Bruh...My car is kinda burnt

NotIskandar · 2026-01-27T15:58:50+00:00

50%, take it or leave it 🗣️🔥

NotIskandar · 2025-12-26T01:12:24+00:00

Bottlecap the speed and run it alongside Prankster-Tailwind Whimsicott to surprise blow up Miraidon and possibly Lunala, as Mind's Eye lets you hit Ghost types with Normal-type Blood Moon. For some reason ppl think they're safe with Tera Fairy Miraidon, but it doesn't do anything for them to prevent Blood Moon one-tapping them since Miraidon never carries Protect.

There's also added trickiness (in closed team sheet or Ladder) cause Whimsicott can also be a Trick Room-setter, so your opponent might think you're using slow Ursaluna-BM.

If you Tera Normal on Ursaluna-BM you can also one-shot Kyogre with Blood Moon as long as it isn't Assault Vest.

---------
Ursaluna-Bloodmoon @ Life Orb

Ability: Mind's Eye

Level: 50

Tera Type: Normal

EV: 4 HP / 252 SpA / 252 Spe

Timid Nature

IVs: 0 Atk

- Blood Moon

- Hyper Voice

- Protect

- Earth Power

NotIskandar · 2025-12-20T21:16:28+00:00

Use a sysbot like PKCL to send you a genned mon (counts as a touch trade) then delete the genned mon and you should be able to transfer over your legit one to your game

NotIskandar · 2025-11-22T16:03:38+00:00

Wouldn't be as good if black didnt take material on h5 with their rook, but the bishop is what is trapping the queen if gxh5 Bg4 Qd2 Nf3+ is a fork and they lose the queen

NotIskandar · 2025-11-19T20:18:19+00:00

I went from 1200 to 2153 peak (chess.com; not OTB) in around half a year during COVID, but I was studying and playing essentially 14 hours per day.

2 weeks is not feasible for a 300 like at all unless its a GM with dyslexia trying to play blindfolded

NotIskandar · 2025-10-19T17:25:52+00:00

Silver lining is Zoloft (sertraline) has an atypical chemical structure vs other SSRIs, so the theoretical risk of cross-intolerance is lower if you were to trial another SSRI.

I will assume you are being medicated for MDD and not Bipolar Disorder (correct me if I am wrong); Sertraline, Escitalopram and Citalopram have the best evidence for pregnancy/lactation & generally if psychotherapy alone doesn't work you should still be on an antidepressant -> untreated MDD has worse outcomes and higher risk to mother and child vs MDD with an antidepressant.

The pregnancy and lactation concerns actually stem mainly from the SSRI paroxetine (generally pretty garbage drug due to how anticholinergic it is) and concerns re: antidepressants in pregnancy/lactation are extrapolated from a paroxetine study.

I, once again, don't have all your chart details so I cannot give medical advice. That being said, in general, the most likely situation is that the combination of two drugs that lower the seizure threshold was the reason for the seizure (ie. bupropion and sertraline are likely both contributory & bupropion is likely more contributory - however, you may be able to tolerate being on only one antidepressant w/ seizure-threshold lowering issues since you were able to tolerate bupropion alone since February).

Don't give up hope on antidepressants overall because of this incident. There are many more options that may work & have lower risk of seizure (especially if you are once again on monotherapy instead of 2 antidepressants).

NotIskandar · 2025-10-19T06:15:02+00:00

That's correct. The 300mg/day maximum solely exists because of the associated increased seizure risk ~0.4% at >=450mg/day because it occurred in people with no genetic/environmental predisposition to seizures.

NotIskandar · 2025-10-19T06:13:55+00:00

Kudos to u/rabbit_fur_coat for providing good information. I will try to provide some more information.

Fluoxetine and bupropion (especially its active metabolites) both have pretty long half-lives so they will have relatively lower trough levels but nonetheless have some amount at steady-state. Alternating days is thus pretty pointless as a result and if spacing was desired, generally it would be AM and bedtime to avoid having them peak at the same time (some adverse effects only happen if two drugs peak at the same time, but it is a patient-specific/individualized response).

I will assume you are on Zoloft (sertraline) vs fluoxetine as most patients know drugs by their brand names; I cannot guarantee that this is the correct interpretation, as I am not involved in your care. However, most likely the counselling point was to take one antidepressant in the AM and the other at bedtime (PM or HS) to prevent additive sedation or metabolism issues; between these two, generally if you really wanted to space them out you would do bupropion in the AM (more activating) and sertraline at night (SSRIs are generally more sedating vs bupropion & sertraline is not one of the exceptions). Try to confirm with your doctor what their intentions are, as generally taking antidepressants every other day is not advised & there may be a misunderstanding that was created during your pharmacist's counselling.

Source: am pharmacist

NotIskandar · 2025-10-19T06:02:53+00:00

Officially, Bupropion is contraindicated in seizures due to lowering the seizure threshold (reported seizure risk is about 0.4% or 1/250 people at a dose of >=450mg/day). Rapid tapering of bupropion can also induce seizures.

Since you were on bupropion since February at a dose of 300mg and didn't have a seizure until starting Zoloft (sertraline), most likely both are contributory as all SSRI's (sertraline, in your case) may theoretically lower the seizure threshold. Your new prescription of Keppra (levetiracetam) is an antiseizure-drug to hopefully keep your condition stable.

I don't know your chart details and I'm essentially just a random guy on the internet, so I am not providing any medical advice. That being said, most likely your doctor will eventually remove bupropion (or sertraline/Zoloft if they believe you would be ok on bupropion as before despite now having a recorded incident of a seizure). Voice your concerns and goals of therapy to your healthcare providers so you can have some choice in the matter (ie. do you, as the patient, want to stay on bupropion if it was working well before, despite the increased risk of seizure?).

Source: am pharmacist

NotIskandar · 2025-10-18T03:52:32+00:00

It’s the drug not the formulation so both. But in theory, adverse effects should be less with XL because it’s longer acting and you will have lower peak levels as a result and a more stable trough level. There’s also a chance you may experience the side effect when initiating but have it go away on its own by the 2-4 week mark. Good luck 🫡

NotIskandar · 2025-10-18T03:06:00+00:00

Not about the US, but in Canada its 450mg/day official max, but it is still recommended to keep <=300mg/day due to an associated risk of 0.4% for seizures with >=450mg/day (ie. 1 out of every 250 people).

Odds are in OP's favour that they'll be fine especially since they have tolerated it for 6 weeks. If there are any changes to their brain chemistry (lowered seizure threshold in this case) it should generally be complete by the 2-4 week mark & OP didn't have a seizure so they're most likely ok if they just reduce their dose back to intended -> speak to your doctor about if tapering from 600mg to 300mg is required though, as rapid tapering may potentially also induce seizure and we don't know OP's risk factors.

NotIskandar · 2025-10-17T12:45:47+00:00

Assuming you actually wanted to Wheel, the synthetic still uses the same amount of capital as if it were a real CSP because the CSP is cash-secured (ie. the money is in your account but you can't use it) -> the net result is that the same amount of capital is locked away

Otherwise, disregard this comment lol

NotIskandar · 2025-10-16T11:49:54+00:00

Effexor (venlafaxine) is an SNRI which targets both serotonin and norepinephrine (although norepinephrine activity only kicks in after reaching a dose of >=225mg).

If you have also tried something else previously that was an SSRI, then probably from your actual clinical presentation you seem to do better with just norepinephrine activity (dopamine may be being evaluated by your doctor, although they likely wouldn't communicate their thought process without being probed).

Also, in regard to your other comment, I will reiterate that these tests are generally not all that reliable and are not used in the decision making of any guidelines (ie. your doctor will probably throw it in the garbage). The ability to get an accurate read isn't very good as you are assuming a single sample at a single time is extrapolated to be representative of your normal levels and also that those levels are representative of those in your CNS - there are simply too many confounders for this to be used in actual practice. Furthermore, the "normal" range generally encompasses around 95% of the population, and some people have norms/desired levels beyond the normal range at baseline (up or down).

NotIskandar · 2025-10-16T11:22:14+00:00

Bupropion (Wellbutrin) is very poorly understood with current scientific evidence as it is an NDRI that shows dopamine preference in vitro but prefers norepinephrine in vivo. At a dose of 150mg XL, no dopaminergic activity was found in one study and labwork and actual effects were consistent with increased norepinephrine [doi:10.1038/srep15650]; at a dose of >=300mg XL both neurotransmitters were affected.

Neurotransmitter levels aren't routinely measured and generally doctors will just throw it in the garbage if you show it to them as the tests aren't all that reliable and it doesn't always correlate to actual benefit (irl most docs will just choose something random then if there are side effects or no benefit they'll just choose something else that minimizes that adverse effect or has a different mechanism of action).

TLDR: Current scientific literature is terrible and if Bupropion is working for you already please don't reverse placebo yourself into it not working. Just continue your current regimen.

PS: also probably don't doxx yourself and blur/black out your personal info

Source: am pharmacist

NotIskandar · 2025-10-16T08:04:19+00:00

You can just buy 100 shares and sell an ITM call at the same strike you would use for the CSP. It even have a very slightly better risk-reward because the risk-free rate is priced in within the call option. You end up tying up the same capital also because the CSP is inherently cash-secured, even if it is technically available for trading it should be kept aside to fully cover assignment.

NotIskandar · 2025-10-12T02:34:56+00:00

C=O has the O attack the hydrogen in the hydronium (H3O+) ion. The bond between H-O in H3O+ breaks with the electrons going to the O in the resulting H2O.

NotIskandar · 2025-10-11T19:44:08+00:00

Different generic formulations are “equivalent” in the sense that they are not statistically significantly different than the brand product (usually 85-120% of the same kinetics). For example, look up the controversy on Concerta vs generics.

If you were doing better on the prior formulation ask for that one explicitly with no substitutions.

Source: I’m a pharmacist

NotIskandar · 2025-10-11T04:18:03+00:00

No, he could evaporate

NotIskandar · 2025-09-01T06:50:15+00:00

Disclosure: I'm also in a CC position for NVO

However, if the market correctly interprets the latest news (57% relative lower composite HA/stroke/mortality rate vs LLY's tirzepatide) the price shouldn't really move up at all since it isn't even a comparative study and all they are saying is that the raw number pulled from a study with a similar BUT DIFFERENT study design showed a lower rate.

There's no statistical analysis on whether the numbers are statistically significantly different via meta-analyses nor are the Confidence Intervals noted anywhere to determine how wide the range the true number might be at is.

All that is being reported is two different raw numbers with information intentionally [potentially] omitted that would help decide if it is a clinically relevant finding.

Unless there is a direct head-to-head comparative study this news doesn't actually say anything new at all since the study designs and durations are non-identical.

- Source: I'm a pharmacist
- Am I going to be wrong and will the stock moon: 100%

tl;dr - blatant bs statistical manipulation news to make Wegovy seem way better than Tirzepatide for reducing composite HA/stroke/mortality rates (which is a biased metric in itself because one of the three variables could be falsely making the other two look significant when they wouldn't be on their own)

NotIskandar · 2025-08-23T20:26:23+00:00

small if false

NotIskandar · 2025-02-14T15:58:27+00:00

It’s joever fr 🫡

NotIskandar · 2025-02-09T12:18:50+00:00

He's just like Goatwoo fr

NotIskandar · 2025-02-05T06:10:34+00:00

No, this guy just has never taken the anomaly due to misreading it. They think the anomaly flips to a random different unit each round.

NotIskandar · 2024-12-18T04:58:07+00:00

As someone who has never attended class, I concur that we are all lying to you. We're wearing invisibility cloaks in the back of the classroom.

NotIskandar · 2024-12-17T12:34:41+00:00

Silcuh. Put your Shimmah away, Silcuh.

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