What You Need To Know - Antidepressants And Herbs In The Treatment Of Depression

What You Need To Know - Antidepressants And Herbs In The Treatment Of Depression

People Use The Conversation Depression Loosely To Miserly A Number Of Different Moods.
I exalt to use the term " clinical depression " to distinguish the type of depression that may improve with medication. Clinical depression is more than the " blues " or hurt. It is not something a person can " unbiased get over " or prattle themselves out of. Clinical depression is at smallest partially based on brain biochemical imbalance ( we are still in early stages of understanding this ) and often runs in families. Stress and psychological factors also play an important role, although we do not fully accept the causes and factors that corollary in clinical depression.
Common Symptoms Of Depression Accommodate:
ท sad or irritable tenor
ท loss of note / energy
ท poor or excessive sleep and appetite
ท difficulty with concentration and memory
ท physical complaints
Types Of Depression:
There are four types of depression listed in the current Diagnostic and Statistical Manual ( DSM 4 TR ). The intent of this manual is to help those in the mental health field make accurate diagnoses. One of its goals is to make the diagnosis more consistent between providers. Unfortunately it is often used haphazardly.
1. Reconciliation Disorder With Depressed Mood: A reaction to a stressor. ( Loss of a loved one, undertaking, legitimate illness, modification etc. ) This type of disturbed spirit is usually mild and self - limiting. When symptoms last longer than 6 months fresh type of depression should be considered. Counseling, therapy and support may be valid treatment. Medication is not usually necessary.
2. Dysthymia: A chronic low - level depression. It can be very debilitating and may be a part of the personality. It also can be difficult to treat with medication; therapy is recommended.
3. Upper depression: A severe form of depression with multiple symptoms as described considerable. Medication is necessary and usually very effective. Therapy may be helpful after acute symptoms have abated. Suicide implied the urge be monitored. This can be severe enough to cause nonsensical ( loss of substantiality ) symptoms, such as delusions and hallucinations.
4. Bi - Polar 1 Disorder: A cycle of depression and elevation of humour ( hypomania or mania ). This can be very severe, with fantastic symptoms. Antidepressants may be avoided due to risk of switching the humour to mania. This condition needs expert psychiatric treatment usually with temper stabilizing medication. ( By the way there is a expressing amount of confusion and disagreement about this diagnosis especially between Bipolar 1 and Bipolar 2 disorders. Bipolar 2 disorder is less severe and medication is often not necessary. )
Differential Diagnosis ( problems that may be gone with depression )
ท hypothyroidism ( low thyroid )
ท substance maul
ท chronic pain
ท side effects of medication
Target Symptoms Of Depression:
Identifying and describing specific target symptoms is crucial if treatment is to be monitored and its ' dynamism evaluated. It is easy to fail how severe symptoms were when depression is resolved. The more specific the target symptoms are, the better to keep passageway of changes. Some examples of target symptoms are listed below.
ท sleep disturbance ( difficulty falling or staying faint, awakening often during the obscurity, early morning awakening, oversleeping )
ท concentration / memory problems
ท low energy level
ท irritability
ท physical symptoms
ท change in appetite ( decreased or enhanced )
ท lack of motivation / consequence
ท mood changes ( torment, anger dejection )
Selective Serotonin Reuptake Inhibitors ( Ssris ) The Most Commonly Used Antidepressants.
SSRIs have been on the market for over 20 yrs. They increase levels of serotonin in the brain. Serotonin is a substance that allows chemical action in the brain ( neurotransmitter ). Serotonin is known to play a role in depression and anxiety. SSRIs are used for treatment of depression, anxiety, Overdone - obsessive disorder ( OCD ), and occasionally other illnesses. ( Fibromyalgia, chronic weariness, pain ). SSRIs have much fewer side effects than the older antidepressants ( tricyclics such as Elavil ); they are not as lethal in overdose, and work well for most people. They are much more esteemed so tricyclics. All SSRI ' s are effective although side effects may differ quite. Whereas people are different, some may cope more positively to one particular medication forasmuch as to major. Choosing between the SSRI ' S is usually dependent on the side flak framework ( look at below ), and the prescriber ' s and patient ' s preference and practice. They are usually the first choice in depression and often the first choice in anxiety disorders. With anxious patients it is helpful to start low and increase the dose slowly in computation to minimize the side corollary of activation. Anxious patients can be very sensitive to this side outgrowth. Higher doses of medications are often needed in Compulsive Obsessive disorder and Panic disorder.
1. Prozac TM ( fluoxetine )
This may be more influential initially. It has a longish half - life and thence stays in the system longer. Once a day dosing is usual; recently Prozac introduced a once a lastingness dose.
2. Paxil TM ( paroxetine )
May be more placatory initially, weight gain can be a problem. Once a day dosing is the norm.
3. Zoloft TM ( sertaline )
May have fewer interactions with other medications. Weight gain may be a problem. May cause more paunch confused and diarrhea. Once a day dosing is the gauge.
4. Luvox TM ( fluvoxamine )
Sometimes used for OCD, multiple dosing. Not used frequently in US. Needs higher doses that may cause drowsiness.
5. Celexa TM ( citalopram )
Said to be " more " selective for a particular type of serotonin and so concluding to have less side effects and interactions. May have less weight gain. Once a day dosing is the norm.
6. Lexapro TM ( escitalopram )
Similar to Celexa some feel it was manufactured since the patent on Celexa was running out. Spoken to work quicker wherefore the other SSRIs.
Side Effects - SSRI ' s
Most SSRI ' s have reciprocal side effects. Some patients do better on one than on enhanced. This cannot be set on before a trial of the medication is given.
ท Nausea is a common problem. Taking the medication with food helps and this side precipitate. It usually passes in time.
ท Headache is usually mild and goes away with time ( about one tour ) if it continues it may be necessary to change medication.
ท Activation or sedation: patient can feel either activated ( hyper, trembling ) or sedated. Patients with anxiety / panic are more likely to feel activated. To avoid this start with a low dose and increase as tolerated. Sedation will often disappear with time but occasionally a change in medication is necessary.
ท Sexual dysfunction can be a representative problem with some antidepressants. Use may determination in decreased sexual hobby or adeptness. Most common treatments for sexual dysfunction count: drug holidays ( catching the drug for one or two days once the patient is stable, ( cannot be done with Prozac due to staying in the body longer ), changing medication, or using an additional medication. ( Some such drugs combine: Periactin, Amantadine, Yohimbine, Ginkgo others. All have only limited laugher. ) Gossip to your prescriber if this is an affair for you.
ท Weight Gain can be a problem that is often not taken seriously enough. Weight gain may start after you have been on the medication for a while. It may be necessary to change to a different antidepressant.
ท Agitation / Initiative / There has been some anecdotal reports about patients becoming more energetic on SSRIs. The research does not support this. However, that job should be taken seriously, and attempts made to avoid a drug the patient is concerned about. The identical is true about the reports of amassed suicide.
Other Antidepressants
These drugs are consideration to influence a number of neurotransmitters ( serotonin, dopamine, nor - epinephrine being the leading ones. )
1. Wellbutrin TM ( buproprion )
This should not be used in patients with a history of seizures. Vocal to cause less sexual dysfunction and weight gain. Now has a prolonged release routine but still is usually given twice a day. This is the equivalent drug as Zyban, which is used for warm cessation. Obviously, they should not be used calm.
2. Trazodone
This is not a very effective antidepressant; it is however very helpful for sleep and may be used in low doses for anxiety. It should be used in caution with men due to
possible priaprism ( This is an involuntary erection that in the worst event may not go away ).
3. Effexor XR TM ( venlafaxine HCI ) Is speculation to have fewer interactions. Less weight gain and sexual dysfunction
4. Remeron TM ( mirtazapine )
Is verbal to have less sexual dysfunction and fewer interactions. Weight gain can be a problem. Used at lower doses ( 15 mg ) this is a good sleep aid, but is not powerful enough to be an antidepressant. At higher doses no longer specifically helpful with sleep.
5. Tricyclics
This is an older class of antidepressants that are no longer the first choice. They can have severe side effects including sedation, weight gain, effects on the heart, and drug interactions. These drugs are used in anxiety, depression and some pain syndromes. They are much less appreciated than SSRI ' s. These drugs are lethal in overdose! ( IE.: amitriptyline, nortriptyline, desipramine )
6. MAOI ' S ( monoamine oxidase inhibitor )
These are augmented older class of antidepressants with many dietary restrictions and interactions. Not currently used very often. ( I. e.: Nardil TM, Parnate TM )
Herbs & Supplements For Depression
How herbs and supplements work is not fully implicit, but they have been used for thousands of years. They can be potent and should be used with care. They should not be mixed with other medications for anxiety or depression. You should let your health care provider know if you are considering taking supplements.
Research on supplements has been conducted in other countries for many years. In the US research has been slow due to the fact that pharmaceutical companies ( who sponsor most research ) don ' t glimpse them as a moneymaker. This is changing however, and there is some research underway. Pharmaceutical companies are now infant to cause prescriptions forms of some supplements. Some of the outcomes of herbal research have been manifold, and more studies are main. There are a number of supplements advertised for use in depression and anxiety, the proximate are the most well studied and most commonly used.
ท Omega 3 Fatty Acids ( Fish Oil )
Some of the research on fish oil is truly abnormal. It indicates that it may be equitable as effective as antidepressants in treating depression. The research was done using 4000mg a day of fish oil.
S - Adenosylmethionine is a labyrinthine found in all living tissue, and is set in the liver and brain. There have been a number of studies that have shown its power in depression. It is also used in hepatitis and arthritis. There have been no side effects or interactions with other medications found. SAM - e uses B12 and folate in its lowering of homocysteine levels. It is consequently suggested that convincing levels of folate and B12 be sanguine when taking SAM - e. The dose of SAM - e is between 800 and 1600 mg a day to treat depression. It is valued, and many pills may need to be caught to get a resultant dose. Research in the US is main. Studies in other countries have been very benign. ( Benjamin, 2000 )
ท St. John ' s Wort
Used for beer to fair depression. The course of enterprise is inexplicable, some think it works like an SSRI or MAOI. The dose most commonly suggested is 300 mg, ( standardized to. 3 % hypercin ) three times a day. Side effects are usually ale but may allow for photosensitivity, emotional vulnerability, itching, and fatigue and weight increase. Alcohol, tyrosine, narcotics, amphetamines, and over the counter cold and flu remedies should involuntary be avoided to be on the safe side. It interacts with drugs for HIV, and some other medications that are metabolized by the liver ( as many other drugs do also ). The research on St. John ' s Wort has been ofttimes benign ( Muskin, 2000 ) with one recent study rival its potential.
ท Ginkgo Biloba
Ginkgo is used for mighty depression in elderly, early Alzheimer ' s disease, impotence, reasoning vascular lack and peripheral circulatory disorders. Ginkgo should be standardized to 6 % terpene lactones, 24 % ginkgo flavones glycosides. The suggested dose for prevention is 120 - 160 mg a day in divided doses. Up to 240 mg a day may be used in Alzheimer ' s or hard depression. Side effects have not been reported. May be helpful for sexual dysfunction with SSRIs. This will thin your blood and increase blood flow, should be stopped a few days before surgery. There are over 400 published studies with Ginkgo in studies of circulation. ( Brown, 1998 )
Issues With Herbs & Supplements
Herbs have been used worldwide for many years. Although they are realizing to be " natural ", remember, averse reactions, side effects and interactions with other drugs / herbs / supplements are possible.
There is a need of standards in manufacturing and often it is tough to know exactly what you are getting or how it has been purified. Name brands you are intimate with should be used.
Some Herbs can be speculative ( as can some medications ). Read and appreciate labels, the active ingredient should be " standardized " although this is no guarantee.
Herbs may have interactions with other drugs, side effects and perhaps dangersome effects on pregnancy. They should be considered seriously, and researched carefully before use. Under dosing is also a common problem, ( both with medication and herbs ) as is not giving herbs in a producing dose or enough time to work.
Cost is a element as herbs can be high-priced and are not hermetic by insurance.
Combination herbs should be used with care and only if one is sure of the dosage of all ingredients.
Drug / Herb Interactions
Drug interactions can be a problem with any medication and some herbs. Herbs should not be mixed with drugs for the corresponding condition. Information is being discovered at a rapid degree about interactions. There is much we have to learn and caution is advised in the use of herbs. Discussion with health care providers who are bright or at antecedent unbarred to these ideas can helpful. If your health care provider is not willing to consider and be unbolted to learning about herbs perhaps you should consider a change of provider.
Some people may be slow metabolizes and need lower doses.
Over the counter drugs should be used with care when taking herbs.
Grapefruit Juice has been found to interact with many drugs, and prevailing herbs.
Caffeine may interact with some drugs and herbs.
Alcohol should not be mixed with most medications and some herbs.
Helpful Hints For Prescribers And Patients When Using Medications / Herbs
ท A full trial is crucial of medications, and supplements is important and often not done. This means a full dose should be prescribed for a trenchant coil of time.
ท There is some information that indicates frequent authentic and stopping antidepressant medications may model to ineffectiveness.
ท Monitor target symptoms in tidiness to persuade endowment.
ท Change one medication at a time in lineup to strikingly identify the eventuality of each one.
ท Consider cost and the patient ' s insurance
ท There is less suicide risk by overdose when using SSRI ' s thereupon tricyclics.
ท In anxious patients start low; increase slowly ( but not too slowly, in scheme to avoid discouragement due to twist of time needed for improvement )
ท Understand and consider side effects when choosing a medication. This will help to know what to gather, reduce anxiety, and decrease early stop.
ท The first treatment for depression should be 8 - 12 months in skein, and there is a 50 % relapse proportion after that. A second treatment regimen should last 18 months and has a 70 % relapse scale. After this medication may be needed for life.
ท Try to avoid visionary expectations about medications.
ท If you medical provider is not avid to gibber with you about these issues, feasibly you should seek a new one!
ท Always tell your health care provider when you are taking supplements of any cordial!
References:
Benjamin, S. ( 2000 ). Cam Spotlight SAM - e For Depression and More? Patient Care for the Boost Practitioner March, 22 - 26.
Blumenthal, M. Goldberg, A. Brinckmann ( Eds ). ( 2000 ) Herbal Medicine, Expanded Commission E Monographs. Newton, MA: Integrative Medicine ommunications.
Brown, D. ( 1998 ) Phytotherapy, Herbal Medicine meets Clinical Science. Bothell, Washington: Bastyr University, Permanent Professional Education Program
Diagnostic and Statistical Instruction of Mental Disorders DSM - IV - TR ( Subject Procession ) ( 2000 ) American Psychiatric Association
Physicians Desk Reference ( 2006 ) Thompson Healthcare.
Keegan, L ( 2001 ) Healing with Akin & Alternative Therapies. New York: Delmar.
Muskin, P. ( 2000 ) Comparable and Alternative Medicine in Psychiatry, Washington, DC: American Psychiatric Press.