Tag Archives: stress

Cellular Stress, Chronic Stress, and Fluoroquinolone Toxicity


My Healing Journey

Acupuncture helped me immensely in my journey through fluoroquinolone toxicity, and I even credit my acupuncturist with saving my life when I felt like a bomb was going off in my body. Several people have asked me what my acupuncturist did that helped me through fluoroquinolone toxicity. The honest answer is—I’m not sure. I don’t know enough about acupuncture or to tell anyone else how they might be able to replicate his methods or my healing. I do know, however, that I was spiraling when I first saw him. I was anxious, scared, and on the verge of panic because something was wrong with my body, and I had no idea what was going on or how to fix it. My acupuncturist was able to stop my cycle of anxiety, fear, and panic. He was able to calm me down. It helped—immensely—and it saved me from getting worse physically and psychologically.

A lot of the things that helped me to heal from my adverse-reaction to Cipro/ciprofloxacin were things that diminished my anxiety, quelled my fears, and calmed me down. I took a Mindfulness Based Stress Reduction class (through my health insurer—Kaiser Permanente) within weeks of getting floxed, and it helped a lot (I always felt better the day after the classes). I learned to meditate and I started some spiritual practices, and those were helpful as well. I removed stress and fear inducing things from my life (mainly, I got off the internet), and I found that I felt better when I removed those influences from my life.

I’m not saying that fluoroquinolone toxicity reactions are because of stress or anxiety, or that they’re “all in your head.” I am, however, saying that reducing stress helped me to recover, and that things that increased my stress levels made me feel worse. I also think that we shouldn’t have knee-jerk reactions against hypotheses about fluoroquinolone toxicity that look at how we react to stress—after all, stress affects everything (hormones, mental function, cardiovascular system, digestion, etc.). Additionally, there have recently been some interesting studies and hypotheses about how people respond to stress on a cellular metabolic level that are likely applicable to floxies.

Are Some People Genetically Predisposed Toward Shutting Down in Times of Stress?

On Dr. Sharon Meglathery’s web site, http://www.rccxandillness.com/, she hypothesizes that people who have a variety of multi-symptom, chronic illnesses (including ME/CFS, fibromyalgia, POTS, EDS, autoimmune diseases, psychiatric diseases, etc.) have a common set of gene mutations that make them unable to cope with stress on a cellular/chemical level. She notes that:

Let me illustrate how a clinically “healthy” carrier for a non-functioning CYP21A2 mutation (or a person with 2 mutated copies of partially functioning genes) could possibly develop chronic illness: Cortisol is a hormone needed for a normal stress response. Cortisol is made from 17hydroxyprogesterone by the enzyme called 21hydroxylase. 21hydroxylase is coded for by the CYP21A2 gene in the RCCX module. If a carrier for a CYP21A2 mutation which makes no functioning 21hydroxylase or a homozygote for partially functioning 21hydroxylase has chronic stress and needs to make lots of cortisol all of the time, it is possible that there may not be enough 21hydroxylase available to make the amount of cortisol the body needs. In this case, cortisol levels would be abnormally low for the amount of stress, 17hydroxyprogesterone would be abnormally high causing symptoms and some of the 17hydroxyprogesterone would be used by an enzyme coded for by CYP17 to make an abnormally high amount of androgens (male sex hormones) also causing symptoms. As I will show later, the symptoms caused by these hormonal abnormalities are shockingly familiar to those with chronic illness. Further, high cortisol releasing hormone (CRH), released when cortisol is too low can turn on devastating inflammatory cascades, including mast cell activation. (High CRH has recently been found to be associated with FM).”

Could the people who get “floxed” have CYP21A2 mutations that make them unable to cope with stress on a cellular level? Might the multi-symptom, chronic illness and disability that many floxies suffer from start with improper cortisol synthesis? It certainly sounds like a reasonable hypothesis to me.

Of course, the hypothesis that Dr. Meglathery is putting forth needs to be studied in order to be verified, and then further studies would need to be done to see if people suffering from fluoroquinolone toxicity have these genetic mutations, in order to verify that hypothesis. We are in the very early stages of figuring out what is going on in the bodies of everyone suffering from multi-symptom, chronic, illnesses—especially those caused by pharmaceuticals.

The Stress and Chronic Illness Cycle

Dr. Meglathery also explains how chronic stress could lead to the following ailments in people who are genetically predisposed to being unable to produce sufficient levels of cortisol:

At this point, if you are aware, you usually see some mild MCAS symptoms (allergy symptoms: hives, migraines, food intolerances, asthma, diarrhea, irritability, brain fog, increased distractibility and escalating sensory issues). CRH, the hormone released by the hypothalamus telling the body (via the pituitary) to make cortisol when cortisol is inappropriately low, is released in a pulsatile fashion. CRH is the most potent activator of mast cells in the body and found to be high in FM (Published by Dr. Theoharides, 1/16). It also decreases stomach acid, possibly contributing to dysbiosis and malabsorption; it stimulates the sympathetic nervous system causing the release of even more adrenaline and nor-adrenaline (norepinephrine) and it directly turns on the immune system. CRH release may be the master switch which propels a person with CYP21A2 mutations into irreversible chronic illness by effecting downstream changes which place an insurmountable and persistent stress load on the body. The demand for 21hydroxylase can now never be sated. I believe that people with CYP21A2 mutations who are exposed to Borrelia burgdorferi, the pathogen in Lyme Disease (which directly activates mast cells) and other strong infectious stressors, like EBV, jump straight to immune system activation, flipping the switch by bypassing CRH initially, but CRH rises later in response to the chronic stress of infection, locking them into chronic illness. Low blood volume/orthostatic challenges worsen (POTS), pain syndromes develop (via low cortisol, increased subluxations/injuries, inflammatory mediators affecting nerves, high 17hydroxyprogesterone), raised intracranial pressure/acquired chiari malformation can occur (via progesterone, low magnesium, brain inflammation from MCAS, etc.) and MCAS is present consistently.

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With the immune system dysregulated, dysbiosis becomes fully established with gut inflammation and malabsorption. The body becomes colonized with new pathogens (through the porous gut and other pathways) and SIBO can occur. Pathogens already present start to cause problems (fungus-athlete’s foot, herpes virus-cold sores, low virulence bacteria and viruses like mycoplasma, etc), the ability to fight serious infection drops and in many, the ability to fight the viruses which cause colds increases. The body is now under tremendous physical stress and the person is under tremendous negative emotional stress, both of which increase the cortisol deficit and sustain the growing list of medical issues. If brain inflammation is part of the picture (likely as part of MCAS), we get psychosis and severe mood disorders plus or minus the physical issues. This is a downward spiral which few escape.”

Many of the symptoms that Dr. Meglathery mentions in the above paragraphs are too familiar to people who are floxed. Mast cell activation (MCAS), and the symptoms that come along with it—hives, migraines, food intolerances, asthma, diarrhea, irritability, brain fog, increased distractibility and escalating sensory issues—are common among those who are floxed. Low stomach acid, dysbiosis and malabsorption are also common among those who are floxed. Many people with fluoroquinolone toxicity also suffer from symptoms of POTS/dysautonomia. Small intestinal bacterial overgrowth (SIBO) has occurred in those suffering from fluoroquinolone toxicity as well. Symptoms of brain inflammation, sometimes including psychosis and other severe mood disorders, can also occur in those with fluoroquinolone toxicity.

As you can see from Dr. Meglathery’s connections above, stress, especially chronic stress, can start a cycle of chronic illness in those who are genetically predisposed, and the chronic illness cycle includes many of the symptoms of fluoroquinolone toxicity.

Cellular Stress and Chronic Illness

The tendency for chronic illness to be self-perpetuating on a cellular level is also demonstrated in Dr. Robert K. Naviaux’s acclaimed 2016 study, “Metabolic Features of Chronic Fatigue Syndrome,” which finds that, in ME/CFS patients, mitochondria respond to stressors by decreasing oxygen consumption and the transfer of cellular energy production—ATP—from inside the cell (where it belongs), to outside of cells (“Finding ATP outside a cell is a sign that something major has gone wrong.”). People with ME/CFS get “stuck” in a state of “hypometabolic response to environmental stress similar to dauer” – a cellular state that is similar to hibernation. This hypometabolic/dauer state is triggered by mitochondrial stressors (mitochondrial stressors can include emotional and psychological stress, as well as things like viruses, toxins—including many pharmaceuticals, malnutrition, etc.). It is noted in “The Core Problem in Chronic Fatigue Syndrome Identified? Naviaux’s Metabolomics Study Breaks Fresh Ground” that:

Naviaux believes the mitochondria are able to sense every kind of danger – from pathogens to pH changes to toxic elements from pesticides, heavy metals, etc. to inflammation. They sense trouble in the form of an infection when they detect a drop in voltage caused by the diversion of electrons (NADH / NADPH) to make viral components or respond to a broad variety of toxins.

In the cell danger response (CDR) the mitochondria respond instantaneously to that loss by decreasing their oxygen consumption – thus thwarting pathogens from using the building blocks of the cell to replicate. Because the oxygen is no longer being used, it builds up in the cells causing a oxidatively charged environment which interrupts viral synthesis. The CDR also stiffens the membrane of the cell to stop pathogens from exiting it, warns other cells of the danger, and emits ATP in order to warn other cells to get their defenses up.”

Fluoroquinolones can cause mitochondrial damage, and may trigger the CDR, by depleting mitochondrial DNA. Fluoroquinolones have been shown to “cause mitochondrial dysfunction and ROS overproduction in mammalian cells.” For many people, the cycle of stress, chronic illness, hypometabolism, and dauer, starts with an assault on mitochondria from fluoroquinolone antibiotics.

Concluding Thoughts on Stress and Fluoroquinolone Toxicity

Again, I want to emphasize that these connections are hypotheses, not proven facts. However, as the fields of metabolomics and genetics progress, I suspect that we will find answers to fluoroquinolone toxicity, and all other multi-symptom, chronic illnesses.

You may be wondering, how does one get out of the stress/chronic illness cycle? As anyone who has researched or experienced a chronic illness knows, that question is much easier asked than answered. The fluoroquinolone toxicity recovery stories on this site give some valuable suggestions for those dealing with fluoroquinolone toxicity, as does the post “I’m Floxed, Now What?” Before getting too overwhelmed with advice though, a first-step in the right direction may be to reduce stress. We all have stress in our lives—but if there are things that you can do to avoid it (staying away from people and information that give you anxiety, and also avoiding mitochondrial toxins), or that help you to cope with it (meditation, mindfulness, etc.), those things may be helpful in starting your fluoroquinolone toxicity (or other chronic illness) recovery journey. It is difficult to reverse the cellular cycles of chronic illness, and reducing stress is not a quick-fix or easy answer, it is more like a starting point.

I know that it sounds simplistic and dismissive to tell you to “reduce stress,” but hopefully the information above demonstrates that stress is related to every bodily function, and it is intimately connected to chronic illness. Neither chronic illness nor stress, nor their connections, are trivial or to be dismissed in any way. If Dr. Meglathery is right, and there are some people who are genetically predisposed toward an inability to handle stress on a cellular level, avoiding stress (including toxins, viruses, etc.) may be key for avoiding chronic illness for those people. I suspect that everyone who is “floxed” falls into the category of “those people” who are more succeptible to harm from stressors than others. It isn’t easy to avoid stress (or stressors like toxins and viruses), but doing so may be necessary for your health, and it also may be a key to your healing. Most stress-reduction exercises and tools are inexpensive and easy to access, so they’re almost certainly worth a try.

 

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Treating Fluoroquinolone Anxiety

Free-floating, often severe, anxiety is a common symptom of fluoroquinolone toxicity.

Fluoroquinolones thoroughly mess up GABA neurotransmitters, and GABA “plays the principal role in reducing neuronal excitability throughout the nervous system.”  Here are a few articles that describe how fluoroquinolones negatively affect GABA – Article 1, Article 2, Article 3.

To put what fluoroquinolones do to GABA neurotransmitters into a framework, they basically throw people into protracted benzodiazepine withdrawal.  People who have gone through benzodiazepine withdrawal at any time in life should NEVER take a fluoroquinolone.  See “Benzodiazepine tolerance, dependency, and withdrawal syndromes and interactions with fluoroquinolone antimicrobials” for more information about how fluoroquinolones affect people who have a history of benzodiazepine use and withdrawal.

The things that help people through protracted benzodiazepine withdrawal may be helpful for floxies too.  GABA neurotransmitters and receptors have been iatrogenically damaged by both drugs, and they need to heal.  From what I understand, the Ashton Manual has a lot of good information in it about healing from benzodiazepine withdrawal.  Support sites like www.benzobuddies.org may also be helpful.

A very interesting review of supplements to treat anxiety (specifically benzodiazepine induced anxiety, but the advice is applicable to floxies too) can be found through this link –

http://www.longecity.org/forum/topic/54028-treating-anxiety-safely-effectively/

Additionally, Ruth has researched and written extensively about fluoroquinolone induced anxiety and I suggest reading her story – https://floxiehope.com/ruths-story-cipro-toxicity/ and listening to her podcast – https://floxiehope.com/2015/01/07/the-floxie-hope-podcast-episode-6-ruth-young/.  She also wrote some very interesting and insightful comments on my story starting about June 9, 2015 – https://floxiehope.com/lisas-recovery-story-cipro-toxicity/comment-page-13/#comments.

Ruth mentions supplementing uridine in her story:

I also have found that uridine works really well when I get that horrible insomnia and nothing else is helping. Uridine has it’s own receptors in the brain, so maybe it is a way floxies can bypass GABA receptor damage. I cannot prevent a relapse with it. I take it after the relapse starts, 500-750 mg with a fish oil capsule to help it work better. It’s something to have in reserve for those times you just want to crawl out of your own skin and you need to get some rest. Taking it every day did nothing for me. It has to be timed just right, at the moment that every time I’m starting to fall asleep symptoms are getting more intense and now I’m standing there by my bed with my skin just burning, knowing I am not going to sleep. A couple uridine and I’m out within thirty minutes.

It has recently come to my attention that uridine helps to reduce epileptic seizures and that increases free GABA, thus it has a calming influence. I have found it to be useful.

The things that helped me to get through cipro-induced anxiety are: 1. Acupuncture, 2. Meditation, 3. Stress reduction – especially flox related stress – that meant getting off the internet.

I went through a recent period of pain that induced anxiety. Kava helped me a lot. The longecity article recommends against kava, and I think that their concerns are valid. It is only for short-term use and it probably isn’t best for people who have had a history of benzo withdrawal. Personally, I’ve never had a benzo and I only needed to use kava for a short period of time.  It was a life-saver during the time I used it. Be careful with it though.

There is a vicious cycle when it comes to fluoroquinolone toxicity symptoms and anxiety.  Fluoroquinolone toxicity symptoms lead to stress and anxiety (it’s a pretty reasonable to be stressed and anxious when you’re suddenly in pain, you can’t move but when you do you tear tendons, you lose your memory, and suffer from chronic insomnia – to name just a few symptoms of fluoroquinolone toxicity), stress and anxiety negatively affect the autonomic nervous system (ANS) and lead to dysautonomia, ANS damage leads to more fluoroquinolone toxicity symptoms, which leads to more stress, and so on, and so on.

I don’t think that fluoroquinolone toxicity is “just” anxiety, but I do think that anxiety makes every symptom of fluoroquinolone toxicity worse.  I also think that there is nothing to be trivialized about anxiety.  It’s not a choice.  It’s the central and autonomic nervous systems going completely hay-wire, and both stress and anxiety can lead to serious health problems.

I know that anxiety makes you not want to do these things, but I also suggest trying really hard to do the simple things that make you healthy and happy. Sleep plenty. Enjoy your food. Laugh a lot. Be social. Hang out with a pet and/or children. Those things are healthy and they are healing. They’re easier said than done, but they’re certainly worth a try.

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In my opinion, it’s imperative for floxies to get stress and anxiety symptoms under control.  Neither stress nor anxiety are easy things to control, and, like I said earlier, it’s not a choice – it’s GABA neurotransmitter damage – but anything that can be done to reduce stress and anxiety will help the GABA neurotransmitters to heal, and will help the ANS and CNS to normalize.

Fluoroquinolone induced anxiety can be crawl-out-of-your-skin horrible, but it does get better.  Hang in there, my friends.

 

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Cipro is no better than a PLACEBO at treating chronic prostatitis / chronic pelvic pain syndrome

It is noted in the book, A Headache in the Pelvis, that, “Ciprofloxacin, one of the most powerful antibiotics, on a long-term basis proves to be only as effective as a placebo” for treatment of chronic prostatitis / chronic pelvic pain syndrome (CP/CPPS).

I just about fell out of my chair when I read that.

Ciprofloxacin, not only one of the most powerful antibiotics, but also one of the most dangerous antibiotics, is NO MORE EFFECTIVE THAN A PLACEBO for treatment of chronic prostatitis.  Despite their lack of effectiveness, “Quinolones, such as ciprofloxacin, are commonly used to treat CP/CPPS because of their excellent penetration into the prostate.”

Ciprofloxacin penetrates the prostate, and every cell in the body well, but that doesn’t seem like a good enough reason to give it out to the 9-12% of men who suffer from prostatitis if it is NO MORE EFFECTIVE THAN A PLACEBO in treating chronic prostatitis.

Let’s do a cost/benefit analysis of ciprofloxacin versus a placebo.

Placebo

Benefits:  Some potential alleviation of symptoms, as well as potential increases in physical and mental health scores.  (The placebo effect is amazing – it’s not the same as doing nothing.)

Costs:  The potential for “nocebo” effects exists – the experience of adverse effects based on the expectation of adverse effects.  A placebo is a sugar pill though, and the potential for adverse effects is negligible.

Ciprofloxacin

Benefits:  Some potential alleviation of symptoms, as well as potential increases in physical and mental health scores.  (Same potential benefits as the placebo.)

Costs:  Ciprofloxacin and other fluoroquinolones can kill people – DEATH is a potential effect.  If they don’t kill the patient, they can still structurally weakening of every tendon in one’s body, cause mitochondrial dysfunction and potentially increase the risk of all of the diseases related to mitochondrial dysfunction (including neurodegenerative and autoimmune diseases), lead to serious central nervous system adverse effects including seizures, anxiety, depression, suicidal ideation and intracranial pressure, cause liver and kidney failure, PERMANENT peripheral neuropathy, and more.  There is a 43 PAGE warning label for ciprofloxacin.  Many things are missing from the warning label, and a list of some of the adverse effects can be found HERE.  When patients are given ciprofloxacin, they are not only risking a single adverse effect listed on the warning label, they are risking multiple, devastating effects that may be permanent.

Opting for the sugar pill seems pretty reasonable—better, actually.

It is criminal to subject people to a drug as dangerous as ciprofloxacin for a condition that it isn’t effective at treating.  It is NOT a benign drug.  It is a topoisomerase interruptera chemo drug – and it should NOT be used frivolously.  Ciprofloxacin, and all the other fluoroquinolones, should only be used in life-threatening situations and they should NEVER be used for conditions that they are not proven effective at treating.  They should NEVER be used in situations where they have been shown to be no more effective than a placebo.

This isn’t rocket science.  Don’t give people dangerous drugs that don’t even have the potential for helping them.  It’s not hard.  But men with CP/CPPS are given ciprofloxacin, and other fluoroquinolones, as if they’re candy, to “treat” their condition.  It’s absurd.

The study that found that CP/CPPS is no more effective than a placebo was published in the Annals of Internal Medicine in 2004 and it was entitled “Ciprofloxacin or Tamsulosin in Men with Chronic Prostatitis / Chronic Pelvic Pain Syndrome: A Randomized, Double-Blind Trial.”  The article notes that:

“Chronic prostatitis / chronic pelvic pain syndrome (CP/CPPS) is a common disorder and accounts for approximately 2 million visits to physicians annually in the United States.  The substantial impact of CP/CPPS includes bothersome lower urinary tract symptoms, sexual dysfunction, reduced quality of life, and increased health care expenditures.  The syndrome is diagnosed only on the basis of symptoms, principally pain or discomfort in the pelvis region.  No objective measures can help define the disease.  Although bacteria can infect the prostate, most men with prostatitis have a negative midstream urine culture, indicating that bacteria may not be the cause of their symptoms.”

“Because the cause of CP/CPPS is unknown, affected men receive many empirical therapies.  The 2 most common treatments prescribed by physicians are antimicrobial agents and a-adrenergic receptor antagonists, although there is little objective evidence to support their use.  Quinolones, such as ciprofloxacin, are commonly used to treat CP/CPPS because of their excellent penetration into the prostate and broad spectrum coverage for uropathogens and other organisms traditionally believed to be associated with the syndrome.” 

After completing a randomized, double-blind trial on men suffering from CP/CPPS, and comparing those who received ciprofloxacin, tamsulosin, a combination of both ciprofloxacin and tamsulosin, and a placebo, it was concluded that, “Ciprofloxacin and tamsulosin did not substantially reduce symptoms in men with long-standing CP/CPPS who had at least moderate symptoms.”

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Ciprofloxacin, and other antibiotics, are given to men with non-bacterial prostatitis for no good reason whatsoever.  They are often given long courses as well – 6 to 12 weeks of the drugs.  That’s a long enough course for many of the men who are given these drugs to cross their tolerance threshold for the drugs and get floxed.

If ciprofloxacin was effective at treating CP/CPPS, perhaps it would be worth the risk of getting floxed.  But ciprofloxacin isn’t effective at treating CP/CPPS.  It’s no more effective than a sugar pill and it is beyond ridiculous and wrong to expose men to a dangerous drug that doesn’t even help them.

CP/CPPS has been shown to be treatable through the techniques outlined in A Headache in the Pelvis: A new understanding and treatment for prostatitis and chronic pain syndromes.  The effective treatments include trigger point therapy and concomitant relaxation training.  More information about the treatments can be found in the article, “6-Day Intensive Treatment Protocol for Refractory Chronic Prostatitis/Chronic Pelvic Pain Syndrome Using Myofascial Release and Paradoxical Relaxation Training,” as well as on the web site http://www.pelvicpainhelp.com/.

Many symptoms of CP/CPPS, and other pelvic pain syndromes, react well to relaxation training and appear to be a response to stress and anxiety.  “Chronic pelvic pain reflects tension in the pelvic floor, initiated or exacerbated by cycles of mental tension, anxiety and stress.”  Pelvic pain syndromes are no more a choice than other bodily manifestations of stress such as heart attacks, back pain or tension headaches.  The pain is real and it is not “in the patient’s head.”  The brain is not separate from the body though, and what is going on in the head can have bodily manifestations.

The effects of ciprofloxacin, and other fluoroquinolones, on neurotransmitters may exacerbate CP/CPPS and other diseases related to stress and anxiety.  Fluoroquinolones block GABA-A receptors.  GABA receptors are the neurotransmitters that induce a calming response.  When GABA receptors are blocked by fluoroquinolones, anxiety, insomnia, fearfulness, loss of confidence, loss of self, psychiatric illness and even seizures can result.  Floxed patients often report being unable to relax, a reduced threshold for stress, autonomic nervous system dysfunction, and other symptoms of GABA neurotransmitter dysfunction.  Fluoroquinolones activate the sympathetic nervous system and disrupt the balance between the sympathetic and parasympathetic nervous systems.

If CP/CPPS is primarily a response to anxiety, stress and disregulation of the sympathetic/parasympthetic nervous systems, ciprofloxacin may not only fail to improve chronic pelvic pain conditions, it may exacerbate them.

Prescribing ciprofloxacin, or any other fluoroquinolone, to patients with chronic pain and non-bacterial prostatitis, is not only not helpful – IT IS HARMFUL, and may exacerbate the condition it is prescribed to treat.

Post-script note – Many people, especially elderly women, are given fluoroquinolones to treat asymptomatic urinary tract infections after a urinalysis shows bacteria in their urine.  It has recently been noted that URINE ISN’T STERILE.  And again, people are getting floxed for no good reason.

Sources:

A Headache in the Pelvis, a New, Revised, Expanded and Updated 6th Edition: A New Understanding and Treatment for Chronic Pelvic Pain Syndromes by David Wise and Rodney Anderson

Alexander RB, et al. “Ciprofloxacin or tamsulosin in men with chronic prostatitis/chronic pelvic pain syndrome: a randomized, double-blind trial.” Annals of Internal Medicine, 2004 Oct 19;141(8):581-9.

Anderson RU, et al. “6-day intensive treatment protocol for refractory chronic prostatitis/chronic pelvic pain syndrome using myofascial release and paradoxical relaxation training.” The Journal of Urology, 2011 Apr;185(4):1294-9. doi: 10.1016/j.juro.2010.11.076. Epub 2011 Feb 22.

“What is the mechanism by which the fluoroquinolone antibiotics (e.g., ciprofloxacin, gemifloxacin, levofloxacin, moxifloxacin) can increase a patient’s risk for developing a seizure or worsen epilepsy?Pharmacology Weekly, ©2008 – 2014 Pharmacology Weekly, Inc.

 

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