I can't find any information to validate some of what you write about (drug-wise) - despite looking for quite some time. I know a bit about psychopharmocotherapy - and, of course, I know that all drugs alone or in combination can cause dramatic reactions.
Even a simple antidepressant.
However, you say that the FDA outlaws the combination of the two drugs.
That's not true. These two drugs are still prescribed together - as far as I can see - both here and abroad (I checked in the UK, too). Doctors are told they are contraindicated (in combination) unless "the benefit outweighs the risks." So, there is a warning.
Here is what is written about using amitriptyline and sertraline (an SSRI and a tricyclic) together:
MONITOR CLOSELY: Coadministration with sertraline may increase the plasma concentrations of some tricyclic antidepressants (TCAs). The proposed mechanism is sertraline inhibition of CYP450 2D6, the isoenzyme responsible for the metabolic clearance of many antidepressant and psychotropic drugs. Moderate to significant increases (up to 250%) in plasma levels have been reported for desipramine and nortriptyline. Pharmacodynamically, the combination of sertraline (or any other selective serotonin reuptake inhibitor) and a TCA may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5HT1A receptors. The syndrome has been reported in a case involving sertraline and amitriptyline.
MANAGEMENT: Caution is advised if sertraline (or other SSRIs) is prescribed with TCAs. Pharmacologic response and plasma TCA levels should be monitored more closely whenever sertraline is added to or withdrawn from therapy in patients stabilized on their existing antidepressant regimen, and the TCA dosage adjusted as necessary. Patients should be monitored closely for signs and symptoms of TCA toxicity (e.g., sedation, dry mouth, blurred vision, constipation, urinary retention) and/or excessive serotonergic activity (e.g., CNS irritability, altered consciousness, confusion, myoclonus, ataxia, abdominal cramping, hyperpyrexia, shivering, pupillary dilation, diaphoresis, hypertension, and tachycardia).
This is not to say that I understand Mr. Shuman's case or situation. But it is to say that the drug interaction CAUSING the murder is a hypothesis. I think it's something that has to be argued in court with a lot more information than just the two drugs interacting negatively.
In any case, this is slightly out of my specialty - so perhaps someone might jump in with more knowledge in this area than I have. I just wanted to track down some facts that didn't make sense to me and see what I could come up with.
Thank you for sharing how things are done in prison. I think we all can see why you did it, even it was a bad choice - and as you stated yourself, you definitely won't screw this one up again, you learned your lesson. Actions always gives consequences, in one way or another. That being said, you worked your way back up again, and that is just sooo good to hear because it shows that you can. You sure can be proud of your accomplishment, and I give you a high five!
Keep up with the good work, and again - thank you for sharing. :-)
I so agree with Melanie above, it really is admirable that you have found a way to keep your mind occupied. *thumbs-up* You should be proud of that. :-)
I hear you. I think it's a good thing that you write blogposts, it's a way to come out with thoughts and things on your mind. So keep up with it - if you can't talk with those around you, at least let it out in a blogpost. If that gives you comfort, then you know it's the right thing to do. :-)
Ahh, 40 years old are young! Being 40 is the new 30's! ;-) I'm older than you, but only 35 in my head, or perhaps only 30.. lol. But feeling like the years have crept up on you, no wonder that you feel that way. Your life have been full of trouble, you have taken alot of bad choices - days you don't even remember, and when you get clear you suddenly wake up realizing all the years have gone by. That being said, I think there are soulmates for everyone, it's definitely not out of date. But I also think we have to do something to find them, kinda meet them halfway. :-)
RSS
Even a simple antidepressant.
However, you say that the FDA outlaws the combination of the two drugs.
That's not true. These two drugs are still prescribed together - as far as I can see - both here and abroad (I checked in the UK, too). Doctors are told they are contraindicated (in combination) unless "the benefit outweighs the risks." So, there is a warning.
Here is what is written about using amitriptyline and sertraline (an SSRI and a tricyclic) together:
MONITOR CLOSELY: Coadministration with sertraline may increase the plasma concentrations of some tricyclic antidepressants (TCAs). The proposed mechanism is sertraline inhibition of CYP450 2D6, the isoenzyme responsible for the metabolic clearance of many antidepressant and psychotropic drugs. Moderate to significant increases (up to 250%) in plasma levels have been reported for desipramine and nortriptyline. Pharmacodynamically, the combination of sertraline (or any other selective serotonin reuptake inhibitor) and a TCA may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5HT1A receptors. The syndrome has been reported in a case involving sertraline and amitriptyline.
MANAGEMENT: Caution is advised if sertraline (or other SSRIs) is prescribed with TCAs. Pharmacologic response and plasma TCA levels should be monitored more closely whenever sertraline is added to or withdrawn from therapy in patients stabilized on their existing antidepressant regimen, and the TCA dosage adjusted as necessary. Patients should be monitored closely for signs and symptoms of TCA toxicity (e.g., sedation, dry mouth, blurred vision, constipation, urinary retention) and/or excessive serotonergic activity (e.g., CNS irritability, altered consciousness, confusion, myoclonus, ataxia, abdominal cramping, hyperpyrexia, shivering, pupillary dilation, diaphoresis, hypertension, and tachycardia).
This is not to say that I understand Mr. Shuman's case or situation. But it is to say that the drug interaction CAUSING the murder is a hypothesis. I think it's something that has to be argued in court with a lot more information than just the two drugs interacting negatively.
In any case, this is slightly out of my specialty - so perhaps someone might jump in with more knowledge in this area than I have. I just wanted to track down some facts that didn't make sense to me and see what I could come up with.
I encourage EVERYONE to forward/share this blogpost of yours. Let's start working.
*thumbs-up*
That being said, you worked your way back up again, and that is just sooo good to hear because it shows that you can. You sure can be proud of your accomplishment, and I give you a high five!
Keep up with the good work, and again - thank you for sharing. :-)
You should be proud of that. :-)
Beautiful!
I'm older than you, but only 35 in my head, or perhaps only 30.. lol.
But feeling like the years have crept up on you, no wonder that you feel that way. Your life have been full of trouble, you have taken alot of bad choices - days you don't even remember, and when you get clear you suddenly wake up realizing all the years have gone by. That being said, I think there are soulmates for everyone, it's definitely not out of date. But I also think we have to do something to find them, kinda meet them halfway. :-)