Researchers at the University of North Carolina at Chapel Hill have created a list of prescription drugs that increase the risk of falling for patients aged 65 and older who take four or more medications on a regular basis. "Falls are the leading cause of both fatal and non-fatal injuries for adults 65 and older, and research suggests that those taking four or more medications are at an even great
Selective serotonin reuptake inhibitors (SSRIs) class antidepressants appear to be associated with bleeding in the upper gastrointestinal tract, according to a report in the July issue of Archives of General Psychiatry. The effects appear increased when antidepressants are combined with other stomach-harming medications and decreased when acid-suppressing agents are used. Since the early 1990s, ca
A single antidepressant tablet makes a depressed person see the world in a more positive light just four hours after swallowing it, a new study has shown. Dr Philip Cowen, professor of pharmacology at the Department of Psychiatry at the University of Oxford, told delegates at the Royal College of Psychiatrists' Annual Meeting in London that antidepressant medication starts to work far faster than
In a recent issue of the journal Psychotherapy and Psychosomatics British psychiatrist David Healy attacked the prescribing habits of psychiatrists whom, he claims, are strongly influenced by pharmaceutical propaganda In an editorial commenting on a paper by Harvard investigators on the psychology of risk and prescriptions of psychotropic drugs, Healy denounces a real crisis in psychiatry at prese
As they struggle to contain skyrocketing medication costs, health plans across the U.S. have responded by implementing multi-tiered formularies requiring higher copayments for 'non-preferred' medications. New research from Brandeis University published in the Journal of Mental Health Policy and Economics suggests that the prevalent multi-tiered formulary system does impact how patients fill anti-d
Prostaglandins are infinitesimal, ephemeral lipid signalers in every cell in the body, and regulating every activity that takes place within a cell. As regulators of cellular activity, prostaglandins influence how cells are formed and what part of the body the cell will become. Prostaglandins are vital for cellular growth, health, and replication. Prostaglandins regulate the normal life cycle of a
Philos Ethics Humanit Med. 2008;3:14doi:10.1186/1747-5341-3-14 Effectiveness of antidepressants: an evidence myth constructed from a thousand randomized trials? Ioannidis JPA. Antidepressants, in particular newer agents, are among the most widely prescribed medications worldwide with annual sales of billions of dollars. The introduction of these agents in the market has passed through seemingly st
Montreal, May 22, 2008 - Expectant mothers can safely use prescribed antidepressants during their first trimester, according to a new study from the Université de Montréal and Ste. Justine Hospital published in the British Journal of Psychiatry. Dr Anick Bérard and her team found that antidepressants have no effect on fetal development. "This is the first study to investigate
J Psychiatr Res. 2008 May 9;doi:10.1016/j.jpsychires.2008.02.006 Restless legs syndrome as side effect of second generation antidepressants Rottach KG, Schaner BM, Kirch MH, Zivotofsky AZ, Teufel LM, Gallwitz T, Messer T. Hafenmarkt 12, 87600 Kaufbeuren, Germany. Although of clinical interest, the question is still not fully answered whether antidepressants (AD) can cause or exacerbate restless l
Antidepressants may help body fight HIV and cancer" was the headline in The Independent today. The newspaper article was on research that suggests that antidepressant drugs may help the immune system to fight off serious infection. The newspaper says the drugs could increase the activity of Natural Killer (NK) cells, a part of the immune system that targets cancerous and infected cells and induces
A new revision of the British Association for Psychopharmacology's clinical guidelines to help doctors manage patients with depression has challenged the rationale behind the UK government's policy of rolling out cognitive behavioral therapy (CBT) as the preferred treatment for milder depression. According to a comprehensive review of treatments for depression, there is a lack of evidence for CBT being more helpful than other forms of psychological support in mild depression or for its efficacy in severe depression. There is also good evidence for antidepressants being effective in depression, with benefit increasing the more severe the depression. This is contrary to recent reports that antidepressants don't work except in the most severe depression. Dr Ian Anderson, Senior Lecturer and H
Primary Psychiatry. 2008;15(5):61-69Antidepressants and Insomnia Zammit GK. President and CEO of Clinilabs, director of the Sleep Disorders Institute, and clinical associate professor at the Columbia University College of Physicians and Surgeons in New York City. Mood disorders and insomnia are often comorbid conditions, sharing a complex and bi-directional relationship. Complicating the situation, mood stabilizers can disrupt sleep in a variety of different ways depending on a drug's mechanism of action, dosage level, and timing of administration. The treatment of comorbid depression and insomnia can be achieved through the use of a sedating antidepressant, a combination of two antidepressants, or a combination of an antidepressant in conjunction with a hypnotic. Common practices typicall
Binge eating is considered an eating disorder when you can’t stop yourself from eating a large amount of food in a short amount of time, even when you aren’t hungry.
Most people who have this problem feel very unhappy with themselves after a binging episode, and many binge eaters also suffer from depression.
Compulsive overeating is usually [...]
There is a small but distinct risk serotonin syndrome following concomitant use of the atypical opioid painkiller tramadol (*Tramal®, Ultram®) with Selective Serotonin Re-uptake Inhibitor (SSRI) antidepressants. This may be more frequent than with other combinations of serotonergic drugs due to inhibition of tramadol metabolism as well as the combined serotonergic effect. The inhibition of the metabolism of tramadol through CYP2D6 by SSRIs and the potential for 10% of the population to be poor metabolizers of CYP2D6 may explain why this reaction seems to be of significance in only a small number of patients. There are only a limited number of case reports in the literature suggesting the risk may be low, however serotonin syndrome can be serious if undetected and there does not see
About half of all people who take medicine for an anxiety disorder don't get much help from it. And doctors have no definitive way to predict who will, and who won't, benefit from each anti-anxiety prescription they write. But a University of Michigan Medical School researcher and his team are working to bring more certainty to how doctors and patients choose anxiety treatments, by probing the connection between brain activity, genetics and medication. In a paper last month in the Journal of Neuroscience, K. Luan Phan, M.D., and his former University of Chicago colleagues reported intriguing findings from a brain imaging study in occasional, non-dependent, marijuana users. These brain scans show that response to a threat was greatly reduced when study volunteers received THC, compared wit
The use of antidepressants is likely to account for only 10 per cent of the fall in suicide rates among middle aged and older people, suggests a large study in the Journal of Epidemiology and Community Health. Globally, more than 800,000 people commit suicide every year. Rates have been falling in many countries, a factor that has been associated with better recognition of depression and the increasing use of antidepressants, particularly the newer selective serotonin reuptake inhibitors (SSRIs). But research involving more than 2 million Danes aged 50 and above and living in Denmark between 1996 and 2000, throws this into question. The researchers assessed changes in the numbers of middle aged and older people committing suicide during this period and the types of antidepressant drugs th
By Richard A. Friedman, MD I've grown up on medication," my patient Julie told me recently. "I don't have a sense of who I really am without it." At 31, she had been on one antidepressant or another nearly continuously since she was 14. There was little question that she had very serious depression and had survived several suicide attempts. In fact, she credited the medication with saving her life. But now she was raising an equally fundamental question: how the drugs might have affected her psychological development and core identity. More... Copyright 2008 The New York Times Company
This topic is something I am most passionate about. Every lecture I give, every patient I talk to, any chance I have, I discuss this horrible exploitation of human emotion in North America. Every third American, every third patient in my office is on SSRI’s (antidepressants). Prozac, Effexor, Zoloft, Paxil, Lexapro…. SSRI prescriptions have skyrocketed over the last decade and so have the pockets of drug companies Prozac alone netted over 180 billion dollars last year in profit. Let’s break down the words in SSRI: Selective Seretonin Reuptake Inhibitor. This means that the drug Selectively Inhibits the receptors sites for Sereotonin blocking its resorption thereby allowing Seretonin to float within the synaptic cleft longer increasin
This topic is something I am most passionate about. Every lecture I give, every patient I talk to, any chance I have, I discuss this horrible exploitation of human emotion in North America. Every third American, every third patient in my office is on SSRI’s (antidepressants). Prozac, Effexor, Zoloft, Paxil, Lexapro…. SSRI prescriptions have skyrocketed over the last decade and so have the pockets of drug companies Prozac alone netted over 180 billion dollars last year in profit. Let’s break down the words in SSRI: Selective Seretonin Reuptake Inhibitor. This means that the drug Selectively Inhibits the receptors sites for Sereotonin blocking its resorption thereby allowing Seretonin to float within the synaptic cleft longer increasin
Primary Psychiatry. 2008;15(4):50-56 Yanqi Liang, PhD, and Elliott Richelson, MD A major advance in the pharmacotherapy of depression was the introduction of the selective serotonin reuptake inhibitors nearly 2 decades ago. These drugs succeed in treating depressed patients with few of the side effects common to tricyclic antidepressants, which they largely replaced. However, there are still unmet clinical needs with respect to efficacy, onset, and side-effect profile. The effects of the antidepressants occur almost immediately; however, a therapeutic lag is required to affect meaningful symptom improvement. Not all patients respond to antidepressants well, with some patients undergoing adverse events such as sexual dysfunction. Novel therapies or targets that may reduce side effects need
As a pet owner living with an extended family composed of a dog, a cat, a bird, a fish and a couple of reptiles - as well as several excellent, well-trained humans - I was disgusted to read that the FDA approved a new tasty treat, called Reconcile, for troubled dogs. It contains the antidepressant [...]
There is a reason why there are strict laws against medicines being sold only with a prescription-not only are they harmful taken without a doctor’s consultation, but also usually do not take effect in the manner desired by the consumer. Incorrect or excessive dosage is potentially dangerous. Abuse of antidepressants has led to addiction, [...]
There is no question that antidepressants are overprescribed by many doctors. The same goes for tranquilizers. The rate of antidepressant and tranquillizer aspiration in First World countries has reached alarming proportions: clearly better education, more than money, and improved lifestyles have through with little to make us happier as a species.
However, disdain the generalized overconsumption [...]
Attention deficit hyperactivity disorder or ADHD, is a custom-made “disease” to start selling cheap drugs quite de jure to school kids. Have the doctor of the Church prescribe them.
Your kid will be that much better off - or not? It appears that the real gelt about the contrary effects of antidepressant drugs has been kept [...]
There is a reason why there are strict laws against medicines being sold only with a prescription-not only are they harmful taken without a doctor’s consultation, but also usually do not take effect in the manner desired by the consumer. Incorrect or excessive dosage is potentially dangerous. Abuse of antidepressants has led to addiction, [...]
The Johns Hopkins Guide to Antidepressants starts with an introduction to antidepressants, and gives clear illustrations on how the medication affects your moods. You will learn about the differences between the various classes of medications, their risks, and who is NOT a candidate for certain antidepressants.
Produced by Johns Hopkins University
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Taking antidepressants during pregnancy may pose risks for your baby — but stopping may pose risks for you.
Antidepressants are the first line of treatment for most types of depression. Antidepressants can help relieve your symptoms and keep you feeling your best. But there’s more to the story when you’re pregnant or thinking about getting pregnant. [...]
This shocking compilation of video clips will show you the negative side effects of antidepressants. They have caused suicides, violence, and homicidal actions even to the point of school shootings. In addition, they can lead to addiction and withdrawal symptoms.
Alternative applications of “antidepressants”
Although the evidence of efficacy of antidepressants, as a class, is not as convincing as for other types of drugs, there is growing clinical and research evidence to support a widening range of potential indications of these drugs. The partial success of the SSRIs as a group in ameliorating
OCD is encouraging, as is the utility of TCAs (especially imipramine) and MAO inhibitors (less so fluoxetine, not bupropion) in blocking the episodic, acute autonomic expression of panic. The range of disorders suspected of being related to OCD and in which serotonin-enhancing treatments are being explored, includes eating disorders, hair-pulling (trichotillomania) and other repetitive habits, compulsive gambling, kleptomania, premenstrual dysphoria, and perhaps body dysmorphic disorder. Antidepressants have a scientifically demonstrated but incompletely defined place in the overall management of patients with bulimia nervosa and may have an
Treatment-resistance
The problem of apparent “treatment-resistance” in depression requires further study, but many cases respond when a patient actually is willing to follow a previously recommended treatment, or high doses are accepted and pursued for at least 6-8 weeks. Some cases may represent destabilizing effects of overly aggressive antidepressant treatment of patients with overlooked bipolarity, but many others are truly treatment-unresponsive unipolar depressions. In cases of convincing treatment resistance, or loss of response over time (tolerance), evidence that important gains are to be found in exploring a series of similar agents is lacking. It may be useful to try an agent of a dissimilar type, and the most encouraging experience has been reported in adding lithium (while considering previously overlooked, subtle bipolarity and even use of mood-stabilizer therapy alone), changing from a TCA to an MAO inhibitor, or use of ECT (especially in severe, psychotic, o
Antidepressants
Types of antidepressants
Antidepressants currently fall into five major categories: [1] tertiary amine tricyclics (amitriptyline, clomipramine, doxepin, imipramine, trimipramine), secondary amine tricyclics (amoxapine, desipramine, maprotiline, nortriptyline, protriptyline); [2] monoamine oxidase (MAO) inhibitors (phenelzine, tranylcypromine, selegiline [(-)-deprenyl], and experimental short-acting MAO-A inhibitors (eg,, moclobemide [Manerex], marketed in Canada); [3] serotonin-reuptake inhibitors: (SSRIs) clomipramine, citalopram, [±]-fluoxetine, fluvoxamine, sertraline, paroxetine, and the mixed 5-HT/NE uptake inhibitor venlafaxine (plus the withdrawn zimelidine; [4] stimulant-like dopaminergic as well as noradrenergic agents: bupropion (and the withdrawn nomifensine); [5] the atypical antidepressant mirtazapine (Remeron; a sedating antidepressant chemically related to mianserin, with indirect adrenergic and serotonergic actions as an a2 and serotonin 5-HT2 and 5-HT3
The European Medicines Agency (EMEA) recommended contraindicating Acomplia (rimonabant) from sanofi-aventis, in patients with ongoing major depression or who are being treated with antidepressants, because of the risk of psychiatric side effects. Doctors in the EU have already been warned about this since June 2006 but the Agency’s Committee for Medicinal Products for Human Use (CHMP) has now recommended upgrading this warning.
Acomplia has been authorised in the EU since June 2006 as an adjunct to diet and exercise for the treatment of obese or overweight adult patients. Psychiatric side effects, in particular depression, were identified as the main safety issue at the time of approval. They were reflected in the medicine’s product information as a warning that doctors should not prescribe Acomplia in patients with uncontrolled serious psychiatric conditions such as major depression.
As part of its continuous monitoring of the safety of
Approximately one person in 10 taking diet drug Acomplia (rimonabant) experiences psychiatric side effects and about one person in 100 experiences suicidal thoughts, according to U.K. regulators.
Of some 41,000 patients treated with rimonabant since it was launched in the U.K. in June 2006, 364 “psychiatric reactions have been reported,” the Department of Health’s Medicines and Healthcare Products Regulatory Agency (MHRA) said on July 19th.
“Amongst these, there have been 48 reports of depression, 16 reports of suicidal thoughts and one report of self-injury,” the regulatory agency said.
The MHRA said evidence suggested one person in 10 taking Acomplia may develop psychiatric side effects, and “approximately one patient in every 100 may experience suicidal thoughts.”
The MHRA advised: “If you start to experience symptoms of depression while taking Acomplia, or if you are currently being treated with antidepressants, consult your doctor.
“If you have had depression in
Approximately one person in 10 taking diet drug Acomplia (rimonabant) experiences psychiatric side effects and about one person in 100 experiences suicidal thoughts, according to U.K. regulators.
Of some 41,000 patients treated with rimonabant since it was launched in the U.K. in June 2006, 364 “psychiatric reactions have been reported,” the Department of Health’s Medicines and Healthcare Products Regulatory Agency (MHRA) said on July 19th.
“Amongst these, there have been 48 reports of depression, 16 reports of suicidal thoughts and one report of self-injury,” the regulatory agency said.
The MHRA said evidence suggested one person in 10 taking Acomplia may develop psychiatric side effects, and “approximately one patient in every 100 may experience suicidal thoughts.”
The MHRA advised: “If you start to experience symptoms of depression while taking Acomplia, or if you are currently being treated with antidepressants, consult your doctor.
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Introduction: Major (unipolar) depression has five or more symptoms for 2 weeks or more (10-25% females, 5-15% males). Dysthymia is a depressed mood of 2 years or longer in duration. Bipolar disease has a strong hereditary component and patients are likely to have a comorbid substance abuse disorder. Therapeutic effects of antidepressants are no observed for 3-4 weeks. In general, antidepressants that are effective in treating unipolar depression are effective in treating dysthymia. Bipolar disorder is treated with lithium, valproate, or carbamazepine, with haloperidol used to treat acute mania. MAO inhibitors: Phenelzine and tranylcypromine non-selectively inhibit both types of MAO. Inhibition is irreversible. MAO inhibitors have serious toxicities and inhibit the metabolism of other drugs. Interaction with other agents can precipitate a hypertensive crisis. Tricyclic antidepressants: Demethylation on the nitrogen of the side chain reduces sedative activity (desipramine &
Major Depressive Disorder:I. Antidepressants are prescribed specifically for affective disorders thatare characterized by extreme depression (dysphoria), extreme elation (mania),or both. Monopolar depression may affect 15% of all adults during any givenyear of their lifetime. Treatment usually takes 2-4 weeks and leads to 85%remission. II. Affective disorders such as depression are thought to result from achemical imbalance between three neurotransmitters - norepinephrine, serotoninand perhaps dopamine. More recent research has suggested that beta-adrenergicreceptors may be involved.III. As a class of drugs, antidepressants are generally:orally administered (i.m. administration very infrequent and limited tospecific drugs)90-95% bound to plasma proteinsmetabolized by the liver, with metabolites excreted in urinedrugs with long “half-lives” (e.g., imipramine - t½=24 hours)drugs with a relatively small therapeutic indexIV. There are at least four prominent classes of antidepressant
Hi. I'm all better now. My exams are also done and I appear to have a summer job lined up, which means that my life has suddenly become much more simple. Hopefully this will translate into more consistent, high-quality blogging. But don't hold your breath. I appreciate your patience, now let's rock this joint.There are a lot of things that can go wrong with your brain. Often the problem lies in a disruption of the normal levels of neurotransmitters (brain communication chemicals) present in certain parts of the brain. Take dopamine for example. Too much, you become schizophrenic. Too little, you develop Parkinson's disease. I'm grossly oversimplifying things here, but that is the essence of it.Major depressive disorder (also known as clinical depression or unipolar disorder) is thought to have something to do with having too little norepinephrine and/or serotonin (two neurotransmitters) hanging out in the synapses in your brain. This hypothesis was initially put forward based on t
Hi. I'm all better now. My exams are also done and I appear to have a summer job lined up, which means that my life has suddenly become much more simple. Hopefully this will translate into more consistent, high-quality blogging. But don't hold your breath. I appreciate your patience, now let's rock this joint.There are a lot of things that can go wrong with your brain. Often the problem lies in a disruption of the normal levels of neurotransmitters (brain communication chemicals) present in certain parts of the brain. Take dopamine for example. Too much, you become schizophrenic. Too little, you develop Parkinson's disease. I'm grossly oversimplifying things here, but that is the essence of it.Major depressive disorder (also known as clinical depression or unipolar disorder) is thought to have something to do with having too little norepinephrine and/or serotonin (two neurotransmitters) hanging out in the synapses in your brain. This hypothesis was initially put forward based on t
A variety of news sources have reported that Cho Seung Hui, the Virginia Tech shooter who killed 32 students and faculty members in a shooting rampage, was taking antidepressant drugs.Antidepressants have also been used by the perpetrators of previous and similar acts of violence, including the shootings at Columbine High School eight years ago.There are known links between antidepressants and violent acts. Research on the drug Paxil found that more than twice as many people taking it experienced a serious "hostility event" as did those taking a placebo. In the United States, labels for all antidepressants note that anxiety, agitation, panic attacks, irritability, hostility, aggressiveness, impulsivity, and mania are all possible side effects.Part of the cause may be the disconnect with reality these drugs sometimes reportedly cause. In another study of the links between antidepressants and violence, a 12-year-old boy who killed his grandparents while he was on a course of antidepressa
Nowadays, most people when depressed take over the counter antidepressants. Media is one f the factor why these medicines become so popular. They advertise about the benefits of antidepressants here and there. But did you know that antidepressants are not necessary and that they have no significant benefits to your health?Surveys have been made in America about early 90’s where the participants are those people that are having mood problems. 25% of the patients were incorrectly diagnosed with depression. This is because those people are only reacting to those normal stressful events like death of a family member, losing a job, and relationship breakups. These events are normal and just part of our lives; we get really depressed by these events so there’s no use of taking antidepressants. It is also advised that only those people who are diagnosed to have clinical depression should take the antidepressants.Here are some general side effects of taking antidepressants:AnxietyWeight ga
Anyone taking or contemplating anti-depressants for treatment of depression have been concerned about the blackbox warnings from the FDA. The FDA has issued blanket warnings to anyone considering or taking anti-depressants that they may actually induce suicidal thinking.
The truth is that there is still very little and conflicting information about the risks. Highlighting the risks in the way the FDA did by issuing a blackbox warning has been controversial. The problem is that the risks have been assessed in only a few studies and it is not clear what is happening. The other problem is that anti-depressants also treat and prevent suicidal behavior. Not taking an anti-depressant when you need one can also be a grave risk.
There is concern within the psychiatric and advocate community that the FDA is driven more by politics than science these days. A coalition of psychiatry and advocate organizations has issued an open letter to the FDA pointing to the life and death consequences of t
Suicidal individuals taking antidepressant medications appear to have an increased risk of additional suicide attempts, but a reduced risk of dying from suicide or any other cause, according to a large Finnish study
Primary Psychiatry. 2006;13(12):39-45 Rethinking the Older Antidepressants: Why Are We Trying to Emulate Them? Richard Balon, MD Treatment of depression remains unsatisfactory, especially in view of the fact that most depressed patients do not achiev
Parents of children and adolescents with depression should be reassured that the benefits of antidepressants outweigh the risks, despite black box warnings about the potential of suicide in adolescents,
The present study has addressed the question of what is more important for the occurrence of adaptive changes observed in the organism treated with antidepressant drugs: a daily dosing of the drug or the period of time necessary for the plastic event
