PsychoTropicalResearch, serotonin and serotonin syndrome research.

Path to the current page: www.psychotropical.com>>question_advice.shtml

• Home

• Serotonin toxicity / Serotonin syndrome
  • Introduction
  • Summary
  • Spectrum Concept
  • Neuroleptic malignant syndrome
  • Moclobemide & (S)SRIs
  • The clinical picture
  • Treatment of ST
  • MOI-OA-ST
  • Mirtazapine
  • Methylene Blue

• Psychopharmacology Update Notes
  • Mirtazapine
  • Why most new antidepressants are ineffective
  • Dual action antidepressant drugs
  • Lamotrigine
  • Diet and Monoamine oxidase inhibitors
  • Monoamine oxidase inhibitors
  • Latest PUN Notes
  • Serotonin Notes

• Drug Interaction (CYP450) Information
  • Introduction
  • Overview
  • Quiz
  • Quiz Answers
  • CYP notes

• Psychopharmacology Questions Answered

• Publications

• Medico-legal opinions

• Patient Information

• Contact me
  • Contact Dr Gillman
  • Request serotonin toxicity document

Questions

Summary

• I will answer questions about particular aspects of psychopharmacology. There is no fee for any of my advice.
• Most advice will be via V0IP: either skype or Macintosh Ichat (see below)
• Before giving advice I require written information. This necessary written information must be provided before I will arrange to discuss the case.
• A brief medical history, an indication of your pre-existing knowledge and experience, relevant to your question (It is a great help to me to understand what sort of knowledge people have of science, biology and medicine).
• An account of present and previous drug treatment, and any good or bad effects it had. Gender, age and weight.
• You must give the proper (chemical) name of the drug (it is always on the packet),not a brand name, and the dose and frequency and the length of time you have been taking it. Remember that the names, and availability, of most drugs vary from country to country.
• Only simple yes or no questions will be answered via email.
• Ask yourself whether you have made a reasonable effort to answer the question yourself using a search engine like Google before calling on my particular expertise.
• Trying to formulate your question clearly and precisely and to be as short and concise as possible with the information you provide.
• Remember, if you can’t be bothered to take care to present the information properly then I probably won’t even attempt to reply or answer it.

I will answer questions concerning the aspects of psychopharmacology in which I have special expertise, for individuals, family members, and doctors and lawyers. It may be possible to utilize 'Psychopharmacology Update Notes' (PUN) to answer your own question, PUN is a non-profit knowledge resource for both doctors and patients. There is no fee or charge for this service. In order to check that the answer to your question is not already covered adequately by my website I would suggest you do a specific search using relevant key words. If you do not already know how to do this go to the advance search feature on Google and specify a search within a single domain i.e. www.psychotropical.com

NB. Appropriate questions are likely to be related to:

• Serotonin toxicity / serotonin syndrome.
• Neuroleptic malignant syndrome.
• Adverse drug actions.
• Drug-drug interactions.
• The effectiveness of drug treatments.
• Possible alternative treatment strategies.
• Treatment with monoamine oxidase inhibitors (MAOIs).

Quality opinion and information in this complex field is difficult to access, and although most countries offer government funded phone lines where people can ask questions about medication these services have their limitations. They are usually done by pharmacists who are relatively less able to advise on clinical relevance of drug-drug interactions, or their special effects in relation to other illnesses etc. or the appropriateness or effectiveness of your treatment, or optimal alternatives. All of these are very important issues that require expert medical experience.

Note that all answers and opinions can only be general and theoretical, because I have not seen or examined the individual who may be the origin of the question. All clinical matters must be the final decision of the responsible treating doctor and patient who agree on the treatment to be taken, having undertaken the usual medical procedures of history taking and physical and laboratory investigation, and agreed on their course of action. I will always provide supplementary information to any appropriately qualified doctor in order to assist the treatment decision.

Please note that prior to giving advice I would like to have some information. It is relevant for inquirees to note that choosing not to provide appropriate biographical information, and a brief medical history, may lessen the specificity, accuracy and safety of the advice that I may give. Your right to privacy means that you are not obliged to give any information, but on the other hand I may decide that without certain information I am not prepared to commit myself to giving information or advice. An indication of your pre-existing knowledge and experience, relevant to your question, will assist me in pitching the answer at an appropriate level. It is a great help to me to understand what sort of knowledge people have of science, biology and medicine.

A guideline medical history questionnaire is available. It can be downloaded as a Word doc if you click here.

Remember that the names, and availability, of most drugs vary from country to country. You must give the proper name of the drug (it is always on the packet), not a brand name, and the dose and frequency and the length of time you have been taking it. A brief account of previous drug treatment, and any good or bad effects it had on you is valuable. Your gender, age and weight are helpful.

It is your responsibility to seek appropriate consultation with a local physician, and I strongly advise that you should reveal the details of any correspondence or advice or information with any other professionals, to the responsible treating physician, unless you decide that is inappropriate for some special reason. It is advisable to reveal to me the true reason for your question in order for me to give adequate information. I do not have a problem with answering questions for patients who are dissatisfied with their current treatment or advice, or who may be engaging in legal proceedings. However, in all of those, and similar situations, I strongly advise that openness and straightforwardness with your responsible treating physicians is likely to be the best approach.

Now that I have retired I do not charge for the advice that I give. Because all of my difficulty with writing and computer work (as a result of my neck problems), I avoid long e-mails wherever possible. This means that most of the advice I give will be via discussions over the internet using V0IP. I am able to do this utilising either skype or the Macintosh program called Ichat. You will need to be able to check equivalent times in different zones so that you ring me at the correct pre-arranged time! You'll find a clock for the Mac here.

I do not make my personal telephone number available under any circumstances. If and when I give advice I give no undertaking of continued availability to provide ongoing or follow-up advice. The reasons is, being retired, I frequently go away for extended periods of time, during which I may not have internet access.

The only circumstances in which there would be a financial cost related to my advice would be when it is necessary to incur expenses by in relation to providing advice.

Remember: I reserve the right to decline to answer any question if the information supplied, or the question asked, appears to me to be inappropriate, for any reason.

All text ©Dr Ken Gillman MRC Psych - PsychoTropical Research®


|Return to the menu at the top of this page|