Psycho-Babble Medication Thread 575925

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Re: Opiates for depression? jerrympls

Posted by paulbwell on November 10, 2005, at 23:43:19

In reply to Re: Opiates for depression? flmm, posted by jerrympls on November 10, 2005, at 23:29:49

> I'm on an opiate for my depression - hydrocodone. I take 5mg 4x daily. Sure it's not as smooth as one would like - but it sure helps my depression. Been on it for a year now and no tolerance.
>
> Jerry
>
>

Great to hear Jer, hope it continues.

You provide a sound, reasoned, rational, voice in the use of Opi's in the use of mood disorders, and i wish you continued benefit. If only ALL Docs were not so closed minded.

Apparently Stims, of which you take Dex 15mg Spans? can potentiate Opi's? i wonder if you have found this?

Good luck dude, and good health!-you are an inspiration!

Cheers:)

 

Re: Opiates for depression? paulbwell

Posted by jerrympls on November 10, 2005, at 23:59:59

In reply to Re: Opiates for depression? jerrympls, posted by paulbwell on November 10, 2005, at 23:43:19

> > I'm on an opiate for my depression - hydrocodone. I take 5mg 4x daily. Sure it's not as smooth as one would like - but it sure helps my depression. Been on it for a year now and no tolerance.
> >
> > Jerry
> >
> >
>
> Great to hear Jer, hope it continues.
>
> You provide a sound, reasoned, rational, voice in the use of Opi's in the use of mood disorders, and i wish you continued benefit. If only ALL Docs were not so closed minded.
>
> Apparently Stims, of which you take Dex 15mg Spans? can potentiate Opi's? i wonder if you have found this?
>
> Good luck dude, and good health!-you are an inspiration!
>
> Cheers:)
>

I keep telling my doc she should write a paper on my experience since it's been so positive. The more that doctor's publish about opiates helping depression can only help open many closed minded docs.

Actually, I have switched my stim to Adderall - which I find to help much better in the general mood dept. than Dexedrine. I take 20mg XR 3x daily and it (Adderall) works GREAT with the opiate. I only wish there were a longer acting form of hydrocodone.

Thanks for the well wishes! I appreciate it!

Jerry

 

Re: Opiates for depression? jerrympls

Posted by paulbwell on November 11, 2005, at 0:11:57

In reply to Re: Opiates for depression? paulbwell, posted by jerrympls on November 10, 2005, at 23:59:59

> I keep telling my doc she should write a paper on my experience since it's been so positive. The more that doctor's publish about opiates helping depression can only help open many closed minded docs.
>
> Actually, I have switched my stim to Adderall - which I find to help much better in the general mood dept. than Dexedrine. I take 20mg XR 3x daily and it (Adderall) works GREAT with the opiate. I only wish there were a longer acting form of hydrocodone.
>
> Thanks for the well wishes! I appreciate it!
>
> Jerry

Good to hear your doing well!

You prove all the nay-sayers wrong with their idea of folks needing ever increasing doses of Opis-and your Hycodan being stable for 1 year shows this! good for you!

So you switched from Dex to Adderall? perhaps you had become tolerant to dextroamphetamine only. Most say Dex works better? althought Adderall is popular.

I wonder how they differ? effects?

Cheers dude!!

 

Re: Opiates for depression? paulbwell

Posted by jerrympls on November 11, 2005, at 0:19:40

In reply to Re: Opiates for depression? jerrympls, posted by paulbwell on November 11, 2005, at 0:11:57

> > I keep telling my doc she should write a paper on my experience since it's been so positive. The more that doctor's publish about opiates helping depression can only help open many closed minded docs.
> >
> > Actually, I have switched my stim to Adderall - which I find to help much better in the general mood dept. than Dexedrine. I take 20mg XR 3x daily and it (Adderall) works GREAT with the opiate. I only wish there were a longer acting form of hydrocodone.
> >
> > Thanks for the well wishes! I appreciate it!
> >
> > Jerry
>
> Good to hear your doing well!
>
> You prove all the nay-sayers wrong with their idea of folks needing ever increasing doses of Opis-and your Hycodan being stable for 1 year shows this! good for you!
>
> So you switched from Dex to Adderall? perhaps you had become tolerant to dextroamphetamine only. Most say Dex works better? althought Adderall is popular.
>
> I wonder how they differ? effects?
>
> Cheers dude!!

I didn't grow tolerant to the dex. I switched mainly because Adderall helps reverse a lot of the sexual side effects from the Lexapro. For me, Dexedrine helps with energy and concentration mostly - whereas Adderall helps with those too but also gives a more "natural" feeling of well-being - and is smoother (well, the XR form anyway). Dexedrine is a little bit rough around the edges - but not by much. I used to have a lot of severe nighttime anxiety and rumination when my Dexedrine wore off - but not so with Adderall - another reason I like it.

Jerry :-)

 

Re: Opiates for depression?

Posted by paulbwell on November 11, 2005, at 0:28:29

In reply to Re: Opiates for depression? paulbwell, posted by jerrympls on November 11, 2005, at 0:19:40

Hi Ya!

you seem to have blocked me from yr MSN? bring me back on man-we could talk n stuff?

YES?

 

Re: Opiates for depression? paulbwell

Posted by jerrympls on November 11, 2005, at 0:31:10

In reply to Re: Opiates for depression?, posted by paulbwell on November 11, 2005, at 0:28:29

> Hi Ya!
>
> you seem to have blocked me from yr MSN? bring me back on man-we could talk n stuff?
>
> YES?

I've blocked you? I haven't been on in a long time. Perhaps some other night - I'm dead tired - was driving all day today!

 

Re: Opiates for depression?

Posted by paulbwell on November 11, 2005, at 0:38:41

In reply to Re: Opiates for depression? paulbwell, posted by jerrympls on November 11, 2005, at 0:31:10

>
> I've blocked you? I haven't been on in a long time. Perhaps some other night - I'm dead tired - was driving all day today!
>


OK dude-have a good rest.

we'll chat later maybe?

i'm online

 

Re: Opiates for depression?

Posted by linkadge on November 13, 2005, at 9:35:57

In reply to Re: Opiates for depression?, posted by paulbwell on November 11, 2005, at 0:38:41

As positive as jerrympls's story is, there have been equally many (if not many more) people who have used opiates without sucess in treating mood disorders.

Most people who go to withdrawl clinics to stop opiate addictions are really suffering from an underlying mood disorder.

Sometimes tollerance to drugs does not appear in the form one might expect.

Different opiates have different rates of tollerance.

Linkadge

 

Re: Opiates for depression?

Posted by Squiggles on November 13, 2005, at 9:38:25

In reply to Re: Opiates for depression?, posted by linkadge on November 13, 2005, at 9:35:57

Linkadge,

do you think that *some* opiates might
work on depression, but not on manic-depression
for example?

Squiggles

 

Re: Opiates for depression? linkadge

Posted by jerrympls on November 13, 2005, at 11:28:57

In reply to Re: Opiates for depression?, posted by linkadge on November 13, 2005, at 9:35:57

> As positive as jerrympls's story is, there have been equally many (if not many more) people who have used opiates without sucess in treating mood disorders.
>
> Most people who go to withdrawl clinics to stop opiate addictions are really suffering from an underlying mood disorder.
>
> Sometimes tollerance to drugs does not appear in the form one might expect.
>
> Different opiates have different rates of tollerance.
>
>
>
> Linkadge

Just for the record - I've always said that opiate therapy is NOT a cure-all. I still have had some depressive episodes while on the hydrocodone. And I agree it's not something that would work for everyone.

Also - Do you have the research that lists the rate of tolerance for various opiates? I find it hard to believe that scientists know the exact time it takes for anyone taking opiates to develop tolerance. But I could be wrong. And what do you mean by saying sometimes tolerance to drugs does not appear in the form one might expect?

Sorry if I come across a bit defensive but I get the feeling - and correct me if I am wrong - that you are trying to negate my experience. All I can say is that opiate therapy works for me and works well - and that I am not the only one by a longshot. I haven't developed tolerance after a year - but that's not to say I will never develop tolerance. Also, I am not an addict (not that you said that) and never have had a problem with addiction to anything.

So I guess I'm lucky.

 

Re: Opiates for depression?

Posted by linkadge on November 13, 2005, at 17:47:39

In reply to Re: Opiates for depression?, posted by Squiggles on November 13, 2005, at 9:38:25

Opiates can profoundly, if only temporarily, help depression, and the depressive phase of bipolar disorder.

Their long term safety or efficacy however, has never been shown.

They work in depression, because they directly activate the pleasure centres of the brain, like all other agents of abuse, something that other antidepressants don't do.

Another consideration is that, while virtually all antidepressant compounds to date promote neurogenesis, the opiates do not, infact they tend to lead to brain atrophy.

The neucleus accumbens has incredably effective homeostatic mechanisms.

If tollerance to the effects are slow, then it is highly likely that the withdrawl effects will be long lasting.

Linkadge

 

Re: Opiates for depression?

Posted by Squiggles on November 13, 2005, at 17:58:07

In reply to Re: Opiates for depression?, posted by linkadge on November 13, 2005, at 17:47:39

> Opiates can profoundly, if only temporarily, help depression, and the depressive phase of bipolar disorder.
>
> Their long term safety or efficacy however, has never been shown.
>
> They work in depression, because they directly activate the pleasure centres of the brain, like all other agents of abuse, something that other antidepressants don't do.
>
> Another consideration is that, while virtually all antidepressant compounds to date promote neurogenesis, the opiates do not, infact they tend to lead to brain atrophy.
>
> The neucleus accumbens has incredably effective homeostatic mechanisms.
>
> If tollerance to the effects are slow, then it is highly likely that the withdrawl effects will be long lasting.
>
> Linkadge

Well, its efficacy does sound ambiguous
(how is "profoundly" to be compared to
other antidepressants or treatments?)
for different kinds of depression,
but it may be worth a try if a doctor
approves and can monitor the addiction.

If it is very powerful in lifting depression
it may also be a good substitute to
ECT. I have read the arguments that
make this possibly equally ambiguous
treatment justifiable on the grounds
of its speed of reversing suicidal
depression.

Squiggles


 

Re: Opiates for depression? linkadge

Posted by jerrympls on November 13, 2005, at 18:08:44

In reply to Re: Opiates for depression?, posted by linkadge on November 13, 2005, at 17:47:39

> Opiates can profoundly, if only temporarily, help depression, and the depressive phase of bipolar disorder.
>
> Their long term safety or efficacy however, has never been shown.
>
> They work in depression, because they directly activate the pleasure centres of the brain, like all other agents of abuse, something that other antidepressants don't do.
>
> Another consideration is that, while virtually all antidepressant compounds to date promote neurogenesis, the opiates do not, infact they tend to lead to brain atrophy.
>
> The neucleus accumbens has incredably effective homeostatic mechanisms.
>
> If tollerance to the effects are slow, then it is highly likely that the withdrawl effects will be long lasting.
>
> Linkadge
>
>

How long is temporarily? A couple months? a year? 2 years? OH and I did stop taking the hydrocodone for a week without any withdrawl symptoms. Not sure why you're making such generalizations. And for someone like me who has been through the gauntlet of med combos - I would gladly take being on an opiate to my only other option (according to my docs) brain surgery.

Many antidepressant meds do not have long-term safety & efficacy data - and the withdrawl from some SSRIs can be just as bad as a controlled substance.

Link - why are you so negative about the use of opiates for depression? I'm not saying that everything you've posted is wrong or that one shouldn't take into consideration before starting an opiate (under a doctor's care). But you just seem against it.

And like I've always said - opiates are not a cure and they don't fix everything. They do, however, work with dopamine, NE and other neurotransmitters in the brain. When I take the hydrocodone, I do not feel high or buzzed - I feel almost clost to "normal."

I'm interested in how opiates lead to brain atrophy? Do you have any info you can share on that?

Thanks
Jerry

 

Re: Opiates for depression?

Posted by jerrympls on November 13, 2005, at 18:15:40

In reply to Re: Opiates for depression?, posted by Squiggles on November 13, 2005, at 17:58:07

Here's an interesting article I found that suggests watching TV causes the same amount of brain atrophy as opiates do:

http://www.cognitiveliberty.org/5jcl/5JCL59.htm

 

Re: Opiates for depression?

Posted by linkadge on November 13, 2005, at 18:21:45

In reply to Re: Opiates for depression? linkadge, posted by jerrympls on November 13, 2005, at 11:28:57

>Also - Do you have the research that lists the >rate of tolerance for various opiates?

Not specifically, but there is a lot of research done on the effects of opiate tollerance. Methadone, for instance is used as a subsitute for heroin because of the difference in tollerance rates. Most users know, however, that methadone is no less addicting.

The following article is about vicodin, and how tollerance seems to develop more slowly (at least in animal models) to the euphoria, and analgesia.

http://opioids.com/hydrocodone/vicodin.html

>I find it hard to believe that scientists know >the exact time it takes for anyone taking >opiates to develop tolerance.

They don't know specifically, (ie. for any one individual), but opiate tollerance has been one of the biggest pharmacudial issues, in search for effective nonadicting painkillers. Comparisons are made between opiates, in terms of their euphoriant properties, their painkilling properties, and their latencies for tollerance. Some of those proceedures are listed in the above article.

>But I could be wrong. And what do you mean by >saying sometimes tolerance to drugs does not >appear in the form one might expect?

Tollerance can be measured by the degree severity of withdrawl. Ie, missing your 2nd dose would be much easier than missing your 365th dose.
If a particular opiate has a slow tollerance latency, then it is harder to be attuned to the signs.


>Sorry if I come across a bit defensive but I get >the feeling - and correct me if I am wrong - ?>that you are trying to negate my experience. All >I can say is that opiate therapy works for me >and works well - and that I am not the only one >by a longshot. I haven't developed tolerance >after a year - but that's not to say I will >never develop tolerance. Also, I am not an >addict (not that you said that) and never have >had a problem with addiction to anything.

It will come down to what your definition of addicting is. In my definition, something is addicting if missing it would cause significant imparment to your daily functioning.

I'm not trying to negate what you are saying, but I would be concerned for the long term mental health of anybody who used opiates for the treatment of a mood disorder.


Linkadge

 

Re: Opiates for depression?

Posted by linkadge on November 13, 2005, at 18:27:16

In reply to Re: Opiates for depression?, posted by Squiggles on November 13, 2005, at 17:58:07

By profoundly, I mean that opiates can reverse a suicidal depression in minautes. Mind you, that suicidal depression didn't go anywhere.

So, perhaps in an emergency, opiates could prevent suicide.

But keep in mind, there was an article released in the Toronto Star 6 months ago about people jumping off bridges when they could not find their oxycontin in time. People without previous histories of mental illness.

Linkadge

 

Re: Opiates for depression?

Posted by jerrympls on November 13, 2005, at 18:27:55

In reply to Re: Opiates for depression?, posted by Squiggles on November 13, 2005, at 17:58:07

IN my opinion, opiate therapy is by far much safer than ECT. It is known that ECT causes brain damage. And I think that if someone were treatment-resistant and had the choice between the two, they should go with opiate therapy first.

My doctor didn't just come in one day and say "Hey let's put you on an opiate!" I had to dig up some research first. He then took a week to confer with a group of his colleagues and some pain med specialists.

After going over the possibilities of tolerance, addiction,withdrawl, etc. and promising to stop the opiate therapy if any of the above happened - only then did I get to try adding an opiate to my other meds.

I also brought up the point to my doc that tolerance, addiction, abuse, withdrawl are factors of both benzos and stimulants and that those are usually freely prescribed for paitents with depression.

Onoe could also argue that benzos cause brain atrophy and stimulant use could causde receptor burnout - only making depression worse. So I don't see why opiates should be called out as such a risky treatment.

My doctors - since starting the opiate - have watched my case very closely for ANY signs of abuse and tolerance. And thank God -being on an opiate for a year now I have NOT had any problems with abuse or tolerance.

I don't think that opiates are as bad as they're made out to be and that pdocs should look at them more as a treatment adjunct in special cases.

Jerry

 

Re: Opiates for depression?

Posted by linkadge on November 13, 2005, at 18:36:17

In reply to Re: Opiates for depression? linkadge, posted by jerrympls on November 13, 2005, at 18:08:44

I don't personally know how opiates supress neurogenesis, but the connection is being researched.

http://www.utsouthwestern.edu/UTSW/FacDir/CDA/FindAFaculty/Results/FacDir_FacSearchRes/0,2357,46980,00.html

Drugs of abuse, such as opiates, THC, ethanol, and nicotine, are known to decrease the number of new hippocampal cells. We are exploring if all drugs of abuse, regardless of their mechanism of action, similarly alter adult hippocampal neurogenesis, and in delineating the cellular mechanisms underlie the ability of drugs of abuse to alter adult neurogenesis. For example, how do opiates alter the cell cycle of hippocampal progenitors? Do opiates act directly on the progenitors to alter the cell cycle, or do opiates alter hippocampal growth factors, and thus indirectly alter the cell cycle? We are using both traditional and novel approaches to cell cycle analysis to address these questions.

Linkadge

 

Re: Opiates for depression? linkadge

Posted by jerrympls on November 13, 2005, at 18:38:27

In reply to Re: Opiates for depression?, posted by linkadge on November 13, 2005, at 18:27:16

> By profoundly, I mean that opiates can reverse a suicidal depression in minautes. Mind you, that suicidal depression didn't go anywhere.
>
> So, perhaps in an emergency, opiates could prevent suicide.
>
> But keep in mind, there was an article released in the Toronto Star 6 months ago about people jumping off bridges when they could not find their oxycontin in time. People without previous histories of mental illness.
>
> Linkadge

Ok, but in regards to the pepole jumping off bridges because they ran out of oxycontin is a completely different subject because they were severe addicts. I'm talking about using opiates as adjunct therapies to other depression treatments.

Not everyone is an addict or becomes an addict. What's the difference between the addictive nature of stimulants and benzos and that of opiates?

 

Re: Opiates for depression? linkadge

Posted by jerrympls on November 13, 2005, at 18:42:15

In reply to Re: Opiates for depression?, posted by linkadge on November 13, 2005, at 18:21:45

> >Also - Do you have the research that lists the >rate of tolerance for various opiates?
>
> Not specifically, but there is a lot of research done on the effects of opiate tollerance. Methadone, for instance is used as a subsitute for heroin because of the difference in tollerance rates. Most users know, however, that methadone is no less addicting.
>
> The following article is about vicodin, and how tollerance seems to develop more slowly (at least in animal models) to the euphoria, and analgesia.
>
> http://opioids.com/hydrocodone/vicodin.html
>
> >I find it hard to believe that scientists know >the exact time it takes for anyone taking >opiates to develop tolerance.
>
> They don't know specifically, (ie. for any one individual), but opiate tollerance has been one of the biggest pharmacudial issues, in search for effective nonadicting painkillers. Comparisons are made between opiates, in terms of their euphoriant properties, their painkilling properties, and their latencies for tollerance. Some of those proceedures are listed in the above article.
>
> >But I could be wrong. And what do you mean by >saying sometimes tolerance to drugs does not >appear in the form one might expect?
>
> Tollerance can be measured by the degree severity of withdrawl. Ie, missing your 2nd dose would be much easier than missing your 365th dose.
> If a particular opiate has a slow tollerance latency, then it is harder to be attuned to the signs.
>
>
> >Sorry if I come across a bit defensive but I get >the feeling - and correct me if I am wrong - ?>that you are trying to negate my experience. All >I can say is that opiate therapy works for me >and works well - and that I am not the only one >by a longshot. I haven't developed tolerance >after a year - but that's not to say I will >never develop tolerance. Also, I am not an >addict (not that you said that) and never have >had a problem with addiction to anything.
>
> It will come down to what your definition of addicting is. In my definition, something is addicting if missing it would cause significant imparment to your daily functioning.
>
> I'm not trying to negate what you are saying, but I would be concerned for the long term mental health of anybody who used opiates for the treatment of a mood disorder.
>
>
> Linkadge

Thanks for the link and the info.

As far as your statement on addiction, if I miss a dose or two - or even decide to take a day off from the opiate - I do not feel any negative effects. In fact I took 2 weeks off of taking my opiate (because of a script problem). I was worried about withdrawl, however, I didn't experience any.

Many negative things can be said about the use of opiates, but the same can be said of benzos, sleeping meds, and stimulants - yet they are used all the time in psychiatric medicine.

I strongly believe opiates have a place in psychiatric medicine.

Jerry

 

Re: Opiates for depression?

Posted by Squiggles on November 13, 2005, at 18:44:02

In reply to Re: Opiates for depression?, posted by linkadge on November 13, 2005, at 18:27:16

> By profoundly, I mean that opiates can reverse a suicidal depression in minautes. Mind you, that suicidal depression didn't go anywhere.

You are speaking of your own experience? But
I don't doubt it and minutes is much better
than 24 hrs., which is what lithium took for
me. Speaking of lithium, the manic side
is as bad as the depressive, though not
necessarily suicidal.
>
> So, perhaps in an emergency, opiates could prevent suicide.

That would be very good, and would
appease those who fear addiction as
it could be used temporarily at least.
>
> But keep in mind, there was an article released in the Toronto Star 6 months ago about people jumping off bridges when they could not find their oxycontin in time. People without previous histories of mental illness.

One more question, do you know if opiates can
be *added* to an AD, or if a doctor decided it
was OK to give an opiate for depression, would
the patient have to be taken off the AD.

The time a drug is taken can make a big
difference in the and is a "high-maintenance" kind of treatment which may be problematic for
a variety of reasons.

Tx for your interesting presentation on
this topic.

Squiggles

 

Re: Opiates for depression?

Posted by linkadge on November 13, 2005, at 18:45:09

In reply to Re: Opiates for depression?, posted by jerrympls on November 13, 2005, at 18:27:55

No, I am not trying to attack you personally.

You are right, that other treatments for psychiatric disorders carry similar risks, namely the benzo's and the stimulants.

You are also right that opiate therapy is safer than ECT.

I'd be hard pressed to agree that it is a safe treament for depression, but I wish you recovery, in any form that it takes.


Linkadge

 

Re: Opiates for depression?

Posted by linkadge on November 13, 2005, at 18:47:30

In reply to Re: Opiates for depression? linkadge, posted by jerrympls on November 13, 2005, at 18:38:27

There is no difference between the addictive potential of opiates, and benzo's or stimulants.

Significant depression can be a symptom of opiate withdrawl, regardless of weather one considers themselves an addict or not.

Linkadge

 

Re: Opiates for depression? Squiggles

Posted by jerrympls on November 13, 2005, at 18:47:45

In reply to Re: Opiates for depression?, posted by Squiggles on November 13, 2005, at 18:44:02

> > By profoundly, I mean that opiates can reverse a suicidal depression in minautes. Mind you, that suicidal depression didn't go anywhere.
>
> You are speaking of your own experience? But
> I don't doubt it and minutes is much better
> than 24 hrs., which is what lithium took for
> me. Speaking of lithium, the manic side
> is as bad as the depressive, though not
> necessarily suicidal.
> >
> > So, perhaps in an emergency, opiates could prevent suicide.
>
> That would be very good, and would
> appease those who fear addiction as
> it could be used temporarily at least.
> >
> > But keep in mind, there was an article released in the Toronto Star 6 months ago about people jumping off bridges when they could not find their oxycontin in time. People without previous histories of mental illness.
>
> One more question, do you know if opiates can
> be *added* to an AD, or if a doctor decided it
> was OK to give an opiate for depression, would
> the patient have to be taken off the AD.
>
> The time a drug is taken can make a big
> difference in the and is a "high-maintenance" kind of treatment which may be problematic for
> a variety of reasons.
>
> Tx for your interesting presentation on
> this topic.
>
> Squiggles
>
>

Hi Squiggles-

I don't know if you've been reading any of my posts - but I am on an opiate for depression. The opiate (hydrocodone) was added to my other depression meds, including Lexapro, Adderall & ativan. So YES, opiates can work with antidepressants.

Jerry

 

Re: Opiates for depression?

Posted by Squiggles on November 13, 2005, at 18:50:57

In reply to Re: Opiates for depression? Squiggles, posted by jerrympls on November 13, 2005, at 18:47:45

...
> Hi Squiggles-
>
> I don't know if you've been reading any of my posts - but I am on an opiate for depression. The opiate (hydrocodone) was added to my other depression meds, including Lexapro, Adderall & ativan. So YES, opiates can work with antidepressants.
>
> Jerry

I did not read that Jerry. Thanks - that's
very good and I will suggest to my friend
that she consult her doctor about that -
you may recall the problem we are dealing
with (witht the present tricyclic) is anhedonia.

Thanks for that bit of info.

Squiggles


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