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Saturday, October 14, 2006

Arnica

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Arnica is available in tablet form and is very
effective at eliminating the more severe
symptoms of anxiety as they happen. They can
also be taken to help against insomnia and
physical exhaustion. They are fast acting; relief
comes within a few minutes of taking them.
Arnica can be taken as often as you wish
making it ideal for carrying with you and taking
them only when you feel anxious. Like all drugs,
there is a risk of psychological dependency, but
better to be dependent on a harmless natural
substance than a mind altering synthetic drug.

Friday, October 13, 2006

St Johns Wort

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St Johns Wort is often called natural Prozac as it
has a similar effect on the brain. Its active
ingredient is Hypericin a natural ingredient also
found in chamomile tea. A report in the British
Medical Journal in August 1996 concluded that
St John’s Wort appeared to be as affective as
prescribed antidepressants and to have fewer
side effects. It is reported that in Germany in
1994, where natural medicines are used much
more widely, 66 million prescriptions for St
John’s Wort were issued without one reported
case of ill effects. Like SSRI’s St Johns Wort is
taken in tablet form and its therapeutic effect is
cumulative over about two to four weeks, much
like Prozac. It can be very effective and is a
well-tested and much used alternative without
the synthetic element of Prozac. It is worth
considering however, that it is always best to
get medical advice before taking any
medication, St John’s Wort is reported to effect
the way other medicines are metabolized, can
make the patient photosensitive (sensitive to.sunlight) and other side effects.

Thursday, October 12, 2006

Zoloft (sestraline)

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Use:
SSRI. Depression: Patients > 18 years of age: Initially, 50 mg once daily; increase dosage gradually, if needed, at 1-week intervals. Maximum: 200 mg/day. Maintenance: lowest effective dose.

Panic disorder: 25 mg once daily and increase, if necessary, by 50 mg increments at intervals of no less than 1 week, to a maximum of 200 mg/day.

Obsessive-compulsive disorder (OCD): Initially, 50 mg/day. Thereafter, increase the dosage, if necessary, by 50 mg increments, over several weeks or months, to a maximum of 200 mg/day.

Zoloft's effectiveness for more than 12 weeks of therapy in panic disorder and OCD not yet established.

Contraindications:
Not to be use with an MAOI or within 14 days of starting or discontinuing MAOI therapy. Concomitant use with pimozide.

Precautions:
Pregnancy, lactation, patients< 18 years of age. Seizure disorders, a history of drug abuse, renal or hepatic impairment. Activation of mania/hypomania, suicidal tendency, concomitant illnesses that could affect metabolism or hemodynamic responses. Rare reports of altered platelet function; hyponatremia, possibly due to the syndrome of inappropriate antidiuretic hormone secretion.

Side effects:
Nausea, diarrhea/loose stools, dyspepsia, male sexual dysfunction (primarily ejaculatory delay), insomnia, somnolence, tremor, increased sweating, dry mouth, dizziness.

Interactions:
See Contraindications. Use cautiously with CNS-active drugs; serotonergic drugs, such as fenfluramine, should not be used with sertraline. Hypoglycemic agents, drugs highly bound to plasma proteins, cimetidine (may decrease clearance of sertraline). Warfarin (monitor PT). St. John's Wort (increase in undesirable effects).

Patient tips:
Full therapeutic effect may be delayed until 4 or more weeks of treatment. Take capsules with food once daily, preferably with evening meal or breakfast. May cause dizziness (NB driving). Restrict alcohol intake.

Supplied:
25 mg, 50 mg, 100mg capsules.

Wednesday, October 11, 2006

Prozac (fluoxetine)

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Use:
SSRI. Depression: patients > 18 years of age - Initially, 20 mg in the morning; increase dosage gradually only after a trial period of several weeks if required. Maximum: 80 mg/day. Elderly patients: 20 mg/day. Use lower or less frequent dosage in patients with renal and/or hepatic impairment and those receiving multiple medications. When switching patients to a TCA, the TCA dosage may have to be reduced and plasma TCA concentrations may need to be monitored temporarily when fluoxetine is coadministered or hs recently been discontinued. Bulimia nervosa: Adults, 60 mg/day. Assess electrolyte levels prior to starting therapy. Obsessive-compulsive disorder: 20 - 60 mg/day.

Prozac's long-term efficacy in bulimia (i.e., > 16 weeks) and in obsessive-compulsive disorder (i.e., > 13 weeks) has not been evaluated in controlled trials.

Contraindications:
Not to be used with an MAOI or within 14 days of discontinuing MAOI therapy. Allow at least 5 weeks after stopping Prozac before starting an MAOI. Do not administer thioridazine with Prozac or within 5 weeks after Prozac has been discontinued.

Precautions:
Pregnancy, lactation, patients < 18 years of age, elderly patients. History of allergic reactions, seizures, suicidal tendency, activation of mania/hypomania, MI or unstable heart disease, diabetes, severe renal or hepatic impairment, hypokalemia (following self-induced vomiting), hyponatremia, altered platelet function.

Safety/efficacy of combined Prozac/electroconvulsive therapy not established.

Side effects:
Headache, nervousness, insomnia, drowsiness, fatigue or asthenia, anxiety, tremor, dizziness or lightheadedness, nausea, dry mouth, diarrhea, anorexia, excessive sweating. Less frequently, rash, pruritus, weight loss, sexual dysfunction, convulsions.

Interactions:
See Contraindications. Warfarin (monitor PT). Lithium levels may be increased or decreased (monitor). Use cautiously with other CNS-active drugs (e.g. tryptophan), agents highly bound to plasma protein or metabolized by the P450 2D6 system. St. John's Wort (increase in undesirable effects).

Patient tips:
Full therapeutic effect may be delayed until 4 or 5 weeks of treatment. May cause drowsiness, dizziness (NB driving). Restrict alcohol intake.

Supplied:
10mg, 20 mg capsules; 20 mg/5 mL of mint-flavored syrup, 120 mL bottles.

Luvox (Fluvoxetine)

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Fluvoxamine (Luvox) is antidepresant used in treatment of OCD (obsessive-compulsive disorder), depression, panic attac, eating disorders, or chronic tension headaches.

Use:

Depression: Adults, 50 mg once daily at bedtime; increase to 100 mg daily at bedtime after a few days, as tolerated.
Usual effective daily dose: 100-200 mg; maximum is 300 mg/day.

Obsessive-Compulsive Disorder (OCD): Adults, 50 mg once daily at bedtime; increase to 100 mg daily at bedtime after a few days, as tolerated. Usual effective daily dose: 100-300 mg (maximum dose). If no improvement is observed within 10 weeks, reconsider treatment with Luvox.

Contraindications:
Do not use with, or within 2 weeks of ending MAOI therapy. At least 2 weeks should elapse before starting an MAOI follow cessation of Luvox. Concurrent administration of terfenadine, astemizole, thioridazine, mesoridazine or cisapride.

Precautions:
Use in women of child-bearing potential or nursing mothers only if clearly needed. Safety/efficacy in children < 18 years of age not established. Seizures, suicidal tendency. MI or unstable heart disease. Abnormal bleeding, hepatic enzyme increases. Avoid concurrent electroshock therapy. Consider gradual dosage reduction before stopping Luvox therapy.

Side effects:
Somnolence, dry mouth, nervousness, insomnia, dizziness, tremor, agitation, asthenia, abnormal ejaculation, g.i. disturbances including nausea, vomiting, diarrhea, constipation, anorexia and dyspepsia. Rare cases of seratonin syndrome, particularly when combined with other serotonergic drugs.

Interactions:
See Contraindications. Lithium, sumatriptan and tryptophan may enhance Luvox's serotonergic effects. Luvox co-administration may increase plasma levels of CYP450 substrates that have a narrow therapeutic index: CYP 1A2 (TCAs, neuroleptics, theophylline, warfarin, propranolol); CYP 3A4 (carbamazepine, methadone, cyclosporine); CYP2C (diazepam, phenytoin). St. John's Wort (increase in undesirable effects).

Patient tips:
Therapeutic response may be delayed until 2 or more weeks of treatment. Swallow tablets with water and without chewing. May cause dizziness (NB driving). Restrict alcohol intake

Thursday, October 05, 2006

CELEXA (citalopram)

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GENERIC NAME: citalopram
BRAND NAME: Celexa
DRUG CLASS AND MECHANISM: Citalopram is an antidepressant medication that affects neurotransmitters, the chemical transmitters within the brain. Many experts believe that an imbalance among neurotransmitters is the cause of depression. Citalopram works by preventing the uptake of one neurotransmitter, serotonin, by nerve cells after it has been released. The reduced uptake caused by citalopram results in more free serotonin in the brain to stimulate nerve cells. Citalopram is in the class of drugs called selective serotonin reuptake inhibitors (SSRIs), a class that also contains fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft).

GENERIC AVAILABLE: No

PRESCRIPTION: Yes

PREPARATIONS: Tablets (oval): 20mg, 40mg.

STORAGE: Tablets should be kept at room temperature, 15° to 30°C (59° to 86°F).

PRESCRIBED FOR: Citalopram is used for the management of depression. It also has been tested in persons with panic disorders and obsessive- compulsive disorders.

DOSING: Citalopram is given as a single daily dose, usually in the morning. As with all antidepressants, it may take several weeks of treatment before maximum effects are seen. Doses are often adjusted slowly upwards to find the most effective dose. Elderly patients, debilitated persons, and patients with certain kidney or liver diseases may need lower doses.

DRUG INTERACTIONS: All SSRIs, including citalopram, should not be taken with any of the mono-amine oxidase (MAO) inhibitor-class of antidepressants, for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and procarbazine (Matulane). Such combinations may lead to confusion, high blood pressure, tremor, and hyperactivity. This same type of interaction also may occur with selegiline (Eldepryl), fenfluramine (Pondimin), and dexfenfluramine (Redux). Tryptophan can cause headaches, nausea, sweating, and dizziness when taken with any SSRI.

PREGNANCY: There are no adequate studies of citalopram in pregnant women.

NURSING MOTHERS: It is not known if citalopram is secreted in breast milk.

SIDE EFFECTS: Nausea, excessive sweating, tremor, vomiting, headache, and inability to sleep. 1 in 6 persons experience a side effect. Some patients may experience withdrawal symptoms upon stopping some SSRI's that include dizziness, tingling sensations, tiredness, vivid dreams,irritability, tingling sensations,or poor mood.

It has been suggested that SSRIs may cause depression to worsen. These potential side effects are difficult to evaluate in depressed pacients because depression can progress both with or without treatment. No conclusions can yet be drawn about the relationship between SSRIs and worsening depression. Patients receiving SSRIs should be watched for worsening depression and tendencion to suicide.

Wednesday, October 04, 2006

SSRIs

Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants for treating depression, anxiety disorders and some personality disorders. Studies found that SSRIs, as a side effect of their action, may cause in many people a delay of sexual climax, so they can be used to develop drugs specifically targeted to treat premature ejaculation.

SSRI drugs are designed to allow the available neurotransmitter serotonin to be utilized more efficiently. A low level of utilization of serotonin is currently seen as one among several neurochemical symptoms of depression. Low levels of serotonin in turn can be caused by an anxiety disorder, because serotonin is needed to metabolize stress hormones.

These medications evolve their effects at the serotonin transporter. They increase the extracellular level of the neurotransmitter serotonin by inhibiting its reuptake into the presynaptic cell. They have no or only weak effects on other monoamine transporters, thus having little direct influence on the level of other neurotransmitters. That distinguishes them from the older tricyclic antidepressants (TCAs), thus they are named selective. SSRIs are considered to be considerably safer than TCAs, since the toxic dose is much higher and they are said to have fewer and weaker side effects and drug interactions.

Tuesday, October 03, 2006

List of Antidepressants

SSRIs
Celexa (citalopram)
Lexapro (escitalopram oxalate)
Luvox (fluvoxamine)
Paxil (paroxetine)
Prozac (fluoxetine)
Zoloft (sertraline)

MAOIs
Nardil (phenelzine)
Parnate (tranylcypromine)

Tricyclics
Adapin (doxepin)
Anafranil (clomipramine)
Elavil (amitriptyline)
Endep (amitriptyline)
Ludiomil (maprotiline)
Norpramin (desipramine)
Pamelor (nortryptyline)
Pertofrane (desipramine)
Sinequan (doxepin)
Surmontil (trimipramine)
Tofranil (imipramine)
Vivactil (protriptyline)

Others
Buspar (buspirone)
Cymbalta (duloxetine)
Desyrel (trazodone)
Effexor (venlafaxine)
Edronax, Vestra (reboxetine)
Remeron (mirtazapine)
Serzone ( nefazodone)
Wellbutrin (bupropion)

The most popular methods of relieving depresion related symptoms include:

Prescription Medications
Natural Alternatives and Medicines
Cognitive Behavior Therapy based programs

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