, // ti meni: “vse sadje je kot jabolko, vse / življenje spi, ko ga pojemo, pa umre.” Zaključki pesmi so oblikovani kot duhovite zamisli oziroma teze, s katerimi pesnik hčerko pouči o življenju, obenem pa pravljice in ljudske izštevanke vključi v sodobni čas, ki ga ne razmejuje delitev na dobro in zlo, temveč hierarhija izkoriščevalcev, ki jih poosebljajo plenilci in zajedalci. V petem sklopu z naslovom Krst pri Savici je Potocco preoblikoval Prešernov ep v novodobno politično alegorijo, iz katere razberemo svojevrstno kritiko nekdanjega predsednika in županov: “Kako lep je na odru, kako mavričen kalejdoskop / županov in iztrošenega botoksa, našega gospoda / predsednika. - Že spiš, hči moja? Ne gledaš, / kako se sprašujem – od kod se je vzel ta čudni // noriški delirij?” V zadnjem tematskem sklopu zbirke, ki se (po antidepresivih) imenuje Escitalopram, se je Potocco pozabaval s formo – pesem z naslovom Šolske naloge je sestavil kot naloge iz italijanščine, v kateri so odgovori, ki označujejo sorodnosti in razlike med določenimi besedami, že podani z odebeljeno pisavo in pripadajočimi črtami. Pesem z naslovom Na koncu so zmeraj prioritete, pa vsebuje tri sezname prioritet – dva, zapisana v slovenščini, in enega v italijanščini – z absurdnimi izzivi, ki se nanašajo na obdobje epidemije covida: “...ne povedati za vročino, da ne dobiš karantene //...//za praznike obesiti lučke, ne sebe, //… vesel, da si ti, moja hči, ostala eden polsimptomatski poprček.” Marcello Potocco se izkazuje kot spreten interpret vsakdanjega življenja, ki v medijski retoriki prepoznava ideološke termine in jih duhovito vključuje v poezijo. Ta je tako odsev mitemov iz različnih literarnozgodovinskih obdobij, ki predstavljajo metaforična križišča med nekoč in danes. Zbirka Odisej(ka) v labirintu najde izhod iz kompleksnega stvarstva le s pomočjo strukturalističnih ugank in pesnikove intuicije. Ta se v vsakem sklopu pokaže kot magnetna sila, ki pesnikovo potomko in tudi anonimnega bralca usmerja k točki, iz katere lahko začne spoznavati svet na povsem nov način.
Naomi Simon, MD, talks about her research into mindfulness-based stress reduction (MBSR) and yoga as treatments for anxiety disorders. Dr. Simon is a Professor in the Department of Psychiatry at the NYU Grossman School of Medicine, and Director of the Anxiety, Stress, and Prolonged Grief Program.Topics:Generalized Anxiety Disorder (GAD)Mindfulness-Based Stress Reduction (MBSR)Kundalini yogaSelective serotonin reuptake inhibitors (SSRIs)Access to MBSR & Yoga (including smartphone apps)Cognitive behavioral therapy (CBT)ExerciseMechanism(s) of actionCited: Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders (Nov. 2022)Visit our website for more insights on psychiatry.Podcast producer: Jon Earle
Dans cet épisode, je te partage mon expérience avec les psychédéliques. Bien entendu, je n'incite personne à en consommer. La consommation de psychédélique est INTERDITE en France. Renseigne toi sur les lois de ton pays à ce sujet. SOURCES : Sources : [1] Carhart-Harris, R. L., et al. (2021). Trial of Psilocybin versus Escitalopram for Depression. New England Journal of Medicine, 384(15), 1402-1411. [2] Ross, S., et al. (2016). Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial. Journal of Psychopharmacology, 30(12), 1165-1180. [3] Mitchell, J. M., et al. (2021). MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. Nature Medicine, 27(6), 1025-1033. [4] Johnson, M. W., et al. (2014). Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction. Journal of Psychopharmacology, 28(11), 983-992. [5] Oliveira-Lima, A. J., et al. (2018). Ayahuasca and Its DMT- and β-carbolines–Containing Ingredients Block the Expression of Ethanol-Induced Conditioned Place Preference in Mice: Role of the Treatment Environment. Frontiers in Pharmacology, 9, 1009. Mon canal TELEGRAM : https://t.me/devenonsinspirants
On today's episode, we are celebrating the two year anniversary of the podcast with a special reflection episode with my dear friend, Dan (He/Him). Together we talk about the divine intervention of meeting a kinky person, the uncomfortability of emotions, and embracing the full human experience. If you enjoyed today's podcast, then please subscribe, leave a review, or share this podcast with a friend! To learn more, head over to the website www.modernanarchypodcast.com And if you want to connect deeper with the Modern Anarchy Family, then join the movement by becoming a part of the conscious objectors patreon. Your support is what powers this work and the larger societal change we are creating! Let's continue to challenge our assumptions and grow together. Join the community here: https://www.patreon.com/user?u=54121384 Intro and Outro Song: Wild Wild Woman by Your Smith Modern Anarchy Community: Website Instagram Patreon To Learn More: The Kinky Female Mind: Why Women Fantasize About Rape and BDSM Kinsey sex doc: What I learned by asking more than 4,000 Americans about their sexual fantasies The first FDA-approved medication with an antisuicide indication was clozapine for schizophrenia. Clozapine Side Effects Rare Side Effect of Clozapine: Neuroleptic Malignant Syndrome Ketamine Nasal Spray Is A New Antidepressant Option For People At High Risk of Suicide Ketamine used to treat severe depression in patients with a history of psychosis does not exacerbate psychosis risk, new research suggests. currently available literature does not support the assumption that ketamine will exacerbate psychotic symptoms in predisposed patients Effects of Ketamine in Normal and Schizophrenic Volunteers Money Shot: The Pornhub Story | Official Trailer | Netflix Mindfulness-based stress reduction is as effective as an antidepressant drug for treating anxiety disorders, study finds Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders: A Randomized Clinical Trial Symptom severity and exclusion from antidepressant efficacy trials Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration The drugs don't work? antidepressants and the current and future pharmacological management of depression antidepressants are effective against chronic, moderate and severe depression. They don't help in mild depression. Antidepressants No Better Than Placebo for About 85% of People Inappropriate prescribing Study shatters the myth that BDSM is linked to early-life trauma The Psychology of Kink: a Survey Study into the Relationships of Trauma and Attachment Style with BDSM Interests
On today's episode, we have traditional birth keepers and community herbalists Andi Rose and Jaycee join us for a conversation all about radical holistic healing under capitalism. Together we talk about the healing nature of plants and herbs, the lack of informed consent in medicine, and being understandably upset with our current social conditions. If you enjoyed today's podcast, then please subscribe, leave a review, or share this podcast with a friend! To learn more, head over to the website www.modernanarchypodcast.com And if you want to connect deeper with the Modern Anarchy Family, then join the movement by becoming a part of the conscious objectors patreon. Your support is what powers this work and the larger societal change we are creating! Let's continue to challenge our assumptions and grow together. Join the community here: https://www.patreon.com/user?u=54121384 Intro and Outro Song: Wild Wild Woman by Your Smith Modern Anarchy Community: Website Instagram Patreon Andi and Jaycee's Community: Website Resources to Learn More: Serotonin Is Not Linked with Depression We Still Don't Know How Antidepressants Work Mindfulness-based stress reduction is as effective as an antidepressant drug for treating anxiety disorders, study finds Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders: A Randomized Clinical Trial Exercise and Antidepressants were Equally Effective "Antidepressants are effective against chronic, moderate and severe depression. They don't help in mild depression." Serotonin and brain function: a tale of two receptors SSRI Reduces Negative Effects of Psilocybin, With No Impact on Positive Mood Effects in Study With Promise of Legalization, Psychedelic Companies Joust Over Future Profits
The Serotonin Hypothesis of Depression has never been proven correct. In fact, it has been disproven by multiple researchers. In today's video, I show you the research that shows why SSRI medications and the doctors who prescribe them (and the researchers who study them) fail so many patients. See the video on YouTube HERE Get a FREE AUDIO copy of Dr. Bartemus' Amazon International Best-Selling book, The Autoimmune Answer here: t.ly/UU_H John Bartemus, DC Functional Medicine Charlotte 704-895-2240 http://www.FunctionalMedicineCharlotte.com Disclaimer: *Please note that the information shared on this podcast is informational and educational and is not to be interpreted as medical advice. Before implementing any information from this channel, please consult first with your primary care provider.
On today's episode, we are celebrating the 100th episode with a special masturbation meditation. Slow down and connect with all the pleasure that is possible in your body with this quick 10 minute meditation. **Meditation begins at 9:04** For all of you listeners that continue to tune in each week, from my full heart I want to wish you the deepest thank you. Thank you for joining me on this journey of expansion and growth. I look forward to all the things we will explore together. Sending you so much love! If you enjoyed today's podcast, then please subscribe, leave a review, or share this podcast with a friend! And if you want to connect deeper with the Modern Anarchy Family, then join the movement by becoming a part of the conscious objectors patreon. Your support is what powers this work and the larger societal change we are creating! Let's continue to challenge our assumptions and grow together. Join the community here: https://www.patreon.com/user?u=54121384 Intro and Outro Song: Wild Wild Woman by Your Smith Modern Anarchy Community: Website Instagram Patreon Resources to Learn More: Mindfulness-based stress reduction is as effective as an antidepressant drug for treating anxiety disorders, study finds Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders: A Randomized Clinical Trial Brief Mindfulness Meditation Induces Gray Matter Changes in a Brain HubState and Training Effects of Mindfulness: Meditation on Brain Networks Reflect Neuronal Mechanisms of Its Antidepressant EffectSelf-Medication for Chronic Pain Using Classic Psychedelics: A Qualitative Investigation to Inform Future ResearchFinding the divine within: exploring the role of the sacred in psychedelic integration therapy for sexual trauma and dysfunction
The World Health Organization estimates that one billion people have a mental health condition, but 70% of them aren't getting care. So, what is the best way to address this supply-demand imbalance? How do we help someone with a clinical diagnosis manage their condition? And what can we do to support the mental health needs of people before they develop a serious issue? Russell Glass is CEO of Headspace Health, the world's most comprehensive and accessible mental health care platform. Russ leads the company in helping create a world where everyone is kind to their mind by way of mindfulness and meditation tools, behavioral health coaching, therapy and psychiatry services. On this episode of HLTH Matters, Russ joins host Dr. Guatam Gulati to explore the root causes of the mental health crisis in the US and explain the benefit of a virtual-first approach to care. Russ discusses how Headspace helps its members get the right level of care and what his team does to alert the appropriate authorities when a user has suicidal or homicidal intent. Listen in for Russ' insight on the over-prescription of psychotropic drugs like Lexapro and learn how to prevent serious mental health issues with a simple mindfulness and meditation practice. Topics CoveredHeadspace Health's mission to transform mental health careThe supply-demand imbalance that inspired Russ' work in mental healthWhy Russ takes a broad definition of mental healthHow Headspace offers mindfulness/meditation, behavioral health coaching and therapy servicesWhen virtual mental health interventions are appropriate and when in-person care works bestHow fast we adopted virtual mental health solutions during COVIDThe root causes of the mental health crisis in the USHow Headspace helps its members get the right level of careHow to prevent serious mental health issues with mindfulness and meditationHow Russ thinks about crime being attributed to the mental health crisis in the US What Headspace does to alert the appropriate authorities when a member has suicidal or homicidal intent Connect with Russell GlassHeadspace Health Connect with Dr. Guatam GulatiHLTHDr. Gulati on TwitterDr. Gulati on LinkedIn ResourcesGingerSocial Determinants of HealthGeneralized Anxiety Disorder Mental Health AssessmentColumbia Suicide Severity Rating Scale‘Mindfulness-Based Stress Reduction vs. Escitalopram for the Treatment of Adults with Anxiety Disorders' in JAMA Psychiatry
Dr. Ebell and Dr. Wilkes discuss the POEM titled ' Mindfulness-based stress reduction is noninferior to escitalopram for adults with anxiety disorder '
Welcome to Group Therapy!! Licensed psychologists Dr. Jessica Rabon, Dr. Justin Puder, Dr. Kristen Casey and licensed therapist Kristen Gingrich LCSW, CADC, CCS are coming together to create a podcast to talk about topics chosen by you, the listeners, in a laid back, relatable way. Kinda like group therapy. From mental health to relationships, hot topics to current events, fun topics and everything in between, including anxiety, our goal is for your voices to be heard and you to feel like you are part of the group. So settle in, take a seat, and Welcome to Group Therapy! Disclaimer: Welcome to Group Therapy Podcast is not a replacement for therapy, is not actual group therapy, nor will specific therapeutic advice be given on the show. Although we are all licensed therapists, we are not YOUR therapist. It is meant to be for educational and entertainment purposes only. Follow us on social media! Instagram: @welcometogrouptherapypod TikTok: @welcometogrouptherapypod Submit your podcast topic requests here! Dr. Justin Puder @amoderntherapist Dr. Kristen Casey @drkristencasey Dr. Jessica Rabon @jessicaleighphd Kristen Gingrich LCSW, CADC, CSS @notyouraveragethrpst Article in this Episode: Mindfulness-Based Stress Reduction vs Escitalopram from the Treatment of Adults with Anxiety Disorders: A Randomized Clinical Trial
The NACE Journal Club with Dr. Neil Skolnik, is a new series of episodes that provide review and analysis of recently published journal articles important to the practice of primary care medicine. In this episode Dr. Skolnik and guests review the following publications:1. The protective effect of exercise against Covid infection and hospitalization in individuals vaccinated against covid, Association between regular physical activity and the protective effect of vaccination against SARS-CoV-2 in a South African case–control study. Collie S, et al. Br J Sports Med2022;0:1–7. doi:10.1136/bjsports-2022-105734Guest: Connie Jiang, MD is chief resident in the family medicine residency at Jefferson-Abington Health, Abington Hospital, Abington, PA2. Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction. Solomon, et.al. N Engl J Med 2022; 387:1089-1098DOI: 10.1056/NEJMoa2206286Guest: Orly Vardeny, Pharm.D is a BPS Board Certified clinical pharmacist with current research that focuses on novel therapies in the treatment of heart failure and the impact of influenza vaccination on heart disease. She has over 10 years of experience researching the effects of medications on cardiovascular conditions. Dr. Varney is a Core Investigator at the Center for Care Delivery and Outcomes Research, United States Department of Veterans Affairs, Associate Professor of Medicine, University of Minnesota Medical School, and Adjunct Faculty, University of Minnesota College of Pharmacy.3. Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders: A Randomized Clinical Trial. Hoge EA, et al, JAMA Psychiatry. 2023 Jan 1;80(1):13-21. doi: 10.1001/jamapsychiatry.2022.3679.Guest: Bridget Smith, MD is a second-year resident in the family medicine residency at Jefferson Health – Abington, Abington Hospital, Abington, PA 4. Empagliflozin in Patients with Chronic Kidney Disease. The EMPA-KIDNEY Collaborative Group, N Engl J Med 2023; 388:117-127DOI: 10.1056/NEJMoa2204233Guest: Katie McKormick, MD is a second year resident in the family medicine residency at Jefferson Health – Abington, Abington Hospital, Abington, PAMedical Director and Host: Neil Skolnik, MD, is an academic family physician who sees patients and teaches residents and medical students as professor of Family and Community Medicine at the Sidney Kimmel Medical College, Thomas Jefferson University and Associate Director, Family Medicine Residency Program at Abington Jefferson Health in Pennsylvania. Dr. Skolnik graduated from Emory University School of Medicine in Atlanta, Georgia, and did his residency training at Thomas Jefferson University Hospital in Philadelphia.Please visit http://naceonline.com to engage in more live and on demand CME/CE content.
An online transcript is available .There's growing evidence that the routine practice of meditation improves quality of life (including relief from anxiety, increased focus, and the mitigation of negative emotions) and that these benefits can be seen after as few as five sessions of meditation. But we didn't really need scientific journals to tell us that: Practitioners of mindfulness meditation have been enjoying the benefits of this natural brain hack for millennia. On today's program, host Seán Collins talks with a pioneering neuroscience researcher who describes what goes on in the brains of people who meditate, with a hospice doctor who trains his colleagues in techniques of meditation to help them deal with the stresses of their work, and with the founder of a program in Southern California that teaches at-risk youth to meditate as part of a program in effective social and emotional learning..Michael Posner, Ph.D., M.S.Professor EmeritusDepartment of PsychologyUniversity of OregonEugene, Ore..Glen Komatsu, M.D.Chief Medical OfficerProvidence Hospice, Los Angeles CountyTorrance, Calif..Patricia JonesFounderP.S. I Love You FoundationRedondo Beach, Calif..Seán refers to the Balance app — a personalized meditation coaching tool which is available for both the Apple and Android platforms..MORE INFORMATIONShort-term meditation training improves attention and self-regulation (Tang, Posner, et al., 2007)Short-term meditation induces white matter changes in the anterior cingulate (Tang, Posner, et al., 2010)Mechanisms of white matter change induced by meditation training (Posner, Tang, & Lynch, 2014)Circuitry of self-control and its role in reducing addiction (Tang, Posner, et al., 2015)Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders (Hoge, et al. 2023)..
Enjoy our super speedy summary of this fascinating study. Check out www.DrJournalClub.com to watch videos of this as well as more detailed and in-depth versions with analysis, take-homes, and even article walk-throughs where we show you what to look for when taking apart a research article. Oh, and we have approved continuing education courses as well! Read the research article here. Learn more and become a member at www.DrJournalClub.comCheck out our complete offerings of NANCEAC-approved Continuing Education Courses.
Dr. Kristin Dawson and Dr. Mike Stone recap the recent study done by JAME Psychiatry called TAME. The study covers how mindfulness-based stress reduction (MBSR) works in comparison to patients who were prescribed the antidepressant escitalopram, in a randomized 8-week study. TAME Study Center for Mindfulness
Join me with integrative pharmacist, Dr. Trang Nguyen, as we dig deep on Deprescribing, what it is and how to do it. Anyone who is on a journey to feeling healthier and is taking medications needs a strategy to start coming off medications, which is deprescribing. In this episode, we'll cover how the following medications can be prescribed and how you can approach this with your doctor and pharmacist.In this episode, we will discuss deprescribing:Proton Pump Inhibitors (PPI's): omeprazole, pantoprazole and esomeprazoleAnti-Depressants such as: Escitalopram, citalopram, sertraline,We also discuss strategies to deprescribing Opioids and Benzodiazepines.Dr. Trang Nguyen is a Board-Certified Geriatric Pharmacist. In 2017, she found Mimosa Health LLC. Her mission is to provide expert advice on the use of medications by older adults, promote healthy aging, and educate seniors about polypharmacy as well as medication safety. Currently, she is a consultant pharmacist for Skilled Nursing Facilities and a fellow-in-training at the Academy of Integrative Health and Medicine.She is a radio host of “The Medicine Cabinet” show which is broadcast every other Saturday at 5:30 pm Central Time from The Vietnamese Public Radio Station in Oklahoma City. She is the author of “Medication Management for 50+” book .I have some great content coming! Have you been interested in mindfulness as a practice or a way or life?Try my course (for free) Mindfulness Mastery to learn about mindfulness and get updates when my 6 week Mindfulness course is live.My book “Heart of Being” will be out next year. Interested in a preview?I'll be sharing a free chapter to those that sign up here:Welcome to the Art of Healing Podcast.Let's explore your mind, body and spirit through Integrative Medicine, Meditation and Reiki.Welcome to the Art of Healing Podcast.Let's explore your mind, body and spirit through Integrative Medicine, Meditation and Reiki.Don't miss the latest episodes. Sign up to get the weekly newsletters and get the Art of Healing Podcast in your inbox:Healing Arts Weekly Newsletter Thank you for listening to the Art of Healing Podcast.Ready to start your journey into Meditation, Mindfulness or Reiki?Learn about the Programs at Healing Arts here.Want to make sure you catch every episode of the Art of Healing? Click here for my weekly newsletter.Never miss an episode of Art of Healing Podcast...the podcast devoted to helping you heal your mind, body and spirit.Sign up for my weekly newsletter, and never miss an episode along with other great content:Art of Healing PodcastStay in touch socially here:Healing Arts Link in BioLearn more about me and my offerings here:Healing Arts Health and Wellness
Un nouvel épisode du pharmascope est maintenant disponible! Dans de ce 106ème épisode, Sébastien, Nicolas et Isabelle discutent de nouveautés thérapeutiques dans le monde de la vaginose bactérienne, de l'hyperlipidémie et de la dépression. Les objectifs pour cet épisode sont les suivants: Comparer l'efficacité et l'innocuité du VablysMC aux traitements usuels de la vaginose bactérienne Discuter de l'efficacité et de l'innocuité du LeqvioMC dans le traitement de l'hyperlipidémie Discuter de l'efficacité et de l'innocuité de la psilocybine dans le traitement de la dépression Ressources pertinentes en lien avec l'épisode VablysMCBrodeur ME, Bouchard C. VablysMC: un traitement contre la vaginose bactérienne à ajouter à votre liste? Pharmastuce. 2022;4(8). Monographie de produit incluant les renseignements pour la patiente sur le médicament. VablysMC. Duchesnay Inc. Septembre 2021. Weissenbacher ER et coll. A comparison of dequalinium chloride vaginal tablets (Fluomizin®) and clindamycin vaginal cream in the treatment of bacterial vaginosis: a single-blind, randomized clinical trial of efficacy and safety. Gynecol Obstet Invest. 2012;73:8-15. LeqvioMCMorin C, Lamoureux AS. L'inclisiran : la nouvelle recrue des hypolipémiants. Pharmastuce. 2022;4(7). Monographie de produit incluant les renseignements sur le médicament pour le patient. LeqvioMC. Novartis Pharma Canada Inc. Juillet 2021. Ray KK et coll. Two Phase 3 Trials of Inclisiran in Patients with Elevated LDL Cholesterol. N Engl J Med. 2020;382:1507-19. Raal FJ et coll. Inclisiran for the Treatment of Heterozygous Familial Hypercholesterolemia. N Engl J Med. 2020;382:1520-30. Ray KK et coll. Inclisiran and cardiovascular events: a patient-level analysis of phase III trials. Eur Heart J. 2022:ehac594. Epub ahead of print. PMID: 36331326. PsilocybineCarhart-Harris R et coll. Trial of Psilocybin versus Escitalopram for Depression. N Engl J Med. 2021;384:1402-11. Davis AK et coll. Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2021;78:481-9. Goodwin GM et coll. Single-Dose Psilocybin for a Treatment-Resistant Episode of Major Depression. N Engl J Med. 2022;387:1637-48. Bogenschutz MP et coll. Percentage of Heavy Drinking Days Following Psilocybin-Assisted Psychotherapy vs Placebo in the Treatment of Adult Patients With Alcohol Use Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2022;79:953-962.
https://psychiatry.dev/wp-content/uploads/speaker/post-10757.mp3?cb=1668021744.mp3 Playback speed: 0.8x 1x 1.3x 1.6x 2x Download: Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders: A Randomized Clinical Trial – Elizabeth A Hoge etFull EntryMindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders: A Randomized Clinical Trial –
Oopsie Daisy, die Folge ist etwas spät dran liebe MUGPUdel, aber heilige scheisse ist es ne gute Folge. Die beiden sind mal wieder so richtig en fuego mit der Produktion von Unterhaltung. Matilde war spät dran und hat Durchfall. Georg war beim Arzt für seine Beschneidung - würde Matilde seine Vorhaut essen? Matilde lebt ein wildes Leben, Georg redet von Elon Musk und Twitter. Wir enden natürlich mit dummen holländischen Wörtern! BUSSISDieser Podcast wird präsentiert von Hass, Liebe und Weinen. Werdet auch Sponsoren: matildeundgeorg@gmail.com oder auf INSTAGRAM.Folgt UNS unterhttps://www.instagram.com/matildeundgeorg/https://twitter.com/MatildeUndGeorgFolgt Georg unterhttps://www.instagram.com/georgfka/https://twitter.com/GeorgFKaFolgt Matilde unterhttps://www.instagram.com/matikeizer/Special thanks an Andrea Björk für unser Logo, und an Ralf Strecker für den Intro-Jingle. ❤️Support the show
In this episode, Dr. Zach April returns to review the SSRI's. These are some of the best treatment options for mood. We talk about what to expect in general with these medications and review some of the individual medicines including sertraline (Zoloft), fluoxetine (Prozac) and escitalopram (Lexapro) to name a few. A disclaimer, we're providing general guidance but everyone is different and you should always discuss with your health care professional management of any disease and therapy before trying anything you discover from a source on the internet (including this podcast)
Plant Made Hope: Alternative Medicine TalkJoin Doc's Sarah & Alyse for an opinion-based episode about Alternative Medicine(s)!In this episode we chat about:Perspective on if YOU judge alternative medicine.Is alternative medicine a viable option for veterans? How alternative medicine is so much more than yoga therapy.Micro dosing and its role in mental health.How alternative medicine works physiologically and its effects on the brain. Always remember although there are doctors here on the show, we are not YOUR doctor and cannot give you medical advice. If anything from today's episode interests you, speak with your health care provider.Book mentioned: "How to Change Your Mind" by Michael PollanArticle: Carhart-Harris, Robin, et al. "Trial of Psilocybin versus Escitalopram for Depression" . N Engl J Med 2021; 384:1402-1411.
Download the cheat: https://bit.ly/50-meds View the lesson: https://bit.ly/EscitalopramLexaproNursingConsiderations Generic Name Escitalopram Trade Name Lexapro Indication Major depressive disorder, anxiety disorder, PCD, PTSD, social phobia Action Increases the extracellular levels of serotonin in the synaptic cleft by selectively inhibiting its reuptake Therapeutic Class Antidepressant Pharmacologic Class SSRI Nursing Considerations • Contraindicated with MAOI • May cause suicidal thoughts, insomnia, drowsiness, diarrhea, nausea, serotonin syndrome • May cause QT prolongation with certain medications • Assess for sexual dysfunction • May take 4-6 weeks for full affect to take place • Monitor for serotonin syndrome (mental changes, NV, tachycardia, hyperthermia)
HUIHUIHUI was für eine neue Folge. Die schlägt einem so richtig ins Gesicht, man kann kaum wegschauen (hören?) denn diese Folge ist energiegeladen und mächtig. Matilde ist ein Heulweib wegen Facebook, Georg redet über Fynn Kliemann aber er findet Matilde in ihrem Outfit so heiß, dass er kaum weiter ranten kann - oooooh. Sie reden natürlich auch über Escitalopram - weil weiterhin sind sie psychisch krank! Yay! Matilde musste eine Urinprobe abgeben, und wir finden heraus was Georgs "Love Language" ist. Ja es gibt ein kurzes Quiz, aber die beiden geben schnell auf. Georg ist viel auf Blender, und Matilde arbeitet wenig. Ein schönes Ende, denn alles ist ok. Es wird alles ok. Keine Sorge, es ist ok! Dieser Podcast wird präsentiert von Katzen, Hunde, neue Sachen essen und trinken, der Comedian Helen Bauer und dem Twitter von Falk Pyrczek . Werdet auch Sponsoren: matildeundgeorg@gmail.com oder auf INSTAGRAM.Folgt UNS unterhttps://www.facebook.com/matildeundgeorghttps://www.instagram.com/matildeundgeorg/https://twitter.com/MatildeUndGeorgFolgt Georg unterhttps://www.instagram.com/georgfka/https://twitter.com/GeorgFKaFolgt Matilde unterhttps://www.facebook.com/matikeizerhttps://www.instagram.com/matikeizer/Special thanks an Andrea Björk für unser Logo, und an Ralf Strecker für den Intro-Jingle. ❤️Support the show
On Today's show I have Ben Bathen is a brilliant computer engineer who once worked for Google, EA Sports. He helped create games like Rockstar and Grand Theft Auto. He had a growing career as a programmer yet like so many others during his mid-20s he was stressed by an 80-plus-hour-a-week programming job. A psychologist pressured him to take medications. Ben didn't like the idea, but after a lot of convincing, he caved and over several years took a series of different psychiatric drugs. Between 2004 and 2008 his therapist spent every session convincing him to take SSRI (Selective Serotonin Reuptake Inhibitors) better known as antidepressants, including Prozac and Lexapro. In 2017 he had a severe adverse reaction to Lexapro and called the therapists emergency phone line from Springfield, VA. She then filed criminal charges against him in Chula Vista, CA for PC 422 criminal threats and lied under oath while withholding the fact that the medication caused the incidents. He was sentenced to two years in the California State Penitentiary and served 10.5 months at the Chino California Institution for Men, and the Sierra Conservation Center.The FDA warns that SSRI's have certain behaviors associated with them including “anxiety, agitation, panic attacks, insomnia, irritability, hostility, impulsivity, akathisia (severe restlessness), hypomania, and mania.”From the FDA's Pediatric Postmarketing Pharmacovigilance and Drug Utilization Review(Escitalopram), published November 22, 2017“Reviewer's Comments: Aggression collectively refers to, unless otherwise specified, suicide, homicide, and other forms of violence. The difference between these forms of violence is their intended target. Escitalopram is labeled in Section 5, Warnings and Precautions, for “anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, and mania.” Become a Legend!DO you want to find your purpose? Are you tired of just existing in this world and not truly living? If so, reach out to me for a FREE Consultationhttps://www.facebook.com/josh.coffman.31https://www.instagram.com/joshua.coffman1/?hl=enhttps://www.linkedin.com/in/joshua-coffman-a7623b86/
Madhukar Trivedi, MD, and Manish Jha, MD, MBBS, review the evidence on the efficacy of esketamine and ketamine as a treatment for major depressive disorder. Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/968556). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Symptom Clusters as Predictors of Late Response to Antidepressant Treatment https://www.psychiatrist.com/jcp/depression/symptom-clusters-predictors-late-response-antidepressant/ Intranasal Esketamine https://www.janssenlabels.com/package-insert/product-monograph/prescribing-information/SPRAVATO-pi.pdf Sequenced Treatment Alternatives to Relieve Depression (STAR*D) Study https://www.nimh.nih.gov/funding/clinical-research/practical/stard Clinical Results for Patients With Major Depressive Disorder in the Texas Medication Algorithm Project https://jamanetwork.com/journals/jamapsychiatry/fullarticle/482026 Efficacy and Safety of Olanzapine/Fluoxetine Combination vs Fluoxetine Monotherapy Following Successful Combination Therapy of Treatment-Resistant Major Depressive Disorder https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4207330/ Esketamine Nasal Spray for Rapid Reduction of Depressive Symptoms in Patients With Major Depressive Disorder Who Have Active Suicide Ideation With Intent: Results of a Phase 3, Double-Blind, Randomized Study (ASPIRE II) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7816667/ Esketamine Nasal Spray for the Rapid Reduction of Depressive Symptoms in Major Depressive Disorder With Acute Suicidal Ideation or Behavior https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8407443/ Ketamine Versus Midazolam for Recurrence of Suicidality in Adolescents https://clinicaltrials.gov/ct2/show/NCT04592809 Youth Depression and Suicide Research Network (YDSRN) https://clinicaltrials.gov/ct2/show/NCT04572321 The Neurobiology of Depression, Ketamine and Rapid-Acting Antidepressants: Is it Glutamate Inhibition or Activation? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165688/ Effect of Ketamine on Limbic GABA and Glutamate: A Human In Vivo Multivoxel Magnetic Resonance Spectroscopy Study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7507577/ Identifying Novel Mechanisms and Treatment Targets for Irritability and Aggression in Psychiatric Disorders https://www.nature.com/articles/s41386-021-01166-4 Ketamine Versus Midazolam for Recurrence of Suicidality in Adolescents https://clinicaltrials.gov/ct2/show/NCT04592809 Ketamine for Depression: An Update https://www.biologicalpsychiatryjournal.com/article/S0006-3223(16)32579-3/fulltext MDMA-Assisted Therapy for Severe PTSD: A Randomized, Double-Blind, Placebo-Controlled Phase 3 Study https://www.nature.com/articles/s41591-021-01336-3 Trial of Psilocybin versus Escitalopram for Depression https://www.nejm.org/doi/full/10.1056/NEJMoa2032994 The Clinical Pharmacology and Potential Therapeutic Applications of 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) https://onlinelibrary.wiley.com/doi/10.1111/jnc.15587
Un nouvel épisode du pharmascope est maintenant disponible! Dans de ce 93ème épisode, Nicolas, Sébastien et Isabelle reçoivent un invité pour discuter de tout ce qu'il y a à savoir sur les effets indésirables sexuels liés aux antidépresseurs. Les objectifs pour cet épisode sont les suivants: Décrire les effets indésirables sexuels potentiels associés aux antidépresseursExpliquer les bénéfices et les inconvénients des diverses stratégies pouvant améliorer les plaintes sexuelles liées à la prise d'un antidépresseur Ressources pertinentes en lien avec l'épisode Serretti A, Chiesa A. Treatment-emergent sexual dysfunction related to antidepressants: a meta-analysis. J Clin Psychopharmacol. 2009 Jun;29(3):259-66. Reichenpfeider U, Gartlehner G, Morgan LC, et coll. Sexual dysfunction associated with second-generation antidepressants in patients with major depressive disorder: results from a systematic review with network meta-analysis. Drug Saf. 2014 Jan;37(1):19-31. Watanabe R, Omori IM, Nakagawa A, et coll. Mirtazapine versus other antidepressive agents for depression. Cochrane Database Syst Rev. 2011 Dec 7;(12):CD006528. Thase ME, Haight BR, Richard N et coll. Remission rates following antidepressant therapy with bupropion or selective serotonin reuptake inhibitors: a meta-analysis of original data from 7 randomized controlled trials. J Clin Psychiatry. 2005; 66(8): 974-81. Delgado PL, Brannan SK, Mallinckrodt CH et coll. Sexual functioning assessed in 4 double-blind placebo- and paroxetine-controlled trials of duloxetine for major depressive disorder. J Clin Psychiatry. 2005; 66(6): 686-92. Clayton A, Kornstein S, Prakash A et coll. Changes in sexual functioning associated with duloxetine, escitalopram, and placebo in the treatment of patients with major depressive disorder. J Sex Med. 2007; 4(4 Pt 1): 917-29. Montejo-González AL, Llorca G, Izquierdo JA et coll. SSRI-induced sexual dysfunction: fluoxetine, paroxetine, sertraline, and fluvoxamine in a prospective, multicenter, and descriptive clinical study of 344 patients. J Sex Marital Ther. 1997; 23(3): 176-94. Jacobsen PL, Mahableshwarkar AR, Chen Y et coll. Effect of Vortioxetine vs. Escitalopram on Sexual Functioning in Adults with Well-Treated Major Depressive Disorder Experiencing SSRI-Induced Sexual Dysfunction. J Sex Med. 2015; 12(10): 2036-48. Taylor MJ, Rudkin L, Bullemor-Day P et coll. Strategies for managing sexual dysfunction induced by antidepressant medication.Cochrane Database Syst Rev. 2013; (5): CD003382. Clayton AH, Warnock JK, Kornstein SG et coll. A placebo-controlled trial of bupropion SR as an antidote for selective serotonin reuptake inhibitor-induced sexual dysfunction. J Clin Psychiatry. 2004 Jan;65(1):62-7. Aizenberg D, Zemishlany Z, Weizman A. Clin Neuropharmacol. Cyproheptadine treatment of sexual dysfunction induced by serotonin reuptake inhibitors. 1995; 18(4): 320-4. Fava M, Dording CM, Baker RA, et coll. Effects of Adjunctive Aripiprazole on Sexual Functioning in Patients With Major Depressive Disorder and an Inadequate Response to Standard Antidepressant Monotherapy: A Post Hoc Analysis of 3 Randomized, Double-Blind, Placebo-Controlled Studies. Prim Care Companion CNS Disord. 2011; 13(1): PCC.10m00994. Ravindran AV, Kennedy SH, O'Donovan MC, et coll. Osmotic-release oral system methylphenidate augmentation of antidepressant monotherapy in major depressive disorder: results of a double-blind, randomized, placebo-controlled trial. J Clin Psychiatry. 2008 Jan;69(1):87-94. Fooladi E, Bell RJ, Jane F, et coll. Testosterone improves antidepressant-emergent loss of libido in women: findings from a randomized, double-blind, placebo-controlled trial. J Sex Med. 2014 Mar;11(3):831-9. Lorenz TA, Meston CM. Exercise improves sexual function in women taking antidepressants: results from a randomized crossover trial. Depress Anxiety. 2014 Mar;31(3):188-95.
Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers psychedelic-assisted psychotherapy with Dr Emma Hapke and Dr Daniel Rosenbaum, both of whom are psychiatrists at the University Health Network in Toronto and co-founders of UHN's Nikean Psychedelic Psychotherapy Research Centre (in addition to being lecturers in the Department of Psychiatry at the University of Toronto). The learning objectives for this episode are as follows: By the end of this episode, you should be able to… Briefly describe the history of psychedelics in psychiatry List the four classes of psychedelic drugs and their mechanism of action Summarize the evidence regarding psychedelic-assisted psychotherapy for various psychiatric disorders Discuss patient selection considerations for psychedelic-assisted psychotherapy Describe the safety, tolerability and possible side effects of psychedelic-assisted psychotherapy Understand how a psychedelic-assisted psychotherapy session is practically carried out Guests: Dr Emma Hapke and Dr Daniel Rosenbaum Hosts: Dr Chase Thompson (PGY4), Dr Nikhita Singhal (PGY3), Jake Johnston (CC4), and Annie Yu (CC4) Audio editing by: Nikhita Singhal Show notes by: Nikhita Singhal Interview Content: Introduction - 0:00 Learning objectives - 02:47 Definitions/categories of psychedelics - 03:24 Classic psychedelics - 04:15 Empathogens (e.g. MDMA) - 07:15 Etymology of the term “psychedelic” - 09:30 Ketamine - 12:24 Iboga - 13:28 Brief history of psychedelic medicine - 17:51 Current evidence and ongoing trials - 27:38 MDMA and PTSD - 29:26 Psilocybin and treatment-resistant depression - 32:24 A word of caution - 34:29 End-of-life care - 38:47 Practical aspects of psychedelic-assisted psychotherapy sessions - 45:45 Safety considerations - 01:04:04 Future directions - 01:10:33 Closing comments - 01:19:07 Resources: Books: How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence (Michael Pollan) The Doors of Perception (Aldous Huxley) The Human Encounter With Death (Stanislav Grof and Joan Halifax) Brainwashed podcast series (CBC): https://www.cbc.ca/listen/cbc-podcasts/440-brainwashed Zendo Project (psychedelic peer support): https://zendoproject.org Nikean Psychedelic Psychotherapy Research Centre: https://www.uhn.ca/MentalHealth/Research/Nikean-Psychedelic-Psychotherapy-Research-Centre California Institute of Integral Studies (CIIS): https://www.ciis.edu Multidisciplinary Association for Psychedelic Studies (MAPS): https://maps.org PsychEd Episode 27 - Serotonin Pharmacology: From SSRIs to Psychedelics with Dr Robin Carhart-Harris) PsychEd Episode 34 - Ketamine for Treatment-Resistant Depression with Dr Sandhya Prashad References: Carhart-Harris R, Giribaldi B, Watts R, et al. Trial of Psilocybin versus Escitalopram for Depression. N Engl J Med. 2021;384(15):1402-1411. https://doi.org/10.1056/nejmoa2032994 Carhart-Harris R, Nutt D. Serotonin and brain function: a tale of two receptors. Journal of Psychopharmacology. 2017;31(9):1091-1120. https://doi.org/10.1177/0269881117725915 Davis AK, Barrett FS, May DG, et al. Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2021;78(5):481–489. https://doi.org/10.1001/jamapsychiatry.2020.3285 Griffiths RR, Johnson MW, Carducci MA, et al. Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. J Psychopharmacol. 2016;30(12):1181-1197. dhttps://dx.doi.org/10.1177%2F0269881116675513 Griffiths RR, Johnson MW, Richards WA, et al. Psilocybin-occasioned mystical-type experience in combination with meditation and other spiritual practices produces enduring positive changes in psychological functioning and in trait measures of prosocial attitudes and behaviors. J Psychopharmacol. 2018;32(1):49-69. https://doi.org/10.1177/0269881117731279 Johnson MW, Hendricks PS, Barrett FS, Griffiths RR. Classic psychedelics: An integrative review of epidemiology, therapeutics, mystical experience, and brain network function. Pharmacol Ther. 2019;197:83-102. https://doi.org/10.1016/j.pharmthera.2018.11.010 Mitchell JM, Bogenschutz M, Lilienstein A, et al. MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. Nat Med. 2021;27(6):1025-1033. https://doi.org/10.1038/s41591-021-01336-3 Mithoefer MC, Mithoefer AT, Feduccia AA, et al. 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for post-traumatic stress disorder in military veterans, firefighters, and police officers: a randomised, double-blind, dose-response, phase 2 clinical trial. Lancet Psychiatry. 2018;5(6):486-497. https://doi.org/10.1016/s2215-0366(18)30135-4 Nicholas CR, Henriquez KM, Gassman MC, et al. High dose psilocybin is associated with positive subjective effects in healthy volunteers. J Psychopharmacol. 2018;32(7):770-778. https://doi.org/10.1177/0269881118780713 Reiff CM, Richman EE, Nemeroff CB, et al. Psychedelics and Psychedelic-Assisted Psychotherapy. Am J Psychiatry. 2020;177(5):391-410. https://doi.org/10.1176/appi.ajp.2019.19010035 Rosenbaum D, Boyle AB, Rosenblum AM, Ziai S, Chasen MR, Med MP. Psychedelics for psychological and existential distress in palliative and cancer care. Curr Oncol. 2019;26(4):225-226. https://dx.doi.org/10.3747%2Fco.26.5009 Swift TC, Belser AB, Agin-Liebes G, et al. Cancer at the Dinner Table: Experiences of Psilocybin-Assisted Psychotherapy for the Treatment of Cancer-Related Distress. Journal of Humanistic Psychology. 2017;57(5):488-519. https://doi.org/10.1177/0022167817715966 CPA Note: The views expressed in this podcast do not necessarily reflect those of the Canadian Psychiatric Association. For more PsychEd, follow us on Twitter (@psychedpodcast), Facebook (PsychEd Podcast), and Instagram (@psyched.podcast). You can provide feedback by email at psychedpodcast@gmail.com. For more information, visit our website at psychedpodcast.org.
Does SARS-CoV-2 infection have a lasting impact on brain structure? Find out about this and more in today's PV Roundup podcast.
بخش ۲۰در این قسمت لولا وشمیم در مورد پژوهش و مقاله ای در مورد مقایسه اس سیتالوپرام با قارچ سیلوسایبن برای درمان افسردگی صحبت میکنند.https://www.nejm.org/doi/full/10.1056/nejmoa2032994
A recent study Prof David Nutt was involved in pitted psilocybin against escitalopram in a cleverly designed equipoise randomised controlled trial Results showed very rapid improvement (days rather than weeks) of depression symptoms and significantly better scores in wellbeing and depression in patients given psilocybin Whilst it is clear more studies are needed, there is growing interest in the use of psychedelic agents in the treatment of depression amongst younger and trainee psychiatrists, psychotherapists, and the general public As GPs, we should be aware of developments in this area Host: Dr David Lim | Total time: 32 mins Guest: Prof David Nutt, Professor of Neuropsychopharmacology, Director of the Neuropsychopharmacology Unit; Division of Brain Sciences; Imperial College London Register for our fortnightly FREE WEBCASTS Every second Tuesday | 7:00pm-9:00pm AEST Click here to register for the next one See omnystudio.com/listener for privacy information.
The Reaction Brats give each other homework. David listens to Amy Winehouse for the first time, and Robyn gives DJ Shadow a shot, thus summoning her alter ego: DJ Escitalopram. Find out how they feel about these records plus their review of Vegas, an update on the cats, and more pillow talk. Instagram: @reactionbratspod
Dr Margaret Ross is a Senior Clinical Psychologist and Psychotherapist from Melbourne, Australia and the Chief Principal Investigator for Australia's first psilocybin assisted psychotherapy study. Throughout her career, her main focus has been youth mental health and more recently cancer and palliative care. Following working as a research psychologist and clinical trial coordinator for The University of Melbourne and Orygen Youth Health, Margaret decided to move into researching alternatives for her oncology patients who were terrified of dying and experiencing existential distress in the face of their diagnosis. After seeing the compelling results of US-based research into the use of psilocybin assisted therapy for patients with existential distress in the face of terminal cancer, she decided to set on a fight so that similar treatments would soon become an option within Australia. Have a listen to this week's episode in which professor Nutt and Dr Ross talk about the land of Golden Wattle - a DMT-rich plant - fighting for its Drug policies being based on Science.Recent Australian TGA Independent Expert Panel on MDMA and psilocybin consultation PsilocybinRandomized controlled trial (RCT)Open label doseTrial of Psilocybin versus Escitalopram for DepressionDrug Scheduling in the UKStandard for the Uniform Scheduling of Medicines and Poisons (Australia)National Health and Medical Research Council (NHMRC) EntheogensGolden WattleDMTDr Ben Sessa KetamineTherapeutic Goods Administration (TGA)PitjantjatjaraLSD ★ Support this podcast ★
On today's episode, we have psychedelic scientist and researcher Manesh Girn join us for a conversation about how psychedelics affect our brain and their effectiveness in therapy. Together we talk about some of the mythology around psychedelics, your serotonin receptors, and the importance of mindfulness and meditation in creating a positive mental state. If you enjoyed today's podcast, then please subscribe, leave a review, or share this podcast with a friend! And, join the movement by becoming a part of the conscious objectors patreon. Your support is what powers this work and the larger societal change we are fighting towards! Let's continue to challenge our assumptions and grow together. Join the community here: https://www.patreon.com/user?u=54121384 Modern Anarchy Community: Instagram Facebook Patreon Manesh's Community: Instagram Youtube Resources The Challenges of Psychedelic Research The Neuroscience of Psychedelic Drugs: Ending Psychedelic Myths With Professor David Nutt The History of Psychedelics and Psychotherapy Alcohol is a Drug Psychedelics Promote Structural and Functional Neural Plasticity Dr. Stanislav Grof Reframing Bummer Trips: Scientific and Cultural Explanations to Adverse Reactions to Psychedelic Drug Use 2 Claims About Psychedelics and the Default Mode Network DEBUNKED Temporal Dynamics of the Default Mode Network Characterize Meditation-Induced Alterations in Consciousness Characterization and prediction of acute and sustained response to psychedelic psilocybin in a mindfulness group retreat From Sacred Plants to Psychotherapy: The History and Re-Emergence of Psychedelics in Medicine Coffee is a Drug Not a Beverage, Drink Up! Just Not Too Much How to Change Your Mind 5 Psychedelic Stocks to Watch Trial of Psilocybin versus Escitalopram for Depression Synthesis: Legal Psilocybin Center What Happens in the Brain When We Feel Fear
Do psychedelics treat mental illness? In this GameChanger episode host, Geoff Wall and guest, Sarah Grady, a psychiatric pharmacist, discuss a recent NEJM article comparing psilocybin (magic mushrooms) to escitalopram.Redeem your CPE or CME credit here with your GameChangers Subscription!We want your feedback! Share your feedback and experience with GameChangers! https://www.jotform.com/build/90155144694964References and resources:Carhart-Harris R, Giribaldi B, Watts R, et al. Trial of Psilocybin versus Escitalopram for Depression. N Engl J Med. 2021 Apr 15;384(15):1402-1411. doi: 10.1056/NEJMoa2032994. PMID: 33852780.Continuing Education Information:Learning Objectives: 1. Discuss a recent study comparing psilocybin to escitalopram in depression 2. Identify potential patients that could benefit from psilocybin based on the study0.05 CEU | 0.5 HrsACPE UAN: 0107-0000-21-231-H01-PInitial release date: 8/3/21Expiration date: 8/3/22Complete CPE & CME details can be found here.
Click here for a macine generated transcript Surviving a stroke is not the end of a medical issue. It's the start of a new journey, with new challenges. Major depression is often one of those challenges. It interferes with recovery, rehab, adjusting to a new life, and maintaining relationships. In short, it's big problem. And it's pretty common. According to new research by Dr. Laura Stein from the Icahn School of medicine, depression after stroke is twice as likely to occur as depression after heart attack. There's something unique about stroke that leads to depression. On top of that, if a person lived with Generalized Anxiety Disorder before stroke, they are 1.7 x as likely to experience Major Depression after stroke. In this conversation, Dr. Laura Stein talk about her research and what survivors, caregivers, and medical practitioners need to know. Bio Laura K. Stein, MD, MPH is an Assistant Professor of Neurology at the Icahn School of Medicine at Mount Sinai and attending physician at the Mount Sinai and Mount Sinai Queens Stroke Centers. She is board certified in Neurology and Vascular Neurology by the American Board of Psychiatry and Neurology. Dr. Stein received a BA from Amherst College and her MD and MPH from the Icahn School of Medicine at Mount Sinai. She completed her internship, neurology residency, and vascular neurology fellowship at Mount Sinai. Dr. Stein's interests are in stroke clinical care, stroke outcomes research, and medical education. She is the Neurology Residency Associate Program Director and precepts first year medical students in the Art and Science of Medicine preclinical skills course. Dr. Stein received the Department of Neurology Resident Class of 2020 Award of Appreciation for Dedication & Commitment Towards Excellence in Mentorship and 2020 Institute for Medical Education Excellence in Teaching Award. The Research Dr. Stein's research was part of the American Stroke Association's virtual International Stroke Conference. You can read the paper here. You can read the article where I first encountered her work here. The approach of looking at depression after heart attack vs looking at depression after stroke is an interesting one. It's a nice way of controlling for other potential causes. The research looked at Medicare recipients, Medicare is a US government health insurance program, generally for folks 65 and older. It lets researchers draw from a rich collection of data. There are two significant tradeoffs, of course. First, it's restricted to the US so there's no international representation in the study. Obviously, depending on the research question in particular, that may or may not be an issue. Second, it's restricted to folks 65 and older. Can we say that the results of this study apply to younger stroke survivors? Maybe? Probably? We don't know. And this study was not designed to answer that question. I'd say it does get us closer, though, and it opens up an opportunity to do further research that asks different but related questions. That's what good studies do. The answer specific question with solid evidence and clear analysis. And the result can introduce new questions for researchers to explore in different studies. In the meantime, it's likely safe to say, that regardless of age, stroke survivors are probably more likely to experience depression, and the community needs to be vigilant for the signs of depression and seek treatment accordingly. Symptoms of Major Depression Diagnosing depression involves identifying symptoms from a couple lists. To "earn" a depression diagnosis, a patient needs 5 symptoms from list 1 and all 4 from list 2. They are: List 1 (Pick 5 or more) Depressed Mood (most days) Loss of Interest or pleasure Weight loss or gain Insomnia or hypersomnia (nearly every day) Psychomotor agitation or limitation Fatigue (nearly every day) Feelings worthless or experiencing inappropriate guilt Decreased concentration (nearly everyday) Thoughts of death or suicide List 2 (All 4) Symptoms cause significant distress or social/professional impairment Symptoms not attributable to a substance or medical condition Symptoms not explained by another disorder No history of manic episodes You can read more details about the symptoms here. You can probably see one of the issues. Many of those symptoms may be directly attributed to the disabilities and brain damage of the stroke without it being Major Depression. That's why it's important to work with a medical professional to tease them apart. Symptoms of Generalized Anxiety Disorder Generalized Anxiety Disorder is about more than feeling nervous. It's more complicated and severe. The National Institute of Mental Health describes it this way: People with generalized anxiety disorder (GAD) display excessive anxiety or worry, most days for at least 6 months, about a number of things such as personal health, work, social interactions, and everyday routine life circumstances. The fear and anxiety can cause significant problems in areas of their life, such as social interactions, school, and work. Generalized anxiety disorder symptoms include: Feeling restless, wound-up, or on-edge Being easily fatigued Having difficulty concentrating; mind going blank Being irritable Having muscle tension Difficulty controlling feelings of worry Having sleep problems, such as difficulty falling or staying asleep, restlessness, or unsatisfying sleep You can read more about the condition here. Neuropsychology While most psychologists and psychiatrists can help stroke survivors and others with depression and other conditions, there is a specialty that may be even more helpful -- neuropsychology. A while back, I talked with Dr. Karen Sullivan from I Care For Your Brain. She wrote the "Interactive Stroke Recovery Guide."* You can listen to that conversation or learn more at http://Strokecast.com/Karen A neuropsychologist has additional, specialized training to work specifically with folks who have brain injuries. They dive deep into the details of the injury to provide the best customized treatment plan, leveraging expertise that generalists don't have. They work with folks with a wide array of functionality and challenges. FLAME vs FOCUS As long as we are talking about depression, we should also talk about antidepressants a little -- specifically SSRIs and how the relate to stroke. In 2011, the FLAME study was published in the Lancet. In short, it demonstrated that stroke survivors who took Prozac (Fluoxetine) experienced stronger motor recovery. Many hospitals saw those results and began putting more stroke survivors on Prozac because, well, why not? If the patient tolerates it well, and it can help folks work better, it's probably a good idea. And if it reduces or prevent post stroke depression (or other depression) that's a solid win. I talked with Dr. Nirav Shah about this back in November of 2018. You can listen to that episode here. That's how I started on an SSRI in my stay. They originally tried Prozac with me, but I had a not great reaction to it. It apparently gave me an anxiety attack. So we quickly stopped that (thank you, Xanax, I think). We talked about it some more and tried again with a different SSRI -- Lexapro (Escitalopram) because I had tolerated it well during a tough time some years earlier. Cheap, no negative side effects, and potentially helpful is win. A month after my interview with Nirav, and a year and a half after my stroke, the FOCUS study came out, attempting to duplicate the results of the FLAME study on a bigger scale. It failed. The scientific consensus now is that SSRIs do not help with motor recovery. They do still help with depression. The hospital no longer recommends SSRIs as part of the motor recovery protocol. So what does that mean for folks like me? I asked my doctor last year if that meant I should stop taking them. We talked about it and she explained I could certainly stop if I wanted to. "But, dude -- it's 2020." And she had a valid point. (Okay, maybe I paraphrased that) And that's why Escitalopram still has a place in my pill organizer. As always, everyone's stroke and circumstances will vary, so talk to your doctor before making any changes to your medication. Hack of the Week Get a dog. A dog can be helpful after stroke, whether it's a service dog or simply a companion animal. When you have a dog, you have a responsibility to take care of it. You have to feed it, walk it, groom it, and give it cuddles. Sometimes that may be reason enough to get out of bed and get moving for the day. Links Where do we go from here? If you think there's a chance you might be experiencing depression, talk to your medical team Share this episode with someone you know with the link http://Strokecast.com/depression Subscribe to the free, monthly Strokecast email newsletter at http://Strokecast.com/news Don't get best…get better.
You're going to give me serotonin syndrome with your eyes.
What exactly is psychedelic therapy, and what does the research on psychedelic therapy tell us about its effectiveness? In this episode of The Integration Conversation, Brom provides a description of what exactly happens during psychedelic therapy, and then goes over the three most compelling clinical research papers on psychedelic therapy. Learn about how MDMA can treat Post Traumatic Stress Disorder, psilocybin can treat depression, and how psilocybin stacks up against SSRIs like Lexapro.
Trying to keep up with the medical literature but apparently JournalSpotting HQ has a team of actual beavers who chew and digest all the articles then present them in a light-hearted podcast. So why bother?In #33 Dr Barney Hirons and Dr Jon Hudson cover the latest and greatest in medical literature. Including: - What BP is optimum based on the latest meta-analysis?- What to give for generalised epilepsy - Valporate or Keppra? - How Mushrooms really could reduce the risk of cancer- Magic mushrooms vs Escitalopram in Depression- Sleep duration and Dementia risk- Teeth number and Dementia risk (?!)- Long COVID, and how it really sucks- Coffee habits from Mendelian Randomisation- Is weight gain after quitting smoking dangerous?- Burnout riskAlong with some general geeky medic/pizza/rat chat!Follow on Twitter @JournalSpotting or email JournalSpottng@gmail.com!
《新英格蘭醫學期刊》刊登英國團隊研究迷幻蘑菇的成分Psilocybin 與抗憂鬱藥比較的臨床試驗成果,也引發許多對迷幻蘑菇這種「啟靈藥」(psychedelic)或是「致幻劑」的討論。 這篇發表在最頂尖醫學期刊的第二期臨床試驗之後,迷幻蘑菇要成為抗憂鬱藥,到底還有多少距離?台灣與國外對迷幻蘑菇的管制、臨床試驗有哪些差別?臨床試驗中使用Psilocybin 達到抗憂鬱的效果,還有哪些不可或缺的元素? 這些都不是用簡單幾句話能論述的,都在《會談地圖podcast 》目前最長的這集節目中! 論文原文: Trial of Psilocybin versus Escitalopram for Depression. N Engl J Med 2021; 384:1402-1411 Back to the Future — The Therapeutic Potential of Psychedelic Drugs. N Engl J Med 2021; 384:1460-1461 Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder. A Randomized Clinical Trial. JAMA Psychiatry. Published online November 4, 2020. Powered by Firstory Hosting
The psychedelic drug psilocybin, found in magic mushrooms, is as good at reducing symptoms of depression as conventional treatment, a small, early-stage trial has suggested. The study, run by Imperial College London's Centre for Psychedelic Research, is among the first to test psilocybin against the usual drug treatment, an SSRI, in this case Escitalopram. Prof David Nutt is the Deputy Head of the Centre, and co-author of the study, which was published in the New England Journal of Medicine this week. He is the Edmond J. Safra Professor of Neuropsychopharmacology and director of the Neuropsychopharmacology Unit at Imperial College London.
The psychedelic drug psilocybin, found in magic mushrooms, is as good at reducing symptoms of depression as conventional treatment, a small, early-stage trial has suggested. The study, run by Imperial College London's Centre for Psychedelic Research, is among the first to test psilocybin against the usual drug treatment, an SSRI, in this case Escitalopram. Prof David Nutt is the Deputy Head of the Centre, and co-author of the study, which was published in the New England Journal of Medicine this week. He is the Edmond J. Safra Professor of Neuropsychopharmacology and director of the Neuropsychopharmacology Unit at Imperial College London.
Robin Heads the Psychedelic Research Group within the Centre for Psychiatry at Imperial College London, where he has designed several functional brain imaging studies with psilocybin, LSD, MDMA and DMT, plus a clinical trial of psilocybin for treatment resistant depression. He has over 50 published papers in peer-reviewed scientific journals; two of which were ranked in the top 100 most impactful academic articles of 2016. Robin's research has featured in major national and international media and he has given a popular TEDx talk.Does MDMA impact sleep?What does the brain look like under the influence of LSD?How do psychedelics change the quality of brain activity? Can psilocybin be used to treat depression? Psilocybin vs Escitalopram for Major Depressive Disorder Stanislav Grof LSD PsychotherapyRobin's first paper – Waves of the Unconscious Amanda FeildingRobin's PhD Drugs live – Channel 4Psilocybin LSD MDMADMTPsychedelic resting states The entropic brainHomological scaffolds of brain functional networksThe Stoned Ape theory DMT Neural Correlates of the DMT experience Psilocybin for Treatment-Resistant Depression Serotonin and brain function: a tale of two receptors ★ Support this podcast ★
https://astralcodexten.substack.com/p/oh-the-places-youll-go-when-trying I. What is the right dose of Lexapro (escitalopram)? The official FDA packet insert recommends a usual dose of 10 mg, and a maximum safe dose of 20 mg. It says studies fail to show 20 mg works any better than 10, but you can use 20 if you really want to. But Jakubovski et al's Dose-Response Relationship Of Selective Serotonin Reuptake Inhibitors tries to figure out which doses of which antidepressants are equivalent to each other, and comes up with the following suggestion (ignore the graph, read the caption) 16.7 mg Lexapro equals 20 mg of paroxetine (Paxil) or fluoxetine (Prozac). But the maximum approved doses of those medications are 60 mg and 80 mg, respectively. If we convert these to mg imipramine equivalents like the study above uses, Prozac maxes out at 400, Paxil at 300, and Lexapro at 120. So Lexapro has a very low maximum dose compared to other similar antidepressants. Why? Because Lexapro (escitalopram) is a derivative of the older drug Celexa (citalopram). Sometime around 2011, the FDA freaked out that high doses of citalopram might cause a deadly heart condition called torsade de pointes, and lowered the maximum dose to prevent this. Since then it's been pretty conclusively shown that the FDA was mostly wrong about this and kind of bungled the whole process. But they forgot to ever unbungle it, so citalopram still has a lower maximum dose than every other antidepressant. When escitalopram was invented, it inherited its parent chemical's unusually-low maximum dose, and remains at that level today [edit: I got the timing messed up, see here]
For nearly 17 years, since the FDA black box warning about suicidality with antidepressants, our community has been quoting data that downplays this concern. We were wrong. We were deceived. Antidepressants can be lifesaving, but there really is a duty to warn. In this episode, Doctors Martha Ignaszewski and Glen Spielmans talk with us about what went on and how to talk about it with our families. Guests: Dr. Glen Spielmans, professor of psychology at Metropolitan State University in Saint Paul, Minnesota Dr. Martha Ignaszewski, staff psychiatrist at BC Children’s Hospital and a clinical instructor at the University of British Columbia Published On: 3/1/2021 Duration: 24 minutes, 36 seconds Related Articles: "Duty to Warn? Debating Antidepressant Suicidality," The Carlat Child Psychiatry Report, Oct/Nov/Dec 2020 Spielmans GI, Spence-Sing T, Parry P. Duty to Warn: Antidepressant Black Box Suicidality Warning Is Empirically Justified. Front Psychiatry. 2020 Feb 13;11:18. doi: 10.3389/fpsyt.2020.00018. PMID: 32116839; PMCID: PMC7031767. [Link] Ignaszewski MJ, Waslick B. Update on Randomized Placebo-Controlled Trials in the Past Decade for Treatment of Major Depressive Disorder in Child and Adolescent Patients: A Systematic Review. J Child Adolesc Psychopharmacol. 2018 Dec;28(10):668-675. doi: 10.1089/cap.2017.0174. Epub 2018 Jul 31. PMID: 30063169. [Link] Links and References: Gibbons RD, Brown CH, Hur K, Marcus SM, Bhaumik DK, Erkens JA, Herings RM, Mann JJ. Early evidence on the effects of regulators' suicidality warnings on SSRI prescriptions and suicide in children and adolescents. Am J Psychiatry. 2007 Sep;164(9):1356-63. doi:" [Link] Gibbons RD, Brown CH, Hur K, Davis J, Mann JJ. Suicidal thoughts and behavior with antidepressant treatment: reanalysis of the randomized placebo-controlled studies of fluoxetine and venlafaxine. Arch Gen Psychiatry. 2012 Jun;69(6):580-7. doi: 10.1001/archgenpsychiatry.2011.2048. Erratum in: Arch Gen Psychiatry.2013 Aug;70(8):881. PMID: 22309973; PMCID: PMC3367101. [Link] Findling RL, Robb A, Bose A. Escitalopram in the treatment of adolescent depression: a randomized, double-blind, placebo-controlled extension trial. J Child Adolesc Psychopharmacol. 2013 Sep;23(7):468-80. doi: 10.1089/cap.2012.0023. PMID: 24041408; PMCID: PMC3779002. [Link] Healy D, Cattell D. Interface between authorship, industry and science in the domain of therapeutics. Br J Psychiatry. 2003 Jul;183:22-7. PMID: 12835239. [Link] Phase Five Website [Link] Phase Five Marketing Document [Link]
Can you believe this is our 100th episode??? It has been a little over 6 months since our official launch and we are now running full steam, thanks to a hardworking team. Cheers to the members of AMiNDR, and cheers to you for listening to us. This episode is for those of you who are interested in what's already on the marker for treating Alzheimer's diseases. That's right, you have knowingly or by chance stumbled upon our episode on refining or repurposing existing medications, as well as improving methods of drug delivery. You will hear about advances in refining the use of Memantine, Donepezil, and Rivastigmine, and exploring the potential of drugs like Lithium, Escitalopram, or Sildenafil to alleviate the symptoms of AD. We also cover papers that look at refining methods of drug delivery, efficiency, or bioavailability. Sections in this episode: Section 1: Refining existing drugs 3.53 Memantine (1 paper): 4.26 Donepezil (3 papers): 6.03 Rivastigmine (1 paper): 12.55 Section 2: Refining methods (delivery, efficiency, bioavailability): (5 papers) 15.25 Section 3: Repurposing approved drugs (6 papers): 28.26 Bonus paper: 43.29 ------------------------------------------------------------------ To receive the list of papers covered, please fill this form: --------> https://forms.gle/CVVbznAFM8pamdgk6 ------- or by tweeting at us: @AMiNDR_podcast ------------------------------------------------------------------ We would appreciate your feedback so we can better cater to your needs. You can fill our feedback form here ----------> https://forms.gle/5aq2JyrT6g4P1m8v6 You can also share your thoughts and suggestions by contacting us: Email: amindrpodcast@gmail.com Facebook: AMiNDR Twitter: @AMiNDR_podcastInstagram: @AMiNDR.podcast------------------------------------------------------------------ Today's episode was scripted by Sarah Louadi and Naila Kuhlmann, reviewed by Joseph Liang, and hosted and edited by Sarah Louadi. All of this was made possible thanks to an entire team of volunteers behind the scenes. Our music is from "Journey of a Neurotransmitter" by musician and fellow neuroscientist Anusha Kamesh; you can find the original piece and her other music on soundcloud under Anusha Kamesh or on her YouTube channel, AKMusic. https://www.youtube.com/channel/UCMH7chrAdtCUZuGia16FR4w ------------------------------------------------------------------ If you are interested in joining the team, send us your CV by email. We are specifically looking for help with abstract summary and podcast editing. However, if you are interested in helping in other ways, don't hesitate to apply anyways. ------------------------------------------------------------------ *About AMiNDR: * Learn more about this project and the team behind it by listening to our first episode: "Welcome to AMiNDR!"
Real Life Pharmacology - Pharmacology Education for Health Care Professionals
On this episode of the Real Life Pharmacology Podcast, I discuss escitalopram pharmacology. Escitalopram is an SSRI and can be used to manage depression, anxiety, OCD, PTSD, and other psychiatric disorders. If you consider fluoxetine the most activation SSRI and paroxetine the most sedating, escitalopram probably falls somewhere in the middle. Sexual dysfunction is a potential adverse effect with escitalopram. I discuss it further on this episode.
Escitalopram is the S-enantiomer of citalopram. This drug works by selectively inhibiting serotonin. The brand name that escitalopram is most recognized as Lexapro. Dosing is typically initiated at 10 mg po qd with adjustments made incrementally with the max dose generally being around 20 mg per day. There are many off label uses for escitalopram so those should be utilized on a case by case basis. However, the main indications for this drug is to treat depression and anxiety. Escitalopram is not approved for use in patients under the age of 12. The black box warning for escitalopram is for suicidal thoughts and behaviors. Important monitoring parameters are ECG in patients at risk of QT prolongation and pregnancy since the drug crosses the placenta. Go to DrugCardsDaily.com for episode show notes which consist of the drug summary, quiz, and link to the drug card for FREE! Please SUBSCRIBE, FOLLOW, and RATE on Spotify, Apple Podcasts, or wherever your favorite place to listen to podcasts are. The main goal is to go over the Top 200 Drugs with the occasional drug of interest. Also, if you'd like to say hello, suggest a drug, or leave some feedback I'd really appreciate hearing from you! Leave a voice message at anchor.fm/drugcardsdaily or find me on twitter @drugcardsdaily --- Send in a voice message: https://anchor.fm/drugcardsdaily/message
Dr. Yvette I. Sheline discusses her paper, "Effect of Escitalopram Dose and Treatment Duration on CSF Aβ Levels in Healthy Older Adults". Show references: https://n.neurology.org/content/early/2020/09/10/WNL.0000000000010725
In the first segment, Dr. Jeffrey Ratliff talks with Dr. Yvette Sheline about her paper on the Effect of escitalopram on CSF Aβ. In the second part of the podcast, Dr. Stacey Clardy speaks with Dr. Elizabeth Finger about her article on the neural effects of oxytocin on frontotemporal dementia, also from this week’s issue. Disclosures can be found at Neurology.org. CME Opportunity: Listen to this week’s Neurology Podcast and earn 0.5 AMA PRA Category 1 CME Credits™ by completing the online Podcast quiz.
Você sabia que todas as terça-feira tem aula ao vivo sobre diversos assuntos do ramo farmacêutico lá no meu canal no Youtube? Sim, isso mesmo! Toda terça às 20:00 horas eu dou uma aula nova, com assuntos novos! Ficou interessado e quer participar? Então cadastre seu e-mail clicando no link
In this mini-episode Dr. H opens himself up for major audiophile shaming as he (reluctantly) reveals his three desert island albums. With this revelation complete, he then moves on to the challenge at hand-- which three psychiatric medications are at the top of the heap, combining efficacy, safety, and breadth of symptom coverage?A hint-- they all start with the same letter. And they are all generic. And psychiatry would be greatly hamstrung without them. Guesses?? Dr. Hhttps://www.craigheacockmd.com
Está entregue, em sua casa, a Sexta Básica dessa quinzena! No pacote de hoje: Fluoxetina, Paroxetina, Citalopram, Escitalopram, Sertralina, afeto e amor próprio na medida certa! Nesse Setembro Amarelo, oferecemos a todos o alimento necessário para que a mente não caia nas armadilhas da depressão. SAC: Mande suas sugestões de produtos para as próximas caixas e reclamações sobre produtos estragados para: contato@sextabasica.radio.br (Obs.: Não aceitamos devoluções.) Redes sociais: Instagram: @sextabasicapodcast @odilon_silva1 @bnfernandes92 @jonys_macedo @rafafontanari Twitter: @Jonys_macedo @odihsilva @bnfernandes92 @rafafontanari
Today’s question is: How to approach a case of generalized anxiety disorder? Here is a summary of this episode: GAD is a disorder of chronic, excessive worrying. Ensure you have the correct diagnosis according to DSM-5. For patients with bipolar depression, do not use an antidepressant. Instead, you may use hydroxyzine, pregabalin, or benzodiazepines. The first-line treatments are SSRIs. Escitalopram and paroxetine are FDA-approved. Sertraline is also recommended as a possible first-line agent. Download a PDF of this interview here Become a premium member of the Psychopharmacology Institute
Porpoise Crispy Podcast Volume #8 Episode #2 Escitalopram (Lexapro, Cipralex) Curated by JohnFebruary 8, 2019 Celexa helps us remember The Sun Smells Too Loud Mogwai The Hawk Is Howling Lawman Girl Band Lawman Doctor Priests Bodies And Control And Money And Power Wasted Days Cloud Nothings Attack On Memory Reaching For Things HEATER HEATER - Self-Titled 7" Butler Moon Pussy Moon Pussy 2 Grab a Shovel Tørsö Build and Break Leopard Print Jet Ski Meat Wave The Incessant Sunshine Priors New Pleasure Hadrianich Relique Rudimentary Peni Pope Adrian 37th Psychristiatric Lexapro might do it better The pCrispy is only an hour of music so I know you’ve got time to enjoy to these bad asses of the Internets: The Westerino Show Funkytown Bayerclan Squirreling Podcast Secretly Timid
This week, Dr. Nirav Shah and I talk about antidepressants -- SSRIs specifically -- in Stroke Recovery. The FLAME study demonstrated the benefits to motor recovery. SSRI stands for Selective Serotonin Re-uptake Inhibitor. Basically, the way data gets sent from one nerve cell to another is through the use of chemicals, like serotonin. The body produce serotonin and the collects it when done, taking it out of the system. An SSRI slows down the collection process -- it inhibits the re-uptake. That leaves more serotonin floating around the brain. Having more serotonin floating around the brain can help reduce, manage, or eliminate depression and other conditions. That's why SSRIs are some of the most common anti-depressants on the market. The FLAME study looked at how Fluoxetine (AKA Prozac) behaves in folks who recently had a stroke. Fluoxetine is an old school antidepressant and SSRI. The study appeared to show that the extra serotonin in the brain may help promote neuroplasticity and recovery of motor skills after stroke, and that's why we're talking about it today. My Experience When I was inpatient, the doctor put me on an SSRI due to the FLAME study. She tried Prozac (AKA Fluoxetine) first. Unfortunately, it gave me an anxiety attack. On the other hand, I now know what an anxiety attack feels like. Not pleasant. A Xanax took care of that. We tried again the next day, this time with another SSRI called Lexapro (AKA Escitalopram). Someone explained to me that the molecule that makes up Lexapro is the mirror image of the Prozac molecule. I'd had Lexapro in the past, with no ill effects so it was worth a shot. Success! No anxiety attack this time. And that's how an SSRI earned a spot in my daily collection of medication. But did it help my recovery? Maybe. There's no way to tell for sure. The data indicates that it should and there is no reason to think it didn't help. As a side effect, I did not go into the deep depression so common among other stroke survivors. This is a new use for SSRIs, Fluoxetine, and Escitalopram. It's borderline off-label. Not all doctors are familiar with the idea that SSRIs promote the neuroplasticity that supports recovery of motor functions. And that's how I ended up explaining the research to my primary care physician as he reviewed my meds with me post-hospital. The FLAME study covered 6 months. I'm still taking the Lexapro today. When I talked to my rehab doctor about whether I should continue we concluded that since I don't have any negative results from it, we may as well keep it up. If there's a chance it can help, and it's not hurting, then that sounds good to me. Dr. Nirav H. Shah Dr. Nirav H. Shah is a fellowship trained neurologist and sub-specialist in cerebrovascular and stroke medicine with board certifications in t: neurology, stroke medicine, carotid neurosonology, transcranial doppler ultrasound, and neuroimaging. He is a practicing neurohospitalist and served as the stroke medical director at Swedish Medical Center in Seattle. Academically, he is interested in emergent and critical care neurology research and is an associate editor for The Neurohospitalist, a peer-reviewed journal. He enjoys mentoring trainees and collaborating on publications and conference presentations. Outside of clinical care Dr Shah is collaborating with experts to develop scalable technologies capable of ameliorating healthcare’s challenges. He consults with startups and investors to develop technologies and devices so that one day they are available to his patients. He has worked with companies to meet FDA regulations for approval as well as to help them understand the provider perspective of product-market fit. Dr. Shah is also the CEO and Founder of Sentinel Healthcare. He is also a passionate traveler and photographer. So let's fan the FLAME of stroke recovery with Nirav. Hack of the Week Many stroke survivors use a day of the week pill organizer to keep track of meds. And, sometimes, the day of the week. The organizer can also make it easy to keep track of whether or not we've taken pills for the day. After taking your pills, leave the door for that day open exposing the now empty chamber. That gives you and your caregiver an easy to see visual queue the deed is done. Links FLAME study Presentation http://www.my.americanheart.org/idc/groups/ahamah-public/@wcm/@sop/@scon/documents/downloadable/ucm_427770.pdf Efficacy of Fluoxetine - a Trial in Stroke (EFFECTS) https://clinicaltrials.gov/ct2/show/NCT02683213 Predicting recovery in acute poststroke aphasia https://www.ncbi.nlm.nih.gov/pubmed/29451321 Nirav’s previous appearance http://strokecast.com/nirav Nirav on Stem Cells and Stroke Recovery http://strokecast.com/stemcells Nirav on LinkedIn https://www.linkedin.com/in/nirav-h-shah/ Nirav at Swedish https://www.swedish.org/swedish-physicians/profile.aspx?name=nirav+h+shah&id=271893 Nirav on Twitter http://twitter.com/NeuroNirav The Neurohospitalist http://journals.sagepub.com/home/nho Nirav’s Photography www.thoughtpotential.com Sentinel Healthcare http://www.sentinel.healthcare/ Where do we go from here? Check out the links to the FLAME study and the other SSRI stroke studies above. Subscribe to Strokecast for free in your favorite podcast app. Use your pill box door as a reminder/calendar. Don't get best…get better.
The post Escitalopram (Lexapro) Nursing Pharmacology Considerations appeared first on NURSING.com.
The Little Dream by Robin M. Eames She feels the pain before she fully wakes up, stuck in that half-space between slumber and cold daylight. For a moment she doesn't understand. Pain. A bone-deep ache—no, deeper than her bones. Soul-deep. Her eyes crack open. Fuck, it's freezing. Sylvia closes her eyes again, opens them, glares balefully at the open window. She waves a hand, hoping for a little miracle, for everything to fall into place, but the window-frame barely twitches. Might have been telekinesis, might have been her vision blurring from the pain. Her fucking useless powers are all the more fucking useless on bad pain days. She doesn't want to move, because she knows if she moves it'll get worse. She has to get out of bed. The cat needs feeding. For a moment her head is swimming, and she can't remember the cat's name. [Full transcript after the cut] Hello! Welcome to GlitterShip episode 37! This is your host Keffy, and I'm super excited to be sharing this story with you. We're currently running a little behind again, but should be caught up soon. Our Spring 2017 issue is now out, and that's available at glittership.com/buy for anyone who would like to read all of the stories before they come out on the podcast. Our issues are also available as a patron reward, so if you support GlitterShip via Patreon (patreon.com/keffy), you can check out the issue there. First, we'll have a poem by Joanne Rixon and a story by Robin M. Eames. Joanne Rixon lives in the Pacific Northwest with her rescue chihuahua. She mostly writes speculative fiction; this is her first published poem. You can follow her on twitter @JoanneRixon. Robin M. Eames is a 23 year old freelance writer and artist living in Sydney, Australia. They graduated in 2016 with a Bachelor of Arts from the University of Sydney, majoring in History and Gender Studies. Their work has been published in Luna Station Quarterly, Glitterwolf, ARNA, Hermes, and in the anthology Broken Worlds edited by Jack Burgos. Robin uses they/them/their pronouns. Their interests include comparative mythology, queer and disability theory & activism, cats, black tea, and tattoos. You can find their twitter at @robinmarceline and their website at robinmeames.org. I stayed up all night waiting for the election results and then... by Joanne Rixon the morning after my skin began to peel.But I haven’t been in the sun, I said.It’s November and also I’m afraid the cancer will return.But still my fingerprints came off whole, skin curledoff my biceps in sheets.It broke at the wrinkles of my elbows, andwhere my skin was thin and dry it flaked: the tips of my hipbones,my collarbones, stretching. My hair also fell out but that had been happeningfor weeks so it wasn’t surprising. Only the speed of it.Giant handfuls of hair clogged the drain.My scalp turned blotchy as a piebald horse,paler than new cheese, and then began to split.As more layers unloosened, detached—they got damp and rubbery the deeper they went—underneath something began to be visible: gray-brown and nubbled surface;antler-hard to the touch, and I couldn’t stoptouching. It itched.My sister looked at me sideways, poking my shoulderto see for herself.Don’t be afraid, I told her. I’m not.I’m not afraid at all, I said.I didn’t say it. I tried to say it but I couldn’t make it wordsor anything else but small stones falling from my lips.My teeth, little diamonds, ached for somethingto bite. END The Little Dream by Robin M. Eames She feels the pain before she fully wakes up, stuck in that half-space between slumber and cold daylight. For a moment she doesn't understand. Pain. A bone-deep ache—no, deeper than her bones. Soul-deep. Her eyes crack open. Fuck, it's freezing. Sylvia closes her eyes again, opens them, glares balefully at the open window. She waves a hand, hoping for a little miracle, for everything to fall into place, but the window-frame barely twitches. Might have been telekinesis, might have been her vision blurring from the pain. Her fucking useless powers are all the more fucking useless on bad pain days. She doesn't want to move, because she knows if she moves it'll get worse. She has to get out of bed. The cat needs feeding. For a moment her head is swimming, and she can't remember the cat's name. Moth. The cat's name is Moth. Sylvia moves her shoulders experimentally, and is rewarded by a sharp cracking noise. She groans, swings her legs over the edge of the bed, gets stuck. Out of breath. Moth meows plaintively from outside her bedroom door. People say that only humans can develop supercapabilities but Sylvia swears that damn cat's psychic. "Coming," she says. It's a lie. She still can't move. Fucking fibro, fucking cat, fucking Sydney winter weather, fucking rubbish excuse for telekinesis. She didn't wear pajamas to bed and there are goosebumps on her arms. She left her cane next to the front door last night. Yesterday was a 3, maybe a 4. A good day. Today's a 7. It'll be an 8 if she overexerts herself. 1 is painless. "Normal." 10, presumably, is dead. Sylvia steels herself, and then rolls off the bed and lands on the floor with a thump. She can't quite muster the energy to stand up, so she shuffles out of her bedroom on her hands and knees, naked, quietly glad that she doesn't have a housemate to witness her total lack of dignity. On a good day Sylvia can hover. Only a little, about a foot or two above the ground. Fucking typical that her powers are only functional on the days she doesn't need them. "Hello," she says to Moth. He meows at her and then licks her nose. Cane. Cat. Meds. Breakfast. Cane's next to the front door. She tries not to think about how long it takes her to get there, but things are a little easier after that; she levers herself up and hobbles vaguely into the kitchen. Moth rubs against her legs and she startles, almost falls over. Cat. Sylvia cracks open a tin of tuna and he immediately starts purring. Her meds are all the way up on the high shelf, and her shoulders protest just looking at the stretch. That was a great idea, Sylvia-of-yesterday, just bloody brilliant, put your meds where you can't reach them. Breakfast. Her mind stalls. There are eggs in the fridge but she's out of oil or butter to fry them in, there's cereal but no milk, there's bread. Toast. Toast is easy. Sylvia fumbles a knife out of the drawer, jam, the bread, and sinks to the floor, leaning against the kitchen counter. She concentrates, blinks, her eyes burn, and the toast begins to sizzle faintly. Technically it's laser vision, but Brian calls it her toast vision, because it isn't good for much else. Sometimes she can light cigarettes. Knife, jam, bread. Don’t warp the knife. Sometimes Sylvia bends cutlery when she’s stressed, or leaves little fingerprint-shaped dents in metal doorknobs. A hand tremor makes her fumble the knife, but the metal stays intact. She blinks tiredly at her toast for a moment. Bites down and savors the sour-sweetness. Lid back on the jam, jam back up on the kitchen counter. Sylvia's still sitting on the floor. The cat, finished with the tuna, wanders nonchalantly over and sits on her outstretched legs. Meds. Still on the shelf. Escitalopram, estradiol, progesterone, spironolactone, rabeprazole, riboflavin, propranolol, ibuprofen and paracetamol for moderately miserable days, tramadol for really fucking murderously miserable days. Missing a day of meds because she can't get up off the floor. It's sort of funny. Sylvia-of-yesterday was a useless bum and she's never putting her meds on the high shelf ever again. It's a 7 day. Not yet an 8. If she really concentrates… She narrows her eyes at the shelf, flicks her fingers, and her pillbox starts to wobble precariously towards her. Sylvia doesn't dare to breathe. It moves closer—closer—and then twitches and flies right across the room, smacking hard into the opposite wall. Pills scatter everywhere. The cat pounces and starts batting them about the floor. Sylvia closes her eyes, and lets her head fall backwards with a thunk. The day doesn’t really get better from there, but she manages to corral her meds, and get off the floor, eventually. Clothes. Jeans or skirt? How likely is it that she’ll get bashed today? Jeans. No energy to shave. Lydia down the road can shave by shapeshifting. Rude. There are three rubber wristbands on her dresser. One of them says SHE/HER/HERS, the second THEY/THEM/THEIRS, and the third HE/HIM/HIS. Sylvia looks at them for a moment. Contemplates. Puts on the second one. Sylvie locks the door behind them, checks their pockets—keys, wallet, phone—and limps their way to the bus stop. On the bus on the way into uni there’s a businesswoman with huge, bright white wings, one of which is in a splint. The driver argues with her momentarily about whether she should have to buy an extra ticket or not. Sylvie rolls their eyes. The winged woman bumps into several passengers, apologizes, manages to swing her wings around so that they’re not in anyone’s way. When she gets off at the next stop she leaves a thin trail of shed feathers behind her. Sylvie presses their head against the window, feels the shuddering of the bus beneath them. When they get into the lecture theatre, Brian immediately waves them over and then presents his middle finger for inspection. Sylvie raises their eyebrows, and Brian pouts. “I’ve got a papercut.” “Oh, come on—” “Please?” Sylvie grumbles under their breath, but puts their hand over Brian’s, brown over darker brown. They don’t glow, or hum, and their eyes don’t roll back into their head, but when they move their hand away Brian’s papercut is gone. Would be really fucking nice if their healing factor worked on anything worse than papercuts. Abracadabra, fibromyalgia away. The lecture is on Mary Wollstonecraft, Olympe de Gouges, Rousseau, the right to property, the right to vote, the civil rights movement, women’s rights, trans rights, super rights. Sylvie falls asleep halfway through. In the tutorial afterwards someone says “transsexuals—I’m sorry, is that the right term?” and looks at Sylvie expectantly. Brian snickers under his breath and then someone uses the word “aborigine” and he stops laughing and starts cutting into them about it. Why are the Gadigal mob so angry and drunk all the time, the student wants to know. I’ll tell you fucking why says Brian. Last week after class some fucker told Brian and Sylvie “go back to where you came from”. Brian laughed so hard that he cried, and then he yelled so much that his voice went hoarse and he sounded like Batman. Go back to where you came from, go home, get back on your boat. Sylvie used to work in a coffee shop in Surry Hills, before the fibro got so bad that they couldn’t stand for long periods. Sometimes white boys would try to flirt with them, always that expectant look, “where are you from, no, I mean where are you from”. Sylvie’s mum’s family were early settlers, Australian for four generations back, but the fifth generation were from the Pearl River Delta, so apparently that’s all that matters. Sylvie’s dad was mixed, Latino and something else, their mum wasn’t sure. His last name was Rodriguez. They met on their gap years. Where is Sylvie from? Hell if they know. Brian’s rant winds down and the other student looks thoroughly cowed. Sylvie grins at him from the corner of their mouth. Brian sits back, legs splayed open, arms thrown over the seats beside him, owning the room. “See you at the rally tomorrow?” Brian asks, when the tute finishes. “Yeah,” says Sylvie. It’s not far from the university to the hospital, but Sylvie’s back is aching, and their head is throbbing, so they catch the bus again. There’s an echoing in their ears that doesn’t bode well. Their ENT specialist isn’t sure if it’s superhearing or just hypersensitivity to light and sound, but either way it usually leads to a migraine. Most supercapabilities show up around puberty, or even earlier, but Sylvie’s powers have been popping up randomly for years. It would be fun if any of them were actually useful. The woman at reception waves Sylvie through, and they trace their way over the memorised path, through the corridors, up two floors in the lift, tap lightly on the door. “Oh, hi _________,” says Sylvie’s mum. Her voice is barely more than a whisper. “It’s Sylvie,” Sylvie corrects gently. Their mother doesn’t seem to hear them. Sylvie props their cane over the back of the visitor’s chair and sinks into it. “How are you feeling?” No answer. “Mum?” “Hmm?” She startles, eyes wide, hands moving vaguely around. “Oh, same old. They’ve got a new jelly flavor. It’s blue.” “That’s nice.” Their mother blinks, slowly. “How’s uni going?” Sylvie smiles. “It’s good. I got a distinction in my last assignment. There’s a super rights rally tomorrow.” “Supercapable,” corrects Sylvie’s mother, wrinkling her nose. Sylvie just shrugs, puts their hand over their mother’s. Lymphoma. Not much their shitty little healing factor can do about it. But maybe it helps in some small way. Their mother smiles, faintly, and starts to hum. Sylvie doesn’t recognize the tune, but it follows them out of the hospital, back to their flat, and into their dreams that night. The next day is a 6. Low-level aches all over, nausea, headache, sore throat. It’s a blessing after yesterday. Sylvie actually manages to shave and brush their teeth. Same wristband as yesterday: THEY/THEM/THEIRS. They hesitate at their wardrobe, mindful of the rally later today, but—fuck it. Skirt and leggings it is. Their shirt says IN SPACE NO ONE CAN HEAR YOU INSIST THERE ARE ONLY TWO GENDERS. Their phone buzzes, and a picture of Brian pops up, tongue sticking out and green glitter on his eyelashes. The message reads: are u still coming to the rally Yes, they type back. It takes a moment for their phone to buzz again. good bring ur cane umbrella it’s going to rain later Cane umbrella defeats the purpose of the cane, Sylvie replies. Can’t use it to walk when it’s up over my ears. Who thought that was a good idea smh shut up it’s a miracle of fucking technoglogy, says Brian. *technology, says Brian. Sylvie smiles, puts their phone in their pocket, and brings a raincoat. Sylvie and Brian meet at the coffee shop around the corner from Town Hall, where the rally’s going to start. These things always take forever to get going. Sylvie would rather skip the speeches and self-congratulation at the beginning, the harping on of various activist groups, the factional side-eyeing, the pointless circulating petitions. Sylvie inhales. Coffee beans and chocolate. Scent memory to two years ago, scratchy uniform, ten hour workdays. They fumble their way into a booth seat, propping their cane up beside them, cursing when it slips and falls under the table. “You’re too young to be such a crotchety old grandma,” says Brian, then glances at their wristband. Corrects himself. “Grandperson.” “Grandparent,” says Sylvie, and flicks him on the ear. “I went on a date last night,” says Brian, waggling his eyebrows. “How’d it go?” He smiles, long and slow. Sylvie cackles. At least someone’s getting laid. The last date they went on was a mess, months ago, some girl they met on OkCupid. The girl walked through the door and her face fell like a stone. Sylvie doesn’t even know what it was—the cane, the color of their skin, their lipsticked mouth surrounded by stubble. Hell, maybe it was the bright little “super in every sense” pin on their backpack. Maybe some combination of all of them. The girl fled like her heels were on fire. They bum around in the café for a bit before they finally join the rally, a huge throng of people clutching banners and posters and shouting witty slogans about Turnbull, Baird, about the clusterfuck of the last year of Lib government, about how Tony Abbott is afraid of women, gays, supers, and people in boats. Abbott’s sister is a supercapable lesbian, Sylvie remembers. Must make for awkward family dinners. The march begins like a living thing, moving forward in slow, lurching bursts. Sylvie doesn’t even remember what this one is about—some amendment to the super anti-discrimination bill. There’s a rally every weekend these days, it feels like. Which isn’t to say that they’re not important—even just marching, even if nothing comes of it, that’s something. Even the little victories are something. It’s nice, to be surrounded like this, by people like them. People with wings and tails and weird hair and rainbow t-shirts. There’s a queer bloc marching a ways behind them, and a ways behind that there’s a group marching for supercapable refugee rights. There’s an energy in the air, something sparking and growing. And suddenly Brian is clinging hard to Sylvie’s arm and muttering, “Shit, fuck, fuckshit, it’s my fucking ex, let’s get out of here.” Sylvie follows his gaze to a young white girl with an undercut and purple eyebrows. “Your ex-girlfriend?” Sylvie asks, confused. Brian’s gay. Very, very gay. As gay as a—really very gay person. He snorts. “No, you lemon, my ex-dealer. Shit let’s get out of here before she sees us—” Too late. The girl’s eyes are widening with recognition, and she smiles, like a shark, raising her hand over her head to wave. Brian squeaks and pulls hard on Sylvie’s wrist, tugging them through the crowd, stepping on people’s feet and not bothering to apologize. There’s some sort of commotion at the side of the road, people yelling and shoving, and a kid with yellow eyes sends bright illusionary glimmers up into the air. A second later there’s a crack and a hiss and there’s white fog spreading around their legs, only the fog stings horribly, and Sylvie starts to cough, helplessly, tears streaming from their eyes. “It’s tear gas,” chokes out Brian, covering his eyes with his sleeve. “I—fucking—know,” says Sylvie, wheezing, pulling him to the side. Brian’s power is really quite formidable but not, actually, particularly useful—he can analyze the composition of substances, tell you their chemical makeup via touch. He makes a damn good cocktail. “Come on,” says Brian, “let’s go, let’s—fuck—” They stagger out of the crowd, coughing and crying, people shrieking around them. The riot police are wading in now, herding and shoving people fairly indiscriminately. Someone falls down and cries out, a high screech, as the convulsing mass of people around them heaves and moans. This happens every time. Usually the cane offers Sylvie some small measure of protection—it looks bad when the Sydney Morning Herald releases photos of cops beating on cripples. For a moment Sylvie thinks they’re going to get out of this okay, but then Brian falls into a cop’s riot shield and everything goes to shit. The cop yells at him, and Brian yells back, and then the handcuffs are out, and everything sort of goes the way you’d expect. Brian was right—it starts to rain. Hours later, Sylvie has been arguing with the officer at the desk of the police station for longer than they care to admit, but the desk cop won’t budge. It’s bullshit, it’s all bullshit. Brian’s being charged with resisting arrest. Arrest for what? Arrest for resisting. Also, apparently, teetotaler Brian, Brian who’s been sober for more than six months now, Brian who went through screaming withdrawal and came out grinning on the other side, is being drunk and disorderly, so he’s “cooling off” in a cell. A breathalyser test “isn’t necessary”. Sylvie’s nerves are jangling, and the statistics of Aboriginal deaths in custody are parading relentlessly through their head. It’s another two hours and a different officer at the desk before they let Brian be released into Sylvie’s custody. The new officer has flat, pale hair, and a dead-eyed look in her eyes. “___ ______, yes, she’s free to go. No bail.” Sylvie holds in their snarl. Brian’s left eye is bruised and his hair is tousled when they let him out. He’s silent all the way out of the station, until they reach the sidewalk, and then he swears loudly and kicks a tree. His voice cracks. He stands there for a moment, panting hard, whole body shuddering with it. “Let’s go,” he says, eventually. “I want to get the fuck out of here.” He stays at Sylvie’s place that night. Neither of them want to be alone. When they get in the door Sylvie swaps out their pronoun wristband, ties his hair up in a knot. He doesn’t usually feel comfortable wearing masculinity—it’s a skin he was forced to live in for so long that it still, sometimes, hums hotly through his blood, makes his nerves feel like they’re on fire. But it’s a part of him nonetheless. Brian disappears into the bathroom, and Sylvester hears the sound of water running. Moth starts to wind around his legs, purring, nudging his head against the hem of Sylvester’s skirt. Sylvester sinks to the floor, drops his cane with a clatter, and pulls Moth close. Buries his face in his fur. The cat meows indignantly, wriggling a little, and then settles. Sylvester puts the kettle on. After a while Brian emerges from the shower, hair damp, shoulders bowed low. It’s a long night for both of them. Brian sleeps in Sylvester’s bed, their legs tangled around each other, tossing and turning. Every hour or so Sylvester touches a hand lightly to Brian’s brow, and the bruise turns purple-blue, and then grey-green, and then faintly yellow. Irritation from tear gas doesn’t take too long for him to heal, but bruises are different, pressed deeper into flesh. Sometime in the black morning, Sylvester gets out of bed and goes to sit out on the balcony. He sheds his pronoun wristbands to sleep, and sometimes it feels like a shedding of skin. Syl hates wearing pyjamas, even in winter. The clothes feel strangling. It feels like Syl is being reborn every morning, naked, cold, confused. Gender takes so much energy to maintain. To navigate. Sometimes Syl wishes it all just didn’t exist. It seems so much easier for other people. It’s a cloudy night. A few stars wink through the scattered smears of sky. There’s no wind, but sometimes a shiver runs through Syl’s body. Skin open to the air. It feels like Syl can breathe in the universe. It’s hours before the sun begins to rise. Sylvia can hear the birds. She sighs, stretches. Turns back into the apartment. Feeds the cat. Makes tea with honey, bends the spoon. A few tea leaves escape into her cup, and she concentrates, twists her fingers, pulls them out without even touching the liquid. She steps up into the air, just to see if she can, and stays there, hovering a few centimetres above the ground. Only a few centimetres, and she can only maintain it for a second. But for a second she felt like she could fly. After a while Brian emerges with what looks like the contents of Sylvia’s entire bedroom wrapped around him. Bedspread, sheets, scarves, socks. There might be a pillow somewhere in there. “What are you doing up so fucking early.” “Made you tea.” “Thanks,” he says, grasping for the mug. He waves a hand awkwardly at his eye. “Thanks for this, too.” Sylvia just shrugs. “It’s not much.” The guilt is going to eat her up from the inside, gnaw out her bones. She couldn’t do anything. All that time Brian spent in lockup, hours more than he should have, and she couldn’t do anything. Some supers can phase through walls, break iron with their bare hands. Sylvia can heal bruises and stubbed toes. Bend her spoons. And make toast. Maybe Brian reads some of that in her eyes, because his next words are weirdly determined. “Don’t say that.” There’s a little wrinkle between his eyebrows. “It’s useful. It’s little, but it’s useful. Sometimes we need little things.” Sylvia bites down on her tongue, tastes blood in her mouth. “Okay,” she says. “Okay.” For the next few hours they stick by each other, never more than a few feet apart. They catch the bus into uni in silence. Sylvia doesn’t know what’s going to happen next. The police station hasn’t contacted them. They only have one class together, but neither wants to leave the other alone, so they go to Brian’s morning lecture and Sylvia streams hers online in their lunch break. Brian is quiet, listless. The day is already so dull, so draining, that it’s almost not surprising when the girl from the rally yesterday sidles up to them at the campus food court. Her eyebrows are still purple but she’s not smiling this time. “Hey,” she says. “Hey, Brian.” Brian’s head is pillowed in his arms. He cracks an eye to look at her. “Go away, Liv. I got fucking nicked last night. I don’t need this right now.” “That sucks, man,” she says. She seems genuine. “Look, I’ve just got this guy who wants to talk to you. Just one job. Nothing big. He’s so keen though, mate, and he’s got the money, he’s a real fucking big spender.” “Not interested,” says Brian. He closes his eyes again. “Come on, Bri, for old times’ sake? I know you went to druggie rehab or whatever, this isn’t about that, I’m not trying to sell you anything. This guy just wants to talk to you.” “He said no,” says Sylvia. Liv barely spares a glance at her, and tries to move closer to Brian, but Sylvia blocks her with her cane. The girl gets angry then. “Hey, what the fuck? Put that thing away, dude, I don’t even know you. Me and Brian go way back. Brian, listen—” Sylvia concentrates, feels her eyes heat up, glow red, and Liv pales a bit and backs away. Hands raised. “Fine, fuck, no need to get all batshit on me,” she says. “I’ll see you later, Bri.” She leaves, and Sylvia blinks, feels her eyes go back to normal. It was a bluff—the most she could have done is give the girl a spot of sunburn—but Liv didn’t know that. “I’m sorry about that,” says Brian into his arms. “I’m really—I’m sorry. And I’m sorry she called you dude. You didn’t need to do that. Thanks.” Sylvia doesn’t say anything, but she puts her arm around his shoulders, and some of the tension relaxes out of his spine. “She’s a super too, you know?” he says absently. “Low-level empath. I guess it explains why she’s such a dick all the time. Having to feel everyone. Lying to you. Feeling their hatred. Or just—feeling that they don’t even care. It must be hard.” “Are you going to be okay?” asks Sylvia softly. Brian snorts. “I’m always okay.” Sylvia doesn’t know the details, but Brian used to be mixed up in some bad shit. His power might make him a good bartender, but it also makes him a damn good dealer. He can touch something and know instantly if it’s pure, what it’s made up of, how strong it is, how good of a high it’ll give you. Brian grew up with nothing. Of course he used what he was given. And he helped people. There are kids out there cutting molly with bleach, mixing glass splinters into cocaine, taking risks because they can’t do anything else. Sylvia’s not going to judge—whatever makes people feel like life is worth living. But it got dark for Brian, got down to the core of him. He got out. And now this Liv person wants him to get back in. “I’ll take you home tonight,” says Sylvia. Brian laughs, and then looks at her face. “You’re not serious? I live two hours away. Your joints…” “I’m taking you home,” she says. She daydreams through their afternoon lectures, doodling in her notebook rather than taking any meaningful lecture notes. Brian is uncharacteristically quiet for the rest of the day, preferring to doze in his chair rather than make conversation. The lecturer scowls at them at one point, but Sylvia scowls right back. Brian lives out in the western suburbs, all the way out past Blacktown. On the train Sylvia ties her hair up, rubs her lipstick off her mouth. Puts her wristband in her bag. She’s met Brian’s sister before—he lives with her and her kids. She’s a nice woman. Tired, but always smiling. She’s subcapable, and cishet, but one of her daughters is a super, and she’s good at listening. “Ellie’s going to fucking kill me when she hears about the rally,” says Brian, drumming his fingers against his knee. “No, she’s not even going to be mad, she’s just going to be worried. That’s worse.” Sylvia doesn’t say anything. She loves you. At least she cares. She’s your family. Family can be bad for you. Ellie’s a nice woman. But Sylvia’s only met her twice. They get off at Brian’s stop, grab a kebab to share between them from the shop next to the train station. It’s dark already. Sylvia always forgets how early it gets dark in winter. It sneaks up on you. There’s a chill in the air, and Sylvia pulls her hoodie up over her ears. Sylvia isn’t sure exactly when things start to go wrong again. The main street is emptier than usual, but it’s late. One of the streetlights is flickering, casting a ghostly, erratic glow over the street. Brian clutches at her hand and she feels her bones creak. Brian clocks that they’re being followed before Sylvia does. He starts walking in a different direction to his home, back towards the shops, back towards somewhere well-lit. It doesn’t help. Couple minutes later there are three guys in front of them and one behind, all big guys, all muscle. And they’re all white. “Brian, right?” says the guy in front. “Heard you’re the bloke to speak to about getting some lab tests done.” He laughs after he says lab tests. His laugh is normal, nice-sounding. “Nope, that’s not me,” says Brian, pitching his voice a little higher. “Sorry. Hope you find him.” The guy squints a little when he hears Brian’s voice, but then he laughs again. “Sorry, mate. Got your number from Liv. And Jimmy here’s good at finding people.” He nods towards one of his friends, a guy with heterochromic eyes, one purple and one orange. Just fucking great. Brian drops the act. “I don’t know what Liv told you, but I don’t do that shit anymore. I can’t help you. Sorry.” He grabs Sylvia’s arm and moves to pull her away from them, but the guy called Jimmy gets in their way, gets all up in their space. “Better hear him out,” Jimmy says. Brian puffs up like an angry magpie. “I said I don’t fucking do that shit, okay? I don’t need to hear anyone out. I’m fucking leaving.” He shoves the guy, and Jimmy shoves him back, and Sylvia hits Jimmy with her cane. He yelps, and turns a surprisingly wounded look at her. “The fuck?” “We’re fucking leaving,” she parrots, heart in her throat. “You’re not fucking going anywhere,” says the guy in front. He still hasn’t introduced himself. There’s something shining in his hand—a knife? A gun. It’s a fucking gun. Where the fuck did he get a gun. Is it fake? It’s not fake. Shit. Brian snorts. “What are you going to do, shoot me? Good luck getting your lab tests done then.” The guy raises up the gun, trains it between Brian’s eyes, and then slowly, purposefully, lowers it to aim at Brian’s leg. “I can shoot you without killing you,” he says. His voice is terribly even, and his eyes are a very clear blue. “Heard you got arrested last night. Troublemaker, you are, hey? Wonder what the cops’ll think if you get admitted to emergency with a gunshot wound. That’s gang stuff, that is. Bet it wouldn’t look good. And then when you get out, well, Jimmy and me’ll still be here, and we’ll still have that job for you to do. I’ll pay you for it. We’re all gentlemen, right? But you don’t get to walk away.” Brian is breathing hard, fast, like a bird, and Sylvia sees what’s going to happen before he does it. Brian lunges, but Sylvia moves first, and the gun goes off with a ringing bang that makes her ears go numb, and there’s a hot feeling against her hip. Brian is yelping, and pulling her away, and the other guys seem just as shocked as they are. They’re across the street, now, Sylvia propped up in Brian’s arms, splayed over him, and one of the guys says “the cops, Nick, the fucking cops,” frozen, like they don’t know what to do. The blue-eyed guy—Nick—curses, and then they scatter. “Sylvia,” says Brian, gasping, “Sylvia, Sylvie, Syl—you—are you okay—” Sylvia feels like she’s floating. She feels like she could fly. “I’m fine,” she says, and her voice is very far away. She reaches into her hoodie pocket, and pulls out a little crumpled piece of metal. The bullet. Dented and warped just like the contents of her cutlery drawer. “Sylvie—you—what…” He’s patting frantically at her hip, her thigh, feeling for blood. There’s nothing. A high laugh bubbles up in her throat, and she slumps to the ground suddenly, all the adrenaline rushing out of her. She presses the broken little bullet into his hand, and he stares at it, uncomprehending, for a long moment. “You’re… you’re bulletproof,” he breathes, after a long moment. “Sylvia, you’re fucking Wonder Woman!” He laughs then too, a deep belly laugh, and then he whoops, and presses a kiss against her head. “Holy shit, I can’t believe we’re alive. Holy shit, those fucking wankers, they probably pissed themselves when they saw—holy fuck…” “He was right, though,” she says, with sudden clarity, “the cops, we should go—” There are no sirens yet, but that doesn’t mean anything. Maybe the cops got called, maybe they didn’t. Gunshots are loud, but it could have been—an illicit firework, or a car backfiring, or something. No one actually got injured. But Sylvia and Brian are Brown While Walking At Night, so there’s no sense in lingering. Sylvia picks up her cane from where it’s lying beside her, and heaves herself to her feet. Arms around Brian’s shoulders. Brian is weaving around like he’s drunk, still letting out a strangled giggle every now and then, like he can’t quite believe what just happened. Sylvia can’t help but laugh with him. The stars seem very large above them, even though out here with the city lights you can’t see many of them. The sky is cloudless. Everything seems huge, suddenly, like the whole world’s stretched out in front of them, like they can do anything. It’s a cold night. The bullet is warm in her pocket. It’s so small in her hand. Such a little thing. They’re both little, her and Brian, little things under a big sky. That’s okay, though, she thinks. Sometimes you need the little things. END "I stayed up all night waiting for the election results and then..." is copyright Joanne Rixon 2017. "The Little Dream" is copyright Robin M. Eames 2017. This recording is a Creative Commons Attribution-NonCommercial-NoDerivatives license which means you can share it with anyone you’d like, but please don’t change or sell it. Our theme is “Aurora Borealis” by Bird Creek, available through the Google Audio Library. You can support GlitterShip by checking out our Patreon at patreon.com/keffy, subscribing to our feed, or by leaving reviews on iTunes. Thanks for listening, and I’ll be back soon with a reprint of “Lessons From a Clockwork Queen” by Megan Arkenberg.
Editor's Audio Summary by Howard Bauchner, MD, Editor in Chief of JAMA, the Journal of the American Medical Association, for the June 28, 2016 issue
We apologize to our listeners for our show being late this week. We are coming to you directly from the Exploring Psychedelics Conference at Southern Oregon University, and preparations and travel have slowed down the release of this week's episode. On Today's Episode of the podcast, Jonathan talks with Jon Bridge. Jon is a 34 year old father of two. from Canada. The two met through a Facebook Group, The Terence McKenna Experience, thanks to Jon's willingness to share his inspiring story of hope and healing. Jonathan felt called to respond almost immediately after the posting appeared on his feed, and the two connected to share Jon's story. Jon's experience of the failure of standard psychiatricpharmaceutical drugs and his journey back to health with the help of psilocybin mushrooms and a clear understanding that the conditions that ailed him for years did not have to be permanent, or simply "managed" with ill-understood collections of molecules. Jon [I was on] daily doses of high strength, high dose pharmaceutical garbage. I was supposed to be a customer for life. Although I have no credentials behind my name I have a story of healing and hope. I had been a long time sufferer of mental illness but thanks to psychedelic medicines I have discovered a new, better self. My journey into psychedelic healing has just begun and I hope to be able to inspire someone to help themselves. Jon's "before" picture, on the let, is dated March 20, 2010, exactly 6 years before the date of his Facebook post..Looking in the eyes, it feels possible to almost see the changed interior landscape behind them. This is a story that our listeners will not want to miss. (None of Jon or Jonathan's remarks should be interpreted as psychiatric advice. Neither is a licensed therapist. Changes in medicines should be done with the partnership of a qualified professional.) Thanks to everyone who "Liked" Psychedelic Parenting on Facebook and helped us reach our goal of 1000 page likes by the end of March. As of 3/31/16 at 11:59pm, we had 1017 page likes! Thanks again to all who clicked, shared or clickshared... And, as always, if you like what you see and hear, please consider a tax-deductible contribution to the work. Help us keep the podcast streaming and the website improving! Click the purple button below to contribute to Psychedelic Parenting via MAPS Click HERE to join our mailing list or become a part of our "Secret" Facebook discussion group. TOPICS AND WEBSITES DISCUSSED IN THIS EPISODE: Exploring Psychedelics Conference Home Page Facebook Page Grateful Meds Dispensary, Talent, Oregon Home Page Oregon Cannabis Connections: "Third Grateful Meds Dispensary Opens in Talent" Pharmeceutical Products Cyprolex (Generic: Escitalopram) Tryptophan Lithium Seroquel (Generic: Quetiapine) Wellbutrin (Generic: Bupropion) Citalopram (Brand Names: Celexa, Cipramil) Divalproex (Valporate) Stopping Psychiatric Drugs For specific dangers and symptoms and helpful guidelines for coming off psychotropics, see Coming off Psychiatric Medication Ketamine Erowid.org page WebMD: "Ketamine: The Future of Depression Treatment?" ClinicalTrials.gov: "Rapid Antidepressant Effects of Ketamine in Major Depression" Vice.com: "I Used Ketamine to Treat My Depression" Ketamine Advocacy Network: "Provider Directory" Dextromethorphan ("DXM") Erowid.org: "DXM Vault" Psilocybin Erowid.org: "Psilocybin Mushroom Vault" Vice.com: "What it Feels Like to Treat Depression with Magic Mushrooms" New York Times: "Can Mushrooms Treat Depression?" The New Yorker: "The Trip Treatment" By Michael Pollan Mixing Psilocybin and Cannabis (as Jon describes in his story) Shroomery.org forums: "Cannabis and Mushrooms" Erowid Experience Vaults: "Rendered Eternal, Mushrooms and Cannabis" Santa as Shaman When Santa Was a Shaman: Ancient Origins of Santa Claus and the Christmas Tree by Tony van Renterghem NPR.org: "Did 'Shrooms Send Santa and his Reindeer Flying?" Reality Sandwich: "Shaman Claus: The Shamanic Origins of Christmas" Plenty of Fish (POF) Free Online Dating Service
Escitalopram lowered levels of brain toxins; All of us may hallucinate; Potential new Alzheimer's drug also anti-aging; A raisin tests toddlers' future academic ability; Parental warmth after corporal punishment leads to anxiety; Being moody can help us adapt to change.
Medizinische Fakultät - Digitale Hochschulschriften der LMU - Teil 16/19
Thu, 28 Nov 2013 12:00:00 +0100 https://edoc.ub.uni-muenchen.de/16345/ https://edoc.ub.uni-muenchen.de/16345/1/Schmotz_Christian.pdf Schmotz, Christian ddc:610, ddc:600, Me
Interview with Christopher O'Connor, MD, author of Effect of Escitalopram on Mental Stress-Induced Myocardial Ischemia: Results of the REMIT Trial
Editor's Audio Summary by Derek C. Angus, MD, MPH, Contributing Editor, the Journal of the American Medical Association, for the May 22, 2013 issue
Medizinische Fakultät - Digitale Hochschulschriften der LMU - Teil 14/19
Mon, 6 Feb 2012 12:00:00 +0100 https://edoc.ub.uni-muenchen.de/14084/ https://edoc.ub.uni-muenchen.de/14084/1/Sarubin_Nina.pdf Sarubin, Nina