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Medical Forum / General / General / November 2004Use of anti-psychotics
I have a question about the use of anti-psychotics, like Zyprexa for example. Why do some psychiatrists prescribe over 20 mg/day of Zyprexa for example, when on the label it says it has specifically only been tested at maximum dosage of 20 mg/day, for example by the FDA? Some psychiatrists go up to 30 or even 40 per day, because they don't think it is effective at 20 I guess. But aren't there potential health risks for this? Like for example, who knows what's going to happen? Also, it is sometimes prescribed to kids. But there weren't any tests on how it effects kids. Is this smart? Another thing, is that anti-psychotic tests usually last for about 4 weeks, by the FDA for example. And yet, most psychiatrists tell their patients they should be on it for the rest of their life. And they sometimes say it may take a couple of weeks (for example like 4)for it to work. Does the research conducted by the FDA really sufficient to support this hypothesis? Is it sufficient to evaluate long term effects of these drugs? What do you think? There are always potential health risks involved in drug therapy. Anytime you take a drug there is a chance that it may kill you. I have atrial fib so I take Coumadin to prevent potential blood clots. I also have a monthly blood test. I am aware that the Coumadin could kill me for it was originally rat poison! You do have some interesting questions but the package insert is a guideline for doctors. They do not have to follow it like it was law. > I have a question about the use of anti-psychotics, like Zyprexa for > example. Why do some psychiatrists prescribe over 20 mg/day of [quoted text clipped - 12 lines] > hypothesis? Is it sufficient to evaluate long term effects of these > drugs? What do you think? I'll have more time to respond later maybe. My point....the FDA does not do the research or the "tests"...they approve or disapprove products based on several factors, but they (the FDA) do not "do" the testing. > I have a question about the use of anti-psychotics, like Zyprexa for > example. Why do some psychiatrists prescribe over 20 mg/day of [quoted text clipped - 12 lines] > hypothesis? Is it sufficient to evaluate long term effects of these > drugs? What do you think? > I have a question about the use of anti-psychotics, like Zyprexa for > example. Why do some psychiatrists prescribe over 20 mg/day of I have a question about why you are posting this to a physics newsgroup? > > I have a question about the use of anti-psychotics, like Zyprexa for > > example. Why do some psychiatrists prescribe over 20 mg/day of > > I have a question about why you are posting this to a physics newsgroup? ...because there are plenty of crazies here, at this 24/7 cyber party, and this applies to most of the ones who call others crackpots and cranks with equal justification.......AHAHAHAHA.....ahahaha ahahaha......ahahanson >I have a question about the use of anti-psychotics, like Zyprexa for >example. Why do some psychiatrists prescribe over 20 mg/day of [quoted text clipped - 12 lines] >hypothesis? Is it sufficient to evaluate long term effects of these >drugs? What do you think? First, as another poster said, the FDA does not perform the research. Secondly, the research submitted to the FDA by the manufacturer in support of an application for approval to sell the drug legally in the United States is not all of the research and experience available for the drug. They simply do enough to get the drug licensed and then make sure not to make any claims in their advertising beyond its approved indications. Once it's on the market and selling well, why bother spending a few more million or billion dollars to get another indication approved? (While there often is no reason, occasionally there is competition that drives this need, e.g. Nasonex vs. Flonase for the age 2 and up indication.) The lack of enough FDA-approved indications is particularly obvious in pediatrics, where we often use drugs that have never had formal FDA approval for use in kids, but have years of research and experience that supports its safety and efficacy but which research and experience has never been evaluated by the FDA, so the drug will still be labelled "not for kids." PF > I have a question about the use of anti-psychotics, like Zyprexa for > example. Why do some psychiatrists prescribe over 20 mg/day of [quoted text clipped - 12 lines] > hypothesis? Is it sufficient to evaluate long term effects of these > drugs? What do you think? The antipsychotics are garbage. They only cover up the real problems from a persons awareness. Anybody who thinks a pill can solve a human psychological problem needs their head examined. - They neutralize the symptoms without treating the cause. By definition(chemistry dictionary) they are the class of major tranquilizers. The best these drugs can do is neutralize anxiety. If you can't address the cause of the anxiety what is the point? >> I have a question about the use of anti-psychotics, like Zyprexa for >> example. Why do some psychiatrists prescribe over 20 mg/day of [quoted text clipped - 25 lines] > address > the cause of the anxiety what is the point? Because sometimes the /cause/ of the anxiety is chemical. You're not a bright one, are you? Don't answer - it's rhetorical. > > The antipsychotics are garbage. They only cover up the real problems > > from [quoted text clipped - 11 lines] > Because sometimes the /cause/ of the anxiety is chemical. You're not a > bright one, are you? Don't answer - it's rhetorical. I would argue that the "cause" of anxiety is always chemical -- i.e., not matter what the chain of causality, at some point the chemical correlates of anxiety appear in the brain. The question is like asking why treat the wounds of somebody who is exposed to a dangerous environment. You're only treating the symptoms, so what is the point? Obviously you treat the effects as necessary, and preferrably also eliminate the less proximate causes of the bleeding (those other than "I was cut"). But sometimes all you can identify is the last link in the chain. > > > > The antipsychotics are garbage. They only cover up the real problems [quoted text clipped - 23 lines] > the bleeding (those other than "I was cut"). But sometimes all you > can identify is the last link in the chain. You're nutty as a fruitcake. Which comes first psycholgical problem or chemical imbalance? You would only be right if there was no such thing as psychological problems. Mitch Raemsch -- Light Falls -- >> > > The antipsychotics are garbage. They only cover up the real problems >> > > from [quoted text clipped - 29 lines] > You would only be right if there was no such thing as psychological > problems. You're a f.cking twit. > > >> > > The antipsychotics are garbage. They only cover up the real problems [quoted text clipped - 32 lines] > > You're a f.cking twit. Right back at you. Just try showing me where I am wrong. Psychiatry is dangerous because it doesn't deal with the source of the problems only symptoms. Every psychiatrist I have met has had no intention of curing problems. They can't. Most of what they have been taught is wrong. The only doctor capable of helping is one that is comming from a good place. But show me one of them and I'll show you a chicken with teeth. Doctors depend on us to be sick for there livelyhood. Case in point. Mitch Raemsch -- Light Falls -- > > > > > The antipsychotics are garbage. They only cover up the real problems [quoted text clipped - 30 lines] > You would only be right if there was no such thing as psychological > problems. Since I already acknowledged and addressed the assertion that it is better to treat underlying psychological etiology, and your answer is answer is not remotely responsive but simply a restatement of your prior prejudices, I conclude you are only interested in continuual restatement of your own prejudices, not in any dialogue. I responded from sci.physics, and believe me, your type is well-known there, as no doubt everywhere on Usenet. :-/ For the benefit of anybody else who may be reading this, I did not say there is no such thing as physchological problems; I simply said the chemical aspect must always be present and is a point of entry in harm reduction. And it's not clear that psychosis even usually has a psychological etiology in your sense, although it will always have one as an overlay, since psychosis is stressful for the intact part of the mind. But it may often be no more "psychological" in etiology than is a congenital deformity or disfiguring injuries. > Since I already acknowledged and addressed the assertion that it is > better to treat underlying psychological etiology, and your answer is [quoted text clipped - 13 lines] > mind. But it may often be no more "psychological" in etiology than is > a congenital deformity or disfiguring injuries. Do a research on the schizophrenia or more in general psychosis incidence statistics around the World, India, Africa, Latin America and then Europe and USA. Do you think it's about DNA? btw, one should not mix up the anxiety from the medical jargon with the common fear. the medical term 'anxiety' means a 'free floating anxiety', it is without an evident reason, without a dangerous situation/environment. the culprit of anxiety disorder is probably hidden in the subconscious sphere. the fear is a normal reaction to a real danger-has an object. d. > I would argue that the "cause" of anxiety is always chemical -- i.e., > not matter what the chain of causality, at some point the chemical [quoted text clipped - 6 lines] > the bleeding (those other than "I was cut"). But sometimes all you > can identify is the last link in the chain. >btw, one should not mix up the anxiety from the medical jargon with the >common fear. the medical term 'anxiety' means a 'free floating anxiety', it >is without an evident reason, without a dangerous situation/environment. the >culprit of anxiety disorder is probably hidden in the subconscious sphere. >the fear is a normal reaction to a real danger-has an object. I would disagree with this. Medically significant anxiety is one that is maladaptive to the point that it interferes with daily functioning (eating, sleeping, working, etc.) or causes abnormal and significant personal distress (discomfort). There is no requirement that an identifiable "reason" for the anxiety be known or not. With generalized anxiety disorder, there can be no cause. With specific phobias and social anxiety disorder, however, the trigger of anxiety can be known. You may, however, be making the same error the other poster is making in confusing anxiety with paranoia. Anxiety and mood disorders are in one class of psychiatric pathology, whereas paranoia and other thought disorders are in a different class. With paranoia from psychosis, yes, often there is no real danger. PF In the chapter Clinical Psychiatry in "Synopsis of Psychiatry" by H. I. Kaplan& B.J. Sadock (a worldwide known psy-handbook) stands this way: "1. Anxiety: feeling of apprehension caused by anticipation of danger, which may be internal or external. 2. Free-floating anxiety: pervasive, unfocused fear not attached to any idea. 3. Fear: anxiety caused by consciously recognized and REALISTIC (stressed by me) danger." My reaction referred namely to this text: >"The question is like asking why treat the wounds of somebody who is > exposed to a dangerous environment. " Hope it helps to discern between anxiety and fear... BR DP >>btw, one should not mix up the anxiety from the medical jargon with the >>common fear. the medical term 'anxiety' means a 'free floating anxiety', [quoted text clipped - 20 lines] > > PF >In the chapter Clinical Psychiatry in "Synopsis of Psychiatry" by H. I. >Kaplan& B.J. Sadock (a worldwide known psy-handbook) stands this way: [quoted text clipped - 12 lines] >Hope it helps to discern between anxiety and fear... >BR DP It's hard for me to quote properly since you're top posting, but here's what you said before: "btw, one should not mix up the anxiety from the medical jargon with the common fear. the medical term 'anxiety' means a 'free floating anxiety', it is without an evident reason, without a dangerous situation/environment." The quotation you provide to support this does not imply there is a dichotomy between "medical" anxiety and "common" fear. In fact, the word "fear" is used in the definition of "free-floating anxiety" -- hardly proof that the two are mutually exclusive. PF let me put this way: fear - often expressed as anxiety in laics - is a normal reaction to a real danger. anxiety/fear as free-floating fear/anxiety is an abnormal one without evident object which as a rule needs treatment esp. generalized anxiety (GAD) with or without panic reaction and/or phobia... you shouldn't be mislead by similarity of features in both conditions. nevertheless, I must admit that many patients experience fear of anticipated anxiety attack ;-) BR D. >>In the chapter Clinical Psychiatry in "Synopsis of Psychiatry" by H. I. >>Kaplan& B.J. Sadock (a worldwide known psy-handbook) stands this way: [quoted text clipped - 30 lines] > > PF >let me put this way: >fear - often expressed as anxiety in laics - is a normal reaction to a real [quoted text clipped - 5 lines] >nevertheless, I must admit that many patients experience fear of anticipated >anxiety attack ;-) And again I would suggest that you are forgetting the important factor of degree when determining whether anxiety needs treatment or not. Anxiety is part of human nature. Not everyone needs "treatment" for it -- only when it has become maladaptive or causes significant distress. PF > btw, one should not mix up the anxiety from the medical jargon with the > common fear. the medical term 'anxiety' means a 'free floating anxiety', it > is without an evident reason, without a dangerous situation/environment. the > culprit of anxiety disorder is probably hidden in the subconscious sphere. > the fear is a normal reaction to a real danger-has an object. > d. How about an example. A kid who chronically fears the buggeyman is in the closet, is that anxiety disorder? [Would he be treated with medication!] Wow......ask any of my schizophrenic patients how they feel/function off their medication..... I had a woman who was quite stable on Melaril for years. Her psychiatrist stopped it and put her on a different medication (because of the potential for cardiac problems).......immediate decline. Heard voices that hadn't been present for years....and developed other psychotic features. A woman who hadn't been hospitalized for 15 years for psych issues then spent 4 to the next 8 months institutionalized. What has kept her "sane" and home since has been Zyprexa..... Ed > The antipsychotics are garbage. They only cover up the real problems > from [quoted text clipped - 8 lines] > address > the cause of the anxiety what is the point? >The antipsychotics are garbage. They only cover up the real problems >from [quoted text clipped - 8 lines] >address >the cause of the anxiety what is the point? The substance of your message betrays your total ignorance of the definition of psychosis. You seem to confuse "psychological" problems and anxiety with serious thought disorders such as psychosis. You obviously have no experience with truly psychotic people. They are in terrible misery and have real organic brain dysfunction. Furthermore, antipsychotics are among the most effective medications in the psychiatric pharmocopia. Also, since you claim that antipsychotics don't treat "the cause" of psychosis, it appears you believe you know that "the cause" is. Please, enlighten us. PF > They are in > terrible misery and have real organic brain dysfunction. Furthermore, [quoted text clipped - 6 lines] > > PF PF, do you know what the cause is? You mention organic brain dysfunction, is that something physical that you can point to? Now it is true that some patients claim and do appear to be helped by anti-psychotics, but aren't there some that it doesn't help? What kind of treatment are for them? (Plus, does the patient have the right to refuse ll this stuff, whether it helps or not.) Thanks, Joe >> They are in >> terrible misery and have real organic brain dysfunction. Furthermore, [quoted text clipped - 9 lines] > PF, do you know what the cause is? You mention organic brain > dysfunction, is that something physical that you can point to? YEs. That's the goddamned definition of "organic" dementia. Damage or dysfunction of an /organ/. It /can/ be physically pointed to. >> They are in >> terrible misery and have real organic brain dysfunction. Furthermore, [quoted text clipped - 9 lines] >PF, do you know what the cause is? You mention organic brain >dysfunction, is that something physical that you can point to? Ah, my suspicion that your original posting was an anti-psychiatry troll is deepening. It helps to make a few definitions. Psychosis is a symptom. It can be caused by, among other things, a virus infection or drug intoxication. However, the most common cause of psychosis is schizophrenia, which is a chronic, debilitating, and usually progressively worsening disease. Many think of "psychosis" and "schizophrenia" as synonymous, which, of course, is incorrect. I admit I was guilty of this in my post, as I was thinking primarily of schizophrenia when I was talking about psychosis. Now, to answer your question: A common tact used by critics of modern psychiatry, who mainly take their credibility only as rogues against the establishment and not because of any real results or science they can produce in the face of the overwhelming success of mainstream psychiatry, is to claim that, if there is no discrete physical finding (i.e. laboratory or imaging study) that is diagnostic of a certain psychiatric disease, then, therefore, the disease must not exist, and medical treatment is useless and/or unnecessary, and by extension the psychiatric disorder can and should be treated with counselling alone. This, of course, is pure nonsense. Almost all diseases were discovered and described as disease entities long before a definitive diagnostic test was known. The absurdity of this argument is best demonstrated by the example of Rett's syndrome, which is listed as a psychiatric disorder in the DSM-IV. Prior to the recent discovery of a genetic marker for Rett's syndrome, which, although not diagnostic, is strong support for a genetic basis for the disease, would these critics of psychiatry claim that very young girls, previously developing normally, who develop developmental regression, slowing of head growth, and then die within a few years should just have a good talking-to and they'll be fine? In the case of schizophrenia, the differences in brain structure on MRI and frontal lobe functioning on PET scanning, the seasonal pattern of birthdate, the familial predeliction, and the dramatic response to dopamine antagonists all point to a biological basis for the disease. This is the basis for my claim that it is a real organic brain disease. However, claiming that it has an organic cause is not the same as claiming to know what the cause is, which is what "Mitchell" was apparently implying he knows. If Mitchell is going to criticize the use of antipsychotics to "neutralize the symptoms without treating the cause," surely then he can tell us what instead we should be doing to "treat the cause." If not, he should remain quiet. It is far easier to be critical than to be correct. >Now it is true that some patients claim and do appear to be helped by >anti-psychotics, but aren't there some that it doesn't help? Firstly, there are patients who ARE helped by anti-psychotics. Again, your nonsense of saying these patients only "claim" or "appear" to be helped betrays you as an anti-psychiatry troll rather than an interested Usenetter in search of information, which makes me wonder why I'm bothering to reply to you, as the likes of you prefer not to be confused with facts when formulating your opinions (much like the anti-vaccine camp). Secondly, of COURSE there are some who do not respond. Although antipsychotics are, in the majority of cases, beneficial when used appropriately, no medication is 100% effective. >What kind of treatment are for them? Obviously to answer that question one would have to know why the antipsychotic didn't work. Was the diagnosis incorrect? Was the dose too low? >(Plus, does the patient have the right to refuse ll this stuff, >whether it helps or not.) Again, probably a troll to start a debate about involuntary treatment for psychiatric disorders. Let me just say this: If a patient, whether you think it is from a "real" disease or not, claims he is Jesus f.cking Christ and needs to murder children, is dragged by the police into a county mental health facility, and is given a shot of Haldol against his will, whereupon he says, "Maybe I was wrong about this whole child murdering thing," then this is what should be done. Fortunately, the law in most states is on my side, whether you think he should instead have a heart-to-heart with Thomas Szasz instead of an antipsychotic. PF Again, > your nonsense of saying these patients only "claim" or "appear" to be > helped betrays you as an anti-psychiatry troll rather than an > interested Usenetter in search of information, which makes me wonder > why I'm bothering to reply to you, as the likes of you prefer not to > be confused with facts when formulating your opinions (much like the > anti-vaccine camp). Because some - like myself - /are/ Usenetters in search of information, and appreciate such articulate posts? >Again, >> your nonsense of saying these patients only "claim" or "appear" to be [quoted text clipped - 6 lines] >Because some - like myself - /are/ Usenetters in search of information, and >appreciate such articulate posts? Why, thank you. Thank you, PF Riley, for such a well written and informative post. Jackie (retired nurse) > >> They are in > >> terrible misery and have real organic brain dysfunction. Furthermore, [quoted text clipped - 96 lines] > > PF PF, Please continue the conversation, I promise you can change my views. > >PF, do you know what the cause is? You mention organic brain > >dysfunction, is that something physical that you can point to? > > Ah, my suspicion that your original posting was an anti-psychiatry > troll is deepening. I admit I try to hide it ;) But seriously, what are the ideas behind it? If it is physical, which you do argue below very well, what are the ideas for it? I was curious. > The absurdity of this argument is best demonstrated by > the example of Rett's syndrome, which is listed as a psychiatric [quoted text clipped - 5 lines] > growth, and then die within a few years should just have a good > talking-to and they'll be fine? Aren't there a lot of other silly stuff though in DSM-IV? Like sexual identity confusion/fear of being a girl, etc.? Is homosexuality in there? Was it ever? (If so, why was it taken out?) > In the case of schizophrenia, the differences in brain structure on > MRI and frontal lobe functioning on PET scanning, the seasonal pattern > of birthdate, the familial predeliction, and the dramatic response to > dopamine antagonists all point to a biological basis for the disease. > This is the basis for my claim that it is a real organic brain > disease. This business of differences in MRI and PET scans, what are they? I'm sure you're right, but what are they? For example, if I took an MRI scan or PET scan, what would be the differences? Would you expect some? If so, what? > However, claiming that it has an organic cause is not the same as > claiming to know what the cause is, Okay, thanks for clearing that up. Now I have heard all kinds of things, that it comes from cats, that the mother's immune system violates the growth of the fetus, that there may be a viral link (for example in some seasons there is more flu or something like that), to nutrition, etc. What should I believe? > >Now it is true that some patients claim and do appear to be helped by > >anti-psychotics, but aren't there some that it doesn't help? [quoted text clipped - 6 lines] > be confused with facts when formulating your opinions (much like the > anti-vaccine camp). Okay, I guess I did wiggle out of using better, straight up. Now, I am only a little familiar with this, and I have seen someone who drastically got better on an anti-psychotic. He would pause, for very long periods, and it was "confusing" to talk to him. For example, he would ask if I was Jesus, and other things. Then when he was put on an anti-psychotic, clozaril, he was much more responsive (and when I brought up about asking if I was Jesus, he got a little upset!) But it does raise the question of what is better. Who decides what is better? What is better? I mean, how do you measure if an anti-psychotic is "helping"? For example, what if the patient thinks the anti-psychotic is not helping, but the psychiatrist insists it is, what happens then? (In the case of my friend, he agreed that it was helping.) > Obviously to answer that question one would have to know why the > antipsychotic didn't work. Was the diagnosis incorrect? Was the dose > too low? Do people know why an anti-psychotic does work? Isn't there a statement on the anti-psychotic pamphlet that comes with the medications, that says something like: the mechanism for efficacy of the anti-psychotic is not known. Or something like that? But this buisiness of "was the dose too low", irks me a bit. Psychiatrist's have gone over what they were tested at, out of a belief that the dose was too low. Or it's ineffective at the doses tested. Now you mention that there is additional research on the pills, that doesn't go into the pamphlet for example, is there research done that allows for the dose to be increased then what's on the pamphlet? I mean eventhough one thing says it hasn't been tested, is there really research that has been done to allow it? Or is the patient and the psychiatrist the new research! > >(Plus, does the patient have the right to refuse ll this stuff, > >whether it helps or not.) [quoted text clipped - 9 lines] > he should instead have a heart-to-heart with Thomas Szasz instead of > an antipsychotic. Now I attended a meeting, where people said that people diagnosed with schizophrenica are mainly harmless. In fact they were saying that there was a need to inform the public about the misconception that schizophrenics [or people diagnosed with schizophrenia ;)] were violent. Now I have heard mixed things about this. Do this group need to be informed that they are in fact a little more violent? I'll do it. What do you think? Also, there are people who believe "I'm on a mission from Allah, I need to murder children" in some parts of the world. (At least I think there are, if I interpret my TV right.) Aren't some of these things, like the 70 virgins, etc. as weird to us as believing your Jesus Christ. Should we put them on Haldol? Would it have an effect? Would it change their beliefs (for example there arn't 70 virgins waiting for me, I do not need to murder the children of the infidels, etc.)? Is that what the government should do, haul them off and give them Haldol? I'm really curious! But truthfully you seem to be projecting a fear of people diagnosed with schizophrenia, is this justified? James wrote: /* The right to refuse treatment presupposes an informed decision. Being mentally unstable precludes that informed decision. However, once medicated and sane, the patient may then choose to discontinue the medication, and his decision to refuse treatment is not overriden. */ What about making an informed decision beforehand, something to the effect of a legal statement, that if I so happen to be accused of "not being able to make an informed decision" (a very serious judgement to make on another person), I can still gaurantee not to undergo psychiatric treatment. Signed and dated by a lawyer. Isn't this done in some legal cases about how to handle cases when you're on life support, etc.? In which case, if I still am deemed a threat to society, it becomes a completely legal issue and I get my a.s haulled off to jail, not the hospital. I would very much like to make such a statement and have it enforced. /* Then he goes crazy again and murders someone, and blames his psychiatrist for not "making" him continue to take medication. (It has happened.) */ I tell you the truth, if you suggest mandatory enforced medication, permanent, you have no idea how much I will fight you on this. What kind of a troll I can become. I only wish that a cleverer person could defend my position more thoroughly. ps: What if it is against my religion to take "mind altering substances" what then? Is enforced treatment an infringement on my religious rights? [I know "mind altering substances" is a tricky one, for example food is a "mind altering substance", but you get the point. I could just say that it includes the general anti-psychotics.] >Please continue the conversation, I promise you can change my views. Certainly. You raise some very good questions. I apologize if my prior posting seemed a bit mean. I will respond in detail to your latest post in the near future. (But I will drop sci.physics from the follow-up list, which I'm sure will be appreciated.) PF What about the right to refuse treatment? There are cases where the patient gets admitted to the hospital, and they forcably medicate them against their will. Isn't this a violation of rights (what ever they are)? I mean if you have cancer, or are in an automobile accident, you can still walk out of the hospital Against Medical Advice. But if you have schizophrenia for example, it might not be that easy. > What about the right to refuse treatment? There are cases where the > patient gets admitted to the hospital, and they forcably medicate them > against their will. Isn't this a violation of rights (what ever they > are)? I mean if you have cancer, or are in an automobile accident, > you can still walk out of the hospital Against Medical Advice. But if > you have schizophrenia for example, it might not be that easy. The right to refuse treatment presupposes an informed decision. Being mentally unstable precludes that informed decision. However, once medicated and sane, the patient may then choose to discontinue the medication, and his decision to refuse treatment is not overriden. >> What about the right to refuse treatment? There are cases where the >> patient gets admitted to the hospital, and they forcably medicate them [quoted text clipped - 7 lines] >and sane, the patient may then choose to discontinue the medication, and his >decision to refuse treatment is not overriden. Then he goes crazy again and murders someone, and blames his psychiatrist for not "making" him continue to take medication. (It has happened.) These anti-psychiatry f.cks want, of course, to blame others for what goes wrong but take no responsibility themselves. PF |
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