Depression

[Julia]

Wasting my time but hoping others will understand.

No, Rick, it is never a waste of time to contradict what is wrong, whether that 'wrongness' derives from ignorance, misunderstanding, or even at times simple nastiness.

I didn't read the post correctly and would like to reverse my affirmation with apologies to anyone suffering depression. Sails and Rick are spot on.

I'm relieved to see this post, Wayne. Thought you'd undergone a radical change to your usual understanding.

Read my post further up and I don’t think I stated telling people to “get over it”. Rather they need a firm hand and guidance to develop routine in their lives to manage it. Also like to state, that depression is a natural part of life, everyone will experience it in some point in their lives. It is when it takes control over their lives and happiness leading to many months of ill feelings that there is a problem.

I do wonder how many of you have fought this illness, I have firsthand experience of it over two decades. I understand all the complexities of dealing with and learning to live with depression. I work hard to maintain an active and happy life, it is always in the back of my mind the horrible feelings of desperation when I have had a bad depressive period.

In the majority of case a good foot is needed, however there are always outliners that need professional medical treatment.
I would simply ask any person suffering depression:
1) what is it that has made them feel that way (often they do not know or wish to talk about)

2) what have they done to prevent the feelings from arising ( need to address why the feelings are there, face their demons. In some cases there is no reason but a chemical imbalance in their brain chemistry. In this case often they only treatment if the depression is sever is medication

3) Do they exercise regularly? The benefits of exercise in releasing endorphins in the brain are well documented

4) What food do they eat? Food/fuel is vital to a healthy mind. I can often tell if a depressive period is approaching or I have already entered as my mind/body moves away from healthy food into sugar and preservative rich foods. The more crap I eat, the worse and the longer the depressive period.

5) Do they smoke, drink and take drugs (generally a give in for most depressed people) this is when medication can give them a window to bring structure back into their life and slowly take back control.
The reality is, treatment is often very difficult to find and diagnosis is often incorrect making it harder for a person to persist in getting better.
\
Fire away people.

Satanoperca, maybe if your original post had been along these lines you'd not have drawn the criticism and disagreement you have.

I can at least partly see what you're saying. I have concerns that we are experiencing somewhat of a medicalisation of ordinary human sadness.

This is not in the least to suggest much depression is not intractable and needs medication. But we do seem to jump on the bandwagon of "oh he must be depressed" whenever someone displays a diminished mood.

Anti depressant drugs, whilst very effective for some people, are pretty potent and can cause significant quite dreadful side effects. I've known three people who, when experiencing a period of what I'd describe as 'normal sadness' following the breakup of a relationship, post natal depression and grief at the death of a mother, were prescribed anti depressants. All these three experienced quite terrifying suicidal impulses which they'd certainly not had before starting the medication.

So, I'm with you in first trying conservative, sensible measures like lots of vigorous exercise, healthy eating and avoiding too much alcohol.

And I simply don't believe we should regard ordinary variations of mood as symptoms of a mental illness. Surely we should not expect to be 100% happy all the time?

All that said, I do feel for Mary Jo Fisher as quite obviously anyone in her financial situation does not need to steal groceries, and further someone so in the public eye would be wanting to avoid negative publicity, so surely we need to draw the conclusion that she was not in control of her emotional/psychological state at the time.

Lastly, it's just sad that such an event has been so widely publicised. I can't begin to imagine how much more difficult this will make everything for her.

 

[cynic]

Wake up people and smell the roses the world is a wonderful place to live in.

For those suffering severe depression the universe and everything therein is an unrelenting Hell!

3) Do they exercise regularly? The benefits of exercise in releasing endorphins in the brain are well documented

4) What food do they eat? Food/fuel is vital to a healthy mind. I can often tell if a depressive period is approaching or I have already entered as my mind/body moves away from healthy food into sugar and preservative rich foods. The more crap I eat, the worse and the longer the depressive period.

Several and different treatments assist for depression. Medications [short or long term] often help. So too does CBT [which is probably above on this page].

I also have respect for MBCT [Mindfulness Based Cognitive Therapy] which a Google search will help to define.

The numerous helpful items of advice on this thread accompanied by the sincerity with which they are proffered is most commendable, but please understand the complexity of the human organism and the variety of obscure physiological conditions that can give rise to depression. I know of a number of people who suffer severe depression as a consequence of affliction with Myalgic Encephalomyelitis, Fibro Myalgia and a number of other diseases that are typically associated with Chronic Fatigue Syndrome. For people suffering CFS symptoms popular "cure all" remedies need to be approached with extreme care lest they exacerbate the condition.

Excerpt from "Missed Diagnoses"(ISBN 978-0-557-32517-7) by Byron Hyde M.D.

"Whether this suggested treatment protocol employs pharmaceuticals, cognitive or physical retraining, or alternative medications and treatments, these treatment modalities and philosophies are not medically justifiable and are often potentially dangerous to the patient."

Depression is complicated and dehabilitating.

Nobody would dismiss a more "obvious" medical issue [like epilepsy (or a broken leg)] like this.

Other medical illnesses [like autism and depression] are very individual and more challenging to both diagnose and treat. This does not mean that they are not very real.

Very true.

Would you tell someone with a broken leg, dementia, schizophrenia or post-traumatic-stress disorder to just "get over it"?

I know you wouldn't but I find the fact that this attitude is still out there to be quite "depressing".

Let's support people in trouble and not add to their condition with uninformed posts.

Rick

I wholeheartedly agree.

 

[awg]

With regards to the SA Senator and whether her condition excuses her situation,

well unfortunately for her, she will have to demonstrate the individual facts of the case in public justice, thats how the system works for everyone.

imo, depression or anxiety can give rise to serious lapse of both concentration and judgement, but not normally excuse moral issues, such as a deliberate decision to steal, which is different to forgetting to pay and panicking.

I would agree with santanoperca more contentious remarks to an extent by saying that imo, almost all the heavy lifting has to be done by the sufferer, and if they cant or wont work hard to manage their condition with a planned strategy, then the chance of chronic relapse is higher.

I probably take a bit of a hardline view on that though.

Having said that anyone going through that **** has my sympathy and I dont think their is sufficient kindness and understanding about

Also of issue obviously in all these instances of high profile people, they use their discretional "judgement" as a tool of their work.

If that judgement becomes impaired due to a psychiatric illness ( which it indisputedly can), imo, they really should not be working...(they should be on sick leave)..dunno how you fix that problem. Can you mumble career-damaging stigma?

with up to 5% at any one time and 20% lifetime chance of depression, figures are much higher for anxiety conditions...these are spectrum conditions ranging from mild to severe.

 

[sails]

Just wondering if anyone has any experience or know of anyone else who has come off the antipsychotic drug "seroquel"?

I trusted my daughter's doctor and did not research the medications she was given. She tends to be very flat with depression and I have never seen any mania in her and yet she was given this drug about 3-4 years ago. Whether it is the drug company who is failing to educate or the doctor at fault, I don't know, but the real issues is how to get her off it. I have read blogs of people coming off this stuff and some have found it to be worse than heroin to get off and can permanently damage the brain. I have given her so much support to help her recover not knowing that she is being turned into a zombie by this drug and is becomming more and more incapable of even light duties now.

Her GP wants her off it but it seems he thinks it is easy to come off. I wish he would google "seroquel withdrawal" and see what people have gone through. It seems there is inadequate education for GPs and Psychiatrists when reading the stories of other's journey to get off this horrific stuff which might be OK for extreme mania, but not for general anxiety and insomnia.

A couple of excerpts from the link below:

Once upon a time, antipsychotics were reserved for a relatively small number of patients with hard-core psychiatric diagnoses - primarily schizophrenia and bipolar disorder - to treat such symptoms as delusions, hallucinations, or formal thought disorder. Today, it seems, everyone is taking antipsychotics. Parents are told that their unruly kids are in fact bipolar, and in need of anti-psychotics, while old people with dementia are dosed, in large numbers, with drugs once reserved largely for schizophrenics. Americans with symptoms ranging from chronic depression to anxiety to insomnia are now being prescribed anti-psychotics at rates that seem to indicate a national mass psychosis.

and

Elliott reports in Mother Jones: "After another large analysis in The Lancet found that most atypicals actually performed worse than older drugs, two senior British psychiatrists penned a damning editorial that ran in the same issue. Dr. Peter Tyrer, the editor of the British Journal of Psychiatry, and Dr. Tim Kendall of the Royal College of Psychiatrists wrote: "The spurious invention of the atypicals can now be regarded as invention only, cleverly manipulated by the drug industry for marketing purposes and only now being exposed."

Mass psychosis in the US

 

[Gringotts Bank]

Like most drugs, seroquel has a number of 'off label' uses, anxiety being a common one.

Like most drugs, people have massively different effects, side effects and discontinuation symptoms. I hadn't heard that seroquel was addictive so there shouldn't be withdrawal symptoms (discontinuation symptoms can feel very similar).
While you've seen and read about horrible effects of stopping, there would undoubtedly be just as many people who have no difficulty at all in getting off it, but they tend not to post on forums. That's how drugs are - very unpredictable depending on your own chemistry, genetics, sensitivity, etc.

Your GP will know what medicine is best to use for easing the transition off seroquel.

 

[sails]

Thanks GB. She has already reduced her dose and had side effects of insomnia, nausea and other issues. The second reduction brought severe head pain to the mix and she was so sick she increased the dose until she can report this to her GP when he gets back from holidays.

She does not know all that I have read and so it's not mind over matter. Because this medication is not considered addictive, medicos seem to think there are no withdrawal symptoms. But I have read of those who have said this is every bit as difficult as heroin withdrawal.

And, it if is not addictive, why do people find they have to keep upping to dose to continue getting sleep? And why do many suffer from terrible withdrawal with shooting pains, muscle spasms and twitches, diahorrea, vomiting, severe headaches, often completely sleepless nights for several days, dizziness - just to name a few? This is not good for people who are already struggling in their lives.

I agree that most who get off without any trouble would not post, but we don't know if they exist. And it seems strange that so many people who are unlikely to be related are reporting similar violent symptoms when trying to get off it. And most find that the last 25mgs are the worst.

 

[Gringotts Bank]

Thanks GB. She has already reduced her dose and had side effects of insomnia, nausea and other issues. The second reduction brought severe head pain to the mix and she was so sick she increased the dose until she can report this to her GP when he gets back from holidays.

She does not know all that I have read and so it's not mind over matter. Because this medication is not considered addictive, medicos seem to think there are no withdrawal symptoms. But I have read of those who have said this is every bit as difficult as heroin withdrawal.

And, it if is not addictive, why do people find they have to keep upping to dose to continue getting sleep? And why do many suffer from terrible withdrawal with shooting pains, muscle spasms and twitches, diahorrea, vomiting, severe headaches, often completely sleepless nights for several days, dizziness - just to name a few? This is not good for people who are already struggling in their lives.

I agree that most who get off without any trouble would not post, but we don't know if they exist. And it seems strange that so many people who are unlikely to be related are reporting similar violent symptoms when trying to get off it. And most find that the last 25mgs are the worst.

Any doctor worth his salt will know that coming off psychoactive drugs of any type can be very painful and even dangerous. So it needs to be closely monitored just in case there are symptoms of severe discontinuation, as with your daughter. For some it would be as difficult as heroin withdrawl - I believe it. But only for some. Others would be fine. It's very individual.

Non-addictive drugs shouldn't need to be continually increased for the same effect. So I see your point. But sometimes a person finds that a drug needs to be continually increased over a period of time simply because their symptoms are worsening and so require higher doses. Symptoms can wax and wane due to life events. Some prescription drugs are addictive, but they are ok if used for short periods. Not many doctors will put a young person on benzodiazepines for example, since they are only for short term relief of anxiety or insomnia. They are addictive. I don't think seroquel is addictive though.

All drugs will have a huge list of possible side effects, even aspirin. And you can die a horrible and painful death from taking too much panadol, which is available in supermarkets. Just some examples. The ones with problems will go searching on the internet for others who have had similar problems. Just like if you have a certain thing you want to understand about trading, you go straight to asf and ask someone!

 

[Julia]

Totally sensible comments, GB.
The other point I'd perhaps make is that apparent withdrawal symptoms can occur for reasons other than the reduction of the drug dose, e.g. anxiety about not being able to sleep when the sedative effect of the drug is not there.

People sometimes become obsessed about the need for sleep imo. If sleep has been artificially induced via a sedative drug, then almost certainly there's going to be a rebound problem with insomnia if the drug is withdrawn/reduced. If the person is simply prepared to ride it out, sleep patterns will eventually settle down and be more useful than the drug induced somnolence.

Our society is breeding an ever increasing tendency to pathologise the quite ordinary swings of emotion which we all experience. There's no rule which says we should expect to be happy and productive all the time. Unhappiness, disappointment, failure etc are all part of a normal existence and do not (except in extreme cases) need a pill to make it all go away.

One of your points, Sails, is that you don't believe pharmaceutical companies sufficiently educate doctors. Given that many doctors flat out refuse to see representatives of any drug companies or accept their literature, let's not blame the manufacturers for this.

Doctors also have access to detailed information about every drug and can always seek more if they are unsure by contacting the medical department of a drug company.

In addition, the package insert that comes with the prescribed drug clearly details potential side effects etc.

I don't quite know what more pharmaceutical companies can be expected to do.

 

[sails]

Julia,

If you read my initial post on this subject, I am asking for help. I have asked if anyone has come off this medication. My daughter has become very ill and needs to come off this medication asap. Insomnia is but one of the side effects of withdrawal. Shooting pains, involuntary muscle pains, brain zaps, severe and painful gastric upsets, uncontrollable shaking to name a few can hardly be put down to anxiety about sleep.

Just because I expressed frustration that she has been given such a strong antipsychotic medication doesn't mean I want to have a massive dispute as to whose fault it is and neither do I have time for such an argument. If someone is drowning, do lifesavers sit around to have an argument as to how he got there while he continues to drown? I am asking if anyone has got off this medication safely. I am looking for help from others who may have been through this.

After nearly four years of supporting her and her girls through her depression, I am devastated that she has been given something that could give her permanent brain damage.

My first priority is to learn as much as I can about this medication and how to get her off it as safely as possible. Is that too hard to understand?

 

[sails]

Is this really caused by anxiety about sleep? 25mg is the lowest tablet size. I think the highest is around 300mg, so 25mg would seem to be a low dose.

I made the mistake and quit seroquel from 25mg. I had been on it for 1 year. I have severe spasms that affect my walking. Rigidity is also present. I had insomnia for a week in the beginning but still i did not go back on seroquel or anything to help me sleep.I dont know what to do. I asked a few doctors after a few months of withdrawing it but they said that i should be fine after a year or so. A few said that i should go back on the dosage i was taking. It has been two years now and i dont know what to do. I cannot walk properly and normally like i used to. During the last few weeks of taking seroquel I got so weak and all and my body used to shake while doing pushup that i had to quit cold turkey. Very terrible position i am in. Can anyone tell me what to do or has anyone experienced these symptoms and knows how to get out of this situation? Any professional expert of seroquel affected effects? and withdrawal?

Seroquel Withdrawal

 

[Tink]

Hi Sails

I dont know of anyone thats been through depression/on medication, or any answers regarding your question, but just want to say, must be a very hard and scary time for you -- you are in my thoughts, and I hope all goes well with your daughter.

 

[sails]

Hi Sails

I dont know of anyone thats been through depression/on medication, or any answers regarding your question, but just want to say, must be a very hard and scary time for you -- you are in my thoughts, and I hope all goes well with your daughter.

Thanks Tink - that means a lot

Yes, it is very scary and thanks for understanding my reason for posting...

 

[awg]

Hi Sails

here are some opinions:

*a person with a diagnosed psychiatric condition should take the lowest dose of effective meds for them...consistently.

*Seroquel is an anti-psychotic, very heavy stuff, and should be used by those only who suffer repeat psychosis.

* medication and diagnosis ought be managed by a good psychiatrist.

* management of mental illness in the community by GPs is patchy, for various reasons

* seems the common standard for managing such conditions as severe anxiety, insomnia, alcoholism, agitation, withdrawl etc is Rivotrol, which is a long acting benzo,

*they used to prescribe shorter acting ones like serepax or valium, but that is discouraged due to the side effects and addictiveness

 

[lindsayf]

Hi Sails
Hope the situation can be sorted out quickly.
Having had a chat with my sister who is a pharmacist it sounds like an extreme set of withdrawal symptoms and needs to be managed ( as others have said) by a good team including GP/Psychiatrist and in consultation with any mental health workers who know your daughter. And if you dont have faith in your GP or psychiatrist then go and get new ones asap - if possible. There is plenty of very ordinary care being given out there for one reason or another so dont mess about with anyone who seems to fit this bill.

It sounds like it would be very useful to gather all the members of the care team together for a case review so that everybody knows everything and can discuss options in real time.

Lindsay

 

[Julia]

Julia,

If you read my initial post on this subject, I am asking for help. I have asked if anyone has come off this medication. My daughter has become very ill and needs to come off this medication asap. Insomnia is but one of the side effects of withdrawal.

I should have been more clear about the context of my comments about insomnia.
They were not in relation to insomnia experienced during withdrawal alone, but more in response to the links you have previously sent me via PM about people who have said they have had Seroquel prescribed for insomnia.

To me, prescribing such heavy duty antipsychotic medication for sleeplessness is unreasonable. Given the symptoms described by these people, surely being a bit sleep deprived is more healthy than the effects of a medication absolutely not designed or indicated for such a condition.

Shooting pains, involuntary muscle pains, brain zaps, severe and painful gastric upsets, uncontrollable shaking to name a few can hardly be put down to anxiety about sleep.

I hope this is now clarified above.

Just because I expressed frustration that she has been given such a strong antipsychotic medication doesn't mean I want to have a massive dispute as to whose fault it is and neither do I have time for such an argument.

I do not usually disclose discussions held via PM or email and I don't intend to now, except to simply explain to others reading this thread that you and I have been communicating via email about your concerns for your daughter over some years and in particular regarding the Seroquel during the last week or two.

In the face of your apparently totally blaming the manufacturers of Seroquel for your daughter's distress, I've tried to point out that the problem is more the inappropriate prescribing of it by the GP, given your saying that your daughter has never shown any psychotic symptoms whatsoever.

These are very powerful medications and are designed for the control of the symptoms of schizophrenia and bipolar disorder, not anxiety or depression.

I have repeatedly suggested that the situation needs to be managed by a psychiatrist. Others on this thread have said the same.

You've not agreed or disagreed about this but have indicated ongoing faith in the GP who has apparently caused the problem in the first place, and said you will wait until he gets back from holidays so you can further seek his advice. Again, I've questioned that you should have such confidence in doing this.

If someone is drowning, do lifesavers sit around to have an argument as to how he got there while he continues to drown? I am asking if anyone has got off this medication safely. I am looking for help from others who may have been through this.

I understand that you want to know if others have shared your experience. You've already established this via the internet as I understand the links you've sent me.

After nearly four years of supporting her and her girls through her depression, I am devastated that she has been given something that could give her permanent brain damage.

Of course you are. It's an immensely worrying situation and I feel for you absolutely. I've multiple times expressed my sympathy, concern and support to you over this.

And over the years I've often said how much I admire the way you take over the care of your granddaughters because their mother can't manage.

But, Sails, I think you're taking quite the wrong path on this by trying to manage the withdrawal yourself via comments from anonymous people on the internet.

If your daughter's condition has now deteriorated to the acutely ill state you describe, I'd be getting her to your hospital's A & E Department. You live in an area with a major hospital which will have the appropriate psychiatric staff to make a proper assessment of your daughter's overall situation and manage it properly.

My first priority is to learn as much as I can about this medication and how to get her off it as safely as possible. Is that too hard to understand?

Certainly not. But you need professional advice and management, not comments that may or may not be valid from people who may or may not know what they're talking about, all of us here included.

Please, please, Sails, get your daughter to the hospital.

 

[awg]

Another thing I can observe is that imo it is absolutely critical to have access to a very experienced psychiatrist.

One reason I say that is that Seroquel is sometimes prescribed in cases where elements of various Personality Disorders are diagnosed.

Personality Disorder is an unfortunate diagnosis, but must be clearly faced up too, if thats what the situation is, as treatment is fraught.

I believe most sufferers dont want to know, and practitioners are unwilling to formally diagnose

I know nothing about your daughter, but some internet research will allow you to research the characteristics.

poor sleep issues are strongly correlated to poor mental health

 

[sails]

Thanks Lindsay for taking the time to ask you sister. I am planning to check with some of the local pharmacists to see if they can offer any information.

It seems that "original" symtoms are sometimes blamed for the withdrawal, and yet, those who have weathered it out find these withdrawal symptoms eventually subside suggesting it is more to do with withdrawal of an extremely strong antipsychotic drug. There are some who are left with Diabetes, Gastroparesis , Tardive Dyskinesia and other permanent nasties to varying degrees. However it is mostly the lingering and severe insomnia that plagues so many who have come off it and this can last for months, even longer.

I have also been in touch with the Mental Health Critical Team here and have spoken to one of their staff. He seems familiar with this type of withdrawal and understands that the severe insomnia needs to be addressed. At this stage my daughter is not reducing this medication any further until we are satisfied we have good medical care.

Thanks again Lindsay. And thanks AWG for your help - I am cross with myself for not researching this medication when it was first prescribed having trusted that it was medication she needed. However back then, it seems that it was believed to be some sort of wonder drug with few side effects and no withdrawal so there was probably not much help out there at that time.

 

[sails]

Julia, I have spoken to the hospital and they generally do these withdrawals at home and only hospital if there are problems that cannot be handled at home. The person I spoke to said he agrees that we need to deal with the antihistimine issues (Seroquel has a strong antihistimine component) which will also help with sleep issues and also ensure adequate sleep medication for short term use and this should enable her to come right off it.

Julia, I am not trying to treat this myself. The reduction in doses so far has been as per GP instructions and with the last reduction showing nasty side effects. Because of those side effects, I simply want to be better informed and try to understand what to expect and how to insist on the best medical care. It makes it easier for me to discuss when speaking on the phone to medical professions.

I have found out some useful information from my intensive trawling on the internet, however, any suggestions have been typed up and will give it to her GP - and that include any supplements. Her GP has already recommended omega3 to help protect the nervous system through this process.

I will not be trying to manage anything myself, however, life experience has taught me that it is often beneficial to understand what is going on. If she is treated for withdrawal at home, I will be staying at her place so I also need to have some idea of what is happening. I do have nursing experience, but even with that, I am not trained in this area of psychiatric medicine and would never put my daughter at that sort of risk.

I absolutely agree that it would have been better that this medicine was never prescribed, however, the egg cannot be unscrambled. My focus is to get her the best medical help I can and pray that she will come through it OK.

So, she has put back the offending dose at this stage and the Critical Care professional said to try and get an urgent session with the GP before Friday as he feels she needs to get off this medication soon rather than hobbling along day after day with intermittent sleep which will leave her in a more exhausted state to come right off it. I can't do any more than that as her GP is away on holidays and the hospital want him to deal with it first.

 

[sails]

Another thing I can observe is that imo it is absolutely critical to have access to a very experienced psychiatrist.

One reason I say that is that Seroquel is sometimes prescribed in cases where elements of various Personality Disorders are diagnosed.

Personality Disorder is an unfortunate diagnosis, but must be clearly faced up too, if thats what the situation is, as treatment is fraught.

I believe most sufferers dont want to know, and practitioners are unwilling to formally diagnose

I know nothing about your daughter, but some internet research will allow you to research the characteristics.

poor sleep issues are strongly correlated to poor mental health

Thanks AWG. She was coming off marijuana when she was first put on this medication, so it is possible that the mood swings from that withdrawal gave the impression of a bipolar or some other diagnosis. I understand Seroquel is often used to help people come off illicit drugs, but it makes you wonder if it isn't somewhat self defeating in the longer term.

Once all the withdrawal symptoms have settled down, it is possible that there might be still some mental health disorder which will need help. We can only wait and see on that one and hope she doesn't need anything else. But the Seroquel is causing side effects now, so it has to go.

Agree with sleep deprivation causing mental health problems. It is one of the reasons that sleep needs to be addressed while withdrawing from Seroquel as it's tough enough without enduring night after night with little or no sleep.

 

[sails]

You've not agreed or disagreed about this but have indicated ongoing faith in the GP who has apparently caused the problem in the first place, and said you will wait until he gets back from holidays so you can further seek his advice. Again, I've questioned that you should have such confidence in doing this.

Julia, you can't just rock up to a psychiatrist and demand to be seen. You need a referral - surely you know that? The GP has already discussed such a referral if needed. However, before he went on holidays, the first reduction went OK. That doesn't make him incompetent.

I have also contacted the hospital and, as I have already explained, they prefer to do these withdrawals at home and hospital is only if required.

My daughter has improved somewhat from the bad withdrawal symptoms from the last 25mg drop when we put the medication back to the same level again. While she is not great, she is resting as I have the children as necessary.

Please stop jumping to conclusions and trying to sort out something about which you clearly do not have all the facts. By email you were far more interested in whom might be to blame for her being on it in the first place. The fact is, she is on it and has to come off. I don't care who is to blame, I just want her off safely and with proficient and experienced medical help.