The Pronk Pops Show 740, August 22, 2016, Story 1: Should An Independent Impartial Panel of Physicians Evaluate The Physical and Mental Health of Presidential Candidates? — Hillary Clinton’s Hypothyroidism and Frequent Convulsions and Seizures Becomes An Issue –Diazepam Autoinjections — Dr Steve Pieczenik: Hillary Showing Signs of Dementia / Alzheimers / Tumor/Brain Damage! — Is Clinton Fit To Be President? — No. — Big Lie Media — Yes — Videos

Posted on August 22, 2016. Filed under: 2016 Presidential Campaign, 2016 Presidential Candidates, Addiction, American History, Blogroll, Books, Breaking News, Communications, Corruption, Countries, Culture, Donald J. Trump, Donald Trump, Drugs, Education, Empires, Employment, Federal Bureau of Investigation (FBI), Foreign Policy, Government, Government Spending, Health, Hillary Clinton, History, Human Behavior, Illegal Drugs, Illegal Immigration, Immigration, Independence, Language, Law, Legal Immigration, Life, Lying, Unemployment, United States of America, Videos, Violence, War, Wealth, Wisdom | Tags: , , , , , , , , , , , , , , , |

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The Pronk Pops Show Podcasts

Pronk Pops Show 740: August 22, 2016

Pronk Pops Show 739: August 18, 2016

Pronk Pops Show 738: August 17, 2016

Pronk Pops Show 737: August 16, 2016

Pronk Pops Show 736: August 15, 2016

Pronk Pops Show 735: August 12, 2016

Pronk Pops Show 734: August 11, 2016

Pronk Pops Show 733: August 9, 2016

Pronk Pops Show 732: August 8, 2016

Pronk Pops Show 731: August 4, 2016

Pronk Pops Show 730: August 3, 2016

Pronk Pops Show 729: August 1, 2016

Pronk Pops Show 728: July 29, 2016

Pronk Pops Show 727: July 28, 2016

Pronk Pops Show 726: July 27, 2016

Pronk Pops Show 725: July 26, 2016

Pronk Pops Show 724: July 25, 2016

Pronk Pops Show 723: July 22, 2016

Pronk Pops Show 722: July 21, 2016

Pronk Pops Show 721: July 20, 2016

Pronk Pops Show 720: July 19, 2016

Pronk Pops Show 719: July 18, 2016

Pronk Pops Show 718: July 15, 2016

Pronk Pops Show 717: July 14, 2016

Pronk Pops Show 716: July 13, 2016

Pronk Pops Show 715: July 12, 2016

Pronk Pops Show 714: July 7, 2016

Pronk Pops Show 713: July 6, 2016

Pronk Pops Show 712: July 5, 2016

Pronk Pops Show 711: July 1, 2016

Pronk Pops Show 710: June 30, 2016

Pronk Pops Show 709: June 29, 2016

Pronk Pops Show 708: June 28, 2016

Pronk Pops Show 707: June 27, 2016

Pronk Pops Show 706: June 24, 2016

Pronk Pops Show 705: June 23, 2016

Pronk Pops Show 704: June 22, 2016

Pronk Pops Show 703: June 21, 2016

Pronk Pops Show 702: June 20, 2016

Pronk Pops Show 701: June 17, 2016

Pronk Pops Show 700: June 16, 2016

Pronk Pops Show 699: June 15, 2016

Pronk Pops Show 698: June 14, 2016

Pronk Pops Show 697: June 13, 2016

Pronk Pops Show 696: June 10, 2016

Pronk Pops Show 695: June 9, 2016

Pronk Pops Show 694: June 8, 2016

Pronk Pops Show 693: June 6, 2016

Pronk Pops Show 692: June 3, 2016

Pronk Pops Show 691: June 2, 2016

Pronk Pops Show 690: June 1, 2016

Pronk Pops Show 689: May 31, 2016

Pronk Pops Show 688: May 27, 2016

Pronk Pops Show 687: May 26, 2016

Pronk Pops Show 686: May 25, 2016

Pronk Pops Show 685: May 24, 2016

Pronk Pops Show 684: May 23, 2016

Pronk Pops Show 683: May 20, 2016

Pronk Pops Show 682: May 19, 2016

Pronk Pops Show 681: May 17, 2016

Pronk Pops Show 680: May 16, 2016

Pronk Pops Show 679: May 13, 2016

Pronk Pops Show 678: May 12, 2016

Pronk Pops Show 677: May 11, 2016

Pronk Pops Show 676: May 10, 2016

Pronk Pops Show 675: May 9, 2016

Pronk Pops Show 674: May 6, 2016

Pronk Pops Show 673: May 5, 2016

Pronk Pops Show 672: May 4, 2016

Pronk Pops Show 671: May 3, 2016

Pronk Pops Show 670: May 2, 2016

 

hillary_sick_ben_garrisonHillary-Clinton-Cartoon-Challenge-Accepted

extreme carelessness hillary-clintons-health-mike-cerHillaryClinton dr drew-hillary-glasses-2hillary-clinton-stairs-8-9-16
Hillary-Clinton-frailty-640Hillary-Clintonhillary-reporter-shocked1hillary-clinton-mental-940autoinjection devicehillary-handler-seizure-drugHillary-seizure-doctoseizures hillary

WHATS WRONG WITH HILLARY CLINTON ? Seizure? Health Problem? CRAZY?

Benenson Angered, Won’t Answer MSNBC’s Questions About Clinton Health

Dr Steve Pieczenik: Hillary Showing Signs of Dementia / Alzheimers / Tumor

HILLARY ON THE BRINK – Mainstream Media Trying To Cover Up Hillary Clinton’s Health Problems

Dr. Drew: Hillary Has “Brain Damage”

[youtub4e=https://www.youtube.com/watch?v=2dCJ2ohcP2M]

Dr. Drew speaks out on Hillary’s Health (Full Interview)

Dr. Drew “Gravely Concerned” About Hillary Clinton’s Health

The Truth About Hillary’s Bizarre Behavior

Paul Joseph Watson: Hillary’s health — and the media coverup

Hillary Clinton’s Health | Mike Cernovich and Stefan Molyneux

Hillary’s Campaign Is In Complete Damage Control Mode

Hillary Clinton Has A Seizure/Stroke On Video! (WTF Is Wrong With Her, Is She Dying?)

Another Hillary Clinton Seizure

Hillary Clinton Handler Seen With Auto-Injector Syringe For Anti-Seizure Drug Diazepam

Medical Specialist Examine Hillary’s Health Issues…

Proof Hillary Clinton Is Having Frequent Seizures: Doctors with Diazepam Autoinjector in Las Vegas

HILLARY CLINTON COUGHING FIT

Hillary Clinton’s Medical Issues

Proof Hillary Clinton Is Very Sick And Dying

Secret Service Agent Tells All – Hillary Clinton is CRAZY – Gary Byrne – Full Interview

Dr. Ben Carson: Clinton’s health records should be public

Woodrow Wilson’s Health Crisis

JFK & Addison’s Disease

JFK hid serious health problems to become president

New Revelations on JFK’s Health, Love Affairs, Brothers and Father, and Plans (2003)

Hiding a Disability

History in Five: James Tobin on How Polio Shaped FDR’s Political Career

The illusion that Franklin Roosevelt could walk

President Roosevelt’s War on Polio

Most Want to See Clinton, Trump Tax Returns, Medical Records

Thursday, August 11, 2016

Republicans are again asking questions about Hillary Clinton’s health, while Democrats continue to insist that Donald Trump release his tax returns. Most voters still believe major White House hopefuls should make public recent tax returns, but now most also think they should release their medical records, too.

A new Rasmussen Reports national telephone and online survey finds that 67% of Likely U.S. Voters think all presidential candidates should release at least their most recent tax returns to the public, although that’s down slightly from 73% who felt that way a year ago. Just 23% disagree. (To see survey question wording, click here.)

In July 2012 during the last presidential race, only six percent (6%) thought the release of the most recent year’s tax return was enough. Twenty-nine percent (29%) felt returns from the most recent two years were necessary, while 60% wanted to see more than that.

But 59% of voters also now believe all major presidential candidates should release at least their most recent medical records to the public. That’s up dramatically from 38% in May 2014 when questions about Clinton’s health were first being raised. Thirty percent (30%) don’t think candidates should have to release their recent medical records, while 11% are undecided.

Interestingly, Democrats (62%) believe even more strongly than Republicans (58%) and voters not affiliated with either major party (57%) that presidential candidates should release their recent medical records. Most Republicans (59%) favor release of the most recent tax returns, but they’re less supportive than Democrats (77%) and unaffiliateds (63%) are.

(Want a free daily e-mail update? If it’s in the news, it’s in our polls). Rasmussen Reports updates are also available on Twitter or Facebook.

The survey of 1,000 Likely Voters was conducted on August 9-10, 2016 by Rasmussen Reports. The margin of sampling error is +/- 3 percentage points with a 95% level of confidence. Field work for all Rasmussen Reports surveys is conducted by Pulse Opinion Research, LLC. See methodology.

[Rasmussen Reports analysts Amy Holmes  and Fran Coombs are available for interested media. Please call 732-776-9777 ext. 205 for interviews.]

Rasmussen Reports’ latest weekly White House Watch survey finds Clinton with 43% support to Trump’s 40%. Libertarian candidate Gary Johnson picks up eight percent (8%) of the vote, while Green Party nominee Jill Stein trails with two percent (2%).

Just 49% of voters who support Trump for president think the candidates should release their most recent tax returns, compared to 82% of voters who support Clinton. Voters who back Clinton (63%) are slightly more supportive of candidates releasing their medical records compared to Trump supporters (58%).

Younger voters feel less strongly than their elders do that candidates should release their recent medical records and tax returns.

Last year’s survey found that 80% of all voters think it is likely that a candidate is hiding something of significance if he or she refuses to release tax returns, including 47% who say it’s Very Likely. 

A plurality of voters believe Clinton and Trump are less honest than most politicians, but Republicans have a lot more confidence in Trump’s honesty than Democrats do in the honesty of Clinton.

Republicans and unaffiliated voters tend to see Trump’s lifetime of business experience as good training for the White House. Most Democrats do not. GOP voters aren’t nearly as worried as the others that Trump’s business interests may be a potential conflict of interest problem down the road.

Wall Street Journal columnist Peggy Noonan wrote earlier this year that the only person who can beat Trump is Trump himself, and so far voters think that’s exactly what he’s doing.

Additional information from this survey and a full demographic breakdown are available to Platinum Members only.

Please sign up for the Rasmussen Reports daily email update (it’s free) or follow us on Twitter orFacebook. Let us keep you up to date with the latest public opinion news.

http://www.rasmussenreports.com/public_content/politics/general_politics/august_2016/most_want_to_see_clinton_trump_tax_returns_medical_records

Multiple sources raise serious questions about Hillary Clinton’s physical health

Several sources have raised serious questions about Hillary Clinton’s fitness to serve at president of the United States based on her physical health.  Some of these individuals are people who observed her in various settings that called her mental and physical status into question.  Others are physicians who reviewed the 2012 ABC News report after Clinton’s fall and subsequent concussion

Read more: http://www.americanthinker.com/blog/2016/01/multiple_sources_raise_serious_questions_about_hillary_clintons_physical_health.html#ixzz4I681XZrn
Follow us: @AmericanThinker on Twitter | AmericanThinker on Facebook

Non-medical observers

Breitbart News reports that John Cardillo, a former NYPD officer who provided VIP security details, knows two sources (a federal agent and an NYPD officer who worked a security detail) who observed Clinton’s health-related behaviors over the past several years.  Neither officer knows the other, yet their stories are almost identical.  Observations include witnessing Clinton become pale, sweaty, disoriented, fatigued, dizzy, on the verge of fainting, and/or unable to walk to her car after giving a speech.

Republican strategist Roger Stone told Breitbart News he was also aware of Clinton’s health problems and does not believe she has the physical stamina to be president, stating: “A number of New York Democrats, very prominent, well-known, wealthy New York Democrats, told me last year that Hillary had very significant health issues and that they were surprised that she was running in view of her health problems and her lack of stamina. So far, she’s run a very controlled campaign.”  Stone also referenced Huma Abedin’s comment in an email that Clinton is “often confused.”

Medical opinions

Dr. Jane Orient, medical doctor, stated that “[c]oncussions can cause long-term damage including cognitive problems, even when standard studies including CT or MRI look normal. Not saying Mrs. Clinton has any of the above – just speaking generally and hypothetically.”

Daniel Kassicieh, D.O. (osteopath), neurologist, agreed with Orient about the possibility of Clinton suffering long-term cognitive symptoms.  He has stated that concussions in older adults can be more serious, resulting in a condition known as post-concussion syndrome.  Symptoms include persistent dizziness, complaints of memory difficulties, forgetfulness, loss of ability to focus on complex tasks or concepts, and indecisiveness.  Risk factors for developing post-concussion syndrome include age (Clinton was 65 when this happened) and being female.

Kassicieh noted that he has treated many post-concussion syndrome patients and believes that Clinton is suffering from this based on reports he has read and observation of her behaviors, stating: “I think she has latent post-concussion syndrome, and I can understand that as a politician they would want to be covering that up.”  He further noted that as a neurologist, he would not want a president with this diagnosis, because “super high-level cognitive abilities are clearly impaired and even their routine multitasking high-stress abilities are affected because post-concussion syndrome patients in general don’t tolerate even moderate work, stress-related environments.”  Kassicieh added that if Clinton is suffering from post-concussion syndrome, her symptoms could appear “well beyond a year” after her concussion.

Dr. Drew Pinsky, internal medicine physician, confirmed that symptoms could last more than a year after a head injury of the sort Clinton suffered and that symptoms are “not trivial” and are “very serious,” particularly for individuals in their 60s.

Dr. Nicholas C. Bambakidis, neurosurgeon, appeared less concerned than others, stating that the type of blood clot Clinton had is often without cause and can be associated with any number of factors.  If untreated, the clot can progress, cause brain bleeds and/or swelling that can result in a stroke, and can, in some cases, be fatal.  However, Bambakidis confirmed that if treated in a timely fashion, there should be no longstanding issues with a person’s health, and that this appears to be the case with Clinton.

Breitbart News compiled a list of questions and sent them to Clinton spokesman, Nick Merrill, including:

1) Does Secretary Clinton have difficulty with fatigue, dizziness and being disoriented? Does she have difficulty after speeches and during debates continuing for lengthy periods of time–or for instance walking back to her car after events?

2) Is she suffering from latent post concussion syndrome?

3) Is she being completely honest with the public about her health? Does she have a clean bill of health?

4) Is she able to conduct high level cognitive abilities on the same level she has been able to throughout her life? Is she able to conduct routine multitasking high stress abilities on the same level she has been able to throughout her life?

5) Does she have or did she have a transverse sinus thrombosis, or blood clot?

6) Is she capable of serving as President of the United States with these conditions and symptoms?

7) Has she done tests with a doctor on a treadmill? Has she gotten a doctor-supervised sleep study? Has she worked with a doctor on metabolic studies? Has she gotten cancer screenings?

8) Does she have a medical team attending to her? What are the details of that?

Merrill responded by telling Breitbart News that Clinton’s doctors already answered those questions and the information is in her health statement.  Clinton’s doctor (since 2001), Lisa Bardack, wrote in a letter that she deemed Clinton fit to serve as president.  Bardack confirms the following:

  • Healthy 67-year-old female.
  • Current medical conditions: hypothyroidism and seasonal pollen allergies.
  • Prior health history: (1) 1998 and 2009: deep vein thrombosis, (2) 2009: elbow fracture, (3) 2012: concussion, (4) 2012: stomach virus causing dehydration, fainting, and a concussion, and (5) 2013: transverse sinus venous thrombosis; anti-coagulation therapy; concussion symptoms resolved within two months; follow-up tests showed complete resolution and total dissolution of the thrombosis; tested negative for all clotting disorders; put on daily anticoagulation as a precautionary measure.
  • Family history: (1) father who lived into his 80s and died of a stroke, (2) mother who lived into her 90s and died of a heart attack, and (3) one brother with heart disease.

The doctor’s letter noted various preventative tests and screenings that have all been negative and confirmed that Clinton’s last physical in March of 2015 showed she was in excellent health.  Her letter ended:

In summary, Mrs. Clinton is a healthy female with hypothyroidism and seasonal allergies, on long-term anticoagulation,” Dr. Bardack wrote. “She participates in a healthy lifestyle and has had a full medical evaluation, which reveals no evidence of additional medical issues or cardiovascular disease. Her cancer screening evaluations are all negative. She is in excellent physical condition and fit to serve as President of the United States.

In June of last year, Robby Mook, Clinton’s campaign manager, wouldn’t commit to releasing Clinton’s full health records.  The letter from Clinton’s personal physician was forwarded to Breitbart News after that Mook interview.

No health records.  Just a letter.  Lots of questions.

Sounds about right for Hillary Clinton.

http://www.americanthinker.com/blog/2016/01/multiple_sources_raise_serious_questions_about_hillary_clintons_physical_health.html#ixzz4I68GrWZn

Diazepam

From Wikipedia, the free encyclopedia
Diazepam
Diazepam structure.svg
Diazepam ball-and-stick model.png
Systematic (IUPAC) name
7-chloro-1-methyl-5-phenyl-3H-1,4-benzodiazepin-2-one
Clinical data
Pronunciation /dˈæzpæm/
Trade names Valium and many others
AHFS/Drugs.com Monograph
MedlinePlus a682047
License data
Pregnancy
category
  • AU:C
  • US:D (Evidence of risk)
Dependence
liability
Moderate
Addiction
liability
Moderate[1][2]
Routes of
administration
Oral, IM, IV, suppository
Legal status
Legal status
Pharmacokinetic data
Bioavailability 93–100%
Metabolism HepaticCYP2B6 (minor route) todesmethyldiazepam,CYP2C19 (major route) to inactive metabolites,CYP3A4 (major route) to desmethyldiazepam
Biological half-life 20–100 hours (36–200 hours for main active metabolite desmethyldiazepam)
Excretion Renal
Identifiers
CAS Number 439-14-5 Yes
ATC code N05BA01 (WHO)
PubChem CID 3016
IUPHAR/BPS 3364
DrugBank DB00829 
ChemSpider 2908 Yes
UNII Q3JTX2Q7TU Yes
KEGG D00293 Yes
ChEBI CHEBI:49575 Yes
ChEMBL CHEMBL12 Yes
Chemical data
Formula C16H13ClN2O
Molar mass 284.7 g/mol
Yes(what is this?)(verify)

Diazepam, first marketed as Valium, is a medication of the benzodiazepine family that typically produces a calming effect. It is commonly used to treat a range of conditions includinganxiety, alcohol withdrawal syndrome, benzodiazepine withdrawal syndrome, muscle spasms, seizures, trouble sleeping, and restless legs syndrome.[3] It may also be used to cause memory loss during certain medical procedures.[4][5] It can be taken by mouth, inserted into the rectum, injected into muscle, or injected into a vein.[5] When given into a vein, effects begin in one to five minutes and last up to an hour.[5] By mouth, effects may take 40 minutes to begin.[6]

Common side effects include sleepiness and trouble with coordination.[5] Serious side effects are rare.[3] They include suicide, decreased breathing, and an increased risk of seizures if used too frequently in those with epilepsy.[3][5] Occasionally excitement or agitation may occur.[7][8]Long term use can result in tolerance, dependence, and withdrawal symptoms on dose reduction. Abrupt stopping after long term use can be potentially dangerous.[3] After stopping, cognitive problems may persist for six months or longer.[7] It is not recommended during pregnancy or breastfeeding.[5] Its mechanism of action is by increasing the effect of the neurotransmitter gamma-Aminobutyric acid (GABA).[7]

Diazepam was first synthesized by Leo Sternbach, and was first manufactured by Hoffmann-La Roche. It has been one of the most frequently prescribed medications in the world since its launch in 1963. In the United States it was the highest selling medication between 1968 and 1982, selling more than two billion tablets in 1978 alone. In 1985 the patent ended, and there are now more than 500 brands available on the market.[3] Diazepam is on the World Health Organization’s List of Essential Medicines, the most important medications needed in a basic health system.[9] The wholesale cost in the developing world is about 0.01 USD per dose as of 2014.[10] In the United States it is about 0.40 USD per dose.[5]

Medical uses

Diazepam tablets (2, 5, and 10 mg)

Diazepam is mainly used to treat anxiety, insomnia, panic attacks and symptoms of acute alcohol withdrawal. It is also used as a premedication for inducing sedation, anxiolysis, or amnesia before certain medical procedures (e.g., endoscopy).[11][12] Diazepam is the drug of choice for treating benzodiazepine dependence with its long half-life allowing easier dose reduction. Benzodiazepines have a relatively low toxicity in overdose.[7]

Diazepam has a number of uses including:

Dosages should be determined on an individual basis, depending on the condition being treated, severity of symptoms, patient body weight, and any other conditions the person may have.[18]

Seizures

Intravenous diazepam or lorazepam are first-line treatments for status epilepticus.[7][20] However, lorazepam has advantages over diazepam, including a higher rate of terminating seizures and a more prolonged anticonvulsant effect.[21][needs update] Diazepam is rarely used for the long-term treatment of epilepsy because tolerance to its anticonvulsant effects usually develops within six to 12 months of treatment, effectively rendering it useless for that purpose.[18][22]

The anticonvulsant effects of diazepam can help in the treatment of seizures due to a drug overdose or chemical toxicity as a result of exposure to sarin, VX, or soman (or otherorganophosphate poisons), lindane, chloroquine, physostigmine, or pyrethroids.[18][23]

It is sometimes used intermittently for the prevention of febrile seizures that may occur in children under five years of age.[7] This use; however, is not typically recommended as the benefits are small and side effects are common.[24] Long-term use of diazepam for the management of epilepsy is not recommended; however, a subgroup of individuals with treatment-resistant epilepsy benefit from long-term benzodiazepines, and for such individuals, clorazepate has been recommended due to its slower onset of tolerance to the anticonvulsant effects.[7]

Other

Diazepam is used for the emergency treatment of eclampsia, when IVmagnesium sulfate and blood-pressure control measures have failed.[25][26] Benzodiazepines do not have any pain-relieving properties themselves, and are generally recommended to avoid in individuals with pain.[27] However, benzodiazepines such as diazepam can be used for their muscle-relaxant properties to alleviate pain caused by muscle spasms and various dystonias, including blepharospasm.[28][29] Tolerance often develops to the muscle relaxant effects of benzodiazepines such as diazepam.[30]Baclofen[31] or tizanidine is sometimes used as an alternative to diazepam.

Availability

Diazepam is marketed in over 500 brands throughout the world.[32] It is supplied in oral, injectable, inhalation, and rectal forms.[18][33][34]

The United States military employs a specialized diazepam preparation known as Convulsive Antidote, Nerve Agent (CANA), which contains diazepam. One CANA kit is typically issued to service members, along with three Mark I NAAK kits, when operating in circumstances where chemical weapons in the form of nerve agents are considered a potential hazard. Both of these kits deliver drugs using autoinjectors. They are intended for use in “buddy aid” or “self aid” administration of the drugs in the field prior to decontamination and delivery of the patient to definitive medical care.[35]

Contraindications

Use of diazepam should be avoided, when possible, in individuals with:[36]

Caution

  • Benzodiazepine abuse and misuse should be checked if used in the alcohol- or drug-dependent people or those with comorbid psychiatric disorders.[37]
  • Pediatric patients
    • Less than 18 years of age, this treatment is usually not indicated, except for treatment of epilepsy, and pre- or postoperative treatment. The smallest possible effective dose should be used for this group of patients.[38]
    • Under 6 months of age, safety and effectiveness have not been established; diazepam should not be given to those in this age group.[17][38]
  • Elderly and very ill patients can possibly suffer apnea or cardiac arrest. Concomitant use of other central nervous system depressants increases this risk. The smallest possible effective dose should be used for this group of patients.[17][38][39] The elderly metabolise benzodiazepines much more slowly than younger adults, and are also more sensitive to the effects of benzodiazepines, even at similar blood plasma levels. Doses of diazepam are recommended to be about half of those given to younger people, and treatment limited to a maximum of two weeks. Long-acting benzodiazepines such as diazepam are not recommended for the elderly.[7] Diazepam can also be dangerous in geriatric patients owing to a significant increased risk of falls.[40]
  • Intravenous or intramuscular injections in hypotensive people or those in shock should be administered carefully and vital signs should be monitored.[39]
  • Benzodiazepines such as diazepam are lipophilic and rapidly penetrate membranes, so rapidly cross over into the placenta with significant uptake of the drug. Use of benzodiazepines including diazepam in late pregnancy, especially high doses, can result in floppy infant syndrome.[41] Diazepam when taken late in pregnancy, during the third trimester, causes a definite risk of a severe benzodiazepine withdrawal syndrome in the neonate with symptoms including hypotonia, and reluctance to suck, to apnoeic spells, cyanosis, and impaired metabolic responses to cold stress. Floppy infant syndrome and sedation in the newborn may also occur. Symptoms of floppy infant syndrome and the neonatal benzodiazepine withdrawal syndrome have been reported to persist from hours to months after birth.[42]

Adverse effects

Adverse effects of benzodiazepines such as diazepam include anterograde amnesia and confusion (especially pronounced in higher doses) and sedation. The elderly are more prone to adverse effects of diazepam, such as confusion, amnesia, ataxia, and hangover effects, as well as falls. Long-term use of benzodiazepines such as diazepam is associated with drug tolerance, benzodiazepine dependence, and benzodiazepine withdrawal syndrome.[7] Like other benzodiazepines, diazepam can impair short-term memory and learning of new information. While benzodiazepine drugs such as diazepam can cause anterograde amnesia, they do not cause retrograde amnesia; information learned before using benzodiazepines is not impaired. Tolerance to the cognitive-impairing effects of benzodiazepines does not tend to develop with long-term use, and the elderly are more sensitive to them.[43] Additionally, after cessation of benzodiazepines, cognitive deficits may persist for at least six months; it is unclear whether these impairments take longer than six months to abate or if they are permanent. Benzodiazepines may also cause or worsen depression.[7] Infusions or repeated intravenous injections of diazepam when managing seizures, for example, may lead to drug toxicity, including respiratory depression, sedation andhypotension. Drug tolerance may also develop to infusions of diazepam if it is given for longer than 24 hours.[7] Adverse effects such as sedation, benzodiazepine dependence, and abuse potential limit the use of benzodiazepines.[44]

Diazepam has a range of side effects common to most benzodiazepines, including:

Less commonly, paradoxical side effects can occur, including nervousness, irritability, excitement, worsening of seizures, insomnia, muscle cramps, changes in libido, and in some cases, rage and violence. These adverse reactions are more likely to occur in children, the elderly, and individuals with a history of drug or alcohol abuse and or aggression.[7][47][48][49] Diazepam may increase, in some people, the propensity toward self-harming behaviours and, in extreme cases, may provoke suicidal tendencies or acts.[50] Very rarely dystonia can occur.[51]

Diazepam may impair the ability to drive vehicles or operate machinery. The impairment is worsened by consumption of alcohol, because both act as central nervous system depressants.[17]

During the course of therapy, tolerance to the sedative effects usually develops, but not to the anxiolytic and myorelaxant effects.[52]

Patients with severe attacks of apnea during sleep may suffer respiratory depression (hypoventilation), leading to respiratory arrest and death.

Diazepam in doses of 5 mg or more causes significant deterioration in alertness performance combined with increased feelings of sleepiness.[53]

Tolerance and dependence

Diazepam, as with other benzodiazepine drugs, can cause tolerance, physical dependence, substance use disorder, and benzodiazepine withdrawal syndrome. Withdrawal from diazepam or other benzodiazepines often leads to withdrawal symptoms similar to those seen during barbiturate or alcohol withdrawal. The higher the dose and the longer the drug is taken, the greater the risk of experiencing unpleasant withdrawal symptoms.

Withdrawal symptoms can occur from standard dosages and also after short-term use, and can range from insomnia and anxiety to more serious symptoms, including seizures and psychosis. Withdrawal symptoms can sometimes resemble pre-existing conditions and be misdiagnosed. Diazepam may produce less intense withdrawal symptoms due to its long elimination half-life.

Benzodiazepine treatment should be discontinued as soon as possible by a slow and gradual dose reduction regimen.[7][54] Tolerance develops to the therapeutic effects of benzodiazepines; for example tolerance occurs to the anticonvulsant effects and as a result benzodiazepines are not generally recommended for the long-term management of epilepsy. Dose increases may overcome the effects of tolerance, but tolerance may then develop to the higher dose and adverse effects may increase. The mechanism of tolerance to benzodiazepines includes uncoupling of receptor sites, alterations in gene expression, down-regulation of receptor sites, and desensitisation of receptor sites to the effect of GABA. About one-third of individuals who take benzodiazepines for longer than four weeks become dependent and experience withdrawal syndrome on cessation.[7]

Differences in rates of withdrawal (50–100%) vary depending on the patient sample. For example, a random sample of long-term benzodiazepine users typically finds around 50% experience few or no withdrawal symptoms, with the other 50% experiencing notable withdrawal symptoms. Certain select patient groups show a higher rate of notable withdrawal symptoms, up to 100%.[55]

Rebound anxiety, more severe than baseline anxiety, is also a common withdrawal symptom when discontinuing diazepam or other benzodiazepines.[56] Diazepam is therefore only recommended for short-term therapy at the lowest possible dose owing to risks of severe withdrawal problems from low doses even after gradual reduction.[57] The risk of pharmacological dependence on diazepam is significant, and patients experience symptoms of benzodiazepine withdrawal syndrome if it is taken for six weeks or longer.[58] In humans, tolerance to the anticonvulsant effects of diazepam occurs frequently.[59]

Dependence

Improper or excessive use of diazepam can lead to dependence.[60] At a particularly high risk for diazepam misuse, abuse or dependence are:

  • People with a history of alcohol or drug abuse or dependence[17][61] Diazepam increases craving for alcohol in problem alcohol consumers. Diazepam also increases the volume of alcohol consumed by problem drinkers.[62]
  • People with severe personality disorders, such as borderline personality disorder[63]

Patients from the aforementioned groups should be monitored very closely during therapy for signs of abuse and development of dependence. Therapy should be discontinued if any of these signs are noted, although if dependence has developed, therapy must still be discontinued gradually to avoid severe withdrawal symptoms. Long-term therapy in these people is not recommended.[17][61]

People suspected of being dependent on benzodiazepine drugs should be very gradually tapered off the drug. Withdrawals can be life-threatening, particularly when excessive doses have been taken for extended periods of time. Equal prudence should be used whether dependence has occurred in therapeutic or recreational contexts.

Overdose

An individual who has consumed too much diazepam typically displays one or more of these symptoms in a period of approximately four hours immediately following a suspected overdose:[17][64]

  • Drowsiness
  • Mental confusion
  • Hypotension
  • Impaired motor functions
    • Impaired reflexes
    • Impaired coordination
    • Impaired balance
    • Dizziness
  • Coma

Although not usually fatal when taken alone, a diazepam overdose is considered a medical emergency and generally requires the immediate attention of medical personnel. The antidote for an overdose of diazepam (or any other benzodiazepine) is flumazenil (Anexate). This drug is only used in cases with severe respiratory depression or cardiovascular complications. Because flumazenil is a short-acting drug, and the effects of diazepam can last for days, several doses of flumazenil may be necessary. Artificial respiration and stabilization of cardiovascular functions may also be necessary. Though not routinely indicated, activated charcoal can be used for decontamination of the stomach following a diazepam overdose. Emesis is contraindicated. Dialysis is minimally effective. Hypotension may be treated with levarterenol or metaraminol.[17][18][64][65]

The oral LD50 (lethal dose in 50% of the population) of diazepam is 720 mg/kg in mice and 1240 mg/kg in rats.[17] D. J. Greenblatt and colleagues reported in 1978 on two patients who had taken 500 and 2000 mg of diazepam, respectively, went into moderately deep comas, and were discharged within 48 hours without having experienced any important complications, in spite of having high concentrations of diazepam and its metabolites desmethyldiazepam, oxazepam, and temazepam, according to samples taken in the hospital and as follow-up.[66]

Overdoses of diazepam with alcohol, opiates and/or other depressants may be fatal.[65][67]

Interactions

If diazepam is administered concomitantly with other drugs, attention should be paid to the possible pharmacological interactions. Particular care should be taken with drugs that potentiate the effects of diazepam, such as barbiturates, phenothiazines, opioids, and antidepressants.[17]

Diazepam does not increase or decrease hepatic enzyme activity, and does not alter the metabolism of other compounds. No evidence would suggest diazepam alters its own metabolism with chronic administration.[18]

Agents with an effect on hepatic cytochrome P450 pathways or conjugation can alter the rate of diazepam metabolism. These interactions would be expected to be most significant with long-term diazepam therapy, and their clinical significance is variable.[18]

Pharmacology

5 mg Valium Roche packaging Australia

Diazepam is a long-acting “classical” benzodiazepine. Other classical benzodiazepines include chlordiazepoxide, clonazepam, lorazepam, oxazepam, nitrazepam, temazepam, flurazepam,bromazepam, and clorazepate.[75] Diazepam has anticonvulsant properties.[76] Diazepam has no effect on GABA levels and no effect on glutamate decarboxylase activity, but has a slight effect on gamma-aminobutyric acid transaminase activity. It differs from some other anticonvulsive drugs with which it was compared.[77] Benzodiazepines act via micromolarbenzodiazepine binding sites as Ca2+ channel blockers and significantly inhibit depolarization-sensitive Calcium uptake in rat nerve cell preparations.[78]

Diazepam inhibits acetylcholine release in mouse hippocampal synaptosomes. This has been found by measuring sodium-dependent high-affinity choline uptake in mouse brain cells in vitro, after pretreatment of the mice with diazepam in vivo. This may play a role in explaining diazepam’s anticonvulsant properties.[79]

Diazepam binds with high affinity to glial cells in animal cell cultures.[80] Diazepam at high doses has been found to decrease histamine turnover in mouse brain via diazepam’s action at the benzodiazepine-GABA receptor complex.[81] Diazepam also decreases prolactin release in rats.[82]

Mechanism of action

See also: Benzodiazepine

Benzodiazepines are positive allosteric modulators of the GABA type A receptors (GABAA). The GABAA receptors are ligand-gated chloride-selective ion channels that are activated by GABA, the major inhibitory neurotransmitter in the brain. Binding of benzodiazepines to this receptor complex promotes binding of GABA, which in turn increases the total conduction of chloride ions across the neuronal cell membrane. This increased chloride ion influx hyperpolarizes the neuron’s membrane potential. As a result, the difference between resting potential and threshold potential is increased and firing is less likely.

The GABAA receptor is a heteromer composed of five subunits, the most common ones being two αs, two βs, and one γ (α2β2γ). For each subunit, many subtypes exist (α1–6, β1–3, and γ1–3). GABAA receptors containing the α1 subunit mediate the sedative, the anterograde amnesic, and partly the anticonvulsive effects of diazepam. GABAA receptors containing α2 mediate the anxiolytic actions and to a large degree the myorelaxant effects. GABAA receptors containing α3 and α5 also contribute to benzodiazepines myorelaxant actions, whereas GABAA receptors comprising the α5 subunit were shown to modulate the temporal and spatial memory effects of benzodiazepines.[83]

Diazepam appears to act on areas of the limbic system, thalamus, and hypothalamus, inducing anxiolytic effects. Benzodiazepine drugs including diazepam increase the inhibitory processes in the cerebral cortex.[84]

The anticonvulsant properties of diazepam and other benzodiazepines may be in part or entirely due to binding to voltage-dependent sodium channels rather than benzodiazepine receptors. Sustained repetitive firing seems limited by benzodiazepines’ effect of slowing recovery of sodium channels from inactivation.[85]

The muscle relaxant properties of diazepam are produced via inhibition of polysynaptic pathways in the spinal cord.[86]

Pharmacokinetics

Diazepam can be administered orally, intravenously (must be diluted, as it is painful and damaging to veins), intramuscularly (IM), or as a suppository.[18]

When administered orally, it is rapidly absorbed and has a fast onset of action. The onset of action is one to five minutes for IV administration and 15–30 minutes for IM administration. The duration of diazepam’s peak pharmacological effects is 15 minutes to one hour for both routes of administration.[46] The bioavailability after oral administration is 100%, and 90% after rectal administration. Peak plasma levels occur between 30 and 90 minutes after oral administration and between 30 and 60 minutes after intramuscular administration; after rectal administration, peak plasma levels occur after 10 to 45 minutes. Diazepam is highly protein-bound, with 96 to 99% of the absorbed drug being protein-bound. The distribution half-life of diazepam is two to 13 minutes.[7]

When diazepam is administered IM, absorption is slow, erratic, and incomplete.[11]

Diazepam is highly lipid-soluble, and is widely distributed throughout the body after administration. It easily crosses both the blood–brain barrier and the placenta, and is excreted into breast milk. After absorption, diazepam is redistributed into muscle and adipose tissue. Continual daily doses of diazepam quickly build to a high concentration in the body (mainly in adipose tissue), far in excess of the actual dose for any given day.[7][18]

Diazepam is stored preferentially in some organs, including the heart. Absorption by any administered route and the risk of accumulation is significantly increased in the neonate, and withdrawal of diazepam during pregnancy and breast feeding is clinically justified.[87]

Diazepam undergoes oxidative metabolism by demethylation (CYP 2C9, 2C19, 2B6, 3A4, and 3A5), hydroxylation (CYP 3A4 and 2C19) and glucuronidation in the liver as part of the cytochrome P450 enzyme system. It has several pharmacologically active metabolites. The main active metabolite of diazepam is desmethyldiazepam (also known as nordazepam or nordiazepam). Its other active metabolites include the minor active metabolites temazepam and oxazepam. These metabolites are conjugated with glucuronide, and are excreted primarily in the urine. Because of these active metabolites, the serum values of diazepam alone are not useful in predicting the effects of the drug. Diazepam has a biphasic half-life of about one to three days, and two to seven days for the active metabolite desmethyldiazepam.[7] Most of the drug is metabolised; very little diazepam is excreted unchanged.[18] The elimination half-life of diazepam and also the active metabolite desmethyldiazepam increases significantly in the elderly, which may result in prolonged action, as well as accumulation of the drug during repeated administration.[88]

Physical and chemical properties

Diazepam occurs as solid white or yellow crystals with a melting point of 131.5 to 134.5 °C. It is odorless, and has a slightly bitter taste. The British Pharmacopoeia lists it as being very slightly soluble in water, soluble in alcohol, and freely soluble in chloroform. The United States Pharmacopoeia lists diazepam as soluble 1 in 16 ethyl alcohol, 1 in 2 of chloroform, 1 in 39 ether, and practically insoluble in water. The pH of diazepam is neutral (i.e., pH = 7). Due to additives such as benzoic acid/benzoate in the injectable form. (Plumb’s, 6th edition page 372) Diazepam has a shelf life of five years for oral tablets and three years for IV/IM solutions.[18] Diazepam should be stored at room temperature (15–30 °C). The solution for parenteral injection should be protected from light and kept from freezing. The oral forms should be stored in air-tight containers and protected from light.[33]

Diazepam can absorb into plastics, so liquid preparations should not be kept in plastic bottles or syringes, etc. As such, it can leach into the plastic bags and tubing used for intravenous infusions. Absorption appears to depend on several factors, such as temperature, concentration, flow rates, and tube length. Diazepam should not be administered if a precipitate has formed and does not dissolve.[33]

Detection in body fluids

Diazepam may be quantified in blood or plasma to confirm a diagnosis of poisoning in hospitalized patients, provide evidence in an impaired driving arrest, or to assist in a medicolegal death investigation. Blood or plasma diazepam concentrations are usually in a range of 0.1–1.0 mg/l in persons receiving the drug therapeutically, 1–5 mg/l in those arrested for impaired driving, and 2–20 mg/l in victims of acute overdose. Most commercial immunoassays for the benzodiazepine class of drugs cross-react with diazepam, but confirmation and quantitation are usually performed using chromatographic techniques.[89][90][91]

History

Diazepam was the second benzodiazepine invented by Dr. Leo Sternbach of Hoffmann-La Roche at the company’s Nutley, New Jersey, facility[92] following chlordiazepoxide (Librium), which was approved for use in 1960. Released in 1963 as an improved version of Librium, diazepam became incredibly popular, helping Roche to become a pharmaceutical industry giant. It is 2.5 times more potent than its predecessor, which it quickly surpassed in terms of sales. After this initial success, other pharmaceutical companies began to introduce other benzodiazepine derivatives.[93]

The benzodiazepines gained popularity among medical professionals as an improvement over barbiturates, which have a comparatively narrow therapeutic index, and are far more sedative at therapeutic doses. The benzodiazepines are also far less dangerous; death rarely results from diazepam overdose, except in cases where it is consumed with large amounts of other depressants (such as alcohol or opioids).[65] Benzodiazepine drugs such as diazepam initially had widespread public support, but with time the view changed to one of growing criticism and calls for restrictions on their prescription.[94]

Diazepam was the top-selling pharmaceutical in the United States from 1969 to 1982, with peak sales in 1978 of 2.3 billion tablets.[93] Diazepam, along with oxazepam, nitrazepam and temazepam, represents 82% of the benzodiazepine market in Australia.[95] While psychiatrists continue to prescribe diazepam for the short-term relief of anxiety, neurology has taken the lead in prescribing diazepam for the palliative treatment of certain types of epilepsy and spastic activity, for example, forms of paresis. It is also the first line of defense for a rare disorder called stiff-person syndrome.[16]

Society and culture

Recreational use

Diazepam is a drug of potential abuse and can cause drug dependence. Urgent action by national governments has been recommended to improve prescribing patterns of benzodiazepines such as diazepam.[96][97] A single dose of diazepam modulates the dopamine system in similar ways to how morphine and alcohol modulate the dopaminergic pathways.[98] Between 50 and 64% of rats will self-administer diazepam.[99] Diazepam has been shown to be able to substitute for the behavioural effects of barbiturates in a primate study.[100] Diazepam has been found as an adulterant in heroin.[101]

Diazepam drug misuse can occur either through recreational misuse where the drug is taken to achieve a high or when the drug is continued long term against medical advice.[102]

Sometimes, it is used by stimulant users to “come down” and sleep and to help control the urge to binge.[103]

A large-scale study in the US, conducted by SAMHSA, using data from 2011, determined benzodiazepines were present in 28.7% of emergency department visits involving nonmedical use of pharmaceuticals. In this regard, benzodiazepines are second only to opiates, the study found in 39.2% of visits. About 29.3% of drug-related suicide attempts involve benzodiazepines, making them the most frequently represented class in drug-related suicideattempts. Males abuse benzodiazepines as commonly as females.[104]

Benzodiazepines, including diazepam, nitrazepam, and flunitrazepam, account for the largest volume of forged drug prescriptions in Sweden, a total of 52% of drug forgeries being for benzodiazepines.[105]

Diazepam was detected in 26% of cases of people suspected of driving under the influence of drugs in Sweden, and its active metabolite nordazepam was detected in 28% of cases. Other benzodiazepines and zolpidem and zopiclone also were found in high numbers. Many drivers had blood levels far exceeding the therapeutic dose range, suggesting a high degree of abuse potential for benzodiazepines and zolpidem and zopiclone.[89] In Northern Ireland in cases where drugs were detected in samples from impaired drivers who were not impaired by alcohol, benzodiazepines were found in 87% of cases. Diazepam was the most commonly detected benzodiazepine.[106]

Legal status

Diazepam is regulated in most countries as a prescription drug:

  • International: diazepam is a Schedule IV controlled drug under the Convention on Psychotropic Substances.[107]
  • UK: classified as a controlled drug, listed under Schedule IV, Part I (CD Benz POM) of the Misuse of Drugs Regulations 2001, allowing possession with a valid prescription. The Misuse of Drugs Act 1971 makes it illegal to possess the drug without a prescription, and for such purposes it is classified as a Class C drug.[108]
  • Germany: classified as a prescription drug, or in high dosage as a restricted drug (Betäubungsmittelgesetz, Anhang III).[109]
  • Australia: Diazepam is Schedule 4 substance under the Poisons Standard (October 2015).[110] A schedule 4 drug is outlined in the Poisons Act 1964 as, “Substances, the use or supply of which should be by or on the order of persons permitted by State or Territory legislation to prescribe and should be available from a pharmacist on prescription.” [110]

Judicial executions

The states of California and Florida offer diazepam to condemned inmates as a pre-execution sedative as part of their lethal injection program, although the state of California has not executed a prisoner since 2006.[111][112]

Veterinary uses

Diazepam is used as a short-term sedative and anxiolytic for cats and dogs,[113] sometimes used as an appetite stimulant.[113][114] It can also be used to stop seizures in dogs and cats.[115][116]

https://en.wikipedia.org/wiki/Diazepam

 

Steve Pieczenik

From Wikipedia, the free encyclopedia
Steve Pieczenik
Born December 7, 1943 (age 72)
Havana, Cuba
Occupation Author, publisher, civil servant, psychiatrist
Nationality American
Genre Military fiction, spy fiction
Website
www.stevepieczenik.com

Steve Pieczenik, MD, PhD[1] (born December 7, 1943, in Havana, Cuba) is an American psychiatrist, former United States Department of State official, author, and publisher.

Early life and education

Pieczenik was born in Cuba of Jewish parents from Russia and Poland and was raised in France.[2] His father, a doctor from Dombrovicz who studied and worked in Toulouse, France,[3] fled Poland before World War II. His mother, a Russian Jew from Bialystok, Poland,[3] fled Europe after many of her family members were killed. The couple met in Portugal, where both had fled ahead of the Nazi invaders.[3] Pieczenik was born in Cuba in 1943.[3][4]After living in Toulouse for six years, Pieczenik’s family migrated to the United States, where they settled in the Harlem area[3] of New York City, New York.[5] Steve Pieczenik was eight years old when his parents received their entry visa to the US.[3]

Pieczenik is a classical pianist and wrote a full-length musical at the age of eight.[4]

Pieczenik is a Harvard University-trained psychiatrist and has a doctorate in international relations from the Massachusetts Institute of Technology (MIT).[3]

Pieczenik’s autobiography notes that he attended Booker T. Washington High School in the Harlem neighborhood of New York City. Pieczenik received a full scholarship to Cornell University at the age of 16.[3] According to Pieczenik, he received a BA degree in Pre-Medicine and Psychology from Cornell in 1964, and later attended Cornell University Medical College. He attained his PhD in international relations from MIT while studying at Harvard Medical School.[4] Pieczenik claims to be the first psychiatrist ever to receive a PhD focusing on international relations.[5]

While doing his psychiatric residency at Harvard, he was awarded the Harry E. Solomon award for his paper entitled: “The hierarchy of ego-defense mechanisms in foreign policy decision making”.[3]

An article written by Pieczenik, “Psychological dimensions of international dependency”, appears in the American Journal of Psychiatry, Vol 132(4), Apr 1975, 428-431.[6]

Professional life

Pieczenik was Deputy Assistant Secretary of State under Henry Kissinger, Cyrus Vance and James Baker.[3] His expertise includes foreign policy, international crisis management and psychological warfare.[7] He served the presidential administrations of Gerald Ford, Jimmy Carter, Ronald Reagan and George H.W. Bush in the capacity of deputy assistant secretary.[8]

In 1974, Pieczenik joined the US State Department as a consultant to help in the restructuring of its Office for the Prevention of Terrorism.[2]

In 1976, Pieczenik was made Deputy Assistant Secretary of State for management.[2][5][9][10]

At the US State Department, he served as a “specialist on hostage taking”.[11] He has been credited with devising successful negotiating strategies and tactics used in several high-profile hostage situations, including the 1976TWA Flight 355 hostage situation and the 1977 kidnapping of the son of Cyprus’ president.[2] He was involved in negotiations for the release of Aldo Moro after Moro was kidnapped.[12] As a renowned psychiatrist, he was utilized as a press source for early information on the mental state of the hostages involved in the Iranian hostage crisis after they were freed.[13] In 1977, Pulitzer Prize–winning journalist Mary McGrory described Stephen Pieczenik as “one of the most ‘brilliantly competent’ men in the field of terrorism”.[14] He worked “side by side” with Police Chief Maurice J. Cullinane in the Washington, D.C. command center of Mayor Walter Washington during the 1977 Hanafi Siege.[15] In 1978, Pieczenik was known as “a psychiatrist and political scientist in the U.S. State Department whose credentials and experiences are probably unique among officials handling terrorist situations”.[2]

On September 17, 1978 the Camp David Accords were signed. Pieczenik was at the secret Camp David negotiations leading up to the signing of the Accords. He worked out strategy and tactics based on psychopolitical dynamics. He correctly predicted that given their common backgrounds, Egyptian President Anwar El Sadat and Israeli Prime Minister Menachem Begin would get along.[3]

In 1979, he resigned as Deputy Assistant Secretary of State over the handling of the Iranian hostage crisis.[4]

In the early 1980s, Pieczenik wrote an article for The Washington Post in which he claimed to have heard a senior US official in the State Department Operations Center give permission for the attack that led to the death of US Ambassador Adolph Dubs in Kabul, Afghanistan in 1979.[16]

Pieczenik got to know Syrian President Hafez Assad well during his 20 years in the US State Department.[3]

In 1982, Pieczenik was mentioned in an article in The New York Times as “a psychiatrist who has treated C.I.A. employees”.[17]

In 2001, Pieczenik operated as chief executive officer of Strategic Intelligence Associates, a consulting firm.[18]

Pieczenik has been affiliated in a professional capacity as a psychiatrist with the National Institute of Mental Health.[19]

Pieczenik has consulted with the United States Institute of Peace and the RAND Corporation.[20]

As recently as October 6, 2012, Pieczenik was listed as a member of the Council on Foreign Relations (CFR).[21] According to Internet Archive, his name was removed from the CFR roster sometime between October 6 and November 18, 2012.[22] Publicly, Pieczenik no longer appears as a member of the CFR.[23]

Pieczenik is fluent in five languages, including Russian, Spanish and French.[2][3][4]

Pieczenik has lectured at the National Defense University.[7]

Writing ventures

Pieczenik has made a number of ventures into fiction, as an author (of State of Emergency and a number of other books)[24] and as a business partner of Tom Clancy for several series of novels.[25]

He studied medicine and writing, beginning with drama and poetry. But eventually “I turned to fiction because it allows me to address reality as it is or could be.”[3]

Pieczenik received a listed credit as “co-creator” for both Tom Clancy’s Op-Center and Tom Clancy’s Net Force, two best-selling series of novels, as a result of a business relationship with Tom Clancy. He was not directly involved in writing books in these series, but “assembled a team” including the ghost-writer who did author the novels, and someone to handle the “packaging” of the novels.[25][26] The Op-Center series alone had grossed more than 28 million dollars in net profit for the partnership by 2003.[25] Tom Clancy’s Op-Center: Out of the Ashes was released in 2014 by St. Martins Press.

Books he has authored include: novel Mind Palace (1985), novel Blood Heat (1989), self-help My Life Is Great! (1990) and paper-back edition Hidden Passions (1991), novel Maximum Vigilance (1993), novel Pax Pacifica(1995), novel State Of Emergency (1999), novel My Beloved Talleyrand (2005).[27] He’s also credited under the pseudonym Alexander Court for writing the novels Active Measures (2001), and Active Pursuit (2002).[28]

Pieczenik has had at least two articles published in the American Intelligence Journal, a peer-reviewed journal published by the National Military Intelligence Association.[29]

In September 2010, John Neustadt was recognized by Elsevier as being one of the Top Ten Cited Authors in 2007 & 2008 for his article, “Mitochondrial dysfunction and molecular pathways of disease.” This article was co-authored with Pieczenik.[30]

Pieczenik is the co-author of the published textbook, Foundations and Applications of Medical Biochemistry in Clinical Practice.[30]

Controversies

In 1992, Pieczenik told Newsday that in his professional opinion, President Bush[clarification needed] was “clinically depressed”. As a result, he was brought up on an ethics charge before the American Psychiatric Association and reprimanded. He subsequently quit the APA.[4]

He calls himself a “maverick troublemaker. You make your own rules. You pay the consequences.”[4]

The role he played in the negotiations to bring about the release of Aldo Moro, an Italian politician kidnapped by the Red Brigades, is fraught with controversy.[citation needed]

On May 3, 2011, radio host Alex Jones aired an interview in which Pieczenik claimed that Osama bin Laden had died of Marfan syndrome in 2001 shortly after the September 11 attacks, and that the attacks on the United States on 9/11 were part of a false flag operation by entities within the American government, the Israeli leadership and Mossad.[31]

On October 20, 2011 in an interview with Alex Jones, Pieczenik claimed that Libyan leader Muammar Gaddafi was alive, and said, “There’s no way they killed Muammar Gaddafi, that’s not our operating mode and I’ve been involved in 30 years with the takeouts and regime changes.” He also criticised President Barack Obama, calling him an “obsessional pathological liar”.[32][33]

On September 16, 2012, during an interview with Alex Jones, Pieczenik stated that Israel planned to initiate war with Iran during Yom Kippur 2012 unless ex-Mossad and ex-Shin Bet agents assassinated Benjamin Netanyahu.[34]

On March 27, 2013, Pieczenik claimed that the Sandy Hook Elementary School shooting was a hoax and a false flag event.[35]

On 9 May 2013, Pieczenik claimed that the 2012 Benghazi attack was the result of a turf war between the Central Intelligence Agency (CIA) and the military intelligence. He suggested that the CIA wished to get rid of General David Petraeus, and wanted to get John O. Brennan, through his illegal SOCOM unit, to arm Syria.[36]

References

  1. Jump up^ Leland, John (July 20, 1992), “Books too early: Could Perot save us from this surplus?”, The New York Times, retrieved May 5, 2011
  2. ^ Jump up to:a b c d e f Toth, Robert C. (1978-04-21). “U.S. scientist aids in Moro search”. St. Petersburg Times. Los Angeles Times. pp. 9A. Retrieved 2011-05-14. Credited with devising negotiating strategy and tactics
  3. ^ Jump up to:a b c d e f g h i j k l m n Kaye, Helen (July 7, 1995). “US psychiatrist and ME expert analyzes region”. Jerusalem Post. The Jerusalem Post. Retrieved 2011-05-14. He was deputy assistant secretary of state under Henry Kissinger, Cyrus Vance and James Baker.
  4. ^ Jump up to:a b c d e f g Mansfield, Stephanie (February 27, 1995). “He’s Been There, Done That; Steve Pieczenik, Tom Clancy’s Man on the Inside”. The Washington Post. The Washington Post Company. Retrieved 2011-05-14. His father, a doctor, fled Poland before World War II. His mother, a Russian Jew, fled Europe after many of her family members were killed. The couple met in Portugal, where both had fled ahead of the Nazi invaders.
  5. ^ Jump up to:a b c “Biography”. Steve Pieczenik. Retrieved 2012-05-07.
  6. Jump up^ Pieczenik, Steve R. (Apr 1975). “Psychological dimensions of international dependency.”. The American Journal of Psychiatry. 132 (4): 428–431. doi:10.1176/ajp.132.4.428. Retrieved 2011-05-14. Analyzes the psychological consequences of international dependency
  7. ^ Jump up to:a b Kelley, Matt (February 26, 2002). “Rumsfeld: Pentagon to Close Office”. AP Online. Associated Press. Retrieved 2011-05-14. Dr. Steve Pieczenik, a psychological warfare expert who has worked for the State Department and lectured at the National Defense University.
  8. Jump up^ Romano, Lois (June 10, 1992). “The reliable source”. The Washington Post. The Washington Post. Retrieved 2011-05-14. Pieczenik served as deputy secretary during the Ford, Carter, Reagan and Bush administrations.
  9. Jump up^ Goleman, Daniel (March 8, 1985), “Seat Of Power And Woe”, The New York Times, retrieved May 5, 2011
  10. Jump up^ Kenneth Rapoza (2012-04-18). “Osama bin Laden Already Becoming the New Roswell – Forbes”. Blogs.forbes.com. Retrieved 2012-05-07.
  11. Jump up^ Geyer, Georgie Anne (1980-01-18). “We Have Ignored Soviet Paranoia”. Sarasota Herald-Tribune. pp. 7A. Retrieved 2011-05-14. U.S. State Department specialist on hostage taking
  12. Jump up^ Moore, Malcolm (March 11, 2008), “US envoy admits role in Aldo Moro killing”, The Daily Telegraph, London, archived from the original on September 24, 2012, retrieved May 5, 2011
  13. Jump up^ Taubman, Philip (January 28, 1981), “Conflicts In Mental Reports Raise Questions On Captives”, The New York Times, retrieved May 5, 2011
  14. Jump up^ McGrory, Mary (1977-03-13). “How Experts Can Tame Terrorists”. The Pittsburgh Press. pp. B2. Retrieved 2011-05-14. One of the most “brilliantly competent” men in the field of terrorism…
  15. Jump up^ McGrory, Mary (1977-03-13). “Balking terrorists requires expertise”. Eugene Register-Guard. pp. 17A. Retrieved 2011-05-14. …at the command center of Mayor Walter Washington and worked “side by side” with Police Chief Maurice J. Cullinane
  16. Jump up^ “Coverup charged in death of U.S. envoy”. Spokane Daily Chronicle. United Press International. 1981-02-18. p. 15. Retrieved 2011-05-14. I was present. I heard it. |first1= missing |last1= in Authors list (help)
  17. Jump up^ TAUBMAN, PHILIP (October 13, 1982). “Psychiatrists describe kafkaesque portfolio”. The New York Times. The New York Times. Retrieved 2011-05-14. Dr. Steve R. Pieczenik, a psychiatrist who has treated C.I.A. employees.
  18. Jump up^ Stanton, John J. (December 1, 2001). “U.S. Intelligence Community Reaches Crossroads: CIA official says agency is implementing reforms to address new threats. (Analysis).”. National Defense. National Defense Industrial Association. Retrieved 2011-05-14. Steve Pieczenik, chief executive officer of Strategic Intelligence Associates, a consulting firm.
  19. Jump up^ “THE ANNUAL REPORT OF THE SUPERINTENDENT 1976” (PDF). Retrieved 2012-05-07.
  20. Jump up^ “U.S. Negotiating Behavior” (PDF). Retrieved 2012-05-07.
  21. Jump up^ “Membership Roster – Council on Foreign Relations 10/06/2012”. Cfr.org. Archived from the original on October 6, 2012. Retrieved 2013-04-23.
  22. Jump up^ “Membership Roster – Council on Foreign Relations 11/16/2012”. Cfr.org. Archived from the original on November 18, 2012. Retrieved 2013-04-23.
  23. Jump up^ “Membership Roster – Council on Foreign Relations Current”. Cfr.org. Retrieved 2013-04-23.
  24. Jump up^ Pieczenik, Steve (1997). State of Emergency (First ed.). Putnam Adult. ISBN 0-399-14323-8.
  25. ^ Jump up to:a b c “Thomas L. Clancy, Jr. v. Wanda T. King, No. 112, September Term 2007.” (PDF). Retrieved 2012-05-07.
  26. Jump up^ “Steve Pieczenik: Books”. Amazon.com. Retrieved 2012-05-07.
  27. Jump up^ “Barnes and Noble”. Productsearch.barnesandnoble.com. 2012-04-27. Retrieved 2012-05-07.
  28. Jump up^ “Steve Pieczenik”. Steve Pieczenik. Retrieved 2012-05-07.
  29. Jump up^ “AIJ 2004 to 2010 – National Military Intelligence Association”. Nmia.org. 2002-11-12. Retrieved 2012-05-07.
  30. ^ Jump up to:a b “Montana Integrative Medicine – Bozeman, MT :: About”. Montanaim.com. Retrieved 2012-05-07.
  31. Jump up^ Watson, Paul (2011-05-04). “Top Government Insider: Bin Laden Died In 2001, 9/11 A False Flag”. Infowars. Retrieved 2011-05-13.
  32. Jump up^ No Way They Killed Gaddafi – Steve Pieczenik Reports | Source One – Independent News And Views
  33. Jump up^ Former Deputy Assistant Secretary of State Dr. Steve Pieczenik Absolute Sure MUAMMAR GADDAFI Is ALIVE – ‘Obama Is An Obsessional Pathological Liar!’ (Video)
  34. Jump up^ Insider: U.S. Ambassador Killing an Inside Job! (YouTube/Flash FLV). Infowars.com. September 16, 2012. Event occurs at 19:55. The Israelis will be very predictable, on Yom Kippur [2012] they will try to initiate another war, unless their ex-Mossad operatives and their ex-Shin Bet will take out Netanyahu, and do to Netanyahu what happened to Rabin.
  35. Jump up^ Video on YouTube
  36. Jump up^ Video on YouTube

External links

https://en.wikipedia.org/wiki/Steve_Pieczenik

 

 

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