Call to Action Alert for an Attorney

Please visit Soulful Sepulcher's post Enforcing the ADA: A call to action: Attorney needed for information on the current legal struggles of Stan Cavers of Is Something Not Quite Right With Stan who suffered Traumatic Brain Injury as a result of an assault on him at his workplace on June 13, 2008 and was then terminated by his employer the very next day.

Matisse - Joy of Life

For all of us.

Stop drug ADs

I came across with this petition and decided to post it due to the Abilify TV ad.

Tell Congress: Stop Prescription Drug Ads

Each year, drug executives spend $4 billion on prescription drug ads for pills they say will make you feel happier, sleep better and improve your sex life.

The ads are not educational, and do not promote public health. They can be extremely dangerous, as the Vioxx tragedy shows.

The Public Health Protection Act will stop all direct-to-consumer drug ads. Thirty-nine organizations have endorsed this legislation.

Now we need your help.

Tell your Members of Congress to support the Public Health Protection Act. Take action now.

I own you nice things

I Know I've been a bore the last weeks with all these data. I'll try to show you good things.
I believe Matisse is a good beginning.
Love you all.

SSRIs side effects are not manageable diseases

I've came across with this site because someone has searched "effexor xr case reports of motion sickness" and found the post I've reported feeling dizzy.
I still feel dizzy but after trying to find help with physicians I've realized that there's nothing to do but live with it and hope it will go away. It comes and goes.
There are many reports of side effects related to SSRIs and other psych-drugs all over the Web. The great majority find no help to cope with side effects.
This is one report from the site:

"I have been on antidepressants for approximately 11 years. Zoloft, Wellbutrin, Celexa. I want to get off antidepressants altoghter. My reasons:
1. I developed vertigo ( possibly Menieres Disease) I wonder whether there is a correlation between anti depressants and vertigo &/or Menieres Disease?
3. I believe that other symptoms have occurred due to my lengthy stay on antidepressants: shingles, bells palsy like symptoms, vertigo, menopausal symptoms starting at age 36. Confirmed menopausal at aged 42.

I was also prescribed lamictal (few days bad reaction: rash over body and I could not move the right side of face. The doctor feared bells palsy but it did not last. Treatment was stopped immediately, I was sent to the ER for a shot to rid the rash. Apparently a very small percentage who take lamictal develop a rash. An of this small percentage, a small percent of this population will die from the reaction because there is no known antidote. My advice, never take lamictal, it is NOT worth the risk. For people who are depressed, they can not even make the correct decision to take or not take the drug. They are in the hands of their psychiatrist and NO known antidote is a NO option for the patient.
Posted by: jz at January 17, 2006 12:32 PM

I don't even know what to say about it all.

SocialAudit discussion - SSRIs withdrawal hell

I've just found the SocialAudit discussion thread on "problems with Effexor withdrawal" that I've saved. I'm reading the comments and I'm trying to find among many some that could give an idea of what kind of problems were discussed. It's hard. But here are five of them and the last one is from "Anon" someone who used to help a lot answering some of the biggest concerns in 2005.
It's heartbreaking reading all this suffering. There was a thread for every SSRI but the complains were the same.

_____________________________________________________________________
By Roxan Brown on Tuesday, October 28, 2003 - 01:49 pm:

I have a nephew who was on efixor and he tried to commit sucide by hanging is this a side effect can any one tell me?
Thank-you
_____________________________________________________________________
By LEENA DUTRISAC on Tuesday, February 22, 2005 - 09:06 pm:

HELLO ALL - MY SINCERE PRAYERS FOR ANYONE WHO IS TRYING TO ESCAPE FROM THIS DRUG - WITHOUT PRE-WARNING FROM MY DR ABOUT THE POSSIBLE SIDE EFFECTS I WAS PERSCRIBED EFFEOR - MY DOSSAGE WAS 300 MLS A DAY... I AM 31 YEARS OLD WITH TWO KIDS. I HAVE BEEN FEELING BETTER IN MY LIFE AND HAD DECIDED LAST WEEK TO COME OFF THIS DRUG - WELL MY GOD - IF I HAD ANY IDEA WHAT THE CONSIQUENCES WERE I THINK I'D OF SHOT MYSELF LAST WEEK. LUCKY I HAVE KIDS SO I STILL HAVE TO BE HERE ON THE PLANET FOR A WHILE YET - TO MAKE THIS LONG TERRIBLE STORY SHORT I HAVE BEEN SUFFERING FROM CONSTANT SHOCKS, CONSTANT CRYING OUTBURSTS, SUICIDAL TOUGHTS, HORRIBLE VIVID NIGHTMARES AND A NUMBER OF OTHER TERRIBLY UNCOMFORTABLE SIDE EFFECTS. I HAVE NOT BEEN ABLE TO CARE FOR MY CHILDERN AND NOW HAVE A FRIEND HELPING OUT. IF I HAD BEEN GIVEN INFORMATION ABOUT THE WITHDRAWL OF THIS EVIL DRUG I WOULD HAVE NEVER AGGRED TO TAKE IT. IT IS APAUING TO ME THAT DR.S JUST HAND THIS STUFF OUT......... I CAN GARUNTEE THERE WILL BE SUICIDES DIRECTLY RELATED TO THIS DRUG - IT IS A SAD STATE OF AFFAIRS......... THANK YOU TO ALL WHO HAVE SHARED YOUR STORIES ON THIS SITE AS IF IT WERE NOT FOR ALL YOUR EXPERIENCES I WOULD HAVE DEFINATLEY LOST IT ............... TODAY IS DAY 4 AND I AM FEELING A BIT BETTER - LEENA
_____________________________________________________________________
By Anonymous on Sunday, March 6, 2005 - 04:03 pm:

I have been off Effexor for about five years now, yet I STILL have one symptom that appeared either while on it or going off it, I don't remember: when lying in bed going to sleep or waking up, I hear a sudden whoosh sound, maybe every half minute, not regular. I remember five years ago I was going off Effexor and was hearing the same sound triggered by moving my eyes suddenly. There were some other symptoms such as dizziness when walking. I was having so much trouble going to sleep one night that it suddenly occurred to me that it might be related to going off Effexor. I got up and got on the internet and did some searching, and I found hundreds of testimonials about symptoms like mine from Effexor withdrawal. It was a relief, and caused me to do the withdrawal more gradually. After I was completely off it, all symptoms except this ear whoosh sound stopped. The whoosh has never stopped. I'm reasonably sure it appeared while taking Effexor, and was severe at that time. I keep having the feeling that there is something I think about that causes it. This morning I finally identified what I believe is the trigger for the sound: beginning to fall asleep, or conscious attention beginning to relax. Have you ever been driving and almost fallen asleep and jerked awake? Have you noticed that that jerk is accompanied by a sudden whoosh sound in the ears? That is EXACTLY the sound I hear now when relaxing in bed in the morning, every 5-30 seconds. I believe it was caused by Effexor, although I can't be certain. It is also possible, however, that Prozac also causes this, because Prozac has been my antidepressant of choice, and though I'm not on it now, I was about 3 months ago. I don't notice this symptom being any worse, though, when I'm on Prozac. I think Effexor is dangerous. I tell friends asking about antidepressants to avoid that one like the plague.
____________________________________________________________________
By Anonymous on Wednesday, August 31, 2005 - 07:30 am:

I recently discontinued using venlafaxine, after only nine months, due to certain impairments in my daily life such as; huge impairments in short term memory, complete loss of pleasure in reading when I used to be an avid reader, memory loss in the way of spelling and such, problems in recalling familiar words and speech issues (i.e. unablity to speak the words that I'm thinking of, occasional stuttering), and severe loss of inhibitions (i.e. no conscience), and reoccurances of psychotic episodes from childhood.
I've been about a off effexor for three weeks now and things aren't getting back to normal. Could this be frontal lobe damage or something and is this likely to be permanent? I am 18 thus my brain should be more elastic than someone older. Does anyone have any knowledge about this for it would be much appreciated.
____________________________________________________________________
By Anon on Wednesday, August 31, 2005 - 02:35 pm:

Hello. The deficits you list have been experienced by many, many people. Some people are finding that they have to live with long-term damage, however you have only just come off the drug and are highly likely to be in the throes of withdrawal... and withdrawal symptoms show a great deal of overlap when compared with the side-effects: including the memory problems, feeling detatched or unreal, confusion or cognitive difficulties, auditory and visual hallucinations, murderous urges, and manic-like reactions.

Time may prove to be a great healer. Lots of people suffering badly, withdrawal-wise, concur in stating the worst was at the 3 month mark.

I had all the 'huge impairments in short term memory, complete loss of pleasure in reading when I used to be an avid reader, memory loss in the way of spelling and such, problems in recalling familiar words and speech issues (i.e. unablity to speak the words that I'm thinking of, occasional stuttering), and severe loss of inhibitions (i.e. no conscience)'... myself, whilst on this category of antidepressant. And more. A lot of what I found helped me, in the immediate aftermath, turned out to be eerily similar to the advice offered over here.

Could it be frontal lobe damage? Well these drugs can certainly cause long-term damage, but it is a little more difficult to pin down the where and the how. Many of the symptoms do tie in with that theory, but that's a long, long way from fact. Many of them also tie in with hormonal damage, and dopamine receptor damage, and no doubt a host of other unknowns... I think that although 'the truth is out there', it's going to take some finding, especially given the significant lack of research. The book which addresses many of these issues is Joseph Glenmullen's 'Prozac Backlash' (equally relevant to venlafaxine).

Other people have posted to this board describing long-term after effects, if you use the search facility at the bottom of this page, you will find them swiftly.

You've been off them only 3 weeks. No time at all. You may find significant improvement occurs over the coming weeks, as your body adapts to its non-drug environment. Try a little mild exercise, a good old-fashioned diet (staying away from the additives & artificial sweeteners), and attempt to let yourself relax at least once in the day... easy to say, not so easy to do... give yourself as many advantages as possible: good nutrition, the exercise endorphins, stress reduction, natural sleep.

And time.

UK Parliament blames MHRA and prescribers

In march 2005 the review "The Influence of Pharmaceutical Industry" was concluded. It's amazing that it raises so many problems such as MHRA failure in all regulatory process and the accountability prescribers should hold dear.
These are some excerpts and there's much more on the review:

"The industry is by no means solely to blame for the difficulties we describe. The regulators and prescribers are also open to criticism. The regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), has failed to adequately scrutinise licensing data and its post-marketing surveillance is inadequate.The MHRA Chairman stated that trust was integral to effective regulation, but trust, while convenient, may mean that the regulatory process is not strict enough.The organisation has been too close to the industry, a closeness underpinned by common policy objectives, agreed processes, frequent contact, consultation and interchange of staff. We are concerned that a rather lax regime is exacerbated by the MHRA’s need to compete with other European regulators for licence application business.

Inappropriate prescription of medicines by GPs is of particular concern. Some have prescribed SSRIs, for instance, on a grand scale.This is in part due to inadequacies in the education of medical practitioners which has meant that too few non-specialists are able to make objective assessments of the merits of drugs and too many seem not to recognise how little is known about the properties of a drug at the time of licensing, particularly about its adverse consequences. However, many prescribers have behaved responsibly and with restraint, which makes those who have not, all the more culpable.The constraints in place for hospital doctors do not apply to GPs. Drug companies are criticised for giving hospitality and recruiting ‘key opinion leaders’, but the prescribers must be equally to blame for accepting the hospitality and some ‘key opinion leaders’ for lending their names to work they did not produce, often for very considerable sums.

Greater transparency is also fundamental to the medicines regulatory system.There has to be better public access to materials considered by the MHRA prior to licensing.

The aim of new drugs should be real therapeutic benefit for patients. Clinical trials should focus on using health outcomes that are relevant to patients.To achieve this we recommend better communication between the MHRA and companies early in the early stages of the development of a drug. Improvements in the post-licensing surveillance of medicines are also badly needed. This will require systematic appraisals of medicines.

We recommend that more research be undertaken into the adverse effects of drugs, both during drug development and medicines licensing. The Government should, as a matter of urgency, fund research into the costs of drug-induced illness. (emphasis mine)

We recommend that the MHRA find ways of ensuring greater restraint in medicines promotion, particularly soon after launch. There should also be strengthened guidelines requiring the declaration of links between pharmaceutical companies and patient groups. In view of the failings of the MHRA, we recommend a fundamental review of the organisation in order to ensure that safe and effective medicines,with necessary prescribing constraints, are licensed.
In view of the failings of the MHRA, we recommend a fundamental review of the organisation in order to ensure that safe and effective medicines, with necessary prescribing constraints, are licensed." p. 4-5

Problems and solutions are known but nothing is done. Blaming MHRA and prescribers is not enough. After publishing this review UK Parliament has forgotten health problems even the costs of drug-induced illness.

Health Canada Warns of Venlafaxine Overdosage, Increased Risk of Fatal Outcome

Health Canada Endorsed Important Safety Information on VENLAFAXINE XR

OTTOWA, Ontario -- October 23, 2008

Dear Healthcare Professional:

SUBJECT: Safety Information Regarding Overdosage of Venlafaxine HCl Extended-Release
Capsules

Venlafaxine HCl Extended-Release Capsule manufacturers wish to provide you with important safety information regarding venlafaxine XR. Published retrospective studies 1,2,3,4 have reported that venlafaxine overdosage may be associated with an increased risk of fatal outcome compared to that observed with Selective Serotonin Reuptake Inhibitor (SSRI) antidepressants, but lower than that for tricyclic antidepressants. Although the extent to which the finding of an increased risk of fatal outcomes can be attributed to the toxicity of venlafaxine in overdosage, as opposed to some characteristics of venlafaxine-treated patients, is not clear,5 post-market reports of fatal acute overdoses have been received for venlafaxine alone at doses as low as approximately 1 gram.


- Prescriptions for venlafaxine XR should be written for the smallest quantity of drug consistent with good patient management, in order to reduce the risk of overdose, particularly in patients who have more severe illness or risk factors for suicidal behaviour.
- The potential for suicide attempt in seriously depressed patients is inherent to the illness, and may persist until significant remission occurs.(emphasis mine)* Clinical monitoring for suicidal ideation and/or other indicators of suicidal behaviour is recommended for all depressed patients.
- Increased risk of behavioural and emotional changes, including self-harm, has been seen with treatment with venlafaxine, as with other antidepressant drugs, and health care providers, patients, family members and/or caregivers should be vigilant for such changes.
-All antidepressants have a potential risk of fatal outcome in overdose.

Manufacturers of all extended release venlafaxine products are working with Health Canada to include this safety information in the Overdosage section in all Canadian Product Monographs for venlafaxine extended release capsules. Managing marketed health product-related adverse reactions depends on health care professionals and consumers reporting them. Reporting rates determined on the basis of spontaneously reported post-marketing adverse reactions are generally presumed to underestimate the risks associated with health product treatments. Any case of overdose or other serious or unexpected adverse reactions in patients receiving venlafaxine XR should be reported to the manufacturer or Health Canada at the following
addresses:

Source: Health Canada

*They will always deny drug-induce suicide ideation that has nothing to do with depression.

Psychiatry is an accident in some people's life

I've stopped posting for the last days. My problem is: I'm tired.
First I've started not visiting my blog buddies because I was feeling very sad. I kept on posting some data and kept on commenting just when I thought it was necessary to discuss pharmaceutical and treatments and diagnosis issues.
I got angry and sad.
I know it's hard to raise awareness on all of this. But sometimes it's overwhelmingly hard at least for me.
Sometimes, for no reason, I feel like crying and I've noticed I've been too stressed and angry, sad, angry...
One of the things that strikes me the most is that everything is out in the open. There's enough data, nevertheless, we have to keep on repeating over and over again the same and when we think we have already said enough its necessary not only start it again but another information of an off-label use of a drug that makes no sense or another strange news that only shows that it's getting far out of control.
It seems we are the only to care. It's amazing that psychiatrists don't say a word about their views on their clinical experience and when some of them express themselves is to claim that they never heard about it and according to their clinical experience this has never happened...
I have to find a way to keep on it without being too passionate.

I wrote it three or four days ago but I didn't publish it. Now I'm sad because when I look at my life I see the story of 15 years coping with side effects and withdrawals. That's it. That's all.
All I needed was someone to take all the drugs but side effects were seen as diseases and it's amazing that we believe even though deep inside we have a suspicion that something is not right.
I've been crying and feeling sorry for these years that went away and I can't even remember well what has happened or what drug was I withdrawing or starting to take.
I wish I could say: "-I've been depressed, took some pills that helped me and now I'm fine."
This would be easier to explain, It would make some sense and everybody would be happy.
I find myself having to hide it all because nobody will understand what has really happened.
I'm under psychiatric care - I have to go get the prescriptions for the drugs I've tried to withdraw but I couldn't - so, I'm a .............. . - what? fill the blanks.
Now what?
I don't know.
I go out and pretend everything is fine and I even start believing it's fine.
But sometimes it rains.
It's sunny today, but it's raining inside.
I thank I've found you all to share all of this because it's a very lonely and important part of me. Unfortunately some people only see this part of you.

Psychiatrists, please! Can you listen for a moment?

Philip Dawdy have published today Neuroscientist Defends Forced ECT and there has been many comments from patients on psychiatry.
I think it's worthy to take a look just to have an idea on how much harm psychiatry is doing to people.
I'm not anti-psychiatrist or anything of this kind. But with the amount of data available I think that it's about time to have at least some efforts from this branch of medicine to listen to their patients.
This silence and denial of harms have already gone too far.
We deserve some answers.

I've just received a gift!

I hope PreciousRock don't get jealous but I'm starting to think that it would be great to leave Brazil for a while. These lunatic blog friends are so handsome! It's difficult to choose between US or UK.

ECT - voluntary or involuntary - is it a real choice?

Every Wednesday morning Ray Sandford, 54 has been forced to get out to go to receive his ECT treatment. You can read the whole story on this post, an Action Alert, Susan has published today.

"Of course, MindFreedom International has documented proven cases of electroshock against the expressed wishes of the subject all over the world, including in the USA. MindFreedom succeeded in having the United Nations World Health Organization call in writing for a global ban on all involuntary electroshock."
"Ms. Wilhelm said, “We are following the letter of the law.” She said the State of Minnesota had secured a variety of court orders that require Ray to have forced electroshock against his expressed wishes. Ms. Wilehlm says it’s all legal and she can’t do anything about it."

By the end of Susan's post she had put a link where Philip Dawdy published her letter about her experience with electroshock:

“Mr. and Mrs. S” went my doctor – “We’ve tried everything on your daughter but she is extremely depressed and still suicidal. We’ve tried several different drug therapies and nothing is working, and we are left with two things. She has ten days left on her insurance and if she is still like the way she is now, we will be forced to put her in a state hospital. Or we can try ECT”.

ECT was then explained to my parents, and they saw a video. And with the State’s leading expert on ECT who told them he would be personally administering it, papers were signed, I was convinced by mom and dad “ do this to make your mother happy”, and the next day woken up at 5 am to be driven to the local teaching hospital for my first round.

Please, read the whole letter.
Two months ago I met a mother who was on a Brazilian mental institution where her daughter was for one week being treated with ECT because "-They have tried everything and the last resource was ECT, the psychiatrists told me."

I'm very confused. It seems to me that whether being voluntary or involuntary ECT is being used in a very strange way. If ECT is presented as the last resource is it a real choice the family is doing?

I'm speechless

Just another Zoloft withdrawal story

"Briefly: I stopped taking Sertraline (Zoloft) in early January. My daily dose at that time was extremely high: 300, even as high as 350 mg. a day. I'd been on it for over 4 years--it was prescribed following a knee injury in an aftershock of the Northridge earthquake: I tore my ACL and at the same time had an acute resurgence of Epstein Barr virus. Facing surgery and phsyical therapy, and with my titers way up there, the doctor thought the antidepressants would give me an extra boost to help my recovery.
To make a long story short, my initial low dosage was gradually but steadily increased. By the time I stopped, nearly three months ago now, I was showing signs of serotonin toxicity (constant anxiety) and was also (according to my husband and dentist) grinding my teeth like crazy every night. It just happened, after New Year's, that I ran out of pills at a time when I was too broke to pay for a refill. I decided to stop cold turkey, and prepared for a few bad days at least, knowing a little about potential withdrawal effects. So, at first, the dizziness, nausea, "electric shock" feelings, wild dreams, etc., didn't bother me all that much.
After two straight weeks, though, the continuation of those symptoms plus other ones--itching (not tingling or burning) all over my body, something I'm sure were seizures (a feeling of suddenly falling, sort of "blacking out" but not quite, followed almost instantly by tremendous muscle jerks in my legs or arms ...anyway, it was almost impossible to get to sleep at night from the itching, "falling" and muscle spasms. My primary care doctor (who'd prescribed the antidepressants for some time, since I did not go to a psychiatrist) prescribed Ativan, which I started to take at night only, in gradually diminishing amounts, so I could get to sleep at all. On the other hand, positive effects of stopping the Zoloft included a return of sexual responsiveness (extremely welcome!) and, despite powerful emotions (rage, grief as I hadn't felt them in years) I was, and am, generally grateful to experience what seems to be an emotional range that had been blunted for several years.
My problem is this: It is now nearly three months since I stopped taking the Zoloft. Once the "physical" signs of withdrawal began to diminish (e.g., I haven't needed to take anything to sleep for three weeks now; I no longer experience the "itching" or the "passing-out sensation followed by muscle spasms") -- now, however, I seem to be mired in one of the worst depressions of my life. I've put on somewhere between 10-15 pounds over the past two months. My energy is low; I feel like I'm slogging through water much of the time. Basically, I'm sure I have all the classic symptoms of major depression, including powerful feelings of anguish, rage, and hopelessness -- except, thanks to many years working with a wonderful therapist and my own insight into antidepressants, I also recognize the perhaps iatrogenic nature of all this and am trying to ride it out, not to take it too personally.
But how long can this last? In your document, you raise questions about long-term effects and discuss liver enzyme changes, etc., but I guess I would like to know whether any studies have been done mapping (or attempting to map) the specific changes wrought by SSRIs on the neural pathways themselves -- for example, is it possible that long-term use of Zoloft (for example) has permanently altered or damaged my body's own ability to process or regulate serotonin uptake? In other words, will "waiting this out" prove to be an empty exercise, and I will be forced back onto SSRIs to beat this depression?
I write you now a bit at my wit's end. It's not getting worse; it's just lasting and lasting and I feel exhausted and unsure how to proceed. Whatever they say about these drugs being "not addictive" -- I could testify that I have reached a point where I literally crave my Zoloft, where the only thing stopping me from calling the pharmacy to refill my still-existing prescription is will power, that simple.
Thank you for your time and any insights. Yours is the first site I've seen (and in my search for answers, I've searched quite a few) that seems to have an educated, research-laden handle on this issue. During the worst of it, my own doctor threw up his hands. He's a good guy, but was totally stymied. He didn't know, and the Neuropsychiatric Department at UCLA said no research into this subject is even being done (but I could come down, get assessed for meds!).
I believe it's an issue of tremendous importance -- to people like me, certainly, but also to the thousands if not millions of people who thoughtlessly and trustingly pop their antidepressant pills just to make it to work every day. Not to mention the future generations of children who, if they have their way and start using these drugs for so-called "early childhood" psychiatric illness, may end up having their brains scrambled forever. The spectre of permanent, unalterable damage is truly frightening. But I'll get off that pulpit and stick to my questions. I hope you'll find the time to reply. I've been perusing your site for some weeks before choosing to write you. Quite frankly, I was getting to a point where I wanted to call 60 Minutes in, immediately, to do a "whistle-blowing" story on what may be one of the most widespread medical horror stories of our time. Think, with millions of people popping these pills, they'd have an interested viewing audience? ... I'm selfishly concerned about me, also about the prevalence and damage from SSRIs to the lives of a much wider group of people."

I've saved this testimony on 07/29, 2005.

Wyeth has answer me about side effects of XR version

São Paulo, 04 de novembro de 2008.


Prezada Ana,

I had left the e-mail in Portuguese here but I've just deleted it - November, 9 - because the word "discontinuity" appeared and Brazilian people have found the blog thinking that it had to due with withdrawal symptoms.

The most important:
They claim that Wyeth has not stop commercializing the drug - it's not on the market I can't find it anywhere - and that it's necessary that the physician makes an authorization to the change. Well, my psychiatrist told me last year that the common version was not on sale any longer and that I had to change to the XR version.
They ask me to report them the side effects I'm experiencing.
I'll send this e-mail to my psychiatrists. Although he is a very good psychiatrist and a researcher he must not be aware of what is for sale or not.
If the change can only be made following the psychiatrist's advice how can it be that the common version is not on the market?
I have already reported it to Anvisa, our regulatory agency, last year. They said the common version was on the market. But I don't know where can I find it.
Not even the 28 capsules boxes are available!

One of those Effexor XR days - Thank you Wyeth!

It's impossible to be stand up. Huge headache and dizziness. Last year the Effexor common version disappeared from Brazilian market and I had to start taking the XR version. Side effects got worse. I've already wrote to Wyeth and to Brazilian regulatory agency asking what has happened and that I'm much better on the common version. No reply from Wyeth that even took away from the market the 28 capsules box and only sell 14 capsules boxes.
It must be more profitable.
I've just send another message on the Brazilian Wyeth site asking what has happened with the common version.
I will not have an answer.
I'll just lay down and wait to get better.
I have some catch ups to my blog buddies.
I need to explain why I'm not visiting blogs like I used to.
I'll do it when I get better.

Regulating Pharmas conduct is not that difficult

This report made by Consumer International have some examples of measures taken by European countries. These are some examples and I cannot help thinking about seeing some of the worse harms being on the list. If in the next two decades perhaps I could see it.

AstraZeneca

-In another case, the company provided airfare and accommodation for doctors to attend a conference on bipolar disorder in Cannes on the French Riviera and was put on probation by Dutch authorities for violating the Code on the Promotion of Medicinal Products. (WOW! Discussing bipolarity in Cannes on the French Riviera! Cool!)
-The Dutch Code Commission in 2004 found AstraZeneca’s claims in its promotion of Seroquel unjustified, not based in two relevant studies and therefore misleading.

Eli-Lilly

-Published data for Lilly’s antidepressant Prozac claimed that the drugs reduces the likelihood that people will harm themselves. However, data from clinical trials indicated the opposite, namely that people continue to harm themselves.

GlaxoSmithKline

-Before GSK’s anti-depressant Paxil was approved for use against `social phobia’ in 1999, the company organised a large public awareness campaign about the condition, renaming it `social anxiety disorder’. GSK has been accused of grossly exaggerating the numbers suffering from this condition, leading to much higher sales of Paxil and inappropriate drug use.
-In February 2003, Italian authorities started an investigation against GSK for corruption of over 4,000 doctors. The total value of illegal gifts was estimated at 228 million euros from 1999 to 2002. These incentives suggest that doctors would have prescribed 7-8% more GSK products each than otherwise would have been the case.
-Promotional materials for GSKs antidepressant Paxil claimed that the drug reduces the likelihood that people would harm themselves. However, data from clinical trials indicated the opposite, namely that people continue to harm themselves.
-In May 2004, GSK was accused of fraudulent manoeuvres to extend patent protection over its anti-depressant Paxil and its antibiotic Augmentin, in order to prevent competition from generics.

Pfizer

-In 2004 Pfizer pleaded guilty on charges of falsely marketing its epilepsy drug Neurontin for off-label uses.
-The Dutch Code Commission granted a complaint filed by a doctor against Pfizer in 2004. The doctor complained about an invitation that he had received from Pfizer for a information meeting about Celebrex. Pfizer promised to cover expenses by giving 200 euro for doctors signing up to the meeting.
Pfizer has sponsored an Impotence Association campaign in which the logo of Pfizer figured prominently on the advertisements. The UK Prescription Medicines Code of Practice Authority (PMCPA) ruled that this was inappropriate and could encourage patients to ask doctors specifically for Viagra.

Source:
Branding the Cure: A consumer perspective on Corporate Social
Responsibility, Drug Promotion and the Pharmaceutical Industry in Europe. .pdf
can be downloaded free-of-charge from the CI website.

WHO conceals depleted uranium toxicity

According to WHO "No reproductive or developmental effects have been reported in humans."

Depleted Uranium Weapons – a BBC investigation by Angus Stickle
"depleted uranium is genotoxic - it chemically alters DNA and could be a precursor to tumour growth."

I don't know what to think about WHO.


More informations and photos Takashi Morizumi.

My life under psychiatric drugs

I try hard not to think about it. But I feel terrible knowing that I'll have to take these drugs for the rest of my life. I also think about what kind of changes these things I don't need to take because I've never been depressed or manic or nothing are promoting in my body.
As I already said I've spend two years of my life withdrawing Effexor and felt all withdrawal symptoms. It was hell and I had to go back to the drug because I felt physical and emotional things that I cannot even describe. I only could withdraw 400 mg of Seroquel and clonazepam, the drug that led me to a psychiatrist in search for help to withdraw and made of me a psychiatric patient because of the wrong prescription of an antidepressant and side effects were seen as diseases by other psychiatrist... blah blah... sick to death of this story.
I have to go home at midnight and if I plan to travel I have to think about the drugs I'll have to carry if I spend three days without these drugs I'll be put on a mental institution yadda yadda.... I'll have to ask for prescriptions to buy these drugs forever.
You know it all.
But not the people I know. They don't have a clue about what has happened to me.
Trying to withdraw it all over again?
I'm 49 and 9 months, 50 years old.
I would live withdrawal hell for the rest of my life?
These and other questions and feelings come to my mind from time to time.

Nemeroff in Brazil

This is one of many sites that are online in Brazilian Portuguese.

No need to translate because you already know about the wonders of Cymbalta in healing chemical imbalance and the few side effects of this wonderful drug.

Just take a look at the source - the last paragraph of the page:

Ref. Bibliograf.:
Nemeroff CB, Schatzberg AF, Goldstein DJ, Detke MJ, Mallinckrodt C, Lu Y. Duloxetin for the treatment of major depressive disorder. Psychopharmacology Bull 2002. 36(4): 106-132.
http://pi.lilly.com/us/cymbalta-pi.pdf

Rob Robinson - Paxil activist recommend books

I'm following Fiddaman steps. In this post he has homaged Rob Robinson, who has created SSRIcitizen .org, by putting online again some of his writings that he has saved. I've saved three pages in 2005 and I think that this page on books are of great help.

Recommended Reading

"Let Them Eat Prozac" by David Healy, M.D. "Prozac Backlash" by Joseph Glenmullen, M.D. "Talking Back To Prozac" by Peter R. Breggin, M.D. "Medicines Out Of Control" by Charles Medawar and Anita Hardon. "The Truth About the Drug Companies: How They Deceive Us and What to Do About It" by Marcia Angell. "On the Take: How Big Business Is Corrupting American Medicine" by Dr. Jerome Kassirer, M.D. "Prescription for Disaster" by Thomas J. Moore. "Overdosed America: The Broken Promise of American Medicine" by Dr. John Abramson, M.D. "The Anti-Depressant Fact Book" by Dr. Peter R. Breggin, M.D. "Blind Reason" by Patricia Griffon

You owe it to yourself and your health to take some time and fully explore the associated web links.

Let Them Eat Prozac
by David Healy, M.D.
http://www.healyprozac.com/

Dr. David Healy is Reader in Psychological Medicine at the University of Wales College of Medicine and Visiting Professor of Medicine at the University of Toronto. He is author of more than 120 peer reviewed articles and more than a dozen books, including The Antidepressant Era (Harvard) and The Creation of Psychopharmacology (Harvard). He is considered one of the world's foremost authorities on SSRIs.
Note: The following book review is by Arthur Schafer, director of the Centre for Professional and Applied Ethics at the University of Manitoba. His study of pharmaceutical research ethics is forthcoming in The Journal of Medical Ethics.

"Before Prozac, few people risked getting depression. Now, it seems, we are all at risk. Better pay close attention, then, to David Healy's wonderfully perspicuous account of how a treatment can manufacture disease.
Of course, depression has always been with us, and Healy presents some moving stories of how this disease can blight the lives of those affected. The great boom in depressive illness, however, dates back only to the discovery and marketing of Prozac.
Prior to the 1990s, comparatively few people were thought to suffer from depression: perhaps one person in 10,000. With the discovery of the Prozac family of drugs there came, not coincidentally, an explosive increase in diagnoses of depressive illness. Current estimates claim that one in 10 of the population is clinically depressed. A thousand-fold increase. In barely a decade, depression has gone from being a rare disorder to being classed as one of the greatest afflictions of humankind — requiring that millions of comparatively healthy people be treated with powerful medication. An old cliché jumps irresistibly to mind: To the man with a hammer in his hand, everything looks like a nail.
As one of the first researchers to investigate the serotonin reuptake mechanisms in depressed people, Healy was in the vanguard of the SSRI revolution that gave the world Prozac, Paxil, Zoloft and Celexa. He has been a consultant for many of the leading players — Eli Lilly, Pharmacia and Upjohn — and has spoken at international symposia for Pfizer, SmithKline Beecham and AstraZeneca. Harvard University Press has published two of his dozen books. Little wonder, then, that the University of Toronto faculty of medicine was initially thrilled to recruit Healy to its department of psychiatry.
In the world of psychopharmacology, Healy is an insider's insider. This inside track makes his account of the sordid underbelly of the drug industry both more believable and more disquieting. He really does know where the bodies are buried, literally as well as figuratively, and readers will find their confidence in the integrity of drug research badly shaken.
Although Healy was an early advocate of Prozac, his clinical research persuaded him that the Prozac drug group could trigger suicide and violence in some patients. Later, when he gained access to internal company communications, he discovered that the companies themselves knew of the problem.
Healy concludes that SSRIs might benefit some people in the short term, but he finds little reason to think that they help things to turn out better in the long run. Most worryingly, he presents persuasive evidence that the SSRIs make a significant number of people suicidal and a larger number addicted.
There is no nice way of putting this: The drug companies have subordinated patient safety on the altar of blockbuster profits. Aggressive marketing has persuaded the medical profession to prescribe SSRI drugs to people who are simply struggling with mundane anxieties. Unwilling to risk the death of a goose that lays such golden eggs, the companies refuse to sponsor the kind of large-scale scientific research that would map out the true frequency and seriousness of side effects. Absent such research, doctors and patients are unable to make properly informed choices.
There may be only 50 ways to leave your lover, but there are at least 150 ways to design drug experiments so that they are skewed in favor of the sponsoring company's products. From my own research on the ethics of clinical trials, I thought I knew all the tricks of the trade. I was mistaken. Healy has taught me some new ones.
Want to eliminate evidence of dangerous side effects from your new anti-depressant? First, ensure that company scientists design the experiment and tabulate the data before it is turned over to the university scientist whose name will grace the eventual publication. Better yet, when volunteers enrolled in the experiment become agitated (and potentially suicidal or violent), code them as "failing to respond to treatment." Amazingly, by this simple sleight of hand, the alarming side effects disappear. What isn't recorded doesn't exist. The respected scientist whose name goes on the ghost-written publication -- a widespread practice, as Healy shows -- seldom sees the raw data and is happy to collect a generous fee from the company along with the status that comes with having "his" research published in a prestigious journal.
Leading drug industry figures play an unsavory role in this story, but it cannot be said that either the medical profession or government regulators emerge with armour shining. Those charged with protecting the public from unjustifiable harms seem not yet to have taken on board the central lesson of the 1962 thalidomide tragedy: All drugs are inherently risky. Only honest and well-designed research can tell us which drugs offer which patients the likelihood of more benefit than harm.
Because universities and hospitals float on a sea of drug company money, few seem keen to raise critical questions about unethical research practices. Moreover, when researchers demonstrate moral courage by going public with evidence of harmful side effects, they may find themselves sued by the company (Toronto doctor Nancy Olivieri for example, was threatened with legal action by a pharmaceutical company after she told her patients of the potential dangers of a drug she was testing on them. Others risk termination).
Let Them Eat Prozac tells a compelling story, with strong resemblances to a detective novel. The drama of Healy's personal odyssey, from pro-industry scientist to embattled critic, illuminates the dark side of the bargain between modern science and Big Pharma. The book is edifying and frightening. But never depressing."

Prozac Backlash
by Joseph Glenmullen, M.D.
http://www.prozacbacklash.com/

Joseph Glenmullen, M.D. is a clinical instructor in psychiatry at Harvard Medical School, is on the staff of Harvard University Health Services and is in private practice in Harvard Square. A strong patient advocate, Dr. Glenmullen testified at the FDA hearing that resulted in the recent warning that antidepressants make patients, including children and adolescents, suicidal. The warning covers all ten of the currently popular antidepressants: Prozac, Zoloft, Paxil, Effexor, Celexa, Lexapro, Wellbutrin, Luvox, Remeron, and Serzone.
The following book review appeared in The Boston Globe on June 8, 2000

"In a front-page article on June 8, 2000 by Mitchell Zuckoff entitled 'Prozac data was kept from trial, suit says,' the Globe reported: 'In a federal lawsuit filed yesterday in Hawaii, the family of William Forsyth says that Lilly 'committed a fraud on the court' by failing to tell the family's lawyers about a patent that claims a new version of the drug eliminates side effects of the existing Prozac, including violent suicidal thoughts.On March 3, 1992, 11 days after he began taking Prozac, Forsyth fatally stabbed his wife multiple times with a serrated kitchen knife and then impaled himself on the blade.Of some 200 lawsuits filed against Lilly asserting that the use of Prozac led to suicide or violence, the Forsyth case was only the second to yield a verdict. Lilly settled many of the others, and the only other one to reach a jury, in 1994, was widely reported to have been a victory for the company. In fact, it was settled in a secret agreement between Lilly and the plaintiffs.'
Prozac Backlash reports in detail on the secret settlement in this 1994 test case against Prozac and Lilly, which went to trial. Lilly won what appeared to be a jury verdict in the trial, which the pharmaceutical company widely publicized. But a later Attorney General's investigation revealed that Lilly had secretly settled the case during the trial although the victims and pharmaceutical company continued as apparent adversaries in front of the judge and jury. After the investigation, in 1997 Lilly quietly agreed to the final judgement in the trial being changed from a jury verdict in Lilly's favor to 'dismissed as settled.'
The Globe quoted Dr. Glenmullen on the patent for the new Prozac: 'To me the new patent can be compared to the tobacco papers. It's a pharmaceutical company document that acknowledges this dangerous side effect which has been downplayed by Eli Lilly and other pharmaceutical companies for a decade.'"

Talking Back To Prozac
by Peter R. Breggin, M.D.
http://www.breggin.com/prbbooks.html

“Peter Breggin is Prozac’s worst enemy.”— Time

"There is unquestionably a great deal of truth in what Breggin writes. Let the pill-swallower beware." — Los Angeles Times

Peter R. Breggin, M.D. began in the full time private practice of psychiatry in 1968. Dr. Breggin has been informing the professions, media and the public about the potential dangers of drugs, electroshock, psychosurgery, involuntary treatment, and the biological theories of psychiatry for over three decades. Since 1964 Dr. Breggin has been publishing peer-reviewed articles and medical books in his subspecialty of clinical psychopharmacology. He is the author of dozens of scientific articles and more than fifteen professional books about psychiatric medication, the FDA and drug approval process, the evaluation of clinical trials, and standards of care in psychiatry and related fields.
For thirty years Dr. Breggin has served as a medical expert in many civil and criminal suits including product liability suits against the manufacturers of psychiatric drugs. His work provided the scientific basis for the original combined Prozac suits and for the more recent Ritalin class action suits. His efforts as a medical expert have resulted in the FDA changing numerous official drug labels.
Dr. Breggin's background includes Harvard College, Case Western Reserve Medical School, a teaching fellowship at Harvard Medical School, a two-year staff appointment to the National Institute of Mental Health, and a faculty appointment to the Johns Hopkins University Department of Counseling.

Medicines Out Of Control?
by Charles Medawar and Anita Hardon
http://www.socialaudit.org.uk/

Charles Medawar is layman, a specialist on medicines policy and drug safety issues with a particular interest in corporate, governmental and professional accountability. He writes, broadcasts and lectures regularly, and runs a web site (www.socialaudit.org.uk) which now attracts some 500,000 visitors a year. Anita Hardon is Professor in Anthropology of Care and Health at the University of Amsterdam. She has published widely, specializing on women’s health issues and studies of medicines’ use in Asia, Africa and Europe, and teaches international courses on promoting rational drug use. She currently chairs the Health Action International (Europe) foundation board.
The following book overview is taken from Social Audit’s web site:
"Published in March 2004, Medicines out of Control? draws on the SSRI antidepressant case history to describe a system of medicines’ control tainted by secrecy and conflicts of interest, barely accountable to the public, lacking in common sense and losing sight of the meaning of health. Subtitled Antidepressants and the Conspiracy of Goodwill, this book reveals a demonstrably chaotic system of drug evaluation, driven by the almost unquestioned assumption that health is the product of greater ‘disease awareness’ and more new drugs.
These trends reflect the growing dominance of global and market values that now threaten to turn pharmaceutical medicine into something of a polluting enterprise, deeply damaging to the atmosphere of health. Alas, this is no more obvious than global warming to the driver of your average car.
Medicines out of Control? is an attempt to promote a complete rethink about what medicines contribute to health, and the basis of decision-making about drug benefits, risks and harm."
What has emerged from all this is a story about the promotion, regulation, prescribing and use of mood-regulating drugs, mainly antidepressants like Prozac, Seroxat and Paxil. As it unfolds a drug crisis in the making, the story develops as a picture of unhealthy dependence on corporate and professional power.
The story leads to analysis: an attempt to explain to an engaged and curious layperson the basis for thinking that, for all the triumphs and gains, pharmaceutical medicine is losing sight of health and dangerously lacking in public accountability. However, the question mark in the book title is emphatic – an invitation to make up your own mind how you find medicine and what you want it to be.
This book is in no way a guide to your medical treatment; at best it can help to explain only how and why you may be treated as you are. On the basis of your experience and what you read, you might conclude either that the control of medicines is in dire need of overhaul and rethinking, or that it is an affront even to suggest that.
Either way — or perhaps something in between — this analysis is offered for peer-review and consultation, and is meant to promote comment and debate. The authors and sponsors would welcome feedback, to help prepare the next edition of this book. This first edition is intended for only limited circulation, through 2004. A revised and popular edition of this book is planned.

You can contact Charles Medawar by writing care of: Social Audit Ltd, P.O. Box 111, London NW1 8XG, UK., or sending him an email at: charles@socialaudit.org.uk

You can contact Anita Hardon by writing care of: Health Action International (Europe), J. van Lennepkade 334-T, 1053 NJ Amsterdam, The Netherlands, or sending her an email at: anita@haiweb.org

The Truth About The Drug Companies: How They Deceive Us And What To Do About It
By Marcia Angell

and

On The Take: How Big Business Is
Corrupting American Medicine
By Dr. Jerome Kassirer, M.D.

Reviewed by Shannon Brownlee, a Bernard L. Schwartz Senior Fellow at the New America Foundation.

Every author should be so lucky. While Jerome Kassirer and Marcia Angell were holed up in their offices, typing away, Congress launched an investigation into financial entanglements between industry and the National Institutes of Health. Then Pfizer was hit with nearly half a billion dollars in fines for paying doctors to hype its anti-seizure drug Neurontin for unapproved — and largely unproven — uses. Now, New York state attorney general Eliot Spitzer has accused another drug giant, GlaxoSmithKline, of burying evidence that the antidepressant Paxil can trigger suicide. It's great news for Angell's and Kassirer's book sales, bad news for the rest of us.
These stories about the unholy alliance between the pharmaceutical industry, researchers, and doctors may have seemed, to the casual observer, like nothing more than isolated blips. Sad to say — as these surprisingly bare-knuckled books by the last two editors-in-chief at the New England Journal of Medicine make clear — such accounts provide a mere glimpse of the corruption of medical science.
In the last two decades, the drug and biotech industries have gained unprecedented leverage over what doctors and patients know — and don't know— about the $200 billion worth of prescription pharmaceuticals consumed by Americans each year. Industry has gained that leverage by funding and, increasingly, controlling medical research. It has also used its deep pockets to effectively buy the loyalty of physicians in private practice and to sway the opinion of thought-leaders in academia. Grasp the full scope of industry influence over medical science and practice, and it's enough to make anybody think twice before filling a prescription.
At NEJM, Angell and Kassirer had front-row seats to industry's infiltration of medical science. Angell aims her broadsides at the misdeeds of the pharmaceutical industry, which, she writes, “has moved very far from its original high purpose of discovering and producing useful new drugs. Now primarily a marketing machine to sell drugs of dubious benefit, this industry uses its wealth and power to co-opt every institution that might stand in its way, including the U.S. Congress, the Food and Drug Administration, academic medical centers, and the medical profession itself.”
Drug company influence begins with funding most of the clinical research upon which the nation depends for accurate information about the uses and dangers of drugs. That means that the studies in scientific journals are increasingly likely to be designed, controlled, and even ghostwritten by marketing departments, Angell argues, rather than scientists.
Many researchers and doctors maintain — and no doubt believe — that science always arrives at the truth, and that their professional judgment cannot be influenced by this influx of industry money. But all evidence suggests otherwise. Studies involving thousands of published papers show unequivocally that corporate largesse skews science: When industry (rather than government) pays for a study, that study is more likely to reflect well on its products. Similarly, authors who argue favorably for a company's drug are more likely to have financial ties to the company than researchers whose opinion is either neutral or negative.
The bottom line is that the medical journals, those critical reference points for doctors, are filled with happy talk about drugs that are often either more dangerous or less efficacious than promised. Far from being an exception, GlaxoSmithKline's apparent failure to publish negative data about Paxil is now routine in an industry that treats scientific journals less as repositories of knowledge than, as Richard Horton, editor of the British medical journal The Lancet, puts it, “information laundering operations.”
Where Angell chronicles the drug companies' driving role in all of this, Kassirer details the complicity of increasing numbers of doctors and academics who are living high on the industry hog. Kassirer describes going to a medical meeting where the atmosphere seems less conducive to the exchange of sober scientific information and more “Hollywood set.” As he recalls, "Scores of beautiful men and women from pharmaceutical, biotechnology, device, and book companies greet the doctors wandering through the hall, where enormous, expensive, artistic creations announce the success of the companies' drugs with lights, sound... and electronic wizardry." Doctors crowd in for free notepads, pens, and T-shirts emblazoned with drug brands. Then there are the dinners at chic restaurants, and all-expenses-paid excursions to nearby attractions.
These freebies are only the most visible aspect of the culture of greed and self-deception that now permeates much of academic medicine and private practice. A quarter of academic scientists now have financial ties to industry: Companies woo them with invitations to sit on scientific advisory committees (for a salary, of course), lucrative consulting contracts, and stock options potentially worth millions of dollars. Doctors in private practice get on the gravy train by accepting bounties for enrolling patients in studies, or signing up as “consultants” in exchange for being flown to exotic locales to hear lectures about a company's drugs. All the perks add up. For one head of an academic medical department, according to an investigation by the Boston Globe, industry liaisons amounted to more than $400,000 in a single year.
None of this would matter so much if prescription drugs were just another type of consumer product, like fancy vodka or luxury cars. But drugs are not like other goods, and the corrupting influence of pharmaceutical industry money has hurt patients. Earlier this year, to take just the most recent example, the FDA cautioned doctors about prescribing certain antidepressants to children after reviewing 12 studies that found them no more effective in teens and children than a placebo and after the British government warned that one brand was three times as likely to trigger suicide. Those results undoubtedly came as a shock to the doctors around the country who have been writing 10 million antidepressant prescriptions for children and adolescents each year.
Both Kassirer and Angell offer a variety of potential fixes, ranging from creating a federally funded institute for drug studies to changing patent laws so the industry will stop padding profits by reformulating existing drugs and return to its original mission of coming up with truly innovative drugs. More difficult to remedy, however, is the loss of the scientific ethos, the idea that doing good is ample compensation. Not even science can overcome the corrupting influence of money.
This groundbreaking book sounds a clear warning about the serious health risks associated with prescription drugs and over-the-counter medications — and exposes the side effects that kill 100,000 people a year and put another million in the hospital. Consumer advocate and prizewinning investigative journalist Thomas Moore reveals the shocking truth about the dangers you face each time you swallow a pill, offering invaluable advice on becoming an informed consumer — and keeping yourself and your family safe.

Overdosed America: The Broken Promise of American Medicine
By Dr. John Abramson, M.D.

Reviewed by Publishers Weekly.

The Anti-Depressant Fact Book
By Dr. Peter Breggin, M.D.

Known as “the Ralph Nader of psychiatry,” Dr. Peter Breggin has been the medical expert in countless court cases involving the use or misuse of psychoactive medications. This unusual position has given him unprecedented access to private pharmaceutical research and correspondence files, information from which informs this straight-talking guide to the most prescribed and controversial category of American drugs: antidepressants. The Anti-Depressant Fact Book is up-to-the minute and easy-to-access. Hard-hitting and enlightening, every current, former, and prospective antidepressant-user will want to read this book.

Blind Reason
By Patricia Griffon

Ms. Griffin is a survivor of a severe and protracted Paxil withdrawal from. Blind Reason, nominated for a Pulitzer Prize in 2003, grew out of her tragedy. From a review at Amazon: “Nobody prepared me for what I would find between the covers of this fantastic book. I had just finished reading King of Torts when someone suggested Blind Reason, which made Grisham's tale of pharmaceutical corruption look like a comic book. Griffon's attention to detail is astounding; her research into the Third Reich, the CIA and the pharmaceutical industry is meticulous. The plot is fast-paced and the dialogue, on a host of subjects, is brilliant, but I was left with the haunting question of how much of what Griffon wrote is fact or fiction. The lines are definitely blurred. This is a great weekend read.”