Anti Depressants Watch

Tera
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#21
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#21
(Original post by Sarahl89)
I know that not all anti depressants are addictive in this way, but i still personally wouldn't touch them with a barge pole. We know so little about the brain as it is that i dont see how we can reasonably administer mind altering drugs and expect to know all the effects of them at this point in time.
To be quite frank, living with a manic mother who isn't medicated is actually pushing the rest of the family into mental illness. It's tiring, physically and emotionally. Every day is a battle. How do you convince a person who, the vast majority of the time, doesn't think there's anything wrong with them to see a counselor and keep going?

My mum has been to four different psychiatrists/counselors/therapists and never more than twice to each. The responses have either come back that she mentally drains even a trained professional or that there's nothing wrong with her and that her family are all the ones with issues so treatment is terminated. It depends when you ask her and what mood she's in. If you ask me, it's all lies or there are a hell of a lot of unprofessional people in the healthcare system.

My point is this, if she isn't medicated (this she has once mentioned was suggested, again... when her guard was down) then she's going to push people around her to breaking point. Sometimes, it's just necessary. To regain control of your life and get proper help and for the good of the people you love. Living with a bi-polar person is impossible without medication.
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Laus
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#22
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#22
(Original post by Sarahl89)
i still personally wouldn't touch them with a barge pole. We know so little about the brain as it is that i dont see how we can reasonably administer mind altering drugs and expect to know all the effects of them at this point in time
You are entitled to your opinion and I'm glad that you don't ever anticipate needing them. We know enough about the brain to cite which regions do what, for instance (but I see the point you are trying to make). Antidepressants are not mind altering in the way that LSD or magic-mushrooms are mind altering. I don't see the world in a completely new light and I'm certainly not happy and chirpy 24/7. If you had cancer, would you refuse treatment on the basis that we don't know enough about cancer to administer such drugs into the body? Every ache and pain is inextricably linked to the central nervous system. For instance, when we take a painkiller (say, ibuprofen or Paracetamol), they are, essentially, doing the same thing. They work chiefly by blocking the body's production of prostaglandins, one of the main sets of chemicals that produce the sensation of swelling and pain. Narcotic drugs, such as morphine and codeine, work by blocking the path of the chemical messengers that signal pain in the spinal cord and brain.

We need to do something to help these people, as 80% of suicides are associated with clinical depression and it is considered a terminal illness due to the likelihood of suicide when left untreated. I'm not talking about those who feel down in the dumps, I'm talking about people like Tera's mum. Depression is so multifaceted and I agree that first and foremost, counselling/therapy etc. should be encouraged. Yes, antidepressants are over-prescribed but that isn't to say they aren't helping some people who actually need them. If people read that study properly then they would see that there was a part which said that antidepressants could help in extreme cases (which is why the placebo works on some people and not on others). What is more, they did not mention that those who participated in the study were suffering from 'mind depression'. My GP said that these studies have done more harm than good. Journalists don't care about the effect that their misinformed 'findings' might have on people, obviously.

I don't want to have an argument with you, hun; and I'm not doing this to put you on the spot or to rubbish your point of view. I'm more incensed by those people who trivialise depression by asserting that all mentally ill people need is a sugar-coated placebo. People who frequently refer to antidepressants as 'happy pills' are, for me anyway, trivialising something that kills people on a daily basis. What can we do? Do we need a tumour the size of a grapefruit to be taken seriously?

Laus
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YAP
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#23
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#23
(Original post by Sarahl89)
i know this; if you re read my post you will notice that i never claimed to be an expert on the matter; im well aware it is much more complicated than this.
Well you said that; but you also said you couldn't see how someone could argue with your post. One can only 'not argue' with viewpoints which are wholly correct; therefore, surely, your implication was that yours was definitive and hence as good as an expert's?

Sometimes it is the case though. Yes it can work for some people, but for others it simply can't and doesn't.
I know that anti-depressants don't work for everyone: come into the Depression Society, get to know the people there, then we'll talk. The fact is, they don't work for everyone, but as Laus has said, what's the alternative - suicide?

Go and have a look at the NICE guidelines on the treatment of depression in primary care: mild-depression, they're the first to admit that anti-depressants don't have a lot to offer and talking therapies are the first line. Moderate depression - urgent talking therapy/medication/combination of the two. Severe depression - medication to help get the patient's head together, then talking therapy. The use of anti-depressants is well thought out and based on clinical evidence on when they are likely to be efficacious.

Seroxat for an example ~ i fail to see how you can argue that it is an addictive drug.
Piece of piddle that one. Administer seroxat to a rat for a month, give them access to a stash of it, they won't help themselves. Ergo, not addictive. Seroxat has a 24 hour half-life and a steep withdrawal curve, and sudden withdrawal causes some side effects, but it is not addictive - there's no craving, it's just a case of it needing tapering off.

From Seroxat, actually, one way is to cross-taper with fluoxetine and then come off that - it has a much longer half life, and a consequentially more gradual withdrawal curve.

I know that not all anti depressants are addictive in this way, but i still personally wouldn't touch them with a barge pole. We know so little about the brain as it is
You know so little about the brain as it is. There are many great minds working in the area, the drugs go through massive clinical trials. Some have even been around for decades now, so have gone through widespread human trials (millions of people). Incidentally, would you take paracetamol? We don't really know how that works either, a few hypotheses are floating around but nothing solid, something new to do with COX-3 inhibition but that's still up for debate. The fact is, they have been shown to work, long-term studies and lab experiments indicate they are safe, so to people who are depressed they are a lifeline.

As Laus has said, no-one actually wants to take anti-depressants, but needs must - if you develop severe depression (and I wouldn't wish it upon you, not even to teach you a lesson) I'm sure you'd take them if they offered a chance of giving you your life back and recovering from being a mere shadow of your former shelf.

Heck, people even go for electro-convulsive therapy - sending thousands of volts across their brain to induce seizures. Medication has reduced dramatically the amount of ECT that is practised each year, but it's been shown to help in severe depression; and, isn't something one would normally consider. But, if it's that or knowing you're going to pop down to your nearest train track to leap away from the misery of your life, then sometimes, needs must.
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YAP
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#24
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#24
(Original post by kastro9)
lool "corrupt centres". Its just greatly convenient that pharma conceals results that don't go along with what they want, this study had to get the unpublished data via the freedom of information act.
It's not even so much that the results were concealed, it's just that the results were utter crap due to centre mismanagement. There's a lot of it goes on in drug trials, not just anti-depressants, and through the same process of including these dodgy locally mismanaged results, one could show that just about anything is ineffective.

It is convenient though, as you say, that people changing pay rolls and getting access to their old results through the FOI act could published this skewed report to keep their new employer happy. It's still fundamentally flawed, regardless of the politics of the whole thing.

If you want to see a trial done well, look up STAR*D trials. It's real-world, there was only one centre (well-managed) with patients who were preseng in primary care with depression. They formed a staged rank of different medications, and worked patients up the ranks as necessary. It clearly shows the efficacy of the medication as a treatment for depression - and they didn't, if I recall, supplement the trial with psychotherapy, which would have improved results even further.

Bottom line, clinical trials are hard to do well and easy to do badly; that recent paper has been discredited by many sources, and it's a shame that people cite it as 'see, see, anti-depressants don't work!'. A little scrutiny and understanding of experimental design (*cough* Dr YAP PhD *cough*), and one can immediately see how they got the results they did and why they are invalid.
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Custer
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#25
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#25
(Original post by YAP)
It's not even so much that the results were concealed, it's just that the results were utter crap due to centre mismanagement. There's a lot of it goes on in drug trials, not just anti-depressants, and through the same process of including these dodgy locally mismanaged results, one could show that just about anything is ineffective.

It is convenient though, as you say, that people changing pay rolls and getting access to their old results through the FOI act could published this skewed report to keep their new employer happy. It's still fundamentally flawed, regardless of the politics of the whole thing.

If you want to see a trial done well, look up STAR*D trials. It's real-world, there was only one centre (well-managed) with patients who were preseng in primary care with depression. They formed a staged rank of different medications, and worked patients up the ranks as necessary. It clearly shows the efficacy of the medication as a treatment for depression - and they didn't, if I recall, supplement the trial with psychotherapy, which would have improved results even further.

Bottom line, clinical trials are hard to do well and easy to do badly; that recent paper has been discredited by many sources, and it's a shame that people cite it as 'see, see, anti-depressants don't work!'. A little scrutiny and understanding of experimental design (*cough* Dr YAP PhD *cough*), and one can immediately see how they got the results they did and why they are invalid.
If you really want to point out flawed studies, we can just look at the 1960's study that formulated the whole farce of chemical imbalances. Its based on the observation that mood is altered with drugs (what a surprise!), rather than direct observation of any chemical imbalances.

No experiment has ever shown that anyone has an "imbalance" and no experiment could demonstrate the existence of a "chemical imbalance," because no one has the slightest idea what a normal and healthy chemical "balance" would look like.
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banksy
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#26
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#26
I've been on anti-depressants for a while and they don't make you hysterical, there is placebo effect involved without a doubt, especially in the first week or so.

They're not "happy pills".

Depending on what kind of anti depressants have been prescribed, there actually might no be any benefits gained from them - in actual terms.

There was a thing about Prozac being fake and relying basically on placebo to function.
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ellieluna
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#27
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#27
Antidepressants if anything have a flat effect on the person meaning that they can become quite emotionally numb. We learnt this in psychology. So no it wouldn't be the drug that is causing her behaviour.
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Laus
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#28
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#28
(Original post by banksy)
I've been on anti-depressants for a while and they don't make you hysterical, there is placebo effect involved without a doubt, especially in the first week or so.

They're not "happy pills".

Depending on what kind of anti depressants have been prescribed, there actually might no be any benefits gained from them - in actual terms.

There was a thing about Prozac being fake and relying basically on placebo to function.
In the first week, I felt worse. This was before I read the leaflet. I didn't know that feelings/thoughts/reactions etc. are likely to get worse before they get better. Antidepressants take at least 6-8 weeks before they have any positive effect. They are no quick fix.

Prozac is not 'fake'. They administered placebos to patients who were taking part in a study; half were given Prozac or Seroxat (I think) and the other half were given a placebo. If people think their antidepressant is, essentially, a pretend pill, then they may stop taking them. This is very dangerous as, if you don't reduce your dose over a set time, patients can experience horrendous withdrawal effects.

I only notice things like this because; if people make unsubstantiated claims in a health forum, others reading it might get the wrong idea, e.g. people might stop taking their Prozac because you claim that someone said it was fake. I know what article you are talking about but not everyone will.
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YAP
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#29
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#29
(Original post by kastro9)
No experiment has ever shown that anyone has an "imbalance" and no experiment could demonstrate the existence of a "chemical imbalance," because no one has the slightest idea what a normal and healthy chemical "balance" would look like.
Moot point. Let's come back to paracetamol - no-one really knows how it works, but it does. Lack of understanding the precise mechanism doesn't mean it doesn't work. Ergo, flapping about chemical imbalances and whether or not they exist does not disprove the wide body of literature that shows that anti-depressants are more effective than placebo; any more than flapping about not knowing how paracetamol works means that hospitals should stop using it to bring down patients' temperatures.
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YAP
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#30
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#30
(Original post by Laus)
I only notice things like this because; if people make unsubstantiated claims in a health forum, others reading it might get the wrong idea, e.g. people might stop taking their Prozac because you claim that someone said it was fake. I know what article you are talking about but not everyone will.
Yep, I agree with Laus. It might say at the top of H&R that all advice is unprofessional, but that doesn't give you a licence to make unsubstantiated claims. In one sense, yes, making stuff up is very much unprofessional - i.e. something no professional would do - but if you're going to give out advice or make medical claims, at least make some effort to make sure what you're saying is accurate.

There are two aspects of H&R where it is quite important to get your facts right; and I'd suggest you stay away from these unless you're quite sure. First, contraception: if you wrote 'I heard that one cannot get pregnant whilst having sex in a jacuzzi as the water is too hot' in a thread asking for contraceptive advice, you would be duly flogged. And quite right - it's utter crap. Second, mental health: quitting some mental health drugs cold turkey can cause an increased incidence of suicidal thoughts, so don't make remarks that encourage vulnerable people to stop taking their medication and wind up killing themselves. So, you get people like me jumping on you for being irresponsible; don't be surprised, it's damned important....
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Laus
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#31
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#31
(Original post by ellieluna)
Antidepressants if anything have a flat effect on the person meaning that they can become quite emotionally numb. We learnt this in psychology. So no it wouldn't be the drug that is causing her behaviour.
I don't think they make all people feel 'emotionally numb'. If anything, they have the effect of balancing a person's emotions so that neither happiness nor sadness is too extreme. If the OP's friend is on antidepressants and yet, still appears to experience extreme happiness, what effect have they had on her? As I mentioned previously, antidepressants can be administered to those who don't really need them. Obviously, I can't dictate who can and who can't go on medication; that is up to the patient and their GP. If a person is just a bit low then, chances are, a pill might just make them uncharacteristically happy and content. If a person is clinically depressed, however, it is likely to improve a person's well-being because they actually need something to restore a sense of 'normality'.

Recent studies have shown that imbalances in serotonin levels can trigger depression. GP's treat some patients with serotonin reuptake inhibitors (SSRI) because these medications can help to regulate serotonin levels.

When people experience stress, for example, they have higher levels of Cortisol in their bloodstream. Much like cortisol, neurotransmitters such as serotonin and norepinephrine, are much lower in many depressed patients and appear to be one of the major players in mood and a variety of other disorders. We don't know how but we know that it does (through Lab tests etc.). Low serotonin isn't necessarily the cause of the depression, either; it is, in some cases, a symptom i.e. circumstances, traumatic experiences etc. can actually cause a persons hormonal level to deplete (much like stress e.g. stage fright, fear of flying etc. causes a persons level of Cortisol to raise).
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Custer
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#32
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#32
(Original post by YAP)
Moot point. Let's come back to paracetamol - no-one really knows how it works, but it does. Lack of understanding the precise mechanism doesn't mean it doesn't work. Ergo, flapping about chemical imbalances and whether or not they exist does not disprove the wide body of literature that shows that anti-depressants are more effective than placebo; any more than flapping about not knowing how paracetamol works means that hospitals should stop using it to bring down patients' temperatures.
At least with paracetamol, we can measure what we are trying to alleviate, e.g. temperature. In the case of SSRI's, we are just guessing a chemical imbalance is what needs fixing.

As for masses of literature on the subject, you have yourself already pointed out the readiness of people to produce results if it means they get paid more.

(Original post by YAP)
Now, however, the same authors who published work years ago on how these drugs were effective no longer work for the pharmaceutical companies - the payroll they are now on favours not giving out medication, rather than giving it out. So they pull out all of these flawed trials...
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ellieluna
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#33
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#33
(Original post by Laus)
I don't think they make all people feel 'emotionally numb'. If anything, they have the effect of balancing a person's emotions so that neither happiness nor sadness is too extreme.
Oh yeah, I'm thinking of schizophrenia (depression and schiz. come up in the same module), I knew it was something like that, the phrase 'emotionally numb' comes from schizophrenic drugs. But the effect is kind of similar.. [I'm confusing myself].
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Laus
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#34
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#34
(Original post by ellieluna)
Oh yeah, I'm thinking of schizophrenia (depression and schiz. come up in the same module), I knew it was something like that, the phrase 'emotionally numb' comes from schizophrenic drugs. But the effect is kind of similar.. [I'm confusing myself].
Lol, don't worry. A schizophrenic doesn't have to be depressed, just like a depressed person doesn't have to be schizophrenic! They can make a person feel quite indifferent but I wouldn't say that was the same for everyone. Plenty of people live a 'normal' life whilst on medication i.e. they can go out and have a good time, go to uni, socialise with friends etc. Obviously, there are extremes and, as we have already established, not all people need medication. When that's the case, I think it means you ought to take an alternative route.
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Laus
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#35
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#35
(Original post by kastro9)
At least with paracetamol, we can measure what we are trying to alleviate, e.g. temperature. In the case of SSRI's, we are just guessing a chemical imbalance is what needs fixing.

As for masses of literature on the subject, you have yourself already pointed out the readiness of people to produce results if it means they get paid more.
So the alleviation of misery, exhaustion, anhedonia, anxiety (and all of the symptoms that come with it e.g. increased heart rate, profuse sweating, breathing difficulties etc.), not being able to think clearly, feeling of failure, suicidal thoughts, irritability, anger, lack of confidence, agoraphobia/sociophobia, sleeplessness, physical aches and pains e.g. back and neck ache, extreme weight loss or weight gain is mere guesswork?

What is more, antidepressants can help someone who has OCD, premenstrual dysphoric disorder (PMDD), Posttraumatic-Stress-Disorder (PTSD), Seasonal Affective Disorder (SAD), anxiety, social anxiety disorders, binge eating disorder, anorexia, bulimia, aggression and personality disorders e.g. schizophrenia...

Want more evidence?
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Custer
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#36
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#36
(Original post by Laus)
So the alleviation of misery, exhaustion, anhedonia, anxiety (and all of the symptoms that come with it e.g. increased heart rate, profuse sweating, breathing difficulties etc.), not being able to think clearly, feeling of failure, suicidal thoughts, irritability, anger, lack of confidence, agoraphobia/sociophobia, sleeplessness, physical aches and pains e.g. back and neck ache, extreme weight loss or weight gain is mere guesswork?

What is more, antidepressants can help someone who has OCD, premenstrual dysphoric disorder (PMDD), Posttraumatic-Stress-Disorder (PTSD), Seasonal Affective Disorder (SAD), anxiety, social anxiety disorders, binge eating disorder, anorexia, bulimia, aggression and personality disorders e.g. schizophrenia...

Want more evidence?
But when it can be achieved with a placebo, who cares.
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YAP
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#37
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#37
(Original post by kastro9)
At least with paracetamol, we can measure what we are trying to alleviate, e.g. temperature. In the case of SSRI's, we are just guessing a chemical imbalance is what needs fixing.

As for masses of literature on the subject, you have yourself already pointed out the readiness of people to produce results if it means they get paid more.
How many times do I need to mention the STAR*D trials? They measured success based on patient response; and weren't doing it to get paid, just to construct treatment programmes. STAR*D heavily influenced the NICE guidelines in this country; seriously, it's a solid piece of work, that is hard to argue with unless, well, unless you don't really have a handle on how to argue against it....
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Laus
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#38
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#38
(Original post by kastro9)
But when it can be achieved with a placebo, who cares.
Give me strength.

The millions of families that lose their loved ones because their sons, daughters, husbands, wives etc. have been too ashamed and too frightened to seek help CARE. The billions of people who hate their lives so much that they stare at four walls for hours and cry themselves to sleep every night; I think they CARE, don't you?

As I said before, those people obviously didn't need a bloody pill in the first place! All participants were suffering from mild depression i.e. something that, in my opinion, does not require a life-saving pill in the first place! If someone who is low is given a placebo and told that it will magic all of their problems away, chances are, it may. It is NOT the same for clinical depression; you know the kind that causes people to take their own lives. It's like with alcohol, give someone orange juice and inform them it has vodka in it (when it doesn't), a large majority will act drunk (this was in the newspaper not so long ago). That doesn't mean that actual alcoholic beverages don't have an effect on your body.
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emerley
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#39
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#39
to whoever negged me, it did absolutely nothing as you have no rep power, be man enough to leave a name next time so I can laugh at you properly!
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YAP
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#40
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#40
(Original post by emerley)
to whoever negged me, it did absolutely nothing as you have no rep power, be man enough to leave a name next time so I can laugh at you properly!
I don't see why your post warranted a neg rep, it was a perfectly reasonable question . Glad it didn't do any damage; I'd have pos repped you to balance it out if that was the case, given I see neg rep as the enemy of reason.
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