![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1048 to 1072 of 8406. Go back in thread:
Posted by wharfrat on October 29, 2002, at 9:55:20
In reply to Anyone switched to Lexapro? « ggrrl, posted by Dr. Bob on June 11, 2002, at 7:52:48
Is anyone out there taking lexapro for general anxiety disorder?
Posted by bridgette on October 29, 2002, at 10:52:39
In reply to Re: Citalopram pharmacology » Malcolm, posted by dr. dave on October 29, 2002, at 5:11:46
any better than a placebo? Is that what the study says? But, don't they say that about all SSRI's. That they all have a placebo effect. I read that in a study that was in all the newspapers in July.
Posted by Erin on October 29, 2002, at 11:53:40
In reply to Re: Anyone taking lexapro for GAD?, posted by wharfrat on October 29, 2002, at 9:55:20
> Is anyone out there taking lexapro for general anxiety disorder?
I have been taking Lexapro for about 3-4 weeks for major depression and general anxiety disorder. It has been a god-send for me as I do not experience the level of anxiety I once did. This is not to say that there is no anxiety at all, I do experience the normal anxiety. New places, people and things, changes in my life give me a greater level of anxiety but this is true for most people. I will continue my journey with Lexapro and pray that it will help me down the road in recovery.
Posted by johnj on October 29, 2002, at 17:15:50
In reply to Re: Citalopram pharmacology (nm), posted by Malcolm on October 29, 2002, at 14:51:32
Hello,
Does it sound strange to start off with a low dose? I was told to start with 5 mg, but was thinking I would rather start with half that. I am med sensitive and thought that may be better. Anybody with experience out there? Someone mentioned that at low does, Celexa, gave vivid dreams. I didn't know if it is ok to start slow and move up slowly. Thanks
johnj
Posted by chad_3 on October 29, 2002, at 23:21:20
In reply to Re: Doesn't anyone like Lexapro, posted by shakingoscar on October 29, 2002, at 5:18:06
Hi ShakingOscar
I admit your name caught my attention which is why I read your post - I have read almost nothing on this new SSRI except that I heard it blocks 5ht-2 and 5ht-3 somewhat (aka: Remeron) - but has little to no norephinephine effect (kinda like Serzone - except Serzone does have mild NE effects)
Well except that Lexapro supposedly blocks part of 5ht-3, and based on effects on depression (weak effect - sometimes anxiety or tension , etc) - these comments remind me of Serzone - which sounds to me like they are both similar pharacological profiles.
Serzone is now used probably more to augment that anything - as an axiolytic, or to reduce some SSRI sexual side effects since it partially blocks serotonin.
Anyway - long story short - this Lexapro sounds to me more like an augmenting agent than a standalone antidepressant - but I'm just taking a wild guess here on the little bit I've heard.
Chad
> I gave it ten weeks for the lexapro to work after being on 60mg celexa for nearly a year. I really wish I hadnt switched - the full ten weeks I was up and down like a yoyo and unfortunately, mostly very down and anxious and VERY TENSE.
>
> Lexapro? never again!
Posted by dr. dave on October 30, 2002, at 6:20:32
In reply to Lexapro doesn't work???, posted by bridgette on October 29, 2002, at 10:52:39
> any better than a placebo? Is that what the study says? But, don't they say that about all SSRI's. That they all have a placebo effect. I read that in a study that was in all the newspapers in July.
Different studies give you a range of different results, which shows you the dangers of seeing the result of a single trial as 'scientific proof' of anything. Some show greater efficacy, some don't. I think the truth is that Lexapro is more effective than placebo, particularly for more severe depression, but the increase in effectiveness over placebo is such that you can't detect it in some trials.
It's also worth remembering that these trials show averages for a big group of people, and that for an individual the benefit over placebo might be much bigger than the average difference. But then again, sometimes there will be zero advantage.
Posted by Phyl on October 30, 2002, at 6:40:12
In reply to Starting an SSRI Question(lexapro), posted by johnj on October 29, 2002, at 17:15:50
I was told to start with 10 mg of Lexapro but cut it in half. I have been taking 5 for almost four weeks. I notice little difference during the daytime, but am always ready to go to sleep at about 7:00 p.m. I usually sleep for 4-5 hours and then take a Lorezepam to get through to the morning. I think I was prescribed Lexapro for a specific phobia (driving on highways); so far, I'm still afraid to drive, so am not sure what it is doing for me. I go see my internist this morning to clarify a few things. Originally he put me on Trazodone for insomnia but that did a real job on me and I was taken off of it immediately. I think I will stay on 5 mg. I, too, am very sensitive to meds. Good luck!
Posted by SLS on October 30, 2002, at 7:26:31
In reply to Citalopram pharmacology, posted by dr. dave on August 20, 2002, at 15:22:46
> The statement '10mg Lex is 40mg Celexa' doesn't make any sense.
I'm not sure if this refers to my post along another thread, but what I meant by Celexa 60mg = Lexapro 10mg is that they seem to be relatively equivalent therapeutic dosages. This is based upon my memory of the earliest personal anecdotal reports posted by people on PB. Since writing that, I think it looks more like Celexa 60mg = Lexapro 20mg. This is nothing more than my gross observations that I haven't documented. However, this in no way a statement of relative efficacy. Celexa 60mg might be less effective than Lexapro 20mg.> Let's get down to the science here - '10mg lex' is 10mg of s-citalopram. '40mg Celexa' is 20mg s-citalopram plus 20mg r-citalopram. That's different.
Celexa and Lexapro are different. Period.
http://www.dr-bob.org/babble/20021006/msgs/123211.html
http://www.dr-bob.org/babble/20020906/msgs/119448.html
Do you feel you know enough about the brain, physiology, organic chemistry, and the pharmacology of these two drugs to state anything about getting down to science? I admit that I don't (not such a revelation). I just like doing thought experiments - you know - theory. My theories are constructed with great care but with insufficient knowledge for them to be worth a damn.
> A study has been presented claiming 10mg Lexapro is as effective as 40mg Celexa - but Jack Gorman in his meta-analysis of the research states that this study was too small to demonstrate differences in efficacy. The result of one small trial is not necessarily the complete and absolute truth.
I think that empirical observation is essential to help validate the musings of theoreticians.
- Scott
Posted by Amberlin on October 30, 2002, at 9:42:53
In reply to Anyone switched to Lexapro? « ggrrl, posted by Dr. Bob on June 11, 2002, at 7:52:48
Just switched today.
No side effects, of course I didn't think I would experience any. I had been on Effexor for two years previously, went to Celexa for a month, and now on Lexapro. I feel like a guinea pig.But I'll remain positive and hope that Lexapro works.
Posted by dr. justin on October 30, 2002, at 19:34:27
In reply to Anyone switched to Lexapro? « ggrrl, posted by Dr. Bob on June 11, 2002, at 7:52:48
I hope to switch to Lexapro shortly; my physiatrist, whom I am fortunate to have, is the head of my alma mata's psychiatry department and has never steered me wrong (please don't interpret that to mean I haven't had to ride the medicine merry-go-round, I just think my ride may have been shorter because of his talent). He has recommended to me that I shift from Celexa to Lexapro. I'll come back and post with the differences a month or so after I make the switch.
Also, since others have, I wanted to share the combo that really worked for me, for those of you that are just starting your battle. No one falls into any of the seemingly arbitrary categories for these illnesses, but if I was to describe my problem, it would be as follows: Imagine a triangle. Each of the three points are labeled "Depression", "Anxiety", and "OCD." A point describing my condition is in the triangle, and the closer it is to a tip, the more of that condition I experience. My illness "floats" inside this triangle, occasionally drifting closer to one point than the other two, but always on the move. Very hard to combat. If this sounds familiar, I really have had it under control the past 3 years with this “recipe”:
150 mg Wellbutrin SR 2x/day
40 mg Celexa in the morning
4 mg Klonopin in the eveningI hope you all get feeling better; hang in there!
Posted by sjl on October 30, 2002, at 21:10:02
In reply to Anyone switched to Lexapro? « ggrrl, posted by Dr. Bob on June 11, 2002, at 7:52:48
Hi,
I just started on lexapro(10mg) for anxiety and I've gotten some strange side-effects. About 2 hours after I take it, I start twitching, yawning, and feeling like I need to flex my muscles. My jaw also starts to shake a bit. Anyone else get effects like this? Is this normal?Thanks,
sjl
Posted by dr. justin on October 30, 2002, at 22:37:26
In reply to Just started on lexapro...., posted by sjl on October 30, 2002, at 21:10:02
sjl,
I can't comment on Lexapro yet, but I've been taking its "Father", Celexa, for a couple of years now. When I first started taking it, I can clearly remember experiencing facial twitching. Occasionally, the twitching would occur across my back or in my legs. I believe it was somewhat similar to what you described is happening to you. It eventually went away, but when I increased from 20 mg to 40 mg (roughly, the Lexapro 10 mg equivalent) the twitching came back very strong. After 2-3 weeks, it faded again for me. If it really starts to bother you, I'd recommend notifying your physician, but if you're just nervous that you're having some bizarre side-effect, I wouldn't sweat it. Lexapro claims it eliminates or diminishes some of Celexa's uncomfortable side-effects; I guess the twitching isn't one of them. Take care.
~ Justin
Posted by ANXIETY ANN on October 30, 2002, at 22:47:47
In reply to Just started on lexapro...., posted by sjl on October 30, 2002, at 21:10:02
> Hi,
> I just started on lexapro(10mg) for anxiety and I've gotten some strange side-effects. About 2 hours after I take it, I start twitching, yawning, and feeling like I need to flex my muscles. My jaw also starts to shake a bit. Anyone else get effects like this? Is this normal?
>
> Thanks,
> sjl
Sj1,
when I first started taking Lexapro (10mg) I had terrible jaw and back of the neck/head pain. This lasted for about a week. I've been taking Lexapro now for almost a month and the neck and head pain is gone. Sometimes I notice that my jaw is tense but nothing like it was in the beginning. If you haven't been on Lexapro for long, I'd give it a little more time.
Good Luck, Ann
Posted by ANXIETY ANN on October 30, 2002, at 22:54:39
In reply to Re: Anyone switched to Lexapro? My recipe » Dr. Bob, posted by dr. justin on October 30, 2002, at 19:34:27
> I hope to switch to Lexapro shortly; my physiatrist, whom I am fortunate to have, is the head of my alma mata's psychiatry department and has never steered me wrong (please don't interpret that to mean I haven't had to ride the medicine merry-go-round, I just think my ride may have been shorter because of his talent). He has recommended to me that I shift from Celexa to Lexapro. I'll come back and post with the differences a month or so after I make the switch.
>
> Also, since others have, I wanted to share the combo that really worked for me, for those of you that are just starting your battle. No one falls into any of the seemingly arbitrary categories for these illnesses, but if I was to describe my problem, it would be as follows: Imagine a triangle. Each of the three points are labeled "Depression", "Anxiety", and "OCD." A point describing my condition is in the triangle, and the closer it is to a tip, the more of that condition I experience. My illness "floats" inside this triangle, occasionally drifting closer to one point than the other two, but always on the move. Very hard to combat. If this sounds familiar, I really have had it under control the past 3 years with this “recipe”:
>
> 150 mg Wellbutrin SR 2x/day
> 40 mg Celexa in the morning
> 4 mg Klonopin in the evening
>
> I hope you all get feeling better; hang in there!Hi,
I was wondering how you like the Wellbutrin SR? Does it have alot of side effects when you first start taking it? My doc told me that he may put me on Wellbutrin as well as Lexapro. My main problem is generalized anxiety and panic attacks. Any advice?
Posted by dr. justin on October 30, 2002, at 23:56:52
In reply to Re: Anyone switched to Lexapro? My recipe, posted by ANXIETY ANN on October 30, 2002, at 22:54:39
A. Ann,
The Wellbutrin SR has been my rock. The SSRI's have changed over time, as well as the CNS depressants, but good ol' Wellbutrin SR has always been there for me, and always worked. Not so much on its own; it seems to function as an "enhancer" to the other medications I'm on, but in a pinch (i.e., your SSRI starts to give you intolerable side-effects and you need to stop it ASAP) the Wellbutrin SR will hold you over for a while. I can't say enough nice things about it.
However, there is a reason I keep adding the "SR" after Wellbutrin. Until recently, I had lousy health insurance that didn't cover these meds at all. My psychiatrist recommended we use regular Wellbutrin, as it was much cheaper. Well, it was too intense for me-- it gave me panic attacks! This was strange, because I’d never had any type of anxiety-related problem with the sustained-release form.
I also suffer mainly from GAD and panic attacks. Wellbutrin SR has always served me well, and has been the only medication that has remained a constant in my five years of treatment. My only other piece of advice is to watch the dosage-- it was such a good thing I wanted to try 450 mg/day as opposed to 300. The stronger dose made it far less effective. I've found 150 mg when I wake and 150 mg at dinner time does the job. I hope it does for you too. Good luck!
~ Justin
Posted by dr. dave on October 31, 2002, at 8:26:26
In reply to Re: Citalopram pharmacology » dr. dave, posted by SLS on October 30, 2002, at 7:26:31
Dear Scott,
> Do you feel you know enough about the brain, physiology, organic chemistry, and the pharmacology of these two drugs to state anything about getting down to science? I admit that I don't (not such a revelation). I just like doing thought experiments - you know - theory. My theories are constructed with great care but with insufficient knowledge for them to be worth a damn.I'm sorry if anything I've said seems arrogant. The main point I've been trying to make on this board is that claims are being made on very weak evidence about this drug, and there is no clear reason why, pharmacologically, the claims would be true - by which I mean there's no plausible mechanism of action (for any superiority over citalopram) that's been substantiated at all.
I feel qualified to comment on the science as it's what I've been educated in for many years, and it's my job to have an understanding of it - but I'm only commenting, which is not to say I don't get things wrong sometimes.
I couldn't agree more that what matters is what happens in real life, whatever the theories. Obviously Lexapro helps a lot of people and I'm not sure I have ever suggested otherwise. Whether it turns out to be significantly different from Celexa time will tell.
David
Posted by fiddlepuppy on October 31, 2002, at 17:54:02
In reply to Re: Citalopram pharmacology » SLS, posted by dr. dave on October 31, 2002, at 8:26:26
Lexapro at even 5 mg has made my anxiety, restlessness and agitation intolerable. I have been on it for 4 weeks. I am begging my doc to take me off it now.
Posted by SLS on October 31, 2002, at 19:57:13
In reply to Re: Citalopram pharmacology » SLS, posted by dr. dave on October 31, 2002, at 8:26:26
Hi, Dr. Dave.
> > Do you feel you know enough about the brain, physiology, organic chemistry, and the pharmacology of these two drugs to state anything about getting down to science? I admit that I don't (not such a revelation). I just like doing thought experiments - you know - theory. My theories are constructed with great care but with insufficient knowledge for them to be worth a damn.
> The main point I've been trying to make on this board is that claims are being made on very weak evidence about this drug,
I haven't been following the posts closely enough. What are the claims being made? What evidence has been offered to cooraborate these claims? Thanks.
> by which I mean there's no plausible mechanism of action (for any superiority over citalopram) that's been substantiated at all.
How would you critique my hypothesis regarding antagonistic stereochemisty between the enantiomers? How might this relationship be viewed with respect to the actions of partial agonists at neurotransmitter receptors?
> I feel qualified to comment on the science as it's what I've been educated in for many years, and it's my job to have an understanding of it - but I'm only commenting, which is not to say I don't get things wrong sometimes.
What is your background, and how are you applying it today?
I wish I had more. I might be able to help figure out this MF.
Be well.
Sincerely,
Scott
Posted by grace on October 31, 2002, at 21:53:08
In reply to Re: Anyone taking lexapro for GAD?, posted by wharfrat on October 29, 2002, at 9:55:20
> Is anyone out there taking lexapro for general anxiety disorder?
I am diagnosed with anxiety disorder & panic attacks, which I guess is pretty close to GAD. I was recently switched from Celexa to Lexapro due to the side effects I've had on Celexa. So far (week 3) I feel GREAT...actually really great except that I'm still really tired all the time, which was part of my prob with Celexa. Sexual side effects are another prob, but that's another story. A lot of the drugs that are prescribed for depression seem to have a lot of anti-anxiety properties as well and usually are pretty effective. Celexa has worked for me, as has Serzone and now Lexapro. I also take .5mg of Klonopin twice a day. Good luck!
Posted by Jaycee on November 1, 2002, at 6:23:18
In reply to Anyone switched to Lexapro? « ggrrl, posted by Dr. Bob on June 11, 2002, at 7:52:48
5 weeks now on lex, increased sex drive, very very weird dreams, less headaches, have dizzy feeling in the morning which is relieved by 2 ibuprofen (can't figure that one out), seems to wear off around 7pm, start feeling slight anxiety. Eating like crazy..crave carbs/sweets, gained 4 lbs in 5 weeks. See doc on monday, will evaluate then.
Posted by maririp on November 1, 2002, at 7:11:06
In reply to 5 weeks lexapro, posted by Jaycee on November 1, 2002, at 6:23:18
> 5 weeks now on lex, increased sex drive, very very weird dreams, less headaches, have dizzy feeling in the morning which is relieved by 2 ibuprofen (can't figure that one out), seems to wear off around 7pm, start feeling slight anxiety. Eating like crazy..crave carbs/sweets, gained 4 lbs in 5 weeks. See doc on monday, will evaluate then.
I have been on lexapro 2 months. My sex drive is good but no orgasms..My appetite is better and I do crave sweets more but I dont find myself eating 24/7 like I did with other antidpressants. I felt dizzy and zoned out only the first few days..Iam not noticing any real bad side effects and I feel great. Mari
Posted by dr. dave on November 1, 2002, at 7:11:50
In reply to Re: Citalopram pharmacology » dr. dave, posted by SLS on October 31, 2002, at 19:57:13
Dear Scott,
> > The main point I've been trying to make on this board is that claims are being made on very weak evidence about this drug,
>
> I haven't been following the posts closely enough. What are the claims being made? What evidence has been offered to cooraborate these claims? Thanks.
The basic claim is that it is significantly different from Celexa in terms of side-effects and efficacy. I'm not sure there's been any particular evidence cited to support the idea that it has fewer side-effects, it's just one of those things that is claimed and then gets repeated and repeated. The evidence from the three trials from the initial development programme that Forest and Lundbeck ran clearly show there is no significant difference. I've quoted the figures in a previous post.In terms of efficacy, the main evidence cited is a meta-analysis of the three initial trials that compared citalopram and escitalopram. On the outcome measure that was defined at the outset of the trials, there was no significant difference. By analysing the data differently they have come up with some results which show a marginal but statistically significant difference in favour of escitalopram. I am highly skeptical of the clinical significance of this result, given that it is in the context of so many other results which show no difference, and the small magnitude of the difference.
> How would you critique my hypothesis regarding antagonistic stereochemisty between the enantiomers? How might this relationship be viewed with respect to the actions of partial agonists at neurotransmitter receptors?The affinity of r-citalopram for the serotonin re-uptake transporter is much much less than that of s-citalopram, by an order of about thirty times. There is therefore little chance of significant competition. The r-citalopram molecules have just too weak an affinity for the transporter to stop the s-citalopram molecules muscling in.
> > I feel qualified to comment on the science as it's what I've been educated in for many years, and it's my job to have an understanding of it - but I'm only commenting, which is not to say I don't get things wrong sometimes.
>
> What is your background, and how are you applying it today?
>
I studied natural sciences and medical science at Cambridge University in the UK, and I'm now a practicing psychiatrist.David
Posted by wharfrat on November 1, 2002, at 9:35:05
In reply to Re: Week 5 » wharfrat, posted by ANXIETY ANN on October 28, 2002, at 14:39:17
> > Ann,
> > Thanks for the support. Lexapro is the first antidepressant I've ever taken and I'm on other meds. I'm a 41 year old male. My new doctor (Family Physician)Is trying them on me. After other Doc's have told me over the past five or six years that there's nothing wrong with me I'm just to uptight, need to relax and not let things bother me. Easy for them to say! My new Doc thinks from talking with him, that I have a case of mild depression (mild?). Looking at some web sites I think I might have general anxiety disorder. 9 out of 10 symptoms are me. Worry about everything, insomnia, weight loss, anxiety, restlessness, irritabilty and so on. And this is nothing new. My wife told me the other day that I'm reminding her of how I was when we met 18 years ago, Happy, funny, less irritable, angry etc. But I think I've had a problem since I was a kid and it's just gotten worse. Actually I think it's inherited. My Mom took valium for years and my Dad was such an ill tempered tyrant, that my sister got married just to get away & I could'nt hardly stay through High School. Dad got on Paxil a couple of years ago but I don't think he takes them like he should. He's happy on them and meaner than hell off them. Anyway, that's my story and I don't intend to stop Lexapro or missing a dose. Don't want to take a chance of slipping back to the oldself. Myself and my family don't like him.
>
> Hi I can totally relate to your story. I was given Lexapro for extreme anxiety that started as a child. I started having full blown panic attacks in 1996 I too saw several docs who told me I needed to calm down (they should have a panic attack before they pretend to know what their talking about) I was put on xanax and was on that for 4 years but it didn't get rid of the generalized anxiety just the acute panic attacks. I am still in counseling and I take adivan for anxiety at least until I get adjusted to Lexapro. Anxiety does run in families my grandmother father and aunt all suffer from anxiety disorder. If your anxiety does not get better I would talk to your doc about maybe taking adivan to get you through. It soulds almost like what happened in the garage with the kids was the start of a panic attack. Did you feel like you had trouble breating , real nervous and dizzy ? Felt like you had to get out of there fast? All classic signs of panic. Talk to your doc if you like him or find on that specialzes in Anxiety and Depression. Good luck Ann
>
Ann, may have had small panic attacks and not really known what was going, the garage thing was probably a small one but Tues. at work, I'm working along minding my own business and suddenly start having butterflies in the stomach, dizzy,feel like I'm smothering and an urgent need to get away. I just left work without saying a word to anyone and it took about 45 min before it went away. Saw Doc Wed. he said definite panic attack, prescribed xanax,gave me 6 months scrip for lexapro (since It's working well for me) and sent me on my way. I wonder though if the Lex intensified the panic attack. I mean, it was a bad one. What do you think?
Posted by wharfrat on November 1, 2002, at 10:05:26
In reply to Re: 5 weeks lexapro, posted by maririp on November 1, 2002, at 7:11:06
> > 5 weeks now on lex, increased sex drive, very very weird dreams, less headaches, have dizzy feeling in the morning which is relieved by 2 ibuprofen (can't figure that one out), seems to wear off around 7pm, start feeling slight anxiety. Eating like crazy..crave carbs/sweets, gained 4 lbs in 5 weeks. See doc on monday, will evaluate then.
>
> I have been on lexapro 2 months. My sex drive is good but no orgasms..My appetite is better and I do crave sweets more but I dont find myself eating 24/7 like I did with other antidpressants. I felt dizzy and zoned out only the first few days..Iam not noticing any real bad side effects and I feel great. MariI know what Ya'll mean about the sweets. Reese's stocks should be going up. Plowed thru my kid's halloween candy after he went to bed (I ought to be ashamed! NOT!!)Never been a big guy, around 140 LBs. forever. Gained 5 in 5 weeks. Never really cared for candy before either. Sex drive of an 18 year old, but it's always been that way. Got to really relax to "complete the mission" wink, wink. Otherwise feeling great. Headaches went away after about a week. Did I say I'm feeling really great? This reality has woken me up to the fact that my job really sucks!! But I could care less - Wharf
Posted by Dkk1040 on November 1, 2002, at 11:27:05
In reply to Anyone switched to Lexapro? « ggrrl, posted by Dr. Bob on June 11, 2002, at 7:52:48
> [Posted by ggrrl on June 11, 2002, at 1:19:51]
>
> > Seems like there are a lot of people on here who have talked about Lexapro's improved side-effects, specifically that it has less tiredness and sexual side effects than Celexa. Some have said that it has the same side effects as Celexa. However most people are quoting from press releases - does anyone here know from experience (theirs or others')?
>
>I've switched to Lexapro from two years on Celexa. Celexa gave me dry mouth and headaches Lexapro does not! I am very very grateful for Lexapro and wouldn't want to live life without it.
To the people that post on the board, a question.... What is your life like without this drug, is it better or worse? Some of the SE I'd rather live with than live life without the replacement of the brain chemical I lack, namely seratonin. Of all the side effects people state on this board MOST are treatable, tolerable, and improve over time. Give it a chance! Some take weeks to months, NOT just one dosage, or a day, or a week. This is not a "make me feel better now" drug. Best wishes to everyone, and if this drug does NOT work for you please don't give up hope, but be persistent and try something else.
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.