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    By X. Tjalf. City University of Los Angeles. 2018.

    Want to cope with this pernicious purchase 120 mg silvitra amex, baffling condition? Are You a Narcissist or a Psychopath - or suspect that You are one purchase silvitra 120 mg on-line... Click to buy the Narcissism and Abuse Series of SIXTEEN e-Books (more than 5,500 pages) for less than the price of the print edition! He set about to know everything there is about the psychopathic narcissist. He knows everything there is to know about narcissistic and psychopathic abusers and how to cope with them effectively. Anthony Benis, Mount Sinai Hospital, New York, and author "Towards Self and Sanity - On the Genetic Origins of the Human Character")"Sam Vaknin is a leading authority on the topic of narcissism. The author has done probably more than anyone else to educate others to this poorly understood condition. In this, his twelfth book, he shares his considerable knowledgeand experience of narcissism in a comprehensive yet easy to read style. Sam has plugged all the loopholes, exposed all the plots, and introduced a new language to confront the Narcissist. If you want to breathe again, if you are at your wits end, if everything has been tried and failed, if you NEED a change, then Malignant Self Love can give you your life back. The result: Our members go zooming up the learning curve of understanding the Narcissistic Personality Disorder. The ICD-10, the International Classification of Diseases, published by the World Health Organisation in Geneva [1992] regards the Narcissistic Personality Disorder (NPD) as "a personality disorder that fits none of the specific rubrics". It relegates it to the category "Other Specific Personality Disorders" together with the eccentric, "haltlose", immature, passive-aggressive, and psychoneurotic personality disorders and types. The American Psychiatric Association, based in Washington D. The DSM-IV-TR defines Narcissistic Personality Disorder (NPD) as "an all-pervasive pattern of grandiosity (in fantasy or behaviour), need for admiration or adulation and lack of empathy, usually beginning by early adulthood and present in various contexts", such as family life and work. Five (or more) of these criteria must be met for a diagnosis of Narcissistic Personality Disorder (NPD) to be rendered. Demands automatic and full compliance with his or her unreasonable expectations for special and favourable priority treatment;Is "interpersonally exploitative", i. Is unable or unwilling to identify with, acknowledge, or accept the feelings, needs, preferences, priorities, and choices of others;Constantly envious of others and seeks to hurt or destroy the objects of his or her frustration. Suffers from persecutory (paranoid) delusions as he or she believes that they feel the same about him or her and are likely to act similarly;Behaves arrogantly and haughtily. Feels superior, omnipotent, omniscient, invincible, immune, "above the law", and omnipresent (magical thinking). Rages when frustrated, contradicted, or confronted by people he or she considers inferior to him or her and unworthy. According to the DSM IV-TR, between 2% and 16% of the population in clinical settings (between 0. Most narcissists (50-75%, according to the DSM-IV-TR) are men. We must carefully distinguish between the narcissistic traits of adolescents - narcissism is an integral part of their healthy personal development - and the full-fledge disorder. These inevitably involve narcissistic assertiveness which is not to be conflated or confused with Narcissistic Personality Disorder (NPD). Almost 75 percent of individuals diagnosed with NPD are male (APA, DSM IV-TR 2000). In certain situations, such as under constant public scrutiny and exposure, a transient and reactive form of the Narcissistic Personality Disorder (NPD) has been observed by Robert Milman and labelled "Acquired Situational Narcissism". There is only scant research regarding the Narcissistic Personality Disorder (NPD), but studies have not demonstrated any ethnic, social, cultural, economic, genetic, or professional predilection to it. Narcissistic Personality Disorder (NPD) is often diagnosed with other mental health disorders ("co-morbidity"), such as mood disorders, eating disorders, and substance-related disorders.

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    Includes definition buy cheap silvitra 120mg line, signs and symptoms discount silvitra 120mg overnight delivery, causes and treatment of Internet addiction. To begin with, Internet Addiction Disorder (IAD) is not a real disorder; at least not as far as the American Psychiatric Association is concerned. It started out as a hoax, when in 1995, psychiatrist Ivan Goldberg posted the fabricated symptoms of Internet addiction on his website and the post became viral and was passed around the internet. Goldberg used the symptoms of pathological gambling as his model for Internet Addiction Disorder. In June 2007, the American Medical Association declined to recommend to the American Psychiatric Association that they include Internet Addiction Disorder as a formal diagnosis in the 2012 edition of the DSM. Instead, the group recommended further research of "video game overuse. Among the necessary research is a way to define "overuse" and a way to differentiate an "internet addiction" from obsession and compulsion and self-medication for depression or other disorders. Others, however, do believe internet addiction to be a true disorder and they are trying to get it included in the bible of psychiatric diagnosis, the Diagnostic and Statistical Manual (DSM). Two of the leaders at the forefront of this movement are Kimberly Young, PhD, of the Center for Online Addiction and a leading researcher in Internet addiction and Dr. Maressa Hecht Orzack, the director of the Computer Addiction Study Center at McLean Hospital in Belmont, Mass. Orzack opened a clinic for Internet addicts at the hospital in 1996, when, she said, "everybody thought I was crazy. Orzack said she got the idea after she discovered she had become addicted to computer solitaire, procrastinating and losing sleep and time with her family. Orzack started the clinic, she saw two patients a week at most. Now she sees dozens and receives five or six calls daily from those seeking treatment for internet addiction elsewhere in the country. More and more of those calls, she said, are coming from people concerned about family members addicted to Internet video games, online gambling and internet pornography. A growing number of therapists and inpatient rehabilitation centers are often treating Internet addicts with the same approaches used to treat chemical addictions; including the use of 12-step programs. Because the addiction to the internet is not recognized in psychiatry as a disorder, insurance companies do not reimburse for treatment. So patients with an online addiction either pay out of pocket, or therapists and treatment centers bill for other afflictions, including the nonspecific impulse control disorder. One inpatient program, at Proctor Hospital in Peoria, Ill. Experts there said they see similar signs of withdrawal in those patients as in alcohol addicts or drug addicts, including profuse sweating, severe anxiety and paranoid symptoms. Hilarie Cash, who runs Internet/Computer Addiction Services in Redmond, Washington (home of Microsoft) and other therapists report seeing a growing number of teenagers and young adults as patients, who grew up spending hours on the computer, playing games and sending instant messages. These patients appear to have significant developmental problems, including attention deficit disorder and a lack of social skills. APA Monitor on Psychology, "Is Internet Addiction Real? Symptoms to tell if your teenager is addicted to the internet. The amount of time teenagers spend online is a source of frustration for many parents. Initially, parents welcomed the Internet into their homes, believing they were opening up an exciting new world of educational opportunities for their children. However, many parents soon realized that, instead of using the Internet for homework or research, their kids became Internet addicts and were spending hours instant messaging with friends, playing online games or talking to strangers in chat rooms. The Internet has made this challenge even more difficult.

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    P We do not know how to Love our self in healthy ways because our parents did not know how to Love themselves purchase silvitra 120 mg overnight delivery. P We were raised in shame-based societies that taught us that there is something wrong with being human discount silvitra 120mg without prescription. P That does not mean just romantic relationships, or family relationships, or even human relationships in general. P Instead of being traumatized in a foreign country against an identified enemy during a war, as soldiers who have delayed stress are - we were traumatized in our sanctuaries by the people we loved the most. Traditionally, in this society, men have been taught that anger is the only acceptable emotion for a man to express, while women are taught that it is not acceptable for them to be angry. P If it is not ok to own all of our emotions then we can not know who we are as emotional beings. P P The condition of codependence is about giving power over our self esteem to outside sources/agencies or external manifestations. P We were taught to look outside of our selves to people, places, and things - to money, property and prestige, to determine if we have worth. P We make money or achievement or popularity or material possessions or the "right" marriage the Higher Power that determines if we have worth. P We do not know how to Love our self in healthy ways because our parents did not know how to Love themselves. P We were raised in shame-based societies that taught us that there is something wrong with being human. P The messages we got often included that there is something wrong: P with making mistakes; P with not being perfect; P with being sexual; with being emotional; with being too fat or too thin or too tall or too short or too whatever. P As children we were taught to determine our worth in comparison with others. P If we were smarter than, prettier than, better grades than, faster than, etc. In a codependent society everyone has to have someone to look down on in order to feel good about themselves. P And, conversely, there is always someone we can compare ourselves to that can cause us to not feel good enough. The condition of codependence is about giving power over our self esteem to outside sources/agencies or external manifestations. We were taught to look outside of our selves to people, places, and things - to money, property and prestige, to determine if we have worth. We make money or achievement or popularity or material possessions or the "right" marriage the Higher Power that determines if we have worth. We take our self-definition and self-worth from external manifestations of our own being so that looks or talent or intelligence becomes the Higher Power that we look to in determining if we have worth. All outside and external conditions are temporary and could change in a moment. If we make a temporary condition our Higher Power we are setting ourselves up to be a victim - and, in blind devotion to that Higher Power we are pursuing, we often victimize other people on our way to proving we have worth. That we all have equal worth as Spiritual Beings, as sons and daughters of the God-Force / Goddess Energy / Great Spirit - not because of any external manifestation or outside condition. Instead of being traumatized in a foreign country against an identified enemy during a war, as soldiers who have delayed stress are - we were traumatized in our sanctuaries by the people we loved the most. Instead of having experienced that trauma for a year or two as a soldier might - we experienced it on a daily basis for 16 or 17 or 18 years. A soldier has to shut down emotionally in order to survive in a war zone. We had to shut down emotionally because we were surrounded by adults who were emotional cripples of one sort or another. When a society is emotionally dishonest, the people of that society are set up to be emotionally dysfunctional. In this society being emotional is described as falling apart, losing it, going to pieces, coming unglued, etc. The goal is balance between emotional and mental - between the intuitive and the rational. If it is not ok to own all of our emotions then we can not know who we are as emotional beings.

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    In addition generic silvitra 120mg with mastercard, alpha-methyl-p-tyrosine order 120mg silvitra with mastercard, a dopamine synthesis inhibitor, blocks the action of amphetamine, but does not block locomotor activity induced by modafinil. Armodafinil and modafinil have wake-promoting actions similar to sympathomimetic agents including amphetamine and methylphenidate, although their pharmacologic profile is not identical to that of the sympathomimetic amines. In addition to its wake-promoting effects and ability to increase locomotor activity in animals, modafinil produces psychoactive and euphoric effects, alterations in mood, perception, thinking, and feelings typical of other CNS stimulants in humans. Modafinil has reinforcing properties, as evidenced by its self-administration in monkeys previously trained to self-administer cocaine; modafinil was also partially discriminated as stimulant-like. Based on nonclinical studies, two major metabolites, acid and sulfone, of modafinil or armodafinil, do not appear to contribute to the CNS-activating properties of the parent compounds. The active component of NUVIGIL is armodafinil, which is the longer-lived enantiomer of modafinil. NUVIGIL exhibits linear time-independent kinetics following single and multiple oral dose administration. Increase in systemic exposure is proportional over the dose range of 50 to 400 mg. No time-dependent change in kinetics was observed through 12 weeks of dosing. Apparent steady state for NUVIGIL was reached within 7 days of dosing. At steady state, the systemic exposure for NUVIGIL is 1. The concentration-time profiles of the pure R-enantiomer following administration of 50 mg NUVIGIL or 100 mg PROVIGIL(modafinil) are nearly superimposable. NUVIGIL is readily absorbed after oral administration. The absolute oral bioavailability was not determined due to the aqueous insolubility of armodafinil, which precluded intravenous administration. Peak plasma concentrations are attained at approximately 2 hours in the fasted state. Food effect on the overall bioavailability of NUVIGIL is considered minimal; however, time to reach peak concentration (t) may be delayed by approximately 2-4 hours in the fed state. Since the delay in tis also associated with elevated plasma levels later in time, food can potentially affect the onset and time course of pharmacologic action for NUVIGIL. NUVIGIL has an apparent volume of distribution of approximately 42 L. Data specific to armodafinil protein binding are not available. However, modafinil is moderately bound to plasma protein (approximately 60%), mainly to albumin. The potential for interactions of NUVIGIL with highly protein-bound drugs is considered to be minimal. In vitro and in vivo data show that armodafinil undergoes hydrolytic deamidation, S-oxidation, and aromatic ring hydroxylation, with subsequent glucuronide conjugation of the hydroxylated products. Amide hydrolysis is the single most prominent metabolic pathway, with sulfone formation by cytochrome P450 (CYP) 3A4/5 being next in importance. The other oxidative products are formed too slowly in vitro to enable identification of the enzyme(s) responsible. Only two metabolites reach appreciable concentrations in plasma (i. Data specific to NUVIGIL disposition are not available. However, modafinil is mainly eliminated via metabolism, predominantly in the liver, with less than 10% of the parent compound excreted in the urine. A total of 81% of the administered radioactivity was recovered in 11 days post-dose, predominantly in the urine (80% vs 1.

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    Further cheap 120 mg silvitra, valproate has little effect on the metabolism of olanzapine in vitro silvitra 120mg discount. In vivo administration of olanzapine (10 mg daily for 2 weeks) did not affect the steady state plasma concentrations of valproate. Therefore, concomitant olanzapine administration does not require dosage adjustment of valproate. Single doses of olanzapine did not affect the pharmacokinetics of imipramine or its active metabolite desipramine, and warfarin. Multiple doses of olanzapine did not influence the kinetics of diazepam and its active metabolite N-desmethyldiazepam, ethanol, or biperiden. However, the co-administration of either diazepam or ethanol with olanzapine potentiated the orthostatic hypotension observed with olanzapine. Multiple doses of olanzapine did not affect the pharmacokinetics of theophylline or its metabolites. Lorazepam -- Administration of intramuscular lorazepam (2 mg) 1 hour after intramuscular olanzapine for injection (5 mg) did not significantly affect the pharmacokinetics of olanzapine, unconjugated lorazepam, or total lorazepam. However, this co-administration of intramuscular lorazepam and intramuscular olanzapine for injection added to the somnolence observed with either drug alone ( see Hemodynamic Effects ). Carcinogenesis -- Oral carcinogenicity studies were conducted in mice and rats. Olanzapine was administered to mice in two 78-week studies at doses of 3, 10, 30/20 mg/kg/day (equivalent to 0. The incidence of liver hemangiomas and hemangiosarcomas was significantly increased in one mouse study in female mice dosed at 8 mg/kg/day (2 times the maximum recommended human daily oral dose on a mg/m 2 basis). These tumors were not increased in another mouse study in females dosed at 10 or 30/20 mg/kg/day (2-5 times the maximum recommended human daily oral dose on a mg/m 2 basis); in this study, there was a high incidence of early mortalities in males of the 30/20 mg/kg/day group. The incidence of mammary gland adenomas and adenocarcinomas was significantly increased in female mice dosed at >/=2 mg/kg/day and in female rats dosed at >/=4 mg/kg/day (0. Antipsychotic drugs have been shown to chronically elevate prolactin levels in rodents. Serum prolactin levels were not measured during the olanzapine carcinogenicity studies; however, measurements during subchronic toxicity studies showed that olanzapine elevated serum prolactin levels up to 4-fold in rats at the same doses used in the carcinogenicity study. An increase in mammary gland neoplasms has been found in rodents after chronic administration of other antipsychotic drugs and is considered to be prolactin mediated. The relevance for human risk of the finding of prolactin mediated endocrine tumors in rodents is unknown ( see Hyperprolactinemia under PRECAUTIONS, General ). Mutagenesis -- No evidence of mutagenic potential for olanzapine was found in the Ames reverse mutation test, in vivo micronucleus test in mice, the chromosomal aberration test in Chinese hamster ovary cells, unscheduled DNA synthesis test in rat hepatocytes, induction of forward mutation test in mouse lymphoma cells, or in vivo sister chromatid exchange test in bone marrow of Chinese hamsters. Impairment of Fertility -- In an oral fertility and reproductive performance study in rats, male mating performance, but not fertility, was impaired at a dose of 22. Discontinuance of olanzapine treatment reversed the effects on male mating performance. In female rats, the precoital period was increased and the mating index reduced at 5 mg/kg/day (2. Pregnancy Category C -- In oral reproduction studies in rats at doses up to 18 mg/kg/day and in rabbits at doses up to 30 mg/kg/day (9 and 30 times the maximum recommended human daily oral dose on a mg/m 2 basis, respectively) no evidence of teratogenicity was observed. In an oral rat teratology study, early resorptions and increased numbers of nonviable fetuses were observed at a dose of 18 mg/kg/day (9 times the maximum recommended human daily oral dose on a mg/m 2 basis). Gestation was prolonged at 10 mg/kg/day (5 times the maximum recommended human daily oral dose on a mg/m 2 basis). In an oral rabbit teratology study, fetal toxicity (manifested as increased resorptions and decreased fetal weight) occurred at a maternally toxic dose of 30 mg/kg/day (30 times the maximum recommended human daily oral dose on a mg/m 2 basis). Placental transfer of olanzapine occurs in rat pups. There are no adequate and well-controlled trials with olanzapine in pregnant females. Seven pregnancies were observed during clinical trials with olanzapine, including 2 resulting in normal births, 1 resulting in neonatal death due to a cardiovascular defect, 3 therapeutic abortions, and 1 spontaneous abortion.

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