Depression Series (Part 3): What to Do with Those Antidepressant Side Effects?
Maria's depression was difficult to treat. As you can recall, various medications had been tried to no avail. But after several months of treatment, Maria has eventually become stable on a combination of two antidepressants. She's now able to do her usual activities and is motivated to go back to work ? something she has struggled to do for a while. Despite her improvement, antidepressant side effects have emerged and are bothersome.
Maria begins to consider discontinuing her medications prematurely.Antidepressant side effects are real and negatively affect patient's compliance. Many patients like Maria consider stopping the medication even at the risk of relapse because of distressing side effects.How do you deal with some of the common antidepressant side effects?Insomnia Some antidepressants e.g. SSRIs (serotonin-reuptake inhibitor) are highly stimulating that they cause insomnia when taken in the afternoon or at bedtime. Take this type of medication in the morning. Discuss with your physician the use of a sedating medication such as trazodone or sedative-hypnotic drug along with the antidepressant.
If you want to take only one pill, talk to your doctor about switching to a sedating antidepressant such as mirtazapine. Moreover, sleep hygiene should be practiced. Avoid naps and intake of caffeinated drinks such as coffee and soda in the afternoon and evening. Involve in regular exercise and physical activities during the day. Moreover, use the bedroom only for sleep and sex and not for recreational activities.Weight gainRegular exercise is weight gain's antidote.
If no medical contraindication, you may consider jogging, walking, or swimming. To reduce some excess and unwanted fat, keep yourself busy with physical and recreational activities.How about diet? Diet has always been a part of any weight control regimen. Monitor your carbohydrate intake. Ice cream, chocolates, and other high-caloric foods should be reduced. If none of the above works, talk to your doctor about switching pills.Sexual dysfunctionSexual dysfunction happens too often but is rarely asked or discussed in the clinic.
Some physicians and patients feel embarrassed about this subject. When you have concerns, be open to your physician. Discuss the possibility of switching medication to an antidepressant (such as bupropion or mirtazapine) that doesn't significantly impair sexual functioning. Also, talk to your doctor about adding another drug such as bupropion, yohimbine, or even mirtazapine to counteract the sexual side effect.How do you know if the sexual dysfunction is from the pill rather than from depression? If the dysfunction persists despite successful remission of depression, then you should consider other causes such as drug-induced dysfunction or other medical causes e.g. diabetes.Dry mouth Tricyclic antidepressants (TCA e.g.
amitriptyline) are notorious for causing dry mouth. Why? These drugs have distressing anticholinergic side effects. Avoid this type of drugs. If TCA is still considered, talk about the use of desipramine or nortriptyline. Compared to other TCAs, these two drugs have less anticholinergic effects.Moreover, try ice chips.
Frequent sips of water should also help. To avoid dental cavities, try sugarless candy or sugar-free gum. ConstipationLike dry mouth, constipation is usually caused by TCAs. To prevent it from happening, drink enough water and eat high fiber foods such as vegetables and fruits. Consider stool softeners if the above interventions fail.
If possible, avoid TCAs.Nausea and vomitingPatience is the key in dealing with these side effects. Frequently, patients develop tolerance within two weeks. Take the medication with food. If ineffective, talk to your doctor about possibly reducing the dose of your medication or trying antacid or bismuth salicylate (Pepto-Bismol)Memory lapsesIf given permission by your doctor, try to reduce the dose. Also, discuss with your physician about switching antidepressant (especially if dose reduction doesn't alleviate your concern) and avoiding drugs with anticholinergic side effects.
Moreover, don't mix the antidepressant with alcohol. The alcohol-drug interaction can only worsen the memory and cognitive functioning. While on psychotropic drugs, be careful driving and using mechanized equipment. DizzinessWhile still in bed, sit up for 30 seconds, then stand up for another 30 seconds while holding a rail, a table, or a chair before walking. Take the medication at bedtime.
Some people use support hose with success.Agitation or anxietySome people benefit from a brief use of benzodiazepine such as lorazepam. Breathing exercises and progressive muscle relaxation should also help.In general, some side effects such as gastrointestinal upset and insomnia may resolve in a few days. Patience is the key. However, be on guard. When they occur, address them promptly.
I'm not however suggesting that you should be your own doctor. Collaborating with your doctor is an effective way to cope with mental illness and medication problems. Treatment options such as the need to switch or reduce medications should be discussed in an open and accepting manner..
Black Gay TV Talk Show Debuts Across America
(ContentDesk) July 8, 2005 -- Reaching into nearly 16 million households, the world's first black gay/lesbian, TV news/talk show debuts across America on DirecTV channel 227 and on Comcast Cable TV101 Southern California. The Herndon Davis Reports, http://herndondavis.com, hosted by its creator and namesake, is a one hour long, black gay/lesbian focused, empowerment news program. The nationally syndicated show aggressively tackles a variety of socioeconomic and political issues impacting the gay/lesbian community but from a distinctly black gay/lesbian affirming perspective.Broadcasting on DirecTV channel 227, the news/talk show can be seen on Sunday mornings beginning July 17, from 8am-9am and on Comcast Cable TV101 Southern California starting July 18, 7-8am. "I'm very excited about the opportunity to spotlight the accomplishments and the challenges of the black gay/lesbian community" adds Davis."From understanding the DL "down...
Black Gay TV Talk Show Debuts Across America
Depression > Black Gay TV Talk Show Debuts Across America
Exercise and the Time Clock
I have to admit that I sometimes find it amusing when someone knows I am a trainer and proceeds to elaborate on the hours that they spend in the gym.
One example was a few years back when I was introduced to a nice young women, who proceeded to tell me that she went to the gym twice a day, an hour each time.
Unless this second hour was spent in the jacuzzi or making up for lost time due to chatting with fellow gym-goers during the earlier timeslot, I would be leary.
Instead of being impressed by her exuberant enthusiasm for working out, my thoughts were that one of those hours might be better spent in a counseling office.
Excessive exercising is unsafe and a sign of other deep-rooted problems.
So, the question remains how many ticks on the clock should pass before you head for the locker room?
And what compels a person to go way overboard in their exercise routine?First off, if you are one of our valued clients, you already know that...
Depression > Exercise and the Time Clock
What Exactly is Testosterone?
Testosterone is a member of the steroid family of hormones called androgens. More and more, this family is derived through chemical conversion from the steroid ring-structure of cholesterol. This hormone plays a vital role in the bodies of both men and women.There are only minor differences between this hormone and others such as estrogen, progesterone, DHEA, cortisone, and androstenedione. They are small molecules, which becomes important when we look at what routes of administration are available.As commonly known, testosterone stimulates the development of the penis and testes, growth of facial and pubic hair, deepening of the voice, changes in body shape, growth of bones, and increased muscle mass and strength in males. It helps maintain sex drive and the production of sperm cells, and it may play a role in balding.
Mood is also affected by testosterone, and low levels of the hormone can cause severe and prolonged depression as well as fatigue, to name a few conditions. High...
What Exactly is Testosterone?
Depression > What Exactly is Testosterone?
Herbal Acne Solutions
For centuries, acne has been the bane of human beings - especially teens. Acne affects over 40 million Americans. Acne has a far-reaching effect on individuals. Social withdrawal, lowered self-esteem, depression and lack of self-confidence are common among its victims. Hundreds of remedies have been tested over the years.
These fall into three basic categories ? commercial chemical and antibiotic cures, homegrown remedies and commercial herbal treatment. Most people agree that chemical-based formulas provide fairly good results. However, they require time to work, and the chemicals used in these products could damage the skin. However, they require time to work, and the chemicals used in these products could damage the skin.
Homegrown remedies are wide-ranging and at times bizarre. Desperate acne sufferers seeking overnight relief have concocted them.
Most of the remedies recommended in this category use the contents of kitchen and bathroom ingredients and...
Herbal Acne Solutions
Depression > Herbal Acne Solutions