Sunday, April 28, 2024
Wednesday, April 24, 2024
Is prefering Nikki Haley really equivalent to voting for Donald Trump?
Is prefeeing Nikki Haley really equivalent to voting for Donald Trump?
by Donald H Marks, physician scientist
https://docs.google.com/document/d/1v62Wn5NwEsSx4axk_CnVte-_z8iV0VeIKIKCbokJ-Gc/edit?usp=drivesdk
With Nikki Haley moving up in the polls, many have asked whether there is any difference between Nikki and the Donald. In the past, Nikki has definitely said that there is no difference, no daylight between her opinions and those of the Donald. Yet, there are IMO some major differences between Nikki Haley and TFG in terms of political views and style. Here are some examples:
- Haley has directly criticized Trump for his involvement in the US Capitol riot on January 6, 2021, and said he has no future in the GOP⁶. She also said that Trump's actions since Election Day "will be judged harshly by history" and that he "let us down" as a party and a country⁶.
- Haley has slammed Trump for his recent comments on Hezbollah, a militant group that is designated as a terrorist organization by the US and many other countries⁵. She said that Trump's praise for Hezbollah's leader Hassan Nasrallah was "a betrayal of our ally Israel and a gift to our enemy Iran"⁵. She also said that Trump's remarks showed that he has lost sight of who America's friends and enemies are⁵.
- Haley has a more conventional Republican message than Trump, who has often deviated from the party's orthodoxy on issues such as trade, immigration, foreign policy, and social issues⁴. Haley has emphasized her conservative credentials on fiscal responsibility, national security, pro-life, and pro-Israel stances⁴. She has also tried to appeal to a broader base of voters, including women, minorities, and moderates⁴.
These are just some of the differences between Nikki Haley and Donald Trump, so yes there is a difference and a point to be made when voting for one versus the other.
Source: Conversation with Bing, 11/30/2023
(1) Nikki Haley criticizes Trump and says he has no future in the GOP. https://www.cnn.com/2021/02/12/politics/nikki-haley-donald-trump-gop/index.html.
(2) ‘These are not good or smart people’: Haley slams Trump ... - POLITICO. https://www.politico.com/news/2023/10/28/these-are-not-good-or-smart-people-haley-slams-trump-on-praise-for-u-s-adversaries-00124102.
(3) Opinion | Why Nikki Haley Might Become Donald Trump’s Biggest Rival .... https://www.politico.com/news/magazine/2023/11/02/mag-lowry-nikki-haley-00124866.
(4) Trump slams JPMorgan CEO Jamie Dimon for praising Nikki Haley. https://www.msn.com/en-us/news/politics/trump-slams-jpmorgan-ceo-jamie-dimon-for-praising-nikki-haley/ar-AA1kMY4p.
(5) Donald Trump Melts Down Over Support for Nikki Haley. https://www.msn.com/en-us/news/other/donald-trump-melts-down-over-support-for-nikki-haley/ar-AA1kNwhV.
(6) One Response at Nikki Haley Event That's a Warning Sign for Trump. https://www.msn.com/en-us/news/politics/one-response-at-nikki-haley-event-thats-a-warning-sign-for-trump/ar-AA1kNfWx.
(7) Getty Images. https://www.gettyimages.com/detail/news-photo/nikki-haley-in-conversation-with-all-due-respect-at-92nd-news-photo/1187294330.
Warnings of Suicide and Homicidal thought, anger agitation aggression irritability from prescription Medication, Antidepressants anti-anxiety anti-psychotics ADHA
Warnings of Suicide and Homicidal thought, anger agitation aggression irritability as an adverse effect of prescription Medication such as Antidepressants, Anti-anxiety anti-depressants, ADHD and others
by Donald H. Marks M.D. Ph.D. FACP
New or worsening (psychiatric) symptoms can represent adverse effects of prescribed medications, rather than a progression of the underlying disease state. Patients and their families should be informed and warned, as I have urged (cited ref below).
The treating/prescribing physician of medications that Can cause CNS adverse events should perform an adequate medical and psychiatric history and evaluation to ascertain the risk for using these medications in each patient. Professional help should be sought from psychiatrists with a good knowledge of psychopharmacology and substance-induced mood disorder (SIMD). Consideration should be given to the consequences in each patient of inducing increased anxiety, aggression, agitation, anger, depression, hallucinations, impulsivity, irritability, paranoia, or suicidal or homicidal ideation. IMO all patients who receive psych drugs, and their immediate family and caregivers, must receive specific warning about potential induction of CNS adverse events, including: anxiety, aggression, agitation, anger, depression, hallucinations, impulsivity, irritability, paranoia, suicidal or homicidal ideation. (Marks et al 2008)
Patients receiving these listed medications should be queried at regular intervals for the development of CNS adverse events, and appropriate follow-up should be performed. If a person receiving these medications develops new or heightened homicidal thoughts, it is important for the treating/prescribing physician to determine whether the medication should be discontinued. Patients developing CNS adverse events should be questioned concerning their degree of risk to themselves and others, and they should be requested to notify anyone who may be at risk from their actions. Professional psychiatric input should be considered. All these actions should be documented in the medical records.
References
Marks DH, Breggin PR. Braslow D. Homicidal Ideation Causally Related to Therapeutic Medications https://bit.ly/3x7yjtw Ethical Human Psychology and Psychiatry, Volume 10, Number 3, 2008
Guidelines to prescribing anti-psychotics to patients on methadone
Some Suggested Guidelines to Prescribing Anti-psychotics
to Patients on Methadone
By Donald H. Marks MD PhD
2023
With reference to disruptive patients with underlying psychosis or other mental health disorders in the presence of opioid use disorder, I want to bring up that prescribing and continuing methadone MTD for patients on antipsychotics can present several challenges, separate from psychological and counseling issues. As prescribers of methadone and refillers of antipsychotic medicines, we must consider several of these medical issues. Methadone used for opioid addiction treatment has drug-drug interactions between antipsychotics and methadone which can lead to adverse effects, and altered medication metabolism and effectiveness. Additionally, individuals on methadone may have complex medical and psychiatric histories, which can complicate treatment decisions for all these medicines. Close monitoring and coordination between healthcare providers and prescribing psychiatrists are crucial to ensure patient safety and optimal outcomes.
Taking certain medications with CNS effects during treatment with methadone may increase the risk of serious or life-threatening side effects such as breathing problems, sedation, or coma.
CNS drugs that can interact with MTD include : antipsychotics such as aripiprazole (Abilify), asenapine (Saphris), cariprazine (Vraylar), chlorpromazine, clozapine (Versacloz), fluphenazine, haloperidol (Haldol), iloperidone (Fanapt), loxapine, lurasidone (Latuda), molindone, olanzapine (Zyprexa), paliperidone (Invega), perphenazine, pimavanserin (Nuplazid), quetiapine (Seroquel), risperidone (Risperdal), thioridazine, thiothixene, trifluoperazine, and ziprasidone (Geodon); benzodiazepines such as alprazolam (Xanax), chlordiazepoxide (Librium), clonazepam (Klonopin), clorazepate (Gen-Xene, Tranxene), diazepam (Diastat, Valium), estazolam, flurazepam, lorazepam (Ativan), oxazepam, temazepam (Restoril), and triazolam (Halcion); opiate (narcotic) medications for pain and cough; medications for nausea or mental illness; muscle relaxants; sedatives; sleeping pills; or tranquilizers.
Patients should be monitored carefully, in conjunction / coordination with the prescribers of these CNS meds. Patients should be warned of unusual dizziness, lightheadedness, extreme sleepiness, slowed or difficult breathing, or unresponsiveness. Caregivers or family members should be made aware, with the patient’s permission, of which symptoms may be serious so they can call the doctor or emergency medical care if the patient is unable to seek treatment on their own.
For the safety of patients and staff , we need to keep all these issues in mind. In particular, medical staff are not just the prescriber of medication but also MCAC and SCAC can also be the drug dispensors, so dispensing large quantities of medication can be problematic in terms of drugs interactions, safety, effectiveness, and danger to the patient and the community.
Continued involvement with patients should be part of a multidisciplinary meeting where everyone can have input and appropriate decisions can be made.
References
Marks Donald H. 2023. Cocaine Use in the setting of Methadone treatment for Opioid Use Disorder
https://docs.google.com/document/d/1YE072K39xeCar3ziHhEJLlS9LD1AYHTLmgHa_j82SAI/edit?usp=sharing
Marks DH. Evaluation of Cognitive Impairment. Internet J Health. 8(1), 2008.
Marks DH. Evaluation of Medical Causation, in Drug Injury: Liability, Analysis and Prevention, 3rd and 4th Editions, O’Donnell JT editor. L&J Publications, 2012 and 2016.
Marks DH and Middlekoop T. Accutane: Focus on Psychiatric Toxicity and Suicide, in Drug Injury: Liability, Analysis and Prevention, Second Edition, Chapter 20. O’Donnell JT editor. L&J Publications, 2005.
Wednesday, April 17, 2024
PTSD and anxiety, there's an app to help that. And just maybe help you get off all your toxic meds?
Photo bySimon HurryonUnsplash
Full disclosure, I am a medical doctor, and many of my patients have psych disorders like anxiety depression, PTSD and manic-like illness. While I do occasionally treat psych disorders, I am not a psychiatrist. But many of these patients who need or could benefit from medication and psychotherapy simply can not afford it, or don't have access to care.
Here is the good news and the hope. There are apps specifically designed to help individuals cope with PTSD anxiety and depression symptoms. These apps, and more are coming, can provide tools for managing anxiety, stress, and triggers, as well as offering resources for relaxation, mindfulness, and grounding techniques. Some apps also offer cognitive behavioral therapy exercises, guided meditations, and mood-tracking features to help users better understand and manage their symptoms.
While apps can be a helpful supplement to traditional therapy and medication, it's important to remember that they are not a replacement for professional medical advice. It's always recommended to consult with a healthcare provider before making any changes to your treatment plan, including reducing or stopping medication.
pills in a bottlePhoto byAlexander GreyonUnsplash
Ultimately, whether or not an app can help someone get off medications for PTSD anxiety depression will depend on the individual's unique circumstances and the severity of their symptoms. It's crucial to approach treatment holistically and work closely with healthcare professionals to determine the most effective and safe approach. It's essential to view these apps as tools to complement existing treatment strategies rather than a cure-all solution. Building a comprehensive support system that includes professional guidance, self-care practices, and possibly app-based tools can enhance overall well-being. Each person's journey with PTSD is unique, so it's vital to personalize the treatment approach with a healthcare provider's guidance and supervision.
smartphone appsPhoto byNathan DumlaoonUnsplash
In navigating the possibility of reducing medication use, it's crucial to prioritize safety and well-being. Collaboration with healthcare professionals can help individuals make informed decisions about their treatment plan, considering factors like symptom management, potential risks, and overall progress. Finding the right balance between medication, therapy, self-care practices, and technological tools can empower individuals in their healing process and promote advocate for improved healthcare access.