On 04-06-94 14:32, Thomas E. Simkins (CCB wrote to ALL about "Re: should i
stop taking":

TE-- Melissa:  I'm not an M.D. but I've been on Prozac for 2 years naow.  
TE--first started

TE--first started, it kicked in in about 2 weeks although I've heard that

TE--weeks is more usual.  From my experience, I'd say that if Prozac was

TE--going to do anything, it would give you some indication by now.

<discussion of learning how Prozac works from Kramer's book deleted>

Yes you're right, you're not an M.D., and your answer is inaccurate and
potentially misleading. Decisions about starting and stopping and
changing dosages of psychiatric medications are delicate matters and alot
of factors have to be weighed, and IMHO you are irresponsible to answer
this question.

Is anyone else bothered by what this newsgroup has become, as exemplified
by this post? I thought it was for pharmacological discussions of relevance
to pharmacists and physicians, or is that just my wish? As a physician, I'm
getting quite impatient with all the queries for advice from people who
should be discussing their medication with their prescribing doctors, and
all the replies from people who are not knowledgable or responsible enough
to be posting.

Oh! for a moderator...

_______________________________________________________

              82 Perry, Brookline MA 02146-6907 USA
              or: Dept. of Psychiatry, UMass Med Ctr, Worcester MA 01605 USA
---
 * WaveRdr 1.10 # 212 * The truth doesn't hurt unless it ought to.

Elliot's point is quite valid - many of the questions posted here should
be discussed with the individual's physician or pharmacist.  Regretably,
the system for distribution of information is so flawed that sci.med.pharmacy
may become a source of information for many people who are required to get
most of their {*filter*} from mail order pharmacies, and the rest of their Rxs
filled at high volume pharmacy operations where the pharmacist simply has
no time to talk (even presuming a willingness to deal with a patient instead
of a pill counter).  Physicians have become similarly isolated, as people
are forced to use emergency rooms as primary care practitioners.
        In Pharmacy, we are familiar with the presctription labeled "take
as directed".  When the patient asks us for instructions on how to take the
medication, we refer them back to their MD.  The patient responds "I can't
ask HIM, he's very busy!"  This is a pattern even in private practice.
        And, as for sci.med.pharmacy, it is a place where people can post
questions, and occasionally get an answer.  The group lacks a core of
dedicated professionals who will each offer 1 hour per week researching
accurate answers, so that there is a risk.
        Where is Steve Dyer now that we really need him?
        But, to conclude my original premise - patient's should ask
their MDs.  The fact that questions are still posted here, and answered
imperfectly, seems to indicate that we (MD, RPh together) have failed to
fulfill our professional responsibilities, at least on a nation wide scale.
That's the price of economy.

This IS a unmoderated Usenet group, which means you get what you pay for
... not what you wish it were.  Life is tough ;^>!  Personally i've always
assumed that ANYTHING you read on the net has to be accepted with caution,
and have tried to make that clear in my posts as well. It does worry me
that someone might unwisely use anecdotal information from s.m.p. to alter
their medical regimen without consultation. However, there are reasons i
feel this type of group can provide a very useful forum as is, for reasons
i'll try to explain here.

 I heartily agree with you that people should always ask their MD and/or
pharmacist about medications etc., if for no other reason than liability
issues.  However, as another response to your post indicates, the system
doesnt work very well in many, perhaps most, peoples' experiences.  On the
patient's side, too many people dont think or are too timid (?) to ask
their MDs basic questions about prescriptions etc; this is ridiculous,
since they ARE paying for the service and such information is a basic
component. Caveat emptor, at the very least.... Worse yet, many people
simply stop taking any {*filter*} with side effects they dont like, without
talking to the MD and finding alternative approaches (smaller dose,
different drug, whatever).  This may be dumb but surveys show this happens
far too often. Sad, because any decent MD would rather have a well-informed
 (and informative) patient than an ignorant (or dead) one.  Right?

On the MD side, however, far too many prescriptions are handed out with at
best a cursory attempt to ensure that patients will use them correctly and
do not have potential conflicts.  I'm not making this up, i am speaking
from experience -- i am rarely asked what other medications i'm taking when
given a prescription, and often have to (gently) force the MD to look the
damn thing up in the PDR to ensure that there arent counterindications or
conflicts i should be aware of.  It's reasonable to avoid telling people
about minor potential side effects, since humans have notoriously vivid
imaginations, but it is negligent, e.g., to give known migraine-producing
{*filter*} to a migraine sufferer.  In this regard (preventing drug conflicts
and getting side-effect information) I've found pharmacists to be
invaluable, and yet many people don't even realize that you CAN ask
pharmacists such questions.

Another problem is that the doctor's experience with prescribing a given
drug may not cover all possibilities. Many {*filter*} arent tested on all
segments of the population (women, for example), so the PDR statistics may
not reflect the full range of human reactions to a specific drug.
Furthermore, there may not be a concensus among MDs about the best regimen
for each drug, since they each get a limited amount of feedback from their
own patients.  Of course, this is no excuse for a patient to mess around
randomly with his/her medications, without talking to the MD. But it does
help to hear other peoples' experiences with the same medication, if you
are having problems or disturbing effects and need some basis for
discussion with the doctor.  Even if the doc disapproves of a particular
approach, a patient can learn alot by asking for the reasons!  I can give
several examples where recounting personal experiences with a certain drug
has helped a friend find a way to tolerate a previously intolerable
medication, or to switch to something preferable --- with the approval of
their MD, of course.  

As a scientist i find it natural to ask questions and use discussion and
prior knowledge to assess the pros and cons of my MDs' suggestions.  I am
not merely a passive receptacle for medical care, but prefer to be as
active a participant as possible (given that I dont have an MD's broad
medical knowledge and experience, but i do know more about how I feel).
Those patients who arent used to this mode of thinking, however, usually
take whatever the MD says as inarguable truth, and have no idea what
information they may be missing or even what questions should be asked.  As
an MD, how do you deal with these 2 types of patients? Do you get offended
by the inquisitive ones? If so, do you see why groups like s.m.p. are the
way they are?

--
Judy Karpen                        "I'm a scientist...I dont think, I
observe! "

                                                 Moon Men" )

Is there any great mystery why professionals won't answer in this forum.
It's a guarentee that the individual is incompetant. There's no way that  
you can possibly answer patient specific questions here appropriately.

Despite warnings of the problems with  answering drug information
questions here. Stege Dyer dedicated himself to force this newsgreoup
into a discussion
group on {*filter*}, with the admonishment that anyone who took his advice
and got hurt was a fool.  Who got what they deserved by listening to him,
and by getting advice on this newsgroup.

He appears to
be a dilletant who has no professional background. Often answers
inappropriately to questions. Provides answers which smack of being
cut out of computer databases (occasionally with rewording), but never
with any clinical accumen which is absolutely necessary to answer any
drug information question appropriately. He has frequently provided answers
which could harm the patient, and has posted in response when individuals
specifically asked for a health professional to answer.

Although Mr. Dyer superficially appears quite knowledgable. Steve Dyer is
basically a
danger and is the last person who we need to answer questions.

So do something about it. But not by answering DI questions in a forum
where you're guarenteed to give inappropriate information, and thus
likely to harm patients.

Ron Kavanagh, BS Pharm. Pharm.D, Fellow of the American Foundation for
Pharmaceutical Education, Ph.D. Candidate in Pharmacokinetics,
Pharmacodynamics and Drug Metabolism

Department of Pharmaceutics
School of Pharmacy
University of Washington

   >>        Where is Steve Dyer now that we really need him?

Mostly busy with personal matters right now which are taking up
a lot of the free time I'd otherwise be spending here.  But since
your question elicited a personal attack...

   >Despite warnings of the problems with  answering drug information
   >questions here. Stege Dyer dedicated himself to force this newsgreoup
   >into a discussion group on {*filter*}, with the admonishment that anyone who
   >took his advice and got hurt was a fool.  Who got what they deserved by
   >listening to him, and by getting advice on this newsgroup.

Amazing.  Let me provide a bit of context for people who might be
unfamiliar with Kavanaugh's unseemly attempt to{*filter*} his still-
unhealed wounds in public.  When non-professionals first started
posting questions about {*filter*} here in sci.med.pharmacy, he came down on
them hard.  I made the point that if people have questions about {*filter*}
(and they will--it's unavoidable in a public unmoderated newsgroup with
a name like this), if the question isn't of a clinical nature, and
there are many questions of this kind, someone knowledgable might as
well answer them.  In fact, it might even be that the "professionals"
reading such comments would learn something too.  (It would be a
mistake to think that an article posted in response to a request in a
USENET newsgroup is solely directed at the person asking the
question.)  He didn't like that, it stuck in his craw, and you see the
fruits of his displeasure in this feeble attempt to smear me once
again.

In fact, Kavanaugh has posted little to sci.med.pharmacy other
than his original objection and the contretemps following it
when the topic somehow turns to me.  He'd rather stay quiet when
he has an opportunity to share his knowledge, but will speak up
in an instant when he has an opportunity to spew bile.  This behavior
leaves me thoroughly unimpressed.

   >He appears to be a dilletant who has no professional background.

I enjoy the subject of pharmacology--it's my passion.  I'd probably
have gone into the field if I didn't make too much money working
with computers.  I've never misrepresented myself in this regard
(in fact, I usually post as much every few months.)  In any case,
this is hardly relevant; what matters is content, and I am
completely unapologetic for what I've written on the topics
of {*filter*} and pharmacology.  Kavanaugh would appear to think
otherwise, but as you see, there's no content in his objections,
just undifferentiated emotion.

   >Often answers inappropriately to questions.

Oh, really?  Perhaps you could provide examples here.  You don't have any.

   >Provides answers which smack of being
   >cut out of computer databases (occasionally with rewording), but never
   >with any clinical accumen which is absolutely necessary to answer any
   >drug information question appropriately.

I never provide answers out of computer databases.  I write from
what I know, and I never write about topics I'm not familiar with.

   >He has frequently provided answers which could harm the patient,

Hmmm, I've never seen any objections from you, and I've only
received favorable comments from qualified people who have enough
self-esteem to respect knowledge when they recognize it.

   >and has posted in response when individuals
   >specifically asked for a health professional to answer.

Someone's got to give them reliable information.  It's not
forthcoming otherwise.

   >Although Mr. Dyer superficially appears quite knowledgable. Steve Dyer is
   >basically a danger and is the last person who we need to answer questions.

I'll let my behavior here and in sci.med stand on its own merits.

   >So do something about it. But not by answering DI questions in a forum
   >where you're guarenteed to give inappropriate information, and thus
   >likely to harm patients.

This is the crux of the argument, and one where I completely disagree
with Kavanaugh.  I think it's perfectly possible to answer questions
abotu {*filter*} when the topic does not concern itself with clinical
matters.  That's not enough for him however.  Everyone has to agree
with him or suffer his wrath.  If he had something worthwhile to
contribute to the newsgroup alongside this, it might even be excusable.

   >Ron Kavanagh, BS Pharm. Pharm.D, Fellow of the American Foundation for
   >Pharmaceutical Education, Ph.D. Candidate in Pharmacokinetics,
   >Pharmacodynamics and Drug Metabolism
   >
   >Department of Pharmaceutics
   >School of Pharmacy
   >University of Washington

Have you ever noticed that people in the fields which get the least
respect are the ones who are so credentials conscious?  I'm loathe
to point that out, but with a .sig like this one, I can't resist--
it verges on self-parody.

--
Steve Dyer

It's well and good to make claims which can't be verified. My original
post was directed to health professionals about the dangers of answering
questions in this forum. As I recall you immediately took it a different
way and began a series of personal attacks on me to which I never
responded in kind.

I agree that it's unavoidable in this forum.

But you do answer clinical questions, and even provide recomendations.
Are you changing what you say again?

  In fact, it might even be that the
"professionals"

No, I think that professionals can learn a lot from questions or
discussions from patients. However what you don't seem to realize who
these other readers are likely to be.
There are a lot of individuals without any medical background who may
take something and apply it to themselves when that would not be in their
best interest.

Actually, I've posted quite a bit on pharmacy education (which was on one
the designated purposes of this newsgroup), as well as a number of
threads on pharmacokinetics and on pharmacy practice.  

However as I recall, in spite of the fact that pharmacy education was one
of the original purposes of this newsgroup in the call for votes (While
drug information is not and diganosing etc. which is specifically
prohibited in sci.med.etc.) . I seem
to recall you wanting to prohibit all discussions of pharmacy education
by pharmacy students.

somehow turns to me.

I only did so in this case because of the 'testimonal' to you and because
most nonprofessionals would be unable to tell how truely little you know
and understand.

You've tried this ploy, how many, a hundred, two hundred times? Asking me
and other pharmaicsts to show how much we  know by acting in a totally
irresponsible manner by providing inappropriate answers when we don't
have sufficient information about the patient's medical background.

 but will speak up

This is a forum to share opinions. It's my opinion that you think you
know more than you really do about {*filter*} and drug use.

In other words you agree that you're a dilletant.

I disagree. There have been instances where individuals have asked
specifically for pharmacists and you were the first to reply. Also don't
forget the threads on what is your background. Is he a PhD, an MD, a RPh
and MD.

 >this is hardly relevant; what matters is content,

I agree that content is the crux of the issue. And your posts
frequently have inappropriate content. I'm not saying that your posts are
or are not factually correct or incorrect, I can't keep up with current
literature on all areas of drug use, as you seem to think that you can, only
that you confuse facts with appropriateness.

That's obvious. You were quite frank in stating that you didn't care if
anyone got hurt as a result of your postings. And if they did then it was
there fault for trusting any information provided by you on the net,
since net info way notoriously faulty. Yet you keep going ahead providing
faulty information and recommendations.

  Kavanaugh would appear to
think >otherwise, but as you see, there's no content in his objections,

How about the person who simply asked for a list of side effects of
trazodone (an antidepressant).

 You had no idea if this was a from a person who had been
taking it for a while and was experiencing something which was a new
complaint. Or if the person hadn't begun to take it yet and was just
curious about what to expect. Or if the individual had simply read
something about trazodone somewhere and was simply curious. Or if the person
was taking trazodone, if they were also taking any other
medications which could have similar side effects or could alter the
degree or severity of trazodone side effects. Or what the patient's age
and other medical conditions were, Or if the poster was asking for
herself or was simply curious beause a close friend was taking the drug. Or
even if the patient was a man or a woman.

In other words you had absolutely no information about the patient
whatsoever and why they were asking the question.

Then you wnet into a tirade about how trazodone causes priaprism (painful
{*filter*}s) and that any MD who prescribed it was negligent, when you
don't even know what the situation was or if the patient involved was a man
or a woman. This  is hardly what I would call a competant answer.

In fact any health professional who answered this superficially obivious
and simple question by just providing a list of side effects, or in the
way you did, I would call incompetant.

Oh, and lets not forget all those other readers, remember those other
people who you like to point out might also learn something. How about
all those patients  who may have been on
trazodone for a while, (probally saw the topic header and since they were
on trazodone were curious about what was being said and read what you had to
say.

What about people who have been on trazodone for a while with no problem
but where then scared to take it anymore. Even though the possiblity of
this side effect occuring was not relevant to them because they had been
on the medication too long.

What happens if not only frightening someone, they stop taking their
medication.

 (this kind of thing happens constantly, one of the most difficult things
 with drug therapy is compliance)

 You do recall that hospitalization and even suicide are
possible consequences of untreated depression. And before you begin about
how unlikely this is, please recall the number of people on the net
who might read it, and that 15% of the population suffers from
depression. So even a small percentage of suicides or even
recurrence of depressive illness, which could effect their ability to
keep their job and livlihood) is a huge number of people.

Even if this only happens to one individual, is this acceptable to you

Oh, I forgot. Your attitude is it's tough luck if anybody gets hurt based
upon what you say. They should know better than to go by what someone has
to say on the net.

So you claim, however it's difficult to prove this. And besides even if
it's just paraphrasing a hard copy text, what's the effective difference.

  I
write
from >what I know, and I never write about topics I'm not familiar with.

I would disagree  with this. How about our diagreement on legal
liablility for health professionals who provide information in this
forum. You claimed that by answering a patient's question that a
professional wasn't entering into a professional relationship with all
the associated responsibilities. As I recall you shut up pretty fast when
I pointed out a current articles, even though the issue is hardly new.

Or what about pharmacy history, or how retail pharmacies operate, or the
level of training of pharmacists.

I try not to  waste my time policing you.  Also this is an obvious ploy
to try to get me into a situation where I'm  legally liability in a forum
where a professional is guarenteed to be
negligent because it's impossible to get all the pertinent medical
information in this forum. Where on the other hand you as a
nonprofessional could argue that you're not liable being a
non-professional. However I wonder about that since you have on occasion
passed yourself off as a professional by not contradicting others who
claimed that you were, and acting in a manner which seem to indicate a
professional giving his expert opinion. Last I checked this could be
construed as practicing a profession without a license. And no you don't
need to be financially compensented. But then I'm not a lawyer, but only
a lay person in the law who is speculating.

Claim which can't be verified.

As far as self-esteem. You seem to have some ...

read more »

   >>if the question isn't of a  clinical nature, and
   >>there are many questions of this kind, someone knowledgable might as
   >>well answer them.
   >
   >But you do answer clinical questions, and even provide recomendations.
   >Are you changing what you say again?

No, I'm correcting you.  I don't provide medical advice; I don't
recommend anything.

   >No, I think that professionals can learn a lot from questions or
   >discussions from patients. However what you don't seem to realize who
   >these other readers are likely to be.
   >There are a lot of individuals without any medical background who may
   >take something and apply it to themselves when that would not be in their
   >best interest.

I feel like I'm discussing contraception with the Pope here.
Believe it or not, people aren't as dumb as you prefer to assume.
There are as many mistakes made out of ignorance than from knowing
"too much".  You'd prefer to say nothing, lest what you say might
be misinterpreted or misused.  I think this is an extremely conservative
position.  I don't think it's good or bad, but I don't think it's
the only position possible, even for a pharmacist.

   >Actually, I've posted quite a bit on pharmacy education (which was on one
   >the designated purposes of this newsgroup), as well as a number of
   >threads on pharmacokinetics and on pharmacy practice.  

"Quite a bit" would be stretching the term.

   >However as I recall, in spite of the fact that pharmacy education was one
   >of the original purposes of this newsgroup in the call for votes (While
   >drug information is not and diganosing etc. which is specifically
   >prohibited in sci.med.etc.) .

Who's "diganosing" anything?

   >I seem
   >to recall you wanting to prohibit all discussions of pharmacy education
   >by pharmacy students.

Huh?  Don't be ridiculous.

   >I only did so in this case because of the 'testimonal' to you and because
   >most nonprofessionals would be unable to tell how truely little you know
   >and understand.

Well, the "testimonial" came from a PharmD.  Surely, that counts
for something in your eyes. :-)

   >You've tried this ploy, how many, a hundred, two hundred times? Asking me
   >and other pharmaicsts to show how much we  know by acting in a totally
   >irresponsible manner by providing inappropriate answers when we don't
   >have sufficient information about the patient's medical background.

It's not a ploy, it's an observation.  You seem to think that replying
to a question here is part of your professional practice; part of the
compact, if you will, between yourself and a patient.  I would absolutely
agree that a pharmacist discussing a question one-on-one with a customer
has a set of responsibilities to observe, and should exercise prudence
in listening and in choosing what to say.  I don't happen to think this
extends to answering generic questions about {*filter*} in a forum like USENET.
The nature of the interaction is different, the expectations are different,
replies are one-to-many, and there is no professional relationship between
individuals here.  Like I've said before, this has worked out pretty well
in sci.med, where you see a good number of doctors actually discussing (gasp)
medical issues and replying (gasp, gasp) to questions.  You seem to think
otherwise, which is your perogative, but that's just one opinion.

   >This is a forum to share opinions. It's my opinion that you think you
   >know more than you really do about {*filter*} and drug use.

Well, I always consider the source before taking an objection seriously.

   > In other words, you're a dillettant

No, I'm a dilettante.  Admittedly, a dilettante with a number of
pharmacology courses under his belt which I've taken at Harvard.
Not that that counts for much, actually (seriously, it doesn't,
nor are these responsible for what little I do know and understand,
but perhaps Ronald will be impressed).

   >I disagree. There have been instances where individuals have asked
   >specifically for pharmacists and you were the first to reply.

You mean the _only_ to reply. :-)

   >Also don't
   >forget the threads on what is your background. Is he a PhD, an MD, a RPh
   >and MD.

I'm sure people are curious; that's why it comes up.  Ronald Kavanaugh PharmD
is going to get fewer questions along this line.

   >I agree that content is the crux of the issue. And your posts
   >frequently have inappropriate content. I'm not saying that your posts are
   >or are not factually correct or incorrect, I can't keep up with current
   >literature on all areas of drug use, as you seem to think that you can,
   >only that you confuse facts with appropriateness.

This comes back to an understanding of what the interaction is between
individuals here.

   >anyone got hurt as a result of your postings. And if they did then it was
   >there fault for trusting any information provided by you on the net,
   >since net info way notoriously faulty. Yet you keep going ahead providing
   >faulty information and recommendations.

Calling my information faulty doesn't make it so.  Claiming that I
make recommendations doesn't mean that I do so.  A reply here is
not a professional communication between a professional and his/her
patient.

   >How about the person who simply asked for a list of side effects of
   >trazodone (an antidepressant).
   >[long list of horror stories omitted]
   >Then you wnet into a tirade about how trazodone causes priaprism (painful
   >{*filter*}s) and that any MD who prescribed it was negligent, when you
   >don't even know what the situation was or if the patient involved was a man
   >or a woman. This  is hardly what I would call a competant answer.

I don't recall going on any tirade; I merely mentioned that one rare
side effect of trazodone in men is priapism.  This is an interesting
observation, because it's so peculiar--few other {*filter*} cause this.
I think it's possible to answer a question like this without assuming
that someone is going to misinterpret what is said and stop their
medication inappropriately.

   >In fact any health professional who answered this superficially obivious
   >and simple question by just providing a list of side effects, or in the
   >way you did, I would call incompetant.

I think that providing a list of side effects by itself isn't very interesting,
nor does it deliver much information to the person asking the question
or to others reading the reply.

   >[long list of horror stories ommited]
   >Even if this only happens to one individual, is this acceptable to you

No more acceptible than what happens when someone asks a question
about a drug they're taking, hears nothing in response, and
makes inappropriate decisions based on their fears and misapprehensions
because they didn't get information which might have helped them.
This cuts both ways.

   >Oh, I forgot. Your attitude is it's tough luck if anybody gets hurt based
   >upon what you say. They should know better than to go by what someone has
   >to say on the net.

Like I said, it cuts both ways.  No one should use the net as their
sole source of information, but that doesn't mean that it can't or
shouldn't be a resource.

   >>I never provide answers out of computer databases.
   >
   >So you claim, however it's difficult to prove this. And besides even if
   >it's just paraphrasing a hard copy text, what's the effective difference.

I have 20 years of experience reading the pharmacological literature.
I have a large library of textboooks and reprints, but I rarely consult them
when I answer a question, unless there's a fine point I want to make sure
I'm not misrepresenting.  When I write something, I'm writing from memory.
I don't claim that my own experience is equivalent to someone with
clinical experience, but that doesn't mean that I can't make a contribution,
either.

   >I would disagree  with this. How about our diagreement on legal
   >liablility for health professionals who provide information in this
   >forum. You claimed that by answering a patient's question that a
   >professional wasn't entering into a professional relationship with all
   >the associated responsibilities. As I recall you shut up pretty fast when
   >I pointed out a current articles, even though the issue is hardly new.

In fact, we're covering this disagreement again here.  I think by keeping
quiet, you're certainly covering your butt, but you're eliminating
out-of-hand any potential contributions you might otherwise make.
There's (non-legal) precedent for a way for health professionals
can interact with laypeople effectively, and that's in sci.med.

   >Or what about pharmacy history, or how retail pharmacies operate, or the
   >level of training of pharmacists.

What about it?  All good stuff to discuss.

   >I try not to  waste my time policing you.  Also this is an obvious ploy
   >to try to get me into a situation where I'm  legally liability in a forum
   >where a professional is guarenteed to be
   >negligent because it's impossible to get all the pertinent medical
   >information in this forum. Where on the other hand you as a
   >nonprofessional could argue that you're not liable being a
   >non-professional. However I wonder about that since you have on occasion
   >passed yourself off as a professional by not contradicting others who
   >claimed that you were, and acting in a manner which seem to indicate a
   >professional giving his expert opinion. Last I checked this could be
   >construed as practicing a profession without a license. And no you don't
   >need to be financially compensented. But then I'm not a lawyer, but only
   >a lay person in the law who is speculating.

Yammer, yammer.

   >>and I've only
   >>received favorable comments from qualified people who have enough
   >>self-esteem to respect
...

read more »

: >Elliot's point is quite valid - many of the questions posted here should
: >be discussed with the individual's physician or pharmacist.

: Is there any great mystery why professionals won't answer in this forum.
: It's a guarentee that the individual is incompetant. There's no way that  
: you can possibly answer patient specific questions here appropriately.

I agree with the above. I am a pharmacist and although I know the answers to
some of the questions, I refrain from posting because there is always the
danger that I do not have the complete picture; my advice could do more harm
than good however informed. Even a simple query about the use of a drug begs
the question - why is the person asking? How is he/she going to use the
info?

So to those who will persist in asking questions about personal drug use,
beware of the replies. To those who persist in replying to these questions,
you could be doing harm.

Andrew

Here here!  I've been reading this newsgroup for about 6 months hoping that
it would be of some use in my teaching or research.  It rarely is.  For
anything of value the discussions out of deMontfort University are
infinitely better.

This newsgroup should be re-titled alt. prozac.  Personally, I am
utterly bored by the endless re-hash on prozac, ritalin etc etc.

I had thought psychiatry was increasingly headed towards biological
directions.  Based on most of the stuff in this newsgroup, the
talking cure seems to have lost absolutely none of its former
glory!

I will continue to skim this group.  Every now and again something of
interest pops up but it is truly a low-yield activity.  in the mean time
just talk amongst yourselves.

John Rovers, PharmD
Drake University
College of Pharmacy

Hi, I'm quite new to this newsgroup, and a Brit as well so theres two
good reasons for ignoring what I'm saying. However I'm posting this from
Miami where I'm at the American College of Physicians meeting, so I must
have something in my favour.

I believe that peer comment on drug therapy can be very useful. Several
people during the Prozac debate have emphasised the length of time it can
take to work, and have given positive encourgement, even though this must
be weighed against the odd piece of negative advice.

There are many questions on pharmacology, frequently encountered side
effects and individual fears which can be very helpfully answered by
willing professionals and sometimes lay people.

And if the question is should I change the {*filter*} I'm getting this provides
a forum for support so the patient can have a more informed discussion
with the physician. However it is no surprise that some physicians and
pharmacists alike hope to maintain the magic and mystique of their profession
and oppose all attempts to increase patient access to information.

Kevin.

: >   >>        Where is Steve Dyer now that we really need him?
: >
: >Amazing.  Let me provide a bit of context for people who might be

: >          A whole chunk deleted ...

I do not know about you but I find the dialogue between Ronald Kavanagh and
Steve Dyer to be very enlightening, especially Steve Dyer's "read at your
own risk" attitude. This callous approach immediately tells you that he does
not appreciate the nature of the information he imparts. If you have been at
the receiving end of Mr Dyer's "facts", read those "facts" again in the
light of the attitude in which they were given ... risky, eh?

Andrew

Kavanagh game, set, match. 'nuff said.
--
John T. Robicheau
University of Pittsburgh

%%%%%%%

I feel that these are two very paternalistic views.

Steve Dyer has been a wealth of information for many years on sci.med, and I,
for one, appreciate it.

People ask questions, gentlemen, because they do not understand, or are
seeking information in order to make a decision. My Internist, pharmacist
and I are partners in MY health care, and I make the final decision after
listening to all the input.

A few weeks back, I posted a question asking for opinions on which OTC
medications people who hang out here felt were best for treating {*filter*}age
acne. _Nobody_ replied. I posed the question because my son is 15 yrs old
and has the usual minor acne problems associated with this age group. It is
not severe enough to need evaluation by a physician....and I posted what I
just said in my original request for info!

I am seeking input for my son. Do you remember what it was like being 15 yrs
old? As his Dad, I love him and want to help, but don't want to be throwing
money away on OTC products which are snake oil.

But nobody answers because: 1) You want to know why I ask the question and
2) What am I going to do with the information received?

Use your brain and be considerate, like Steve, Doug Anderson and others
have for years. Many/most questions asked here can be answered easily. If
the question should not be answered, then say why!

Is it any wonder this newsgroup is as dead as it is? Seems like those with
the answers are read-only. If you disagree, then answer _my_ question :->

I cannot see that a "read at your own risk" attitude is callous.  I thought
that a general principle in the sci.med.* newsgroups is that one should regard
them as discussion only, and should not act [therapeutically] on such
information unless it is to *personally* consult an expert.  Any data gleaned
from sci.med.* can then be debated in the context of a full medical history and
the legal protection of the doctor/patient relationship.  Further, the average
GP may not have the knowledge or the time to discuss, for example, the
mechanism of action of a particular drug; I believe that many thinking people
value such information.  Incidentally, it is a very good thing that some of the
advice in sci.med.* groups is not heeded!  I stress that the last comment does
not refer to any of the participants in this current row.

I am not a professional pharmacologist, but I have the normal medical training
in the subject and I try to keep up to date.  From what I have seen of Steve
Dyer's postings they are accurate and concise and seem to me to show a good
understanding of a tricky subject.  Even excepting my own lack of expertise, on
occassions when a thread has interested me and I have researched it further I
have noticed no faults in his exegeses (not that I was especially looking for
them!)  There are not that many knowledgeable regular contributors to sci.etc.
May I state that I have never met (nor corresponded with) Steve Dyer and have
no axe to grind on his behalf.  I can only judge as I find in the newsgroups.

--
___________________________________________________________________________
Michael Diffin