Real Milk is Raw Milk

2011 UPDATE - March  Only 2 deaths from raw milk, that was really cheese.  Sounds like Big Dairy is in control of your food choices at CDC.

There's another related number that has been around much longer, and it's this: Between 1998 and 2008, there have been two deaths from raw milk. This number comes up repeatedly in media reporting about raw milk, courtesy of the CDC, even though I have reported that those illnesses appear to have come from queso fresco cheese, a soft fresh cheese that isn't legal under FDA regulations requiring a minimum 60 day aging period.http://www.thecompletepatient.com/journal/2011/2/18/the-power-of-numbers-in-the-war-over-raw-dairy-how-the-cdc-c.html

UPDATE: 21 July 2010  -  War Over Raw Milk
Raw Food Raid

2 June - Remember that when milk began to be homogenized in the 1950s the rate of atherosclerosis started to skyrocket.  What we need is a return to real food, not corporate-dictated processed products.

" Milk from dairy cows that graze on pasture land rather than in feedlots might be healthier for your heart, according to a report in the American Journal of Clinical Nutrition.

Dairy products are the main source of conjugated linoleic acid (CLA), an unsaturated fat that some studies show could protect the heart. Pasture-grazing dairy cows have more CLA in their milk than grain-fed cows, according to the report.

In a study of 3,600 people, the researchers found that people with the highest concentration of CLAs had a 36 percent lower risk of heart attack than people with the lowest CLAs."Read more...

Real Milk Nutrition
 
UPDATE: 24 April, 2010 -  While I am pleased to see this judge ruled with common sense and in keeping with the law I am baffled that the "health blogger" sourced in these articles failed to refer to Dr. Frank McCoy in regard to natural healing with food, especially raw milk.  But them we are in the superficial zone these days as far as source material, too bad.

Judge sides with activist in raw milk dispute

Feds Serve Warrant on Dairy Farmer

UPDATE: 18 April, 2010 - The Raw Milk Debate: Don't Have a Cow, Man
UPDATE 29 March -  FOOD POLICE AT IT AGAIN

FDA Alerts Consumers of Raw Milk Danger, By Cole Petrochko, Staff Writer, MedPage Today, 23 March 09
WASHINGTON -- An outbreak of campylobacteriosis has prompted the FDA and several Midwestern state health agencies to warn consumers against drinking unpasteurized, raw milk.
The Michigan Department of Community Health had received at least 12 confirmed reports of raw milk-related illness as of March, 24, the FDA reported in its announcement of the alert.
Unpasteurized milk may contain a variety of infectious bacteria, such as Salmonella and E. Coli, which can cause illness or death, the agency noted.
Adverse events related to drinking the raw milk include vomiting, diarrhea, abdominal pain, fever, headache, and body ache.
While most healthy patients recover quickly from milk-borne illnesses, the FDA cautioned that severe reactions may occur in some victims, particularly in pregnant women, older patients, infants, younger children, and patients with a weakened immune system.
Although the FDA has required pasteurization of almost all packaged milk products (excluding some aged cheeses) since 1987, dairy disease is still a threat, according to a Dec. 2008 report in Clinical Infectious Diseases that cited an annual average of 5.2 outbreaks per year between 1993 and 2006. (See Raw Milk Remains a Health Threat)
The FDA noted that from 1998 to 2008, 1,614 illnesses and two deaths related to raw milk were reported.
Proponents of unpasteurized milk claim it's more nutritious than treated milk and inherently antimicrobial.
Not so, the FDA asserted.
"There is no meaningful nutritional difference between pasteurized and raw milk, and raw milk does not contain compounds that will kill harmful bacteria," the agency said.
The FDA's investigation into the outbreak is aided by the Michigan Department of Community Health, the Illinois Department of Public Health, the Indiana State Board of Animal Health, and the Indiana State Health Department.© 2004-2010 MedPage Today, LLC. All Rights Reserved.

NB: High Doses of vitamin C have been shown effective in treating food borne illness.  
 

UPDATE: 28 March, 2010 

The Pasteurized Milk Ordinance (PMO) that was first proposed in 1924 by the United States Public Health Service has been adopted, in its 2003 revision, by 46 out of 50 states. (The four non-adopting states have passed similar ordinances of their own.) The PMO calls for the pasteurization of milk as a way of killing any potentially disease-causing bacteria in the milk, including Campylobacter, Escherichia, Listeria, Salmonella, Yersinia, and Brucella. I would also like to note that in 32 states, it is legal to sell and distribute raw, non-pasteurized milk and that both forms of milk exist in the majority of states.
Today there are more pasteurization options in the marketplace than there were in 1924; these options include high-temperature, short-time methods as well as low-temperature, longer time methods. The goal of all methods is the same: to kill potentially pathogenic bacteria that may be present in the milk or milk product (like cheese or yogurt).

Temperature	Time	Pasteurization Type
63ºC (145ºF)*	30 minutes	Vat Pasteurization
72ºC (161ºF)*	15 seconds	High temperature short time Pasteurization (HTST)
89ºC (191ºF)	1.0 second	Ultra Pasteurization (UP)
90ºC (194ºF)	0.5 seconds	Ultra Pasteurization (UP)
94ºC (201ºF)	0.1 seconds	Ultra Pasteurization (UP)
96ºC (204ºF)	0.05 seconds	Ultra Pasteurization (UP)
100ºC (212ºF)	0.01 seconds	Ultra Pasteurization (UP)
138ºC (280ºF)	2.0 seconds	Ultra-high temperature (UHT) sterilization

Note: * = These temperatures and times are appropriate if the milk does not contain added sweeteners, and if it has not been condensed. If either of those changes applies, then the temperature must be increased by 3ºC (5ºF). In addition, eggnog is an exception to these rules and must be pasteurized according to a different set of times and temperatures.
There's no debate about the effectiveness of pasteurization for killing unwanted bacteria. There's also no doubt that pasteurization gives dairy products a longer shelf life by lowering the presence of bacteria that cause spoilage. But pasteurization also kills desirable bacteria found in fresh milk, and it denatures milk enzymes that may be active in the human digestive tract when fresh milk is consumed.
There is little research, however, to determine what nutritional benefits are lost when milk is pasteurized. I've seen speculation about changes in protein structure, calcium, amino acid, and vitamin C bioavailability all being triggered by pasteurization, but I have not seen research that confirms or rejects these occurrences.
As I mentioned earlier, in the majority of states, dairy farms are free to produce raw (unpasteurized) milk as long as they adhere to the conditions and restrictions set out in state law. The safety of unpasteurized milk depends on the quality of the cow's life,
including the immediate environment and feeding. It also depends on the quality of handling facilities once the cow has been milked. For these reasons, I recommend a very careful look at any dairy farm's procedures, track record, and publicly available information before becoming a regular consumer of its unpasteurized milk. Producers of raw milk should be carefully monitoring the milk for the presence of microorganisms and will be able to certify that the milk meets all federal and state regulations in this regard.
Because freshness is at a premium, and the product shelf life is greatly shortened (which is not necessarily bad) the dairy should be within driving distance of your residence so you can visit it in person. In some states, like Indiana, where it is illegal for a local dairy to sell unpasteurized milk, cows from the dairy may be leased in order for consumers to obtain a regular supply of raw milk.
In the absence of a very high-quality dairy farm in driving distance from your residence, I recommend purchase of pasteurized milk. Even though it's one step further from natural milk (which I would prefer), the health risks-however small-don't seem like a worthwhile trade-off in exchange for the potential benefits. If a high quality dairy farm, producing certified organic milk in unpasteurized form is available in your area, I would recommend considering this option. Courtesy: WHFOODS.ORG

Original Post 23 March 2009 :
A few years ago I was able to get some delicious raw milk from a cow down the road. I loved it each time I received my big glass gallon jar of this liquid. It brought back memories when I saw the rich, uncooked, deep yellow cream floating on top.

Some years ago I drove down the big long hill from my home back then and stopped at the Wagon Wheel to buy raw milk.

Before that I drove out to Willapa Valley for fresh liquid delight from Verna Kuttle's cows.

Before Washington, when my children were quite young, I walked next door to the farm each afternoon at milking time and drew a gallon of freshly collected raw milk from the big stainless steel cooler.

And even before that, as a small child I recall in delight on a day out at the farm, getting fresh creamy milk, still warm from the cow.

I am happy to say that my children probably had more raw, uncooked and non-homogenized milk than I did. None of us are the worse for it.

Sadly over the years Washington has been under the Olympia gestapo for any effort to have access to raw milk.

For year's you had to find a farmer to sell it too you and even then it was only sold as "pet" milk. I'm glad I had pets.

It's just the insanity of lack of knowledge that government workers seem to fall into, lock step.

No one dare ask if it might be good for you.

Funny too because one of the very first books I had when I was studying naturopathy in the 1960s had pages of treatments based on consuming raw milk.

Maybe times are changing.

Got Raw Milk?By Jennifer Adler M.S., C.N.

Welcome to the largest underground food revolution—the raw milk movement. As a nutritionist I have been a part of this underground movement since 1999 and have been amazed at how this creamy-colored substance has brought together Republicans and Democrats, as well as liberals and fundamental Christians—all for a common cause. Who knew that milk, that stuff that you put on your cereal, could have such power?

Since ancient times, an exclusive raw-milk diet has been used to cure many diseases. In the early 1900s, the “Milk Cure” was used at the Mayo clinic to successfully treat cancer, weight loss, kidney disease, allergies, skin problems, urinary tract problems, prostate problems, chronic fatigue and many other chronic conditions. However, after 1947, raw milk became very difficult to obtain due to pasteurization laws.

Pasteurization, heating foods to a minimum of 161.5∝F and holding that temperature for at least fifteen seconds, is done to kill bacteria. Currently, many raw foods are viewed as dangerous and laws enacted in the name of public health and safety require more foods to be sterilized by pasteurization. Pasteurization was implemented in the 1920s to combat tuberculosis, infant diarrhea and other diseases caused by poor animal nutrition and dirty production methods. However, refrigerated trucks, stainless steel tanks, milking machines and inspection methods make pasteurization unnecessary for today’s world. As Sally Fallon states in Nourishing Traditions, pasteurization destroys the enzymes needed to digest dairy and diminishes vitamin content, denatures fragile milk proteins, destroys vitamins C, B12 and B6, and kills beneficial bacteria. Pasteurized milk can promote pathogens because the beneficial bacteria naturally found in milk provide protection against invading pathogens. When milk is pasteurized, the protective bacteria is destroyed.

What is happening locally?

In Washington, due in a large part to the efforts of local activist, Emmy McAllister, raw milk sales are legal on the farm, through home delivery and retail stores, if local health ordinances permit. So take advantage of being one of only eleven states that allow raw milk to be sold retail, taste the magic and feel the difference for yourself.

Mark McAfee, owner of Organic Pastures, the largest raw dairy in the United States, boasts about his company’s safety record. McAfee has inoculated pathogenic contaminants such as E. coli 0157:H7, Listeria and Salmonella into his raw milk and pasteurized milk. In the raw milk, none of the pathogens survive because the natural bacteria protect the milk. In the pasteurized milk, in which the bacteria and enzymes have been destroyed, the pathogens take over. Even Louis Pasteur, the man credited with inventing pasteurization, in his later years stated that pasteurization was not the panacea once touted. In addition, raw milk never goes rancid, it just changes from milk to curds and whey and so on. Pasteurized milk goes dangerously rancid without refrigeration.

Is raw milk dangerous? It can be. Food can be the perfect vehicle for pathogens and disease. However, the reason pathogens in food are so prevalent may have more to do with factory farming and industrial food. Raw milk is not inherently dangerous. As Sandor Ellix Katz puts it in his book The Revolution will not be Microwaved, food is most often contaminated in the course of its processing, handling and storage, or as a result of diseased animals. Healthy plants and animals produce safe, healthy food worthy of a revolution.

Why has raw milk become such a huge health movement? The reasons range from culinary to health to political. On the health side, I have seen numerous incidences of people with dairy sensitivities finding themselves able to consume raw dairy without problems. Raw dairy contains the enzymes necessary for digestion; amazing how brilliant nature is. On the culinary side, raw milk tastes like real milk: delicious, creamy and satisfying on a core level. I have gone to great lengths over the years to procure raw dairy because once exposed the real stuff, I can’t go back. Politically, I along with many other activists, use my dollar to vote for the world I want to see. My vision is a land that promotes sustainable, small-scale farms with healthy, happy animals grazing freely on the grass they were meant to eat. Where I can go to a farmer I know by name to pick up my milk, along with other culinary delights. Where I can compare the milk from Iris to the milk that Lupita provides to see which suits my palate. Pasteurization laws conveniently put milk in the hands of large, industrialized, faceless, dairy operations that provide less than excellent living accommodations for their four-legged inhabitants.

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Posted in: 2009,Dr Frank McCoy,health,Mayo Clinic,milk cure,natural health news,nutriton,raw milk

No Difference in Psych Drugs for Depression

SSRI group of anti-depressant pharmaceuticals have been problematic ever since Prozac was introduced some decades ago. The list of side effects and untoward behavior related to fluoride containing drugs also creates other concerns.

If it all boils down to looking at the issues of side effects, cost and response then I would suggest that better evaluation of the person's state of general health, especially endocrine health, and nutritional status be addressed before prescribing any of these drugs.

For example, I learned that a friend was taking Chantix in an effort to stop smoking. My knowledge of this person's situation is that he was smoking to cover up a deep seated emotionally painful life event.

After he started on Chantix, and while he was taking endocrine system altering drugs for prostate cancer, he became depressed.

He was just written an Rx for Lexapro, however, no effort was taken to evaluate his history and symptoms or look at drug side effects and related issues.

I can't quite get the current ethic to overlook this basic health care function, but perhaps it is why I gave up on my work in mainstream medicine 15 years ago after I was attacked by a young girl taking Zoloft, and seriously injured.

Internist Group Finds No Efficacy Difference Among Modern Antidepressants
By John Gever, Senior Editor, MedPage Today
Published: November 17, 2008

Practice Guidelines


PHILADELPHIA, Nov. 17 -- Second-generation antidepressants all have similar efficacy, so physicians should base their medication choices for depressed patients on side effects, cost, and patient response, according to a new practice guideline from the American College of Physicians.

Clinicians should also begin monitoring patients for adverse effects and clinical response within one to two weeks of starting antidepressant therapy, recommended Amir Qaseem, M.D., Ph.D., M.H.A., of the American College of Physicians, and the other authors of the guideline, published in the Nov. 18 issue of Annals of Internal Medicine.

"The current evidence did not show any clinically significant differences between efficacy, effectiveness, or quality of life between various second-generation antidepressants," said Dr. Qaseem.
Action Points

* Explain to interested patients that a treatment guideline from the American College of Physicians recommends that second-generation antidepressant choices be made on the basis of side effects, cost, and patient preference, since efficacy of these drugs is equivalent.

* Explain that individual patient factors should always guide treatment decisions.

* Note that the guidelines do not address use of older medications that are still available and may be appropriate for some patients.

The findings do not differ markedly from the American Psychiatric Association's current practice guideline on major depressive disorder, last updated in 2005.

"The effectiveness of antidepressant medications is generally comparable between classes and within classes of medications," according to the APA guideline. "Therefore, the initial selection of an antidepressant medication will largely be based on the anticipated side effects, the safety or tolerability of these side effects for individual patients, patient preference, quantity and quality of clinical trial data regarding the medication, and its cost."

The ACP's recommendations were based on a review of more than 200 published studies of a dozen antidepressants, conducted by a separate group of researchers led by Gerald Gartlehner, M.D., of Danube University in Krems, Austria.

Drugs covered in the review included:

* Fluoxetine (Prozac)
* Sertraline (Zoloft)
* Paroxetine (Paxil)
* Bupropion (Wellbutrin)
* Citolapram (Celexa)
* Escitolapram (Lexapro)
* Duloxetine (Cymbalta)
* Fluvoxamine (Luvox)
* Mirtazapine (Remeron)
* Trazodone (Desyrel)
* Nefazodone (Serzone)
* Venlafaxine (Effexor)

The guideline also calls for physicians to modify treatment if patients fail to respond adequately within six to eight weeks.

Drugs that show adequate symptom relief should be maintained for four to nine months after a major depressive episode, or longer in the case of recurrent episodes.

The review and guidelines do not address more traditional medications such as tricyclic antidepressants and monoamine oxidase inhibitors.

Dr. Qaseem and colleagues said these agents are no longer in common use because newer drugs have similar effectiveness with less toxicity.

Among the newer drugs, the review disclosed no efficacy differences among patient subgroups defined by age, sex, race-ethnicity, or comorbid conditions.

A few studies identified certain agents as better than others in patients with other neuropsychiatric symptoms besides depression, such as insomnia or anxiety. But these studies were mostly not of the highest quality, and others found little or no difference.

Those findings stand in contrast to the APA's depression guideline, which suggests that some subgroups may benefit more than others from particular agents, although with no specifics.

The ACP review found relatively few clear differences between second-generation drugs in side effects.

"Most of the second-generation antidepressants had similar adverse events, with some differences in the incidence of specific adverse events," according to the guideline authors.

Nausea and vomiting were more common with venlafaxine than with other agents, they noted, whereas sertraline appeared especially prone to cause diarrhea.

Weight gain was more frequent with mirtazapine and paroxetine, and drowsiness was relatively common with trazodone compared with several other drugs.

Sexual adverse effects were another area where drugs have different profiles.

For example, bupropion was less likely to have sexual adverse effects than fluoxetine and sertraline, whereas paroxetine had relatively high rates.

The ACP review found little difference between agents in suicidality, although non-fatal suicide attempts appeared to be more common with SSRIs (citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, and venlafaxine) than with other drug classes.

Few data were available on other severe adverse effects such as seizures, cardiovascular problems, liver toxicity, hyponatremia, or serotonergic abnormalities, the researchers said.

The guideline graded the evidence and recommendations by using the American College of Physicians clinical practice guidelines grading system.

All four recommendations were considered to be strong with moderate quality evidence.

The American College of Physicians funded the review underlying the recommendations.

Authors of the guideline reported relationships with Atlantic Philanthropies, Novo Nordisk, Boehringer Ingelheim, Sanofi Pasteur, and Endo.

Authors of the literature review reported relationships with GlaxoSmithKline, Pfizer, Wyeth-Ayerst, Shire Pharmaceutical, Phillips Lytle, Bristol-Myers Squibb, Novartis, Robert Wood Johnson Foundation, and M-3 Corporation.

Primary source: Annals of Internal Medicine
Source reference: Qaseem A, et al "Using second-generation antidepressants to treat depressive disorders: a clinical practice guideline from the American College of Physicians" Ann Intern Med 2008; 149: 725-33.

Additional source: Annals of Internal Medicine
Source reference: Gartlehner G, et al "Comparative benefits and harms of second-generation antidepressants: background paper for the American College of Physicians" Ann Intern Med 2008; 149: 734-50.

And as an additional consideration, it has been suggested that more than 85% of physicians are unaware that Serotonin Syndrome even exists.

How Common or Significant Is Serotonin Syndrome?

Joel Lamoure, RPh, BSP, FASCP
Medscape Pharmacists. 11/10/2008 ©2008 Medscape

Question
We are seeing more patients who are taking multiple antidepressants of different classes. All drug interaction programs cite drug-drug interactions leading to the potentially severe toxicity known as serotonin syndrome. Just how common and clinically significant is serotonin syndrome?

Response from Joel Lamoure, RPh, BSP, FASCP
Assistant Professor, Department of Psychiatry, University of Western Ontario, London, Ontario, Canada; Mental Health Pharmacist, London Health Sciences Centre, London, Ontario, Canada

The Toxic Exposure Surveillance System reviewed cases from office-based practices, inpatient settings, and emergency departments and found that during 2004, selective serotonin reuptake inhibitors (SSRIs) caused significant toxic effects in 8187 persons, leading to 103 deaths.[1] The true incidence of serotonin syndrome and associated morbidity are likely to be much greater. This syndrome may be underdiagnosed given the fact that SSRIs are not the only contributing class of agents. Moreover, it has been suggested that more than 85% of physicians are unaware that the syndrome even exists.[2]

Serotonin syndrome is a condition caused most often by the concurrent use of 2 or more agents that enhance synaptic serotonin levels.[3] A triad of clinical changes -- cognitive, neuromuscular, and autonomic -- characterizes this syndrome. Specific changes may include confusion, delirium, agitation, restlessness, muscular spasms, hyperpyrexia, diaphoresis, tachycardia, blood pressure fluctuations, mydriasis, nausea, or diarrhea.[4,5] Symptoms often develop within 2 hours of the increase in the synaptic level of serotonin.[6] The clinician must be proactive to identify the early symptoms, such as cognitive changes, when they occur.

Confusion about symptoms may be responsible for the difficulty in assessing the actual incidence of serotonin syndrome.[2] Agitation, a cardinal symptom of serotonin syndrome, is clinically similar to activation, an adverse effect associated with SSRI use.[7]

Polypharmacy is pandemic, and the incidence of serotonin syndrome may be on the rise. Both drug factors and patient factors can contribute to the toxicity of SSRIs in some individuals. A wide range of medications can increase serotonin levels in the body. When these agents are combined, the risk of serotonin syndrome increases. Drug classes implicated include anti-migraine agents (eg, triptans); antidepressants (eg, SSRIs, serotonin-norepinephrine reuptake inhibitors, buspirone, tricyclic antidepressants, monoamine oxidase inhibitors); antipsychotics; anticonvulsants; anti-Parkinsonian agents; analgesics (eg, meperidine, tramadol); over-the-counter products (eg, medications containing dextromethorphan); herbal products (eg, St. John's Wort); and antibiotics (eg, linezolid).[6,8-14]

Concurrent use of medications that interact with serotonergic drugs through the inhibition of the cytochrome P450 pathway can also contribute to serotonin syndrome.[15] For example, extra caution should be observed if a patient is taking an SSRI in addition to a cytochrome P450 2D6 (CYP2D6) inhibitor because SSRIs are extensively hepatically metabolized by this isozyme.

Susceptibility to the serotonin syndrome can also be conferred by patient factors, such as the capacity to metabolize certain drugs. One of the key enzymes related to adverse drug reactions, the CYP2D6 system, has a high degree of genetic polymorphism.[16] An example of this was reported in a study of 4 elderly patients who ostensibly developed serotonin syndrome as a result of an interaction between tramadol and mirtazapine.[17] The patients had auditory and visual hallucinations, myoclonus, hypertension, and changes in behavior. Tramadol may be subject to genetic polymorphism; about 7% of whites are poor metabolizers of CYP2D6.[18,19] Consequently, these patients would have higher serum levels of tramadol and be at increased risk for serotonin syndrome when a second serotonergic agent is added.[18]

Although rare in monotherapy, serotonin syndrome is more prevalent with polypharmacy, even across medication classes. When a computer flags this interaction, the clinician should consider the whole patient: What medications has the patient taken previously? What adverse reactions have previously been experienced? When making an evidence-based recommendation, it is essential to apply the therapeutic thought process and carry out a sound risk-benefit assessment. Awareness of serotonin syndrome and education about its effects are vital. All of these factors must be considered, lest all the "holes in the Swiss cheese line up" and the patient comes to harm.[20]

The author acknowledges Jessica Stovel, pharmacist, and Katherine Bateman, pharmacy resident at London Health Sciences Centre, for their research and contributions to this article.

References
Watson WA, Litovitz TL, Rodgers GC, et al. 2004 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. 2005;23:589-666. Abstract
Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med. 2005;352:1112-1120. Abstract
Dunkley EJ, Isbister GK, Sibbritt D, Dawson AH, Whyte IM. The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicity. Q J Med. 2003;96:635-642.
Lane R, Baldwin D. Selective serotonin reuptake inhibitor-induced serotonin syndrome: review. J Clin Psychopharmacol. 1997;17:208-221. Abstract
Isbister GK, Bowe SJ, Dawson A, Whyte IM. Relative toxicity of selective serotonin reuptake inhibitors (SSRIs) in overdose. J Toxicol Clin Toxicol. 2004;42:277-285. Abstract
Turner EH, Loftis JM, Blackwell AD. Serotonin a la carte: supplementation with the serotonin precursor 5-hydroxytryptophan. Pharmacol Ther. 2006;109:325-338. Abstract
Vorstman J, Lahuis B, Buitelaar JK. SSRIs associated with behavioral activation and suicidal ideation. (letter) J Am Acad Child Adolesc Psychiatry. 2001; 40:1364-1365.
Mills K. Serotonin syndrome. A clinical update. Crit Care Clin. 1997;13:763-783. Abstract
Mitchell, PB. Drug interactions of clinical significance with selective serotonin reuptake inhibitors. Drug Sa.f 1997;17:390-406.
Egberts AC, ter Borgh J, Brodie-Meijer CC. Serotonin syndrome attributed to tramadol addition to paroxetine therapy. Int Clin Psychopharmacol. 1997;12:181-182. Abstract
Manos G. Possible serotonin syndrome associated with buspirone added to fluoxetine. Ann Pharmacother. 2000;34: 871-874. Abstract
Sclar DA , Robison LM , Skaer TL. Concomitant triptan and SSRI or SNRI use: a risk for serotonin syndrome. Headache. 2008;48:126-129. Abstract
Lavery S, Ravi H, McDaniel WW, Pushkin YR. Linezolid and serotonin syndrome. Psychosomatics. 2001;42:432-434. Abstract
Gardner DM, Lynd LD. Sumatriptan contraindications and the serotonin syndrome. Ann Pharmacother. 1998;32:33-38. Abstract
Looper KJ. Potential medical and surgical complications of serotonergic antidepressant medications. Psychosomatics. 2007;48:1-19. Abstract
Ingelman-Sundberg M, Genetic polymorphisms of cytochrome P450 2D6 (CYP2D6): clinical consequences, evolutionary aspects and functional diversity. Pharmacogenomics J. 2005;5: 6–13.
Gnanadesigan N, Espinoza RT, Smith R, Israel M, Reuben DB. Interaction of serotonergic antidepressants and opiod analgesics: Is serotonin syndrome going undetected? J Am Med Dir Assoc. 2005;6:265-269.
Gan SH, Ismail R, Wan Adnan WA, Wan Z. Correlation of tramadol pharmacokinetics and CYP2D6*10 genotype in Malaysian subjects. J Pharm Biomed Anal. 2002;30:189-195. Abstract
Enggaard TP, Poulsen L, Arendt-Nielsen L, Brosen K, Ossig J, Sindrup SH. The analgesic effect of tramadol after intravenous injection in healthy volunteers in relation to CYP2D6. Anesth Analg. 2006;102:146-150. Abstract
Reason J. Human error: models and management. BMJ. 2000;320:768-770. Abstract

Suggested Readings: Evans RW. The FDA alert on serotonin syndrome with combined use of SSRIs or SNRIs and triptans: an analysis of the 29 case reports. Medscape General Medicine. 2007;9:48. Available at: http://www.medscape.com/viewarticle/561741 Accessed October 31, 2008.

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Posted in: depression,endocrine issues,health news,natural health news,natural news,nutriton,SSRI