17 U.S. Code § 107 - Limitations on exclusive rights: Fair use
Notwithstanding the provisions of sections 106 and 106A, the fair use of a copyrighted work, including such use by reproduction in copies or phonorecords or by any other means specified by that section, for purposes such as criticism, comment, news reporting, teaching (including multiple copies for classroom use), scholarship, or research, is not an infringement of copyright. In determining whether the use made of a work in any particular case is a fair use the factors to be considered shall include—
(1) the purpose and character of the use, including whether such use is of a commercial nature or is for nonprofit educational purposes [all mirrored content falls under this clause, any ads present are mirrored from the original site, mirrored content earns me no revenue whatsoever];
(2) the nature of the copyrighted work [this is a unique resource for the mentally ill, and preservation of it can be argued to be incredibly important];
(3) the amount and substantiality of the portion used in relation to the copyrighted work as a whole; and
(4) the effect of the use upon the potential market for or value of the copyrighted work. [absolutely none whatsoever, as the original work no longer exists anywhere else (outside of whatever bits and pieces archive.org managed to capture) - the original site was intermittantly completely unavailable for a extended period of time before its SSL certificate expired (and was never renewed), and eventually the site went offline for good, then finally the DNS records were removed at some point prior to May 2018, so at this point it is well beyond the 'dead and rotting' stage]
The fact that a work is unpublished shall not itself bar a finding of fair use if such finding is made upon consideration of all the above factors.

This domain is not controlled by Jerod Poore, and I will NOT continue redirecting traffic from this domain to crazymeds.us [as I formerly did] while Jerod continues with his immature temper tantrum over adblock or continues to fail to maintain his site, fucking over his entire community and countless visitors in the process. [belated clarification: with specific regards to the adblock drama I was referring to Poore at one point replacing his entire site with a single page complaining about the amount of revenue lost to users with ad blocking active, which is something that I took extreme exception to because this affected ALL visitors to the site regardless of if or if not they were actually using ad blocking]
This mirror is unfortunately incomplete (and very slightly outdated), as /CrazyTalk/ was not included when I scraped the site (it was far too large to scrape given the site's extremely poor performance, my wish to avoid worsening the poor performance further, and other factors). If you're looking for a replacement forum, I suggest visiting https://www.crazyboards.org/forums/. There are issues with many of the mirrored pages, I am working on identifying and fixing them, but I do not have the time to address every single issue at this moment (although by now the majority of these issues have been resolved). Dynamic content is obviously completely broken (this is beyond my control), and the loss of /CrazyTalk/ is quite bad given how much good user-generated info was on there, but you have Jerod to "thank" for that. Maybe I'll bring it back online at some point, but it wouldn't be the same as before. For now, I suggest visiting CrazyBoards instead.
Note (Oct 9 2018): Infrequent additional updates regarding the status of this site will be posted on https://info.crazymeds.net


Highlighting uses, dosage, how to take & discontinue, side effects, pros & cons, and more

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Brand & Generic Names; Drug Classes

US brand name: OnePageMedicationArticle
Generic name: short med

Drug Class(es)

Primary drug class: Miscellaneous
Additional drug class(es): The first section should be fairly clear. All medication pages begin with the US Brand name and the English-language generic name1. More about drug classes where there’s room.

Approved & Off-Label Uses (Indications)

OnePageMedicationArticle’s US FDA Approved Treatment(s)

  • One Page Medication Article’s main use is to be the sample one-page article about a medication.
  • FDA-approved uses/indications will be listed here. If we’re really on the ball the approval date will be here as well.
  • If a drug has multiple forms the different forms will often have different approvals.
    • Typically this involves immediate-release pills, and occasionally oral solutions (because “liquid” is too vague), having one set of approvals and the controlled- (CR)/sustained- (SR)/extended- (XR,XL,X$) release form having another.

More About Drug Classes

As for the drug classes to which a medication belongs:

  • All medications are grouped into classes.
  • The “primary drug class” is a combination of what a drug was initially approved to treat and its chemical structure.
  • What we use for a med’s drug class is almost always the same as how you’d find the drug classified in the PDR.
  • There are two notable exceptions to the above.
    • One is Strattera, which we primarily classify as an antidepressant based upon its chemical structure2. Offically Strattera is a non-stimulant treatment for ADD/ADHD.
      • If we write any articles about the other meds that fall into that category, we’ll create a class for them.
    • The other is lithium. Officially lithium is classified an antipsychotic. We have it classified as a mood stabilizer because it doesn’t really fit anywhere else.3
  • Additional drug classes are those for which the med has FDA approval (such as how most SSRIs are approved to treat anxiety conditions, e.g.) or is frequently prescribed off-label (like all the Antiepileptic Drugs/Anticonvulsants (AEDs) and Antipsychotics (APs) not approved to treat bipolar disorder that are thrown at it anyway).

Uses Approved Overseas but not in the US

Sometimes a drug is approved for a use outside of the US, but isn’t approved for it here.

  • We’ll list the countries, trade name (see below), and what it’s approved for.
  • See the Celexa page for an example.

Off-Label Uses of OnePageMedicationArticle

“Off-label” means using a drug for something for which it does not have the FDA’s official blessing.

  • As mentioned above, lots of AEDs and APs that are not approved to treat bipolar disorder, but are frequently prescribed off-label to treat it.
  • Hardly any antidepressant is approved to treat bipolar disorder, so all those prescriptions for SSRIs and SNRIs to treat bipolar are off-label.
    • Except they’re being prescribed to treat depression. Which is why lots of people have been diagnosed with both bipolar disorder and a depression disorder.
  • With off-label prescriptions I try to include links to studies that show why it’s a good idea.
    • Or why it’s a stupid idea. Sometimes the FDA manages to get it right.
  • If there are enough off-label uses, or enough studies full of conflicting data, I’ll try to group them into some kind of vague organization.
  • See the Celexa page for an example of a shitload of off-label uses.

When & If OnePageMedicationArticle Will Work

OnePageMedicationArticle’s Usual Onset of Action (when it starts working)

Isn’t this one of the most important question your doctor or pharmacist should be able to answer? Yes, it is. Did you remember to ask them that?

Here’s how I derive this answer: the experiences of lots4 of people, all the studies I can find, and, depending on the med in question and its use, either or both The Prescriber’s Guide (Essential Psychopharmacology Series) by Stephen Stahl or Essential Neuropharmacology: The Prescriber’s Guide Stephen D. Silberstein, Michael J. Marmura.

Return to Table of Contents

Likelihood of Working

Isn’t this an even more important question to ask your doctor or pharmacist? While you might find how long it will take a med to work on other sites, I don’t know of any site other than Crazymeds that gives you the likelihood of a medication working.

As with how long it takes for a drug to work, it’s a synthesis of anecdotal evidence, lots and lots of studies - especially from clinical trials - and two or more of the first six from this list of Professional-grade books.

See the Celexa page

Return to Table of Contents

Taking and Discontinuing

How to Take OnePageMedicationArticle

Taking a med is something your doctor and/or pharmacist should explain to you. In case you didn’t quite understand it, or want to get an idea of what it’s like…

  • The manufacturer’s guidelines from the prescribing information (PI sheet) will be here, either quoted verbatim or summarized5.
  • Often we disagree with the amount you start with, how much and how often the dosage is increased.
    • Increasing the amount of a medication from its initial dosage is called “titrating.”
    • Because “raising” or “taking more” is too vague. Or something.
    • How often you plan on increasing the dosage (10mg a week, e.g.) is a titration schedule.
  • So you’ll usually see our suggestion for a plan to increase how much you take and how often you should do that.
  • But we generally have the same plan for almost every med on this site:
    • Increase your dosage by the lowest amount available until it works, and keep taking that amount.
      • If your symptoms begin to return, time to take more.
      • If your symptoms have been gone for more than a year, or two, or for however long you’re comfortable with, talk to your doctor about taking less.

Return to Table of Contents

How to Stop Taking OnePageMedicationArticle (discontinuation / withdrawal)

How you stop taking a drug can be just as, if not more important than how you take it.

  • Fortunately more drug companies are including precise, or at least less vague, discontinuation plans in the prescribing information.
  • As with the titration schedule, if there is one it will be included here.
  • More often than not we’ll agree with anything that gives specific or relative (half, quarter, etc.) dosages and the number of days to wait before the next reduction in how much to take.
  • If we can’t find any better information, the rule of thumb is to decrease the dosage however many mg we would titrate (see above) each time every (half-life (see below) multiplied by five and rounded up to the nearest day) days.
  • That doesn’t work for drugs with super-short half-lives (like opioids and Neurontin), but it does for most crazy meds.

Return to Table of Contents

OnePageMedicationArticle’s Pros and Cons

Pros

  • A short list of why this might be the drug for you.
  • Why it’s better for its approved & off-label uses than other medications that treat the same things.
  • And/or why it sucks less than those meds.

Return to Table of Contents

Cons

  • A short list of why this might not be the drug for you.
  • Why it’s not as good for its approved & off-label uses than other medications that treat the same things.
  • And/or why it sucks more than those meds.

Return to Table of Contents

Interesting Stuff your Doctor Probably didn’t Tell You about OnePageMedicationArticle

  • “Interesting” is really subjective.
    • Sometimes it can mean “important.”
    • Fortunately, even in this world of the once-every-three-months 15-minute medication check appointment, most doctors, with the pharmacists backing them up, cover the important stuff.
    • We’ll try to cover everything that’s really important as well.
  • Most of the time it’s things like:
    • How eating a med with food can increase or decrease how well you absorb it, but it may or may not make that much of a difference.
    • Or how Gabitril is better distributed through your body during the day than at night.
    • How various meds work better for one gender than another.

Return to Table of Contents

Best Known for

There’s usually one, sometimes two, things a drug is known for. Lamictal has The Rash. Effexor has the discontinuation syndrome from hell. Topamax will make you skinny and stupid.

Sometimes the effect is so bad that it will tarnish the entire class of meds, such as Depakote making people think all AEDs / mood stabilizers cause massive weight gain. While Paxil is well-known for killing your libido and also having the discontinuation syndrome from hell, the way it screws up tamoxifen has given many people the impression that all antidepressants, and not just any type of medication that affects CYP2D6 (more on this below in drug-drug interactions), can mess with tamoxifen.

Return to Table of Contents




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OnePageMedicationArticle’s Potential Side Effects

Potential Side Effects All Crazy Meds Have

No matter which neurological and/or psychiatric drug you take, you’ll probably get one or more of these side effects. These will usually be gone, or at least will diminish to the point where you barely notice it most of the time, within a week or two.

  • Headache
  • Drowsiness / fatigue - even when taking stimulants in some circumstances.
  • Insomnia, instead of or alternating with the drowsiness.
  • Nausea
  • Assorted other minor GI complaints (constipation, diarrhea, etc.)
  • Generally feeling spacey / out of it
    • Which can all add up to the ever-helpful “flu-like symptoms” listed as an adverse event on the PI sheet of practically every medication on the planet used to treat almost any condition humans and other animals could have.6
  • All crazy meds can, and probably will affect your dreams as well. There is no way of telling if that will be good or bad, let alone if this side effect is permanent or temporary.
  • Any of the above side effects you see listed again below means they’re even more likely to happen and/or stick around longer and/or are worse than most other meds.

Typical Potential Side Effects

  • Side effects are divided into three categories: Typical, Uncommon, and Freaky Rare.
  • Typical/common side effects (“adverse reactions” in doctorese) are those that practically everyone who takes a medication is going to get.
  • On a medication page this part invariably starts with “The usual for [the class of the med]…”.
    • For SSRIs, SNRIs, and TCAs that can be most, if not all of the typical side effects.
    • The main difference for each med in those classes is how long the typical side effects will last.
  • Most common side effects either go away or subside to something you can live with in two to four weeks.
  • The sources for typical and uncommon side effects are:
    • the Prescribing Information (PI)
    • the experiences of people taking the med gleaned from review sites (see below) and assorted medication-related and non-medication-related blogs, fora, etc.
    • and the Consumer-grade books you’ll find in the article’s bibliography7.
  • Not all side effects will be listed! See the PI for that.

Return to Table of Contents

Uncommon Potential Side Effects

  • These are the side effects that happen, but not all that often.
  • File under “don’t be surprised if you get one or more of these.”
  • How long they can last is highly variable, from a few days to as long as you’re taking the drug.
    • The most frustrating is “You’ll know it’s a temporary side effect when it stops.”
    • Unfortunately there are a very few side effects where that timeline applies even after you stop taking the med.

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Freaky Rare Side Effects

  • My favorite type of side effect, only because one person’s misfortune8 is another person’s comedy. Sometimes.
  • The key words here are:
    • “Rare”, which, depending on the popularity of the med and nature of the available side effects, is in the neighborhood of fewer than one person in 10,000 to fewer than one person in 100,000.
    • And “freaky,” which isn’t as subjective as it seems
      • although you’d have to read a shitload of PI, books, and everything else dealing with medication side effects to get an idea of what is really strange
  • The weirdest and most detailed dreams you’ve experienced isn’t freaky, that sort of thing is one of the most common side effect of all crazy meds.
  • Your hair changing color, that’s freaky.
  • So is your skin getting bigger, like you just had a massive amount of liposuction done.
  • So is going deaf. Permanently.
  • My absolute favorite is for Savella (milnacipran).
  • Freaky rare side effects come from the PI, case reports like the one for Savella, and even from the Crazy Talk forum. Although on the last one I like to see something similar in The Literature.

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What You Really Need to be Careful About

If a drug has a “Black Box Warning” - something potentially bad enough that it is the first thing in the PI, written in a bold and larger typeface, all caps, and printed/displayed within a black box - that will be summarized here.

Pregnancy category can be A, B, C, D, or X. C is what you’ll see for most crazy meds, and most medications in general. It basically translates to “We really don’t know if it’s going to do anything to your baby or not.” For a far more detailed explanation of what the different codes mean and how it’s used, see the page on Topamax’s black box and other warnings.

Return to Table of Contents

Pregnancy Category

C-Use with caution Return to Table of Contents

Pharmacology

OnePageMedicationArticle’s Half-Life & How Long Until It Clears Your System

20–30 hours covers most crazy meds, clearence is 5 to 7 days.

Steady State

5 to 7 days is typical.

Half-life is the average time it takes for you to process half of the drug’s active ingredient. If a drug has a half-life of around 24 hours and you take a dose of 100mg, you’ll have roughly the equivalent a 50mg dose after one day, a 25mg dose after two days, and so on. The rule of thumb is: multiply the half-life by five and you get how long it is for the dose you took to be cleared from your bloodstream9, so there’s nothing swimming around to attach itself to your brain and start doing stuff. That’s called “plasma clearance.” Complete clearance is a complex equation based on a lot of factors which may or may not: be published in the PI sheet, include personal data like your weight, or even completely figured out by corporate and independent researchers. It usually winds up being 2–5 days after plasma clearance no matter what10, but can take weeks. Sometimes a drug will clear from your brain and other organs before it clears from your blood.

Steady state is the flipside of half-life. This is when you can expect to get over side effects caused by fluctuating amounts of a medication in your bloodstream. Often, but not always the same amount of time as the plasma clearance above.

Return to Table of Contents

How short med Works

the current best guess at any rate
Here is where we try to translate and update what is in a medication’s Prescribing Information. Changing this:

The mechanism of action of citalopram HBr as an antidepressant is presumed to be linked to potentiation of serotonergic activity in the central nervous system (CNS) resulting from its inhibition of CNS neuronal reuptake of serotonin (5-HT). In vitro and in vivo studies in animals suggest that citalopram is a highly selective serotonin reuptake inhibitor (SSRI) with minimal effects on norepinephrine (NE) and dopamine (DA) neuronal reuptake. Tolerance to the inhibition of 5-HT uptake is not induced by long-term (14-day) treatment of rats with citalopram. Citalopram is a racemic mixture (50/50), and the inhibition of 5-HT reuptake by citalopram is primarily due to the (S)-enantiomer.

Citalopram has no or very low affinity for 5-HT1A, 5-HT2A, dopamine D1 and D2, α1-, α2-, and β- adrenergic, histamine H1, gamma aminobutyric acid (GABA), muscarinic cholinergic, and benzodiazepine receptors. Antagonism of muscarinic, histaminergic, and adrenergic receptors has been hypothesized to be associated with various anticholinergic, sedative, and cardiovascular effects of other psychotropic drugs. Celexa PI sheet

Into this:

Based upon our Communications Interference Hypothesis of psychiatric and neurological conditions (or brain cooties as we often call them):

  • Celexa treats depression and anxiety by effectively raising serotonin levels in your brain.
  • It does so by letting your synapses soak in serotonin for longer than usual by slowing (inhibiting) the mechanism of serotonin transmission deeper into the neurons (reuptake).
  • Depending on where, and to what extent that effect on serotonin occurs, your brain is happier.
    • However, the regulation of your dopamine can also be affected, which is the likely cause of various side effects, especially those involving sexual dysfunction.
  • This study may explain why it, and probably other SSRIs, works in treating OCD.
  • Your guess is as good as, if not better than, mine when it comes to how any crazy meds work in regards to things like PMDD.

Crazymeds’ Celexa (citalopram) Synopsis

Return to Table of Contents

Active Ingredient

short med HCl is what you’d probably see if “short med” were an antidepressant.


The active ingredient is usually the same as the generic name, but more often than not it’s a chemical salt of the substance identified as the generic. E.g. Fluoxetine is the generic for Prozac, but the active ingredient is fluoxetine hydrochloride (or HCl). It usually doesn’t make much of a difference outside of the more esoteric aspects of a drug’s pharmacology, but not always.

Return to Table of Contents

Shelf Life

3 years is typical. We don’t always have this, as it’s not required for US medications. Return to Table of Contents

OnePageMedicationArticle’s Noted Drug-Drug, Drug-Food & Drug-Supplement Interactions

Note the link to Drugs.com’s drug-drug and drug-food interaction checker and the med’s PI. That is where you’ll find all known drug-drug and drug-food interactions.

What we try to provide are

  • The ones that doctors and pharmacists sometimes miss or should be repeated
    • Like CYP2D6 inhibitors (Paxil e.g.) + tamoxifen = that breast cancer isn’t going away.
  • The little known
    • rooibos (Aspalathus linearis)/ red tea is a potent inducer of UGTs
      • in English: that shit will require you to take more Lamictal. How much more? Who the fuck knows.
  • Or the unusual
    • Topamax + lithium = variable lithium levels.
    • Don’t mix or wash down that truly vile-tasting11 Risperdal with tea or cola.
      • I don’t know why. It’s in the PI.

Return to Table of Contents

Check for Other Drug-Drug, Drug-Food & Drug-Supplement Interactions OnePageMedicationArticle may have at

Drugs.com’s drug-drug and drug-food interaction checker

It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on teh Faecesbooks.
Learn more about drug-everything interactions on our page of tips about taking crazy meds.


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Name, Address, Serial Number (Generic and Overseas Availability)

Available in the US as a generic? Yes

Other Trade Names and Overseas Availability

Not including controlled/extended/sustained release suffixes (Efexor ER, Trevilor retard e.g.) or branded generics that are a hyphenate of the generic name and the drug company name (Apo-Citalopram e.g.).

First, some more information about the deceptively simple question “Available in the US as a generic?” There are three answers to that question:

  • Yes - you can get it from a US pharmacy.
  • No - can’t get if from a US pharmacy. It may or may not be available from another country.
  • Pending - it will be available “soon”.

In the US, where intellectual property is so important that its regulation is in our Constitution before who gets to declare war and how, just because a medication has passed its patent date doesn’t mean anyone can start making a generic version. The FDA has its own complicated set of protections and regulations12 to not only protect the original13 (pioneer) manufacturer’s exclusive rights to sell the a drug, but to allegedly protect the public from sub-standard generic products as well. So we basically have a two-part process:

  • Both the patent date and exclusivity date of the brand-name must expire.
    • Which some drug companies will fight by doing all sorts of tricks.
  • One or more drug companies must get approval to make a generic version.

See this topic for more about the process of a medication becoming generic.

As for what this part of the page is about:

  • A drug can have many more names than the US brand name and English-language generic name.
    • In some countries the INN / generic name is transcribed into a local phonetic equivalent.
    • In Spanish it’s often so close as to be redundant (e.g. topiramato vs. topiramate).
      • In Finnish it’s practically a different drug. Compare escitalopram vs. essitalopraami with Lamictal vs. Lamisil.
      • I can understand the need to transliterate the INN / generic name into another alphabet (topiramate becomes топирамат in Russian), but giving a med a different generic name using the Latin alphabet just makes it difficult to find.
  • And just because you can get a drug here doesn’t mean you can get it everywhere.
  • I also want to write about more meds available outside of the US that should be available here, like reboxetine.
    • Or are popular or otherwise interesting.
  • We’ll try to list all the countries where a drug is available, regardless of name.
  • Older drugs, like carbamazepine, lithium, Thorazine, valproic acid, and the TCAs have an absolute shitload of names.
    • And not just different brand names, but different “branded generics.”
    • Huh? To make it even more confusing, “branded generic” can mean:
      • A generic drug produced by a generics manufacturer that is a wholly-owned subsidiary of the company that makes the branded version.
      • A branded generic is also a generic drug given a ‘brand’ name by the manufacturer (e.g. Teva’s Budeprion), but otherwise has the same active ingredient as the original branded version (Wellbutrin).
      • A branded generic is also a generic drug given a ‘brand’ name by the manufacturer (e.g. Sanofi-Aventis’ Aplenzin, which is bupropion hydrobromide) and uses a salt of the active ingredient that is different from the original branded version and other generics (Wellbutrin, Budeprion and all the others are bupropion hydrochloride).
      • For our purposes a “branded generic” name refers to the second and third definitions.

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Shapes & Sizes (How Supplied)

Tablets, capsules, intramuscular (IM) injection, under-the-tongue (orally disintegrating) tablets (ODT), suppositories, oral solution (liquid), whatever the shape and size. “Size” being defined as the dosage. If we’re really on the ball will include the color and what’s written or embossed on the pill (the imprint). Truthfully, the odds are this will be empty. Return to Table of Contents

Comments, PI Sheet, Ratings, Reviews and More

Comments

Because this article is displayed in a template for a one-page synopsis with another page for reviews, there’s no built-in wikitrail as there is for the multi-page article. If there were, it would look like:

Drug Guide Index | MultiPageMedicationArticle (longmed) Overview

  • This will often be the personal experiences of the author.
  • Normally on this type of article there wouldn’t be so much detail in most of the areas above. That sort of thing is reserved for the comments section.
  • If there’s something there isn’t a place for, like failed and/or dangerous off-label uses, comparisons with other medications, that would go here.
  • A couple more things to cover about these articles:
    • Ratings. Anyone can rate the med and the article.
    • The way the wiki software is written you can’t rate both at the same time. It’s pick one, click submit, scroll back down, pick the other, click submit.
      • Don’t blame me, I didn’t write it.
    • Please rate this guide. I have no idea how much good any of this crap does.
  • I know there is way too much in the way of ads for Amazon and CafePress crap. Sorry.
  • I’m sure I’ll come up with more.

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Rate OnePageMedicationArticle

Give your overall impression of OnePageMedicationArticle on a scale of 0 to 5.

Get all critical about OnePageMedicationArticle

0 stars Everybody hates me.


Rate this article

If you’re still feeling judgmental as well as just mental14, please boost or destroy my self-confidence by honestly (and anonymously) rating this article on a scale of 0 to 5. The more value-judgments the better, even if you can criticize my work only once.

Get all judgmental about the OnePageMedicationArticle (short med) Synopsis

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Pages and Forum Topics Google Thinks are Relevant to Your Mental Health

Full US PI sheet, Global SPCs & PILs, Other Consumer Review & Rating Sites, and Other Sites that may be of Interest

OnePageMedicationArticle’s Full US Prescribing Information / PI Sheet

A note about the US Prescribing Information (PI) link: The PI I have isn’t always the latest one. So why don’t I just link to the one on the drug company’s website? Because they are constantly moving them around. The URLs change almost as quickly as they buy and sell each other or their product lines.

What good are the PI equivalents from around the world?

  • Mainly they’re for the handful of geeks like me who like to look at things from multiple sources and spot the differences.
    • It’s an otaku thing.
  • Every now and then it pays off.
  • For one thing I can’t get the shelf life from the US PI, but it is in the UK SPC and New Zealand MDS.
  • And very rare side effects will show up only outside of the US and not make it into the US PI.
  • Such as the temporary (as in 20 minutes) blindness that sometimes happens after taking Topamax.
    • Weird, huh?
  • Also the occurrence of adverse reactions can vary from country to country.
    • Statistical flukes?
    • Genetics?
    • Diet?
    • The weather?
  • Damned if I know, but it’s fascinating as hell.

These are the best English-language sources for equivalents to the US PI I know of so far. Unless a med is available only in the US, as Strattera was for a long-ass time, medication articles should have a link to one or more of these sites:

Consumer review & rating sites that usually have statistically significant (i.e. at least 20 reviews for some meds) data:

Other sites that might be useful, that there should be links to if we have our act together:

  • The drug’s official site, if there is one.
    • Meds that hit the market before the mid-to-late 1990s won’t have one.
    • Meds approved between 199x and five-to-ten years prior to whenever you’re reading this will have one, but it will either redirect to the manufacturer/trademark holder’s main site, or be nothing more than a place for the PI.
      • At least it will be the most recent PI. As I mentioned above, I don’t always have usually don’t have the most recent one.
    • Only recent and/or the really successful older meds, such as Topamax, will have websites with something useful15.
    • If it exists, I’ll link to it. Because that will show you how much the drug company cares about the med, and its customers.
  • DrugsDB - more than just the PI translated into English.
  • Chem Spider - Probably more than you ever wanted to know about

Return to Table of Contents

Discussion board

If you have any questions not answered here, please see the Crazymeds OnePageMedicationArticle discussion board. Return to Table of Contents



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References

The books, journal articles, and whatever else used as source material for this article. At the very least there will be the PI. We’ll be including copies of links in the article here for clearer citing. Here’s a typical list of books you’ll find in the bibliography section of a medication article:

Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications (Essential Psychopharmacology Series) Third edition by Stephen M. Stahl © 2008 Published by Cambridge University Press.

Primer of Drug Action 12th edition by Robert M. Julien Ph.D, Claire D. Advokat, Joseph Comaty © 2011 Published by Worth Publishers.

The Prescriber’s Guide (Essential Psychopharmacology Series) Third edition by Stephen Stahl © 2009 Published by Cambridge University Press.

Clinical Handbook of Psychotropic Drugs 18th edition Adil S. Virani, K. Bezchlibnyk-Butler, J. Jeffries © 2009 Published by Hogrefe & Huber Publishers.

Mosby’s Drug Consult 2007 (Generic Prescription Physician’s Reference Book Series) © 2007 An imprint of Elsevier. Also the 2004 edition, but only on pages that haven’t been fully updated yet.

Instant Psychopharmacology 2nd Edition Ronald J. Diamond M.D. © 2002. Published by W.W. Norton

The Complete Guide to Psychiatric Drugs Edward Drummond, M.D. © 2000. Published by John Wiley & Sons, Inc.

PDR: Physicians’ Desk Reference 2010 64th edition back through to 53rd edition of 1999. Old copies of the PDR come in handy for PI sheets that are no longer available and difficult to find, as well as to track the changes in both indications and adverse effects.

Healing Anxiety & Depression Daniel G. Amen, M.D., and Lisa C. Routh, M.D. © 2003. Published by G.P. Putnam’s Sons. Return to Table of Contents


1 In theory there is supposed to be one, single, international non-proprietary, or generic, name (the INN) used in all countries for any give medication. In practice the generic name is frequently internationalized into local languages.

2 I.e. it's a copy of reboxetine

3 Seriously, lithium is really difficult to classify. When it comes to bipolar disorder it acts like an AED, especially when you consider its side effects. Except that it causes seizures. They use lithium to give rats seizures to see how well, and exactly how AEDs work.

4 "Lots" depends on the popularity of the med. For something like Celexa and Lexapro it's many thousands for each. For something like Gabitril it's closer to a dozen.

5 And translated from doctorese to English.

6 As well as being an indication of half of said conditions.

7 The books geared toward consumers have a better idea of what sort of side effects show up how often than the ones doctors are expected to read.

8 Including my own, as Mouse and I have had one or more of the freaky rare side effects from several of the meds discussed on this site.

9 Based on Julien's calculations from A Primer of Drug Action, the half-life multiplied by five is the generally accepted estimate of how long it takes a single dose of any given drug to be eliminated from the blood stream/plasma of someone with a normal metabolism. That's also the rough estimate for steady state if they can't get, or won't provide a number for that.

10 For crazy meds. I have no idea what the average complete clearance is for other types of medications. For all I know there are drugs that utterly vanish from your system in under five passes, and others that won't let go of your squishy bits for years after you stop taking them.

11 I've had homemade Absinthe. I know what vile tastes like. Risperdal oral solution tastes worse than tincture of wormwood. Mixing / following the 'absinthe' with milk was a bad idea. The people at Ortho-McNeil Janssen Caroliner Hunger Force must have been really, really high on Absinthe to suggest mixing liquid Risperdal with low-fat milk.

12 Which is fair, if you think about it. If you were to make a med you'd have to patent it before you began clinical trials, because by that time the drug's chemical structure is completely out in the open. But then the med completely fails the trials. But you notice something odd in the results, run some more tests on the ever-willing rats, and try again for a completely new use. After a few more years it gets approved! By the time everything is set to manufacture it, your patent is a year or two away from expiring. It could be the greatest drug ever developed. Something that completely cures a rare and painful childhood ailment that is 100% fatal by the time they're 12. If you had only a year to come close to recouping your development costs that drug could cost $25,000 a treatment.

13 Or whoever owns the company that developed the med. Or whoever owns the rights to the med.

14 Thank you! I'll be here all weak. Be sure to tip your content provider. And don't try the veal, it's cruelicious!

15 At least the drug companies think they sites are useful. Once in awhile they actually are. The J&J sites, Topamax, Topamax for Epilepsy, Risperdal, Invega, and Invega Sustenna, are more than just fancier versions of the ads you'd see in Parade.


If you have any questions not answered here, please see the Crazymeds OnePageMedicationArticle discussion board. We welcome criticisms of the articles, notifications of bad links, site problems, consumer experiences with medications, etc. I’m not always able to write back. Hence I never answer questions about meds via e-mail that are answered by this or other articles. Especially if they have been repeatedly asked on the forum. That’s why we write these damn things. Questions about which meds are best for your condition should also be asked on the forum; because this is a free site, so the price of admission is making things easier for somebody else searching for the same answer. We don’t deal with children on the forum or in private because after doing this for ten years I don’t have the emotional stamina to deal with kids who have brain cooties. How to contact Crazymeds. — Jerod Poore, CME, Publisher Crazymeds (crazymeds.net)


Last modified on Thursday, 29 May, 2014 at 12:54:28 by JerodPoorePage Author Date created
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OnePageMedicationArticle, and all other drug names on this page and used throughout the site, are a trademark of someone else. OnePageMedicationArticle’s PI Sheet will probably have the name of the manufacturer and trademark owner (they’re not always the same company) at or near the very bottom. Or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing. It may of changed hands by the time you finished reading this article.




Page design and explanatory material by Jerod Poore, copyright © 2003 - 2015. All rights reserved.
Keep up with Crazymeds and and/or my slow descent into irreparable madness boring life. Pick your preferred social media target(s):

Almost all of the material on this site is by Jerod Poore and is copyright © 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, and 2015 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.



All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else. Plus we are big pottymouths and talk about S-E-X a lot.
Know your sources!
Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained from the medications’ product information / summary of product characteristic (PI/SPC) sheets and/or medication guides - which is all you get from sites like WebMD, RxList, NAMBLA NAMI, etc., the sources that are referenced throughout the site, our personal experience and the experiences family, friends, and what people have reported on various reputable sites all over teh intergoogles. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or medication guide/patient information leaflet (PIL) that comes with your medications and never ever throw them away. OK, you can throw away duplicate copies, but keep at least one, as that’s your proof of purchase of having taken a med in case a doctor doubts your medical history. Plus they take up less space than a bottle, although keeping one inside of a pill bottle is even better.
Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
Very little information about visitors to this site is collected or saved. From time to time I look at search terms used and which pages they bring up in an effort to make the information I present more relevant. And the country of origin, just because I’m geeky like that. That’s about it. Depending on how you feel about Schrodinger, our privacy policy should either assuage or exacerbate your paranoia.
Crazymeds is optimized for ridiculously large screens and browsers that don’t block ads. I use Firefox and Chrome, running under Windows 72. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazymeds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazymeds is not responsible for whatever weird shit your browser does or does not do when you read this site3.
No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this website. Use only as directed. Void where prohibited. Contains nuts. Certain restrictions may apply. All data are subject to availability. Not available on all mobile devices, in the 12 Galaxies Guiltied to a Zegnatronic Rocket Society, or in all dimensions of reality. Hail Xenu!

‘Everything is true, nothing is permitted.’ - Jerod Poore


1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.

2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.

3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?* I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion as anonymity on teh Intergoogles. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.

* Yes, I know I’m using open source browsers. I also test the site using the now-defunct IE and Safari browsers. Their popularity - and superiority - killed IE and Safari, so that’s why I rely on the open source browsers. It’s like brand vs. generic meds. Sometimes the generic is better than the brand.

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