![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 47. This is the beginning of the thread.
Posted by 4WD on September 4, 2004, at 15:58:30
First, "brief" hx.
Was on Effexor 37.5mg/day. I wanted to switch because while Effexor keeps me out of the black pit, I am still lethargic and anhedonic. Also, I have (relatively) mild side effects from Effexor that I'd rather do without (anorgasmia, tinnitus, dry mouth, inability to cry, general lack of emotion). In the past I've been on imipramine, Prozac, Celexa, Zoloft, Paxil and Wellbutrin. These all worked for depression but caused bad side effects even at half dosages, notably insomnia, severe muscle tension in my neck and shoulders, anxiety and anorgasmia. Not all side effects with each drug, but some combination.
10 weeks ago, I went off Effexor and on St. Johns' wort. Still felt very tired and apathetic but not severely depressed. On July 1, my father died and there was a lot of ugly family stuff to deal with (my mom has Alzheimer's and I am responsible for her as well as for my dad - both in assisted living and my sister stole half their money and is mad at me for trying legally to get it back for them). Managed the death stuff okay and three weeks later finally quit the SJW since it didn't seem to be helping. A week later, I lapsed into severe depression and crippling anxiety. (The anxiety was exacerbated by the progesterone in my new HRT, I think, but can't yet prove. I'm off HRT now but when stabilized will give it another try to see for sure.)
Resumed EFfexor XR and within a week I was no longer severely depressed but still having horrible anxiety. On Klonopin for a while while waiting for anxiety to subside. Then off Klonopin but having some rebound insomnia. (Insomnia has been a lifelong problem for me.)
Had an appointment with new pdoc on Thursday, Sept 2. He prescribed Cymbalta 30mg/day. Instructions were to continue Effexor, start Cymbalta for 3-4 days then taper Effexor. I went ahead and quit the Effexor, though, and started the Cymbalta on Friday yesterday. No withdrawal effects from the Effexor at all.
Friday 9-3-04 Day 1:
Took first Cymbalta at 2:30 pm (I didn't get out of bed til then - insomnia kept me awake til 4 the night before). After about three hours, I started to feel tired. Not sleepy, just tired, unmotivated. (However, I have been unmotivated for years so I can't blame that on the Cym.) Also, no anxiety. I noticed some increase in dry mouth but no other side effects. Went to bed at 1pm (my usual time) and immediately fell asleep. No insomnia!
No improvement in depression, motivation, energy or anhedonia.
Day 2 - Saturday 9-4-04Woke up to alarm at 11a.m. and was able to wake up without turning alarm off and going back to sleep. Didn't feel groggy or medicated. Took Cymbalta at 11. By about 2pm I started to feel tired again, yawning. (This from someone who does *not* get sleepy, ever.) Two cups of green tea later, I can't tell I've taken anything. No side effects other than mild dry mouth and a bit of irritability. Still no Effexor withdrawal effects.
I feel depression-wise exactly like I felt while taking 37.5mg/day Effexor.
No improvement in depression, motivation, energy, anhedonia. No decline, either, though.
Re sexual side effects: Normally after being completely off Effexor for three days, I would be experiencing a rebound effect of much quicker, easier orgasm. That isn't happening but neither is there anything more than a very mild delay so far.
One positive side effect: I can go longer without having to pee. I drink a lot of liquids and I'm normally in the bathroom every hour or so. That has decreased. And - I didn't have to get up during the night last night at all.
Next post won't be so long. Sorry about all the hx but I figured some of it was relevant.
Marsha
P.S. Does anyone know why the 30mg Cymbalta is in capsules and the 60mg is apparently in enteric coated tablets? My doc tried to give me samples of Cymbalta but only had the 60 mg. I had to tell him they couldn't be broken in half. My cynical surmise is that Lilly doesn't *want* people breaking the 60's in half in order to save on costs (if they're taking 30mg per day).
Posted by 4WD on September 4, 2004, at 21:16:18
In reply to Cymbalta Journal, posted by 4WD on September 4, 2004, at 15:58:30
I forgot to say, I also am bulimic, (30 years duration) in remission now for about 6 weeks (I think the increased anxiety kept me from wanting to eat.) The Effexor helped somewhat with the bulimia but not a lot, so it will be interesting to see what the Cymbalta does there.
Also, I am still experiencing the high-pitched whining sound inside my head that was a side effect of Effexor.
Posted by iris2 on September 5, 2004, at 15:33:30
In reply to Cymbalta Journal, posted by 4WD on September 4, 2004, at 15:58:30
> I went ahead and quit the Effexor, >
>
> One positive side effect: I can go longer without having to pee. I drink a lot of liquids and I'm normally in the bathroom every hour or so. That has decreased. And - I didn't have to get up during the night last night at all.Marsha,
I have interstitial cystitis. Even before I had it diagnosed I took Effexor and had a lot of problems with frequency and urgency peeing with effexor. I think this is getting better because you are not taking the effexor anymore. It is one of the reasons I want to take duloxetine.
irene
Posted by 4WD on September 5, 2004, at 15:52:18
In reply to Re: Cymbalta Journal, posted by 4WD on September 4, 2004, at 21:16:18
Day 3, Sunday, 9-5-04
30mg
Didn't sleep as well last night even though I took .5mg Klonopin.
This morning woke up without much trouble.
There is a still a high pitched hum in my head, kind of like having the printer running in the background, not noticing it until you turn it off and then realize how annoying it was. It's a higher frequency sound, though. Had this with Effexor as well.
I notice today I have about 50 percent more physical energy than usual. I have only about five percent more motivation to do something constructive with the energy, though. I have a little anxiety, maybe a result of having the energy but not feeling like doing anything with it. It's a slightly wired kind of energy, not motivated from inside. It makes me want to smoke too much.
I have had some twinges today of what I can only call angst. Just out of nowhere a feeling of deep anguish swells up inside me, lasts a few seconds and then leaves. I kind of think it might be the ability to feel returning (had almost no emotion while on Effexor). At least I hope that's all it is. Could also be from the Klonopin last night.
No improvement in anhedonia.
Physical side effects (except for hum in head) are not very noticeable. No somnolence except for a couple of yawns during church. No effect on appetite one way or the other. A little bit of heartburn (which is very unusual for me). No increased pain in my neck and shoulders (this happened within the first week of tx with several SSRIs). DRy mouth is slightly less today than yesterday.
One positive side effect: I think my nose is less stopped up than it was. I usually have some degree of congestion and it seems to be less for the last day or so.
I have no more Klonopin except for an Rx which I haven't filled and don't intend to get filled so we'll see how the sleeping goes tonight.
Marsha
Posted by 4WD on September 5, 2004, at 16:32:30
In reply to Re: Cymbalta Journal, posted by 4WD on September 5, 2004, at 15:52:18
I'm so p'd off that I never never want to do anything. It's a beautiful day, I live half a mile from the ocean, there's a great gym here, I have friends who love me, my husband is at work and I have the whole day to do whatever I want with it and THERE IS NOTHING I WANT TO DO!
I am bored and I cannot think of a single thing to do that I can even begin to want to do. I hate it hate it hate it.
Posted by Paul_d_234 on September 6, 2004, at 8:54:20
In reply to I am so sick of never wanting to do anything!!!!!, posted by 4WD on September 5, 2004, at 16:32:30
Marsha,
Hang in there. Hopefully soon you will be at the beach. How is the cymbalta treating you?
Posted by iris2 on September 6, 2004, at 10:34:09
In reply to I am so sick of never wanting to do anything!!!!!, posted by 4WD on September 5, 2004, at 16:32:30
> I'm so p'd off that I never never want to do anything. It's a beautiful day, I live half a mile from the ocean, there's a great gym here, I have friends who love me, my husband is at work and I have the whole day to do whatever I want with it and THERE IS NOTHING I WANT TO DO!
>
I am the same way. Yesterday I looked outside and it was beautiful and I cried but stayed inside all day. I find people to do things with that are forgiving if I cancel and I tend to motivate myself more . You said you have friends. Perhaps you can ask them to make a few suggestions about things to do together and just pick a couple that at least you will not dislike. I try to join groups that I have even a little interest in. Like I like to walk. I met a couple of people who do things with me outside the group. I also joined the "caring committee" at church. This is a great one because I can be involved even if I cannot make it to the meetings. It sounds like I get out a lot or am busy. I get out about once a week now. Better than it was which was never!> I am bored and I cannot think of a single thing to do that I can even begin to want to do. I hate it hate it hate it.
If you are bored it might be a good sign. When I am at my worst I am not even bored. It is when I am feeling a bit okay that I become bored with my time.
Are you a “people person”? For some reason you come across that way. I am and when I can get myself to go out I generally have a good time. It usually does not lift my mood and I am the same when I come back but for a few hours I get some relief or forget how bad I actually feel.
I have a lot of time on my hands. If you have any interest in emailing beyond this board my address is irene@pghmail.com I will not take it personally if you are not interested. I have given my address to two others and yes I know all will see it here.
Take care of yourself; perhaps the Cymbalta will motivate you more,
irene
Posted by 4WD on September 6, 2004, at 12:22:34
In reply to Re: I am so sick of never wanting to do anything!!!!! » 4WD, posted by iris2 on September 6, 2004, at 10:34:09
Paul and Irene,
Thanks. I guess I needed to vent. I am just tired of waiting for one med after another to *do* something. I know it hasn't been long enough for the cymbalta to kick in yet - will post day four results a little later here.
Marsha
Posted by iris2 on September 6, 2004, at 13:05:04
In reply to Re: I am so sick of never wanting to do anything!!!!!, posted by 4WD on September 6, 2004, at 12:22:34
Marsha,
Vent any time you need to. If not on the board send it to my email. If you do not want a response just indicate
It is all rather frustrating. What choice but to keep on trying!
irene
Posted by 4WD on September 6, 2004, at 17:32:17
In reply to Cymbalta Journal, posted by 4WD on September 4, 2004, at 15:58:30
Day Four 9-6-04
Cymbalta 30mg (a.m.)
I slept great last night. No insomnia. I usually have a problem falling asleep but I am doing well these last three nights.
Still no side effects except for the high pitched tone in my head (I think this is a rare side effect - it happens to me also with Effexor but not with SSRIs.) Some dry mouth is all.
My libido is returning!!!!I actually feel twinges of wanting to have sex.
My mood is not subtantially improved. I still feel rather grim most of the day and have some mild anxiety in the morning. This is peaking earlier now, though, and is going away sooner.
Normally I would feel my worst about 4-5 pm and start to feel gradually better until by bedtime I would feel fairly okay. Today I started feeling better by about 4pm. (I get up about 10, go to bed about 1)I am still experiencing some twinges of anguish/grief sort of feelings now and then. They only last a short while. I think it is normal for me to be feeling this as my father died two months ago and the Effexor did not allow me to experience much grief.
I am experiencing an increase in physical energy. I am not as slow-moving; I don't have as much of that "heavy as lead" and hard-to-drag-myself-around feeling. I still don't have much motivation to do anything with the energy, though.
No improvement in anhedonia. Still no desire to engage in "formerly pleasurable activities."
Subjectively, I don't think I can say I feel much better. Objectively, I have done some things today and yesterday that surprise me. I went to the gym two days in a row (treadmill 30 minutes)and I have trimmed dead leaves off some potted plants that have been needing it for months. That doesn't sound like much, even to me, but it's something.
Marsha
Posted by Paul_d_234 on September 6, 2004, at 19:31:30
In reply to Re: Cymbalta Journal - Day Four, posted by 4WD on September 6, 2004, at 17:32:17
SOunds great, sounds like progress. Does Cymbalta have any wieght gain affeects? Was weight gain a problem on Effexor?
Posted by Bill LL on September 7, 2004, at 9:02:12
In reply to Re: Cymbalta Journal - Day Four, posted by 4WD on September 6, 2004, at 17:32:17
It sounds like you are off to a good start in that you have more energy, less anxiety, more libido, doing more activities such as yard york and gym, and less nasal congestion. Hopefully your mood will lift soon. If it does not, you may want to try a higher dose.
Your log as been very helpful to me so far. I take Lexapro (an SSRI) 30 mg and Strattera 120 mg. The Lexapro gives me a certain degree of nasal congestion, but its not too bad. I think that's because it and some other antidepressants act as an antihistamine which causes dryness.
As for the enteric capsule, you may be correct that Lily is being greedy in trying to make a pill that cannot be cut. I'm going to check into that. I think that some enteric pills can be cut because the enteric protection is spread throughout the pill and not just on the coating. But I'm not sure.
Posted by 4WD on September 7, 2004, at 14:24:17
In reply to Re: Cymbalta Journal - Day Four, posted by Bill LL on September 7, 2004, at 9:02:12
> It sounds like you are off to a good start in that you have more energy, less anxiety, more libido, doing more activities such as yard york and gym, and less nasal congestion. Hopefully your mood will lift soon. If it does not, you may want to try a higher dose.
I don't know if I can take a higher dose because of the buzz/tone thingy in my head. That is such a weird side effect - my doctors all shake their heads. I know it's from SNRIs, though, because it goes away if I switch to an ssri or if I'm not on meds.
>
> Your log as been very helpful to me so far. I take Lexapro (an SSRI) 30 mg and Strattera 120 mg. The Lexapro gives me a certain degree of nasal congestion, but its not too bad. I think that's because it and some other antidepressants act as an antihistamine which causes dryness.Thanks. I was wondering if anyone was reading it. I was thinking this morning that Cymbalta feels a little like Lexapro without the sexual side effects. Mostly in that I am waking up earlier after less sleep and I have more energy. I get the nasal congestion from all a/d's I've tried.
>
> As for the enteric capsule, you may be correct that Lily is being greedy in trying to make a pill that cannot be cut. I'm going to check into that. I think that some enteric pills can be cut because the enteric protection is spread throughout the pill and not just on the coating. But I'm not sure.
Here is what I can't figure out. My 30mg Cymbalta is a capsule. It's filled with the little pulvules, just like Effexor, except all the granules are the same size. Now, these granules can't each individually be enteric coated, can they? So it must be dissolving in the stomach environment. So why is the 60 mg in tablets and why do *they* need to be enteric coated? This matters a lot to me because I think I may need to be on 30mg/day but in divided doses or possibly 40mg/ in divided doses. I.e. 15mg morning, 15mg night.Does anyone know whether the 40mg is capsules or tablets?
Marsha
Posted by Cecilia on September 8, 2004, at 2:40:40
In reply to Re: Cymbalta Journal - Day Four » Bill LL, posted by 4WD on September 7, 2004, at 14:24:17
That`s interesting that your 60mg dose is in a tablet. I haven`t actually seen Cymbalta yet, but the prescribing info I printed off from Lilly`s www.cymbalta.com site says it comes in 20 mg, 30 mg and 60 mg capsules(20 mg green, 30 mg white and blue and 60 mg green and blue) and that all are enteric coated and should not be chewed, crushed, sprinkled on food or mixed with liquid. I agree it`s probably greed that made Lilly design a form that can`t be split. Anyone with spare cash probably won`t go wrong by investing in pharmaceuticals. Cecilia
Posted by 4WD on September 8, 2004, at 14:52:01
In reply to Re: Cymbalta 4WD, posted by Cecilia on September 8, 2004, at 2:40:40
> That`s interesting that your 60mg dose is in a tablet. I haven`t actually seen Cymbalta yet, but the prescribing info I printed off from Lilly`s www.cymbalta.com site says it comes in 20 mg, 30 mg and 60 mg capsules(20 mg green, 30 mg white and blue and 60 mg green and blue) and that all are enteric coated and should not be chewed, crushed, sprinkled on food or mixed with liquid. I agree it`s probably greed that made Lilly design a form that can`t be split. Anyone with spare cash probably won`t go wrong by investing in pharmaceuticals. Cecilia
Hi Cecilia,
Actually I don't have a 60 mg dose. I just thought I'd read here that someone was thinking about splitting their 60 mg "pill" and I assumed it was a tablet. But I have been splitting my 30 mg dose. I was having trouble with waking up earlier than I wanted and thought it might be because the single morning dose I was taking was wearing off (they say doses below 60mg day should be taken b.i.d.). So I'm taking half the 30mg capsule in the am and half at night now. I did sleep longer this morning. Who knows? Maybe at my next appointment, I will request 20mg b.i.d. I don't want to go to 60mg if I don't have to.
Marsha
Posted by 4WD on September 8, 2004, at 17:32:55
In reply to Cymbalta Journal, posted by 4WD on September 4, 2004, at 15:58:30
Days 5 & 6
Cymbalta 30 mg
I had a really bad day yesterday (day 5). Lots of anxiety in the morning which didn't really abate last night like it normally would. I felt really grim and bleak. I've had this feeling before so I went back to my calendar to look and try to make some connections. I found I had noted feeling this way after switching from Effexor to Wellbutrin and also after switching from Effexor to Paxil. It finally occurred to me that the problem may not lie with the *new* drug but with withdrawal from the *old* drug. My pdoc had told me to continue my Effexor at my regular 37.5 mg dosage, add Cymbalta 30mg for 3-4 days, then start tapering the Effexor. I hate Effexor so much that I decided (brilliantly) to stop it completely immediately-figuring that going from one SNRI to another would be a snap. After I got my epiphany yesterday, though, I took about 1/8 of a 150mg Effexor. Again today I took about 1/8 (or 19mg) Effexor. I feel better already. The anxiety has lessened by about 50% and the grim bleak feeling has almost gone away. (I was only completely off the Effexor for less than 1 week)
Anyway, my mistake in not tapering the Effexor obviously is going to have some influence on how I'm feeling and what I'm reporting here. Sorry.
Side effects: Still some dry mouth. Some slight orgasm delay but nothing like with an equivalent amount of Effexor, Zoloft, Prozac or Celexa. Still have the ringing in my ears.
No increase or decrease in appetite or weight.
I am falling asleep more easily at night but was waking up earlier than I should. I thought this might be because the once daily morning dose was wearing off too quickly so yesterday I took half the capsule in the morning and half before bed. I woke up earlier again but was able to go back to sleep easily til my normal time.
Efficacy: I have much more energy. The psychomotor retardation is completely gone. I am no longer a slug. However, I seem to be more sensitive to caffeine. Two cups of tea made me a bit jittery.I am not depressed in the sense of feeling sad or hopeless. I am no longer having suicidal ideation.
I still don't feel much inner motivation to "go out and do things." I still can't think of anything that seems like it would be pleasurable to do. So I guess that means:
No improvement in anhedonia.
I did involuntarily smile a couple of times today. That hasn't happened in a while. I didn't realize I hadn't smiled (except deliberately) until I noticed myself doing it today and was surprised by it.
Marsha
Posted by Paul_d_234 on September 8, 2004, at 20:01:51
In reply to Re: Cymbalta Journal -Days Five Six, posted by 4WD on September 8, 2004, at 17:32:55
Marsha,
I am very happy to hear of your progress. Good luck - hope the smiles keep coming.
Posted by iris2 on September 8, 2004, at 21:50:21
In reply to Re: Cymbalta Journal -Days Five Six, posted by 4WD on September 8, 2004, at 17:32:55
Marsha,
Sounds like things are looking up. In fact if it were me writing my family and friends would be celebrating and baking me a cake( which I would not eat of course:) ).
I'm looking forward to your continued progress and HAPPINESS
irene
Posted by 4WD on September 8, 2004, at 22:13:58
In reply to Cymbalta Journal, posted by 4WD on September 4, 2004, at 15:58:30
I don't know if this is from the Effexor withdrawal or if it's because there isn't enough Effexor and the Cymbalta hasn't kicked in good yet or if the Cymbalta is making me anxious. I was even more anxious on no meds and on Paxil but I am pretty much freaking out. I was trying to tell how bad the ringing in my ears was and so I went in the closet where there was no refrigerator running, no AC running etc. The ringing was very loud and my head felt pressurized. I got out and now I'm so scared. I was scared earlier and went to get the Klonopin Rx filled but nobody had it in stock since it's the wafers (0.125 mg - can that possibly be enough to help anyway?)
I am really scared. There is no one here but me and now I'm crying. I'm so tired of feeling bad. And all the meds have side effects and I'm so tired of trying to cope with all this crap. I don't want to be on meds at all. I just want to be normal. I am so miserable. I don't usually have these attacks at night.
This happens to me every thime I go off effexor. I feel addicted to it like I'll never be able to get off. I hate it. I know it's only been 6 days on cymbalta but it hurts so bad. I feel so bad. I'm so tired of trying. I've put so much into trying to get better and done everything I know to do and I never get better. I'm so scared. At least I have smoe Zyprexa I can take.
Posted by iris2 on September 8, 2004, at 22:27:38
In reply to Help, I'm panicky, posted by 4WD on September 8, 2004, at 22:13:58
It is going to be okay. Is your family coming home soon? The Zyprexa should help a lot. Probably is better than the klonopin would have been so maybe it is a good thing they were out of it. You already know that you have been through this before so remember that and you'll know that it always goes away. Really for panicy stuff I always think Zyprexa or perphenazine or one of the major tranquilizers does the trick in a pinch. I'll be up for a while so I'll check in later to see if you're okay. I hope you just fall asleep though.
irene
Posted by 4WD on September 8, 2004, at 22:39:37
In reply to Re: Help, I'm panicky » 4WD, posted by iris2 on September 8, 2004, at 22:27:38
> It is going to be okay. Is your family coming home soon? The Zyprexa should help a lot. Probably is better than the klonopin would have been so maybe it is a good thing they were out of it. You already know that you have been through this before so remember that and you'll know that it always goes away. Really for panicy stuff I always think Zyprexa or perphenazine or one of the major tranquilizers does the trick in a pinch. I'll be up for a while so I'll check in later to see if you're okay. I hope you just fall asleep though.
>
> ireneThank you Irene. My husband will be home fromn work in about half an hours but I don't want him to come home and find me crying and terrified. He has had to pull me through these attaack so many times befoe\re he must be sick of it by now. God lknows I am sick of it myself. I will wait for the zyprexa to kick in and maybe I will feel better. In the meantime I will just pace and wring my hands and i can't stop crying. i guess it's partly that i feel so sorry for myself right now.
marsha
Posted by iris2 on September 8, 2004, at 23:09:05
In reply to Re: Help, I'm panicky » iris2, posted by 4WD on September 8, 2004, at 22:39:37
Marsha,
Strange I was going to suggest to you to respond to that particular post a few minutes ago.
The Zyprexa should have a fairly quick onset of action so you should start to feel better within the hour. I know the perphenazine I take when I get like that takes about 1/2 hour to start to work. So hopefully you will feel calmer before your husband gets in. Does it make you tired or sleepy? It does for me. Just writng so you'll know that you're not alone. I am usually awake until at least 2pm or later.irene
Posted by 4WD on September 9, 2004, at 20:09:02
In reply to Cymbalta Journal, posted by 4WD on September 4, 2004, at 15:58:30
Cymbalta Day 7 - 9-9-04
Whew. Last night was bad. The Zyprexa helped.
Thanks for all the support (Irene).
Today I feel much better. I've got a few days of a small dose Effexor back in me and will now taper properly.
Efficacy: I still have a lot more energy. I am more talkative, less withdrawn. I feel a little bit of motivation to use the energy only as of today. I have managed to get myself to the gym four times in the last week which definitely did not happen on Effexor.Side effects: The tone in my head is still very bothersome especially if I am somewhere quiet. I don't notice it as much with the AC, computer, refrigerator etc. running but if I am in a quiet place, it is really loud. My head feels like there is too much pressure inside it - this is part of the ear-ringing thing. I complained to my PCP today about it and I am having an MRI done on Monday since I also have another problem which could indicate a pituitary gland tumor. The ear-ringing could be related.
Don't know if the orgasm delay has gotten any better or worse - haven't tried to find out in the last couple days.
My anxiety level has gone back down in general since restarting a small dose of Effexor three days ago. I still have quite a bit of anxiety and have had a couple of bad spells but now that I know it's from the Effexor withdrawal I'm feeling better about it.
I'm still having some dry mouth.
Other than that, no side effects.
Small improvement in motivation.No improvement in anhedonia.
Posted by hope4best on September 9, 2004, at 20:20:57
In reply to Re: Cymbalta Journal, posted by 4WD on September 9, 2004, at 20:09:02
Marsha,
Hang in there, we're pulling for you and there with you in spirit. Thanks for sharing your experiences. I don't want to sound cliche, but for me, the saying "This too shall pass" is always helpful when I feel low, since both good times and bad times shall pass.
Wishing you good times!
Posted by SLS on September 10, 2004, at 7:21:19
In reply to Re: Cymbalta Journal, posted by 4WD on September 9, 2004, at 20:09:02
> Efficacy: I still have a lot more energy
> Small improvement in motivation.
> No improvement in anhedonia.You are on the right track. Energy is usually the first thing to return, with anhedonia being the last. All systems go!
- Scott
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.