Although he was opposed to the war in Viet Nam buy atrovent 20mcg mastercard, his low number in the draft lottery convinced him to join the Air Force rather that be drafted into the army buy 20mcg atrovent otc. Robert was commissioned as an Air force officer on the same day he received his Bachelor of Arts degree in Political Science purchase atrovent 20 mcg with mastercard. He entered Air Force pilots training and was flying solo in jet aircraft before being medically eliminated because of allergies. He was then assigned to an Intelligence wing where he held one of the highest security clearances available. After receiving an early discharge because of the de-escalation in Viet Nam, he entered graduate school. He got involved with the American Indian Movement in the spring of 1973 during their occupation of the village of Wounded Knee in South Dakota. He left graduate school and went to South Dakota to fly an air drop of supplies but the siege ended a few days after his arrival. He remained actively involved with AIM for the rest of that year and had an extensive FBI file compiled on him for his active participation in revolutionary activities against the government. During this time more than a dozen of the people he was closely involved with were killed or went to prison. It was only through divine intervention on several occasions that he survived to return to graduate school. He completed his Masters Degree and was then hired by the U. Civil Service as a Race Relations Orientations Specialist at Edwards Air Force Base in California (a little cosmic irony here. A brief sojourn in England rekindled his love of theater and he moved to Hollywood to pursue an acting career. Over the course of more than a decade pursuing an acting career, he got very few parts of any consequence but was able to play out fully the role of the suffering artist, a perfect expression for his own particular brand of Codependence which also gave ample opportunity for him to fully pursue personal research in the area of substance abuse. He played the role to the hilt in all areas of his life including earning a living by parking cars, driving cabs, and waiting tables. Acting provided an invaluable emotional outlet to explore and express feelings that would otherwise have been unacceptable according to his childhood training and experiences. The personal research of substance abuse almost killed him. Robert was introduced to Twelve Step programs through an intervention by his family on a trip home for the holidays. He started his Twelve Step Recovery in January of 1984 and remained in Nebraska for nine months. During this time he worked first in the family care section of the treatment program which he had gone through and then at a state mental hospital where he started to again utilize his training and skills in communication and counseling. He returned to Hollywood in the fall of 1984 convinced that his new found Spiritual path would facilitate his quest for an Oscar nomination. When that did not materialize in short order, he fled to South Lake Tahoe and went to work in the poker room at a casino. The Universe however had other plans for him and ended his career at the casino so that he could go to work for the Alcoholism Council of the Sierra Nevada. It was there that he started to realize and deal with how Codependent he was in his relationships with others. When funding for his position ended, Robert returned to Southern California and gave acting one last try. It was only a short time however before he went to work in a Chemical Dependence Treatment program in Pasadena. His work as a therapist there and at a subsequent treatment program facilitated and accelerated his personal recovery process. In the spring of 1988, he had a major emotional breakthrough in his recovery and gave himself the gift of entering a thirty day treatment program for Codependence. Sierra Tucson Treatment Center in Arizona was one of the first to pioneer treatment of Codependence and it was there that he learned a great deal about the grieving process and absorbed techniques and knowledge upon which he would later expand. He also realized what a Codependent relationship he had with the romance of Hollywood and upon completion of the program promptly moved. After brief stays in Tucson and Sedona Arizona, he lived in Taos, New Mexico, for a year until his Spiritual path led him to Cambria, California. It was in Cambria that he began a private practice specializing in Codependence Recovery and inner child healing. During almost two years on the coast he became involved in a relationship a tribute to the healing he had done to overcome his terror of intimacy. He and his new "family" (significant other and her daughter) moved back to Taos. Robert remained in Taos refining his practice for several more years before making a successful trip to California in the winter of 1995 to raise funds to publish his first book. He returned to Cambria to set up his publishing company, Joy to You & Me Enterprises, in the fall of 1995. He now practices in Cambria, San Luis Obispo, and Santa Barbara, with occasional forays into Los Angeles. Find out about co-dependence and the co-dependency recovery process. These articles address the spiritual belief system (not the same as God) and its relationship to the codependent recovery process. An innovative new level of Inner Child Healing - a healing paradigm that includes tools, techniques, and perspectives for achieving spiritual integration and emotional balance. A New Age has dawned in human consciousness and we now have tools, knowledge, and access to healing energy and Spiritual guidance that has never before been available. These articles, written by Robert Burney, deal with codependency. What makes a person codependent and how to heal from codependency. When I first came into contact with the word " Codependent " over a decade ago, I did not think that the word had anything to do with me personally. At that time, I heard the word used only in reference to someone who was involved with an Alcoholic - and since I was a Recovering Alcoholic, I obviously could not be Codependent. I paid only slightly more attention to the Adult Children of Alcoholics Syndrome, not because it applied to me personally - I was not from an Alcoholic family - but because many people whom I knew obviously fit the symptoms of that syndrome. It never occurred to me to wonder if the Adult Child Syndrome andCodependence were related. As my Recovery from Alcoholism progressed, however, I began to realize that just being clean and sober was not enough. By that time, the conception of the Adult Child Syndrome had expanded beyond just pertaining to Alcoholic families. I started to realize that, although my family of origin had not been Alcoholic, it had indeed been dysfunctional. I had gone to work in the Alcoholism Recovery field by this time and was confronted daily with the symptoms of Codependence and Adult Child Syndrome. I recognized that the definition of Codependence was also expanding. As I continued my personal Recovery, and continued to be involved in helping others with their Recovery, I was constantly looking for new information. In reading the latest books and attending workshops, I could see a pattern emerging in the expansion of the terms "Codependent" and "Adult Child. I was troubled, however, by the fact that every book I read, and every expert with whom I came into contact defined "Codependence" differently. I began to try to discover, for my own personal benefit, one all-encompassing definition. This search led me to examine the phenomenon in an increasingly larger context. I began to look at the dysfunctional nature of society, and then expanded farther into looking at other societies.
Higher plasma levels in the 6-12 year old group were largely attributable to patients with lower body weights buy cheap atrovent 20mcg on line. By comparison atrovent 20 mcg on line, a group of 22 separately studied adults between 18 and 45 years of age (11 male cheap 20 mcg atrovent with amex, 11 female) received 30 days of 200 mg/day sertraline and exhibited a mean sertraline AUC (0-24 hr) of 2570 ng-hr/mL, mean Cmax of 142 ng/mL, and mean half-life of 27. Relative to the adults, both the 6-2 year olds and the 13-17 year olds showed about 22% lower AUC (0-24 hr) and Cmax values when plasma concentration was adjusted for weight. These data suggest that pediatric patients metabolize sertraline with slightly greater efficiency than adults. Nevertheless, lower doses may be advisable for pediatric patients given their lower body weights, especially in very young patients, in order to avoid excessive plasma levels (see DOSAGE AND ADMINISTRATION ). Age -Sertraline plasma clearance in a group of 16 (8 male, 8 female) elderly patients treated for 14 days at a dose of 100 mg/day was approximately 40% lower than in a similarly studied group of younger (25 to 32 y. Steady-state, therefore, should be achieved after 2 to 3 weeks in older patients. The same study showed a decreased clearance of desmethylsertraline in older males, but not in older females. Liver Disease -As might be predicted from its primary site of metabolism, liver impairment can affect the elimination of sertraline. In patients with chronic mild liver impairment (N=10, 8 patients with Child-Pugh scores of 5-6 and 2 patients with Child-Pugh scores of 7-8) who received 50 mg sertraline per day maintained for 21 days, sertraline clearance was reduced, resulting in approximately 3-fold greater exposure compared to age-matched volunteers with no hepatic impairment (N=10). The exposure to desmethylsertraline was approximately 2-fold greater compared to age-matched volunteers with no hepatic impairment. There were no significant differences in plasma protein binding observed between the two groups. The effects of sertraline in patients with moderate and severe hepatic impairment have not been studied. The results suggest that the use of sertraline in patients with liver disease must be approached with caution. If sertraline is administered to patients with liver impairment, a lower or less frequent dose should be used (see PRECAUTIONS and DOSAGE AND ADMINISTRATION ). Renal Disease -Sertraline is extensively metabolized and excretion of unchanged drug in urine is a minor route of elimination. In volunteers with mild to moderate (CLcr=30-60 mL/min), moderate to severe (CLcr=10-29 mL/min) or severe (receiving hemodialysis) renal impairment (N=10 each group), the pharmacokinetics and protein binding of 200 mg sertraline per day maintained for 21 days were not altered compared to age-matched volunteers (N=12) with no renal impairment. Thus sertraline multiple dose pharmacokinetics appear to be unaffected by renal impairment (see PRECAUTIONS ). Major Depressive Disorder -The efficacy of ZOLOFT as a treatment for major depressive disorder was established in two placebo-controlled studies in adult outpatients meeting DSM-III criteria for major depressive disorder. Study 1 was an 8-week study with flexible dosing of ZOLOFT in a range of 50 to 200 mg/day; the mean dose for completers was 145 mg/day. Study 2 was a 6-week fixed-dose study, including ZOLOFT doses of 50, 100, and 200 mg/day. Overall, these studies demonstrated ZOLOFT to be superior to placebo on the Hamilton Depression Rating Scale and the Clinical Global Impression Severity and Improvement scales. Study 2 was not readily interpretable regarding a dose response relationship for effectiveness. Study 3 involved depressed outpatients who had responded by the end of an initial 8-week open treatment phase on ZOLOFT 50-200 mg/day. These patients (N=295) were randomized to continuation for 44 weeks on double-blind ZOLOFT 50-200 mg/day or placebo. A statistically significantly lower relapse rate was observed for patients taking ZOLOFT compared to those on placebo. Analyses for gender effects on outcome did not suggest any differential responsiveness on the basis of sex. Obsessive-Compulsive Disorder (OCD) -The effectiveness of ZOLOFT in the treatment of OCD was demonstrated in three multicenter placebo-controlled studies of adult outpatients (Studies 1-3). Patients in all studies had moderate to severe OCD (DSM-III or DSM-III-R) with mean baseline ratings on the Yale-Brown Obsessive-Compulsive Scale (YBOCS) total score ranging from 23 to 25. Study 1 was an 8-week study with flexible dosing of ZOLOFT in a range of 50 to 200 mg/day; the mean dose for completers was 186 mg/day. Patients receiving ZOLOFT experienced a mean reduction of approximately 4 points on the YBOCS total score which was significantly greater than the mean reduction of 2 points in placebo-treated patients. Study 2 was a 12-week fixed-dose study, including ZOLOFT doses of 50, 100, and 200 mg/day. Patients receiving ZOLOFT doses of 50 and 200 mg/day experienced mean reductions of approximately 6 points on the YBOCS total score which were significantly greater than the approximately 3 point reduction in placebo-treated patients. Study 3 was a 12-week study with flexible dosing of ZOLOFT in a range of 50 to 200 mg/day; the mean dose for completers was 185 mg/day. Patients receiving ZOLOFT experienced a mean reduction of approximately 7 points on the YBOCS total score which was significantly greater than the mean reduction of approximately 4 points in placebo-treated patients. Analyses for age and gender effects on outcome did not suggest any differential responsiveness on the basis of age or sex. The effectiveness of ZOLOFT for the treatment of OCD was also demonstrated in a 12-week, multicenter, placebo-controlled, parallel group study in a pediatric outpatient population (children and adolescents, ages 6-17). Patients receiving ZOLOFT in this study were initiated at doses of either 25 mg/day (children, ages 6-12) or 50 mg/day (adolescents, ages 13-17), and then titrated over the next four weeks to a maximum dose of 200 mg/day, as tolerated. Patients receiving sertraline experienced a mean reduction of approximately 7 units on the CYBOCS total score which was significantly greater than the 3 unit reduction for placebo patients. Analyses for age and gender effects on outcome did not suggest any differential responsiveness on the basis of age or sex. In a longer-term study, patients meeting DSM-III-R criteria for OCD who had responded during a 52-week single-blind trial on ZOLOFT 50-200 mg/day (n=224) were randomized to continuation of ZOLOFT or to substitution of placebo for up to 28 weeks of observation for discontinuation due to relapse or insufficient clinical response. Response during the single-blind phase was defined as a decrease in the YBOCS score of >/= 25% compared to baseline and a CGI-I of 1 (very much improved), 2 (much improved) or 3 (minimally improved). Patients receiving continued ZOLOFT treatment experienced a significantly lower rate of discontinuation due to relapse or insufficient clinical response over the subsequent 28 weeks compared to those receiving placebo. This pattern was demonstrated in male and female subjects. Panic Disorder -The effectiveness of ZOLOFT in the treatment of panic disorder was demonstrated in three double-blind, placebo-controlled studies (Studies 1-3) of adult outpatients who had a primary diagnosis of panic disorder (DSM-III-R), with or without agoraphobia. ZOLOFT was initiated at 25 mg/day for the first week, and then patients were dosed in a range of 50-200 mg/day on the basis of clinical response and toleration. The mean ZOLOFT doses for completers to 10 weeks were 131 mg/day and 144 mg/day, respectively, for Studies 1 and 2. In these studies, ZOLOFT was shown to be significantly more effective than placebo on change from baseline in panic attack frequency and on the Clinical Global Impression Severity of Illness and Global Improvement scores. The difference between ZOLOFT and placebo in reduction from baseline in the number of full panic attacks was approximately 2 panic attacks per week in both studies. Study 3 was a 12-week fixed-dose study, including ZOLOFT doses of 50, 100, and 200 mg/day. Patients receiving ZOLOFT experienced a significantly greater reduction in panic attack frequency than patients receiving placebo. Study 3 was not readily interpretable regarding a dose response relationship for effectiveness. Subgroup analyses did not indicate that there were any differences in treatment outcomes as a function of age, race, or gender. In a longer-term study, patients meeting DSM-III-R criteria for Panic Disorder who had responded during a 52-week open trial on ZOLOFT 50-200 mg/day (n=183) were randomized to continuation of ZOLOFT or to substitution of placebo for up to 28 weeks of observation for discontinuation due to relapse or insufficient clinical response. Response during the open phase was defined as a CGI-I score of 1 (very much improved) or 2 (much improved). Relapse during the double-blind phase was defined as the following conditions being met on three consecutive visits: (1) CGI-I >/= 3; (2) meets DSM-III-R criteria for Panic Disorder; (3) number of panic attacks greater than at baseline. Patients receiving continued ZOLOFT treatment experienced a significantly lower rate of discontinuation due to relapse or insufficient clinical response over the subsequent 28 weeks compared to those receiving placebo. This pattern was demonstrated in male and female subjects. Posttraumatic Stress Disorder (PTSD) -The effectiveness of ZOLOFT in the treatment of PTSD was established in two multicenter placebo-controlled studies (Studies 1-2) of adult outpatients who met DSM-III-R criteria for PTSD. The mean duration of PTSD for these patients was 12 years (Studies 1 and 2 combined) and 44% of patients (169 of the 385 patients treated) had secondary depressive disorder. ZOLOFT was initiated at 25 mg/day for the first week, and patients were then dosed in the range of 50-200 mg/day on the basis of clinical response and toleration.
Orion: Fabulous question and a very common problem for stalking victims discount atrovent 20mcg visa. If I were you atrovent 20mcg sale, I would also take a long discount 20 mcg atrovent with mastercard, honest look at that last relationship and ask myself, "What did I miss? TexGal: I journaled extensively but I developed a seizure disorder due to a different trauma and the stalking only exacerbated the seizurescheyenne4444: Emotionally, very badly. I became very withdrawn, was frightened for my life, and would walk with my head down so I could not look at others, which would upset him. Also, I was unable to see my friends, and he always watched me or had someone watching me, down to the detail of what I was wearing. So I pretty much gave up and withdrew, letting him make all decisions for me. Orion: About the stalker making all the decisions, this goes back to what I was saying before: that they are often controlling while the relationship is going on. Orion: For Jill - what happened when you told his parents? It seems like he felt ashamed of what he was doing and it did work for awhile. There is no solid evidence, but there do seem to be many cases in the literature of stalkers with bipolar. David: What do you recommend if a person becomes a victim of a stalker? Orion: The most important thing is not to have any contact with the stalker. Even negative attention is worse than no attention at all. If you are considering getting one, you must first research how these orders are handled in similar cases in your jurisdiction. The woman stalking me violated the restraining order 24 times before the police arrested her, and then did so only because the responding officer had himself been stalked. And, again, be aware that getting a restraining order can put you in more danger. David: What you were saying a moment ago, regarding the calls example, sounds very much like "parenting advice;" what a therapist might say to a parent who has a child who acts out a lot. Studying stalkers, including treating them, is so new that there are no known absolute treatments. I have heard mixed opinions about using restraining orders. Women seem to think it just incites the stalker to bother you even more. But my stalker is different than others, I think, because he comes over to my home and enters my home to do damage. Again, the opinions and even the data on restraining orders are mixed. He gets a big kick in the fact that he can come into my house without breaking any windows or doors. David: A few more audience comments on what has been said so far:DawnA: In our California county, we have mandatory 52 week Batterers Treatment Counseling for domestic violence offenders. The treatment provider runs a Stalker group within the program. The stalker continued to "stalk" from jail with letters. TexGal: I helped a lady who was being stalked, even drew a sketch of her stalker, she saw him, she was bi-polar and it caused serious problems with her health. Orion: In terms of punishment: California is the most progressive state for stalking victims. They have many excellent programs like ESP in Los Angeles. In other states, stalkers can get up to 20 years for felony stalking, but the usual punishment is 3-5 years. After they finish with you, do they go onto the next person? One study found that in the case of erotomanic stalkers, 17% stalked previous victims. There is also evidence that in that kind of stalking, having had more than one victim increases the propensity for violence. And I want to thank everyone in the audience for coming and participating. Thomas Schear, is a Certified Alcohol and Drug Counselor with about 20 years experience in the field. The discussion centered around alcoholism and drug addiction and dual diagnosis, along with self-medicating. Our topic tonight is "Addictions and Dual Diagnosis" and our guest is Dr. Thomas Schear is a licensed marriage and family therapist and a Certified Alcohol and Drug Counselor. He has over 15 years of experience working with clients who deal with substance abuse problems and dual diagnosis. Just so everyone is clear on the term dual diagnosis, it means someone who has a mental illness, psychiatric disorder and an addiction. Tonight, we will be talking about addictions issues AND also dual diagnosis. There are a lot of reasons why it is so hard to kick an addiction habit. Part of the reason is that it becomes part of a lifestyle that begins to set the person up to behave in certain ways and expect certain outcomes. For some, reality is too hard to handle in some ways. It seems that the addict is someone who feels pain more readily than the rest of us. David: So, would you say that some people are "more susceptible" to developing an addiction habit than others? To some extent, addictive behaviors are a lifestyle choice. For most of us, using alcohol is no big deal, but for the person who may be more susceptible, their first drink is a sensation and clearly the solution to their problems. David: At this time, I want to give our audience the link to the Addictions Community. Here, you will find lots of information related to the issues we are talking about tonight. Also, you can sign up for the mail list at the top of the page so you can keep up with events like this. Shear, when it comes to treatment for addictions, when is it time to say "I need help"? Schear: Frequently, the user has to experience the consequences of their usage and resultant behaviors before they decide it is time to get help. Generally, family, friends and others, enable the user by paying fines, making excuses, tolerating the intolerable behavior. These people need to withdraw their enabling behaviors, so the user begins to experience the pain associated with their use. The pain of recovery is seen as less than the pain of continuing the addictive behaviors. How does one figure out which treatment for addictions to choose? And, in your experience, what works best in initially treating an addiction habit? Schear: In recent years, Client Placement Criteria have been established by ASAM to better determine what level of care is appropriate for the addictive client. Everyone is measured on several continuums having to do with withdrawal symptoms: how much of a support system does the person have, if they also have medical problems, psychological problems that need additional support, etc. Depending on how "healthy" a person is, will determine where they ought to go for treatment. The person who has no withdrawal symptoms, who has the support of clean and sober family and friends, has a job, no psychiatric or medical problems and maybe a couple of drunk driving charges, may be appropriate for an outpatient setting.
Acute administration of high doses of amphetamine (d- or d buy generic atrovent 20mcg online,l-) has been shown to produce long-lasting neurotoxic effects buy atrovent 20mcg fast delivery, including irreversible nerve fiber damage order atrovent 20 mcg with mastercard, in rodents. The significance of these findings to humans is unknown. A double-blind, randomized, placebo-controlled, parallel-group study was conducted in children aged 6-12 (N=584) who met DSM-IVcriteria for ADHD (either the combined type or the hyperactive-impulsive type). Patients were randomized to fixed-dose treatment groups receiving final doses of 10, 20, or 30 mg of ADDERALL XR or placebo once daily in the morning for three weeks. Significant improvements in patient behavior, based upon teacher ratings of attention and hyperactivity, were observed for all ADDERALL XR doses compared to patients who received placebo, for all three weeks, including the first week of treatment, when all ADDERALL XR subjects were receiving a dose of 10 mg/day. Patients who received ADDERALL XR showed behavioral improvements in both morning and afternoon assessments compared to patients on placebo. In a classroom analogue study, patients (N=51) receiving fixed doses of 10 mg, 20 mg or 30 mg ADDERALL XR demonstrated statistically significant improvements in teacher-rated behavior and performance measures, compared to patients treated with placebo. A double-blind, randomized,multi-center, parallel-group, placebo-controlled study was conducted in adolescents aged 13-17 (N=327) who met DSM-IVcriteria for ADHD. The primary cohort of patients (n=287, weighing ?-T 75kg/165lbs) was randomized to fixed-dose treatment groups and received four weeks of treatment. Patients were randomized to receive final doses of 10 mg, 20 mg, 30 mg, and 40 mg ADDERALL XR or placebo once daily in the morning. Patients randomized to doses greater than 10 mg were titrated to their final doses by 10 mg each week. The secondary cohort consisted of 40 subjects weighing >75kg/165lbs who were randomized to fixed-dose treatment groups receiving final doses of 50 mg and 60 mg ADDERALL XR or placebo once daily in the morning for 4 weeks. The primary efficacy variable was the Attention Deficit Hyperactivity Disorder-Rating Scale IV (ADHD-RS-IV) total score for the primary cohort. The ADHD-RS-IV is an 18-item scale that measures the core symptoms of ADHD. Improvements in the primary cohort were statistically significantly greater in all four primary cohort active treatment groups (ADDERALL XR 10 mg, 20 mg, 30 mg, and 40 mg) compared with the placebo group. There was not adequate evidence that doses greater than 20 mg/day conferred additional benefit. A double-blind, randomized, placebo-controlled, parallel-group study was conducted in adults (N=255) who met DSM-IV^ criteria for ADHD. Patients were randomized to fixed-dose treatment groups receiving final doses of 20, 40, or 60 mg of ADDERALL XR or placebo once daily in the morning for four weeks. Significant improvements, measured with the Attention Deficit Hyperactivity Disorder-Rating Scale (ADHD-RS), an 18- item scale that measures the core symptoms of ADHD, were observed at endpoint for all ADDERALL XR doses compared to patients who received placebo for all four weeks. There was not adequate evidence that doses greater than 20 mg/day conferred additional benefit. ADDERALL XR 10 mg capsules: Blue/blue (imprinted ADDERALL XR 10 mg), bottles of 100, NDC 54092-383-01ADDERALL XR 15 mg capsules: Blue/white (imprinted ADDERALL XR 15 mg), bottles of 100, NDC 54092-385-01ADDERALL XR 20 mg capsules: Orange/orange (imprinted ADDERALL XR 20 mg), bottles of 100, NDC 54092-387-01ADDERALL XR 25 mg capsules: Orange/white (imprinted ADDERALL XR 25 mg), bottles of 100, NDC 54092-389-01ADDERALL XR 30 mg capsules: Natural/orange (imprinted ADDERALL XR 30 mg), bottles of 100, NDC 54092-391-01Dispense in a tight, light-resistant container as defined in the USP. Excursions permitted to 15-30 j C (59-86 j F)Manufactured for Shire US Inc. For more information call 1-800-828-2088Pharmacist: Medication Guide to be dispensed to patientsis registered in the US Patent and Trademark Officeis a registered trademark of Shire LLC, under license to DuramedInform patients, their families, and their caregivers about the benefits and risks associated with treatment with ADDERALL XR and should counsel them in its appropriate use. A patient Medication Guide is available for ADDERALL XR. Instruct patients, their families, and their caregivers to read the Medication Guide and assist them in understanding its contents. Give patients the opportunity to discuss the contents of theMedication Guide and to obtain answers to any questions theymay have. The complete text of the Medication Guide is reprinted at the end of this document. Advise patients that ADDERALL XR is a federally controlled substance because it can be abused or lead to dependence. Additionally, emphasize that ADDERALL XR should be stored in a safe place to prevent misuse and/or abuse. Evaluate patient history (including family history) of abuse or dependence on alcohol, prescription medicines, or illicit drugs [see DRUG ABUSE AND DEPENDENCE (9)]. Advise patients of serious cardiovascular risk (including sudden death, myocardial infarction, stroke, and hypertension) with ADDERALL XR. Patients who develop symptoms such as exertional chest pain, unexplained syncope, or other symptoms suggestive of cardiac disease during treatment should undergo a prompt cardiac evaluation [see WARNINGS AND PRECAUTIONS (5. Prior to initiating treatment with ADDERALL XR, adequately screen patients with comorbid depressive symptoms to determine if they are at risk for bipolar disorder. Such screening should include a detailed psychiatric history, including a family history of suicide, bipolar disorder, and/or depression. Additionally, ADDERALL XR therapy at usual doses may cause treatment-emergent psychotic or manic symptoms in patients without prior history of psychotic symptoms or mania [see WARNINGS AND PRECAUTIONS (5. Monitor growth in children during treatment with ADDERALL XR, and patients who are not growing or gaining weight as expected may need to have their treatment interrupted [see WARNINGS AND PRECAUTIONS (5. Advise patients to notify their physicians if they become pregnant or intend to become pregnant during treatment [see USE IN SPECIFIC POPULATIONS (8. Advise patients not to breast feed if they are taking ADDERALL XR [see USE IN SPECIFIC POPULATIONS (8. ADDERALL XR may impair the ability of the patient to engage in potentially hazardous activities such as operating machinery or vehicles; the patient should therefore be cautioned accordingly. ADDERALL XR^ is registered in the US Patent and Trademark OfficeADDERALL^ is a registered trademark of Shire LLC, under license to DuramedThe information in this monograph is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects. This information is generalized and is not intended as specific medical advice. If you have questions about the medicines you are taking or would like more information, check with your doctor, pharmacist, or nurse. Although most women prefer to leave their fantasies at that, others have a list that they are slowly but surely accomplishing. So the next time your woman seems to be wandering off in thought, who knows, she may be cruising around in the mystical world of sexual fantasy. So do you think you can guess what some of them are? Keep in mind that fantasies are a normal and healthy part of our sexuality. They are either taken from past experiences or may even be entirely imaginary. Sometimes these fantasies are taboo, or socially unacceptable, therefore they are only available through fantasy. Many women relish the idea of meeting up with a mystery man and going to some no-name motel with him for a wild night of uninhibited sex. The creative ideas that flowed from this topic were quite interesting, to say the least. I guess the idea of knowing that others are getting excited by their "performance" provides them with a feeling of empowerment. Although most women agreed that they fantasize about having a master, their role in the scenario differed. Vicky said, "Having him instruct me on how to lick and suck his member or at what pace to ride him will make me orgasm faster than I can say Yes, Master. In some fantasies I obey, yet in others I fight him and refuse to do anything he says until he finally ties me to the bed and calms me with his rhythmic penetration. Yes, virtually every woman wants or will share her body with another woman. Keeping in mind that the women interviewed are professionals with commendable careers, some of them fantasized about being strippers, while others took things a step further and imagined being prostitutes. Obviously, the fantasy is romanticized beyond belief because the life of either is not so glamorous that women would opt to have it as a career choice. In the same instance, women also fantasize about having two men all over their bodies. Some wanted a more gentle erotic scene, while the rare few wanted porno-like sex. One of the most interesting statements regarding two men was having one penetrate her while the other licked her clitoris. It sounds virtually impossible (especially if the guys are not bisexual), but nevertheless intriguing. Other good ones include having two guys perform cunnilingus simultaneously, or having one guy perform oral sex while the other sucks on her breasts.
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