DARE: Towards Robust Text Explanations in Biomedical and Healthcare Applications
Year: 2023

Abstract:
Along with the successful deployment of deep neural networks in several application domains, the need to unravel the black-box nature of these networks has seen a significant increase recently. Several methods have been introduced to provide insight into the inference process of deep neural networks. However, most of these explainability methods have been shown to be brittle in the face of adversarial perturbations of their inputs in the image and generic textual domain. In this work we show that this phenomenon extends to specific and important high stakes domains like biomedical datasets. In particular, we observe that the robustness of explanations should be characterized in terms of the accuracy of the explanation in linking a model’s inputs and its decisions – faithfulness – and its relevance from the perspective of domain experts – plausibility. This is crucial to prevent explanations that are inaccurate but still look convincing in the context of the domain at hand. To this end, we show how to adapt current attribution robustness estimation methods to a given domain, so as to take into account domain-specific plausibility. This results in our DOMAINADAPTIVEARESTIMATOR (DARE) attribution robustness estimator, allowing us to properly characterize the domain-specific robustness of faithful explanations. Next, we provide two methods, adversarial training and FAR training, to mitigate the brittleness characterized by DARE, allowing us to train networks that display robust attributions. Finally, we empirically validate our methods with extensive experiments on three established biomedical benchmarks.

heading: Future Work
text: 12
FAR-IG – – – – – – – – – – – –
types explanation methods is an important future research direction. 8 Limitations and Risks
DARE only works for text. In its introduced form, it requires the prediction gradients for importance ranking, thus can only be used to attack differentiable architectures (up to the embedding layer). Most state-of-the-art classifiers (DNNs, transformers) fulfill this criteria though. Moreover, DARE requires MLMs trained in a specific domain to work – which might not always be readily available. However, as MLMs can be trained in an unsupervised fashion, pretrained MLMs can be finetuned to that domain with rather low effort. The main risk of DARE is that it does not give a guaranteed lower bound of robustness. If an attacker develops a stronger attack that is able to compute better perturbations that alter attributions to a greater extent, having a model that is robust to DARE perturbations might not be sufficient to withstand those stronger attacks. Taking the robustness estimation for granted is a risk, as it is true for most other attacks in traditional adversarial setups. This directly indicates another risk, namely that DARE could be used to attack explanations in deployed systems that are not trained robustly. We train our methods on state-of-the-art Nvidia A100 GPUs. Without having such GPUs available, FAR training in particular becomes a bottleneck, as the computation graph needs to be stored for several forward and backward passes, depending on the attribution method used. On this end, we also require the attributions to be differentiable with respect to the input embeddings, which is an implicit requirement of the FAR training method. We do not see any risks in using FAR to train robust networks. Finally, we do not examine any other aspects of faithful interpretations, only the robustness. We assume that these methods reflect the model behavior to some extent, but do not conclude any experiments to verify this assumption. Further investigation into whether more robust attributions yield better faithfulness in other aspects could be an interesting future research topic. References Emily Alsentzer, John R Murphy, Willie Boag, Wei-
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Thomas Wolf, Lysandre Debut, Victor Sanh, Julien Chaumond, Clement Delangue, Anthony Moi, Pierric Cistac, Tim Rault, Rémi Louf, Morgan Funtowicz, Joe Davison, Sam Shleifer, Patrick von Platen, Clara Ma, Yacine Jernite, Julien Plu, Canwen Xu, Teven Le Scao, Sylvain Gugger, Mariama Drame, Quentin Lhoest, and Alexander M. Rush. 2020. Transformers: State-of-the-Art Natural Language Processing. In Proceedings of the 2020 Conference on Empirical Methods in Natural Language Processing: System Demonstrations, pages 38–45, Online. Association for Computational Linguistics. World Health Organization. 1988. International classification of diseases—Ninth revision (ICD-9). Weekly Epidemiological Record= Relevé épidémiologique hebdomadaire, 63(45):343–344. X Yang, X He, H Zhang, Y Ma, J Bian, and Y Wu. 2020. Measurement of Semantic Textual Similarity in Clinical Texts: Comparison of Transformer-Based Models. JMIR Medical Informatics, 8(11):e19735– e19735. 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A. 2 AR Estimation and Robust Training In order to achieve robust attributions, in addition to the vanilla models we train models with robust training objectives. During adversarial training, we augment the training batches with adversarial samples that maximize classification loss. We use the A2T training method for extracting adversarial samples, with the parameters summarized in Table 8. Our FAR models are trained with the robust objectives from Section 5. 2, and the hyperparameters are written in Table 9. 1https://physionet. org/content/mimiciii/1. 4/
A. 3 More Examples
VANILLA ADVERSARIAL FAR-IG
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’i have been on invokana since september 2013, so a little over a year. i have experienced hair loss, tiredness, and yeast infections. i talked to my doctor about the hair loss, which i experienced for over a year. he has upped my metformin to the maximum dosage. my hair has stopped falling out. i am also using rosemary essential oil to help with hair loss, and probiotics for the yeast infection. i have had amazing results with this medication in regards to blood sugar control. my a1c went from 12. 3 to 7. 1 i have never had
F (s, l =“8. 0”) = 1. 0
’i have been on invokana since september 2013, so a little over a year. i have experienced hair loss, tiredness, and yeast infections. i talked to my doctor about the hair loss, which i experienced for over a year. he has upped my metformin to the maximum dosage. my hair has stopped falling out. i am also using rosemary essential oil to help with hair loss, and probiotics for the yeast infection. i have had amazing results with this medication in regards to blood sugar control. my a1c went from 12. 3 to 7. 1 i have never had
F (s, l =“8. 0”) = 0. 88
’i have been on invokana since september 2013, so a little over a year. i have experienced hair loss, tiredness, and yeast infections. i talked to my doctor about the hair loss, which i experienced for over a year. he has upped my metformin to the maximum dosage. my hair has stopped falling out. i am also using rosemary essential oil to help with hair loss, and probiotics for the yeast infection. i have had amazing results with this medication in regards to blood sugar control. my a1c went from 12. 3 to 7. 1 i have never had
F (s, l =“8. 0”) = 0. 97
A dv
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’i have been on invokana since september 2013, so a little over a year. i have noticed scalp loss, tiredness, and yeast infections. i talked to my doctor about the hair loss, which i experienced for over a year. he has upped my metformin to the maximum dosage. my hair has stopped falling out. i am also using rosemary essential oil to help with hair loss, and probiotics for the yeast infection. i have had numerous results with this medication in regards to blood glucose control. my a1c went from 12. 3 to 7. 1 i have never had
F (sadv, l =“8. 0”) = 0. 77
Cos. = -0. 07 MedSTS = 1. 0
’i have been on invokana since september 2013, taking a tad over a year. i have experienced hair loss, tiredness, and yeast infections. i complained to my doctor about the hair loss, which i experienced for over a year. he has upped my metformin to the recommended dosage. my hair has stopped falling out. i am also using rosemary essential oil to help with hair loss, and probiotics for the yeast infection. i have had amazing results with this medication in regards to blood sugar control. my a1c went from 12. 3 to 7. 1 i have never had
F (sadv, l =“8. 0”) = 0. 73
Cos. = 0. 35 MedSTS = 1. 0
’i have been on invokana since september 2013, so a little over a year. i have experienced hair loss, tiredness, and yeast infections. i talked to my doctor about the hair loss, which i experienced for over a year. he has upped my metformin to the recommended dosage. my hair has stopped falling out. i am also using rosemary olive oil to help with hair loss, and probiotics for the yeast infection. i have had amazing success with this medication in regards to blood pressure control. my a1c went from 12. 3 to 7. 1 i have never had
F (sadv, l =“8. 0”) = 0. 93
Cos. = 0. 58 MedSTS = 1. 0
O ri
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l
’i have had intractable migraine for 28 years, and migraines from the age of 10 until 28 years ago when it never quit. i went through many different trials of treatment &amp; nothing worked, so finally the headache specialist gave me vicodin. it worked and i was able to begin living life again. then a new md took the vicodin away and gave me topamax. my life was hell. i live alone in a 2 story house and i had to scoot up/down on my butt. i am 66 &amp; disabled (from strokes) and i was terrified. F (s, l =“2. 0”) = 1. 0
’i have had intractable migraine for 28 years, and migraines from the age of 10 until 28 years ago when it never quit. i went through many different trials of treatment &amp; nothing worked, so finally the headache specialist gave me vicodin. it worked and i was able to begin living life again. then a new md took the vicodin away and gave me topamax. my life was hell. i live alone in a 2 story house and i had to scoot up/down on my butt. i am 66 &amp; disabled (from strokes) and i was terrified. F (s, l =“2. 0”) = 0. 98
’i have had intractable migraine for 28 years, and migraines from the age of 10 until 28 years ago when it never quit. i went through many different trials of treatment &amp; nothing worked, so finally the headache specialist gave me vicodin. it worked and i was able to begin living life again. then a new md took the vicodin away and gave me topamax. my life was hell. i live alone in a 2 story house and i had to scoot up/down on my butt. i am 66 &amp; disabled (from strokes) and i was terrified. F (s, l =“2. 0”) = 0. 99
A dv
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’i have had intractable migraine for 28 years, and migraines from the age of 10 until 28 years old when it never quit. i went through many different trials of treatment &amp; nothing worked, so finally the arthritis specialist gave me vicodin. it worked and i was able to begin living life again. then a new md took the vicodin away and gave me topamax. my life was saying i was alone in a 2 story house and i had to scoot up/down on my butt. i am 66 &amp; disabled (from strokes) and i was terrified. F (sadv, l =“2. 0”) = 0. 71
Cos. = 0. 01 MedSTS = 0. 89
’i have had intractable epilepsy for 28 years, and migraines from the age of 10 until 28 years ago when it never quit. i went through many different trials of treatment &amp; nothing worked, so finally the epilepsy specialist gave me vicodin. it worked and i was able to begin living life again. then a new md took the vicodin away and gave me topamax. my life was ruined i live alone in a 2 nd house and i had to scoot up/down on my butt. i am 66 &amp; disabled (from strokes) and i was terrified. F (sadv, l =“2. 0”) = 0. 98
Cos. = 0. 26 MedSTS = 0. 81
’i have had intractable epilepsy for 28 years, and migraines from the age of 10 until 28 years ago when it never quit. i went through many different trials of treatment &amp; nothing worked, so finally the epilepsy specialist gave me vicodin. it worked and i was able to begin living life again. then a new md took the vicodin away and gave me topamax. my life was hell. i live alone in a 2 nd flat and i had to scoot up/down on my butt. i am 66 &amp; disabled (from strokes) and i was terrified
F (sadv, l =“2. 0”) = 0. 99
Cos. = 0. 58 MedSTS = 0. 81
O ri
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l
’i have only been using nuva ring for 5 days. i have not been sick in any way. or had mood swings. ive noticed i have alittle nore energy to get things done around the house. my sex drive i believe has increased a tiny bit. already was high but i haven’t had sex yet since i have had it in due to my partners work schedule. i do feel blowed everyday n i get pains in my stomach here and their like period cramps but nothing to intence. i so far do really like this birth control. i hope it makes my period leas painful and. F (s, l =“8. 0”) = 1. 0
’i have only been using nuva ring for 5 days. i have not been sick in any way. or had mood swings. ive noticed i have alittle nore energy to get things done around the house. my sex drive i believe has increased a tiny bit. already was high but i haven’t had sex yet since i have had it in due to my partners work schedule. i do feel blowed everyday n i get pains in my stomach here and their like period cramps but nothing to intence. i so far do really like this birth control. i hope it makes my period leas painful and. F (s, l =“8. 0”) = 0. 93
’i have only been using nuva ring for 5 days. i have not been sick in any way. or had mood swings. ive noticed i have alittle nore energy to get things done around the house. my sex drive i believe has increased a tiny bit. already was high but i haven’t had sex yet since i have had it in due to my partners work schedule. i do feel blowed everyday n i get pains in my stomach here and their like period cramps but nothing to intence. i so far do really like this birth control. i hope it makes my period leas painful and. F (s, l =“8. 0”) = 0. 91
VANILLA ADVERSARIAL FAR-IG A dv er sa ri al ’i have only been using nuva ring for 5 days. i have not been manic in any way. or had mood swings. ive noticed i have alittle nore energy to get things done around the house. my sex drive i believe has increased a tiny bit. already was high but i haven’t had sex yet since i have had it in due to my partners work schedule. i do feel blowed everyday n i get pains in my stomach here and their like period cramps but nothing to intence. lol so NOT do i like this under control. i hope it makes my period leas painful and. F (sadv, l =“8. 0”) = 1. 0
Cos. = -0. 35 MedSTS = 0. 91
’i have only been using nuva ring for 5 days. i have not been manic in any way. or had mood swings. ive noticed i have alittle nore energy to get things done around the house. my sex drive i believe has increased a tiny bit. already was high but i haven’t had sex yet since i have had it in due to my partners work schedule. i do feel blowed everyday n i get pains in my stomach here and their like period cramps but nothing to intence. i so i would not take this birth control. i hope it makes my period leas painful and. F (sadv, l =“8. 0”) = 0. 96
Cos. = -0. 12 MedSTS = 0. 91
’i have only been using nuva ring for 5 days. i have not been depressed in any way. or had mood swings. ive glad i have alittle nore energy to get things done around the house. my gas density i believe has increased a tiny bit. already was high but i haven’t had intercourse yet since i have had it in due to my partners work schedule. i do feel blowed everyday n i get pains in my stomach here and their like period cramps but nothing to intence. i so far do really like this birth control. i hope it makes my period leas painful and. F (sadv, l =“8. 0”) = 0. 48
Cos. = 0. 59 MedSTS = 0. 73
O ri
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l
’i started using this product a little more than a week ago. i applied it three nights in a row as instructed, and went to a party the next day to test it out. i still sweated, but not nearly as much, and i had hope that with time i would be totally sweat free. i applied it once again the following night, only to continue to sweat the next day. since then (it’s been about four days) i have applied hypercare every night without any improvements in the amount i sweat. today was the first day of school and i was sweat the entire day, unable to lift my
F (s, l =“2. 0”) = 1. 0
’i started using this product a little more than a week ago. i applied it three nights in a row as instructed, and went to a party the next day to test it out. i still sweated, but not nearly as much, and i had hope that with time i would be totally sweat free. i applied it once again the following night, only to continue to sweat the next day. since then (it’s been about four days) i have applied hypercare every night without any improvements in the amount i sweat. today was the first day of school and i was sweat the entire day, unable to lift my
F (s, l =“2. 0”) = 0. 97
’i started using this product a little more than a week ago. i applied it three nights in a row as instructed, and went to a party the next day to test it out. i still sweated, but not nearly as much, and i had hope that with time i would be totally sweat free. i applied it once again the following night, only to continue to sweat the next day. since then (it’s been about four days) i have applied hypercare every night without any improvements in the amount i sweat. today was the first day of school and i was sweat the entire day, unable to lift my
F (s, l =“2. 0”) = 1. 0
A dv
er sa
ri al
’i started using this product a little more than a week ago. i applied it three nights in a row as instructed, and went to a party the next day to test it out. i still sweated, but not nearly as much, and i was hope that by time i would be totally sweat free. i applied it once again the following night, only to continue to sweat the next day. since then (it’s been about four days) i have applied this every night without any breaks in the night i sweat. today was the first day of school and i was sweat the entire day, unable to lift my
F (sadv, l =“2. 0”) = 0. 87
Cos. = -0. 27 MedSTS = 1. 0
’i started using this product a little more than a week ago. i applied it three nights in a row as instructed, and went to a party the next day to test it out. i still sweated, but not nearly as much, and i had thought that with time i would be totally much less applied it once again the following night, only to continue to sweat the next day. since then (it’s been about four days) i have applied myself every night without any decrease in the amount i sweat. today was the first day of school and i was sweat the entire day, unable to lift my
F (sadv, l =“2. 0”) = 0. 55
Cos. = 0. 01 MedSTS = 1. 0
’i started using this mask a little more than a week ago. i applied it three nights in a row as instructed, and went to a clinic the next day to test it out. i still sweated, but not nearly as much, and i kept convinced that with time i would be totally sweat free. i applied it once again the following night, only to continue to sweat the next day. since then (it’s been about four days) i have applied hypercare every night without any changes in the amount i sweat. today was the first day of school and i was sweat the entire day, unable to lift my
F (sadv, l =“2. 0”) = 1. 0
Cos. = 0. 42 MedSTS = 0. 91
O ri
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l
’not every medicine is for everyone, but as one who has tried most of the major pharmaceuticals for major depression, panic attacks, severe anxiety and anxiety related bouts of obsessive compulsive disorder, i can tell you lexapro is the only medicine that i’ve been able to stay on and be effective for my mental well-being. it is the only one i’ve had no side effects with. other ssri’s have either: made me more anxious and/or depressed, dry mouth, bad weight gain, or extreme fatigue making me into a walking zombie during the day. i’ve been on lexapro 6 years
F (s, l =“10. 0”) = 1. 0
’not every medicine is for everyone, but as one who has tried most of the major pharmaceuticals for major depression, panic attacks, severe anxiety and anxiety related bouts of obsessive compulsive disorder, i can tell you lexapro is the only medicine that i’ve been able to stay on and be effective for my mental well-being. it is the only one i’ve had no side effects with. other ssri’s have either: made me more anxious and/or depressed, dry mouth, bad weight gain, or extreme fatigue making me into a walking zombie during the day. i’ve been on lexapro 6 years
F (s, l =“10. 0”) = 0. 99
’not every medicine is for everyone, but as one who has tried most of the major pharmaceuticals for major depression, panic attacks, severe anxiety and anxiety related bouts of obsessive compulsive disorder, i can tell you lexapro is the only medicine that i’ve been able to stay on and be effective for my mental well-being. it is the only one i’ve had no side effects with. other ssri’s have either: made me more anxious and/or depressed, dry mouth, bad weight gain, or extreme fatigue making me into a walking zombie during the day. i’ve been on lexapro 6 years
F (s, l =“10. 0”) = 1. 0
VANILLA ADVERSARIAL FAR-IG A dv er sa ri al ’not every medicine is for everyone, but as one who has tried most of the major pharmaceuticals for major depression, panic attacks, severe anxiety and anxiety related bouts of obsessive compulsive disorder, i can reassure you lexapro is the only medicine that i’ve been able to stay on and be effective for my personal well-being. it is the only one i’ve had no side effects with. My ssri’s have never made me more anxious and/or depressed, dry mouth, bad weight gain, or extreme fatigue making me into a walking zombie during the day. i’ve been on lexapro 6 years
F (sadv, l =“10. 0”) = 1. 0
Cos. = -0. 2 MedSTS = 0. 97
’not every medicine is for everyone, but as one who has prescribed most of the major pharmaceuticals for major depression, panic attacks, severe anxiety and anxiety related bouts of obsessive compulsive disorder, i can tell you lexapro is the only medicine that i’ve been able to stay on and be effective for my mental well-being. it is the only one i’ve had no side effects. pill antidepressants have either: made me more anxious and/or depressed, dry mouth, bad weight gain, or extreme fatigue making me into a walking zombie during the day. i’ve been on lexapro 6 years
F (sadv, l =“10. 0”) = 1. 0
Cos. = 0. 04 MedSTS = 0. 95
’not every medicine is for everyone, but as one who has done most of the major medication for major depression, panic attacks, severe anxiety and anxiety related bouts of obsessive compulsive disorder, i can tell you lexapro is the only medicine that i’ve been able to focus on and be positive for my mental well-being. it is the only one i’ve had no side effects with. other ssri’s have either: made me more anxious and/or depressed, dry mouth, bad weight gain, or extreme fatigue making me into a walking zombie during the day. i’ve been on lexapro 6 years
F (sadv, l =“10. 0”) = 1. 0
Cos. = 0. 52 MedSTS = 0. 92
O ri
gi na
l
’just took my first dose 5 mg of brintellix - have been on every possible medication including wellbutrin for 15 years, seroquel for 9 years, lexapro for 2 years, just weaned off lexapro. i feel quite odd, butterflies in stomach and brain fog - my daughter has been on brintellix for 2 months and is still vomiting - if this continues, another failed med. ’
F (s, l =“4. 0”) = 1. 0
’just took my first dose 5 mg of brintellix - have been on every possible medication including wellbutrin for 15 years, seroquel for 9 years, lexapro for 2 years, just weaned off lexapro. i feel quite odd, butterflies in stomach and brain fog - my daughter has been on brintellix for 2 months and is still vomiting - if this continues, another failed med. ’
F (s, l =“4. 0”) = 1. 0
’just took my first dose 5 mg of brintellix - have been on every possible medication including wellbutrin for 15 years, seroquel for 9 years, lexapro for 2 years, just weaned off lexapro. i feel quite odd, butterflies in stomach and brain fog - my daughter has been on brintellix for 2 months and is still vomiting - if this continues, another failed med. ’
F (s, l =“4. 0”) = 1. 0
A dv
er sa
ri al
’just took my first full 5 mg of brintellix - have been on every possible medication including wellbutrin for 15 years, seroquel for 9 years, lexapro for 2 years, just weaned off lexapro. i feel quite and butterflies in stomach and brain fog - my daughter has been on brintellix for 2 months and is still vomiting - if this continues, another new med. ’
F (sadv, l =“4. 0”) = 0. 6
Cos. = -0. 18 MedSTS = 1. 0
’just took my first batch 5 mg of brintellix - have been on every possible medication including wellbutrin for 15 years, seroquel for 9 years, lexapro for 2 years, just weaned off lexapro. i feel quite sick butterflies in stomach and brain fog - my daughter has been on brintellix for 2 months and is still vomiting - if this continues, another miracle med. ’
F (sadv, l =“4. 0”) = 0. 76
Cos. = 0. 04 MedSTS = 1. 0
’just took my first full 5 mg of brintellix - have been on every possible medication including wellbutrin for 15 years, seroquel for 9 years, lexapro for 2 years, just weaned off lexapro. i feel quite odd, butterflies in stomach and brain fog - my daughter has been on brintellix for 2 months and is still awake - if this continues, another antidepressant med. ’
F (sadv, l =“4. 0”) = 1. 0
Cos. = 0. 5 MedSTS = 1. 0
O ri
gi na
l
’after trying zoloft and lexapro, without any success and made my symptoms worse. luvox helped me getting my life back, the best medicine. i feel much more in control of my ocd. excellent. even when i feel sleepy sometimes as a side effect. its worth it!’
F (s, l =“10. 0”) = 1. 0
’after trying zoloft and lexapro, without any success and made my symptoms worse. luvox helped me getting my life back, the best medicine. i feel much more in control of my ocd. excellent. even when i feel sleepy sometimes as a side effect. its worth it!’
F (s, l =“10. 0”) = 1. 0
’after trying zoloft and lexapro, without any success and made my symptoms worse. luvox helped me getting my life back, the best medicine. i feel much more in control of my ocd. excellent. even when i feel sleepy sometimes as a side effect. its worth it!’
F (s, l =“10. 0”) = 1. 0
A dv
er sa
ri al
’after trying zoloft and lexapro, without any success and made my symptoms worse. luvox helped me getting my life back, the best medicine. i feel much more in spite of my euph excellent. even when i feel sleepy sometimes as a side effect. its worth it!’
F (sadv, l =“10. 0”) = 1. 0
Cos. = -0. 34 MedSTS = 0. 79
’after trying zoloft and lexapro, without any success and made my symptoms worse. luvox helped me getting my life back, the best medicine. i feel much more in spite of my sleeping excellent. even when i feel sleepy sometimes as a side effect. its worth it!’
F (sadv, l =“10. 0”) = 1. 0
Cos. = -0. 08 MedSTS = 0. 81
’after trying zoloft and lexapro, without any success and made my symptoms worse. luvox helped me getting my life back, the best thing i feel much more in control of my ocd. excellent. even when i feel pain sometimes as a side effect. its worth it!’
F (sadv, l =“10. 0”) = 1. 0
Cos. = 0. 41 MedSTS = 0. 8
O ri
gi na
l
’i was put on tri sprintec when i started getting my periods every two weeks, and was on it for three months. it fixed my period problem, but i had never had a problem with acne until starting this. my acne got so much worse and would clear up instantly once i started the sugar pills. i went from a d to a dd which is kind of annoying but i didn’t gain much weight at least. the worst part, however, was the tenderness in my breasts, it was horrible. painful to the touch, running or going to the gym was horribly uncomfortable. just like the acne, during the
F (s, l =“6. 0”) = 1. 0
’i was put on tri sprintec when i started getting my periods every two weeks, and was on it for three months. it fixed my period problem, but i had never had a problem with acne until starting this. my acne got so much worse and would clear up instantly once i started the sugar pills. i went from a d to a dd which is kind of annoying but i didn’t gain much weight at least. the worst part, however, was the tenderness in my breasts, it was horrible. painful to the touch, running or going to the gym was horribly uncomfortable. just like the acne, during the
F (s, l =“6. 0”) = 0. 92
’i was put on tri sprintec when i started getting my periods every two weeks, and was on it for three months. it fixed my period problem, but i had never had a problem with acne until starting this. my acne got so much worse and would clear up instantly once i started the sugar pills. i went from a d to a dd which is kind of annoying but i didn’t gain much weight at least. the worst part, however, was the tenderness in my breasts, it was horrible. painful to the touch, running or going to the gym was horribly uncomfortable. just like the acne, during the
F (s, l =“6. 0”) = 1. 0
VANILLA ADVERSARIAL FAR-IG A dv er sa ri al ’i was put on tri sprintec when i started getting my periods every two weeks, and was on it for three months. it cured my period problem, but i had never had a problem with sugar until starting this. my stomach got so much better and would clear up instantly once i started the sugar pills. i went from a d to a dd which is kind of annoying but i didn’t gain much weight at first the worst part, however, was the tenderness in my breasts, it was horrible. painful to the touch, running or going to the gym was horribly uncomfortable. just like the acne, during the
F (sadv, l =“6. 0”) = 0. 98
Cos. = -0. 37 MedSTS = 0. 76
’i was put on tri sprintec when i started getting my periods every two weeks, and was on it for three months. it caused my period problem, but i had never had a problem with this until starting this. my stomach got so much easier and would clear up immediately once i started the sugar pills. i went from a d to a dd which is kind of annoying but i didn’t gain much weight at least. the worst part, however, was the tenderness in my breasts, it was horrible. painful to the touch, running or going to the gym was horribly uncomfortable. just like the acne, during the
F (sadv, l =“6. 0”) = 0. 72
Cos. = -0. 11 MedSTS = 0. 75
’i was put on tri sprintec when i started getting my periods every two weeks, and was on it for three months. it fixed my period problem, but i had never had a problem with this until starting this. my headaches got so much worse and would clear up instantly once i started the sugar syrup which ranging from a d to a dd which is kind of annoying but i didn’t gain much weight at least. the worst part, however, was the tenderness in my breasts, it was horrible. painful to the touch, running or going to the gym was horribly uncomfortable. just like the acne, during the
F (sadv, l =“6. 0”) = 0. 97
Cos. = 0. 68 MedSTS = 0. 82
O ri
gi na
l
’mestinon helps everyone differently. i started out with ocular mg. apparently, this drug helps most people with their ocular mg, but it doesn’t do anything at all to improve my eye. my case of mg rapidly generalized, and difficulty breathing was my 2nd symptom to manifest. mestinon improves my breathing issues somewhat, but doesn’t take the shortness of breath away completely. same with my arms and thighs; it helps, but doesn’t make the weakness disappear altogether. mestinon can cause diarrhea, but most likely won’t if taken alongside a meal or with a small snack. F (s, l =“6. 0”) = 1. 0
’mestinon helps everyone differently. i started out with ocular mg. apparently, this drug helps most people with their ocular mg, but it doesn’t do anything at all to improve my eye. my case of mg rapidly generalized, and difficulty breathing was my 2nd symptom to manifest. mestinon improves my breathing issues somewhat, but doesn’t take the shortness of breath away completely. same with my arms and thighs; it helps, but doesn’t make the weakness disappear altogether. mestinon can cause diarrhea, but most likely won’t if taken alongside a meal or with a small snack. F (s, l =“6. 0”) = 1. 0
’mestinon helps everyone differently. i started out with ocular mg. apparently, this drug helps most people with their ocular mg, but it doesn’t do anything at all to improve my eye. my case of mg rapidly generalized, and difficulty breathing was my 2nd symptom to manifest. mestinon improves my breathing issues somewhat, but doesn’t take the shortness of breath away completely. same with my arms and thighs; it helps, but doesn’t make the weakness disappear altogether. mestinon can cause diarrhea, but most likely won’t if taken alongside a meal or with a small snack. F (s, l =“6. 0”) = 1. 0
A dv
er sa
ri al
’mestinon helps everyone. ’ i started out with ocular mg. apparently, this drug helps most kids with their ocular mg, but it doesn’t do anything at all to improve my eye. my case of mg is generalized, and difficulty breathing was my 2nd symptom to manifest. mestinon improves my breathing issues somewhat, but doesn’t take the shortness of breath away completely. same with my arms and thighs; it helps, but doesn’t make the nausea disappear altogether. mestinon can cause diarrhea, but most likely won’t if taken alongside a meal or with a small snack. F (sadv, l =“6. 0”) = 1. 0
Cos. = -0. 08 MedSTS = 0. 92
’mestinon helps everyone ’ i started out with ocular mg. apparently, this supplement helps most people with their ocular mg, but it doesn’t do anything at all to relieve my eye. my intake of mg rapidly generalized, and difficulty breathing was my 2nd symptom to manifest. mestinon improves my breathing issues somewhat, but doesn’t take the shortness of breath away completely. same with my arms and thighs; it helps, but doesn’t make the weakness disappear altogether. mestinon can cause diarrhea, but most likely won’t if taken alongside a meal or with a small snack. F (sadv, l =“6. 0”) = 0. 99
Cos. = 0. 38 MedSTS = 0. 94
’mestinon helps everyone. ’ i started out with ocular mg. apparently, this pill helps most people with their ocular mg, but it doesn’t do anything at all to improve my eye. my case of mg rapidly generalized, and difficulty breathing was my 2nd cause to manifest. mestinon improves my breathing issues somewhat, but doesn’t take the shortness of coughing away completely. same with my arms and thighs; it helps, but doesn’t make the weakness disappear altogether. mestinon can cause diarrhea, but most likely won’t if taken alongside a meal or with a small snack. F (sadv, l =“6. 0”) = 1. 0
Cos. = 0. 7 MedSTS = 0. 95
O ri
gi na
l
’picked up a nasty h pylori strain from an casual blind date, i know i should have gotten to know the person better. took a while before symptoms showed up. had severe upset stomach, occasional diarrhea, nausea and slow but steady weight loss. took a long time and several doctors to diagnose my steadily worsening condition. tried prevpak first, seemed to work at first butmy infection came back. the new gi then prescribed pylera after my 3rd endoscopy. pylera has worked, it’s been a year and i am still h pylera negative. but it’s been brutal and
F (s, l =“6. 0”) = 1. 0
’picked up a nasty h pylori strain from an casual blind date, i know i should have gotten to know the person better. took a while before symptoms showed up. had severe upset stomach, occasional diarrhea, nausea and slow but steady weight loss. took a long time and several doctors to diagnose my steadily worsening condition. tried prevpak first, seemed to work at first butmy infection came back. the new gi then prescribed pylera after my 3rd endoscopy. pylera has worked, it’s been a year and i am still h pylera negative. but it’s been brutal and
F (s, l =“6. 0”) = 0. 98
’picked up a nasty h pylori strain from an casual blind date, i know i should have gotten to know the person better. took a while before symptoms showed up. had severe upset stomach, occasional diarrhea, nausea and slow but steady weight loss. took a long time and several doctors to diagnose my steadily worsening condition. tried prevpak first, seemed to work at first butmy infection came back. the new gi then prescribed pylera after my 3rd endoscopy. pylera has worked, it’s been a year and i am still h pylera negative. but it’s been brutal and
F (s, l =“6. 0”) = 0. 9
VANILLA ADVERSARIAL FAR-IG A dv er sa ri al ’picked up a nasty h pylori ’ from an casual doctor date, i know i should have gotten to know the person better. took a while until they showed up. had severe upset stomach, occasional diarrhea, nausea and slow but steady weight loss. took a long time and several doctors to diagnose my steadily worsening condition. tried prevpak first, seemed to work at first butmy infection came back. the new gi then prescribed pylera after my 3rd endoscopy. pylera has worked, it’s been a year and i am still h pylera negative. but it’s been brutal and
F (sadv, l =“6. 0”) = 0. 97
Cos. = -0. 19 MedSTS = 0. 98
’picked up a nasty h pylori pill from an anonymous internet date, i know i should have gotten to know the person better. took a while until symptoms showed up. had severe upset stomach, occasional diarrhea, nausea and slow but steady weight loss. took a long time and several doctors to diagnose my steadily worsening condition. tried prevpak first, seemed to work at first butmy infection came back. the new gi then prescribed pylera after my 3rd endoscopy. pylera has worked, it’s been a year and i am still h pylera negative. but it’s been brutal and
F (sadv, l =“6. 0”) = 0. 82
Cos. = 0. 19 MedSTS = 0. 9
’picked up a nasty h pylori rash from an infected infection so i know i should have gotten to know the person better. took a while before symptoms showed up. had severe upset stomach, occasional diarrhea, nausea and slow but steady weight loss. took a long time and several doctors to diagnose my steadily worsening condition. tried prevpak first, seemed to work at first butmy infection came back. the new gi then prescribed pylera after my 3rd endoscopy. pylera has worked, it’s been a year and i am still h pylera negative. but it’s been brutal and
F (sadv, l =“6. 0”) = 0. 78
Cos. = 0. 52 MedSTS = 0. 81
O ri
gi na
l
’mom is 98 years old, the gabapentin capsules was for her knees pain, 100 mg, twice a day. it did help for her pain relief, however we foundshe started having bed side effect as dark urine, feeling tire, not hungry, feeling confused at night time, so we decided to stop the medication. ’
F (s, l =“4. 0”) = 1. 0
’mom is 98 years old, the gabapentin capsules was for her knees pain, 100 mg, twice a day. it did help for her pain relief, however we foundshe started having bed side effect as dark urine, feeling tire, not hungry, feeling confused at night time, so we decided to stop the medication. ’
F (s, l =“4. 0”) = 1. 0
’mom is 98 years old, the gabapentin capsules was for her knees pain, 100 mg, twice a day. it did help for her pain relief, however we foundshe started having bed side effect as dark urine, feeling tire, not hungry, feeling confused at night time, so we decided to stop the medication. ’
F (s, l =“4. 0”) = 1. 0
A dv
er sa
ri al
’mom is 8 years old, the gabapentin capsules was for her knees pain, 100 mg, twice a day. it did help for her pain relief, however we foundshe started having bed side effect as dark urine, feeling tire, not hungry, feeling confused at night time, so we decided to try the medication. ’
F (sadv, l =“4. 0”) = 1. 0
Cos. = 0. 23 MedSTS = 0. 76
’mom is 5 years old, the gabapentin capsules was for her knees pain, 100 mg, twice a day. it did help for her pain relief, however we foundshe started having bed side effect as dark nights feeling tire, not hungry, feeling confused at night time, so we decided to stop the medication. ’
F (sadv, l =“4. 0”) = 1. 0
Cos. = 0. 44 MedSTS = 0. 77
’mom about 16 years old, the gabapentin capsules was for her knees pain, 100 mg, twice a day. it did help for her pain relief, however we foundshe started having bed side effect as dark urine, feeling tire, not hungry, feeling confused at night time, so we decided to stop the medication. ’
F (sadv, l =“4. 0”) = 1. 0
Cos. = 0. 65 MedSTS = 0. 76
O ri
gi na
l
’i was hit by a police car in 2002. i was in recovery for a year. from the head down. broken jaw, 4 disks crushed my neck. both collar bones, 7 broken ribs and a shatered pelvis. so many pills, patches and injections. under the knife many times. a real humpty dumpty story. i have more pins, screws in me than your local hard wear store. note: i don’t want to over state the how effective it is but it works. talking to my doctor about the pain. he gave me this to try. well my 1st thought was &qu
F (s, l =“8. 0”) = 1. 0
’i was hit by a police car in 2002. i was in recovery for a year. from the head down. broken jaw, 4 disks crushed my neck. both collar bones, 7 broken ribs and a shatered pelvis. so many pills, patches and injections. under the knife many times. a real humpty dumpty story. i have more pins, screws in me than your local hard wear store. note: i don’t want to over state the how effective it is but it works. talking to my doctor about the pain. he gave me this to try. well my 1st thought was &qu
F (s, l =“8. 0”) = 0. 95
’i was hit by a police car in 2002. i was in recovery for a year. from the head down. broken jaw, 4 disks crushed my neck. both collar bones, 7 broken ribs and a shatered pelvis. so many pills, patches and injections. under the knife many times. a real humpty dumpty story. i have more pins, screws in me than your local hard wear store. note: i don’t want to over state the how effective it is but it works. talking to my doctor about the pain. he gave me this to try. well my 1st thought was &qu
F (s, l =“8. 0”) = 0. 92
A dv
er sa
ri al
’i was hit by a police car in 2002. i was in jail for a year. from the head down. broken jaw, 4 disks crushed my neck. both collar bones, 7 broken ribs and a shatered pelvis. so many pills, patches and injections. under the covers many times. a real humpty dumpty story. i have more pins, screws in me than your local hard wear store. note: i don’t want to over compl the how horrible it is but it works. lied to my doctor about the pain. he gave me this to try. well my 1st thought was &qu
F (sadv, l =“8. 0”) = 1. 0
Cos. = -0. 35 MedSTS = 0. 9
’i was stopped by a police car in 2002. i was in rehab for a year. from the head down. broken jaw, 4 disks crushed my neck. both collar bones, 7 broken ribs and a shatered pelvis. so many pills, patches and injections. under the counter many times. a real humpty dumpty story. i have more pins, needles in me than your local hard wear store. note: i don’t want to over state the how horrible it is but it works. talking to my doctor about the pain. he gave me this to try. well my 1st thought was &qu
F (sadv, l =“8. 0”) = 0. 7
Cos. = 0. 07 MedSTS = 0. 84
’i was diagnosed by a chirop surgeon in 2002. i was in surgery for a year. from the head down. broken jaw, 4 disks crushed my neck. both collar bones, 7 broken ribs and a shatered pelvis. so many pills, patches and injections. under the knife many times. a real humpty dumpty story. i have more pins, stuck in me than your local hard wear store. note: i don’t want to over state the how effective it is but it works. talking to my doctor about the pain. he gave me this to try. well my 1st thought was &qu
F (sadv, l =“8. 0”) = 0. 52
Cos. = 0. 65 MedSTS = 0. 69
VANILLA ADVERSARIAL FAR-IG O ri gi na l
’been on antidepressants since around 1991 after i had thyroid removed. taking wellbutrin for depression which works okay but last year started having late night anxiety attacks. really bad fear. i don’t understand why. had me walking the streets at 11pm. started viibryd and had weight gain and stomach issues and by the time i got to 40mg the anxiety just stopped! this medicine does as advertised for me, it stops the anxiety. that’s what i needed and that’s what i got. like a miracle. ’
F (s, l =“10. 0”) = 1. 0
’been on antidepressants since around 1991 after i had thyroid removed. taking wellbutrin for depression which works okay but last year started having late night anxiety attacks. really bad fear. i don’t understand why. had me walking the streets at 11pm. started viibryd and had weight gain and stomach issues and by the time i got to 40mg the anxiety just stopped! this medicine does as advertised for me, it stops the anxiety. that’s what i needed and that’s what i got. like a miracle. ’
F (s, l =“10. 0”) = 1. 0
’been on antidepressants since around 1991 after i had thyroid removed. taking wellbutrin for depression which works okay but last year started having late night anxiety attacks. really bad fear. i don’t understand why. had me walking the streets at 11pm. started viibryd and had weight gain and stomach issues and by the time i got to 40mg the anxiety just stopped! this medicine does as advertised for me, it stops the anxiety. that’s what i needed and that’s what i got. like a miracle. ’
F (s, l =“10. 0”) = 1. 0
A dv
er sa
ri al
’been on lithium since around 1991 after i had thyroid removed. taking wellbutrin for depression which works okay but last year started having late night anxiety attacks. really bad fear. i don’t understand why. had me walking the streets at 11pm. started viibryd and had weight gain and stomach issues and by the time i got to 40mg the anxiety just stopped! this medicine does as nothing for me, it stops the anxiety. that’s what i needed and that’s what i got. have a reply
F (sadv, l =“10. 0”) = 0. 98
Cos. = 0. 05 MedSTS = 0. 91
’been on antidepressants since around 2012 after i had thyroid removed. taking wellbutrin for depression which works okay but last year started having late night heart attacks. really bad fear. i don’t understand why. had me walking the streets at 11pm. started viibryd and had weight gain and stomach issues and by the time i got to eat the pain just stopped! this medicine does as advertised for me, it stops the anxiety. that’s what i needed and that’s what i got. like a miracle. ’
F (sadv, l =“10. 0”) = 1. 0
Cos. = 0. 53 MedSTS = 0. 8
’been on lithium since around 1991 after i had thyroid removed. taking wellbutrin for arthritis which works okay but last year started having late night sleep attacks. really bad fear. i don’t understand why. had me walking the streets at 11pm. started viibryd and had weight gain and stomach issues and by the time i got to 40mg the symptoms just stopped! this medicine does as advertised for me, it stops the anxiety. that’s what i needed and that’s what i got. like a miracle. ’
F (sadv, l =“10. 0”) = 0. 96
Cos. = 0. 77 MedSTS = 0. 78
O ri
gi na
l
’i’m a nurse and know all about package inserts explaining side effects but man they weren’t kidding. i was started about 3 weeks ago by my doctor who said i needed to lose a bunch of weight. i expected some stomach upset but not like this. now i understand why the slow titration to higher more effective dosing. i can’t bear the side effects. i cannot work with stomach upset all day and need to rest at night. back to diet and exercise for me. this is just not right. ’
F (s, l =“2. 0”) = 1. 0
’i’m a nurse and know all about package inserts explaining side effects but man they weren’t kidding. i was started about 3 weeks ago by my doctor who said i needed to lose a bunch of weight. i expected some stomach upset but not like this. now i understand why the slow titration to higher more effective dosing. i can’t bear the side effects. i cannot work with stomach upset all day and need to rest at night. back to diet and exercise for me. this is just not right. ’
F (s, l =“2. 0”) = 1. 0
’i’m a nurse and know all about package inserts explaining side effects but man they weren’t kidding. i was started about 3 weeks ago by my doctor who said i needed to lose a bunch of weight. i expected some stomach upset but not like this. now i understand why the slow titration to higher more effective dosing. i can’t bear the side effects. i cannot work with stomach upset all day and need to rest at night. back to diet and exercise for me. this is just not right. ’
F (s, l =“2. 0”) = 0. 99
A dv
er sa
ri al
’i’m a nurse and know all about package inserts explaining side effects but man they weren’t helpful i was started about 3 weeks ago by my doctor who said i needed to lose a bunch of weight. i expected some stomach discomfort but not like this. now i understand why the slow titration to higher more effective dosing. i can’t explain the side effects. i cannot work with stomach upset all day and need to rest at night. back to diet and exercise for me. this is just totally right. ’
F (sadv, l =“2. 0”) = 1. 0
Cos. = -0. 02 MedSTS = 0. 88
’i’m a nurse and know all about package inserts explaining side effects but man they weren’t helpful i was started about 3 weeks ago by my doctor who said i needed to lose a bunch of weight. i expected some stomach problems but not like this. now i understand why the slow titration to higher more insulin dosing. i can’t explain the side effects. i cannot work with stomach upset all day and need to rest at night. back to diet and exercise for me. this is just not right. ’
F (sadv, l =“2. 0”) = 0. 95
Cos. = 0. 28 MedSTS = 0. 87
’i’m a nurse and know all about package pills explaining side effects but man they weren’t kidding. i was started about 3 weeks ago by my doctor who said i needed to lose a bunch of weight. i expected some stomach problems but not like this. now i understand why the slow titration to higher more effective dosing. i can’t bear the side effects. i cannot work with stomach sickness all day and need to rest at night. back to bed and exercise for me. this is just not right. ’
F (sadv, l =“2. 0”) = 0. 99
Cos. = 0. 63 MedSTS = 0. 93
O ri
gi na
l
’my husband got this for me since i haven’t been pooping that well lately. he told me it was better than any others, because you don’t get stomach cramps. wrong. i took 2 a couple of hours ago, and now, my stomach is in the worst pain ever. thankfully, i have had a bm, but i don’t think i will ever take dulcolax again because of the severe pain. ’
F (s, l =“4. 0”) = 1. 0
’my husband got this for me since i haven’t been pooping that well lately. he told me it was better than any others, because you don’t get stomach cramps. wrong. i took 2 a couple of hours ago, and now, my stomach is in the worst pain ever. thankfully, i have had a bm, but i don’t think i will ever take dulcolax again because of the severe pain. ’
F (s, l =“4. 0”) = 1. 0
’my husband got this for me since i haven’t been pooping that well lately. he told me it was better than any others, because you don’t get stomach cramps. wrong. i took 2 a couple of hours ago, and now, my stomach is in the worst pain ever. thankfully, i have had a bm, but i don’t think i will ever take dulcolax again because of the severe pain. ’
F (s, l =“4. 0”) = 1. 0
VANILLA ADVERSARIAL FAR-IG A dv er sa ri al ’my husband got this for me since i haven’t been pooping that well lately. he told me it was better than any others, because you don’t get stomach cramps. wrong. i took 2 a couple of hours ago, and now, my stomach is in the worst pain ever. Recently i have had a bm, but i don’t think i will wanna take dulcolax again because of the constant pain. ’
F (sadv, l =“4. 0”) = 1. 0
Cos. = 0. 16 MedSTS = 0. 98
’my husband got this for me since i haven’t been pooping that well lately. he told me it was better than any others, because you don’t get stomach cramps. wrong. i took 2 a couple of hours ago, and now, my stomach is in the worst pain ever. Recently i have had a relapse but i don’t think i will ever take dulcolax again because of the constant pain. ’
F (sadv, l =“4. 0”) = 1. 0
Cos. = 0. 39 MedSTS = 0. 98
’my surgeon got this for me since i haven’t been exercising that well lately. he told me it was better than any others, because you don’t get stomach cramps. wrong. i took 2 a couple of hours ago, and now, my butt is in the worst pain ever. thankfully, i have had a bm, but i don’t think i will ever take dulcolax again because of the severe pain. ’
F (sadv, l =“4. 0”) = 0. 99
Cos. = 0. 69 MedSTS = 0. 73
O ri
gi na
l
’my husband takes saphris 5 mg twice a day for bipolar depression. he was having delusions and psychosis as well as paranoia. since starting the saphris these have stopped, but there are times when he is very stoned acting, like a zombie. he isn’t responsive or talkative a lot of the time. his sex drive has also become non existent almost and he suffers from ed when we do have sex. it’s so difficult when you have a disease like bd and then you have to take these meds, which help some of the symptoms but bring on others that are unwanted. it’s like
F (s, l =“8. 0”) = 1. 0
’my husband takes saphris 5 mg twice a day for bipolar depression. he was having delusions and psychosis as well as paranoia. since starting the saphris these have stopped, but there are times when he is very stoned acting, like a zombie. he isn’t responsive or talkative a lot of the time. his sex drive has also become non existent almost and he suffers from ed when we do have sex. it’s so difficult when you have a disease like bd and then you have to take these meds, which help some of the symptoms but bring on others that are unwanted. it’s like
F (s, l =“8. 0”) = 0. 66
’my husband takes saphris 5 mg twice a day for bipolar depression. he was having delusions and psychosis as well as paranoia. since starting the saphris these have stopped, but there are times when he is very stoned acting, like a zombie. he isn’t responsive or talkative a lot of the time. his sex drive has also become non existent almost and he suffers from ed when we do have sex. it’s so difficult when you have a disease like bd and then you have to take these meds, which help some of the symptoms but bring on others that are unwanted. it’s like
F (s, l =“8. 0”) = 0. 88
A dv
er sa
ri al
’my husband takes saphris 5 mg twice a day for clinical depression. he was having delusions and psychosis as well as paranoia. since starting the saphris these have stopped, but there are times when he is very strangely acting, like a zombie. he isn’t lucid or talkative a lot of the time his sex drive has also become non existent almost and he suffers from ed when we do have sex. it’s so frustrating when you have a disease like bd and then you have to take these meds, which help some of the symptoms but bring on others that are unwanted. it’s like
F (sadv, l =“8. 0”) = 0. 98
Cos. = -0. 31 MedSTS = 0. 91
’my self takes saphris 5 mg twice a day for clinical depression. he was having delusions and psychosis as well as paranoia. since starting the saphris these have stopped, but there are times when he is very strange acting, like a zombie. he isn’t lucid or talkative a lot of the time. his sex disorder has also become non existent almost and he suffers from ed when we do have sex. it’s so difficult when you have a disease like bd and then you have to take these meds, which help some of the symptoms but bring on others that are unwanted. it’s like
F (sadv, l =“8. 0”) = 0. 55
Cos. = -0. 08 MedSTS = 0. 88
’my self takes saphris 5 x twice a day for mood depression. he was having delusions and psychosis as well as paranoia. since starting the saphris these have stopped, but there are times when he is very stoned acting, like a zombie. he isn’t responsive or talkative a lot of the time. his manic disorder has also become non existent almost and he suffers from ed when we do have sex. it’s so difficult when you have a disease like bd and then you have to take these meds, which help some of the symptoms but bring on others that are unwanted. it’s like
F (sadv, l =“8. 0”) = 0. 87
Cos. = 0. 47 MedSTS = 0. 88
O ri
gi na
l
background thrombospondin - 1 ( tsp - 1 ) promotes breast cancer cell invasion of collagen by upregulating matrix metalloproteinase - 9 ( mmp - 9 ) production. stromal tsp - 1 may play a role in regulating tumor cell invasion. we hypothesize that fibroblasts promote breast cancer cell invasion by upregulating the production of mmp - 9 through tsp - 1. methods mda - mb - 231 human breast carcinoma cells were grown alone or in coculture with human fibroblasts. gelatin zymography and western immunoblot analysis for mmp - 9 were performed on the coculture cell media and the single cell media. inhibition of fibroblast - mediated breast tumor cell invasion by an anti - tsp - 1 or an anti - mmp - 9 antibody was evaluated using a modified boyden chamber. results coculture experiments showed an increased production of mmp - 9 when compared with breast cancer single cell culture or fibroblast single cell culture experiments as demonstrated by zymography and western immunoblot analysis. fibroblast - stimulated mmp - 9 production was comparable with tsp - 1 - stimulated mmp - 9 production. anti - tsp - 1 antibody and anti - mmp - 9 antibody inhibited fibroblast - stimulated tumor cell invasion to 30 % and 26 % of controls , respectively ( p <. 05 )