{"id":53315,"date":"2015-01-16T20:00:25","date_gmt":"2015-01-17T01:00:25","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=53315"},"modified":"2015-01-17T07:52:27","modified_gmt":"2015-01-17T12:52:27","slug":"the-fiction","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2015\/01\/16\/the-fiction\/","title":{"rendered":"the fiction&#8230;"},"content":{"rendered":"\n<div align=\"justify\">University of Chicago Statistician Robert Gibbons was a voting consultant on the 2004 <a target=\"_blank\" href=\"http:\/\/www.fda.gov\/ohrms\/dockets\/ac\/cder04.html#PsychopharmacologicDrugs\"><font color=\"#200020\">FDA Pediatric Advisory Committee<\/font><\/a> that elected to add the Black Box Warning to the labeling of the Antidepressants:      <\/div>\n<ul>\n<div align=\"justify\" class=\"small\"><em>Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children and adolescents in short-term studies of major  depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of Prozac or any other antidepressant in a child or adolescent must balance this risk with the clinical need&#8230;<\/em><\/div>\n<\/ul>\n<div align=\"justify\">Since that time, he and Dr. John Mann, a Professor of Psychiatry at Columbia, have challenged that Warning  with a steady stream of articles occasionally joined by other groups. Here&#8217;s the summary from their most  recent offering:                                 <\/p>\n<blockquote>\n<div align=\"center\" class=\"big\"><a href=\"http:\/\/www.psychiatrictimes.com\/special-reports\/relationship-between-antidepressant-initiation-and-suicide-risk\/page\/0\/1\" target=\"_blank\">The Relationship Between Antidepressant Initiation and Suicide Risk<\/a><\/div>\n<div align=\"center\" class=\"middle\"><strong><font color=\"#200020\">Special Reports, Psychopharmacology, Suicide<\/font><\/strong><\/div>\n<div align=\"center\" class=\"big\"><strong><font color=\"#200020\">Psychiatric Times<\/font><\/strong><\/div>\n<div align=\"center\" class=\"middle\"><strong><font color=\"#0066cc\">By Robert D. Gibbons, PhD and J. John Mann, MD<\/font><\/strong><\/div>\n<div align=\"center\" class=\"small\">December 31, 2014<\/div>\n<div align=\"center\" class=\"middle\">[<a target=\"_blank\" href=\"http:\/\/www.psychiatrictimes.com\/special-reports\/relationship-between-antidepressant-initiation-and-suicide-risk\/page\/0\/1\">full text on-line<\/a> with free registration]<\/div>\n<p>                   <\/p>\n<div align=\"center\"><img loading=\"lazy\" decoding=\"async\" height=\"18\" border=\"0\" width=\"66\" src=\"http:\/\/1boringoldman.com\/images\/snip.gif\" \/><\/div>\n<div align=\"justify\"><u><strong><font color=\"#200020\">Summary<\/font><\/strong><\/u><\/div>\n<div align=\"justify\">The  data show that in adults, antidepressants appear to protect against  suicidal events. SSRIs are associated with lower overall suicide rates  compared with other classes of antidepressants [eg, TCAs].  Antidepressants are effective in reducing symptoms, which, in turn,  mediates suicidal events in adults and the elderly. This does not appear  to be the case for youths, for whom antidepressant medications can  reduce the severity of depression but appear to have no effect one way  or the other on suicidal thoughts and behavior. Conversely to what is  seen in adults, it may be that aggressive-impulsive traits play a more  important role in youth suicide than does depressed mood. The impact of  antidepressants on these traits remains unclear. Youth suicide may also  be potentially related to illicit drug use and social factors, such as  bullying, that are not directly affected by antidepressants.<\/div>\n<p align=\"justify\">The  black box warning and the earlier public health advisory have shown  that discouraging the medication treatment of depression in children is  not an effective solution in preventing suicidal behavior. Careful  monitoring and treatment of depression and monitoring suicide risk in  children is clearly essential. Overall, the clinical evidence is that  the majority of patients, young and old, benefit from antidepressants,  without increased risk of suicide.<\/p>\n<div align=\"justify\">Ten  years after the introduction of the black box warning, it is time that  the FDA reevaluates this decision and that the results be made public.  Moreover, the labeling language should be rewritten to clearly delineate  the risks of treatment compared with the risks of no treatment.<\/div>\n<hr size=\"1\" \/>\n<div align=\"justify\"><sup><em>Dr   Gibbons is Professor of Biostatistics in the departments of medicine,   public health sciences, and psychiatry, and Director of the Center for   Health Statistics at the University of Chicago. Dr Mann is the Paul   Janssen Professor of Translational Neuroscience in the department of   psychiatry at Columbia University, and Director, Molecular Imaging and   Neuropathology Division, the New York State Psychiatric Institute, New   York. The authors report no conflicts of interest concerning the subject   matter of this article.<\/em><\/sup><\/div>\n<\/blockquote>\n<div>You would think that as much time as they&#8217;ve spent on this quest, they&#8217;d at least understand the domain of the FDA&#8217;s power. After approval of a new drug based on proof of efficacy and safety, the FDA is charged with monitoring safety ongoing, even pulling drugs from the market that prove to be toxic. The obvious reason is to alert physicians to the risks using the  drugs as new information becomes available. Drugs are only approved for specific conditions, and  manufacturers are constrained from advertising for anything except the  FDA approved uses. On the other hand, <font color=\"#200020\">the FDA has absolutely no authority over how  physicians actually prescribe the drugs<\/font>. So first, there&#8217;s the simple matter of what Drs. Gibbons and Mann are asking the FDA to do, &quot;<font color=\"#200020\">&#8230; <em>the labeling language should be rewritten to clearly delineate the risks of treatment compared with the risks of no treatment.<\/em><\/font>&quot;  That&#8217;s not remotely an authority the FDA has or should ever have. The FDA  doesn&#8217;t give opinions about risk\/benefit ratios or treatment. That&#8217;s for  the medical profession to determine with clinical use. The FDA simply  certifies minimal efficacy based on a few short term clinical trials,  and reports on the adverse events from the trials and later spontaneous  reports. It&#8217;s actually an absurd request, well outside either the charge or expertise  of the FDA. Surely the authors know that. So one has to wonder why they  would even propose such a thing?<\/div>\n<p align=\"justify\">Then there&#8217;s a fundamental misunderstanding of the practice of medicine  that runs throughout their ten year thread of challenges. The information about  clinical decisions comes from many places:  the doctor&#8217;s own  experience, the experiences of others over time, clinical trials and other studies, the wisdom of the ages, the specifics of the patient being treated, etc. But at the  end of the decision making process, it&#8217;s only the patient in front of  the doctor that&#8217;s being treated &#8211; not some nameless group defined simply by age  and diagnosis. Just that one patient. Gibbons et al argue that because  antidepressant prescription rates fell [or didn&#8217;t continue to climb]  with the Black Box Warning, kids are being deprived of necessary  treatment. And they even propose motives. First, that &quot;<em>discouraging the medication treatment of depression in children is not an effective solution in preventing suicidal behavior<\/em>&quot;  as if that&#8217;s what the FDA did or was tasked to do. Again, the FDA  warned that these drugs can, at times, be associated with suicidality &#8211;  as a <em>drug effect<\/em>! That&#8217;s their job &#8211; drug effects. What doctors  do with the information isn&#8217;t the FDA&#8217;s business [or Dr. Gibbons&#8217;]. The  FDA is supposed to help us by telling us what bad things can happen &#8211;  and that&#8217;s what they did. And further, these authors propose to know the  psychology and motives of doctors, that we were afraid to prescribe  these drugs for inappropriate reasons [like getting sued] because of all  the publicity about the warning &#8211; so we are withholding treatment. They  ignore the much more obvious explanation that knowing of the danger, we became  appropriately more cautious [<em>&quot;Anyone considering the use of Prozac or any other antidepressant in a  child or adolescent must balance this risk with the clinical need&#8230;&quot;<\/em>]. And they imply an efficacy for  antidepressants in teens that&#8217;s mythologic. Only two of the  antidepressants were approved for teens, and they had anything but a  robust effect. They apparently  think that population statistics should determine the  treatment of any given patient. If that&#8217;s the case, we don&#8217;t need  doctors, we only need computers and statisticians.<\/p>\n<div align=\"justify\">And then there&#8217;s this decade-long cascade of papers  with arguments that keep changing as they attempt to prove their point  using population statistics on large databases or a meta-analysis of  other people&#8217;s studies [with no public access to the data]. There are at  least fifty other posts on this blog looking at the details in these  papers [just put &quot;<em>gibbons black box<\/em>&quot; into the search box below]. In particular, see <a href=\"http:\/\/1boringoldman.com\/index.php\/2013\/01\/03\/persistence\/\">persistence&hellip;<\/a>.  It&#8217;s about number 11. below, which has my letter [unpublished] and letters from  two others that were ultimately published in the journal.  <\/div>\n<ol><sup>                                            <\/p>\n<li>\n<div align=\"justify\"><strong><font color=\"#0066ff\">[2005]<\/font><\/strong>&nbsp;&nbsp;<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/15699293\" target=\"_blank\"><font color=\"#0066ff\">The relationship between antidepressant medication use and rate of suicide.<\/font><\/a><\/div>\n<div align=\"justify\"><strong><font color=\"#0066ff\">Gibbons RD, Hur K, Bhaumik DK, Mann JJ.<\/font><\/strong><\/div>\n<\/li>\n<li>\n<div align=\"justify\"><strong><font color=\"#0066ff\">[2006]<\/font><\/strong>&nbsp;&nbsp;<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/17074941\" target=\"_blank\"><font color=\"#0066ff\">The relationship between antidepressant prescription rates and rate of early adolescent suicide.<\/font><\/a><\/div>\n<div align=\"justify\"><strong><font color=\"#0066FF\">Gibbons RD, Hur K, Bhaumik DK, Mann JJ.<\/font><\/strong><\/div>\n<\/li>\n<li>\n<div align=\"justify\"><strong><font color=\"#990000\">[2007]<\/font><\/strong>&nbsp;&nbsp;<a href=\"http:\/\/archpsyc.ama-assn.org\/cgi\/content\/full\/64\/4\/466\" target=\"_blank\"><font color=\"#990000\">Impact of Publicity Concerning Pediatric Suicidality Data on Physician Practice Patterns in the United States<\/font><\/a><\/div>\n<div align=\"justify\"><strong><font color=\"#990000\">Charles  B. Nemeroff, Amir Kalali, Martin B. Keller,  Dennis S. Charney, Susan  E. Lenderts,  Elisa F. Cascade, Hugo Stephenson, and Alan F. Schatzberg<\/font><\/strong><\/div>\n<\/li>\n<li>\n<div align=\"justify\"><strong><font color=\"#0066ff\">[2007]<\/font><\/strong>&nbsp;&nbsp;<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/17592916\" target=\"_blank\"><font color=\"#0066ff\">Association of suicide and antidepressant prescription rates in Japan, 1999-2003.<\/font><\/a><\/div>\n<div align=\"justify\"><strong><font color=\"#0066FF\">Nakagawa A, Grunebaum MF, Ellis SP, Oquendo MA, Kashima H, Gibbons RD, Mann JJ.<\/font><\/strong><\/div>\n<\/li>\n<li>\n<div align=\"justify\"><strong><font color=\"#0066ff\">[2007]<\/font><\/strong>&nbsp;&nbsp;<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/17606656\" target=\"_blank\"><font color=\"#0066ff\">Relationship between antidepressants and suicide attempts: an analysis of the Veterans Health Administration data sets.<\/font><\/a><\/div>\n<div align=\"justify\"><strong><font color=\"#0066FF\">Gibbons RD, Brown CH, Hur K, Marcus SM, Bhaumik DK, Mann JJ.<\/font><\/strong><\/div>\n<\/li>\n<li>\n<div align=\"justify\"><strong><font color=\"#0066ff\">[2007]<\/font><\/strong>&nbsp;&nbsp;<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/17728420\" target=\"_blank\"><font color=\"#0066ff\">Early evidence on the effects of regulators&rsquo; suicidality warnings on SSRI prescriptions and suicide in children and adolescents.<\/font><\/a><\/div>\n<div align=\"justify\"><strong><font color=\"#0066FF\">Gibbons RD, Brown CH, Hur K, Marcus SM, Bhaumik DK, Erkens JA, Herings RM, Mann JJ.<\/font><\/strong><\/div>\n<\/li>\n<li>\n<div align=\"justify\"><strong><font color=\"#0066ff\">[2007]<\/font><\/strong>&nbsp;&nbsp;<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/18092240\" target=\"_blank\"><font color=\"#0066ff\">The role of randomized trials in testing interventions for the prevention of youth suicide.<\/font><\/a><\/div>\n<div align=\"justify\"><strong><font color=\"#0066FF\">Brown CH, Wyman PA, Brinales JM, Gibbons RD.<\/font><\/strong><\/div>\n<\/li>\n<li>\n<div align=\"justify\"><strong><font color=\"#0066ff\">[2008]<\/font><\/strong>&nbsp;&nbsp;<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/18404622\" target=\"_blank\"><font color=\"#0066ff\">Mixed-effects Poisson regression analysis of adverse event reports: the relationship between antidepressants and suicide.<\/font><\/a><\/div>\n<div align=\"justify\"><strong><font color=\"#0066FF\">Gibbons RD, Segawa E, Karabatsos G, Amatya AK, Bhaumik DK, Brown CH, Kapur K, Marcus SM, Hur K, Mann JJ.<\/font><\/strong><\/div>\n<\/li>\n<li>\n<div align=\"justify\"><strong><font color=\"#990000\">[2010]<\/font><\/strong>&nbsp;&nbsp;<a href=\"http:\/\/pediatrics.aappublications.org\/content\/125\/1\/88.long\" target=\"_blank\"><font color=\"#990000\">News coverage of FDA warnings on pediatric antidepressant use and suicidality<\/font><\/a><\/div>\n<div align=\"justify\"><strong><font color=\"#990000\">Barry CL and Busch SH.<\/font><\/strong><\/div>\n<\/li>\n<li>\n<div align=\"justify\"><strong><font color=\"#0066ff\">[2011]<\/font><\/strong>&nbsp;&nbsp;<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21513361\" target=\"_blank\"><font color=\"#0066ff\">Strategies for quantifying the relationship between medications and suicidal behaviour: what has been learned?<\/font><\/a><\/div>\n<div align=\"justify\"><strong><font color=\"#0066FF\">Gibbons RD, Mann JJ.<\/font><\/strong><\/div>\n<\/li>\n<li>\n<div align=\"justify\"><strong><font color=\"#0066ff\">[2012]<\/font><\/strong>&nbsp;&nbsp;<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22309973\" target=\"_blank\"><font color=\"#0066ff\">Suicidal  Thoughts and Behavior With Antidepressant Treatment: Reanalysis of the  Randomized Placebo-Controlled Studies of Fluoxetine and Venlafaxine<\/font><\/a><\/div>\n<div align=\"justify\"><strong><font color=\"#0066FF\">Robert D. Gibbons, Hendricks Brown, Kwan Hur, John M. Davis, and J. John Mann<\/font><\/strong><\/div>\n<\/li>\n<li>\n<div align=\"justify\"><strong><font color=\"#990000\">[2014]<\/font><\/strong>&nbsp;&nbsp;<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/24942789\" target=\"_blank\"><font color=\"#990000\">Changes  in antidepressant use by young people and suicidal behavior after FDA  warnings and media coverage: quasi-experimental study<\/font><\/a><\/div>\n<div align=\"justify\"><strong><font color=\"#990000\">Christine  Y Lu, Fang Zhang , Matthew D Lakoma analyst, Jeanne M Madden, Donna  Rusinak, Robert B Penfold, Gregory Simon, Brian K Ahmedani, Gregory  Clarke, Enid M Hunkeler, Beth Waitzfelder, Ashli Owen-Smith, Marsha A  Raebel, Rebecca Rossom, Karen J Coleman, Laurel A Copeland, Stephen B  Soumerai<\/font><\/strong><\/div>\n<\/li>\n<li>\n<div align=\"justify\"><strong><font color=\"#0066ff\">[2014]<\/font><\/strong>&nbsp;&nbsp;<a target=\"_blank\" href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/25263479\"><font color=\"#0066ff\">Antidepressant treatment and suicide attempts and self-inflicted injury in children and adolescents<\/font><\/a><\/div>\n<div align=\"justify\"><strong><font color=\"#0066FF\">by Gibbons RD, Coca Perraillon M, Hur K, Conti RM, Valuck RJ, and Brent DA<\/font><\/strong><\/div>\n<\/li>\n<li>\n<div align=\"justify\"><strong><font color=\"#0066ff\">[2014]<\/font><\/strong>&nbsp;&nbsp;<a target=\"_blank\" href=\"http:\/\/www.nytimes.com\/roomfordebate\/2014\/10\/07\/did-the-blockbuster-prozac-help-or-hurt-medicine\/prozac-is-no-magic-pill-but-it-works?comments#permid=13037514\"><font color=\"#0066ff\">Prozac Is No Magic Pill, but It&nbsp;Works<\/font><\/a><\/div>\n<\/li>\n<div align=\"justify\"><strong><font color=\"#0066FF\">by Robert Gibbons and J. John Mann<\/font><\/strong><\/div>\n<li>\n<div align=\"justify\"><strong><font color=\"#990000\">[2014]<\/font><\/strong>&nbsp;&nbsp;<a href=\"http:\/\/psychnews.psychiatryonline.org\/doi\/full\/10.1176\/appi.pn.2014.11b1B\" target=\"_blank\"><font color=\"#990000\">FDA Actions on Antidepressants and Suicidality: 10 Years Later<\/font><\/a><\/div>\n<div align=\"justify\"><strong><font color=\"#990000\">by Mark Moran<\/font><\/strong><\/div>\n<\/li>\n<li>\n<div align=\"justify\"><strong><font color=\"#990000\">[2014]<\/font><\/strong>&nbsp;&nbsp;<a target=\"_blank\" href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMp1408480#t=article\"><font color=\"#990000\">Antidepressants&#8217; Black-Box Warning: 10 Years Later<\/font><\/a><\/div>\n<div align=\"justify\"><strong><font color=\"#990000\">by Richard A. Friedman, M.D.<\/font><\/strong><\/div>\n<\/li>\n<li>\n<div align=\"justify\"><strong><font color=\"#0066ff\">[2014]<\/font><\/strong>&nbsp;&nbsp;<a href=\"http:\/\/www.psychiatrictimes.com\/special-reports\/relationship-between-antidepressant-initiation-and-suicide-risk\/page\/0\/1\" target=\"_blank\"><font color=\"#0066ff\">The Relationship Between Antidepressant Initiation and Suicide Risk<\/font><\/a><\/div>\n<div align=\"justify\"><strong><font color=\"#0066FF\">Robert D. Gibbons, PhD and J. John Mann, MD<\/font><\/strong><\/div>\n<\/li>\n<p>                                                <\/sup><\/ol>\n<div align=\"justify\">As I said <a href=\"http:\/\/1boringoldman.com\/index.php\/2015\/01\/07\/boxes-black-are-back-ii-a-confusion-of-tongues\/\" target=\"_blank\">last week<\/a>:<\/div>\n<ul>\n<div align=\"justify\" class=\"small\"><em>I&rsquo;m  obviously not writing about this because I&rsquo;m conflicted about the   Black Box Warning. I&rsquo;ve seen enough adolescent patients with the   Akathisia syndrome from SSRIs to know it&rsquo;s a real thing. And I know of   completed suicides that I am sure were SSRI induced.<\/em><\/div>\n<\/ul>\n<div align=\"justify\"> I&#8217;m  suspicious that the six articles in 2014 [12.-17.] are harbingers of an effort to get the FDA to convene yet another hearing to revoke  the Black Box Warning, now ten years after its adoption, based on the monotonous arguments in the articles listed here. Again from <a href=\"http:\/\/1boringoldman.com\/index.php\/2015\/01\/07\/boxes-black-are-back-ii-a-confusion-of-tongues\/\" target=\"_blank\">last week<\/a>:<\/div>\n<ul>\n<div align=\"justify\" class=\"small\"><em>They are proposing that warning the clinicians of a potential problem  has lead to what they think is an error, so we shouldn&rsquo;t warn the<\/em><em><\/em><em> clinicians<\/em>?? however rare?? They speculate that operating without being warned, they may ultimately help more people in  their ignorance [or silence]?? And perhaps we shouldn&rsquo;t warn our  patients either, so they&rsquo;ll follow our [proxied] advice?? There&rsquo;s nothing  I know about Medicine that supports that <strong><font color=\"#200020\">confusion of tongues<\/font><\/strong>.  These highly placed doctors are not thinking like clinicians, and  their group-think has no place in the hierarchy of Medicine as I know  it. They&rsquo;re not speaking the right language&#8230; Individual  physicians have to construct an <strong><font color=\"#200020\">individualized risk\/benefit <\/font><\/strong>estimate on every shared decision from a baby aspirin a day to dangerous  and life threatening chemotherapy using known poisons. You can&rsquo;t do that  living in the dark about risk&hellip;<\/div>\n<\/ul><\/div>\n<div align=\"justify\">The majority of this four page Psychiatric Times piece is designed to bolster the fiction that the Black Box Warning was motivated to affect suicide rates rather than what it says: to warn doctors of Akathisia and suicidality &#8211; an idiosyncratic drug effect that afflicts some child and adolescent patients.<\/div>\n","protected":false},"excerpt":{"rendered":"<p>University of Chicago Statistician Robert Gibbons was a voting consultant on the 2004 FDA Pediatric Advisory Committee that elected to add the Black Box Warning to the labeling of the Antidepressants: Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children and adolescents in short-term studies of major depressive disorder [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[5],"tags":[],"class_list":["post-53315","post","type-post","status-publish","format-standard","hentry","category-opinion"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/53315","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/comments?post=53315"}],"version-history":[{"count":8,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/53315\/revisions"}],"predecessor-version":[{"id":53326,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/53315\/revisions\/53326"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=53315"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=53315"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=53315"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}