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P. K. Gillman now has his own youtube channel. Check it out!

GizmoHurensohn

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Jul 8, 2019
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Bravoncius Roxford

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Dr.Gillman is great. Arguably greatest psychiatrist and pharmacologist in the World. A true expert in pharmacoloy. It was Dr.Gilmman who identified methylene blue and it's main metabolite as potent MAOIs.

And speaking of MAOIs, Dr.Gillman is the greatest MAOI expert in the World, and not only the ones used for depression. A lot of neurologists who treat Parksinson's ask for Dr.Gillman's to fine tune the use of selegiline, safinamide and rasgiline for their own patients.

He usually treats the most severe cases of treatment-resistent depression, using the (very)old non-selective irreversible MAOIs with sometimes Lithium and methylphenidate for augmentation. When patients come to him from other doctors after having taken a lot of different SSRIs, NSRIs and atypical ones like mirtazapine and agomelatine and everything failed, and he prescribes them the old MAOIs, he usually tells the patient:

"Ok, time for you to take a real antidepressant."

When one his patients failed to respond to moclobemide prescribed by other doctor, after also having failed on several SSRI's, Dr.Gillman told him:

"Time for a real MAOI..."

Dr.Gillman has been heavily criticized for his radical position that the only true antidepressants are the old non-selective MAOIs and the tricyclic, clomipramine. According to him, the SSRIs, NSRIs, RIMAs like moclobemide, the atypicals and all other tricyclics other than clomipramine are what he calls the "anodyne" drugs, that is, do no harm but do no good either. He considers them to be mild sedatives and tranquilizers for people that ocasionally get the blues. But for the truly depressed, they are as effective as a sugar pill. They are not effective for significantly raising mood, and dealing with severe angst.

Dr.Gillman also controversially augments these drugs with stuff that you really shouldn't take with them. For the most severe cases of treatment-resistent depression, where the person has responded only modestly to even the non-selective MAOIs, Dr.Gillman augments the MAOI with methylphenidate, low doses of amphetamines and tryptophan. He describes a patient that he prescribed 500 mg of tryptophan before bed time while on phenelzine, but instead the patient misread the instructions and took 5 grams and was rushed to the hospital with quite severe symptoms of clonus and hyperthermia and other classic signs of serotonin syndrome.

Now, I have never taken the old non-selective irreversible MAOIs(and never will), but I have taken clomipramine. There is a reason why this drug is not prescribed often, and that is because it is really fucking powerful and nasty. A few hours after popping 25 miligrams, it hit me like a freigh train. Imagine the most emotionally relaxed and comfortable feeling ever, mixed with an intense feeling of physical energy and desire to move around, severe nausea and constipation and being completely unable to piss or shit no matter what. Yeah, nasty stuff. I took it for only 5 days and by the fifth day I was the happiest I've ever been in my life in a "I don't give a damn about mine or anyone else's problems" way. But not drowsy, but actually very energetic and full of vigour. Yeah,it was a nice experience,but the side effects are really nasty. I'll just leave this one for people that want to kill themselves.
 
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GizmoHurensohn

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Now, I have never taken the old non-selective irreversible MAOIs(and never will), but I have taken clomipramine. There is a reason why this drug is not prescribed often, and that is because it is really fucking powerful and nasty. A few hours after popping 25 miligrams, it hit me like a freigh train. Imagine the most emotionally relaxed and comfortable feeling ever, mixed with an intense feeling of physical energy and desire to move around, severe nausea and constipation and being completely unable to piss or shit no matter what. Yeah, nasty stuff. I took it for only 5 days and by the fifth day I was the happiest I've ever been in my life in a "I don't give a damn about mine or anyone else's problems" way. But not drowsy, but actually very energetic and full of vigour. Yeah,it was a nice experience,but the side effects are really nasty. I'll just leave this one for people that want to kill themselves.
Don't the side effects fade away after some time?
 

Bravoncius Roxford

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Don't the side effects fade away after some time?
Sure, but they never go away completely. More like your body adapts to restore homeostatic balance. The problem with clomipramine is that it is a tricyclic, and tricyclics are potent antagonists of the muscarinic acetylcholine receptors. Long-term users of tricyclics have statistically higher levels of dementia in old age because acetylcholine is essential for memory formation and fluid thought. They are "dumb drugs". Now, if you are suicidally depressed it doesen't matter if you might become senile 30 or 40 years down the road, as you have the more pressing issue of not blowing your brains out. In fact, one of the reasons why tricyclics are more effective for serious depression than the SSRIs is because they are anti-cholinergics. Stimulation of muscarinic receptors causes agitation and depression. One of the most serious long-term effects of people that survived poisoning by sarin, VX and other nerve agents is a severe depression that is not amenable to any sort of treatment. Antagomnism of AC receptors adds another dimension to the antidepressant effect of clomipramine besides it's highly potent inhibition of the reuptake of both serotonin and norepinephrine.
 

Skorpio

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May 11, 2011
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Lot of Gilmans in pharm/chemistry (Goodmen?). I originally thought you were talking about Nobel laureate Alfred Gilmen.

Good shit.
 

Hylight

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Very interesting information to go through, great format and research source or reference.
P Ken Gillman
PsychoTropical research


Serotonin syndrome: history and risk
Authors
PK Gillman
Publication date
1998/9/10
Journal
Fundamental & clinical pharmacology
Volume
12
Issue
5
Pages
482-491
Publisher
Blackwell Publishing Ltd
Description
This review focuses on the history of investigations into the behavioural reaction resulting from excess stimulation of postsynaptic 5‐hydroxytryptamine receptors and the relative risk of this occurring with different combinations of drugs. Other aspects, particularly treatment with 5‐hydroxytryptamine receptor antagonists, are reviewed in a recent separate paper [44]. The first human case was in 1955 and animal work had defined the characteristic features by 1958, and established they were lessened by chlorpromazine. Substantial evidence of a ‘dose‐effect’ relationship existed by 1984. The relative risk with different drug combinations is assessed from available evidence and argued to be strongly associated with the degree of elevation of 5‐hydroxytryptamine, which is greatest following combinations of irreversible inhibitors of monoamine oxidase A and B with potent serotonin reuptake inhibitors. The various …
Total citations
Cited by 180

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Scholar articles
Serotonin syndrome: history and risk
PK Gillman - Fundamental & clinical pharmacology, 1998
Cited by 170 Related articles All 4 versions
The serotonin syndrome*
PK Gillman - N. Engl. J. Med, 2005
Cited by 11 Related articles All 3 versions

^^ oh i couldn't find the Podcast
 
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