Posted by chemist on August 10, 2005, at 0:52:40
In reply to Re: meds?, posted by Lorne on August 6, 2005, at 22:20:32
hello there, chemist here...your cards are not being counted properly: you claim here to work in the ``Mental Health profession,'' yet a few posts down the way, you detail why exactly you no longer do so. please clarify in re: your status. do you, or do you not, work in the Mental Health profession? it is germane if only to establish whether or not anything else you pen - inclusive of your generous directive to physically harm persons who, such as i, promote the use of medications - is actually true and/or worthy of note.
second: clozapine has a 30+ year literature base detailing the characterization of ADMET and clinical efficacy in treatment of psychosis. your hypothetical HIV-positive, cigarette-smoking sufferer of self-reported ``episodic schizophrenia'' disappearing from our radar due to clozapine is not likely: an unpaid bill to the ISP will also result in immediate loss of communication. while reduced WBC is a real issue with clozapine, it is not an atypical antipsychotic, nor would it be prescribed by any physician for a patient with co-morbid HIV. period. further, self-reported episodic schizophrenia is in the same league as jumbo shrimp and military intelligence.
third: the metabolism of clozapine is reduced when nicotine is brought on-board, not the converse, as you report.
fourth: S-nicotine has been long-established as an effective drug in allevation of at least some of the positive and negative affect of schizophrenia. thus, while not a foregone conclusion, the slowed metabolism of clozapine and intake of nicotine are likely going to aid the patient, although breathing-related issues remain with cigarettes, to say the least.
finally: the rubber meets the road as noted by many others when the patient and physician get together and prescriptions are dispensed. the internet is hardly a repository of reliable or even somewhat helpful medical insight - the clozapine example and questionable employment position(s) are two issues that immediately come to mind - and most people in this forum appear to be well aware of that fact.
all the best, chemist
> Third party experiences are not "Doctorly advice", unless that third person is a doctor.
>
> Let me put my cards on the table, I work in the Mental Health profession and I've seen quite a few clients die as a result of street corner psychopharm advice. While I'm sorry if I came across as sharp to you, I'm trying to keep you from being the next chart review someone has to do.
>
> Medications are selected based on a clients unique medical, psychological and situational variables. To do it correctly requires extensive clinical training and experience, not just an internet connection.
>
> See your doctor if you want to discuss your meds. It will save your life.
>
>
> Lorne
poster:chemist
thread:537421
URL: http://www.dr-bob.org/babble/subs/20050722/msgs/539861.html