The Role of Glutamatergic Signaling in Major Depressive Disorder

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  • Опубликовано: 23 дек 2024

Комментарии • 146

  • @josecardona1050
    @josecardona1050 4 года назад +45

    With much sincerity and honesty I confess that I have reveled in this presentation. Dr. Rakesh possesses magical communication skills. Thank you for your contribution to science.

    • @whbclaire
      @whbclaire 2 года назад +3

      We need more doctors like him. I'm a medical director in CME and I am already trying to figure out what program we can recruit him for.

    • @aphysique
      @aphysique 2 года назад

      @@whbclaire what would you suggest as medication for anxiety & or depression.. Benzo's really helped in previous yrs, however they cause worse signaling & the normal baseline of anxiety I do believe are elevated if one doesn't tke these meds all the time?

    • @goodintentions1302
      @goodintentions1302 2 года назад +1

      As a 73 years old highschool graduate woman, treatment resistant depressed person who deals with as yet unhealed childhood SA by a number of family members, Lupus, Hashimoto's, a left frontal meningioma, Chronic Regional Pain Syndrome, extremely severe sleep apnea with Central Sleep Apnea being primary, this starting to play spontaneously after a video I'd chosen... What a blessing! Although I don't understand everything, I know other things to research. I've had to be my own advocate & I've always been a reader who researches my issues. I'm disappointed that doctors still try to convince me to take another antidepressant & have never mentioned ketamine. I'm finally taking LDN, which has helped me with neck & back pain, as well as CRPS, after years of trying to convince doctors who either didn't know about it, or believed pain medication, with detrimental side effects was a better idea. In my area of the country, doctors tend to move away so it hasn't an option to stay with one primary care doctor. Thank You for sharing this! I'll definitely be listening to this several times. ☮️🙏🏼

    • @goodintentions1302
      @goodintentions1302 2 года назад +1

      I also want to add that within the first few minutes I went to my kitchen & took the L-glutamine supplement I purchased for my gut. ☮️💞🙏🏼

    • @marshahines3171
      @marshahines3171 Год назад

      @@goodintentions1302Bravo🌀🙏🏽💙
      Good for you to continue your own research & journey for your mental/emotional health.
      Much • Much Admiration!
      I’m finding a Ketamine therapist who integrates with Internal Family Systems therapy.
      Bright future if docs pay attention! ❤

  • @yeastspread3433
    @yeastspread3433 3 года назад +10

    That glutamate into glutamine, is what causes the inflammation in brain nerve cells, which presents as depression/anxiety in the cognitive experience, I almost missed the glycin in the reaction chain and didn't realise the implication. It's why any inflammatories such as tumeric/cumin/lions/panadol mane work so well to reverse the brain fog, it was just an inflammation issue.
    Thank you, I was able to end 14 years of anxiety and depression with the information from this lecture, the most important lecture of my life. I have a very good autobiographical memory (as does everyone in my family) and now I can revisit my memories without being overwhelmed and just learn and observe now.

    • @Army1SGRetired
      @Army1SGRetired 3 года назад +2

      If I may ask, how did you end your anxiety and depression?

    • @yeastspread3433
      @yeastspread3433 3 года назад +4

      @@Army1SGRetired For me, a mix of functional mushroom teas (no psychaleics) did most of the work. I suspect lion's mane was the most important one (beta gloucons and anti inflamitories for the brain). I used a mix of Lions mane, Reishi, Chaga and Turkeys tale.
      I suspect the main issue on a chemical level effecting my conscious experience was inflammation of my nerve cells (brain fog and anxiety symptoms tracked back to this). So I did as much as I could to reverse that, and supply the beta gloucons (in lion's mane, of even oats) to heal the damage, lead to a massive improvement personally.
      While I can still experience sadness/regret, it passed much faster and doesn't stay with me long. It's not like being in any antidepressants I've had.
      The other half of the equation was finding my way to increase VTA dopamine flow. The most dominate and sustainable pattern appears to be setting a long term ethical life goal that feels like it's a 50/50 change, and thats stimulates the VTA dopamine.

    • @dawnlokki4734
      @dawnlokki4734 2 года назад +3

      L thiamine and magnesium glycanate also.

    • @yeastspread3433
      @yeastspread3433 2 года назад +4

      @@Army1SGRetired in the end. I had to find a way to look at my trauma, and recover from it. And it all comes out as tears. When we "bottle up our feelings" they litteryally get stuck in our body "the body keeps the score" and I suspect it's this glutamate/GABA/glutamine cycle.
      But once you heal one trauma, you will forever have tools and a way to heal all your traumas, and it's just a matter of time.
      I strongly recommend lion's mane as a tea, to re-grow the neurons we loose after so many years of depression and anxiety (which slowly melts the pre-frontal cortex).

    • @Army1SGRetired
      @Army1SGRetired 2 года назад +2

      @@yeastspread3433 thanks for sharing what worked for you and I'm so glad to hear you have made such great progress!

  • @toddbukauskas8804
    @toddbukauskas8804 2 года назад +3

    I was so sad when I realized the presentation was over.
    It's okay, I'll just watch it again.

  • @VapidVulpes
    @VapidVulpes 9 месяцев назад

    Yes, these next two slides are indeed exactly why I came here. This worked so amazingly well, that I have been able to learn how to love myself in a way that I had never knew I needed for 35 years of my life. All I want to do now is better understand this mechanism and all of the related mechanisms so that I can do what this substance has done for me, on my own with my own brain chemistry and exercise and life and diet and everything in between. Absolutely amazing stuff! Such a great lecturer! Thank you so much for this!

  • @belugabath
    @belugabath 3 года назад +3

    Dr Rakesh one of best speakers I have seen Dr Agresti

  • @cxdyjak
    @cxdyjak 2 года назад +1

    Dr Jain, It is always such a joy to hear you speak and take complex material and processes and make them entertaining and simple. It was a pleasure working with you while I was at Eisai. Thank you!

  • @baileybayer9462
    @baileybayer9462 3 года назад +3

    The concepts, information, and resources within this presentation could change the way we look at the mechanisms of the brain forever. Truly one of the most important lectures I have ever seen, thank you

  • @lifeisfun_28
    @lifeisfun_28 3 года назад +2

    I could listen to him all day long!! Amazing stuff! Thank you for posting it in RUclips

  • @sarapanzarella97
    @sarapanzarella97 2 года назад +9

    I found the first half great. As someone who has suffered from not being able to handle excess glutamate my whole life and finding ways to mitigate it - I am drawn to any good presentation on the subject. But where the medical field always seem to miss their mark is the WHY - in this case why does the individual have this problem with glutamate in the first place? Not everyone has issues it - before shooting at your goal in the dark look at the individuals genetics and then tailor your treatment - your outcomes will be much better. Like I have a ton of variants in the GAD1 genes that are suppose to make GAD67 enzyme - which converts glutamate to GABA - help me with that and you will help me in my journey instead of a "lets try this and see if it works".

    • @hiljim01
      @hiljim01 Год назад

      as i said in my reply you should look at dr holton's work with gulf war and fibromyalgia.

    • @Boojerella
      @Boojerella Месяц назад

      Do you have any generational, birth or childhood traumas?
      I have similar genes - and together with all three types of trauma - my nervous system has been running on glutamate. Always a driven adrenaline junkie perfectionist who was in chronic hypervigilance in my surroundings. and so I figure I’ve always had a full bucket - doesn’t take much to tip it over with any amount of stress. But clinically - I would give this presentation all the awards if it tied in the CELL DANGER RESPONSE” where glutamate and calcium act as triggers of danger to our mitochondria. Until we use nervous system tools to calm our nervous system - the immune system can’t kick into gear- explains chronic disease - the inability to return to wellness. CDR - research by Dr Robert Naviaux

  • @swarajjoye
    @swarajjoye 2 года назад +11

    Hi Rakesh, what a mind blowing presentation. Excellent work. I appreciate your time, effort, research, dedication and commitment in preparing this presentation.
    I couldn't agree more on all suggestions and treatments.
    I would like to add on few suggestions if you don't mind.
    In addition to Glutamate based therapy, Ketamine, or Esketamine, physical exercise and meditation. Dietary and fluid consumption is also as important as the above, especially have a diverse gut bacteria, gut bacteria. In recent researchers, our gut have millions of neurons which cleverly interact with the brain neurotransmitters, serotonin, dopamine, Glutamate, and others.
    Food high in magnesium and zinc.
    Good Sleep hygiene.
    Glutamate therapy is no doubt the most effective intervention for treatment resistant depression, but we also need to emphasise on healthy eating and sleep hygiene.
    In this current era, many food are destroying our gut colony, we haven't got a diversity gut bacteria. We rely on fast food, process food, and sadly enough increase use of pesticides.

  • @VapidVulpes
    @VapidVulpes 9 месяцев назад

    Presence of psychiatric symptoms, and the absence of wellness. Such a great way of putting it!

  • @LaurieRojas
    @LaurieRojas 2 года назад +1

    this is the best deep dive into Ketamine research for MDD

  • @CrossCultural-c7f
    @CrossCultural-c7f 5 лет назад +12

    Rakesh, That was an awesome lecture!! I love your enthusiasm and as usual, your clear explaination. Like the geek that I am, I saved it on my youtube list.

    • @CrossCultural-c7f
      @CrossCultural-c7f 3 года назад +3

      Rakesh - HaHa!!! I am listening to this presentation again. I shared the link with a patient of mine who is a fellow physician who just seems so fixated on adderall and dopamine for his ADD. I hope your presentation helps him see why psychiatry is a medical specialty. I do appreciate your big picture view.

  • @specialist-in-tech
    @specialist-in-tech Год назад +1

    Wow. And this is more than 4 years ago. How come so few psychiatrists adopting this in their practices ? FDA approval problems ? Malpractice worries ? In ability to understand, regulate or manage ? No use of blood tests for glutamate toxicity ?

  • @JustT725
    @JustT725 3 года назад +1

    This should be a TED TALK!

  • @lorenatorres8705
    @lorenatorres8705 4 года назад +3

    This conference is so insightful and complete... thank you very much Professor!

  • @pssix03
    @pssix03 Год назад

    So awesome, brought tears of joy to my eyes ❤❤

  • @hiljim01
    @hiljim01 Год назад +2

    I would have appreciated some discussion of diet. With so many dietary additives that work thru the glutamate system that seems to be low hanging fruit. I would look at the work of dr holton with gulf war veterans that is amazing and very relevant to this talk. BUT this talk is amazing sir excellent work and i love that it is on youtube now i can watch it a few times so i can force it into my brain. thanks for your hard work.

  • @The_Tiffster
    @The_Tiffster 3 года назад +1

    Phenomenal presentation! It takes superior skill and talent to deliver this type of information in a manner that is so engaging and interest-provoking! I love his passion! I could listen to him talk all day!

  • @greggl.friedmanmd7512
    @greggl.friedmanmd7512 4 года назад +3

    Excellent Psychiatry Video. 5 Stars. By Gregg L. Friedman MD

  • @krishnavaddadi9829
    @krishnavaddadi9829 2 года назад +1

    Excellent presentation Thank you

  • @brucehutchinson9527
    @brucehutchinson9527 3 года назад +1

    Totally transformative concepts.
    Mind-blowing figuratively and literally.

  • @theallin1mentalhealthchann914
    @theallin1mentalhealthchann914 3 года назад +4

    I'm a provider and received Ketamine Infusions IV and now at home. You can get at home treatments which are sent to your home, sublingual (under the tongue) or nasal for less than $400 for a month of treatment. This is less than cost of an infusion, includes the MD, prescriber, staff. The reason is the prescription of Ketamine is typically $30. Im a licensed provider in 10 states and it is more of a cure than anything I have seen by far. PTSD/OCD/Treatment Resistant Depression in me and better than I have ever been in 20 years.

    • @tim40gabby25
      @tim40gabby25 3 года назад +1

      Interesting. Do you have any reference which summarises the system you describe? I'd appreciate that. UK concerned parent here.

    • @theallin1mentalhealthchann914
      @theallin1mentalhealthchann914 3 года назад

      @@tim40gabby25 Hi Andrew, what are you exactly looking for? Companies that provide this or research articles? If you are looking for research you can watch/research videos here, testimonals of patients and providers plus I read research articles I found, I also watched a hour long conference in Australia with a MD among other MD's in his 7 year experience conducting Ketamine treatment...hope this helps or starts the process...

    • @tim40gabby25
      @tim40gabby25 3 года назад +1

      @@theallin1mentalhealthchann914 Thank you. This is what the Net does best. Starts the process. Prof Nutt in the UK is the man, I'm guessing we're a tadge behind. SSRIs are old school now. The synaptogenesis within 15 mins under the influence of ketamine is interesting, is'nt it?

    • @theallin1mentalhealthchann914
      @theallin1mentalhealthchann914 3 года назад +1

      @@tim40gabby25 Yes sir, did my 5th oral treatment last night actually, better everytime. No words to how amazing it is...I did research a year before diving in and glad I did both!

    • @georginarandolphgirl66
      @georginarandolphgirl66 3 года назад

      How long did you have to take it for and were you also resistent to medications?

  • @SarahJones-kp9bq
    @SarahJones-kp9bq 3 года назад +1

    I love this guys ability to take complex chemistry and make it understandable and accessible using picture thinkin & concepts we already understand. Very engaging and gifted effective commicator, he could teach teach you anything using this method! Love it. So very interesting 👌

  • @akshu251
    @akshu251 2 года назад

    I am a new fan of Dr. Rakesh Jain. I am new to the field and somehow this is the first video that I watched. This presentation motivated me to learn more. Thank you.

  • @RealGirlLive
    @RealGirlLive 3 года назад +22

    Ketamine is a miracle. It cured my suicidal depression. I’m so glad psychiatry is going deeper into glutamate and nmda. In the future I hope for a pill that can provide the antidepressant affects of ketamine without the “trippy” affects

    • @aphysique
      @aphysique 3 года назад +2

      Wasn't it super expensive

    • @tim40gabby25
      @tim40gabby25 3 года назад +1

      "effects", but great comment :)

    • @chgofirefighter
      @chgofirefighter 3 года назад +2

      I did 2 treatments and ketamine hasn’t done much of anything, but there’s a 6 protocol but I was hoping. for “something” but?

    • @chgofirefighter
      @chgofirefighter 3 года назад +2

      @@aphysique there’s foundations that helps with treatment, serenity foundation is one of them.

    • @RealGirlLive
      @RealGirlLive 3 года назад

      @@aphysique look up dr Scott smith treatments. His are 250

  • @thedownwarddoug6642
    @thedownwarddoug6642 3 года назад +3

    Jeff Goldblums greatest performance yet

  • @buddhabrot3
    @buddhabrot3 4 года назад +3

    Thank you for this inspiring talk

  • @locustphysalis3300
    @locustphysalis3300 19 дней назад

    58:46 this truly confuses me, so I used to think glutamate downregulation is the issue and ketamine as an NMDA antagonist would stimulate glutamate (AMPA) as two negatives makes a positive (NMDA is a glutamate inhibitor and you would be inhibiting it) but by this graph the activity would already be too high, so why would you use ketamine to stimulate it even further? Some help would be greatly appreciated!

  • @popurikrishna5776
    @popurikrishna5776 2 года назад

    Amazing presentation! Fantastic delivery! thank you for your contribution

  • @spadress
    @spadress 3 года назад +1

    I love this dudes style of presentation :D

  • @yeetlord-to9jr
    @yeetlord-to9jr 3 года назад +4

    "so essential that is's nonessential"
    took me a minute to figure that one out

  • @JustT725
    @JustT725 2 года назад

    This is my 2nd time listening to this lecture. It will not be my last!

  • @joakazia7425
    @joakazia7425 2 года назад +1

    I hope someone can help with my question- how does ketamine cause sedation when it increases glutamate release from neurones? (I thought glutamate was an excitatory neurotransmitter?) Thank you.

  • @arthurmorgan7729
    @arthurmorgan7729 5 лет назад +2

    Excellent lecture, thank you!

  • @icanduo
    @icanduo 2 года назад +1

    I wish I could afford the IV injection. I'm trying the sublingual next week. I hope it works as well as IV form.

  • @word2RG
    @word2RG Год назад

    I you could boost GABA, would that also eventually increase Glutamate?

  • @INounCf
    @INounCf 11 месяцев назад

    Apparently i just discovered a gem of a channel?

  • @JABDUDE
    @JABDUDE 3 года назад +1

    love this guy

  • @seanjurkowski7166
    @seanjurkowski7166 3 года назад

    Great talk! Thank you, Dr Jain.

  • @POLYLIVING
    @POLYLIVING 2 года назад

    Magnificent narrative! Thank u so much for all your hard work✨👏🙂

  • @JustT725
    @JustT725 3 года назад

    Awesome presentation!

  • @Ami-ej4yh
    @Ami-ej4yh 3 года назад

    Amazing lecture, thank you. How would I get these lecture slides please?

  • @RealProfessionalHumanBeing
    @RealProfessionalHumanBeing 2 года назад

    Thank you so much for this.

  • @aug.jam.1
    @aug.jam.1 2 года назад +3

    Ketamine helped me tremendously. No more panic attacks, no more suicidal thoughs, less stress and no more depression. Almost immediately after my first intravenous session. I use no other anti depressants anymore

    • @dakshinamurti
      @dakshinamurti Год назад

      hello. do you have to use it all your life? what is the dose/frequency? also, does it in any way negatively impact libido or sexual function?

    • @aug.jam.1
      @aug.jam.1 Год назад

      @@dakshinamurti oh no, I only had 5 sessions at the hospital. After that I have never had it again luckily.

  • @woolfy02
    @woolfy02 5 лет назад +2

    So what do the people with TRD rely on without access to esketamine? Isn't there a few mood stabilizers that work on NDMA in some form?

    • @Clem62
      @Clem62 5 лет назад +5

      dextromethorphan

    • @buddhabrot3
      @buddhabrot3 4 года назад +3

      To be honest dextromethorphan is for me not really helpful in treating depression. It is in the management of pain. The feeling of it isn't really pleaseant. Amitriptilyne is a NMDA Antagonist as well es fluoxetine or gabapentin (non competitive). Lithium is involved in controlling excitotoxicity of glutamate in different brain areas. You could try these. And get them completely legal from your psychiatrist. If youre really desperate ( like I am) you can try huperzin A. D,L-phenylalanine or cat's claw, ibogaine or if you get your hands on it minocycline (antibioticum) which are nmda antagonists and antiinflammation. But the last things I mentioned there is not a lot of research whatsoever so be careful, especially mixing with other psychotrope medications which is nothing I can recommend in any way. You could also try to target gaba wich should be a lot easier. Maybe ask your psychiatrist for gabapentine, maybe pregabaline or other moodstabilizers, lamotrigine, valproate,lithium.....

    • @buddhabrot3
      @buddhabrot3 4 года назад

      Edit: dont take ibogaine this was a bad advise

    • @dmanzawsome
      @dmanzawsome 4 года назад +2

      The ammino acid in tea called l-theanine is an NDMA antagonist perhaps it might be a usefull tool for one that cannot get other glutamate altering substances.

    • @Aerafae
      @Aerafae 4 года назад

      Suprised no one has said it but agmatine is perfect for this

  • @soleyeiny
    @soleyeiny 3 года назад

    Estonish presentation, thanks!

  • @rebekkad.2092
    @rebekkad.2092 Год назад +1

    My husband has a severe glutamatergic dysfunction and NAC seems to be the single most important supplement in his daily life. It is fast acting and has helped tremendously with his depression and anxiety. Thank you for this video.

    • @sigikah3916
      @sigikah3916 Год назад

      Try l-serine. It will be converted to d-serine via racemase action. D-serine has similarities to ketamine.

  • @HairGlitter
    @HairGlitter 3 года назад

    This guy is brilliant

  • @richg9578
    @richg9578 7 месяцев назад

    I look forward to the moment and that buried moments do, and now that's over til tomorrow, but can you and I minfulfullness x

  • @gosilat1234
    @gosilat1234 5 лет назад

    Thank you.

  • @subodhgautam649
    @subodhgautam649 3 года назад

    So when are we expecting troriluzole Sir...with due respect sir..?

  • @popurikrishna5776
    @popurikrishna5776 2 года назад

    can I use your slides for presentation of grand rounds in our psychiatric department on the clinical use of ketamine

  • @nadaashraf9715
    @nadaashraf9715 2 года назад

    That was an awesome lecture! thanks a lot for this presentation, but can you send me the powerpoint. it will help me a lot through my studies. thanks again

  • @santicruz4012
    @santicruz4012 2 года назад

    Awesome presentation, Dr Jain :)
    I would like to learn more about this topic. Could you please send me the references?

  • @amasvodka
    @amasvodka 5 лет назад

    Thank you!

  • @criticadorauniversal
    @criticadorauniversal 3 года назад

    glutamatergic dysfunction and adaptogenic plant?

  • @owlymcowlface7893
    @owlymcowlface7893 Год назад

    It's like we've been looking at the nodes as causation and ignoring the network and network traffic to make an IT based analogy..

  • @ЧеловекСталь-и1ц
    @ЧеловекСталь-и1ц 3 года назад +2

    i bet cocaine , amphetamine , opioids , will improve symptoms of depression as well. but is it save ? is ketamine save in the long run ? does ketamine really works because of its effects on nmda or there is also another pathways ? why he is so sure ?

  • @dawnlokki4734
    @dawnlokki4734 2 года назад +1

    I believe my long term use of xanax/lorazepam is what keeps my glutamate high..
    When it's effect stops inbetween doses my glutamate goes high...
    Yes, you are so accurate as I have clinical deppresion... Anxiety disorders..
    Currently using magnesium chloride magnesium glycanate and chloride.
    L thiamine stacked with nasal breathing to bring back balance......
    glutamate excitotoxicity... It's real.....

    • @BrianSmith-lo3mj
      @BrianSmith-lo3mj 2 года назад +1

      Thank you for pointing that out ... because I believe the long term use of Clonazepam (Klonopin) does the same thing to me.

  • @defforadio6428
    @defforadio6428 3 года назад

    Very nice!

  • @JustT725
    @JustT725 2 года назад +3

    Am I the only one that feels like this is too good to be true? As much as I enjoy the presenter's energy, I can't help but feel this is a infomercial. I was literally waiting for him to say "but wait there's more, if you call within the next 30 minutes we will also include a sense of humor and an overall feeling wellness.

    • @cristinatorregiani3144
      @cristinatorregiani3144 11 месяцев назад

      It IS an inforemecial. Have you seen one of the first slides, where the ties he has with big Pharma are listed? This is infomercial for the very expensive Spravato. That said, an infomercial is not necessarily advertising a bad product. It could be indeed a new important huge step indeed. Btw, anybody here scared about mayor activation) because I am. mayor activation helps neurodegenesus yes, but also proliferation of other, not wanted, cell -aka cancer.

  • @Zooman160
    @Zooman160 2 года назад

    Do high levels of glutamate in the urine mean high levels of glutamate in the brain

  • @jeffmyers7062
    @jeffmyers7062 3 года назад

    this is a very interviewed video!

  • @tim40gabby25
    @tim40gabby25 3 года назад

    If you have no time for Q&A, prune your slides. I propose lectures are entirely Q&A, as the slides should be viewed before those carbon footprint intense flights. Not a popular view, I expect. Old UK medic here, just saying :)

  • @MarionFiedlerMusic
    @MarionFiedlerMusic 2 года назад

    Dang. My world just changed.

  • @kodithebear
    @kodithebear Год назад

    NAC helps

  • @kihntagious
    @kihntagious Год назад

    The ketamine relieved the major depressive disorder for me. The deep everpresent down I had is gone

  • @facelessstateofmind
    @facelessstateofmind 3 года назад +2

    The most potent and abundant neurotransmitter in the brain…
    Hmmm, maybe research should have started with glutamate to begin with…

  • @johnathanabrams8434
    @johnathanabrams8434 Год назад

    When glutamate reaches toxic levels and creates apopticic changes in the dorsal horn inhibitory interneurons pharmaceuticals and cognitive behavioral therapy no longer do anything.

    • @Boojerella
      @Boojerella Месяц назад

      Would love research saying this

  • @Arcticnick
    @Arcticnick 2 года назад

    So 'regulate glutamate'

  • @timmeagher5662
    @timmeagher5662 Год назад

    What are psychiatrists? Babies? It's like he's teaching 4 year olds neuroscience.

  • @cynigirl1utube160
    @cynigirl1utube160 2 года назад

    Ketamine didn't help me

  • @Baghuul
    @Baghuul 2 года назад

    I never new Dinesh D'souza was a neuroscientist.

  • @Christopher-b1p
    @Christopher-b1p 15 дней назад

    If you thonk neurogenesis and neuroplasticity is so.important, then you should drink green tea.

  • @roksanamarkova2821
    @roksanamarkova2821 2 года назад

    this guy is giving major Jeff Goldblum vibes :D

  • @douglaserickson2866
    @douglaserickson2866 2 года назад

    Applause

  • @katherenewedic8076
    @katherenewedic8076 Год назад

    really one thing for cause, effect, and treatment? no science here. undoubtedly your assistance and such did some research. and your dramatics devalue your words.