PsychoTropical Research (PTR)

Hello, and welcome to ‘PsychoTropical’ which has been my website for 20 years.

I am Dr Ken Gillman, a retired psychiatrist and clinical neuro-pharmacologist who does research and has published many scientific review papers in the field of neuro-pharmacology — see ‘Publications’. I am an internationally acknowledged authority on Serotonin Toxicity (ST), aka Serotonin Syndrome (SS), and an expert on MAOIs, and drug adverse reactions and interactions, especially those relating to MAOIs, TCAs, SSRIs and SNRIs.

I live in tropical north Queensland, Australia: hence the web site name ‘PsychoTropical‘ (psychotropic: a drug that effects the brain).

You might like to read the other parts in this homepage section which tell more about the website and how it is organised.

Psychotropical.com has been awarded the Expertido ‘one of the best psychiatry sites’ accolade, and you can verify that here: https://www.expertido.org/best-psychiatry-blogs-reviews

Therefore, we are displaying their logo.

And more exciting news. The level of donations to the website this year has been sufficient to enable me to commit to employing a part-time IT & Admin assistant for the website, and my ‘International MAOI expert group’ — this group is a success, it is mobilizing many experts world-wide to take action concerning the lessening usage and availability of MAOIs.

Until now my inability to do much keyboard work, because of my disability, has been a limiting factor, especially with the computer programs and internet platforms, that are necessary.

Heidi Counsell has filled the role of IT and Admin Assistant with enthusiasm and continues to make substantial progress with various aspects of our advancement, especially Podcasts and UTube videos. It is surprising how much work is involved in that kind of thing — her skills have turbo-charged the whole enterprise, and the information disseminating process.

So, check out the menu ‘View/listen’ for important additions, and the links to Facetime, Twitter, etc., as well as increased content and functionality of the website itself.

Everyone reading this can contribute, with just a click, to helping achieve one of the most important goals that I have, in whatever working years may remain for me. That goal is improving knowledge about MAOIs, and the usage of MAOIs, to an appropriate prominence in the therapeutic armamentarium of doctors. Research and experience indicate achieving that will greatly benefit many people with severe depression (see ‘patient stories’).

Patients who demand MAOI treatment from doctors will be the most influential factor encouraging doctors to learn about them and prescribe them — and suggest your specialist joins the [MAOI group].

All readers have to do to contribute is to ‘click’, spread the word via whatever Apps you use, and we have further integrated more of those Apps into the website, so they are just a click away.

The website

My website covers the effectiveness, and side effects, of drugs that act on the brain (neuro-pharmacology), especially anti-depressants, and also the interactions between these drugs. The quintessential interaction being Serotonin Toxicity (ST), about which I am an internationally acknowledged authority. I am also an expert on the underused anti-depressants drugs called MAOIs. That requires me to be expert in drug adverse reactions and interactions involving most drugs that affect the nervous system, but especially: MAOIs, TCAs, SSRIs and SNRIs.

The content is all written by me: I have published many scientific review papers about neuro-pharmacology* in prestigious journals. Details are in PubMed, the ‘Publications’ menu, and my ‘Google Scholar’ profile which is public (my publication metrics are superior to those of most professors).

*I often hyphenate long scientific words which are not normally hyphenated because in my opinion it makes them easier to read for non-scientific readers.

Many of the commentaries, as I call them, on this website are relatively long; but I do attempt to write them in a way which an educated but non-scientific person can understand. Many have undergone revision from versions first posted some years ago, although the dates of revision, at the moment, have become a little corrupted — in academic circles this process of (critical) revision of texts, sometimes by a different author, is called recension. Therefore, apparent anomalies in the text may reflect that process of recension.

This web site provides free information and expert critical analysis on many aspects of neuro-pharmacology. That involves explaining that drugs do not necessarily do what pharmaceutical companies think, or claim, they do. Inevitably, therefore, I discuss the influences that distort and degrade the accuracy and standard of much of the science that we all read (see menu ‘Bias in science’).

Anyone with questions and comments may contact me [2 A note about Skype and enquiries]. I am often available on Skype and happy to speak with people — remember, if you’re not confident, that Skype can be used just as an instant text platform where I can respond by talking rather than typing (which is much easier for me because of my disability), you do not need to turn on your microphone or camera, or even have one.

Philosophy and motivation

The motivation to maintain this website is to help both doctors and patients, their families and friends, navigate the mass of mis-information they are confronted with: that necessitates experience and critical analysis. One prominent theme is the underuse of what are certainly the most effective of all anti-depressants, for those with severe depression, the old MAOIs, and the extensive mis-information and mis-understanding relating thereto. My editorial about this, titled ‘Much ado about nothing’ [1], was published early 2017 in ‘CNS Spectrums’, and my review about MAOIs and tyramine in 2018 in the J of Neural Transmission in Nov 2018 [2], and the expert group’s ‘position statement’ in late 2019 [3].

Unfortunately, mainstream medicine is almost as prone to distorted information and wishful thinking as is alternative health care. Mis-information is promulgated by powerful wealthy interest groups, especially the pharmaceutical companies, and others, including medical practitioners themselves (status, self-importance, money). See my critical commentaries collected under ‘Bias in science’.

I now think that the medical publication scene and the internet are such that my efforts are more productively directed to putting quality information on my web site, rather than getting more papers published in scientific journals (which nobody reads).

One significant major downside of capitalism is that it favours a plutocratic hegemony*: that is not good for science generally, nor is it good for patients, because it produces a strong distorting bias pushing doctors in the direction of using newer well-advertised expensive treatments, rather than the best treatments.

*If you think I used too many big words, just remember is all you have to do is right click on them to find an explanation or definition.

Well informed consumers are needed to drive change effectively and quickly, because direct attempts to re-educate doctors have not succeeded, largely because pharmaceutical companies have a stranglehold on post-graduate medical education (the plutocratic hegemony).

Writing scientific papers is time consuming, especially for me when keyboard work is limited due to my bad neck. I am not a professor, although people justifiably assume that anyone who has published as many papers as I have must be a professor — that is a logical assumption since the ‘average’ professor has 1,000 citations and an ‘H-index’ of 14 (mine is 3,500 and 27) and I have published more original single-author review papers that most professors. If my alma mater still conferred the prestigious honorary degree of D.Sc. (Doctor of Science) I have been informed by a couple of eminent professors that I would be ‘in the running’.

My papers include recent reviews covering the interesting story of my discoveries about methylene blue [4, 5], which we have shown to be a monoamine oxidase inhibitor, as well as my review of the pharmacology of monoamine oxidase inhibitors (MAOIs), much overdue since this is a neglected area [1, 2]; and my review of neuroleptic malignant syndrome (NMS) [6]. My review paper about tricyclic antidepressants, in the British Journal of Pharmacology, has been influential and is the most cited paper in this field over the last thirty years [7] — it has 458 citations, and still steadily rising, 50 more this year).

References

1. Gillman, P.K., “Much ado about nothing”: monoamine oxidase inhibitors, drug interactions, and dietary tyramine. CNS Spectr, 2017: p. 1-3.

2. Gillman, P.K., A reassesment of the safety profile of monoamine oxidase inhibitors: elucidating tired old tyramine myths. J Neural Transm (Vienna), 2018. 125(11): p. 1707-1717.

3. Gillman, P.K., S. Feinberg, and L. Fochtmann, Revitalizing monoamine oxidase inhibitors: A call for action. CNS spectrums, 2019: p. http://dx.doi.org/10.1017/S1092852919001196.

4. Gillman, P.K., CNS toxicity involving methylene blue: the exemplar for understanding and predicting drug interactions that precipitate serotonin toxicity. Journal of Psychopharmacology, 2011. 25(3): p. 429-3.

5. Ramsay, R.R., C. Dunford, and P.K. Gillman, Methylene blue and serotonin toxicity: inhibition of monoamine oxidase A (MAO A) confirms a theoretical prediction. Br J Pharmacol, 2007. 152(6): p. 946-51.

6. Gillman, P.K., Neuroleptic Malignant Syndrome: Mechanisms, Interactions and Causality. Movement Disorders, 2010. 25(12): p. 1780-1790.

7. Gillman, P.K., Tricyclic antidepressant pharmacology and therapeutic drug interactions updated. British Journal of Pharmacology 2007. 151(6): p. 737-48.

PsychoTropical: Dr Ken Gillman

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