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cleolinda · 1 year

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Samsara (Guerlain, 1989 EdP & 2023 EdT)

A sandalwood overdose embellished by ylang-ylang and jasmine. Samsara is the first woody women's fragrance in perfumery. It is constructed over a beautifully crafted sandalwood, used for the first time in these quantities in perfumery. (Guerlain.com)

From Eau de Tati, the back story:

Jean-Paul Guerlain created Samsara in 1985 for Decia de Powell, the woman he loved and who wore the fragrance for four years before it was launched. Jean-Paul took the opportunity to create the perfume for her, as she could not find a perfume that appealed to her. She liked jasmine and sandalwood, in particular, and these were the raw materials on which Samsara was based.

It seems that Gérard Anthony co-created the fragrance, but Guerlain has always loved a good legend. Whether the Sanskrit word "saṃsāra" ("the concept of rebirth and 'cyclicality of all life, matter, existence'") suits the fragrance as a name is a lengthy discussion I'll leave to others.

On the face of it, Samsara is another Guerlain journey into orientalism (stop that!); it's a classic example of loud 1980s fragrance (outdated); it's a benchmark in the Western perfume industry's use of sandalwood (notable). I wanted to write up this one purely because I already had it on hand: when I say "1989," I mean, my mom gave me an eau de parfum sample in 1989. I would have been about ten years old, and I loved collecting little sample vials that gave me too many headaches to actually use—just to keep in my little treasure boxes full of costume jewelry and tumbled rocks and skeleton keys. Apparently I was a magpie, or maybe a dragon. There's only about five molecules left, but as it turns out, that is more than enough.

I also ordered a fresh decant of the current formulation from the Perfumed Court—all they had was the eau de toilette, not the EdP, so this is not a one-to-one comparison. Instead, we have, on one hand, the most aged a Samsara can get, saved since its debut year, and on the other, the lightest, freshest iteration possible. It's lovely, that new EdT. But it's not what I expected at all. A couple of years ago I managed to uncork the 1989 Samsara, and all I got was this incredible note of mingled sandalwood and jasmine—just the richest, smoothest, deepest thing you've ever smelled. But the new one, from my notes: "BUBBLEGUM??"

Powdery fresh floral, rose? Like a living flower that happens to be powdery, not a cosmetic. Very very fresh and outdoorsy, like a garden. The vague idea of sandalwood underneath. Something a bit sweeter coming out, maybe vanilla jasmine. Very light, very easy to wear. Airy, breezy. Sheer.

And then, ten minutes in, bubblegum came out. Motherfucking bubblegum. I had to look up what the old-fashioned Bazooka Joe-type flavor is, because it's not that—there's no tiny twang of clove or wintergreen hiding behind the fruits and vanilla. This is straight-up Juicy Fruit gum. Which involves banana, pineapple, and maybe peach, for a flavor "resembling jackfruit." Now, apparently jackfruit contains "banana oil," aka isoamyl acetate, so I went and googled it on a hunch: yes, it’s in ylang ylang too. Combine that with Samsara's actual peach note (although it smells fresher than the lactone in Mitsouko) and vanilla—

Basenotes.com: Green notes, peach, ylang ylang, bergamot, lemon, iris and orris, violet, jasmine, rose, narcissus, sandalwood, tonka, amber, musk, and vanilla.

—and you've got a powdery-nectar sandalwood bubblegum. It's so good. Two birthdays ago, I got myself a wide-ranging set of essential oils, just so I could see what things smell like individually; the night after I tried Samsara, I started messing around with them, and it's 10,000% the ylang that's bringing the strange fruity note. I rarely if ever see anyone mention the ylang-ylang in Samsara—they always talk about how strong the jasmine is, but I SWEAR TO YOU that this is what it does on me. In fact, twenty minutes in, Bubble Ylang was mostly what I was smelling.

At the same time, the fresh EdT was really, really powdery—you see iris there in not one but two levels of the note pyramid, and orris is just iris root. The classic Guerlains use the ionones of iris and violet a lot; they're in the house accord, the Guerlinade, which I may also try to get a sample of. But the powder is so much stronger in Samsara than I expected. I was promised a sandalwood overdose, and I'm sitting here with Juicy Fruit floating over a bed of irises—like the row of cool dark purple ones we had lining our driveway when I was a kid—at the half-hour mark. According to my notes, I didn't really get ~sandalwood until an hour-twenty, and even that was still blurring into the ylang-ylang. (Apparently these two notes are really compatible; it's the only thing same combination I liked in Chanel No. 5.) That said, it's lovely and sweet and easygoing if you APPLY SPARINGLY. Of the three Guerlains I've tried, this one was by far the easiest to wear.

Which is wild, because supposedly, Samsara is A Sandalwood Bomb, a true big-hair fume of the '80s that will choke you out of a room. And yet, I didn't even get the sandalwood clearly until more than an hour in. There's two reasons for this, I discovered:

One is that I microdose perfume. I always point this out because I want you to understand that if you apply more fragrance than I do, you are not going to get the tame results I do. If you spray Tyrannosaurus Rex all over yourself, there is nothing god or mortal can do for you. I used two swipes of the Samsara sample wand on my left wrist—and it did project a good bit, but it was comfortable. If I'd done the same on my right wrist to balance it out, I would have considered myself good to go for a perfume-appropriate occasion. Maybe if you didn't deploy FIVE SPRAYS you wouldn’t be choking on it, idk idk.

The other reason is that the current formulation of Samsara uses Australian sandalwood—whereas the original used a much richer Indian variety. I was surprised to discover that Samsara has always been formulated as a meeting of natural and synthetic sandalwoods, though. But the current version has a newer synthetic: Javanol. And the thing about Javanol is that some people can't smell it. And I may be one of them. Because there is no reason "an overdose of sandalwood" should smell this modest to me, in the same perfume that is shouting white floral, unless I physically cannot perceive its loudest component. But I'm smelling some sandalwood; that must be the natural oil.

For more on Javanol, I turn to a fragrance I haven't actually tried yet: Escentric Molecules' Molecule 04. Javanol is, in fact, that molecule. The product website explains, it's a synthetic that

retains the radiance and endurance of natural sandalwood, but is sheer and transparent like no sandalwood in nature. “What I love about Javanol is its almost psychedelic freshness,” says [creator] Geza Schoen. “It smells as if liquid metallic grapefruit peel were poured over a bed of velvety cream-coloured roses.” Javanol is like Iso E Super, the molecule in Escentric Molecules 01, in some ways. Like Iso E Super, it comes and goes. The person wearing it loses the ability to smell it after a short while, only to re-connect with it later.

Well, "it comes and goes" may be why I'm not smelling as much sandalwood in Samsara as advertised, I guess—maybe I’m not totally anosmic to Javanol? The company that makes it, Givaudan, says that the aromachemical has

a rich, natural, creamy sandalwood note like beta santanol combined with some rosy nuances. It can also be used at very low dosage (below 0.1%) to bring richness and creaminess to all types of accords. With its exceptional low threshold, Javanol™ is approximately 8 times more effective in wash tests than the most powerful sandalwood product. [...] In the quest for the perfect Indian Sandalwood, Javanol™ is probably the most versatile note with its power, radiance, woodiness and rosiness, blending perfectly with flowers.

Javanol blends so perfectly with ylang and jasmine, in fact, that I can hardly distinguish it through most of Samsara's lifespan on my skin (I appreciate a good olfactory chimera, so that's fine). I can also see why you'd reformulate Samsara, already famous for its Godzilla-sized projection, with the biggest, loudest synthetic sandalwood on the market. But the thing is, the Beast of Givaudan wasn't created until 1996. Javanol may be what Guerlain has paired with Australian sandalwood nowadays, but my original sample was made with [probably a mix of synthetics including] Givaudan's Sandalore and the good stuff—20% (!) Mysore sandalwood.

Mysore Sandalwood Oil is a trademarked perfume oil extracted from the Santalum album variety of sandalwood tree (also known as a "royal tree") in the Mysore district of Karnataka, India. The tree species is said to be one of the best varieties in the world. (Wikipedia, the most concise explainer)

It's also the most expensive. But while I'm sure reformulations are a cost-cutting measure, sandalwood sustainability has also become a huge issue; I'm happy with synthetics if it helps the cause. The Australian sandalwood used in the current Samsara seems to be a popular and less-threatened natural option; it's also in two other fragrances I'm trying at the moment, Le Labo's Santal 33 and Tom Ford's Santal Blush. But it's like the difference between tulle and velvet. You can still use it beautifully, but there is a smoothness and a weight that's missing. People say that Mysore sandalwood is "creamy," even sweet, and it is, but not in a dairy or dessert way; it's legitimately this kind of olfactory texture that's so good. By contrast, the scent of Australian sandalwood feels a little harsh in the top of my nose, full of wood grain and pencil shavings, but also lighter. And yet it blends just as well with the notes of the new Samsara, just in different ways.

As for the old—Mysore and Sandalore® were what greeted me when I uncapped my vintage, 34-year-old sample:

oh my god. ohhhhh my gooooood.

That big sweet fruity ylang-ylang immediately bounced right out—how had I only smelled jasmine in the vial before? I'll stop here and tell you a little bit about ylang-ylang, which is not the note I was expecting to go on about, but here we are:

When you hear about "white florals," they're generally talking about jasmine, gardenia, tuberose (you'll remember this one from HYPNOTIC POISON), lily, lily of the valley—and ylang ylang, even though the latter is a showy yellow flower. I truly don't know how to describe the White Floral if you're not familiar with it, especially since I've never perceived any funky "animalic" indole notes. It's just good to me, very rich, very perfumy, and apparently it does, in an aromatherapy context, have a slightly sedative effect; this may be why people talk about "narcotic" white florals. Ylang-ylang takes the woozy richness of jasmine and, uniquely, adds that fruity, slightly spicy, banana-esque note; I'd love to look for the differences between white florals as I try out more fragrances. With Samsara(s), the jasmine doesn't seem distinct to me, serving instead to support the ylang-ylang, and maybe this is why I only smelled jasmine in the vial: it's my skin chemistry, once again, that's playing favorites.

You know what else my skin apparently loves? Expensive vintage sandalwood. The original Samsara skipped straight to the 1:20 mark and—speaking of narcotics—hit me like a tranquilizer dart. I just curled up on my bed and held my wrist to my nose for about an hour. I was like a cat on the 'nip. My God. I had some hand-me-down incense sticks from the '70s when I was a teenager, and I have been chasing that sandalwood high for three decades. This is it. The blanket of iris, the bergamot blast other reviewers talk about (I only got it the third time I wore the EdT), the supporting cast of notes—barely there. Just the gold.

For about two hours, it was amazing. Then, gradually, Samsara grew more and more overpowering, like a rogue science project slowly ballooning out of control. I ended up wiping it off with a little jojoba oil—not washing it off (DON'T WASTE IT!!), but reducing the amount I had on. There's only about two drops, thick as maple syrup, left in that vial, and that's fine.

Meanwhile, every time I wear the current eau de toilette, it disappears after about three hours.

I wish I'd been able to get a current EdP sample to compare the two formulations directly. But you know what? I still enjoy the iris-forward, sandalwood-backward Samsara. It's easy to wear and it doesn't overstay its welcome, which is a good thing for someone with fragrance sensitivities (me). As much as I love the smooth golden Mysore aspect, I'd rather have the option to reapply than be trapped with the Sandalwood That Ate 1989.

Perfume discussion masterpost

#perfume #perfume discussion #perfume: guerlain #the beast of givaudan #note: sandalwood #note: ylang ylang #note: iris #note: white florals #note: javanol #long post

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feytouched · 3 months

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hii my mutual bies recommended you to me as someone who knows a lot about perfumes :3 i would ask you to suggest something based on my vibes but as we aren't mutuals i will vaguely ask if you could please recommend me a scent suitable for an elegant femme fatale? 😔 i know it doesn't narrow it down but admittedly i don't know enough about scents to ask for something more specific except that i can say i don't like citrus-y notes and perfumes that are too heavy

thank you if you got this far 😭 and love your blog theme by the way :3

hi!! any friend of bies is a friend of mine, so i hope i can help!

when people say they don't like heavy perfumes, they usually mean one of two things (or both at once): perfumes that are strong in terms of sillage and staying power and that can be overpowering and headache-y for those of us who are more scent-sensitive, or perfumes that smell cloying or old-fashioned, which is far more subjective.

since i don't know any more specifics (feel free to send a follow-up ask if you'd like!), i'll go off of what bies suggested as well as what you said and give you a few suggestions to look into, hopefully covering different approaches:

athalia by parfums de marly: powdery, incense-y scent with a somber yet graceful iris at its heart. this is the first thing that came to mind when thinking of the archetypal vintage femme fatale; it has orange in the top notes, but it's worth sampling imo.

moscow by bpal: one of my favourite lily of the valley fragrances. smells like a rich woman that wears expensive soap like it's perfume, walking down the street on a sunny yet cold day with a lavish bouquet in her arms.

carmen 7 by alkemia: a more sensuous and gourmand scent, loads of pear, praline, lychee, jasmine and gardenia.

datura noir by serge lutens: less intense than the name suggests, but still very elegant. creamy lactonic tuberose, heliotrope, hints of coconut and bitter almonds.

peony couture by vilhelm parfumerie: goes onto the skin with the smoothness and precision of a vintage dior satin dress. peony and rose with a gorgeous woody incense base.

l'ombre dans l'eau by diptyque: a modernist take on a rose fragrance; green, a little bit bitter, dense with foliage, but the rose underneath is realistic and stunning. a bit of a different, fresher approach that conveys both elegance and thorns.

i have longer reviews of all of these on my blog; since i focus on niche and luxury perfumes, i would highly recommend ordering samples to try before you commit to a full bottle, especially if you're not sure what you like yet. best of luck, and please do report back if you find something you enjoy!

#answered #scents

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emotionallychargedtowel · 1 month

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sécrétions pas si magnifique

Once @wen-kexing-apologist brought the existence of the perfume Sécrétions Magnifiques by Etat Libre d’Orange to my attention, I felt like I had to at least smell it once. It has a unique marketing angle--it's supposed to smell like sex, to put it briefly--and reviews for it are highly polarized and fascinatingly vivid, particularly the negative ones. And yeah, the name means Magnificent Secretions. Naturally, I wanted to investigate.

A friend of mine got me some perfume samples as a belated Christmas gift and I asked her to include a sample of Sécrétions in the order. It took me a while to try it because I wanted to do so on a day when I was at home on my own and could put it on early in the day to give it a chance to fizzle out before my family got back. After all, some reviewers had said it was absolutely rank. A little while back, the right opportunity arose and I gave it a go.

My notes on the opening (the initial, soon-after-application scent):

Definitely aquatic, sweeter than expected (almost fruity), with a slight powdery quality. A really sharp metallic note (according to my info, this metallic note is via an aldehyde so it’s no surprise that it hits hard in the opening). Any muskiness seems to have been mostly swallowed up by the sweet gourmand note. The milky coconut notes are mostly just reading as sweet at this point. The whole thing is a really weird mixture. It’s not a complete juxtaposition, so I guess some skillful blending is happening here since the notes are so disparate. But it’s still a decidedly odd combination of elements.

And the drydown (the part after it has, you know, dried down):

It comes across as much more blended at this point. Aquatic and metallic notes that seemed volatile, like they wouldn’t last past the opening, stick around longer than expected. The gourmand notes get more distinctly lactonic and the salty aspect of the aquatic notes is a bit more noticeable. So at this point, it smells more like what I expected from its description—salty, metallic milk. The musk note is also in evidence but I really had to look for it, and it gets lost in the composition quickly.

(Segueing out of writing up my notes and into the general discussion...)

The sex smell concept makes a bit more sense at the drydown stage, but it’s still not a comparison I ever would have made unprompted. When you’re looking for it, though, it’s at least somewhat possible to read it that way. It’s not much like any sex smell I’ve ever come in contact with, but you could imagine it being one under certain circumstances (particularly since these sorts of smells vary so much between individuals). But even if I give it the benefit of the doubt in this way, it's still skewed in a direction that isn't entirely up my alley.

Basically, there are a number of secretions the name of this fragrance could theoretically refer to, and a good sex smell fragrance would, I think, smell at least a bit like all of them. The main ones would be sweat, semen, and vaginal fluid. And of the two I can sort of make out in this fragrance if I squint hard enough, the most prominent by far is what I can only call a semen accord.

Which may have something to do with why even when I could kind of see a way in which they accomplished what they were going for, this didn't appeal to me that much. A perfume that's supposed to smell like sex that is this bereft of pussy is, well, a choice. I dunno, maybe I’m just too bisexual for this stuff.

All of this might seem less glaring if it weren’t for the fact that the musk component wasn’t very noticeable either in the opening or the drydown. After all, sweat is pretty much the one universal sex smell. But I kept losing track of the musk entirely. It’s striking that seemingly volatile notes like the aldehydes in this stuck around for a surprisingly long time but the musk, which was never prominent, faded quickly. (I haven’t tried a lot of musk-heavy perfumes but my understanding was that musk notes usually stick around for longer than this.)

The saltiness combined with the metallic aldehydes caused this fragrance to give me a very distinct feeling in my nose. The combination of the smell and the nose feeling reminded me of the weird feeling/smell you get when you do a somersault in a chlorinated pool, something I haven't experienced in at least thirty years. That was a weird association to have side-by-side with the sex smell association. I found myself trying to imagine what sort of highly specific sex situation would result in this combination of elements. Things involving chlorine? Being upside down?

I guess there is one other thing I could liken that nasal sensation to: the feeling you get when, uh, ingesting certain substances through the nose. Not something I have a lot of familiarity with and what little I do have is decades old, but there was a similarity there. Once again, these associations evoke some pretty specific scenarios. Together, the chlorine/cocaine sensation and the predominance of the semen accord over any other "secretion" notes suggest some pretty specific scenarios rather than more general, highly relatable sexual situations. I couldn't help wondering what it might say about this perfumer that this is what he comes up with when commissioned to create a sex smell fragrance.

To sum up, this perfume sent me down a weird aesthetic rabbit-hole with some surprising associations. It was at least interesting to try. I think the perfumer would have liked it if this had caused some kind of bonkers erotic version of Proust's madeleine effect in me, but instead of bringing back memories it just made me feel compelled to somehow reconcile its weirdness with its marketing claims in a way that led to some truly random trains of thought. I didn't find this stuff repellent, like a lot of people do. I didn't find it sexy at all, like at least some others seem to. It was rather middling in terms of quality for me. There's something impressive about the fact that the perfumer was able to make something relatively cohesive out of such disparate notes, but just because it's not a total cacophony of unrelated smells doesn't mean it actually smells good. I guess if I had to say what the worst thing about it was, it's that it was, no pun intended, rather masturbatory. Because it turned out to be a pretty gratuitous exercise and it has the air of something that its creator/s thought was a hell of a lot cleverer than it actually was.

#secretions magnifiques #l'etat libre d'orange #perfume reviews

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noseandnous · 3 months

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Debaser by D.S. & Durga: Midgar shuffle

…don’t know about you, but I am un CHIEN! Andalusien! --Black Francis

I picked up a number of samples by the indie perfumer D.S. & Durga, including “Steamed Rainbow,” “Deep Dark Vanilla,” “Pistachio,” and this one. Debaser is my favorite so far.

Online reviews are mixed. The famous and eloquent Kafkaesque likes this, but argues an incongruity in its name; while Debaser cites the 1989 Pixies tune, the Black Francis screech is nowhere to be found in this pleasant, fig-based fragrance, powdered with a little iris, warmed up with tonka and coconut, sweetened with pear, and something slightly spicy and woody underneath. Other reviewers have taken up this theme, confused by the edgy name, complaining, even, about false advertising. Many allusions to green accords, garden wanders, fresh meadows, and so forth; all the traditional imagery of the mainstream mind as it seeks an exit from the ordinary.

I smell these described notes, certainly—the milky fig, the coconut, not too sweet but very present; the bassy tonka, the blonde wood, the iris and the moss all cutting through the lactones and preventing them from getting insipid.

But I am not transported to a bosky grove or dew-laden meadow: this fragrance is no portal to Narnia.

It's a little like one of those reversible pictures--a goose one way, an old lady another; if you focus too much on the fig and all its lacy green assumptions, you miss the city.

Because the thing is I get a very specific hit of leather jacket—no, vinyl… no, leather after all, a biker jacket, nice and bulky, the kind you wear as armor for the subway. The jacket you wear as you stand in the corner of the mechanics’ garage when your moto goes tits-up. The one you have on as you chew on a pear-flavored hard candy, lounging, inconspicuous, waiting for that guy on your docket--the dumb one, the weak link--to come out of the liquor store and lead you to your real quarry.

The one you wear when even the rain feels dirty.

The longer I had Debaser on, the more the affect crystallized: it’s Midgar, buddy. If this name means nothing to you, don’t worry. Just drop in the degraded urban environment of your choice, but fill it with the joy and optimism peculiar to that space, the joy of catching the last train, the joy of spicy red oil noodles, the joy of sarcastic jokes with your partner in crime.

For friends of mine who know where Midgar is—thus what I mean by citing it—I should warn you that depending on your skin chemistry, you may have to traverse an astonishing amount of coconut before the leather jacket, the train, the slanting light all come out to play. You may also find the pear alienating. Me, I like it; it’s artificial, but it’s not pretending. You keep the little tin of those little pear-flavored jewels in the pocket of that leather jacket and you watch the sun track across the hoardings as you listen to the buskers, taking your time.

It’s a good day.

#olfactory #fragrance review #D.S. & Durga #debaser

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gucciyae · 6 months

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Palimar

Hard feet against cold earthen floors. The smell of jaggery-sweetened vorn being stirred slowly in a dimly lit kitchen. Crows swoop down to claim the leftovers of last night’s kori-rotti. A cool breeze from the west sets a gentle tempo for the dancing wildgrass. I march forward.

Opa begins his seemingly endless chant, “Left, left, left-right-left. Left, left, left-right-left.” Our straightened legs lead the way, arms swinging in unison. Summers at Palimar usually followed the same rhythm.

Located in the Udupi district of Karnataka, visits to my ancestral home have become my favourite summer tradition. As the years went on and the family grew larger, so did the sound of crackling firewood heating our baths for the evening, the pat-pat-pat of marching feet against rough concrete, and the roaring laughter of my cousins running through the hallways.

Our visits begin early in the morning, bellies filled with a helping of dosa and chai, we make our way onboard an express bus. If we get lucky, all three of us cousins would sit in the same row. Alas, the Sunday crowd warrants a narrow seat by the bus driver, one that my cousin sister– Anushka and I squeeze ourselves into.

Each stop is marked by the bus conductor's shouted reminders, followed by an organized chaos of travellers moving in and out of the metal box on wheels. After all these years, Anushka, Aarav and I have learned to sleep through the blaring bus horns, which explains our shock and excitement upon reaching the Padubidri bus stand so soon.

It doesn't take too long for Oma to hail an auto rickshaw, directing the driver with such practiced ease, she rivals a modern day GPS. To an ordinary traveller, the entirety of Palimar might seem to be composed of the same visual elements; local shrubbery, roads that twist and turn into infinity, and the occasional clay house. However, to those of us who pay attention to her little details, the ancestral house leads us onward by the sweet smell of young coconut growing on trees, and the sound of the crashing waves of her backwaters.

The auto rickshaw stops a few paces away from a one story house, cracked maroon and blue paint coats the clay walls, unruly weeds run wild throughout her front yard, and the concrete pavement has turned algal. By the time my grandparents moved away, we were left with no farm animals to herd. However, this does not stop Anushka from her annual attempts to domesticate the stray dogs of Palimar.

We continue towards the house, our bodies coated in a thin layer of sweat from the summer heat, and set down our plastic bags filled with water bottles and steel tumblers.

“Mom, did you carry a bottle of Thums Up?” Aarav drones, dragging out each syllable in a childish lilt. Before his mother has a chance to answer, Oma returns to the verandah holding young coconuts, ushering us to pick some more from the base of the surrounding coconut trees. And so begins a competition of speed, strength, and differentiation among me and my cousins.

Covered in sticks, mud, and the occasional beetle, the three of us scurry back to the concrete pavement, careful not to drop our hard-earned treasures.

Now, here comes my favourite part of the summer tradition, hacking open of the coconuts. Opa walks out to the verandah bearing a koiti, and reaches for the pile of coconuts laid on the ground. We all hold our breaths as Opa makes the first strike, exhaling as a thick piece of husk is chopped off. I've always been in awe of his precision, lean hands grip the coconut with the same firmness as his voice. The steel tumblers that were packed in plastic bags are now being passed around, and my father pours out the translucent fluid into each vessel.

As a kid, I found the lactonic notes from young coconut water quite repulsive. I cannot tell you when it was exactly, but as our visits to Palimar grew less frequent, my longing for the cold and nourishing elixir grew fonder. A stroll along Padubidri beach takes me back to my summers of the 2010s, though, my memories have started to blur together— dark smoke flowing out of the chimney before our evening baths, the chicken coop and the incessant clucking of its residents, my plastic swing attached to the bedroom door frame, and Aunty Kalyani along with her cow– which she milked every evening during her visits.

Twilight draws in, a symphony of riverside cicadas makes itself known to us, and the husks of tender coconut have piled up to my height. A heaviness sets into our limbs as we move to pack away the used tumblers, and the air carries the aroma of coconut oil used to prepare the neighbour’s supper. Reluctantly, Opa makes his way down from the verandah, leading us back to the bus stand. All is quiet, for everyone is musing the very same idea– another afternoon at the Palimar house.

I wait another year.

#first post on here! hope you all like :D #this piece is dedicated to my Opa- my late grandfather who passed earlier this year #i miss him a lot and i hope he likes this :)#writerscommunity #writing #writeblr #writerscorner #writers on tumblr #some translations for readers!#oma- german for grandma #opa- german for grandpa #vorn- a sweet dish made by slow cooking pulses/rice in milk and aromatics #kori-rotti: red-chili and coconut milk based chicken curry and crisp wafers made from rice batter #koiti: billhook machete used by farmers to cut crop

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regulushair · 10 months

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A (mostly) designer mess:

Adèle by Gritti - this is still the sorry tale of me trying to find any osmanthus fragrance that actually smells like apricots or peaches and not like... well, what I usually feel osmanthus smells like - odd slightly sour (maybe starting to spoil) fruit notes. As you could have guessed this is not the case - still how I usually feel osmanthus and pretty much nothing else. Sadly.

Tutù Blanc by Gritti - very sweet somewhat vague fruits (I was hoping for bright raspberries but I didn't really get any) with some powderiness coming from helliotrope and musk. It's okay, but not too good in my opinion.

Girl Life by Rochas - very very sweet - practically syrupy - white flowers - with a bit of a fruity opening. Very similar to the original version and somewhat similar to L'interdits (supposedly even more similar to the original version as well, and not Rouge that I've tried). Nice enough.

Light Blue by Dolce&Gabbana - this classical fragrance has been talked a lot around here (perfume online space) so I decided to actually try it and it's actually very fresh and very pleasant - nice bright citruses straight from the fridge. The sad thing is that it has pretty pure longevity - practically disappears in a few hours.

Light Blue Summer Vibes by Dolce&Gabbana - while we're here I've also decided to try this newest flanker and it's pretty similar to the original - bergamot at the top and all that - but this has slightly better longevity and is a tad sweeter at the bottom (I don't feel actually peaches there though). The bottle is so pretty though...

Signorina Misteriosa by Salvatore Ferragamo - the only reason I wanted to try this one is that I liked the pyramid (and was a little intrigued by blackberry there). Well, it's very lactonic - with all those creamy sweet white flowers and literal milk mousse note - and feels a bit like fruit yogurt - because while blackberry isn't especially obvious it gives fruitiness. Nice little thing.

Girl by Rochas - tried this one on myself because I really wanted something simple and got it - very very sweet white flowers. That's it. In my opinion they're a bit too vague (and not obvious neroli) and while so sweet not especially edible - not gourmanic (like, for example Sintra is). Still nice - not wishlist worthy, but if I somehow accidentally acquired a bottle I'd use it.

#perfume #at the alchemist #gritti

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jovoy · 2 years

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good morning today i am doing something different i am holding a little competition..between two very famous very hyped fig fragrances that i see a lot of people compare to each other. thats right ladies and gentlemen this is a philosykos vs debaser death match (this is the philosykos eau de toilette cuz it was cheaper so not an exact comparison. btw so this is not a proper scietific comparison at all in fact i shouldnt be doing this probably actually)

ok starting with philosykos the opening is extremely green and woody its like standing under a fig tree. fairly sharp and not sweet at all but still very pleasant..i would say extremely unisex from the get go. debaser on the other hand the opening has a sweet roundness and a lactonic quality from the coconut and you immediately get the fig as well. starts out more feminine for sure but still unisex if youre into that. and then as philosykos dries down you begin to smell something a bit sweeter and the actual fruit itself comes out which seems a little counterintuitive based on the top/heart/base notes but its what happens at least in my opinion. debaser to me is a bit less refined and the experience is much more linear. the opening is what you get for the entire wear time basically. but if you love the opening like i do thats a great thing and it lasts for a significantly longer period of time than philosykos which tends to be very fleeting. which i wont hold against it because it is an edt rather than an edp like i said earlier. altogether i do find these different enough to rationalize wanting a full bottle of both which is nice because previously i thought they were too similar. i think philosykos edt is much more suited to spring and summer however and debaser has a certain sweetness and warmth to it that is best fit for colder months but it could definitely be an all year long fragrance if you wanted it to be. overall i think theyre more dissimilar than i initially thought and this experiment was kind of bogus from the get go. but i have come to the conclusion that both of these are pretty excellent especially if you like fig and you could definitely enjoy both of them separately and have both in a collection. theyre different moods and interpretations of fig.

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curareblog · 4 months

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Brown Girl Jane // Discovery Set // Individual Reviews Below

Brown Girl Jane is, by all accounts, #thatgirl for many in the #blackownedfragrance space. I’d be lying if I didn’t mention that the cleanliness of the overall brand design and vision didn’t elevate it to the next level. That was a lot of “didn’t” usage. Unlike some brands that may smell overly synthetic, or some that go a little too avant garde in the begin - Brown Girl Jane did stick in the lane of nice scents that don’t offend and delivered well.

Bahia // 6.5/10

We lived, laughed, and loved with gardenia notes… We really did. I love white florals, all except GARDENIA. This is no fault of the brand, of course, but gardenia always strikes me as just somewhat stomach turning unless dosed correctly. Bahia is far from the most offensive in this respect. It doesn’t screech and mercifully the gardenia fades into the background as a clean musk takes over. If I were to reach for a gardenia scent that (shockingly) stays away from the stomach churning waxiness that I don’t love about most modern gardenia scents, I’d stick with Gardenia Petale by Van Cleef, personally.

Casablanca // 6/10

Again, this is not an offensive scent. It starts off with an interesting combination of cardamom and marshmallow, but it dries down so quickly to a somewhat tart (think the mouthwatering quality of Ombre Leather) and powdery sweetness. It’s this linearity that I think I would find cloying throughout the day, sadly.

Lamu // 8/10

Surprising no one, a summery coconut citrus concoction is among my winners. Here I get the same gardenia note, thankfully turned down several notches so that it places nicely with a hint of lactonic coconut and citrus. This particular combination of coconut and citrus strongly reminds me of a flanker to Light Blue called Light Blue Sun, which I believe has been discontinued. Where the lemon and coconut of Light Blue Sun play the role of competing, albeit delicious, ice cream flavors in my cup, Lamu harmonizes these notes much more seamlessly. The whole Light Blue collection is my ride or die, but Lamu might just deprioritize Light Blue Sun for me.

Dawn // 5/10

Tart in a somewhat acrid way? The olfactory version of milk curdling due to a citrus fruit. Not unbearable but not enjoyable.

Dusk // 6/10

Almondy sandalwood. Safe, quiet, and somewhat creaming. Limited projection at best.

Dare // 7/10

Intriguing “earthy” leather and cherry combination. Subtle hint of something with a dirt-like quality I’m confused by I’m also impressed by it being something different.

#BrownGirlJane #DiscoverySet #IndividualReviews #BlackOwnedFragrance #ThatGirl #FragrancePerfume #ScentSensation #PerfumeLover #FragranceAddict #LuxuryFragrance

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ladyjunosteelofcarteblanche · 3 years

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The Carte Blanche and their signature scents

Peter Ransom: Bad Boy - Carolina Herrera

my Nureyev kinnie gf wears this and I feel like that’s enough evidence but regardless, Juno’s description of Peter smelling like « earth and spice » in What Lies Beyond p3 is further proof. it’s a pretty woody and amber based perfume making it really warm and spicy but the top and mid notes of pepper, sage, and cedar balance it out to create that earthy spicy smell. he definitely matches his perfumes to his bath products so even if he isn’t wearing a scent, he still smells good, hence why even when the cologne wore off, his bed still smelled nice. (also the name is really iconic afsjshxhd)

Juno Steel: Black Saffron - Byredo

with warm spicy, leathery mid notes, this is something that gives me very noir detective vibes but then there are the top notes of saffron, juniper berries and chinese grapefruit which shift the narrative a little and turn it from an entirely brooding scent to one that is more light. it’s a really androgynous perfume in that it ties together the more traditionally masculine smelling woody leather with the more traditionally feminine violets and spiced citrus smell. the base note of cashmeran gives it a softer and sweeter dry down but the vetiver pulls through with that earthy leather smell, perfectly encapsulating our dear detective in a single bottle. he would also would wear Whispers in the Library but that’s just me projecting

Buddy Aurinko: Jazz Club - Replica

this fragrance is super boozy which already fits Buddy so well but on top of that, there are the tobacco and vanilla base notes that give it a very sweet but smoky scent. the styrax gives it that floral smell with some dry, spicy bite bringing in that powerful feminine energy (we stan), the other notes are more citrusy and spicy and are really prominent at the top but the dry down is what really makes this perfume, it’s intoxicating, heady, and bold, just perfect for Mrs. Aurinko.

Vespa Ilkay: Wood Sage and Sea Salt - Jo Malone

Vespa doesn’t really seem like the type to wear perfumes all that much but at some point Buddy drags her to a fragrance shop her and Buddy went shopping and Vespa found this scent (it’s also the perfume she wore on their wedding day). it’s a very aromatic scent with lots of notes of citrus and salty fresh air, it also has some musky herbal notes which fit her vibes pretty well. while it’s not exactly something you would expect her to wear at first, the dichotomy between the bright scent and her abrasive nature and the likeness between the rugged mineral musk and her projected persona makes this a fun choice.

Rita [Redacted]: Cloud - Ariana Grande

It’s sweet and playful which is already a scent I feel like rita would love but it also has notes of coconut, praline and vanilla that really add some complexity to the scent, while most of the notes are sugary and lactonic, the top notes of lavender, pear and bergamot create a nice balance with them. she is happy go lucky and sweeter than sugar but she is also a character with layers and is more than just a superficial persona which this perfume does a good job of encompassing. I also feel like she switches between this perfume and A Whiff of Waffle Cone from Salt and Straw sometimes depending on how sweet she wants to go.

Jet Siquliak: Old Spice Dynasty Deodorant but sometimes Duel - Annick Goutal

l i s t e n I can’t imagine the big guy caring much for fragrances when the only thing it’ll add is an extra step to his morning routine so (according to him), it would be much more efficient to just wear a deodorant that has a very distinct smell, hence Old Spice Dynasty, a very woody and leathery scent meant to replicate modern masculine colognes. Occasionally he’ll wear Duel but not very often, it’s similar to Dynasty with the woody, spicy and leathery notes but is also a bit more fresh with orris root, petitgrain and artemisia.

The Ruby 7: Molecule 01 - Escentric Molecules

this funky little perfume deals with some pretty futuristic stuff in terms of its scent profile, it is made of one note and one note only, a molecule called Iso E. It’s a velvety sensual cedarwood but varies greatly depending on the person (or car) who is wearing it, the scent wears close to the skin and has a distinctive smell depending on how it reacts to your body chemistry, some will adore the fragrance on them, some may not even be able to smell it while others will find the scent downright offensive, this perfectly encapsulates the radical nature of the Ruby and there really isn’t a better fitting perfume.

I could talk for hours about all the different fragrances everyone in the penumbra pod wears and I’ll probably be making a separate post just on all of the signature scents of Nureyev’s aliases lol

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fruitchouli · 3 years

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can you recommend any good lactonic perfumes

diesel plus plus feminine smells like the bottle looks it’s soft kind of sweet synthetic comforting milky fuzzy with a “sharper” note some people compare to milk turning sour , i find it more to be a kind of plastic / rubber smell . it’s not going for natural it’s very purposefully synthetic and we love it for that

gushy rush is classic probably most popular milky fragrance it is also extremely synthetic and loving it . it’s like milky rubber red balloon peach rings candies pulsing red strobe lights and drogas.

this one ees like a rice puddin for when ur daddy’s little girl or whayeber i never saw that movie . rice note goes rly lactonic with the banilla and it’s like creamy rice pudding dessert u eat outside and the trees with flowers on them the smell is picked up by the light breeze and the air is floral and fragrant

this one is a champaca milk bananer. it’s very creamy milky fleshy tropical floral , sweet with banana and pear on a soft warm base . slight indolic quality from the champaca keeps it from being too mom ish . very comforting to me

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your-dietician · 3 years

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The Overlooked Drugs to Reconsider When Prescribing for Pain

New Post has been published on https://depression-md.com/the-overlooked-drugs-to-reconsider-when-prescribing-for-pain/

The Overlooked Drugs to Reconsider When Prescribing for Pain

A review of pain medications of the past and how they may help to optimize the treatments of today.

Pain-treating clinicians are constantly searching for medications that improve patient outcomes and/or that can minimize the use of opioids. Perhaps, older treatment modalities just need to be reconsidered.

Background

The management of pain – whether acute or chronic – is one of the most difficult medical conditions to treat and when treatment options are limited, the patient is the one left to suffer while the clinician bears the burden of trying to help the patient. The current opioid crisis in the US has significantly shifted the pendulum of opioid prescribing practices due to various restrictive guidelines, laws, regulations, and policies at both the federal and state level. Clinicians are challenged and quite possibly hesitant with managing complex pain syndromes in individuals with medical comorbidities.

Not all pharmacologic treatment options are viable for every case due to patient-specific factors, compelling medical indications and comorbidities, drug interactions, and even pharmacogenetics. Over time, some pharmacologic options are withdrawn from the market by the manufacturer, forgotten, or underutilized due to a lack of clinician knowledge or familiarity.

Here, we revisit this “land of lost analgesics” with the goal of refamiliarizing pain-treating clinicians – whether in specialty or primary care – with alternative treatment options that are worth consideration when initial first and second-line pain therapies have been optimized or are contraindicated. Potential uses, clinical considerations, and US availability are noted for each.

Not all pharmacologic treatment options are viable for every patient. Here, we revisit the “land of lost analgesics” with the goal of refamiliarizing pain-treating clinicians – whether in specialty or primary care – with alternative treatment options. (Image: iStock)

Skeletal Muscle Relaxants

Skeletal muscle relaxants are a broad category of medications consisting of a wide spectrum of drugs with different indications and mechanisms of action. Muscle relaxants can be divided into two main categories: antispasmodic and antispasticity medications. Antispasmodics are used to reduce muscle spasms resulting from a painful condition whereas antispasticity medications are used to decrease spasticity that hinders functionality.1

Orphenadrine citrate

Orphenadrine citrate is classified as an antispasmodic with the mechanism of action being unclear, but is a derivative of diphenhydramine and its activity is believed to be related to its sedative effects. In four placebo-controlled trials, orphenadrine was found to be fairly effective in some musculoskeletal conditions (acute low back pain, neck pain, nocturnal leg cramps) as well as symptoms of pain intensity, stiffness, and functionality.2

However, given orphenadrine’s chemical nature, it consequently possesses anticholinergic activity and thus patients may experience dry mouth, blurry vision, constipation, urinary retention, and cognitive dysfunction.1 Orphenadrine citrate is indicated for mild to moderate pain of acute MSK disorders and as an adjunct to rest, PT, and other measures for relief of discomfort associated with acute painful MSK conditions. In 2020, FDA granted a supplemental ANDA for a combination formulation of orphenadrine citrate with aspirin and caffeine in 2020.

Brand names: Norflex, Norgesic, Orphenesic Forte

Formulations: oral, injectable

Potential targets: acute low back pain, neck pain, nocturnal leg cramps

Available in US: Yes

Tolperisone

Tolperisone is classified as an antispasmodic with the mechanism of action possessing lidocaine-like-activity by stabilizing nerve membranes of mono- and polysynaptic reflexes in the spinal cord by blocking in a dose-dependent manner.1 Tolperisone was shown to be more effective than placebo for patients with chronic low back pain and overall improvement with short term use over 21 days, but no reduction of muscle spasms or pain.1 Unlike other skeletal muscle relaxants, tolperisone has been shown to exhibit less somnolence or cognitive adverse effects when used with for up to 14 days.3 As a skeletal muscle relaxant with less CNS adverse effects than currently available in some analgesics, tolperisone may offer a more promising option for patients.

Brand names: Mydocalm

Formulation: oral

Potential targets: low back pain

Available in US: No, but the manufacturer is recruiting for Phase 3 STAR study under ClinicalTrials.gov #NCT04671082; utilized in Europe since the 1960s

Dantrolene sodium

Dantrolene is classified as an antispasmodic medication with the mechanism of action on the PNS by blocking the calcium channel of the sarcoplasmic reticulum to reduce the concentration of calcium and diminishing the potential for an actin-myosin interaction which could produce a muscle contraction.1,2 Dantrolene has shown some efficacy for use in spasticity in debilitating conditions that hinders functionality, but there is little evidence exhibiting effectiveness for musculoskeletal conditions.1 Despite dantrolene bypassing the CNS and avoiding the typical adverse effects, it is consequently associated with hepatotoxicity and muscular weakness.1

Dantrolene is still commercially available in oral and injectable formulations and FDA approved for the treatment of spasticity associated with upper motor neuron disorders such as cerebral palsy, multiple sclerosis, spinal cord injury, and stroke.

Brand names: Dantrium, Ryanodex

Formulations: Oral, injectable

Potential targets: Muscle relaxation after CNS injury

Available in US: Yes

See also, a case report and review of dantrolene for muscle spasticity.

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

NSAIDs are used to inhibit the enzyme cyclooxygenase (COX) which is a bifunctional membrane-bound hemoproteinthat catalyzes the reduction of arachidonicacid to cyclic endoperoxide by bis-dioxygenation for the biosynthesisof prostaglandins, prostacyclin and thromboxanes.4

There are two principle isoforms of COX enzymes which are bifunctional enzymes consisting of both cyclooxygenase and peroxidase activity: COX-1 and COX-2. COX-1 is predominantly responsible for the production of prostaglandins necessary for maintaining normal endocrine and renal function, gastric mucosal lining, and hemostasis by mediating thromboxane A2 production to cause vasoconstriction and activate platelet aggregation. COX-2 is produced in response to inflammatory and mitogenic stimuli which is important in facilitating inflammation as well as the production of prostacyclin to promote vasodilation and inhibit platelet aggregation.5

Rofecoxib

Rofecoxib is a COX-2 selective NSAID consisting of a methylsulfone moiety and a lactone ring structure that makes it >800 times more selective for COX-2 than COX-1.6 In comparison to other NSAIDs, rofecoxib is about 6 to >20 times more selective for COX-2 than celecoxib, diclofenac, indomethacin, or meloxicam. As an NSAID with significant COX-2 specificity, rofecoxib has benefits of yielding effective analgesic and anti-inflammatory activity with reduced potential for GI-related adverse effects.6 Rofecoxib was originally FDA-approved for the management of acute pain in adults, primary dysmenorrhea, and osteoarthritis.4,6

In a Cochrane review of 26 RCTs evaluating the efficacy and safety of rofecoxib use in osteoarthritis compared to placebo, celecoxib, diclofenac, ibuprofen, naproxen, nimesulide, nabumetone, acetaminophen, and diclofenac/misoprostol combination, evidence showed that rofecoxib was more effective than placebo, but displayed no difference in efficacy when compared to the other NSAIDs at equivalent doses. From a safety standpoint, rofecoxib resulted in fewer GI-related adverse effects compared to celecoxib, ibuprofen, and naproxen with only one trial comparing rofecoxib to celecoxib reporting on the overall rates of GI-related adverse events comparing high dose rofecoxib with low dose celecoxib.7

In a similar fashion, three trials examining cardiovascular safety of rofecoxib and celecoxib used non-comparable doses with the results of those studies suggesting that rofecoxib caused more patients to experience a significant increase in systolic blood pressure and peripheral edema. However, there was no difference between rofecoxib and celecoxib in studies conducted among the general populations.7

In another Cochrane review of two RCTs evaluating the efficacy and safety of rofecoxib use in rheumatoid arthritis, one trial compared to placebo which rofecoxib exhibited a greater degree of efficacy while having a similar a safety profile.The second trial, known as the VIOXX GI Outcomes Research (VIGOR) study,was primarily designed to assess the safety of rofecoxib compared to naproxen which showed similar efficacy and lower GI-related adverse effects and bleeding, but consequently revealed a greater incidental finding of non-fatal myocardial infarctionsin the rofecoxib population.8,9

Fortunately, the overall mortality rate and rate of death from cardiovascular causes were similar in the two study groups. In another significant study, the Adenomatous Polyp Prevention on VIOXX (APPROVe) trial compared rofecoxib to placebo to evaluate its effectiveness in preventing the recurrence of colon polyps, but was unfortunately terminated prematurely due to increased incidence of myocardial infarctions and ischemic cerebrovascular eventsinitially seen following 18 months of continuous treatment.9,10

Similar to other NSAIDs with nephrotoxic adverse effects, rofecoxib causes dose-independent reductions in glomerular filtration rate and acute renal failure as well as reversible interstitial nephritis.11 Rofecoxib was subsequently voluntarily withdrawn from the market in September 2004. However, other COX-2 selective NSAIDs such as celecoxib, diclofenac, etodolac, and meloxicam are still commercially available for clinical use.

Benoxaprofen

Benoxaprofen is a arylalkanoic and proprionic acid derivative NSAID initially FDA-approved for the treatment of osteoarthritis and rheumatoid arthritis. Unlike other NSAIDs, benoxaprofen is a weak COX inhibitor, but also has an additional mechanism of action by inhibiting 5-lipoxygenase and mononuclear leukocyte migration and their chemotactic response. Benoxaprofen had a long elimination half-life 28-35 hours which allowed for once daily dosing making it convenient for clinicians to prescribe and patients to be adherent to therapy.12,13

There was strong consideration that benoxaprofen had disease-modifying effects in rheumatoid arthritis.13 A clinical trial in 2,204 patients with either active rheumatoid arthritis or symptomatic osteoarthritis treated with benoxaprofen for an average period of 14 months was shown effective for continuous antirheumatic stabilization with a single daily dose.14

Compared to other NSAIDs in rheumatoid arthritis and osteoarthritis, benoxaprofen has been shown to be more effective than aspirin or ibuprofen and more effective than ibuprofen with comparable efficacy to aspirin respectively.14 When benoxaprofen was compared to other NSAIDs such as indomethacin, naproxen, and sulindac, there was no significant difference in efficacy with rheumatoid arthritis patients.12

From an adverse effect profile, benoxaprofen is somewhat unique as it is associated with low incidences of peripheral edema and peptic ulcers, but has a high frequency of phototoxicity and onycholysis.12,14 Photosensitivity typically appears within 48 hours of treatment initiation and resolves 48 hours following discontinuation. Unfortunately, benoxaprofen was voluntarily withdrawn from manufacturer due to cholestatic jaundice with nephrotoxicity and hepatotoxicity. However, benoxaprofen is not unique with respect to its dual activity as a weak inhibitor of COX and its inhibitory effects on mononuclear leukocytes as sulindac has comparable potency and is still commercially available for clinical use.12

Choline Magnesium Trisalicylate

Choline magnesium trisalicylate (CMT) is a non-acetylated salicylate arylpropionic acid and arylacetic acid derivative NSAID that structurally contains choline salicylate and magnesium salicylate with analgesic and anti-inflammatory properties similar to aspirin. CMT does not inhibit platelet aggregation induced by two physiological aggregating agents, collagen and arachidonic acid or spontaneous platelet aggregation.15 The acetyl moiety on aspirin’s hydroxyl group facilitates it to alter factors of platelet function by irreversible acetylation of COX and thus inhibits the conversion of arachidonic acid to thromboxane A2 resulting in suppressing platelet aggregation and prolonged bleeding time. Unlike aspirin, CMT lacks an acetyl moiety and has choline and magnesium substituents on the carboxyl groups of the three salicylate molecules in its structure and as a result there is no interference with platelet aggregation or effect on bleeding.16

CMT may be an alternative NSAID for patients prescribed lithium as non-acetylated salicylates may be preferred to minimize risk for potential drug interactions and inducing lithium toxicity.17 However, CMT should still be used with caution and or avoided in patients with renal dysfunction, and compelling cardiovascular comorbidities such as congestive heart failure and coronary artery disease while prescribed other anticoagulants such as P2Y12 antagonists, phosphodiesterase-3 enzyme inhibitors, vitamin k antagonists, and direct-acting oral anticoagulants.

The most common adverse effects with CMT are similar to traditional NSAIDs with tinnitus and gastrointestinal issues (ie, gastric upset, heartburn, epigastric pain, diarrhea). CMT is FDA-approved for use in the relief of mild to moderate pain, management of acute painful shoulder, management of pyrexia, relief of sighs/symptoms of osteoarthritis, rheumatoid arthritis, and other arthritis (long-term management and acute flares), and anti-inflammatory or analgesic management (in children) of juvenile idiopathic arthritis and other appropriate conditions.

Zomepirac

Zomepirac is a pyrrole acetic acid a NSAID structurally similar to tolmetin, but is more lipophilic and may potentially have central analgesic effects. Zomepirac is nearly equivalent in potency to indomethacin and tolmetin as a COX-1 inhibitor of prostaglandin synthesis and was 2 or 3 times less active than diclofenac, but more active than aspirin, ibuprofen, or naproxen.Zomepirac is typically dosed 100 mg every 4 to 6 hours as needed, but should not be dosed greater than 400mg/day for three months or longer or exceed 600mg/day as these doses have not been studied and are not recommended.18,19

In looking at the data, zomepirac has demonstrated efficacy in relieving moderate to severe acute postoperative orthopedic, gynecologic, abdominal, and thoracic as well as dental pain.18-20 Zomepirac displayed greater efficacy over some opioids and may have been considered a viable option as an opioid sparing analgesic. In singe-dose studies in patients with acute pain, zomepirac 100mg exhibited greater efficacy compared to codeine 60 mg as well as other single agent non-opioid analgesics and other analgesic combinations. In single-dose crossover studies comprised of patients with moderate to severe postoperative pain, oral zomepirac 100 or 200mg was compared to intramuscular morphine 16mg and provided comparable analgesic effects and suggesting a “ceiling effect” of analgesic activity while also indicating that oral zomepirac was about one-sixth as potent as intramuscular morphine, but with a slower onset and longer duration of action.19

Adverse effects of zomepirac are fairly similar to other commonly prescribed NSAIDs such as gastrointestinal-related, however zomepirac exhibited a higher incidence of urogenital symptoms (ie. dysuria, cystitis, urinary frequency, hematuria, pyuria, and urinary tract infections) compared to other common NSAIDs and should be monitored more closely if used longer than six months. Following a single 200-mg dose, zomepirac sodium was shown to prolong the template bleeding time and decrease platelet retention significantly. Unlike aspirin and similar to other NSAIDs, zomepirac platelet inhibition is reversible and returns to normal function after 24 to 48 hours following discontinuation of therapy.18,20 Unfortunately, zomepirac was voluntarily withdrawn in due to various case reports of anaphylactic reactions. However, other COX-1 selective NSAIDs such as indomethacin and tolmetin with similar potency are still commercially available for use clinically applicable.

Brand names: Zomax

Formulation: oral

Potential targets: moderate to severe acute postoperative orthopedic, gynecologic, abdominal, thoracic, and dental pain

Available in US: No

Adjuvant Analgesics

Neuropathic pain can be one of the more challenging pain syndromes as intolerable symptoms may be intermittent, constant, aggravated, or spontaneous. Adjuvant analgesics consisting of antidepressants, anticonvulsants, as well as other medications with unique properties affecting the nerve cell membrane may be used to help minimize the frequency and intensity in alleviating neuropathic pain symptoms. Some adjuvant analgesics may benefit other medical conditions as well, such as comorbid mental health disorders, potentially minimizing the need for polypharmacy and pill burden.

Maprotiline

Maprotiline is a dibenzo-bicyclo-octadiene secondary amine tetracyclic antidepressant with a large lipophilic carbocyclic moiety and is distinguishable from tricyclic antidepressants by the presence of an ethylene bridge rendering its three-dimensional stereochemical configuration. Maprotiline exhibits similar activity as amitriptyline and imipramine, but has a more rapid onset of action and less anticholinergic adverse effects.21,22

Similar to imipramine, maprotiline exhibits strong norepinephrine reuptake inhibition activity across the nerve cell membrane as well as weak alpha-2 adrenergic blocking activity. Maprotiline undergoes first-pass hepatic metabolism primarily by N-demethylation, oxidative deamination, and aliphatic and aromatic hydroxylation to active formation of aromatic methoxy derivatives.21, 22 Maprotiline may initiated at 75 mg/day and can be titrated up to 225-300mg/day.22

In a double-blind cross over study with maprotiline 75mg/day compared to placebo in patients with chronic tension headache, treatment with maprotiline over a 6-week period was shown to be superior to placebo with mild side effects (drowsiness, dry mouth, increased appetite/weight gain).23 A study group consisting of patients with pain and depression were treated with maprotiline and gradually titrated to a target dose up to 300mg/day (150mg/day if 60 years or older) as tolerated resulted in 72% of patients responding with a greater than a 50% reduction in pain.24 In a randomized, double-blind, crossover trial, maprotiline was compared with amitriptyline in the treatment of postherpetic neuralgia displaying some pain relief, but was not as effective as amitriptyline unless treatment with amitriptyline had failed.25

Maprotiline has similar adverse effect profile as traditional tricyclic antidepressants given its anticholinergic activity with dizziness/faintness, blurry vision, dry mouth, constipation, orthostatic hypotension and tachycardia, but to a lesser degree as well as cutaneous rashes which are more common. Cardiovascular effects have been demonstrated with maprotiline as it can cause a decrease in standing systolic pressure, flattening of T-waves, an increase in heart rate and PR interval, prolongation of the pre-ejection period, as well as QT prolongation.22

Brand names: Ludiomil

Formulation: oral

Potential targets: depressionand anxiety

Available in US: Yes

More on the overlap between chronic pain conditions and psychiatric disorders.

Antiarrhythmics

Mexiletine

Mexiletine is a class 1B antiarrythmic agent FDA-approved for the treatment of ventricular arrhythmias. Pharmacologically, mexiletine is a structural analogue of lidocaine and acts by blocking voltage-gated sodium channels decreasing the rate of depolarization of ventricular cardiac myocytes, but also has similar potency in local anesthetic properties.26,27

Mexiletine is a racemic mixture of R-(–)- and S-(+)-enantiomers that possess characteristic antiarrhythmic potency with the R-(–)-enantiomer exhibiting increased cardiac sodium channel binding and greater antiarrhythmic activity than the S-(+)-enantiomer, but neither of the isomers significantly changed the electrocardiographic intervals (PR, QRS, QTc) or refractory periods.26 Mexiletine has been used to treat various neuropathic pain syndromes including: alcoholic neuropathy, cancer and radiation-induced neuropathic pain, painful diabetic neuropathy, dysaesthetic pain associated with multiple sclerosis, HIV-induced neuropathy, myofascial pain, peripheral nerve disease, phantom limb pain, postherpetic neuralgia, spinal cord injury, thalamic (post-stroke) pain, and trigeminal neuralgia.28

Mexiletine has a narrow therapeutic range from 0.75 to 2 mg/L that correlates serum concentration level to both its antiarrhythmic efficacy as well as adverse effects.26 However, there are no serum mexiletine concentration levels that correlate with efficacy in relieving neuropathic pain syndromes that have been studied. Therapeutic doses of mexiletine have ranged from 300 to 675mg/day, but clinicians should be vigilant and avoid dosages that can result in serum concentrations exceeding >2 mg/L. Mexiletine is predominantly hepatically metabolized via CYP2D6 to p-Hydroxymexilitine so dosage adjustments are not necessary in patients with severe renal dysfunction or on hemodialysis.28 The consequences of genetic polymorphism to CYPD6 in patients receiving mexiletine for neuropathic pain remain unclear, but should be used with caution and monitored closely during initiation and dose titrations especially in the setting of potential clinically significant drug-drug interactions.26,28

Opioids may have a potential clinically significant drug interaction with mexiletine. Despite there being no studies designed to evaluate the effects of opioids on the pharmacokinetics of mexiletine, it has been reported that patients taking morphine have significantly lower mean concentrations of mexiletine 3 hours following the first dose. The mechanism caused by the lower mexiletine serum concentration is believed to be due to opioids inhibiting gastric emptying and in turn slowing the absorption of mexiletine.26 (More on opioids below.)

The most common adverse effects patients may experience with mexiletine are dizziness or lightheadedness, tremor, nervousness, ataxia, nausea, anorexia, and gastric irritation, but tolerability may be improved with food or reducing the dose.27 Mexiletineis still commercially available in oral formulations and FDA-approved for the management of ventricular arrhythmias, but may potentially be an alternative option as an adjunct analgesic for neuropathic pain who have failed response or cannot tolerate first line treatment options.

Brand names: Mexitil

Formulation: oral

Potential targets: neuropathic pain

Available in US: Yes

Opioids

Opioids are not just purely mu-opioid agonists; some can be mixedmu opioid receptor agonist-antagonists, as well as agonists of the delta and or kappa opioid receptors with varying pharmacodynamic effects. Mixedmu opioid receptor agonist-antagonists are not used as often as full mu-opioid agonists due to their limited commercial availability, but as a result of their antagonist activity has less dependence and abuse potential.

Opioid analgesics may be considered as adjunctive therapy upon initiation and during optimization of non-opioid analgesics especially for severe pain, but dose and duration of therapy should be kept to a minimum where possible and consideration should be made to taper toward discontinuation as goals of therapy are met and as overall pain improves with optimization of non-opioid analgesics. If opioids are to be used, risk mitigation strategies such as obtaining an opioid treatment agreement or consent, review of prescription drug monitoring program reports, and conducting urine drug testing should be performed periodically as clinically indicated as recommended per established clinical practice guidelines as well as state regulations.

Butorphanol

Butorphanol is a synthetic phenanthrene kappa opioid receptor agonist, mixed mu opioid receptor agonist-antagonist, as well as apartial sigma receptor agonist which is responsible for psychotomimetic effects such as dysphoria, respiratory and vasomotor stimulation.29 potency of parental butorphanol ranges from 4 to 8 times more than morphine, 30 to 40 times more than meperidine, and 15 to 24 times more than pentazocine whereas oral is about 7 times more than codeine and 6 times more than pentazocine.29,30

Butorphanol’s antagonist activity is about 30 times more than pentazocine while only a fraction (1/40) of naloxone and given its high binding affinity to the mu opioid receptor, higher doses of naloxone may be necessary in order to reverse any adverse effects of butorphanol compared to pure opioid agonists such as morphine.29 The absorption of butorphanol is adequate via oral and parenteral routes, but undergoes extensive first-pass hepatic metabolism primarily by hydroxylation to the major metabolite hydroxybutorphanol and N-dealkykation to minor metabolite norbutorphanol which leaves oral bioavailability yielding about only 5 to 17%. With transnasal administration of butorphanol on the other hand, this route of administration bypasses the gastrointestinal tract, and improving bioavailability to about 48 to 70% similar to parenteral administration.30

Additionally, transnasal butorphanol absorbs rapidly while providing onset of analgesia within 15 minutes making it an ideal short-term treatment option for patients with moderate to severe acute postoperative, musculoskeletal and migraine headache pain. The bioavailability and pharmacokinetics of transnasal butorphanol may be influenced by age and sex as the median value for tmax was marginally higher in the elderly (older than 65 years) in elderly men (75%), but was significantly lower in elderly women (48%). However, the bioavailability in young men (68%) and young women (70%) the Cmax and AUC values were relatively similar.30

The most common adverse effects to be expected from butorphanol are sedation, drowsiness, dizziness, as well as nausea and/or vomiting. Unlike pure opioid agonists such as morphine which can cause respiratory depression in a dose proportional manner, butorphanol exhibits a ‘ceiling effect’ with respect to the degree of respiratory depression such as increasing doses beyond 2mg may not result in a corresponding increase in degree of respiratory depression, but the duration of respiratory depression increases with higher doses.29,30 Butorphanol has hemodynamic effects similar to pentazocine but to a lesser degree with cardiovascular effects consisting of: increased pulmonary artery and wedge pressure, increased left ventricular end diastolic pressure, increased systemic arterial pressure, increased pulmonary vascular resistance, as well as increases to cardiac index and cardiac work.29

Considering these cardiovascular effects, butorphanol should be used with caution or avoided where possible in patients with acute myocardial infarction, coronary insufficiency, or ventricular dysfunction. Butorphanol is FDA-approved for use in the relief of moderate to severe pain, as a supplement to balanced anesthesia, for the relief of postpartum pain, and as preoperative or preanesthetic medication with the ladder three indications utilizing injectable formulations only.29

Brand names: Stadol (International)

Formulation: nasal, injectable

Potential targets: moderate to severe pain, postpartum pain, perioperative

Available in US: Yes (generic); Stadol (US) was discontinued due to severe hypertension

Nalbuphine

Nalbuphine is a semi-synthetic phenanthrene kappa opioid receptor agonist and mixed mu opioid receptor agonist-antagonist structurally similar to oxymorphone and naloxone.29,31,32The potency of parental nalbuphine is equivalent to approximately 0.7 to 0.8 times that of morphine whereas oral is 3 times more than codeine.29,32

In comparison to pentazocine, nalbuphine is about 3 to 4 times more potent with a longer duration of action and 10 times more effective with its antagonist activity.29,31 Similar to butorphanol, nalbuphine exhibits sufficient absorption via oral and parenteral routes, but undergoes extensive first-pass hepatic metabolism with oral bioavailability yielding only about 20%.29

Much like any other opioid, the most common adverse effects exhibited with nalbuphine include sedation, drowsiness, dizziness, as well as nausea and/or vomiting.29 Comparable to butorphanol, nalbuphine also exhibits a “ceiling effect”, but to both the degree and duration of respiratory depression as escalating doses does not prolong the duration of respiratory depression beyond 3 hours regardless of dose and thus resulting in a plateau of the respiratory depression curve.29,31,32 In a study comparing nalbuphine and morphine in patients with acute myocardial infarction, nalbuphine did not cause any adverse clinical or hemodynamic effects despite decreasing heart rate and contractility, but maintained aortic pressure and hence sustaining the balance between myocardial oxygen supply and demand.29

Nalbuphine’s cardiovascular benefits with decreasing heart rate and contractility while maintaining aortic perfusion pressure may prevent further cardiac ischemia in patients with acute myocardial infarction. Nalbuphine is FDA-approved for use as an analgesic for moderate to severe pain, for preoperative analgesia, as a supplement to surgical anesthesia, and as obstetrical analgesia during labor.29

Brand names: Nubain

Formulation: injectable

Potential targets: moderate to severe pain, perioperative, labor

Available in US: Yes

Propoxyphene

Propoxyphene is a synthetic diphenyl heptane mu opioid receptor agonist, kappa opioid receptor agonist, and noncompetitive N-methyl-D-aspartate (NMDA) receptor antagoniststructurally similar to methadone that has two centers of asymmetry and exists as four stereoisomers: alpha-dextrorotatory isomer, alpha-levorotatory isomer, dextropropoxyphene, and levopropoxyphene. Dextropropoxyphene exhibits analgesic activity and levopropoxyphene has antitussive activity while the other levorotatory isomers are relatively inactive, but overall none of the isomers can be converted into methadone.Propoxyphene is about 33.33% to 50% the potency of codeine which is deemed to be less efficacious than a 650 mg dose of aspirin.Propoxyphene has rapid absorption via oral route and undergoes extensive first-pass hepatic metabolism primarily by N-demethylation to norpropoxyphene and yielding bioavailability of about only 18-25% from a 65mg dose. Propoxyphene is both a CYP450 2D6 inhibitor and substrate and consequently may be subjected to genetic polymorphisms as well as potential drug interactions.33,34

In a review written by Miller and colleagues, among 243 articles referencing propoxyphene, only 20 double-blind or triple-blind clinical studies were identified creditable for review. Fifteen studies showed that codeine at lower or equal analgesic doses produced comparable or greater analgesic efficacy than propoxyphene, but within the same parameters no study demonstrated that codeine was inferior to propoxyphene. Seven studies showed that aspirin alone or aspirin in combination with phenacetin, and caffeine (at various doses) were comparable or had greater analgesic efficacy than propoxyphene.35

Not all of the comparison studies reviewed presented propoxyphene as inferior as two separate studies showed that propoxyphene hydrochloride 65 mg was superior to codeine 32.5 mg and aspirin 325 mg alone. When compared to placebo, nine studies showed propoxyphene to be superior while seven other studies it was not.35

Common adverse effects with propoxyphene are similar to other opioids which include: dizziness, lightheadedness, visual disturbances, somnolence, drowsiness, seizures, euphoria, nausea, vomiting, abdominal pain, constipation, urinary retention. The metabolite norpropoxyphene is primarily renally eliminated and if accumulated may result in potentially fatal CNS, cardiac, and respiratory adverse events such as cardiac arrest, pulmonary edema, seizures, and even mortality.34

Norpropoxyphene has more potent direct cardiac adverse effects which include: an increase in bradycardia, decreased contractility, decreased electrical conductivity, QTc interval prolongation, as well as local anesthetic properties similar to lidocaine or quinidine which may precipitate arrhythmias. Incidents of pulmonary edema and seizures were believed to be secondary to propoxyphene and its metabolite norpropoxyphene in both high-risk patients and at high doses. Prior to removal, propoxyphene was falling out of favor by clinicians and was perceived to have no therapeutic benefit in the management of acute and/or chronic pain while having greater mortality risk due to its cardiac and neurologic toxicity profile.34

In 2009, the FDA required the drug manufacturer to conduct a multiple-ascending dose (MAD) study which was a randomized, double-blind, placebo-controlled sequential multiple-ascending dose study of propoxyphene for 11 days evaluating 600 mg and 900 mg cohorts. The results of the MAD study were submitted to the FDA by the manufacturer showing significant QTc interval prolongations observed with propoxyphene 600 mg and 900 mg dose cohorts. In 2010, the FDA concluded that the safety risks of propoxyphene outweighed the benefits and recommended against its use due to significant abnormal heart rhythm and electrical activity changes with the prolonged PR interval, widened QRS complex and prolonged QT interval at therapeutically prescribed doses.36

Propoxyphene was withdrawn by the manufacturer promptly afterward due to the FDA’s cardiotoxicity warning. Other short-acting immediate-release opioids such as codeine, hydrocodone, and oxycodone alone or in combination with acetaminophen are still currently available for use in acute severe breakthrough pain as clinically indicated.

Brand names: Darvocet-N (propoxyphene and acetaminophen)

Formulation: oral

Potential targets: breakthrough pain

Available in US: No, but similar products are still available

Levorphanol

Levorphanol has been referred to as the “forgotten opioid” that is phenanthrene mu, delta, and kappa opioid receptor agonist and non-competitive NMDA receptor antagonist structurally similar to morphine, but without an oxygen and a 6-hydroxyl group.37-39 Similar to morphine, levorphanol has anticholinergic effects and like methadone, levorphanol inhibits the uptake of serotonin and norepinephrine.38 However, unlike methadone, levorphanol has a shorter and more predictable half-life of about 11 to 16 hours with a longer duration of action, and no CYP450 or P-gp drug interactions or associated with any QTc prolongation risk.37

Levorphanol exhibits good absorption through the intramuscular, subcutaneous, and oral routes of administration and undergoes phase II metabolism via glucuronidation to levorphanol-3-glucuronide that is renally eliminated. In some special populations such the elderly, palliative care, and SCI patients, levorphanol may be a viable option and may require a lesser need for coadministration of adjuvant analgesics.37

Common adverse effects with levorphanol are similar to other opioids such as nausea, vomiting, sedation, dizziness, constipation, pruritis, urinary retention, but a unique adverse effect is a potential increase in bile duct pressure which should be avoided in biliary surgery patients.39 Levorphanol is FDA-approved for management of pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate.

Brand names: Levo-Dromoran

Formulation: oral

Potential targets: severe pain

Available in US: Yes

Clinical Takeaways

Pharmacologic options of the past for treating acute, chronic, and perioperative pain may still be of clinical use. While some analgesic medications, including adjuvants, have been voluntarily withdrawn from the market by the manufacturer, others are still available and simply remain forgotten or underutilized. Pain practitioners across specialties are encouraged to refamiliarize themselves with these drugs in case they may benefit a particular patient who is refractory to or contraindicated for more widely used products.

Not all pharmacologic treatment options, however, are viable for every case; as with any prescription, risks and benefits must be weighed. Having a fuller, even if older, arsenal of potential treatment modalities for pain management can only serve to benefit the clinician and the patient. All pharmacologic treatment options old and new should be reconsidered based within patient-specific clinical parameters and trialed as potential alternative analgesics where possible.

Miguel Escanelle, MD, and Christopher P. Emerson, MD, MS, contributed to the research of this article.

This commentary is the sole opinion of the author and does not reflect the opinion of employers, employee affiliates, and/or pharmaceutical companies mentioned or specific drugs discussed. It was not prepared as part of official government duties for Dr. Pham. Dr. Pham dedicates this article mentor and friend Jeffrey Fudin, PharmD.

Last updated on: September 8, 2021

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aleesblog · 3 years

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Gerald Stern Journal of Neural Transmission supplement 2020

Gerald Stern was a doyen of clinical neurology of international repute who made numerous significant contributions to neurology and the field of movement disorders. His early life and career in neurology have been documented in other published eulogies (Lees 2018a, b; Quinn 2019; Lees and Ockelford 2019)—we would urge you to read these as they tell a compelling story of his upbringing, his entry in to medicine, and the start of his love affair with clinical neurology that contains object lessons for those about to embark on a similar voyage. For those of you who never met Gerald or heard him speak and have not read any of his numerous publications, you should indulge yourselves by reading one of his later works (Stern 2011) or the Stanley Fahn Lecture presented at the MDS meeting in 2010 in Bue- nos Aries which you can watch on YouTube (Stern 2010) and an interview carried out by Niall Quinn (Quinn 2010) following that presentation. Then, you will realise what a master of the English language he was, his intellect, his ability to dissect and analyse complex areas of neurology, and how he used his wit and humour to entertain an audience. Gerald showed boundless enthusiasm for clinical neurol- ogy and was beloved by his patients who adored the time and patience which he showed in trying to understand their problems and to treat them to the best of his ability. Such was the respect of his patients that two apparently penniless, little old ladies left him substantial legacies with which he funded his research. Famed for his tact and diplomacy and courteous manner, he was sought out by the rich, the famous, Kings, Presidents, and Popes for his clinical skills. Asked why he preferred to practice private medicine rather than aim for a chair of neurology, he responded in typical fashion ‘My dear boy, I couldn’t possibly afford to be a professor’. A pioneer and a non-conformist—some would say rebel—he was involved in the earliest studies of L-dopa in Parkinson’s disease and subsequently in the introduction of dopamine agonist drugs, notably apomorphine and bromocriptine. Probably, he would have been most proud of his contribution to the introduction of the MAO-B inhibitor deprenyl in to the treatment of Parkinson’s disease, which included being his own guinea pig for testing the safety and effect of the drug—unthinkable in the modern era. Less well known is Gerald’s love of science and laboratory-based research which was fostered by periods in his early career that he spent in USA and in Paris. He must have been one of very few clinicians who subscribed to and read Nature and Science on a regular basis. Enthused by articles that stimulated his imagination, he would be immediately on the telephone to discuss the details of the experiments or he would buttonhole people at meetings and have long conversations which showed the depth of his knowledge and his deep understanding of the relevance to clinical neurology. He would enthuse and even cajole his basic science colleagues in to action to exploit these latest ideas and to translate them in to practical solutions for his patient population. Gerald always described himself as ‘a simple clinician’, but those who worked with him found that he was far from that and including him in the basic science team raised novel ideas and concepts that his lateral thinking brought to the table.Gerald was involved in early studies on the function of the substantia nigra and sub-thalamic nucleus inducing electrolytic lesions in primates under the tutelage of Fred Mettler at Columbia University in New York. This formed the basis of his MD thesis which he wrote sitting on a bidet in a former bordello in Paris. He later forged long-term relationships with Professor Merton Sandler at Queen Charlottes Hospital, London studying catecholamine metabolism and, subsequently, the actions and metabolism of deprenyl. He then became fascinated by the potential for curing Parkinson’s disease through the use of foetal cell transplantation and in many respects was a pioneer in this field enabled by another long-term relationship with Professor Harry Bradford at Imperial College London. One of us (PJ) has personal experience of how Gerald never let an unsolved problem rest. One of his earliest studies, in 1963, was in to the cause of nigro-pallidal degeneration in horses induced by the ingestion of the yellow star thistle. Gerald tried unsuccessfully to induce the same degenerative process in both rodents and primates convinced that there was a specific toxin in the plant that had relevance to human disease. Some 30 years later, when MPTP was first coming to prominence, he related these studies to me, and after reading his paper, I was sufficiently convinced by Gerald’s enthusiasm to go back to the problem. Together with a Swiss phytochemist, toxic components of the plant extracts were identified as sesquiterpene lactones (Cheng et al. 1992)—although it still remains a mystery as to why only horses are affected. In his professional life, Gerald Stern was, by nature, a quiet, generous, and unselfish man who gave his time freely to others and was never one to seek the limelight. In fact, many will remember him because of the patronage which he showed to young neurologists and scientists encouraging them to greater things through his enthusiasm for the field. A gift that is not as common today and for which we are poorer. One of us (PJ) will be forever grateful for the support and encouragement that he received from Gerald in the early part of his career—everything from listening my woes to constructive criticism of my work to bombarding me with ideas to ensuring that I took the right path to achieve my ambitions. He was a father figure to many, but never took the credit for doing so much to advance the field of movement disorders in the UK and on an international basis. Perhaps,in these young people, he recognised something of himself and saw their struggles as the ones which he himself had had to overcome. One or two final quotations personify Gerald and his personality. ‘Surround yourself with clever young people who are more industrious, more imaginative, more intelligent than yourself’ and ‘Be nice to old ladies’. Rest in peace dear friend! References Cheng CH, Costall B, Hamburger M, Hostettmann K, Naylor RJ, Wang Y, Jenner P (1992) Toxic effects of solstitialin A 13-acetate and cynaropicrin from Centaurea solstitialis L. (Asteraceae) in cell cultures of foetal rat brain. Neuropharmacology 31:271–277 Lees AJ (2018a) In memoriam: Gerald Malcom Stern (October 9, 1930–September 9, 2018). Mov Disord 33:1831–1833 Lees, AJ (2018b) Munk’s Roll vol. XII, Royal College of Physicians, London. https://history.rcplondon.ac.uk/inspiring-physicians/geral d-malcolm-stern. Accessed Feb 2020 Lees AJ, Ockelford J (eds) (2019) Remembering Gerald Stern. Virginia Keiley Benefaction, London Quinn N (2010) Interview with Gerald Stern, Buenos Aries, MDS Archives. https://www.youtube.com/watch?v=EST-Otslc8g. Accessed Feb 2020 Quinn N (2019) Gerald Malcolm Stern: 9th October 1930–9th Septem- ber 2018. Mov Disord Clin Pract 6:9–10 Stern G (2010) Stanley Fahn Lecture, MDS Meeting, Buenos Aries. https://www.youtube.com/watch?v=q0_MZWVK3mE. Accessed Feb 2020 Stern G (2011) Why catechol? Mov Disord 26:24–26 Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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iladdie · 6 years

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I am a city person. Not a farmer. So when I thought about Hay I sorta also thought about Straw. Dried plant stuff you feed to your rabbits and they sleep on the stuff. On the odd moments in time where I smelled hay or straw I was probably in a pet store or our on excursion to a farm. Hay bales, Straw bales, all the same right?

So what is hay?

Well they are not as it turns out. Hay turns out to be animal feed especially grown and harvested by farmers for just that purpose.

It seems farmers have YouTube channels too and on one of these I found some insights on how Hay is made. Check out The One Lonely Farmers YouTube Channel here.

So Hay is like dried grassy stuff. So like Hay is Grass that was, at some point, cut down and left to dry and then compacted into bales for like easy warehousing.

In the last couple of weeks of walking my dog I took the time to smell grass that was just cut by a lawn mower. Then I smelled some a day later and another day later. Eventually the stuff dried up and I smelled it some more. The wet/cut grass congener blog can be read here.

The dried stuff smelled like hay. That’s no surprise because it is hay.

So what does Hay smell like?

Well the obvious descriptor would be “Hay”. But that is something of a no-brainer and absolutely useless for my Nerdy Blog.

The kind people of the Good Scent Company made a “Grassy” page holding al the chemicals that have a grassy smell. On this page many chemicals are mentioned for the “grassy” smell and Hexanal and Hexanol are also on this page.

The kind people of the Good Scent Company also made a “Hay” and a “New Mown Hay” page holding al the chemicals that have a hay-like smell. On this page many chemicals are mentioned for the “Hay” smell and unfortunately “Hexanal” and “Hexanol” are not on this page.

Between the “Grassy”, “Hay”, and “New Mown Hay” pages there are very little chemical compound matches. Indicating that the smell of freshly cut grass is a different chemical than dried out hay. That sorta makes sense since dried out stuff does not contain the H2O to solve chemicals in.

I am actually not a step further with finding the chemical in Whisky that matches with “Hay”. So let’s see what the Scientific Community has to say. I copied in all the chemicals that I found on the Good Scent Company page and tried to find out which ones are actually in Whisky. The Chemicals are in order of decreasing odour activity.

para-methyl phenoxyacetaldehyde odor: powerful hay melon ozone floral 2-isopropyl-5-methyl-6,8-dioxa-bicyclo[3.2.1.]octan-7-yl-methyl-ketone odor: hay note benzyl eugenol odor: warm spicy hay para-chloroacetophenone odor: sweet mild acetophenone hay para-dimethyl hydroquinone odor: sweet green new mown hay fennel flavor: sweet green hawthorn new mown hay anisic anise fennel powdery fatty 1,2-dimethyl propyl 3-butenoate odor: fruity with hay quality, less complex and less intense, not appealing (R)-gamma-hexalactone odor: sweet coconut hay herbal methyl nonane dione odor: fruity straw caramel burnt 5-methyl tetrahydrofuran-3-one odor: sweet hay coumarinic octyl crotonate odor: fruity with hay quality, winey with mushroom note, slightly harsh and chemical 2-acetyl-5-methyl furan odor: strong musty nutty hay coconut coumarin milky flavor: Nutty cocoa-like with a toasted bready nuance para-anisyl nitrile odor: sweet floral hawthorn hay coumarin para-cresyl caprylate odor: animal fecal hay ylang jasmin indole green flavor: animal fecal leathery herbal phenolic (R)-gamma-heptalactone odor: sweet spicy herbal hay coumarin trimethyl-3-cyclopentenyl acetonitrile odor: pine rosemary hay 1,3,4-trimethyl-2-methylene pentyl 2-butenoate odor: fruity with dry hay quality, winey, woody, slightly oily, chemical with aldehydic fatty note 1,2,2-trimethyl propyl 2-butenoate odor: fruity, sweet, slightly hay-like, and slightly metallic acetaldehyde dimethyl acetal odor: sharp sweet alcohol ether green new mown hay flavor: sharp ethereal alcoholic fruity green privet Iso-amyl geranate odor: rose lemon honey hay ethyl 3-hydroxyhexanoate odor: fruity grape burnt wood hay spicy pineapple cranberry dusty woody flavor: sweet fruity tropical grape grassy hay cranberry citrus (E,Z)-3,5-octadien-2-one odor: fatty fruity hay green herbal D-(+)-beta-pinene odor: sweet fresh pine woody hay green 2,4,4,6-tetramethyl cyclohexa-2,5-diene-1-one odor: warm sweet slightly minty woody natural green hay butyl phenyl acetate odor: rose honey chocolate flavor: Honey, sweet, chocolate, floral and rose-like dextro-dihydrocarvone odor: warm powerful herbal spearmint flavor: Green, spicy, minty and woody with a camphoreous nuance 3-octen-2-one odor: earthy spicy herbal sweet mushroom hay blueberry flavor: Creamy, earthy, oily with mushroom nuances gamma-heptalactone odor: sweet coconut nutty caramel tonka hay flavor: Sweet, lactonic, creamy, coconut and coumarin, with milky and tobacco nuances 3-phenyl propyl acetate odor: sweet balsam storax spicy cinnamon flavor: Balsamic, floral, fruity, sappy, spicy and cinnamic with powdery nuances 3,5,5-trimethyl hexanol odor: grassy green weedy floral earthy aldehydic hay straw leaf flavor: Green, cooling, herbal, woody, musty, berry, melon, with minty nuances

After lot’s of Command Find searches in many documents I could not find even one of the above chemicals listed in the articles that led to the Revised Scottish whisky Flavour wheel. This seems to correspond with the observation that Monica Lee, Author of the review that led to the Revised Scottish whisky Flavour wheel also could not find the chemical responsible.

The only chemical that comes close to being the one is ethyl 3-hydroxyhexanoate with these odour descriptors: fruity grape burnt wood hay spicy pineapple cranberry dusty woody. See PubChem for more.

I come to a somewhat disappointing observation that I haven’t been able to pin down “Hay”. Ah well, I will probably live!

#RSWFW: C: Grassy, 2. Dried, Hay I am a city person. Not a farmer. So when I thought about Hay I sorta also thought about Straw.

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alchemistalley · 6 years

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Online shopping from a great selection at Alchemist Alley Store. Chamomile: Still a Top Choice for Improved Well-Being People popularly know chamomile as a flower with a daisy-like appearance.1 However, this member of the Asteraceae or Compositae family is actually a potent herb.2 There are two known chamomile plants today: German chamomile (Matricaria recutita) and Roman chamomile (Chamaemelum nobile).3 German chamomile flowers are tiny and have white collars and hollow receptacles, surrounding a raised and cone-shaped yellow center. The flowers are less than an inch wide, grow on long, thin and light green stems and are distributed in a comb-like arrangement. The plant’s leaves are tiny and twice-divided into linear segments.4,5 German chamomile develops wild and close to the ground, but can be also found in herb gardens. This plant, which grows up to 3 feet tall, is native to Europe, North Africa and some parts of Asia. Meanwhile, Roman chamomile has inch-wide white flowers, a disk with a broader conical shape and a solid receptacle. Its leaves are flatter and thicker and are twice or thrice divided into linear segments, and its flowers sit atop slightly hairy stems. Roman chamomile is usually found in Western Europe, northward to Northern Ireland.6 Chamomile’s Important Benefits There are many vital health benefits of chamomile:7,8 • Calming down nerves, promoting general relaxation, relieving stress and controlling insomnia • Combating allergies, eye inflammation and infections • Alleviating muscle spasms and menstrual cramps • Relieving nausea, heartburn and stress-related flatulence • Helping to ease stomach ailments, gastritis, ulcerative colitis, diverticular disease, Crohn’s disease and irritable bowel problems These benefits are linked to the volatile oils found in chamomile flowers, which include bisabolol, bisabolol oxides A and B and matricin, as well as other bioactive ingredients:9,10 Chamazulene or azulenesse Farnese and spiro-ether quiterpene lactones Glycosidese Hydroxycoumarins Flavonoids like apigenin, luteolin, patuletin and quercetin Coumarins like herniarin and umbelliferone Terpenoids Mucilage Common Uses of Chamomile Chamomile is known for its medicinal uses, especially in ancient Egyptian, Greek and Roman civilizations. It helps treat or alleviate conditions like:11,12 Chest colds Sore throats Gum inflammation or gingivitis Acne, psoriasis and/or eczema Minor first-degree burns Abscesses Inflammatory bowel disease or ulcerative colitis Stomach ulcers and cramps Diarrhea or gas Anxiety Insomnia Chickenpox, diaper rash, colic and teething problems in children Nowadays, chamomile can be used to relax muscle contractions, typically the smooth muscles of the intestines. It’s added to salves, lotion or a wash or compress to relieve hemorrhoids, wounds, burns, irritation, cold or canker sores, pink eye, dermatitis and inflammations of mucous tissue.13,14,15 Chamomile is also used as a mouth rinse for sore gums, gingivitis or inflammation of the oral cavity,16 while chamomile vapor may help alleviate cold symptoms or asthma.17 Some salads, soups or drinks use fresh or dried chamomile flowers. The essential oil and flower extracts are also added into foods, while chamomile leaves can be used in salads or steeped into tea.18 Sometimes, chamomile is incorporated into skin and hair care products, ointments, shampoo, soap, detergent, perfume and cosmetics. Chamomile extract may be useful for these purposes:19,20 Mosquito repellent Biological pest control Improvement of dairy Veterinary medicine Reclamation of sodic soils Bioremedication for metals like cadmium How to Grow Chamomile To grow chamomile, use seeds that are relatively easy to grow or plants that can be established quickly into your garden. Plant chamomile in an area with cool weather and under partial shade, (not in areas where summers are hot and humid), and in dry soil with an acidity between 5.6 and 7.5.21,22 Ensure that chamomile plants are at least 6 inches apart from each other.23 Growing chamomile actually involves little fuss, and going overboard on fertilizer may lead to weakly flavored foliage and few flowers. Overwatering should be avoided too, and you must allow the soil to become virtually dry and then soak thoroughly. Chamomile is drought-tolerant, and may only need to be frequently watered during prolonged drought.24 Chamomile plants are recommended as a “companion plant” alongside vegetable crops, since the strong scent keeps potential pests away. Just make sure to check the plants thoroughly. If plants are weak due to a lack of water or other issues, they may attract insects like aphids, mealybugs or thrips.25,26 What Is Chamomile Tea Good For? Drinking chamomile tea is a popular way to get your daily dose of chamomile. Aside from having little to no caffeine (chamomile tea is naturally caffeine-free),27 there are numerous health benefits linked to chamomile tea:28 Improves skin health: Chamomile tea can effectively eliminate oxidative stress and enhances immune response. Boosts immune system: The tea’s phenolic compounds target bacterial infections to help eliminate them from the body. Relieves menstrual discomfort: Bloating, cramping, sweating, inability to sleep, mood swings and other problems experienced during periods may be improved by drinking chamomile tea. Lessens stress: Chamomile tea raises your serotonin and melatonin levels, eliminating feelings of stress and worry, slowing down the mind and combatting anxiety symptoms. Promotes better sleep: For those dealing with restless sleep, chamomile tea may be particularly helpful. It helps you fall asleep faster and wake up feeling more refreshed. Helps manage diabetes: Chamomile tea combats massive drops and spikes of blood sugar levels, and regulates the insulin in the blood. Alleviates stomach issues: Chamomile tea assists in easing the gut’s twisting nature, allowing gas and bowel movement. Strengthens hair: Chamomile tea relieves scalp irritation, builds better hair strands, eliminates dandruff and gives your hair a silkier appearance. Lessens allergic reactions: Chamomile assists with modulating immune response to allergens, and is a known anti-histamine that soothes allergic reactions and prevents worsened symptoms. Enhances health of pregnant women:29 Drinking chamomile tea while pregnant could alleviate morning sickness, constipation, gas or bloating. Reduces colic in babies:30 Diluted chamomile tea may help relieve colic in babies by relaxing their intestines. Try applying hot or cold chamomile tea on irritated skin. A study discovered that direct application could boost healing and reduce appearance of blemishes and wrinkles. Continuous intake of chamomile tea may prevent development of more serious gut conditions. Prior to giving chamomile tea, consult a pediatrician first, since some babies may be allergic to it. If you want to make chamomile tea, try this recipe:31 Chamomile Tea Recipe Ingredients: 2 tsp. dried chamomile flowers 2 cups hot water Optional: 2 tsp. raw honey Procedure: 1. Mix chamomile flowers in hot water and let it infuse for two to three minutes. 2. Strain and serve. 3. Optional: Add honey to flavor it. Take note that chamomile tea can lead to side effects, like allergic reactions and anaphylactic shocks or severe allergic responses, especially if you’re also sensitive to ragweed, daisies, marigold and chrysanthemum.32 Pregnant or breastfeeding women must limit their chamomile tea intake, as its anti-inflammatory properties could be harmful, depending on the expectant mother’s medical history, consumption and other factors. Pregnant women who have a history of hay fever or pollen allergies shouldn’t drink chamomile tea at all.33,34,35 Excess chamomile tea consumption raises a pregnant woman’s risk for preterm labor, excessive uterine contractions, premature delivery and miscarriage (since the tea may serve as an abortifacient). Plus, children whose mothers drank too much chamomile tea were more prone to have circulation problems.36 Make Chamomile Oil a Staple, Too You can reap some of chamomile’s benefits by using chamomile essential oil. German chamomile flowers yield a meager 0.2 to 0.4 percent essential oil, while Roman chamomile flowers produce 1.7 percent essential oil.37 You can find the following ingredients in these oils:38 German Chamomile Oil Roman Chamomile Oil • Oxide azulenes like chamazulene and acetylene derivatives • Farnesene • Sesquiterpenes • Cadinene • Furfural • Spanthulenol • Proazulenes like matricarin and matricin • Alpha-bisabolol • A-pinene • B-pinene • Camphene • Sabinene • 1,8-cineole • Myrcene • Caryophyllene • Y-terpinene • Propyl angelate • Butyl angelate • Chamazulene • Sesquiterpene lactones of the germacranolide variety, particularly nobilin and 3-epinobilin Chamomile oil can induce sleep, calm down nerves and promote a general sense of calmness, making it ideal for people who are nervous or have anxiety problems. It also can help reduce pain caused by sore muscles, tight joints, menstrual cramps or back aches, relaxes your digestive system and relieves indigestion and other stomach problems.39 Chamomile oil is a mainstay in some cosmetic products, since it soothes redness, irritation, itchiness and swelling triggered by rashes or skin irritants. Meanwhile, chamomile oil’s antibacterial properties can assist with wound clean-up and protection. Try inhaling chamomile oil directly or add a few drops to a vaporizer. This works in relieving headaches and soothing nerves. You can also apply it topically to soothe skin problems, add to your bath water or incorporate into cream-based lotions. You can add one to two drops of oil in a glass of water to use as a mouthwash or a remedy against an upset stomach or other gastrointestinal problems. A blend of chamomile and olive oil could be helpful in massaging aching muscles or joints. Storage Tips for Chamomile Ideally, harvest chamomile during the summer. Chamomile flowers continue to bloom all summer long if these are picked daily. However, a major challenge in growing chamomile is the different blooming schedules of flowers. As a rule of thumb, try to harvest chamomile 30 days after the seeds first sprout:40,41 1. Begin harvesting chamomile flowers in the morning after the dew has evaporated, but before the sun is high. 2. Harvest flowers that are nearly open. Pinch the stalk just below the flower head and pop off the bloom. Collect in a tightly woven basket. Once harvested, shake the flowers and check for insects or dirt.42 While you can use fresh flowers immediately, you can also dry chamomile flowers for future use:43 1. Lay flowers in a single layer on trays. 2. Set oven or dehydrator temperature between 115 and 125 degrees F and dry for three to five hours, checking carefully after four hours and rotating the trays periodically to ensure the flowers are evenly dried. Make sure to not overly dry the flowers. Chamomile flowers are considered dried when the tiny petals curl inward, and the blossom’s center is totally dry. 3. Store in an airtight container, out of sunlight. Chamomile May Come With Risky Side Effects Although occurrences of chamomile side effects are relatively uncommon, chamomile can trigger vomiting or allergic reactions, such as difficulty in breathing, closing of the throat, hives or swelling of the lips, tongue or face. Consult a physician or take an allergen test prior to taking chamomile, especially if these conditions apply to you:44,45,46 • If you’re taking warfarin (Coumadin) or another blood thinner (you may not be able to take chamomile or would require special monitoring during treatment) • If you’re allergic to ragweed, asters, marigolds, chrysanthemums or celery, as well as other members of the daisy family, namely arnica, artemisia, feverfew, tansy and yarrow #alchemistalley #holisticwellnessspecialists #DrBowe #DrRacquel #herb #newageherbalist #metaphysicalherbalist #healer #healthiswealth #cbd #tincture #growth

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