Posted by Lou Pilder on March 4, 2015, at 7:55:46 [reposted on March 14, 2015, at 22:17:24 | original URL]
In reply to Re: Lou's reply-hynuen-Robert_Burton_1621 » Lou Pilder, posted by Robert_Burton_1621 on March 4, 2015, at 6:32:25
> > > > Robert,
> > You say that you do not follow my logic. I say to you that what you have posted here could result in the deaths or addictions or life-ruining conditions to other readers here and I am asking that we have an immediate discussion here.
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> Lou, your assertion is misleading, inflammatory and unfair. Nothing I posted "could result in" (i.e., be relevantly causally related to) any of the terrible consequences that you imply in your statement would flow naturally from the post I made.
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> >This is all because the psychiatrist that operates this forum is allowing your claims here to be seen as supportive and I think otherwise,>
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> The psychiatrist who operates this forum imposes as a condition of participation that no-one infers from the posts published here that medical advice is being supplied. The purpose of this forum is not in the online supply of clinical advice on which participants are intended to act but in describing, and thinking out-loud about, medication problems and *possible* medication strategies that participants might *think over*. No post here carries the express or implied intention or expectation that the content of any post should be acted upon *because* of any assumed expertise in the poster or because the reader has read the post here. Indeed, such expectations are very properly, and responsibly, expressly excluded by Dr Hsiung.
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> >and your claim that Mirtazapine is used to treat SS, and that the site drugs.com has erroneous information is what is in issue here.>
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> I never "claimed" that Mirtazapine "is used" (i.e., in the ordinary meaning of that aspect of the tense you have chosen to express my original comment in, habitually) to treat serotonin toxicity. I said that it "has been used" to treat such toxicity; and I say further than an authority argues persuasively that the serotonergic potency of mirtazapine is low to negligible in humans, a fact which the safe combination of venlafaxine and mirtazapine appears to bear out: see Human Psychopharmacology: Clinical and Experimental, (2006) 21, pp 117-25.
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> You produce accurately my claim, based in my experience, that the drug interaction section of drugs.com *has* erroneous information. I.e., that occassionally its information is erroneous in the level of detail it provides. Yet you then proceed, in one of your highly tendentiously phrased questions, to assert that I claimed that drugs.com is not "based on facts". I never claimed such a thing, nor did I ever claim to profess to a degree of knowledge of the entirety of drugs.com beyond my experience of it. My knowledge that it sometimes throws up erroneous information derives, in the instance to which I adverted, from its assertion that the combination of mirtazapine and venlafaxine poses a *major* risk of serotonin toxicity. Drugs.com also asserts that the combination of tranylcypromine and nortriptyline poses a *major* risk of serotonin syndrome, an assertion that is inconsistent with a clinical assessment of the pharmacological mechanisms of each drug. I would pose in reply to you the challenge to produce a citation which demonstrates this information to be accurate.
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> Most certainly did I not assert, or imply, that drugs.com contains information that is *always* or *mostly* erroneous. Not did I ever suggest that drugs.com should not be used or consulted. My point was that it is *better* to refer to specialist views rather than generic information as provided by drugs.com *exclusively*. Drugs.com may be a first port of call, but it shouldn't be the only one.
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> > If you could post answers to the following then by my responses I could address your claims here in what I think could save livesprevent life-ruining conditions and addictions.
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> I do not propose to oblige you in this matter, given the tendentious and quite frankly deeply offensive way you have chosen to phrase your questions. Your purpose is not, clearly, fair-mindedly to elicit clarifications but to inflame prejudice. My answers are as provided above.
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> I note that you have had a habit of delivering yourself of outrageously unfair imputations against Dr. Hsiung. I do not propose to engage with you further given the nature of the imputations you have chosen to direct at myself.
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> It may also be as well to remind you that the primary purpose of this thread is to offer responses to fido; it is not meant for you to indulge in the riding of eccentric hobby-horses.
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> Robert,
You wrote,[...Nothing I Posted could result in...any of the terrible consequences that you imply...].
The consequences of your claims being followed by the readers here, are listed by me as death, life-ruing conditions and addictions. Your claims here are:
A.Drugs.com will say incorrectly that many combinations can cause serotonin syndrome
B. Drugs.com says that the combination of mixing Mirtazapine with venlafaxine carries the risk of serotonin syndrome. *This is just erroneous.* (stars mine)
C. Mirtazapine has been used to treat serotonin syndrome.
Your claims here could be seen as being supportive because the rules by Mr. Hsuing is that if he does not intercede, what is posted is not against his rules. and that being supportive takes precedence. He later goes on to say that he could not intercede where there is a statement that is not supportive because in his thinking it will be good for this community as a whole to do so. This is what is at issue here that I think could cause the deaths of readers, induce a life-ruining condition or addiction and lead parents to drug their child in collaboration with a psychiatrist /doctor.
The rules here are for support and education. Since Mr. Hsiung has not interceded to your claims, the claims could be seen as supportive and educational, and readers could take your claims as facts. I dispute your claims as facts, in particular, but not limited to that you claim that Mirtazapine has been used to treat ss. I would like to see a citation that you use to make that claim so that readers could see for themselves what you are using to claim that Mirtazapine has been used to treat ss, because I do not want readers to be misled to think that because you claim that Mirtazapine has been used to treat ss, that there is a standard treatment for serotonin syndrome by using Mirtazapine which I think could mislead a subset of readers to think that if they do take a combination of drugs that could induce ss, they could be saved from death by going to an emergency room and all the doctors know to bring out a shot of mirtazapine and the sufferer is saved from death. I base that on that I think a subset of readers could be misled unless you post your citation is because there are readers that could think that your use of (has been used to treat ss) is not having a specification as to {how many} people were treated with Mirtazapine when they had ss and if the citation has that it is unreliable information or not. Readers could think that because you claim that Mirtazapine has been used to treat ss that taking Mirtazapine could not induce serotonin syndrome when it actually can, I can post citations to such for anyone requesting those here.
And your claim that the site drugs.com could be incorrect in their list of adverse consequences of taking combinations of drugs, could lead readers to think IMHO to ignore their research because Mr. Hsiung has not interceded where you make that claim. Your claim of the site could be incorrect has the potential for readers to ignore their research and be killed by taking combinations of drugs that they list could cause ss and you say could be incorrect or erroneous. I think that Mr. Hsiung and any deputy of record has an obligation to intercede in claims like you make here in order that no reader takes your claim as fact and dies from your advise or gets a life-ruining condition or addiction. And if parents that are trying to make a more-informed decision as to drug their child or not in collaboration with a psychiatrist/doctor, I do not want them to be misled to think that taking the combination of drugs that could induce ss as stated in drugs.com could be considered by this site to be incorrect and go ahead and have their child take the combination of drugs that drugs.com says could cause death by serotonin syndrome and their child is killed by the drugs. The claim by Mr. Hsiung is that he does what in his thinking will be good for his community as a whole. But more than that, he says that readers are to try to trust him. That part about trusting him is what IMHO could lead readers to think that your claims here are facts because he has not intervened to say otherwise and he wants readers to try to trust him. Readers could think that Mr. Hsiung and any deputy or record are validating your claims because he has not interceded.
Lou
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poster:Lou Pilder
thread:1077523
URL: http://www.dr-bob.org/babble/20150223/msgs/1077524.html