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5HTP depression 5-HTP serotonin 5 HTP ADD ADHD

  When using dopa alone, only 10% to 15% of people suffering with depression report good relief of symptoms of depression and 20% to 25% report some improvement. If over half of your people suffering with depression  are not obtaining relief of depression or attention deficit ADD ADHD with dopa, tyrosine, and dopa, they are not being used properly. It is imperative for proper treatment that the balance of dopa, tyrosine, and dopa is correct  A point of interest, in double-blind studies of depression, 30% to 40% of people suffering with depression report relief of depression symptoms on a placebo. NeuroResearch is not convinced that use of only dopa leads to results better than a sugar pill (placebo) in treatment of depression, anxiety, attention deficit ADD ADHD, a position supported by the medical literature which has to date been unable to show through studies that dopa is effective in treatment of depression, anxiety, attention deficit ADD ADHD,.

5HTP depression 5-HTP serotonin 5 HTP ADD ADHD
5HTP depression 5-HTP serotonin 5 HTP ADD ADHD
dopa depletes dopamine neurotransmitter levels
5HTP depression 5-HTP serotonin 5 HTP ADD ADHD
 
5HTP depression 5-HTP serotonin 5 HTP ADD ADHD
dopa depletes serotonin neurotransmitter levels
5HTP depression 5-HTP serotonin 5 HTP ADD ADHD
 
5HTP depression 5-HTP serotonin 5 HTP ADD ADHD
tyrosine depletes serotonin neurotransmitter levels
5HTP depression 5-HTP serotonin 5 HTP ADD ADHD
 
5HTP depression 5-HTP serotonin 5 HTP ADD ADHD
Reuptake inhibitor depression, anxiety, attention deficit ADD ADHD, drugs deplete serotonin and/or dopamine neurotransmitter levels
5HTP depression 5-HTP serotonin 5 HTP ADD ADHD
 
5HTP depression 5-HTP serotonin 5 HTP ADD ADHD
dopa depletes dopamine neurotransmitter levels
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5HTP depression 5-HTP serotonin 5 HTP ADD ADHD
dopa depletes serotonin neurotransmitter levels
5HTP depression 5-HTP serotonin 5 HTP ADD ADHD
5HTP depression 5-HTP serotonin 5 HTP ADD ADHD

Coast of Maine photo by Marty Hinz, MD

 
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EFFECTIVENESS OF
REUPTAKE INHIBITOR DRUGS
IN THE TREATMENT OF DEPRESSION
By: Marty Hinz, MD
President Clinical Research
NeuroResearch Clinics, Inc.
 

  If you just entered this web site, landing on this page, you have landed on the NeuroResearch Clinics discussion on the effectiveness of prescription drugs in treatment of depression. NeuroResearch Clinics is a neurotransmitter medical research project. The research work of NeuroResearch Clinics is currently being published in a series of papers by the University of Minnesota Medical School. The first medical school paper was submitted for publication November 30, 2008. This web page and the links to the right are an overview of the NeuroResearch Clinics treatment approach of depression in adults and children. Other pages of this web site discuss the details of the NeuroResearch Clinics approach in treatment of numerous other neurotransmitter diseases. (To access the a copy of the first University of Minnesota Medical School paper click on the "NeuroResearch Publishing" link in the left column.)

  Reuptake inhibitor drugs are number one prescription written in the treatment of depression, anxiety, attention deficit ADD ADHD,. These drugs are not as effective as most doctors and people think. This web page is   dedicated to discussing the true effectiveness of reuptake inhibitor drugs used in the treatment of depression by doctors.

Click here for to access a comprehensive list of reuptake inhibitor drugs.
Overview of depression drug effectiveness.
Chapter on "Depression" written by Marty Hinz, MD for John Hopkins medical text book.

  Most people believe when a drug is approved by the FDA as effective it means that most people will get better when treated for the disease that the drug was approved for. In the course of writing a chapter for a new medical text book on depression in the summer of 2008 I pulled a large number of placebo control studies on depression drugs and was stunned at what I found.

  The studies reviewed were preformed at large university and were not sponsored by the drug companies. Most were recent studies, in general the studies were completed since 2003.

  The first thing that stood out was that the "placebo effect" (where people taking a sugar pill known as a placebo gets better) was huge in depression. In general 30% to 40% of people taking a sugar pill in depression studies get relief of symptoms.

  Beyond the placebo effect two results stood out.

First, is the fact that only about 7% of people taking the depression drug in the studies got better results than those taking a sugar pill.

Second, is the fact that no patients 65 years of age and older got any benefits greater than taking a sugar pill in relief of depression symptoms.

  In these studies there were almost 6,000 participants. 93% of the participants got relief of depression symptoms no better than taking a sugar pill, none!

  What do results such as these look like while treating patients in the clinic? For people with depression being treated in the clinic they are started on a reuptake inhibitor drug such as Prozac, Zoloft, Trazodone, Celexa, Lexapro, Effexor, Wellbutrin, etc. (see the list in the right blue column). After one month of treatment about 50% of the people with depression are better. The problem is over 40% of people with depression would have been better with a sugar pill or no drug. The fact is that after one month treatment with reuptake inhibitor drugs over 90% of people with depression are taking a drug that they may believe they are getting benefits from but in reality they are not. 

  If you believe that a depression drug that relieves depression symptoms in only 7% of people taking it is not effective, then these drugs are not effective.

  Further scrutiny reveals that these dugs are loaded with side effects. In the prescribing information of each drug is between 15 and 25 pages of side effects listed. In reviewing side effects the odds of experiencing a drug side effect when taking these drugs is higher than achieving relief of symptoms that is greater than a sugar pills. In the right blue column above on this web page, is a listing of reuptake inhibitor drugs, click on each to review the official prescribing information with side effects. As you open each of these link most have the risk of suicide listed prominently at the top of the first page.

   Side effects and low effectiveness are not the only concerns with these drugs. Other pages of this web site contain in-depth discussions of:

How these drugs used are habit forming and why this occurs (see the "habit forming" link to the right).
How these drugs cause depletion of neurotransmitter levels and make the cause of depression worse. (see the "depletion" link to the right).
 
DRUG EFFECTIVENESS STUDIES WITH FULL TEXT LITERATURE VERSION OF THE STUDY
Depression in the elderly studies

Depression in the adults studies

Depression in the adolescents studies Depression in the children studies
 
 Serotonin, dopamine, and norepinephrine reuptake inhibitor depression, anxiety, attention deficit ADD ADHD, drugs deplete serotonin, dopamine, and norepinephrine neurotransmitter levels. If depletion is severe enough suicide may occur.
From The Formal
"Lexapro Prescribing Information"
For Physicians
Clinical Worsening and Suicide Risk

People with major depressive disorder (MDD), both adult and pediatric, may experience worsening of their depression and/or the emergence of suicidal ideation and behavior (suicidality) or unusual changes in behavior, whether or not they are taking depression medications, and this risk may persist until significant remission occurs. Suicide is a known risk of depression and certain other psychiatric disorders, and these disorders themselves are the strongest predictors of suicide. There has been a long-standing concern, however, that depression drugs may have a role in inducing worsening of depression and the emergence of suicidality in certain people during the early phases of treatment.

5HTP depression 5-HTP serotonin 5 HTP ADD ADHD
5HTP depression 5-HTP serotonin 5 HTP ADD ADHD
5HTP depression 5-HTP serotonin 5 HTP ADD ADHD
5HTP depression 5-HTP serotonin 5 HTP ADD ADHD

Depression Pages Site Map

depression ADHD suicide site map

Depression Pages Links
Main Web Site
Depression Home Page
Depression Drugs
Neurotransmitter Depletion
Drug Effectiveness
Habit Forming
5HTP depression 5-HTP serotonin 5 HTP ADD ADHD
5HTP depression 5-HTP serotonin 5 HTP ADD ADHD

  The cause of depression, anxiety, attention deficit ADD ADHD, etc. is neurotransmitter levels in the brain that are not high enough  Reuptake inhibitor drugs deplete neurotransmitter levels during treatment making the cause of the problem worse (low levels of neurotransmitters). When neurotransmitter levels drop low enough people may commit suicide. Click on the links below, the formal prescribing information for each drug will open.

Prozac
Zoloft
Luvox
Celexa
Lexapro
Effexor
Wellbutrin
Cymbalta
Paxil
Meridia
Amitriptyline
Nortriptyline
Serzone
Norpramin
Pristiq
Strattera
Asendin
Ludiomil
Zyban
Elavil
Sinequan
Tofranil
Amoxapine
Anafrinil
Trazodone
Phentermine
Tenuate
Bontril
Amphetamines

Cocaine

Ecstasy

5HTP depression 5-HTP serotonin 5 HTP ADD ADHD
5HTP depression 5-HTP serotonin 5 HTP ADD ADHD
 
 
 
 
 
 
 
 
 
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The Serotonin, Dopamine, and Norepinephrine Reuptake Inhibitor drugs (Depression Drugs)

 

neurotransmitter neurons depression ADHD suicide

 
SSRIs: Selective Serotonin depression, anxiety, attention deficit ADD ADHD, Reuptake Inhibitors
citalopram (Celexa, Cipramil, Emocal, Sepram) duloxetine (Cymbalta)
fluoxetine (Prozac, Fontex, Seromex, Seronil, Sarafem) fluoxetine (Prozac, Fontex, Seromex, Seronil, Sarafem)
escitalopram oxalate (Lexapro, Cipralex, Esertia) fluvoxamine maleate (Luvox, Faverin, Dumyrox)
sertraline (Zoloft, Lustral, Serlain) paroxetine (Paxil, Seroxat, Aropax, Deroxat, Rexetin)
   
SNRIs: Serotonin Norepinephrine depression, anxiety, attention deficit ADD ADHD, Reuptake Inhibitors
venlafaxine (Effexor XR, Effexor) desvenlafaxine (tradename Pristiq)
sibutramine (Meridia, Reductil) nefazodone (Serzone)
desipramine (Norpramine, Pertofraneis) milnacipran (Dalcipran/ Portugal; Ixel/ France)
duloxetine (Cymbalta)  
 
NRIs: Norepinephrine depression, anxiety, attention deficit ADD ADHD, Reuptake Inhibitors
Atomoxetine (Strattera) Reboxetine (Edronax)
Viloxazine (Vivalan) Maprotiline (Ludiomil)
Nortriptyline (Nortrilen) Bupropion (Wellbutrin, Zyban)
 

Tricyclic depression drugs: non-specific depression, anxiety, attention deficit ADD ADHD, reuptake inhibitors

Amitriptyline ( Elavil, Tryptanol, Endep, Elatrol, Tryptizol, Trepiline, Laroxyl) Amoxapine (Asendin, Asendis, Defanyl, Demolox, Moxadil)
Imipramine (Antideprin, Deprenil, Deprimin, Deprinol, Depsonil, Dynaprin, Eupramin, Imipramil, Irmin, Janimine, Melipramin, Surplix, Tofranil)
Doxepin (Aponal, Adapine, Sinquan, Sinequan
Trimipramine (Stangyl, Surmontil, Rhotrimine)
Nortriptyline (Sensoval, Aventyl, Pamelor and Nortrilen.
Desipramine (brand names Norpramin and Pertofrane)  
   
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EFFICACY OF SEROTONIN, DOPAMINE, AND NOREPINEPHRINE REUPTAKE INHIBITOR depression, anxiety, attention deficit ADD ADHD, DRUGS
Written by: Marty Hinz, MD
President Clinical Research
NeuroResearch Clinics, Inc.
 

The studies of serotonin, dopamine, and norepinephrine reuptake inhibitor depression drugs can be broken down into one of four categories:

  1. Adults over 60 years old (elderly).
  2. Adults under 60 years old
  3. Adolescents
  4. Pediatric

  In reviewing the studies below, it is fair to say that the expectations of a drug side effect occurring when using a serotonin, dopamine, and norepinephrine reuptake inhibitor drug are greater than getting relief of depression symptoms that is greater than placebo.

   Of 5,972 people suffering with depression that participated in the serotonin, dopamine, and norepinephrine reuptake inhibitor depression studies on this web page, 423 people suffering with depression achieved results better than placebo. So what does this mean? First it means that for the 5,549 people suffering with depression that were started on serotonin, dopamine, or norepinephrine reuptake inhibitor depression drugs, their depression outcomes were no better than placebo. This means that 5,549 people with depression were exposed to the side effects and the cost of these drugs with no hope of getting results in treatment of depression that were better than placebo since only 423 people suffering with depression received results that were better than placebo. When you analyze these studies, the bottom line is that only 7.08% of people suffering with depression treated with the serotonin, dopamine, or norepinephrine reuptake inhibitor depression drugs got relief of depression symptoms that were better than placebo.  I.e. they treated everyone so that 7.08% could get depression results better than a sugar pill, and 92.92% got the same results in treatment of depression as if they had taken a sugar pill.

   In the "warnings, precautions, and adverse events" for each of the serotonin, dopamine, and norepinephrine depression drugs are on this web page, as you access information on each depression drug, notice near the top the warning regarding, "Clinical worsening and suicide risk." The serotonin, dopamine, and norepinephrine reuptake inhibitor drugs may deplete serotonin, dopamine, or norepinephrine if dopa, tyrosine, and dopa are not administered simultaneously in proper balance. If you deplete the serotonin, dopamine, and norepinephrine neurotransmitter levels enough the clinical depression picture worsens. The worst case depression scenario is suicide due to drug depletion of the serotonin, dopamine, and norepinephrine neurotransmitter levels.

 
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EFFICACY IN ADULTS
 
STUDY 9: Literature review, N = 1,472. Conclusions: Remission rates (of depression) for the serotonin reuptake inhibitor when used in depression escitalopram (Lexapro) were superior to placebo (48.7% versus 37.6%, P =0.003) 88.8% of people suffering with depression taking Lexapro achieved results no better than placebo. Remission rates (of depression) for serotonin reuptake inhibitor depression citalopram (Celexa) (52.8% versus 43.5%, P = 0.003). 90.7% of people suffering with depression taking Celexa achieved results no better than placebo. Depression remission rates for escitalopram (Lexapro) were ... similar to the serotonin norepinephrine reuptake inhibitor venlafaxine-XR (Effexor-XR) (P= 0.97).

Full text study 9

   
STUDY 10: Randomized double blind placebo controlled 20 month depression study on the incidence of recurrence of depression. Three groups serotonin depression reuptake inhibitor  Zoloft (sertraline) 50 mg per day versus serotonin depression reuptake inhibitor Zoloft (sertraline) 100 mg per day versus placebo. The depression subjects mean age 45.2 years with a standard deviation of 10.5 years, N = 299. Conclusion: "...a new depression episode was recorded in 33.3% of people suffering with depression in the placebo group and in 16.9% of those who received serotonin depression reuptake inhibitor sertraline (Table 2). No statistically significant difference was observed in the incidence of depression recurrence between the 50-mg sertraline group and the 100-mg sertraline group (16.8% and 17.0%." 87% of people suffering with depression taking serotonin depression reuptake inhibitor Zoloft at 50 mg per day or 100 mg per day received depression benefits no better than placebo in prevention of recurrent depression.

Full text study 10

   
STUDY 11: Randomized double blind placebo controlled 8 week depression study of chronic fatigue syndrome in people with depression using serotonin depression reuptake inhibitor Prozac versus placebo average age of the depression subjects about 39 years, N = 96. Conclusions: No significant difference between serotonin depression reuptake inhibitor Prozac or placebo in the treatment of chronic fatigue syndrome or associated depression.

Full text study 11

   
STUDY 12: Randomized placebo controlled double blind depression study of serotonin depression reuptake inhibitor Prozac (fluoxetine) versus depression counseling versus placebo in the treatment of post-partum depression average age about 26 years old, N = 86. Conclusion: No difference in the effectiveness of depression counseling versus serotonin depression reuptake inhibitor Prozac. No benefit from combining depression counseling with Prozac. Depression counseling is just as effective as serotonin depression reuptake inhibitor Prozac treatment under these conditions, without the side effects.

Full text study 12

   
STUDY 13: Randomized double blind placebo controlled 12 week depression study with the treatment of adult depression serotonin depression reuptake inhibitor Prozac (fluoxetine) versus serotonin reuptake inhibitor Paxil (paroxetine) versus placebo mean age 41.3 years (SD 12.6), N = 128. Conclusion: "There were no significant differences among the three depression treatment groups in baseline depression and endpoint depression and anxiety severity, as well as in the degree of depression and anxiety improvement."

Full text study 13

   
STUDY 14: Randomized double blind placebo controlled 3 way depression study of serotonin depression reuptake inhibitor Prozac (fluoxetine) versus serotonin norepinephrine depression reuptake inhibitor Effexor (Venlafaxine) versus placebo in the treatment of depression with adults over 18 years of age, N = 308. Conclusion: "Final depression remission (defined as HAM-D < or =7) rates were 32%, 28%, and 22% for serotonin norepinephrine depression reuptake inhibitor venlafaxine, serotonin depression reuptake inhibitor fluoxetine, and placebo, respectively." Depression treatment under the approach of this study shows that 90% of people suffering with depression treated with serotonin norepinephrine depression reuptake inhibitor Effexor have depression results no better than placebo, and 94% of people suffering with depression treated with serotonin depression reuptake inhibitor Prozac have results no better than placebo.

Full text study 14

   
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EFFICACY IN PEOPLE SUFFERING WITH DEPRESSION OVER 60 YEARS OLD
 
STUDY 1: Randomized placebo controlled depression study, treatment with serotonin depression reuptake inhibitor Celexa (Citalopram) 10 mg to 40 mg per day in people suffering with depression 75 years old and older, N = 174. Conclusion: "In the oldest group of community-dwelling people suffering with depression to be studied to date, depression medication was not more effective than placebo for the treatment of depression."

Full text study 1

   
STUDY 2: Randomized double blind placebo controlled 12 week depression study, treatment with serotonin depression reuptake inhibitor Lexapro (escitalopram) 10 mg to 20 mg per day in people suffering with depression over 60 years old, N = 264. Conclusion: "serotonin depression reuptake inhibitor Escitalopram depression treatment was not significantly different from placebo treatment on the primary depression efficacy measure..."

Full text study 2

   
STUDY 3: Randomized double blind placebo controlled 8 week depression study, treatment with serotonin depression reuptake inhibitor Lexapro (escitalopram) 10 mg per day or serotonin depression reuptake inhibitor Prozac (fluoxetine) 20 mg per day in people suffering with depression in the study were 65 to 93 years old, N = 517. Conclusion: "Both serotonin depression reuptake inhibitor escitalopram and serotonin depression reuptake inhibitor fluoxetine were well tolerated by elderly people suffering with depression with MDD (major depressive disorder). Neither demonstrated superior depression efficacy on primary endpoint versus placebo."

Full text study 3

   
STUDY 4: Randomized double blind placebo controlled 8 week depression study, treatment with serotonin depression reuptake inhibitor Zoloft (sertraline) 50 mg per day versus placebo in people suffering with depression with depression over 60 years old, N = 371. Conclusion: Only 10% of people suffering with depression taking serotonin depression reuptake inhibitor Zoloft (45% got better) showed results better when compared to placebo (35% got better). 90% of people suffering with depression taking Zoloft in this study got results no better than placebo

Full text study 4

   
STUDY 5: Depression participants (age 65 and older) were openly treated with serotonin depression reuptake inhibitor sertraline (Zoloft) and then randomized into a double-blind, placebo controlled depression continuation / maintenance depression study of recurrence of depression (about 2 years duration), N = 113. Drug depression dosage was maintained at levels that achieved remission. Conclusion: "No significant difference between the serotonin depression reuptake inhibitor sertraline and placebo groups was found in the proportion of recurrences."

Full text study 5

   
STUDY 6: 6 week double blind placebo control depression study of depression with serotonin depression reuptake inhibitor Prozac versus placebo in people suffering with depression over 60 years old, N = 671. Conclusions: "...overall depression response (43.9% vs. 31.6%, p = .002) and depression remission (31.6% vs. 18.6%, p < .001) rates." 87.3% of elderly people suffering with depression over 60 years old treated for depression with serotonin depression reuptake inhibitor Prozac can expect depression response that is no better than placebo and 87.0% of people suffering with depression over 60 years old treated with serotonin depression reuptake inhibitor Prozac can expect remission of depression symptoms no better than placebo based on this depression study.

Abstract of study 6

   
STUDY 7: Double blind placebo controlled randomized depression study of serotonin depression reuptake inhibitor Prozac (fluoxetine) versus placebo in treatment of depression in people suffering with Alzheimer, N = 41. Conclusion: "serotonin depression reuptake inhibitor Fluoxetine treatment for depression in AD did not differ significantly from depression treatment with placebo."

Abstract of study 7

   
STUDY 8: Randomized double blind placebo controlled 3 way depression study of serotonin depression reuptake inhibitor Prozac (fluoxetine) versus serotonin norepinephrine depression reuptake inhibitor Effexor (venlafaxine) versus placebo in the treatment of depression in the elderly with a mean age of 71 years, N = 300. Conclusion: "In this study, there was no significant difference in efficacy among placebo, serotonin norepinephrine depression reuptake inhibitor venlafaxine, and serotonin depression reuptake inhibitor fluoxetine for the treatment of depression."

Full text study 8

   
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EFFICACY IN ADOLESCENTS

 
STUDY 15: Literature review, treatment of depression with serotonin depression reuptake inhibitor Prozac (fluoxetine) versus placebo in children over 12 years old, N = 175. Conclusion: "Adolescent depression response rates at exit were not significantly different..." between serotonin depression reuptake inhibitor Prozac and placebo. Based on this study treating adolescents with serotonin depression reuptake inhibitor Prozac for depression is no better than treating with placebo.
   
STUDY 16: 8 week double blind placebo controlled study of serotonin depression reuptake inhibitor Celexa (citalopram) versus placebo in the treatment of depression ages 7 to 17 years, N = 174. Conclusion: "The difference in response rate at week 8 between placebo (24%) and serotonin depression reuptake inhibitor citalopram (36%)..." 88% of depression pediatric people suffering with depression treated for depression with Celexa can expect outcomes no better than placebo based on this depression study.
   

STUDY 17: 10 week double blind placebo controlled depression study of serotonin depression reuptake inhibitor Zoloft (sertraline) versus placebo in the treatment of depression ages 7 to 17, N = 376. Conclusion: "...69% of serotonin depression reuptake inhibitor sertraline-treated people suffering with depression compared with 59% of people suffering with depression treated with placebo were considered depression responders..." 90% of depression pediatric people suffering with depression treated for depression with serotonin depression reuptake inhibitor Zoloft can expect outcomes no better than placebo based on this depression study.

   
STUDY 18: 8 week randomized double blind placebo controlled depression study of serotonin depression reuptake inhibitor Prozac (fluoxetine) versus placebo in the treatment of depression ages 7 to 17, N = 96. Conclusion: However, complete depression symptom remission (Children's Depression Rating Scale--Revised < or = 28) occurred in only 31% of the serotonin depression reuptake inhibitor fluoxetine-treated people and 23% of the placebo people. 92% of pediatric people suffering with depression treated for depression with serotonin reuptake inhibitor Prozac can expect resolution of depression symptoms that is no better than placebo based on this depression study.
   
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EFFICACY IN PEDIATRICS
 

STUDY 19: Double blind placebo controlled 10 week depression study of serotonin depression reuptake inhibitor Zoloft (sertraline) versus placebo 6 to 11 years old for the treatment of depression, n = 177. Conclusion: "There were no statistically significant depression differences in time to first response or first persistent response between serotonin depression reuptake inhibitor sertraline and placebo in depression children..."

Full text study 19

   

STUDY 20: Literature review, treatment of depression with serotonin depression reuptake inhibitor Prozac (fluoxetine) versus placebo in children with depression less than 12 years old, N = 134. Conclusion: "Within depression children, response at exit to serotonin depression reuptake inhibitor fluoxetine was significantly better than placebo (56.9% vs 33.3%; P=.009)" 76.4% of pediatric people suffering with depression treated for depression with serotonin depression reuptake inhibitor Prozac can expect outcomes no better than placebo based on this depression study.

Full text study 20

   
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If you need a medical speaker for AMA Category I CME call NeuroResearch Clinics, Inc.
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DISCLAIMER: NeuroResearch is a research company that provides speakers to programs for AMA category I continuing medical education (CME) for physicians, continuing education for psychologists approved by the American Psychological Association, and licenses intellectual property for use. The NeuroResearch formulas and theory of medicine is designed for the use of combining precursors of the serotonin and catecholamine systems. The formulas are intended to be used as nutritional supplements and not as a drug to treat, mitigate, treat, cure, or prevent disease.   This web site is intended to be educational purposes only. Constantly we receive e-mails from people who are not licensed health care providers. We wish we could answer them, but the new telemedicine laws that were recently legislated (and put in place) prohibit us from providing advice directly to people with no medical license or providing medical care over the Internet.