welcome to anxieties 101!

lifestyle medications

medications

Antidepressant Drugs

For people who're so depressed that they can't function or are suicidal, antidepressant drugs can literally be life savers.

It's important that the doctor should clearly explain:

the proper doses of antidepressant drugs
possible side effects
interactions w/other drugs

Antidepressants can improve mood, sleep, appetite, & concentration. However, w/some drugs it can be between 6 & 12 weeks before real signs of improvement are seen.

Once the symptoms of the diagnosed mental disorder have disappeared, people often need to keep taking the drugs for 6 months or more, to prevent the symptoms reappearing.

Antidepressants are typically taken for several months. In some cases, patients & their physicians may decide that a longer course of therapy is needed.

When people have suffered from several episodes of depression, it may be advisable for them to remain on medication for much longer periods, perhaps even for life.

important new info concerning paxil!

Therapies for Anxiety
by Charles Linden

In order to permanently overcome an anxiety condition, it is vital that the core of the disorder is addressed in a targeted, supportive and seamless process of recovery. The core of anxiety disorder is stored and perpetuated in the amygdala, the 'anxiety control center' of the brain - it is this which MUST be addresses directly in order to fully and permanently erase high anxiety.

Because the Amygdala does not respond to drug therapies, anxiety cannot be eliminated by it. There are a number of drugs licensed as a treatment for anxiety such as certain sedatives and antidepressants, however, they are not curative and tend to offer the sufferer respite from their symptoms.

In isolation, drugs are not the solution to anxiety conditions but used sensibly, they can sometimes be useful in 'taking the edge off' the more severe symptoms.

Why aren’t drugs the solution? Because no drug has, or could ever be, developed that can identify and erase the specific neural pathways in the brain that are responsible for your high anxiety – it’s impossible.

Anxiety Therapy - Psychotherapy
Psychotherapy can be lengthy and costly but there are some elements of this sort of therapy that are very useful in the treatment of anxiety disorders but as a complete cure, it is limited.

Psychotherapy is an event rather than a process. You cannot have constant access to your psychotherapist when you require it and whilst the information and exercises he or she may present to you can seem to be of great benefit, many are very counterproductive.

Psychotherapy can be costly and many psychotherapists lack the experience of helping a wide range of sufferers that is vital if you are to provide seamless and experienced support.

Psychotherapy in isolation is not an effective anxiety therapy – tens of thousands of our ex clients are testament to this.

Most of our Linden Method clients have been down this route and wasted time and money on a process that can go on for months and in some cases, many, many years.

Anxiety Therapy - Alternative Therapies

I am a great advocate of 'do what makes you feel better'. I believe that if you experience something that makes you feel better but does not support your anxious habit, then it can only be good.

There are a number of alternative therapies that causes the sufferer to relax, these are all great and assist with muscle pain, sleeplessness and other symptoms. Alternative drug therapies and homeopathy have limited success in my experience and few of our clients have ever reported experiencing any dramatic changes from their use.

Reflexology, massage, hypnosis and visualization exercises can all be very relaxing and therefore therapeutic but are NOT the solution to anxiety disorders and certainly couldn’t be called anxiety therapy.

The Linden Method includes relaxation audio tracks that can achieve the same results.

Anxiety Therapy - The Linden Method

Like me, you have probably scoured the medical world for an anxiety therapy. When I was looking for an anxiety therapy, I looked in libraries, on the web, phoned specialists in all fields of medicine and went to the hospital (sometimes in an ambulance.)

I became completely obsessed about finding an anxiety therapy... an obsession which fueled the anxiety, but ultimately caused me to discover and develop the most effective anxiety therapy available anywhere.

This Linden Method is an effective anxiety therapy simply because it does what other treatments, therapies and self help methods don't do, it tackles the root cause of the condition, deactivating the 'switch' in the brain which controls anxiety.

Psychologists, doctors and psycho-physiologists agree that the Linden Method is THE only anxiety therapy that works by eliminating the root cause of the anxiety disorder. The NIMH have confirmed what we believed for years, that the Amygdala is to blame... they just haven't found a solution yet!

Dr Romulo Valdez Ph.D Says "I have been trained by the very best in the field of Psychology and Psychiatry, as you can see by my credentials and I endorse the Linden Method with highest regard." Romulo trained at Harvard and is one of Americas most qualified and experienced clinical psychologists.

Author's Bio
Apart from providing support and counseling to anxiety sufferers through 'The Linden Method', I also work in private practice with anxiety disorder sufferers through The Linden Centers and my team of psychologists and counselors around the world.

My 'Method' took seven years to develop and is now, not only, becoming recognized as THE drug free solution to anxiety disorders by government bodies, but is also receiving referrals from psychologists, doctors, psychiatrists, health authorities, insurance companies and other organizations from around the world.

I am also a regular contributor to printed publications such as Natural Health, Women, Women's Own, Pick Me Up, About.com, Top Santé, OK magazine and anxiety disorder websites. I contribute to BBC radio and I am also chairman of the International Association of Anxiety Management.

source site: www.selfgrowth.com

New Warning Issued on Paxil

FDA says company study found higher number of birth defects if used in first trimester

Boomers More Likely to Try Alternative Medicine Treatments range from acupuncture to yoga, study finds

From the Caregiver Anxiety Page:

If you were looking at what type of information was available by clicking on the link at the National Consumer's League - you can see it here!

Comparative Effectiveness of Second-Generation Antidepressants in the Pharmacologic Treatment of Adult Depression

Consumer Summary Guide published 15 Aug 2007

Introduction

1. What does this guide cover?

This guide can help you work with your doctor or nurse to choose medicines for depression. It covers:

Common medicines for adults with depression.
Side effects.
Price.

This guide is based on a government-funded review of research about the medicines often used to treat adults with depression.

What is not covered in this guide?

This guide does not cover:

Treatment of depression in children or teens.
Postpartum depression ("baby blues").
Depression that is part of another mental health condition like bipolar disorder (previously called manic-depressive disorder).
Older antidepressant medicines like amitriptyline (Elavil^®) and phenelzine (Nardil^®).
Other ways to treat depression such as counseling, light therapy, and herbal supplements like St. John's Wort.

2. Fast Facts

Fast Facts on Antidepressants

The antidepressants in this guide work for treating depression. Most people can find one that makes them feel better.
6 out of 10 people will feel better with the first antidepressant they try. The rest of the people will need to try other antidepressants before they find the one that is right for them.
Most people taking antidepressants have at least one side effect.
The most common side effects are

constipation

daytime sleepiness

diarrhea

dizziness

dry mouth

headache

nausea

sexual problems

shakiness

trouble sleeping

weight gain

According to WebMd's Drug Directory:

Citalopram (oral)
Pronunciation: sih TAL oh pram

Celexa

What's the most important information I should know about citalopram?

Don't stop taking citalopram w/out first talking to your doctor. It may take several weeks for you to start feeling better.

Use caution when driving, operating machinery, or performing other hazardous activities. Citalopram may cause dizziness. If you experience dizziness, avoid these activities.

Use alcohol cautiously. Alcohol may increase drowsiness & dizziness while taking citalopram or affect your condition.

What is citalopram?

Citalopram is in a class of drugs called selective serotonin reuptake inhibitors. Citalopram affects chemicals in the brain that may become unbalanced & cause depression.

Citalopram is used to treat depression.

Citalopram may also be used for purposes other than those listed in this medication guide.

What should I discuss w/my healthcare provider before taking citalopram?

You can't take citalopram if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) during the last 2 weeks.

A dangerous drug interaction can occur if citalopram is combined w/any of these medications.

Before taking citalopram, tell your doctor if you

have liver disease
have kidney disease
suffer from seizures
suffer from mania or have suicidal thoughts

You may not be able to take citalopram, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Citalopram shouldn't be taken during treatment w/escitalopram (Lexapro). Also, if you have had an allergic reaction to escitalopram (Lexapro), you may also have an allergic reaction to citalopram.

Don't take citalopram w/out first talking to your doctor if you have had an allergic reaction to either medication in the past.

Citalopram is in the FDA pregnancy category C. This means that it's not known whether citalopram will be harmful to an unborn baby. Don't take citalopram without first talking to your doctor if you are pregnant or could become pregnant during treatment.

Citalopram passes into breast milk & may affect a nursing infant. Don't take citalopram w/out first talking to your doctor if you are breast-feeding a baby.

How should I take citalopram?

Take citalopram exactly as directed by your doctor. If you don't understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose w/a full glass (8 ozs.) of water.

To ensure that you get the correct dose, measure the citalopram solution w/a dose-measuring spoon or cup, not w/a regular table spoon. If you don't have a dose-measuring device, ask your pharmacist where you can get one.

Citalopram may be taken w/or without food.

Citalopram is usually taken once a day. Follow your doctor's instructions. Take the dose at the same time each day.

Don't stop taking citalopram w/out first talking to your doctor. It may take several weeks for you to start feeling better.

Store citalopram at room temperature away from moisture & heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it's almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take a double dose of this medication unless otherwise directed by your doctor.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a citalopram overdose include nausea, vomiting, tremor, drowsiness, dizziness, sweating & a fast heartbeat.

What should I avoid while taking citalopram?

Use caution when driving, operating machinery, or performing other hazardous activities. Citalopram may cause dizziness. If you experience dizziness, avoid these activities.

Use alcohol cautiously. Alcohol may increase drowsiness & dizziness while taking citalopram or affect your condition.

What are the possible side effects of citalopram.

If you experience any of the following serious side effects, stop taking citalopram & call your doctor immediately or seek emergency medical treatment:

an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
an irregular heartbeat or pulse;
low blood pressure (dizziness, weakness);
high blood pressure (severe headache, blurred vision); or
chills or fever.

If you experience any of the following less serious side effects, continue taking citalopram & talk to your doctor:

headache, tremor, nervousness, or anxiety
nausea, diarrhea, dry mouth, or changes in appetite or weight
sleepiness or insomnia
decreased sex drive, impotence, or difficulty having an orgasm

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect citalopram?

You can't take citalopram if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) during the last 2 weeks.

A dangerous drug interaction can occur when citalopram is combined w/any of these medications.

Before taking citalopram, tell your doctor if you are taking any of the following medicines:

another antidepressant such as fluoxetine (Prozac), fluvoxamine (Luvox), sertraline (Zoloft), paroxetine (Paxil), trazodone (Desyrel), or nefazodone (Serzone);
a tricyclic antidepressant such as amitriptyline (Elavil), imipramine (Tofranil), doxepin (Sinequan), nortriptyline (Pamelor) & others
a seizure medication including carbamazepine (Tegretol) or felbamate (Felbatol);
a stomach medicine such as cimetidine (Tagamet, Tagamet HB), ranitidine (Zantac, Zantac 75), or omeprazole (Prilosec);
an antibiotic such as erythromycin (Eryc-Tab, E-Mycin, E.E.S., Erythrocin, P.C.E., others) or clarithromycin (Biaxin);
an antifungal medication such as fluconazole (Diflucan), itraconazole (Sporanox), or ketoconazole (Nizoral);
a migraine medication such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex), or zolmitriptan (Zomig);
the asthma medication zafirlukast (Accolate); or
lithium (Eskalith, Lithobid, Lithonate, Lithotabs).

You may not be able to take citalopram, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with citalopram. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

Where can I get more information?

Your pharmacist has additional information about citalopram written for health professionals that you may read.

What does my medication look like?

Citalopram is available with a prescription under the brand name Celexa. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

Celexa 20 mg--pink, oval, scored tablets
Celexa 40 mg-white, oval, scored tablets
Celexa Oral Solution 10 mg per tsp (5 mL)-peppermint-flavored solution

Antidepressant Could Cause Liver Problems, Maker Warns

Venlafaxine (oral)
Pronunciation: ven la FAK seen

Effexor, Effexor XR

What is the most important information I should know about venlafaxine?

Don't take venlafaxine if you are currently taking or have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days.

Use caution when driving, operating machinery, or performing other hazardous activities. Venlafaxine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.

Use alcohol cautiously. Alcohol may increase drowsiness, dizziness & confusion.

Don't stop taking venlafaxine without first talking to your doctor. Your doctor may need to gradually reduce the dose before stopping the medication completely. Stopping the medication suddenly may cause unpleasant side effects to occur.

What is venlafaxine?

Venlafaxine is an antidepressant medication. It affects chemicals in the brain that may become unbalanced and cause depression or anxiety.

Venlafaxine is used to relieve symptoms of depression, generalized anxiety disorder, and social anxiety disorder (social phobia).

Venlafaxine may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking venlafaxine?

Do not take venlafaxine if you are currently taking or have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days.

Before taking this medication, tell your doctor if you have:

Liver disease;
Kidney disease;
Heart disease or high blood pressure;
Seizures or epilepsy;
A history of mania or bipolar disorder;
Increased pressure in the eye(s) or narrow-angle glaucoma;
Bleeding or blood clotting problems; or
Increased level of cholesterol in the blood.

You may not be able to take venlafaxine, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Venlafaxine is in the FDA pregnancy category C. This means that it's not known whether venlafaxine will be harmful to an unborn baby. Don't take this medication w/out first talking to your doctor if you're pregnant or could become pregnant during treatment.

Venlafaxine passes into breast milk & may affect a nursing baby. Don't take venlafaxine w/out first talking to your doctor if you're breast-feeding a baby.

How should I take venlafaxine?

Take venlafaxine exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain the instructions to you.

Take each dose w/a full glass of water.

Take venlafaxine w/food or milk to lessen stomach upset.

Venlafaxine should be taken at the same time every day.

Each Effexor XR capsule should be swallowed whole w/ fluid & not divided, crushed, chewed, or placed in water.

If swallowing of the Effexor XR capsules is difficult, a capsule may be carefully opened & the entire contents sprinkled onto a spoonful of applesauce. This drug/food mixture should be swallowed immediately without chewing & followed w/a glass of water.

It's important to take venlafaxine regularly to get the most benefit.

Don't stop taking venlafaxine w/out first talking to your doctor. Your doctor may need to gradually reduce the dose before stopping the medication completely. Stopping the medication suddenly may cause unpleasant side effects to occur.

Your doctor may want you to have blood tests or other medical evaluations during treatment w/venlafaxine to monitor progress & side effects.

Store venlafaxine at room temperature away from moisture & heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose & take only the next one as directed. Don't take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention if an overdose is suspected.

Symptoms of a venlafaxine overdose may include dizziness, drowsiness, numbness, nausea, irregular heartbeats, seizures, & unconsciousness.

What should I avoid while taking venlafaxine?

Avoid the use of alcohol. Alcohol may increase drowsiness, dizziness & confusion while taking venlafaxine.

What are the possible side effects of venlafaxine?

If you experience any of the following serious side effects, stop taking venlafaxine & contact your doctor immediately or seek emergency medical treatment:

an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives)
seizures
an irregular heartbeat or severely high blood pressure (blurred vision, headache)

Other, less serious side effects may be more likely to occur. Continue to take venlafaxine & talk to your doctor if you experience:

nausea, vomiting, upset stomach, abdominal pain, or loss of appetite or weight
dry mouth
drowsiness or dizziness
mild tremor, anxiety, or agitation
insomnia
abnormal dreams
sexual problems such as impotence, abnormal ejaculation, difficulty reaching orgasm, or decreased libido
sweating
yawning
increase in blood cholesterol levels (detected by blood tests)

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect venlafaxine?

Don't take venlafaxine if you are currently taking or have taken a monoamine oxidase inhibitor (MAOI) such as:

isocarboxazid (Marplan)
phenelzine (Nardil)
tranylcypromine (Parnate)

in the last 14 days.

Venlafaxine may increase the effects of other drugs that cause drowsiness, including other antidepressants, anxiety medicines, antipsychotics, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers & muscle relaxants. Tell your doctor about all medicines that you are taking & don't take any other medicine w/out first talking to your doctor.

Drugs other than those listed here may also interact w/venlafaxine. Talk to your doctor & pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

Where can I get more information?

Your pharmacist has additional information about venlafaxine written for health professionals that you may read.

What does my medication look like?

Venlafaxine is available w/a prescription under the brand names Effexor & Effexor XR. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it's new to you.

Effexor 25 mg--peach-colored, shield-shaped, scored tablets

Effexor 37.5 mg--peach-colored, shield-shaped, scored tablets

Effexor 50 mg--peach-colored, shield-shaped, scored tablets

Effexor 75 mg--peach-colored, shield-shaped, scored tablets

Effexor 100 mg--peach-colored, shield-shaped, scored tablets

Effexor XR 37.5 mg-grey/peach capsules

Effexor XR 75 mg-peach capsules

Effexor XR 150 mg-dark orange capsules

Fluvoxamine
Pronunciation: flew VOCK sah meen

Luvox

What is the most important information I should know about fluvoxamine?

Do not stop taking fluvoxamine without first talking to your doctor. It may take 4 weeks or more for you to start feeling better and you may experience unpleasant side effects if you stop taking fluvoxamine suddenly.

What is fluvoxamine?

Fluvoxamine is in a class of drugs called selective serotonin reuptake inhibitors. Fluvoxamine affects chemicals in the brain that may become unbalanced and cause obsessive-compulsive symptoms.

Fluvoxamine is used to treat obsessive-compulsive disorders involving recurring thoughts or actions.

Fluvoxamine may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking fluvoxamine?

Do not take fluvoxamine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) during the last 2 weeks. Serious, and sometimes fatal, reactions have occurred when these medicines have been used together.

Do not take fluvoxamine without first talking to your doctor if you are taking thioridazine (Mellaril), cisapride (Propulsid), or pimozide (Orap). A dangerous interaction may occur if these medicines are used together. You must wait 5 weeks after stopping fluvoxamine before taking thioridazine (Mellaril).

Before taking fluvoxamine, tell your doctor if you

have liver disease;
suffer from seizures; or
suffer from mania or have suicidal thoughts.

You may not be able to take fluvoxamine, or you may need a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Fluvoxamine is in the FDA pregnancy category C. This means that it is not known whether it will be harmful to an unborn baby. Do not take fluvoxamine without first talking to your doctor if you are pregnant or could become pregnant during treatment.

Fluvoxamine passes into breast milk and may affect a nursing baby. Do not take fluvoxamine without first talking to your doctor if you are breast-feeding a baby.

How should I take fluvoxamine?

Take fluvoxamine exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with water.

Fluvoxamine may be taken with or without food.

Try to take fluvoxamine at the same time each day

Store fluvoxamine at room temperature away from heat and moisture.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take a double dose of this medication unless otherwise directed by your doctor.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a fluvoxamine overdose include nausea, vomiting, tremor, seizures, agitation, drowsiness, hyperactivity, and enlarged pupils.

What should I avoid while taking fluvoxamine?

Use caution when driving, operating machinery, or performing other hazardous activities. Fluvoxamine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.

Use alcohol cautiously. Alcohol may increase drowsiness or dizziness while taking fluvoxamine.

What are the possible side effects of fluvoxamine?

If you experience any of the following serious side effects, stop taking fluvoxamine and contact your doctor immediately or seek emergency medical treatment:

An allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives)
An irregular heartbeat or pulse
Low blood pressure (dizziness, weakness)
High blood pressure (severe headache, blurred vision)
Chills or fever

If you experience any of the following less serious side effects, continue taking fluvoxamine and talk to your doctor:

Headache
Tremor, nervousness, or anxiety
Nausea, diarrhea, dry mouth, or changes in appetite or weight;
Sleepiness or insomnia
Decreased sex drive, impotence, or difficulty having an orgasm

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect fluvoxamine?

Before taking fluvoxamine, tell your doctor if you are taking any of the following medicines:

a benzodiazepine such as diazepam (Valium), alprazolam (Xanax), chlordiazepoxide (Librium), clorazepate (Tranxene), temazepam (Restoril), triazolam (Halcion), and others;
a tricyclic antidepressant such as amitriptyline (Elavil), imipramine (Tofranil), doxepin (Sinequan), nortriptyline (Pamelor), and others;
a phenothiazine such as chlorpromazine (Thorazine), fluphenazine (Prolixin), mesoridazine (Serentil), perphenazine (Trilafon), prochlorperazine (Compazine), and others;
lithium (Lithobid, Eskalith, others) or clozapine (Clozaril);
almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig);
propranolol (Inderal, Inderal LA) or metoprolol (Lopressor, Toprol XL);
carbamazepine (Tegretol) or phenytoin (Dilantin);
warfarin (Coumadin);
methadone (Dolophine, Methadose) or
tacrine (Cognex).

You may not be able to take fluvoxamine, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with fluvoxamine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

Where can I get more information?

Your pharmacist has additional information about fluvoxamine written for health professionals that you may read.

What does my medication look like?

Fluvoxamine is available with a prescription under the brand name Luvox. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

Luvox 25 mg--elliptical, white, film-coated tablets
Luvox 50 mg--elliptical, yellow, scored, film-coated tablets
Luvox 100 mg--elliptical, beige, scored, film-coated tablets

According to WebMd's Drug Database:

Paroxetine

Pronunciation: pa ROCK sah teen

Brand Names: Paxil, Paxil CR

What is the most important information I should know about paroxetine?

What is paroxetine?
Paroxetine is in a class of drugs called selective serotonin reuptake inhibitors. Paroxetine affects chemicals in the brain that may become unbalanced & cause depression, panic or anxiety, or obsessive or compulsive symptoms.

Paroxetine is used to treat depression, obsessive compulsive disorder, panic disorder, generalized anxiety disorder, social anxiety disorder (social phobia) & posttraumatic stress disorder (PTSD).

Paroxetine may also be used for purposes other than those listed in this medication guide.

What should I discuss w/my healthcare provider before taking paroxetine?

Do not take paroxetine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) during the last 2 weeks.

Serious & sometimes fatal, reactions have occurred when these medicines have been used together. Also, don't take paroxetine if you're taking thioridazine (Mellaril).

Dangerous, even fatal irregular heartbeats may occur if these medicines are taken together. You must wait 5 weeks after stopping paroxetine before taking thioridazine (Mellaril).

Before taking paroxetine, tell your doctor if you have

liver disease,
kidney disease,
seizures or epilepsy, or
a manic disorder or suicidal thoughts.

You may not be able to take paroxetine, or you may need a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Paroxetine is in the FDA pregnancy category C. This means that it's not known whether it'll be harmful to an unborn baby. Don't take paroxetine w/out first talking to your doctor if you're pregnant or could become pregnant during treatment.

Paroxetine passes into breast milk & may affect a nursing baby. Don't take paroxetine w/out first talking to your doctor if you're breast-feeding a baby.

How should I take paroxetine?
Take paroxetine exactly as directed by your doctor. If you don't understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose w/ water.

Swallow the controlled-release tablets (Paxil CR) whole, w/out crushing or chewing. They are specially formulated to release the medication slowly in the body.

Shake the suspension well before measuring a dose. To ensure that you get the correct dose, measure the suspension w/a dose-measuring cup or spoon, not w/a regular table spoon. If you don't have a dose-measuring device, ask your pharmacist for one.

Paroxetine may be taken with or w/out food.
Try to take paroxetine at the same time each day.

Don't stop taking paroxetine w/out first talking to your doctor. It may take 4 weeks or more for you to start feeling better & unpleasant side effects may be experienced if you stop taking paroxetine suddenly.

Store paroxetine at room temperature away from moisture & heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it's almost time for the next regularly scheduled dose, skip the missed dose & take the next one as directed. Don't take a double dose of this medication unless otherwise directed by your doctor.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a paroxetine overdose include:

nausea

vomiting

tremor

seizures

agitation

drowsiness

hyperactivity

enlarged pupils

What should I avoid while taking paroxetine?
Use caution when driving, operating machinery, or performing other hazardous activities. Paroxetine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.

Use alcohol cautiously. Alcohol may increase drowsiness or dizziness while taking paroxetine.

What are the possible side effects of paroxetine?

If you experience any of the following serious side effects, stop taking paroxetine & contact your doctor immediately or seek emergency medical treatment:

an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives)
an irregular heartbeat or pulse
low blood pressure (dizziness, weakness)
high blood pressure (severe headache, blurred vision)
unusual bleeding or bruising
fever or chills
Less serious side effects may be more likely to occur. Continue to take paroxetine & talk to your doctor if you experience

headache
tremor, nervousness, or anxiety
nausea, diarrhea, dry mouth, or changes in appetite or weight
sleepiness or insomnia
decreased sex drive, impotence, or difficulty having an orgasm

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect paroxetine?
Don't take paroxetine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) during the last 2 weeks.

Serious & sometimes fatal, reactions have occurred when these medicines have been used together. Also, do not take paroxetine if you're taking thioridazine (Mellaril).

Dangerous, even fatal irregular heartbeats may occur if these medicines are taken together. You must wait 5 weeks after stopping paroxetine before taking thioridazine (Mellaril).

Before taking paroxetine, tell your doctor if you're taking any of the following medicines:

a benzodiazepine such as diazepam (Valium), alprazolam (Xanax), chlordiazepoxide (Librium), clorazepate (Tranxene), temazepam (Restoril), triazolam (Halcion), & others
a tricyclic antidepressant such as amitriptyline (Elavil), imipramine (Tofranil), doxepin (Sinequan), nortriptyline (Pamelor) & others
a phenothiazine such as chlorpromazine (Thorazine), fluphenazine (Prolixin), mesoridazine (Serentil), perphenazine (Trilafon), prochlorperazine (Compazine) & others
almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig)
carbamazepine (Tegretol) or phenytoin (Dilantin)
lithium (Lithobid, Eskalith, others)
theophylline (Theobid, Theolair, Theochron, Elixophyllin & others)
warfarin (Coumadin)
digoxin (Lanoxin)
cimetidine (Tagamet, Tagamet HB)

You may not be able to take paroxetine, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact w/paroxetine. Talk to your doctor & pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

Where can I get more information?

Your pharmacist has additional information about paroxetine written for health professionals that you may read.

What does my medication look like?

Paroxetine is available w/a prescription under the brand name Paxil. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

Paxil 10 mg--oval, yellow, film-coated scored tablets
Paxil 20 mg--oval, pink, film-coated scored tablets
Paxil 30 mg--oval, blue, film-coated scored tablets
Paxil 40 mg--oval, green, film-coated scored tablets
Paxil CR 12.5 mg--round, pale yellow & white, film-coated tablets
Paxil CR 25 mg--round, pink, film-coated tablets
Paxil CR 37.5 mg-round, blue, film-coated tablets
Paxil 10 mg/5 mL-orange-colored, orange-flavored oral suspension

Anti-Anxiety Medications

High-potency benzodiazepines relieve symptoms quickly & have few side effects, although drowsiness can be a problem. Because people can develop a tolerance to them & would have to continue increasing the dosage to get the same effect -benzodiazepines are generally prescribed for short periods of time.

One exception is panic disorder, for which they may be used for 6 months to a year. People who've had problems w/drug or alcohol abuse aren't usually good candidates for these medications because they may become dependent on them.

Some people experience withdrawal symptoms when they stop taking benzodiazepines, although reducing the dosage gradually can diminish those symptoms.

In certain instances, the symptoms of anxiety can rebound after these medications are stopped. Potential problems w/benzodiazepines have led some physicians to shy away from using them, or to use them in inadequate doses, even when they are of potential benefit to the patient.

Benzodiazepines include clonazepam, which is used for social phobia & GAD; alprazolam, which is helpful for panic disorder & GAD; & lorazepam, which is also useful for panic disorder.

Buspirone, a member of a class of drugs called azipirones, is a newer anti-anxiety medication that is used to treat GAD. Possible side effects include dizziness, headaches, & nausea.

Unlike the benzodiazepines, buspirone must be taken consistently for at least 2 weeks to achieve an anti-anxiety effect.

from WebMd's Drug Directory:

Lorazepam
Pronunciation: lor A ze pam

Ativan

What's the most important information I should know about lorazepam?

Use caution when driving, operating machinery, or performing other hazardous activities. Lorazepam will cause drowsiness & may cause dizziness. If you experience drowsiness or dizziness, avoid these activities.

Avoid alcohol while taking lorazepam. Alcohol may increase drowsiness & dizziness caused by lorazepam. Alcohol may also increase the risk of having a seizure if lorazepam is being taken for a seizure condition.

Lorazepam is habit forming. You can become physically & psychologically dependent on the medication.

Don't take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if lorazepam is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dosage.

What is lorazepam?

Lorazepam is in a class of drugs called benzodiazepines. Lorazepam affects chemicals in the brain that may become unbalanced & cause anxiety, insomnia & seizures.

Lorazepam is used to relieve anxiety, nervousness & tension associated w/anxiety disorders. It is also used to treat certain types of seizure disorders & to relieve insomnia (induce sleep).

Lorazepam may also be used for purposes other than those listed in this medication guide.

Who should not take lorazepam?

Do not take lorazepam if you have narrow-angle glaucoma. Lorazepam may worsen this condition.

Before taking lorazepam, tell your doctor if you

have kidney disease
have liver disease
have asthma, bronchitis, emphysema, or another respiratory disease
are depressed or have suicidal thoughts

You may not be able to take lorazepam, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Lorazepam is in the FDA pregnancy category D. This means that lorazepam is known to be harmful to an unborn baby. Don't take this medication w/out first talking to your doctor if you're pregnant or could become pregnant during treatment.

Lorazepam passes into breast milk. Don't take lorazepam w/out first talking to your doctor if you're breast-feeding a baby.

If you're over 65 years of age, you may be more likely to experience side effects from lorazepam. Your doctor may prescribe a lower dose of this medication.

How should I take lorazepam?

Take lorazepam exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each oral dose w/a full glass of water.

Lorazepam is also available as an injection. If you're using the injection at home, your healthcare provider will give you detailed instructions regarding preparation, administration & storage of the injectable formulation.

Don't take more than is prescribed for you.

Lorazepam is habit forming. You can become physically & psychologically dependent on the medication. Don't take more than the prescribed amount of medication or take it for longer than is directed by your doctor.

Withdrawal effects may occur if lorazepam is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose.

Your doctor may want you to have medical evaluations during treatment with lorazepam to monitor progress and side effects.

Store lorazepam at room temperature away from moisture & heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the dose you missed and take only the next regularly scheduled dose. Do not take a double dose of this medication. A double dose could be dangerous.

What happens if I overdose?

Seek emergency medical attention if an overdose is suspected.

Symptoms of a lorazepam overdose include sleepiness, dizziness, confusion, a slow heart beat, difficulty breathing, difficulty walking & talking, an appearance of being drunk & unconsciousness.

What should I avoid while taking lorazepam?

Avoid alcohol while taking lorazepam. Alcohol may increase drowsiness & dizziness caused by lorazepam. Alcohol may also increase the risk of a seizure if lorazepam is being taken for a seizure condition.

Tell your doctor about all medicines that you're taking & don't take any medicine without first talking to your doctor.

What are the possible side effects of lorazepam?

If you experience any of the following serious side effects, stop taking lorazepam & seek emergency medical attention or contact your doctor immediately:

an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, face, or tongue; or hives);
sores in the mouth or throat;
yellowing of the skin or eyes;
a rash;
hallucinations or severe confusion; or
changes in vision.

Other, less serious side effects may be more likely to occur. Continue to take lorazepam and talk to your doctor if you experience

drowsiness, dizziness, or clumsiness;
depression;
nausea, vomiting, diarrhea, or constipation;
difficulty urinating;
vivid dreams;
headache;
dry mouth;
decreased sex drive; or
changes in behavior.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect lorazepam?

Lorazepam may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines & muscle relaxants. Tell your doctor about all medicines that you are taking & don't take any medicine w/out first talking to your doctor.

Antacids may decrease the effects of lorazepam. Separate doses of an antacid & lorazepam by several hours whenever possible.

Drugs other than those listed here may also interact w/lorazepam. Talk to your doctor & pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals & herbal products.

Where can I get more information?

Your pharmacist has additional information about lorazepam written for health professionals that you may read.

What does my medication look like?

Lorazepam is available w/a prescription under the brand name Ativan. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it's new to you.

Ativan 0.5 mg- 5 sided, white tablets w/a raised "A" on one side
Ativan 1 mg-5 sided, white tablets w/a raised "A" on one side
Ativan 2 mg- 5 sided, white tablets w/a raised "A" on one side

Buspirone
Pronunciation: byoo SPYE rone

BuSpar

What is the most important information I should know about buspirone?

It may be several weeks before you start to feel better, but don't stop taking buspirone w/out first talking to your doctor.

Use caution when driving, operating machinery, or performing other hazardous activities. Although unlikely, it's possible that you will experience some drowsiness or dizziness at the start of therapy w/buspirone. If you experience dizziness or drowsiness, avoid these activities.

Use alcohol cautiously. Alcohol may increase drowsiness & dizziness while you are taking buspirone.

What is buspirone?

Buspirone is an anti-anxiety medicine. Buspirone affects chemicals in your brain that may become unbalanced & cause anxiety.

Buspirone is used to reduce fear, tension & anxiety associated w/anxiety disorders.

Buspirone may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking buspirone?

Don't take buspirone if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) during the last 2 weeks.

Severely high blood pressure may occur if buspirone is taken w/a monoamine oxidase inhibitor.

Before taking buspirone, tell your doctor if you

have had an allergic reaction to buspirone in the past
have taken a monoamine oxidase inhibitor such as phenelzine (Nardil), isocarboxazid (Marplan), tranylcypromine (Parnate) w/in the last 14 days
have kidney disease;
have liver disease
have a history of alcohol or drug addiction

You may not be able to take buspirone, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Buspirone is in the FDA pregnancy category B. This means that it's unlikely to harm an unborn baby. Don't take buspirone without first talking to your doctor if you're pregnant.

Buspirone passes into breast milk & may affect a nursing infant. Don't take this medication w/out first talking to your doctor if you're breast-feeding a baby.

Buspirone has not been approved for use by children younger than 18 years of age.

How should I take buspirone?

Take buspirone exactly as directed by your doctor. If you don't understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose w/a full glass of water.

It may be several weeks before you start to feel better, but don't stop taking buspirone w/out first talking to your doctor.

Grapefruit & grapefruit juice may interact w/buspirone. The interaction could lead to potentially adverse effects. You should discuss the use of grapefruit & grapefruit juice w/your doctor. Don't increase or decrease the amount of grapefruit products in your diet w/out first talking to your doctor.

Store buspirone at room temperature away from moisture & heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it's almost time for your next dose, skip the dose you missed & take only your next regularly scheduled dose. Don't take a double dose of this medication.

What happens if I overdose?

Seek emergency medical treatment.

The symptoms of a buspirone overdose include drowsiness, very deep sleep, nausea, vomiting, and unusually small pupils.

Use caution when driving, operating machinery, or performing other hazardous activities. Although unlikely, it is possible that you'll experience some drowsiness or dizziness at the start of therapy w/buspirone. If you experience dizziness or drowsiness, avoid these activities.

Use alcohol cautiously. Alcohol may increase drowsiness & dizziness while you are taking buspirone.

Buspirone may increase the effects of other drugs that cause drowsiness, including antidepressants, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines & muscle relaxants. Tell your doctor about all medicines that you are taking & don't take any prescription or over-the-counter medicine w/out first talking to your doctor.

What are the possible side effects of buspirone?

If you experience any of the following serious side effects, stop taking buspirone & seek emergency medical attention:

an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; hives)
chest pain or an irregular heartbeat;
headache, dizziness, lightheadedness, slurred speech, confusion, or blurred vision;
numbness or tingling in your hands, feet, arms, or legs;
depression; or
uncontrollable movements of your arms, legs, tongue, or lips.

Other, less serious side effects may be more likely to occur. Continue to take buspirone & talk to your doctor if you experience:

drowsiness or fatigue,
dry mouth, or
an increase in nightmares or dreams

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect buspirone?

Don't take buspirone if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) during the last 2 weeks.

Severely high blood pressure may occur if buspirone is taken w/a monoamine oxidase inhibitor.

Before taking buspirone, tell your doctor if you are taking any of the following medicines:

nefazodone (Serzone)
itraconazole (Sporanox)
erythromycin (E-Mycin, E.E.S., Ery-Tab, Eryc, others)
selegiline (Eldepryl)

You may require a dosage adjustment or special monitoring during treatment if you're taking any of the medicines listed above.

Buspirone may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines & muscle relaxants.

Tell your doctor about all medicines that you're taking & don't take any prescription or over-the-counter medicine w/out first talking to your doctor.

Drugs other than those listed here may also interact w/buspirone. Talk to your doctor & pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

Your pharmacist has additional information about buspirone written for health professionals that you may read.

What does my medication look like?

Buspirone is available w/a prescription under the brand name BuSpar. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it's new to you.

BuSpar 5 mg--white, rounded rectangular, scored tablet
BuSpar 10 mg--white, rounded rectangular, scored tablet
BuSpar 15 mg--two joined, rounded rectangles, forming a white, scored tablet

Once again, according to www.socialfear.com

Long term use of benzodiazepines remains controversial. About 10 are available but Klonopin is by far the most effective for SP. Xanax is sometimes helpful also.

Klonopin (clonazepam): Klonopin is extremely effective for SP & usually works great. Klonopin can be taken either "as needed" or everday. "As needed" (prn) use can be done up to twice per week & will usually provide excellent effect w/in 30 minutes, lasting several hours to 1 day (typical dose .25-.75mg).

Taken "long term", Klonopin may be used alone, although sometimes a non-sedating antidepressant is added if depression also exists. Effective dose in long term use usually ranges from 1-5 mg/day (dose should be raised slowly over a period of weeks to months).

If energy is sub-par but there is no "depression", the addition of low dose stimulant (caffeine, Provigil) may be helpful. Klonopin works so well that taking too much can result in "disinhibition", similar to the opposite of SP. Other phobias, excessive worrying and fear are likely to diminish also.

Xanax XR (alprazolam): Occasionally may be helpful, especially for women. Alprazolam has a short half life which may limit its utility in long term use. This problem may have been lessened with an "XR" version released in the USA in 2003. Males in particular may find Xanax XR to be too sedating.

Myths About Benzodiazepines:

"Benzodiazepines are addictive": FALSE for non drug addicts w/ anxiety disorders.

"Benzodiazepines are hard to quit": FALSE (for SP, not GAD). Taper slow. Can cross-taper gabapentin if desired.

"Benzodiazepine dose keeps escalating": FALSE. Dose stabilizes after a few months w/continued efficacy.

Possible Drawbacks of Long Term Benzodiazepine Use:

Depression may be aggrevated.

Reduced mental sharpness may occur.

Reduced motivation may occur.

The older antidepressants -Tricyclic Antidepressants (TCA's) & Monoamine Oxidase Inhibitors (MAOI's) have effects on both serotonin & noradrenaline.

Their disadvantage is that they can be difficult to tolerate due to:

side effects
in the case of the MAOIs, dietary & medication restrictions

Tricyclics are started at low doses & gradually increased. Tricyclics have been around longer than SSRI's & have been more widely studied for treating anxiety disorders. The tricyclics sometimes cause:

Dizziness
Drowsiness
Dry mouth
Weight gain

When these problems persist or are bothersome, a change in dosage or a switch in medications may be needed.

Clomipramine, the only antidepressant in its class prescribed for OCD, & imipramine, once & sometimes still - prescribed for panic disorder & GAD, are examples of tricyclics.

The TCA's (tricyclic) antidepressants are ineffective in the treatment of primary SP. TCA's emerged in the 1950's along with the MAOI's, and while there are still about 10 of them marketed in the USA, their use has been substantially replaced by the newer antidepressants.

Tofranil (imipramine): This once popular TCA was often used for depression, panic & GAD.

Monoamine oxidase inhibitors, or MAOIs, are the oldest class of antidepressant medications. The most commonly prescribed MAOI is phenelzine, which is helpful for people w/panic disorder & social phobia.

Tranylcypromine & isoprocarboxazid are also used to treat anxiety disorders. People who take MAOIs are put on a restrictive diet because these medications can interact w/some foods & beverages, including:

Cheese & red wine, which contain a chemical called tyramine.

MAOI's also interact w/some other medications, including SSRI's. Interactions between MAOI's & other substances can cause dangerous elevations in blood pressure or other potentially life-threatening reactions.

According to www.socialfear.com

The MAOI "Nardil" is definitely the MOST powerful & effective antidepressant for Social Phobia.

Nardil (phenelzine): Nardil usually works great for SP! It the "Gold Standard" antidepressant for SP. Nardil is excellent for many other anxiety & depressive disorders also.

Reports of Nardil side effects are frequently exaggerated, particularly since Nardil's side effects typically take 2-4 months to diminish or disappear. (this is typical of most medications for mental disorders... eventually the side effects dwindle & sometimes totally disappear)

After several months Nardil tends to cause less side effects than SRI's across comparable dose ranges w/the exception of Prozac. Effective dose range for SP is usually 60-90mg/day.

Nardil is usually initiated at a low dose & increased gradually over a period of several weeks to months. A common error is starting too high or increasing too quickly & working w/a Dr. experienced in prescribing MAOI's is important.

MAOI related "hypertensive crisis" is rare in responsible patients & the risk is probably overestimated in most medical literature.

Many experts consider the MAOI's to be underutilized. Although it's been reported that the MAOI's have seen a small resurgance in recent years, it's likely they will continue to be used sparingly by MD's.

This could change if/when the FDA approves the "selegiline patch" (see below on Eldepryl/selegiline).

Parnate (tranylcypromine): Parnate is not as effective as Nardil for SP, but occasionally may work well. Effects are variable, but people w/Social Phobia most likely to benefit are those who also have significant depression & fatigue.

Augmentation w/a benzodiazepine (ie; Klonopin) can be useful in cases of excess agitation or stimulation.

Eldepryl (selegiline): Currently selegiline is not used much in the USA except in the treatment of Parkinson's Disease, where it used at low dose (5-10mg/day) to boost the effects of L-DOPA.

At low doses, selegiline is a selective MAO-B inhibitor (boosting mainly dopamine in the brain). At higher doses (20mg & up), selegiline also inhibits MAO-A, & has powerful antidepressant effects & a profile similar to Parnate.

Currently the FDA is evaluating a "transdermal patch" delivery method of selegiline (20mg/day) for approval as a new (new patent) antidepressant. The main advantage of the patch delivery is a lack of need for dietary restrictions. Some Dr's believe an FDA approval on the patch could lead to a significant increase in use of the MAOI's.

Aurorix (moclobemide): During the mid 1990's 2 early studies in South America showed high rates of efficacy for moclobemide in the treatment of SP. Unfortunately, two larger North American studies in the late 1990's showed no efficacy at all. While study data is conflicting, real world evidence is that moclobemide is no more effective in the treatment of SP than are the SSRI's. Moclobemide does have some advantages (and disavantages) relative to the SSRI's. Moclobomide is equally effective as an antidepressant and causes no sexual side effects or sedation. However, moclobemide is less effective than the SSRI's in the treatment of most anxiety disorders.

According to WebMd's Drug Database:

What is phenelzine?

Phenelzine is a monoamine oxidase inhibitor (MAOI) in the class of drugs called antidepressants. It works by increasing the levels of certain chemicals in your brain.

Phenelzine is used to treat symptoms of depression such as feelings of:

sadness
worthlessness
guilt
loss of interest in daily activities
changes in appetite
tiredness
sleeping too much
insomnia
thoughts of death or suicide

Phenelzine may also be used for purposes other than those listed in this medication guide.

Who should not take phenelzine?

Before taking this medication, tell your doctor if you have

congestive heart failure, high blood pressure, or any other type of heart disease
liver disease
kidney disease
pheochromocytoma
diabetes
seizures or epilepsy
thyroid problems

You may not be able to take phenelzine, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.

Phenelzine is in the FDA pregnancy category C. This means that it's not known whether phenelzine will harm an unborn baby. Don't take this medication w/out first talking to your doctor if you are pregnant.

It's not known whether phenelzine will harm an nursing baby. Don't take phenelzine w/out first talking to your doctor if you're breast-feeding a baby.

If you're over 60 years of age, you may be more likely to experience side effects from phenelzine. You may require a lower dose of this medication.

How should I take phenelzine?

Take phenelzine exactly as directed by your doctor. If you don't understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose w/ a full glass of water.

Don't stop taking phenelzine w/out the approval of your doctor. It may be 4 weeks or more before you begin to feel better & you may require continuous treatment for quite some time. Talk to your doctor before you stop taking this medication.

Store phenelzine at room temperature away from moisture & heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for your next regularly scheduled dose, skip the missed dose and take only the next one as directed. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a phenelzine overdose include:

excitement
irritability
hyperactivity
anxiety
dizziness
fainting
weakness
insomnia
restlessness
fatigue
hallucinations
flushing
sweating
fast heartbeats
convulsions
a severe headache
coma & death

According to WebMd's Drug Database:

What is the most important information I should know about phenelzine? (Nardil)

What should I avoid while taking phenelzine?

Foods that have high levels of tyramine can cause a severe reaction, including:

a severe headache
large pupils
neck stiffness
nausea
vomiting
sweating
irregular heart beats
chest pain
death

Call your doctor immediately if you experience any of these symptoms. Avoid the following foods:

cheeses, including american, blue, boursault, brick, brie, camembert, cheddar, emmenthaler, gruyere, mozzarella, parmesan, romano, roquefort, stilton & swiss
sour cream & yogurt
beef or chicken liver, fish, meats prepared w/tenderizer, bologna, pepperoni, salami, summer sausage, game meat, meat extracts, caviar, dried fish, herring & shrimp paste
avocados, bananas, figs, raisins & sauerkraut
soy sauce, miso soup, bean curd & fava beans
yeast extracts
ginseng
chocolate
caffeine (coffee, tea, cola, etc.)
beer (alcoholic & nonalcoholic), red wine (especially Chianti), sherry, vermouth & other distilled spirits

Medicines can also cause severe reactions if they are taken w/phenelzine. Don't take any prescription or over-the-counter medicine w/out the approval of your doctor.

Use caution when driving, operating machinery, or performing other hazardous activities. Phenelzine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.

Dizziness may be more likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness & a possible fall.

What are the possible side effects of phenelzine?

If you experience any of the following serious side effects, stop taking phenelzine & seek emergency medical attention:

an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives); or
headache

Other, less serious side effects may be more likely to occur. Continue to take phenelzine & talk to your doctor if you experience:

dizziness or drowsiness
tremors (shaking), weakness, or muscle twitches
restlessness, insomnia, anxiety, or agitation
nausea, decreased appetite, or abdominal pain
diarrhea or constipation
dry mouth
blurred vision

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect phenelzine?
Phenelzine can increase the effects of many other drugs, leading to serious side effects. Don't take phenelzine w/any of the following medicines w/out the approval of your doctor:

anesthetics Tell your doctor & dentist that you're taking phenelzine before you have any type of surgery. You may need to discontinue your phenelzine treatment for a few weeks before receiving an anesthetic
other antidepressant medicines, including venlafaxine (Effexor), amitriptyline (Elavil, Endep), amoxapine (Asendin), imipramine (Tofranil), nortriptyline (Pamelor), doxepin (Sinequan), fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil) & others. Serious (even fatal) reactions may occur.
diabetes medications, including insulin, glipizide (Glucotrol), glyburide (Micronase, Diabeta, Glynase), tolbutamide (Orinase) & tolazamide (Tolinase). Very low blood sugar could result.
sleep (& antiseizure) medicines such as phenobarbital (Luminal, Solfoton), secobarbital (Seconal) & amobarbital (Amytal). You may need reduced doses of these medicines
heart medicines such as propranolol (Inderal), metoprolol (Lopressor), carvedilol (Coreg), labetalol (Normodyne, Trandate), nadolol (Corgard), methyldopa (Aldomet) & reserpine (Serpasil).
diuretics (water pills) such as hydrochlorothiazide (Hydrodiuril, Esidrix, others), chlorothiazide (Diuril, Diurigen), metolazone (Diulo, Mykrox, Zaroxolyn), chlorthalidone (Thalitone, Hygroton) & indapamide (Lozol)
dextromethorphan This cough suppressant is in many prescription & over-the-counter cough & cold products
levodopa (Sinemet, Larodopa, Dopar)
meperidine (Demerol)
sulfonamides such as sulfasalazine (Azulfidine), sulfamethoxazole (Septra, Bactrim, Gantanol), sulfisoxazole (Gantrisin) & others
sumatriptan (Imitrex)
decongestants & diet aids that contain the ingredients phenylpropanolamine, pseudoephedrine, ephedrine, phenylephrine & others
methylphenidate (Ritalin)

Phenelzine may decrease the activity of guanethidine (Ismelin).

Drugs other than those listed here may also interact w/phenelzine. Talk to your doctor & pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

Your pharmacist has more information about phenelzine written for health professionals that you may read.

What does my medication look like?

Phenelzine is available w/a prescription under the brand name Nardil. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it's new to you.

Nardil 15 mg--round, orange tablets

Tranylcypromine
Pronunciation: trah nill SIH pro meen

Parnate

What is the most important information I should know about tranylcypromine?

Avoid alcohol, chocolate, and all of the foods listed in the "What should I avoid while taking tranylcypromine?" section of this leaflet. Foods high in tyramine can cause a severe reaction, including a severe headache, large pupils, neck stiffness, nausea, vomiting, sweating, irregular heartbeats, and chest pain. Call your doctor immediately if you experience any of the symptoms listed above.

Do not take any prescription or over-the-counter medicine without first talking to your doctor. Some medications can cause severe reactions if they are taken with tranylcypromine.

Use caution when driving, operating machinery, or performing other hazardous activities. Tranylcypromine may cause dizziness, drowsiness, or blurred vision. If you experience dizziness, drowsiness, or blurred vision, avoid these activities.

Dizziness may be more likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall.

Do not stop taking this medication without first talking to your doctor.

What is tranylcypromine?

Tranylcypromine is a monoamine oxidase inhibitor (MAOI) in the class of drugs called antidepressants. It works by increasing the levels of certain chemicals in the brain.

Tranylcypromine is used to treat the symptoms of depression such as feelings of sadness, worthlessness, or guilt; loss of interest in daily activities; changes in appetite; tiredness; sleeping too much; insomnia; and thoughts of death or suicide.

Tranylcypromine may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking tranylcypromine?

Before taking this medication, tell your doctor if you have

congestive heart failure, high blood pressure, or any other type of heart disease;
liver disease;
kidney disease;
pheochromocytoma;
diabetes;
seizures or epilepsy; or
thyroid problems.

You may not be able to take tranylcypromine, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Tranylcypromine is in the FDA pregnancy category C. This means that it is not known whether tranylcypromine will be harmful to an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment.

It is not known whether tranylcypromine will harm a nursing baby. Do not take tranylcypromine without first talking to your doctor if you are breast-feeding a baby.

If you are over 60 years of age, you may be more likely to experience side effects from tranylcypromine. You may require a lower dose of this medication.

How should I take tranylcypromine?

Take tranylcypromine exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water.

Do not stop taking tranylcypromine without first talking to your doctor. It may be 4 weeks or more before you begin to feel better, and you may require continuous treatment for quite some time. Talk to your doctor before you stop taking this medication.

Store tranylcypromine at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take only the next one as directed. Do not take a double dose of this medication.

What happens if I overdose?
Seek emergency medical attention.

Symptoms of a tranylcypromine overdose include excitement, irritability, hyperactivity, anxiety, dizziness, fainting, weakness, insomnia, restlessness, fatigue, hallucinations, flushing, sweating, fast heartbeats, convulsions, a severe headache, coma, and death.

What should I avoid while taking tranylcypromine?

Foods that have high levels of tyramine can cause a severe reaction, including a severe headache, large pupils, neck stiffness, nausea, vomiting, sweating, irregular heartbeats, chest pain, and death. Call your doctor immediately if you experience any of these symptoms. Avoid the following foods:

cheeses, including American, Blue, Boursault, Brick, Brie, Camembert, Cheddar, Emmenthaler, Gruyere, Mozzarella, Parmesan, Romano, Roquefort, Stilton, and Swiss;
sour cream and yogurt;
beef or chicken liver, fish, meats prepared with tenderizer, bologna, pepperoni, salami, summer sausage, game meat, meat extracts, caviar, dried fish, herring, and shrimp paste;
avocados, bananas, figs, raisins, and sauerkraut;
soy sauce, miso soup, bean curd, fava beans;
yeast extracts;
ginseng;
chocolate;
caffeine (coffee, tea, cola, etc.); and
beer (alcoholic and nonalcoholic), red wine (especially Chianti), sherry, vermouth, and other distilled spirits.

Do not take any prescription or over-the-counter medicine without first talking to your doctor. Some medications can cause severe reactions if they are taken with tranylcypromine.

Use caution when driving, operating machinery, or performing other hazardous activities. Tranylcypromine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.

Dizziness may be more likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall.

What are the possible side effects of tranylcypromine?

If you experience any of the following serious side effects, stop taking tranylcypromine and seek emergency medical attention or contact your doctor immediately:

an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); or
headache.

Other, less serious side effects may be more likely to occur. Continue to take tranylcypromine and talk to your doctor about any side effects you experience, including:

dizziness or drowsiness;
tremors (shaking), weakness, or muscle twitches;
restlessness, insomnia, anxiety, or agitation;
nausea, decreased appetite, or abdominal pain;
diarrhea or constipation;
dry mouth; or
blurred vision.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect tranylcypromine?

Tranylcypromine can increase the effects of many other drugs, leading to serious side effects. Do not take tranylcypromine with any of the following medicines without first talking to your doctor:

anesthetics. Tell your doctor and dentist that you are taking tranylcypromine before you have any type of surgery. You may need to discontinue treatment with tranylcypromine for a few weeks before receiving an anesthetic.
other antidepressant medicines, including venlafaxine (Effexor), amitriptyline (Elavil, Endep), amoxapine (Asendin), imipramine (Tofranil), nortriptyline (Pamelor), doxepin (Sinequan), fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and others. Serious (even fatal) reactions may occur.
diabetes medications, including insulin, glipizide (Glucotrol), glyburide (Micronase, Diabeta, Glynase), tolbutamide (Orinase), and tolazamide (Tolinase). Very low blood sugar could result.
sleep (and antiseizure) medicines such as phenobarbital (Luminal, Solfoton), secobarbital (Seconal), and amobarbital (Amytal). You may need a reduced dose.
heart medicines such as propranolol (Inderal), metoprolol (Lopressor), carvedilol (Coreg), labetalol (Normodyne, Trandate), nadolol (Corgard), methyldopa (Aldomet), and reserpine (Serapsil).
diuretics (water pills) such as hydrochlorothiazide (Hydrodiuril, Esidrix, others), chlorothiazide (Diuril, Diurigen), metolazone (Diulo, Mykrox, Zaroxolyn), chlorthalidone (Thalitone, Hygroton), and indapamide (Lozol).
dextromethorphan. This cough suppressant is in many prescription and over-the-counter cough and cold products.
levodopa (Sinemet, Larodopa, Dopar).
meperidine (Demerol).
sulfonamides such as sulfasalazine (Azulfidine), sulfamethoxazole (Septra, Bactrim, Gantanol), sulfisoxazole (Gantrisin), and others.
sumatriptan (Imitrex).
decongestants and diet aids that contain the ingredients phenylpropanolamine, pseudoephedrine, ephedrine, phenylephrine, and others.
methylphenidate (Ritalin, Metadate ER, Methylin, Concerta).

Drugs other than those listed here may also interact with tranylcypromine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

Where can I get more information?

Your pharmacist has more information about tranylcypromine written for health professionals that you may read.

What does my medication look like?

Tranylcypromine is available with a prescription under the brand name Parnate. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

Parnate 10 mg--round, red tablets

Other Medications

Beta-blockers, such as propranolol, are often used to treat heart conditions but have also been found to be helpful in certain anxiety disorders, particularly in social phobia.

When a feared situation, such as giving an oral presentation, can be predicted in advance, your doctor may prescribe a beta-blocker that can be taken to keep your heart from pounding, your hands from shaking, & other physical symptoms from developing.

Propranolol
Pronunciation: proe PRAH no lall

Brand Names: Inderal, Inderal LA, InnoPran XL

What is the most important information I should know about propranolol?

Do not stop taking propranolol w/out first talking to your doctor. Stopping the medication suddenly may result in angina (chest pain) & possibly a heart attack. The dosage may need to be reduced gradually before stopping.

Call your doctor immediately if you experience shortness of breath.

Use caution when driving, operating machinery, or performing other hazardous activities. Propranolol may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.

What is propranolol?
Propranolol is in a class of drugs called beta-blockers. Beta-blockers affect the heart & circulatory system (arteries & veins).

Propranolol is used to reduce hypertension (high blood pressure), to treat angina (chest pain), to treat irregular heartbeats, to treat migraines, to treat tremor & to reduce the risk of a recurrent heart attack.

Propranolol may also be used for purposes other than those listed in this medication guide.

What should I discuss w/my healthcare provider before taking propranolol?

Don't take propranolol if you're taking thioridazine (Mellaril). Taking these medicines together could result in dangerous, even fatal, irregular heartbeats.

Before taking propranolol, tell your doctor if you have

asthma
heart problems such as low blood pressure, a slow heart rate, heart block, sick sinus syndrome, a pacemaker, heart failure, or others
diabetes
depression
thyroid disease
kidney disease
liver disease
any type of circulation problems

You may not be able to take propranolol, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Propranolol is in the FDA pregnancy category C. This means it's not known whether propranolol will be harmful to an unborn baby.

Don't take this medication w/out first talking to your doctor if you're pregnant or could become pregnant during treatment.

Propranolol passes into breast milk & may affect a nursing infant. Don't take this medication w/out first talking to your doctor if you are breast-feeding a baby.

How should I take propranolol?

Take propranolol exactly as directed by your doctor. If you don't understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose w/ a full glass of water.
Propranolol can be taken w/or w/out food. Each dose of InnoPran XL should be taken in the same way, either with or w/out food.
Take propranolol at the same time every day whenever possible. InnoPran XL should be taken at bedtime (approximately 10 p.m.).
Don't crush, chew, break, or open the long-acting or extended-release capsules (Inderal LA, InnoPran XL). Swallow them whole.
Don't stop taking propranolol w/out first talking to your doctor. Stopping the medication suddenly may result in angina (chest pain) & possibly a heart attack. The dosage may need to be reduced gradually before stopping.

Store propranolol at room temperature away from moisture & heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it's almost time for the next dose, skip the missed dose & take only the next regularly scheduled dose. Don't take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a propranolol overdose include:

a slow heartbeat
shortness of breath
fainting
dizziness
weakness
confusion
nausea
vomiting

What should I avoid while taking propranolol?

Use caution when driving, operating machinery, or performing other hazardous activities. Propranolol may cause drowsiness, dizziness & blood pressure changes. If you experience drowsiness or dizziness, avoid these activities.

Use alcohol cautiously. Alcohol may increase drowsiness & dizziness while taking this medication.

Tell your doctor & dentist that you're taking this medication before having surgery.

What are the possible side effects of propranolol?

If you experience any of the following serious side effects, stop taking propranolol & call your doctor immediately or seek emergency medical treatment:

an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; hives)
wheezing or shortness of breath
an unusually slow or irregular heart beat
swelling of the feet or lower legs
leg pain or cramping
sudden weight gain (more than 2 pounds in one day or 5 pounds in one week)
chest (heart) pain
unusually cold or blue feet & hands
skin rash.

If you experience any of the following less serious side effects, continue taking propranolol & talk to your doctor:

fatigue or confusion
headache or dizziness
weak pulse or mildly slow heart rate
diarrhea, constipation, gas, nausea, or vomiting
depression
nightmares
impotence (difficulty obtaining or maintaining an erection)

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect propranolol?

Don't take propranolol if you're taking thioridazine (Mellaril). Taking these medicines together could result in dangerous, even fatal, irregular heartbeats.

Before taking propranolol, tell your doctor if you are taking

another heart medicine such as:

nifedipine (Procardia, Adalat)
reserpine (Serpasil)
verapamil (Calan, Verelan, Isoptin)
diltiazem (Cardizem, Dilacor XR)
clonidine (Catapres)
digoxin (Lanoxin)

a diabetes medication such as:

insulin
glyburide (Diabeta, Micronase, Glynase)
glipizide (Glucotrol)
chlorpropamide (Diabinese)
metformin (Glucotrol)

a nonsteroidal anti-inflammatory drug (NSAID) such as:

ibuprofen (Motrin, Advil, others)
naproxen (Aleve, Anaprox, Naprosyn, others)
ketoprofen (Orudis, Orudis KT, Oruvail)

a respiratory medication such as:

albuterol (Ventolin, Proventil, Volmax, others)
bitolterol (Tornalate)
metaproterenol (Alupent, Metaprel)
pirbuterol (Maxair)
terbutaline (Brethaire, Brethine, Bricanyl)
theophylline (Theo-Dur, Theochron, Theolair, others)

& others:

warfarin (Coumadin);
haloperidol (Haldol)
a prescription or over-the-counter cough medication, cold medicine, or diet pill.

You may not be able to take propranolol, or you may require a dosage adjustment or special monitoring during treatment if you're taking any of the medicines listed above.

Drugs other than those listed here may also interact with propranolol or affect your condition. Talk to your doctor & pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

Where can I get more information?

Your pharmacist has additional information about propranolol written for health professionals that you may read.

Propranolol is available w/a prescription under the brand names:

Inderal
Inderal LA
InnoPran XL

Other brand or generic formulations of this medication may also be available. Ask your pharmacist any questions you have about this medication, especially if it's new to you.

MAY 27, 2002

CAN SSRI ANTIDEPRESSANTS MAKE PEOPLE SUICIDAL?

This is one of the stormiest areas in modern medicine: Can the new antidepressants trigger suicidal behavior? This is huge territory and the following links represent only a tiny peek at the issues that have been debated for years.

David Healy Hangs Tough On SSRI-Suicide Link

The David Healy Affair

Brand/Generic Names

Brand Names: Prozac^®, Prozac-Weekly^®, Sarafem^®, Rapiflux^®

Capsules: 10 mg, 20 mg, 40 mg

Delayed Release Capsule: 90 mg

Tablets:10 mg, 20 mg

Oral solution: 20mg/5ml

Generic Name: Fluoxetine

What is Prozac® and what does it treat?

Fluoxetine is an antidepressant medication that works in the brain. It is a member of the selective serotonin reuptake inhibitor (SSRI) class of medicines. It is approved for the treatment of Major Depressive Disorder (MDD), Obsessive Compulsive Disorder (OCD), Panic Disorder, Bulimia Nervosa and Premenstrual Dysphoric Disorder (PMDD).

Major Depression occurs when a person experiences several of the following symptoms concurrently, for at least two weeks: "low" or depressed mood (for example, sad, empty, tearful); decreased interest in most or all activities; changes in appetite (usually decreased); changes in sleep (usually poor sleep); loss of energy; feeling worthless/guilty/ hopeless/ helpless; psychomotor agitation or retardation (i.e. thoughts/movements speeding up or slowing down); difficulty concentrating, and thoughts of death (suicidal thinking).

OCD occurs when a person experiences the following symptoms at the same time: obsessions (unwanted, recurrent and disturbing thoughts) and compulsions (repetitive, ritualized behaviors that the person feels driven to perform in order to lessen the anxiety produced by the obsessions).

Panic Disorder occurs when a person experiences unexpected and repeated episodes of intense fear along with physical symptoms including chest pain, shortness of breath, heart palpitations, sweating, dizziness, and nausea.

Bulimia Nervosa is an eating disorder in which a person eats large amounts of food in a short amount of time (binges) and tries to prevent weight gain by “purging” (e.g. vomiting or using laxatives). This occurs multiple times per week for at least 3 months.

PMDD occurs when a woman experiences symptoms including irritability, mood changes, bloating, tension, breast tenderness and sadness in association with the menstrual cycle.

What is the most important information I should know about Prozac®?

After starting fluoxetine, symptoms gradually decrease over a period of weeks. Sleep and other physical symptoms may improve before there is noticeable improvement in mood or interest in activities. Once symptoms are under control, MDD usually requires long-term treatment to help prevent the return of depressive symptoms. Only your healthcare provider can determine the length of generic name treatment that is right for you.

Do not stop taking fluoxetine or change your dose without talking to with your healthcare provider first.

Stopping fluoxetine abruptly may result in one or more of the following withdrawal symptoms: irritability, nausea, dizziness, vomiting, nightmares, headache and paresthesias (prickling, tingling sensation on the skin).

Because depression is also a part of Bipolar illness, people who take antidepressants may be at risk for "switching" from depression into mania. Symptoms of mania include "high" or irritable mood, very high self esteem, decreased need for sleep, pressure to keep talking, racing thoughts, being easily distracted, frequently involved in activities with a large risk for bad consequences (for example, excessive buying sprees).

Are there specific concerns about Prozac® and pregnancy?

If you are planning on becoming pregnant, notify your healthcare provider so that he/she can best manage your medications. People living with MDD who wish to become pregnant face important decisions, each with risks and benefits. This is a complex decision as untreated MDD or depression relapse may have negative consequences for both the fetus and the mother. There are many dimensions to these choices, so be sure to confer with your doctor and caregivers.

For mothers who have taken SSRIs during their pregnancy, there appears to be less than a 1% chance of infants developing persistent pulmonary hypertension. This is a potentially fatal condition that is associated with use of antidepressants that are similar to fluoxetine in the second half of pregnancy. However, women who discontinued medication therapy were five times more likely to have a depression relapse than those who continued their antidepressant. Untreated depression or depression relapse may have negative consequences for both the fetus and the mother. If you are pregnant, please discuss the risks and benefits of this medication use with your healthcare provider.

Regarding breast-feeding, caution is advised since fluoxetine does pass into breast milk.

What should I discuss with my healthcare provider before taking Prozac®?

The most bothersome symptoms of your condition
If you have thoughts of suicide
Medications you have taken in the past for your condition, whether they were effective or caused any adverse effects
Any medical problems that you may have
All other medications you are currently taking and any medication allergies you have
If you are pregnant, plan to become pregnant, or are breast-feeding
If you drink alcohol or use drugs

How should I take Prozac®?

Fluoxetine is usually taken once daily with or without food.

The weekly formulation is taken once weekly with or without food for the treatment of MDD.

When used for PMDD, fluoxetine may be taken continuously (every day) or intermittently (usually starting 14 days prior to the anticipated onset of menstruation through the first full day of menses and repeating with each cycle). Your healthcare provider will determine the regimen that is right for you.

While the dose usually ranges from 20 mg to 80 mg, your healthcare provider will determine the dose that is right for you based upon your response.

What happens if I miss a dose of Prozac®?

If you miss a dose of fluoxetine, take it as soon as you remember unless it is close to when your next dose is due. If you missed a dose of medication and it is close to the time of your next dose, skip the missed dose and take your next dose at the regularly scheduled time. Do not double your next dose or take more than your prescribed dose.

What should I avoid while taking Prozac®?

Avoid drinking alcohol or using illegal drugs while you are taking antidepressant medications because the beneficial effects of the medication may be decreased and adverse effects may be increased (e.g. sedation).

What happens if I overdose with Prozac®?

If an overdose occurs, whether intentional or accidental, immediate medical attention may be necessary. Call your doctor or emergency medical service (911). You may also contact the poison control center (1-800-222-1222). Symptoms of fluoxetine overdose may include nausea, vomiting, fever, rapid/irregular heart beat, seizure, confusion, sedation, and unresponsiveness. If you suspect overdose, seek medical attention immediately.

What are the possible side effects of Prozac®?

Side effects with fluoxetine are generally mild and are similar to those reported with other SSRI antidepressants. The most commonly reported side effects are increased sweating, sleepiness, insomnia, nausea, diarrhea, tremor, dry mouth, loss of strength, headache, weight loss or gain, dizziness, and restlessness. If you experience side effects after starting fluoxetine they will often improve over the first week or two as you continue to take the medication. Sexual side effects such as problems with ejaculation may also occur, and often do not diminish over time.

Are there any risks for taking Prozac® for long periods of time?

To date, there are no known problems associated with long term use of fluoxetine. It is a safe and effective medication when used as directed.

What other drugs may interact with Prozac®?

Fluoxetine should not be taken with or within two weeks of taking monoamine oxidase inhibitors (MAOIs). These include phenelzine (Nardil®), tranylcypromine (Parnate®), isocarboxazid (Marplan®) and selegeline (Emsam®).

Although rare, there is an increased risk of serotonin syndrome when fluoxetine is used with other medications that increase serotonin such as other antidepressants, migraine medications called “triptans” (e.g. Imitrex®) and the analgesic tramadol (Ultram®).

Always let your doctor know what other prescription, over-the-counter, and herbal medications you are taking.

How long does it take for Prozac® to work?

While depressed mood and lack of interest in activities may need up to 4-6 weeks to improve, disturbances in sleep, energy, or appetite may show some improvement within the first 1-2 weeks. Improvement in these physical symptoms can be an important early signal that the medication is working.

Updated by
Wilfred W. Acholonu, Jr., Pharm.D., BCPP
(April 2007)

Worst Pills, Best Bills

What if I need help paying for medications?

Pharmaceutical Research and Manufacturers Association: your doctor can request a directory of programs for those who cannot afford medication by calling (202) 835-3450
Lilly Cares Program: (800) 545-6962
Pfizer Prescription Assistance: (800) 646-4455
SmithKline Paxil Access to Care Program: (800) 536-0402 (patient requests); (215) 751-5722 (physician requests)
Solvay Patient Assistance Program: (800) 788-9277

Health Tip: Are Sleep Aids For You?

FDA Strengthens Warnings on Sleeping Pills

important new info !!!!

Sharp Increase in Sleeping Pill Use by U.S. Children & Teens

Older Americans Reluctant to Use Sleep Meds: Survey

First Antidepressant Fails 70% of Time :Study Seeks Best, Real-World Depression Treatment: Early Results In

Suicide Drops With Antidepressant Use: FDA Warning May Be Misleading, New Study Shows

an important consideration for all parents:

did you know that many children & teens are being prescribed adult medications for their mental disorders as well as other physical ailments? many of these medicaitons have never been tested on children. click here to read more.

CHILDREN &
ANTIDEPRESSANT MEDICATION, 2004

On March 22, 2004, the Food and Drug Administration (FDA) issued a public health advisory on "Worsening Depression and Suicidality in Patients being Treated with Antidepressant Medications." The advisory asked manufacturers to include a warning statement that recommends close observation of adult and child patients. The FDA action follows a hearing in February 2004, that heard testimony from parents, researchers, and others on suicide and antidpressant medication. AACAP President Richard Sarles, M.D., sent the following message to AACAP members regarding the March advisory. Also included on this page is the statement by AACAP hearing representative, Laurence Greenhill, M.D. Additional information links follow both documents. click here to continue....

U.S. Reverses Psychiatric Drug Test Policy

FDA Warns Against Use of Discontinued ADHD Drug

Your Medicine Cabinet

What can be one of the worst place to store medication? If you said the bathroom cabinetyou're right. That may be where many of us keep medicine. But the bathroom is the place most likely to get hot & humid because constant baths & showers put a lot of moisture in the air. Those kinds of conditions can affect medicine over time.

The American Pharmaceutical Association (APA) says that instead, consumers should use:

a cool dry cabinet in some other room of the house
a location that is out of direct sunlight
a cabinet that can be locked and/or is out of children's reach

Even if you don't have children living w/ you, young grandchildren or friends' children might visit. That's why proper storage & the use of child-proof caps is so important. (Read about "Childproof Home")

Although you want to keep medicine in a cool place, APA says you should not keep medicine in the refrigerator unless specifically instructed to do so by your doctor or pharmacist.

Check the dates

The Food & Drug Administration (FDA) says it's also very important to periodically go thru your medicine & discard any that are out of date. Medication can lose its effectiveness over time. If a medication is past its expiration date, you can either flush it down the toilet & dispose of the bottle safely or bring it to a pharmacist & ask him or her to dispose of it. Even if a medicine isn't past its expiration date, if it's changed colors or developed an unusual odor, discard it.

Original containers

Make sure you keep all medicines in their original containers. The FDA suggests that you save all printed information that comes with the medications, too. And whenever you buy medication, either prescription or over-the-counter, ask your doctor & pharmacist about:

the best way to store it
the best time(s) of day to take the medicine
whether to take it with food or on an empty stomach
possible side effects
potential interactions (Read about "Drug Interaction Precautions")

In addition, the APA says you shouldn't chew, crush or break any capsules or tablets unless instructed to do so by your doctor or pharmacist, since some long-acting medications are absorbed too quickly when chewed. And finally, if a medication seems to be causing any unusual symptoms, you should contact your doctor right away.

Psychotherapy, Medications Best for Youth With Obsessive Compulsive Disorder

Children & adolescents with Obsessive Compulsive Disorder (OCD) respond best to a combination of both psychotherapy & an antidepressant, a major clinical trial has found.

Supported by the National Institutes of Health's (NIH) National Institute of Mental Health, the study recommends that treatment begin with cognitive behavior therapy (CBT), either alone or with a serotonin reuptake inhibitor (SSRI) antidepressant.

The research spotlights the need for improved access to CBT, since most young people with OCD currently receive only the antidepressant, often combined with an antipsychotic medication.

John March, M.D., Duke University, Edna Foa, Ph.D., University of Pennsylvania & colleagues report on the findings of the Pediatric OCD Treatment Study (POTS) in the October 27, 2004 Journal of the American Medical Association (JAMA).

Ninety-seven 7-17 year-olds with OCD completed 12 weeks of treatment with either CBT, the SSRI sertraline, the combination treatment, or a placebo. Independent evaluators, blind to their treatment status, assessed each patient every 4 weeks.

Patients in the study were typical of patients seen in clinical practice. For example, while industry-sponsored trials commonly exclude patients with more than one condition, 80% of study participants had at least one additional psychiatric disorder.

Combining sertraline & CBT was more effective than treatment with just one or the other. CBT alone did prove superior to sertraline, which, in turn, was better than a placebo. By the end of the trial, the remission rates were:

53.6% for combined treatment
39.3% for CBT
21.4% for sertraline
3.6% for placebo.

CBT alone was more effective in the University of Pennsylvania site than at Duke University site, but the combination treatment was equally effective at both sites, suggesting that it may be less susceptible to setting-specific variations.

The strong showing of CBT at the University of Pennsylvania led the researchers to recommend it as "a first line option" for initial treatment. They point out, however, that "only a small minority" of children & adolescents with OCD receives such state-of- the-art care.

"In the Treatment of Adolescents with Depression Study, which compared CBT with an SSRI & combination treatment, for teens with depression, the medication proved superior to CBT.

In this case the reverse was true, but in both studies, combination was superior.

This underscores that different disorders in adolescents respond to different treatments," noted NIMH Director Thomas Insel, M.D.

"We believe that the results of this study will contribute to the appreciation by non-physician mental health clinicians of the strengths and limitations of pharmacological treatments and to the appreciation by physicians of the evidence-based psychosocial treatments," states the article. "It is imperative that the focus of research turn to identifying and testing dissemination strategies for CBT," the researchers add.

There were no episodes of mania, suicidality, or other serious adverse events during the course of the study.

Also participating in the study were Pat Gammon, Ph.D., Allan Chrisman, M.D., John Curry, Ph.D., David Fitzgerald, Ph.D., and Kevin Sullivan, BA, all from Duke University Medical Center; Martin Franklin, Ph.D., Jonathan Huppert, Ph.D., MoiraRynn, M.D., Ning Zhao, Ph.D., and Lori Zoellner, Ph.D., from the University of Pennsylvania; and Henrietta Leonard, M.D., Abbe Garcia, Ph.D., and Jennifer Freeman, Ph.D., from Brown University. The principal statistician was Xin Tu, Ph.D. (University of Pennsylvania).

NIMH is part of the National Institutes of Health (NIH), the Federal Government's primary agency for biomedical and behavioral research. NIH is a component of the U.S. Department of Health and Human Services.

medications prescribed for sleep problems...

from the WebMd Drug Directory:

Zolpidem
Pronunciation: zole PI dem

Ambien

What is zolpidem?

Zolpidem is in a class of drugs called sedative/hypnotics or sleep medications. Zolpidem affects chemicals in your brain that may become unbalanced & cause insomnia.

Zolpidem induces sleep & causes relaxation. It's used to treat sleep disorders such as trouble falling asleep, waking up many times during the night, or waking up too early in the morning.

Zolpidem is for short-term use only--usually 7 to 10 days. Longer-term use must be monitored closely by a doctor.

Zolpidem may also be used for purposes other than those listed in this medication guide.

if you would like to read more about this drug, click here!

The postpartum period brings heightened risk of bipolar relapse, especially in women who discontinue lithium during pregnancy.

Women taking lithium to prevent a recurrence of bipolar illness often discontinue treatment when they are pregnant. But how does this affect their chances of becoming ill again?

In a recent study, researchers compared recurrence rates after discontinuing lithium for women w/bipolar disorder during 40 weeks of pregnancy & 24 postpartum weeks or during an equivalent period of 64 weeks for nonpregnant subjects.

Recurrence rates did not differ for pregnant & nonpregnant women for the initial 40 weeks after discontinuing lithium, but they were approximately 3 times greater during weeks 41-64 for the pregnant subjects.

This finding suggests that the postpartum period specifically presents an elevated risk of relapse for women w/bipolar disorder who discontinue lithium maintenance therapy.

Estrogen affects brain response to commonly prescribed antidepressant medications.

Many widely used antidepressant medications, including the selective serotonin reuptake inhibitors (SSRIs), increase the availability of the neurotransmitter serotonin in the brain. Animal research has revealed that the reproductive hormone estrogen modulates the availability of serotonin in different ways during various phases of the reproductive cycle. Findings such as these may shed light on how changes in circulating sex steroids affect serotonin levels & antidepressant drug responses in women w/mood disorders.

For women w/depression around time of menopause, estrogen may be an alternative to traditional antidepressants.

NIMH intramural scientists conducted the first controlled study of estrogen's effects on mood in women w/depression around the time of menopause.

A 3 to 6 week trial of estrogen was found to be more effective than placebo in reducing symptoms. Estrogen significantly boosted mood in 80% of depressed women (vs. 20% of those who received a placebo), independent of its effect on hot flushes.

Other depression symptoms that improved w/the hormone were:

early morning awakening
loss of enjoyment
sadness
irritability

This level of relief, & the 3 to 6 week period required to achieve a therapeutic effect, were comparable to effects seen w/antidepressant drugs.

Reproductive hormones & stress hormones are linked to depression in women.

NIMH studies have investigated the role of the sex hormone estradiol or the stress hormones ACTH & cortisol in women's risk for depression & anxiety.

One study found that estradiol levels were lower in depressed women than in non-depressed women, but levels of other reproductive hormones were normal.

Another study found that women w/anxiety & depression who also reported histories of childhood abuse had high levels of ACTH & cortisol.

Venlafaxine

The most common side effects in people taking venlafaxine include nausea & loss of appetite, anxiety & nervousness, headache, insomnia & tiredness. Dry mouth, constipation, weight loss, sexual problems, increased blood pressure, increased heart rate & increased cholesterol levels can also occur. The effects of venlafaxine can be increased if it is taken w/the SSRI's & w/quinidine.

Taking Medications

Before taking medication for an anxiety disorder:

Ask your doctor to tell you about the effects & side effects of the drug he or she is prescribing.

Tell your doctor about any alternative therapies or over-the-counter medications you are using.

Ask your doctor when & how the medication will be stopped. Some drugs can't safely be stopped abruptly; they have to be tapered slowly under a physician's supervision.

Be aware that some medications are effective in anxiety disorders only as long as they are taken regularly, & symptoms may occur again when the medications are discontinued.

Work together w/your doctor to determine the right dosage of the right medication to treat your anxiety disorder.

Drug Interaction

Precautions esp. for Seniors

As we get older, we may find ourselves taking more medications. It's not a given that this will happen, but according to the U.S. Food & Drug Administration (FDA), adults over age 65 buy 30% of all prescription drugs sold & 40% of all over-the-counter drugs.

Risky combinations

The use of medications as we get older can cause problems we don't anticipate. One of the most dangerous is potential drug interactions. Again, although not every older adult is taking multiple medications, many are. The FDA says an older person is likely to be taking more than 4 prescription medications at once plus 2 over-the-counter medications. All of this raises the possibility that some of those drugs will interact w/each other.

The National Institute on Aging says it's essential to talk with your doctor before combining medications w/each other, because of all the possible interactions. For example, blood-thinning medication combined w/aspirin may thin the blood more than is desirable. As another example, antacids can interfere w/certain drugs for Parkinson's disease, high blood pressure & heart disease. It's not just physical either.

Combinations of drugs can also produce mental changes as well, leading to confusion, lethargy, or depression.

If someone suspects that their medications are causing problems, they should not stop taking them on their own, but contact their doctor at once. It's also important that doctors be aware of all the drugs a patient may be taking right from the start.

For example, according to the American Heart Association, certain medications can raise blood pressure; therefore, anyone who develops high blood pressure should make sure they tell their doctor about any prescribed and/or over-the-counter medicines they're taking, such as steroids, nonsteroidal anti-inflammatory drugs (NSAIDs), nasal decongestants & other cold remedies, diet pills, antidepressants, & monoamine oxidase inhibitors.

And just because a product is herbal (Read about "Herbal Precautions"), doesn't mean it's necessarily safe for you to take. For example, the American Academy of Family Physicians says ginkgo biloba can cause potential problems if used w/aspirin (Read about "Aspirin and Heart"), warfarin, & other drugs; St. John's wort should not be used if you're taking an antidepressant; ephedra can cause problems if used w/a decongestant or a stimulant drug, or even caffeine. Other herbal remedies also carry potential risks.

Taking precautions

Because of all the possible combinations, it's essential to take precautions. Here are some other suggestions from the FDA:

If you have several doctors, make sure they all know what the others are prescribing
If you take a number of drugs, take them all w/you on a doctor's visit so the doctor can see exactly what medications you're on
If you feel the need for over-the-counter medication to treat a cold or other problem, always check w/your doctor & pharmacist first

Of course, taking drugs in combination is sometimes a necessity. High blood pressure, for example, may require the use of several different drugs. (Read about "High Blood Pressure Many older people have multiple problems & may need multiple drugs to treat these problems. Unless supervised by a doctor, however, taking some mixtures of drugs can be dangerous, so always check w/your doctor first.

other medications prescribed for mental disorders: from WebMd's Drug Directory:

Amphetamine-dextroamphetamine

Pronunciation: am FEH ta meen/deck stroe am FEH ta meen

Adderall,Adderall XR

What is amphetamine-dextroamphetamine?

Amphetamine-dextroamphetamine is a stimulant and appetite suppressant. It stimulates the central nervous system (nerves and brain) by increasing the amount of certain chemicals in the body. This increases heart rate and blood pressure and decreases appetite, among other effects.

Amphetamine-dextroamphetamine is used to treat narcolepsy and attention deficit disorder with hyperactivity (ADHD).

Amphetamine-dextroamphetamine may also be used for purposes other than those listed in this medication guide.

if you would like to learn more about this drug, click here.

It's in the News.....

Yes, we do have a "News Page" with recent news stories for you to access, but instead of having an "archive" with older articles, we're posting them - by subject - on each individual page. Look for It's in the News.... on each page, right hand column at the end of the page! Who knows... you may find articles about what's been bothering you!

It's in the News from Intelihealth.com

Steroid Can Help Meningitis Patients (The Associated Press) Taking steroids along w/antibiotics can prevent brain damage & even death in some meningitis patients, a study found.

An Aetna InteliHealth/Harvard Medical School Look At The News - Halting Use Of Inhaled Corticosteroids (American Thoracic Society) Halting treatment w/inhaled corticosteroids in patients w/chronic obstructive pulmonary disease (COPD) is associated w/both a higher risk & more rapid onset of exacerbations, together w/a significant deterioration in health-related quality of life, according to a study published in the second issue for November 2002 of the American Thoracic Society's peer-reviewed journal.

Aspirin & Second Anti-Clotting Drug Beneficial After Angioplasty (INTELIHEALTH) Treatment w/a second anti-clotting drug, in addition to aspirin, for up to a year after angioplasty reduces rates of death, heart attacks & strokes significantly more than aspirin alone, researchers said.

Feds Seek Public Input On Vaccine: WASHINGTON (AP) The government is seeking public input before it decides whether to let a few dozen toddlers & preschoolers be vaccinated against smallpox, a study to test the best children's vaccine dose but one raising thorny questions about safety & ethics.

FDA Approves Nicotine Lozenge: WASHINGTON (AP) Smokers trying to quit will soon be able to try a nicotine-containing lozenge to help reduce their cigarette cravings.

Wyeth Stops Making Two Vaccinations: TRENTON, N.J. (AP) Wyeth has ended production of its pneumonia & influenza shots, increasing the country's vulnerability to vaccine shortages.

CDC Data Shows Resistance To Cipro: ATLANTA (AP) Research by the CDC indicates that a common bacterium blamed for food poisoning has a growing resistance to a drug used to combat the bug.

Company Gives FDA Ephedra Complaints: WASHINGTON (AP) A leading seller of the dietary supplement ephedra gave the government records of 1,400 customer complaints Tuesday, including 14 that mention serious side effects.

Know How To Read A Drug Label? All over-the-counter medicines must list the active ingredients and provide basic information. Locate this info on key spots on the box or bottle label.

Growth Hormone, Sex Steroid Combination "Not Ready For Prime Time": BETHESDA, MD (NIH) In the first study of the separate & combined effects of growth hormone & sex steroids in healthy older men & women, investigators found that growth hormone replacement substantially increased lean body mass & decreased fat mass in both sexes.

An Aetna InteliHealth/Harvard Medical School Look At The News - Taking Aspirin W/ Arthritis Drugs:(American College of Rheumatology) Patients on low-dose aspirin therapy who had been prescribed a non-steroidal anti-inflammatory drug (NSAID) in the first year following a heart attack were less likely to suffer a recurrent acute heart attack in that year compared to those who had not been prescribed an NSAID, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in New Orleans, Louisiana.

An Aetna InteliHealth/Harvard Medical School Look At The News - OTC Drugs & Blood Pressure: CHICAGO (AP) The popular pain relievers ibuprofen & acetaminophen, contained in scores of over-the-counter remedies, may increase the risk of high blood pressure, a study in women suggests.

Anthrax Drug Takers Report Problems: ATLANTA (AP) Less than half of the people who were prescribed a 60-day course of antibiotics for anthrax during last year's attacks completed the treatment, &a majority complained of side effects, federal officials reported Tuesday.
Life-Saving Properties Of Beta Blockers Extend To More Patients: DALLAS (American Heart Association) Beta blocker drugs have now been shown to lengthen the lives of people at risk of sudden death due to irregular heart beats, according to a study published in the rapid access issue of Circulation: Journal of the American Heart Association.

EU Commission Proposes Plan To Facilitate Sale Of Cheaper Drugs To Poor Nations BRUSSELS, Belgium (AP) The European Union's head office announced plans Wednesday to facilitate the sale of cheaper drugs to treat HIV/AIDS, malaria & tuberculosis in poor nations.

10/14/03 Decline in Teen Suicide Rate Linked to Antidepressants

While suicide still accounts for a significant number of teenage deaths, the rate is dropping & statistical evidence appears to tie the decline with an increased number of adolescents taking antidepressants.

The New York Times reports that Columbia University researchers examined teenage suicide rates & prescriptions filled for children ages 10 - 19 in 588 regions of the country from 1990 - 2000. At first, regions w/higher rates of antidepressant use in 1990 or 2000 had higher suicide rates. But over time, an increase in the use of antidepressants was associated w/a decrease in suicides, the newspaper says.

"People have known for some time that over the last few years there has been an increase in the use of antidepressants" among children, Dr. Mark Olfson told the Times. Olfson, a professor of clinical psychiatry at Columbia & the lead author of the study published this month in The Archives of General Psychiatry, added, "The question we're trying to get at here is, 'Has that contributed to the decline in suicide?' This provides some evidence that it may have."

One weakness in the study may be the reliance on information from groups, rather than from individuals, the newspaper says. Other factors, including tougher gun control laws in some regions & reduced use of alcohol & drugs, may have contributed to the drop in suicides, the Times quotes researchers as saying.

Barry Hoffman and Scott Roberts

How Best to Protect Your Baby?

U.S.News - By Betsy Querna - 2/20/06

Pregnant women may wonder whether to give up their anti-depressants. Two new studies have found that women on a selective serotonin reuptake inhibitor such as Prozac during pregnancy may risk affecting their child.

The reports come on the heels of another last month showing that women who stop taking the drugs are apt to sink back into depression - which itself has been linked to preterm delivery & low birth weight.

One study, in the New England Journal of Medicine, found that taking SSRI's after the 20th week of pregnancy raised the risk of persistent pulmonary hypertension of the newborn, a rare but serious condition in which an infant's circulatory system doesn't develop properly.

The Food & Drug Administration called those results "very concerning" & announced that it may ask for labeling changes on the drugs.

The other, in the Archives of Pediatrics and Adolescent Medicine, found that 30% of babies born to women on SSRI's experienced several days of withdrawal symptoms, such as trouble sleeping & tremors. Experts advise women to talk to their doctors about the pros & cons of halting medication.

News Flash for People With ADHD

Alarmed by 25 sudden deaths in people taking certain drugs for attention deficit hyperactivity disorder, an FDA panel last week recommended a "black box" warning that the drugs might cause cardiovascular problems.

The FDA also found 54 nonfatal problems, including heart attack & stroke in adults & children on Ritalin, Adderall, Concerta & other stimulants. It's not clear whether the drugs were at fault; some people had high blood pressure & other underlying issues.

People with heart problems & hypertension are already cautioned about stimulants. For others, for now, "I don't think the risk in any way justifies not using it,"says Larry Diller, a pediatrician & author of Running on Ritalin . Millions take the drugs safely each day, he notes. - Nancy Shute

No Better Than a Placebo

The prostate gland has two inconvenient features: It wraps around the urethra, and it keeps growing. For older men, urinating often is difficult. Many take saw palmetto, a palm berry extract, to ease symptoms. But a study published last week in the New England Journal of Medicine found it to be no more effective than a placebo. Drug treatments have side effects. What to do? Maybe nothing, if symptoms are minor, says lead author Stephen Bent, an internist at the University of California-San Francisco. - Helen Fields

glossary & terms

for medications

agonist a drug that effectively mimics the action of a natural chemical messenger within the body

anxiolytic the medications that reduce the symptoms of anxiety

benzodiazepines a class of drugs that act as tranquilizers; the most common side effects are drowsiness & withdrawal symptoms upon abrupt ending of treatment

beta blockers a class of drugs typically used to decrease blood pressure & also prescribed to ease physical symptoms of anxiety associated w/social phobia

MAOIs (monoamine oxidase inhibitors) potent anti-depressants thought to regulate chemicals in the central nervous system; they should rarely be the first medication used because they may interact dangerously w/many other medications, foods & beverages

SSRIs (select serotonin reuptake inhibitors) a class of anti-depressants used to treat anxiety disorders; they're thought to work by boosting the amount of serotonin ( a neurotransmitter linked to mood regulation) available to the brain; the most common side effect associated w/SSRI's is mild nausea that generally diminishes after a few weeks. Sexual dysfunction, primarily ejaculatory delay, also has been reported

tricyclic anti-depressants (TCAs) a class of anti-depressants useful in some anxiety disorders; thought to work by regulating several neurotransmitters; TCA's can produce a wide range of side effects, which should be discussed w/your doctor

withdrawal symptoms physical or psychological symptoms such as convulsions, tremor, vomiting, insomnia, anxiety, muscle pain & sweating that follow the abrupt discontinuation of a drug that produces physical dependence

just in case: here's another resource for medications!

Medications for mental illness: Overview

the following web links are provided for your convenience in visiting the source sites for the information displayed on this page...

www.socialfear.com

This article can be accessed directly at:
http://www.healthscout.com/news/1/1502909/main.html

please click on the links to visit the websites to learn more about medications & mental health....

looking for assistance to pay for medications

treatment for youth with obsessive compulsive disorder

how best to protect your baby

Click here to visit the Red Cross page that allows you to access your local chapter of the Red Cross by entering your zip code in the specified box, to see how you can help in your area. You can also call your local Red Cross Chapter that you can find the number for online or in your local phone book to volunteer for any openings that may need to be filled or you can find another way to help others there as well!

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What is venlafaxine?

What happens if I miss a dose?

What happens if I overdose?

What should I avoid while taking venlafaxine?

What are the possible side effects of venlafaxine?

What other drugs will affect venlafaxine?

Where can I get more information?

What does my medication look like?

What is fluvoxamine?

How should I take fluvoxamine?

What happens if I miss a dose?

Where can I get more information?

What does my medication look like?

Brand/Generic Names

Brand Names: Prozac®, Prozac-Weekly®, Sarafem®, Rapiflux®

What is Prozac® and what does it treat?

What is the most important information I should know about Prozac®?

Are there specific concerns about Prozac® and pregnancy?

What should I discuss with my healthcare provider before taking Prozac®?

How should I take Prozac®?

What happens if I miss a dose of Prozac®?

What should I avoid while taking Prozac®?

What happens if I overdose with Prozac®?

What are the possible side effects of Prozac®?

Are there any risks for taking Prozac® for long periods of time?

What other drugs may interact with Prozac®?

How long does it take for Prozac® to work?

How Best to Protect Your Baby?

Medications for mental illness: Overview

Brand Names: Prozac^®, Prozac-Weekly^®, Sarafem^®, Rapiflux^®