1. Depression, Heart Disease May Raise Death Risk
Sept. 15, 2010 -- Patients who suffer from depression and who also have heart disease are almost five times as likely to die as people who are mentally and physically healthy, a new study shows. Researchers in England, Finland, France, and the U.S. examined data from about 6,000 middle-aged adults f
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2. Exercise for Depression: How It Helps
Five years ago, after ending a long-term relationship, Anita became seriously depressed. It benched the once-physically active writer, who asked that her last name be withheld to protect her privacy. She stopped running and began gaining weight and falling out of shape. It was not the first time she
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3. New Parents at Risk for Postpartum Depression
Sept 7, 2010 -- Both moms and dads are at an increased risk for depression during the first year of their infant's life, finds a new study of parents in the U.K. Close to 40% of new moms and 21% of new dads in the U.K experienced a bout of depression during their child's first 12 years of life, but
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4. Is Depression Wrecking Your Weight?
They are both heavy burdens - weight problems and depression. And they often go hand in hand. Some people gain weight when they're depressed. Others lose weight, to an unhealthy degree. Which comes first? And how can you untangle the link between depression and weight -- especially if depression has
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5. SAM-e May Boost Effects of Antidepressants
Sept. 3, 2010 -- SAM-e plus prescription antidepressants may spell relief for hard-to-treat depression, according to a new study published in the August 2010 issue of the American Journal of Psychiatry. Short for S-adenosyl methionine, SAM-e is a dietary supplement that is often used in the treatmen
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6. Saving Your Sex Life When You're Depressed
Chronic depression affects every part of daily life, including sex. It curbs sex drive, yet sex can boost your mood and is important for relationships. And some depression drugs can curb your libido. Breaking this cycle can be hard. How to get out of this funk? There's no one-size-fits-all approach.
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7. Pets for Depression and Health
Traffic was unbearable, the workday was long, and the boss unreasonable. But minutes later, as your pet dog wags his tail and yips his welcome, your symptoms of depression lift. It's not a coincidence, according to psychologists, veterinarians, and researchers, who concur that pets can be good for o
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8. Natural Depression Treatments
While therapy and medication are key in controlling depression, there’s also a lot you can do on your own to fight back. Making changes to your own behavior -- your physical activity, diet, and lifestyle -- can be effective natural depression treatments. “Lifestyle changes are a very important part
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9. Clues Help ID Depressed People at Risk of Bipolar Disorder
Aug. 17, 2010 -- Researchers have discovered clues that may help identify which people with depression are at risk of developing bipolar disorder. The new findings appear in the online version of The American Journal of Psychiatry. Bipolar disorder is a serious condition characterized by the extreme
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10. Internet Overuse May Cause Depression
Aug. 2, 2010 -- Teenagers who are addicted to the Internet are more likely to develop depression or other psychiatric problems than teens who are classified as normal Internet users, a new study says. Researchers in Australia and China studied pathological or uncontrolled Internet use and later ment
# Getting Started: Exercise for Depression
If you’re feeling depressed, it can be difficult to get yourself off the couch, much less exercise. But exercise may be one of the best things you can do for your depression. Physical activity can make you feel better, improve your mood, and help you sleep better. Many studies have shown the benefit
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# Eating Disorders and Depression
Eating disorders often begin with the best of intentions -- a desire to lose weight and control eating. But in some people, those good intentions go badly wrong, resulting in anorexia nervosa, bulimia, binge eating, or other disorders. Why some people are at risk for eating disorders isn’t clear. Bu
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# How Your Depression Medicine Can Affect Your Life
If you’re being treated for depression, taking an antidepressant may be part of your treatment plan. Antidepressants work by balancing chemicals in your brain called neurotransmitters that affect mood and emotions. These depression medicines can help improve your mood, help you sleep better, and inc
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# Depression and Insomnia
Can’t sleep? Feeling depressed? You’re not alone. Both insomnia and depression are surprisingly common complaints. About 15% of adults suffer from chronic insomnia. Nearly as many suffer occasional bouts of depression. Insomnia and depression often go hand-in-hand. Although just 15% of people with d
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# A Holistic Approach to Treating Depression
If you’re depressed, taking medication is only one of many treatment options. A holistic approach focuses on treating your whole being -- body and mind -- to help you feel better. A healthy diet, exercise, and talk therapy are a few of the holistic approaches you can use, along with your medication
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# Getting Started: Talk Therapy for Depression
Many studies have found that talk therapy, or psychotherapy, can help treat depression. Talk therapy can help you learn about your depression and help you find ways to manage your symptoms. “Talk therapy can give you the skills to help handle your depression, so for many people it’s a very empowerin
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# Coming to Terms With Depression
You’ve just been diagnosed with depression. You may feel as if you are the only person in the world with this problem. That kind of feeling is just one symptom of the illness. Of course, you aren’t alone. Nearly 17 million adults in the U.S. suffer from depression. It affects people of all ages, rac
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# Getting Started: Eating Right for Depression
If you’re feeling depressed, what you eat can affect your mood and your health. “A healthy diet is one of the most important facets in treating depression,” says Rosa Schnyer, DAOM, LAc, clinical assistant professor at the University of Texas College of Pharmacy in Austin. “If your body isn’t gettin
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# How Long Should You Take Antidepressants?
If you are considering taking an antidepressant, you may be concerned about how long you’ll need to stay on it. Even if you feel that it will help treat your depression, you may not like taking any medicine if you can help it. You may wonder about side effects or long-term effects of taking a drug t
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# Depression Linked to Alzheimer's Disease
July 6, 2010 -- Older people who suffer from depression have nearly double the risk for developing Alzheimer’s disease and dementia, a new study finds. Researchers followed elderly participants in the ongoing Framingham Heart Study for up to 17 years to explore late-life depression and dementia# Depression: Coping With Anxiety Symptoms
Depression and anxiety might seem like opposites, but they often go together. More than half of the people diagnosed with depression also have anxiety. Either condition can be disabling on its own. Together, depression and anxiety can be especially hard to live with, hard to diagnose, and hard to tr
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# Exercise and Depression: Expert Q&A
Depression is draining. It can make any type of exertion -- going to the grocery store, cleaning up the yard, or exercising -- seem daunting. "Energy loss is one of the key characteristics of depression. Some people feel that it’s the key characteristic of depression," says Robert E. Thayer, PhD, a
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# Antidepressants Linked to Miscarriage Risk
June 2, 2010 -- A Canadian study of more than 5,000 women shows an association between taking antidepressants, particularly the selective serotonin reuptake inhibitors (SSRIs) such as Paxil, Prozac, and Zoloft, and an increased risk for miscarriage. But researchers caution that this association does
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# Survey: Talk Therapy as Good as Antidepressants
June 1, 2010 -- Antidepressants are commonly prescribed for treating both anxiety and depression, but talk therapy appears to work just as well as the medications, according to a new survey. People who both take medicine and get therapy fare even better. Nearly 80% of survey respondents with depress
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# More 'Doctor Time' Helps Ease Depression
May 26, 2010 (New Orleans) -- Simply spending more time with the doctor may help people with depression feel better. That's according to researchers who analyzed data from major studies pitting the antidepressant Effexor against placebo in people with depression. Patients on placebo experienced subs
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# Yoga May Help Fight Depression
May 26, 2010 (New Orleans) -- Yoga may be helpful in the treatment of depression, researchers say. In a small study of healthy people with no psychiatric problems, yoga produced greater improvements in mood than walking, suggesting its beneficial effect is not just from physical activity. "We think
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# Hay Fever Linked to Depression
May 25, 2010 (New Orleans) -- If you suffer from a mood disorder and hay fever, don't be surprised if your mood worsens when pollen season rolls around. Preliminary research shows that people with depression or bipolar disorder who are allergic to tree or ragweed pollen experience worse depression w
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# Long-Term Antidepressants to Prevent Depression?
May 24, 2010 (New Orleans) -- Long-term use of antidepressants may not always be needed to prevent future bouts of depression. So say researchers whose preliminary study shows that at least two-thirds of depressed patients who will relapse do so in the first six months after stopping antidepressant
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# Dads Get Postpartum Depression, Too
May 18, 2010 -- Although postpartum depression in new moms is well known and well documented, slightly more than 10% of new dads also become depressed before or after their baby’s birth. The new findings were presented at a news conference sponsored by the American Medical Association and appear in
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# Craving Carbs: Is It Depression?
Does a bad day at the office or a tiff with your spouse send you marching to the cookie jar or the corner bakery? Or do you find yourself at the vending machine every day precisely at 4 p.m. for some crackers or candy? If either scenario fits, you're not alone. Many people crave carbohydrates -- esp# Cognitive Therapy for Depression
Almost everyone has dark thoughts when his or her mood is bad. With depression, though, the thoughts can be extremely negative. They can also take over and distort your view of reality. Cognitive therapy can be an effective way to defuse those thoughts. When used for depression, cognitive therapy pr
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# Foods to Help You Feel Better
Are you feeling down in the dumps? Are you irritated at how often you’ve been irritable? Perhaps it’s time to look at the foods and drinks you consume to see if they are trashing your mood. Nutrition experts say that the foods you eat can help you feel better -- or feel worse -- in the short-term an
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# Magnet Treatment for Depression Works for Some
May 4, 2010 -- A controversial new treatment for depression, rTMS, helps some patients, a rigorous government-funded study finds. The treatment is called repetitive transcranial magnetic stimulation. It's basically an electromagnet. When applied to the skull just behind the left forehead, the device
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# More Chocolate Means More Depression, or Vice Versa
April 26, 2010 -- Indulging in chocolate may help lift one’s mood, but a new study has found that people who eat the most chocolate have a greater likelihood of depression. A study of 931 men and women in the San Diego area showed that people who ate an average of 8.4 servings of chocolate per month
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# Can Antidepressants Work for Me?
How effective are antidepressants? That's a question that many people with depression have asked -- and research suggests that the answers aren't simple. It's a question that's relevant to millions. About one in 10 Americans takes an antidepressant, now the most commonly prescribed type of drug in
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# Depressed People Smoke More, Quit Less
April 14, 2010 -- Depressed people are more likely to smoke and less likely to quit, a CDC survey suggests. The findings don't prove that depression causes smoking, or that smoking causes depression. But the data, from nationwide surveys of adults conducted from 2005 through 2008, show there's a str
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# Teen Suicide Risk Similar Among Antidepressants
April 12, 2010 -- The heightened risk of teen suicide doesn’t vary among users of different antidepressants, a new study finds. Researchers say the finding supports the FDA’s current "black box" warning on all antidepressants detailing the increased risk of suicide attempts and suicides in children
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# Do Antidepressants in Pregnancy Affect Baby?
Feb. 23, 2010 -- Babies born to women who take antidepressants during pregnancy may experience small delays in reaching certain developmental milestones, but it is not clear if these delays are clinically significant, a study shows. Compared to children born to women who did not take antidepressants
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# Acupuncture Eases Depression in Pregnancy
Feb. 22, 2010 -- Acupuncture may be an effective way to reduce depression during pregnancy, a new study shows. Many pregnant women who have symptoms of depression worry that taking antidepressants might harm their unborn babies -- so they stop taking their medications, say researchers at the Stanfor
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# Internet Addiction Spins Web of Depression
Feb. 4, 2010 -- Internet users who are compulsive about going online and have more social interactions in virtual worlds than the real one may be depressed, according to a new study. Some Internet users retreat from real-life interaction and opt for chat rooms and social networking sites, and this #
Sadness. Irritability. Obsessive thoughts. Extreme moods. The symptoms of depression, anxiety disorder, and bipolar disorder often seem the same. It's not always easy for doctors to determine which mood disorder, or combination, a patient has. Here are some questions that will help both you and your
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# Antidepressants: Best for Severe Depression?
Jan. 5, 2010 -- Some antidepressants may work best for people with very severe depression, according to a new analysis, but may provide little or no benefit over placebo for those with mild, moderate, or severe depression. ''For patients with very severe depression, the medication did have a potent
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# Americans With Depression Are Undertreated
Jan. 4, 2010 -- A new study shows only half of Americans with depression receive any type of treatment for it, and certain minorities may face even greater difficulties in getting the treatment they need. Researchers found only one in five Americans suffering from clinical depression receives treatm
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# Depression and Divorce
The 20-something couple, married just a few years, was eagerly looking forward to the birth of their first baby. Labor and delivery went fine, and the baby was born healthy. But problems began when the new mom, overwhelmed by motherhood, suffered depression. "The husband had to take care of everythi
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# Antidepressants May Raise Stroke Risk
Dec. 14, 2009 -- Older women who take antidepressants may have a slightly higher risk for stroke and death. In a new finding from the large study known as the Women's Health Initiative (WHI), postmenopausal women who took tricyclic or selective serotonin reuptake inhibitor (SSRI) antidepressants had
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# Antidepressant Paxil Also May Affect Personality
Dec. 7, 2009 -- Besides treating depression, the antidepressant Paxil may affect personality traits in positive ways, a new study suggests. Researchers say Paxil and likely other antidepressants in the class of drugs called selective serotonin reuptake inhibitors (SSRIs) may improve higher levels of
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# Seasonal Mood and Hormonal Changes
Many women report mood changes linked to their monthly menstrual cycles. Between 3% and 9% of women of reproductive age experience premenstrual dysphoric disorder (PMDD), often with severe depression symptoms. How are these monthly mood changes -- mild or severe -- affected by seasonal weather and
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# Tempted to Quit Antidepressants?
Antidepressants are designed to boost mood and relieve sadness, but for some patients, their side effects fuel another emotion: frustration. Just ask Maryland resident Jane Niziol. Her doctor prescribed Paxil after a difficult breakup left her feeling depressed and overwhelmed. Niziol recalls the me
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# Lifestyle Tips for Treatment-Resistant Depression
If you have treatment-resistant depression, getting expert medical and psychological treatment is crucial. But recovery isn't only about dutifully taking your medicine and seeing your therapist. There is actually a lot that you can do on your own to support your treatment. "Because some treatments h
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# Treatment-Resistant Depression: Your Continuum of Care
If you've been diagnosed with treatment-resistant depression, you might be wondering what happens next. You've already tried some medications. Maybe you've already tried talk therapy, too. They haven't helped. So what now? "Having treatment-resistant depression is a terrible burden for people," says
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Saturday, September 18, 2010
WebMD Home next page Managing Treatment-Resistant Depression Email a Friend Print Article Managing Treatment-Resistant Depression From Our Sponsor:Sy
Understanding Treatment-Resistant Depression (TRD)
Worldwide, it's estimated that more than 121 million people are affected by depression. For some, finding the right treatment for their depression can be more difficult.
There are many medicines that help to treat depression. But some people have a type of depression called Treatment-Resistant Depression (TRD). A person may have TRD if, during an episode of depression, he or she has had little or no response to treatment with 2 different antidepressants. This may happen even when the person takes the right dose for the right amount of time.
The Impact of TRD
If you are living with TRD, the condition can make your life more difficult. You may even feel that you are the source of your problems, and not your condition. After several unsuccessful attempts to treat your depression, you may feel skeptical that anything will be able to help. But without treatment, your TRD symptoms may continue to have an impact on your life.
Seeking Help
If you are affected by the condition, the first steps toward getting relief can be learning more about TRD and talking to your healthcare professional about TRD. You can also learn more about Symbyax, the first antidepressant approved by the FDA for acute treatment of TRD.
To help you talk to your healthcare professional about your depression experience and to learn if you could have TRD, complete and print the online Doctor Discussion Guide.
Next Article:
Important Safety Information about Symbyax® (olanzapine and fluoxetine HCl)
Please read the Medication Guide that comes with Symbyax before you start taking it and each time you get a refill
What are the possible side effects of Symbyax?
Like all medicines, Symbyax is associated with possible side effects. Tell your doctor about any side effect that concerns you.
Symbyax may be associated with the following serious risks:
* Antidepressants may increase suicidal thoughts or behaviors in some children, adolescents and young adults especially within the first few months of treatment or when changing the dose. No increased risk has been shown for adults over age 24, and risk decreased for those over age 65. All patients starting therapy should be monitored appropriately and observed closely for new or worsening depression symptoms, suicidal thoughts or behavior, or unusual changes in behavior. Symbyax is not approved for children and adolescents.
* Elderly people with psychosis related to dementia (a brain disorder that lessens the ability to remember, think, and reason) are at increased risk of death when taking certain mental health medicines (such as Symbyax) compared with a sugar pill. Symbyax is not approved for these patients.
* Suicidal thoughts or actions. Persons taking Symbyax may be more likely to think about killing themselves or actually try to do so, especially when Symbyax is first started or the dose is changed. People close to patients taking Symbyax can help by paying attention to changes in patient's mood or actions. Contact the doctor right away if someone using Symbyax talks about or shows signs of killing him or herself or has sudden changes in mood, behaviors, thoughts, or feelings. If you are taking Symbyax yourself and you start having any of these symptoms, tell your doctor about this right away.
* Strokes and "mini-strokes" called transient ischemic attacks (TIAs). These are more common in elderly people with psychosis related to dementia. Symbyax is not approved for these patients.
* Severe allergic reactions. Tell your doctor right away if you get red itchy welts (hives) or a rash alone or with fever and joint pain, while taking Symbyax. Call your doctor right away if you become severely ill and have swelling of your face, eyes or mouth, and/or trouble breathing.
* Neuroleptic malignant syndrome (NMS). This is a rare but very serious condition that can happen in people who take certain medicines for mental health problems, including Symbyax. NMS can cause death and must be treated in a hospital. The symptoms include high fever; excessive sweating; rigid muscles; confusion; and changes in breathing, heartbeat, and blood pressure. Call your doctor right away if you become severely ill and have some or all of these symptoms.
* High blood sugar (hyperglycemia). High blood sugar can occur if you have diabetes already or even if you have never had diabetes. In rare cases, this could lead to ketoacidosis (build up of acid in the blood due to ketones), coma, or death. Your doctor should do lab tests to check your blood sugar before you start taking Symbyax and during treatment. In people who do not have diabetes, sometimes high blood sugar goes away when Symbyax is stopped. People with diabetes and some people who did not have diabetes before taking Symbyax need to take medicine for high blood sugar even after they stop taking Symbyax. If you have diabetes, follow your doctor's instructions about how often to check your blood sugar while taking Symbyax.
Call your doctor if you have any of these symptoms of high blood sugar (hyperglycemia) while taking Symbyax:
o feel very thirsty
o need to urinate more than usual
o feel very hungry
o feel weak or tired
o feel sick to your stomach
o feel confused, or your breath smells fruity.
* High cholesterol and triglyceride levels in the blood (fat in the blood). These have been observed in patients treated with Symbyax, especially in teenagers (13-17 years old) who received olanzapine, one of the components of Symbyax. Symbyax is not approved for use in patients less than 18 years old. You may not have any symptoms, so your doctor should do blood tests to check your cholesterol and triglyceride levels before you start taking Symbyax and during treatment.
* Increase in weight (weight gain). Weight gain is very commonly seen in patients who take Symbyax. Teenagers (13-17 years old) who received olanzapine, one of the components of Symbyax, were more likely to gain weight and to gain more weight than adults. Symbyax is not approved for use in patients less than 18 years old. Some patients may gain a lot of weight while taking Symbyax, so your doctor should check your weight regularly. Talk to your doctor about ways to control weight gain, such as eating a healthy, balanced diet, and exercising.
* Tardive dyskinesia. This condition causes body movements that keep happening and that you cannot control. These movements usually affect the face and tongue. Tardive dyskinesia may not go away, even if you stop taking Symbyax. It may also start after you stop taking Symbyax. Tell your doctor if you get any body movements that you cannot control.
* Serotonin syndrome. This is a condition that can be life threatening. Call your doctor right away if you become severely ill and have some or all of these symptoms: agitation; hallucinations; problems with coordination; racing heart beat; over-active reflexes; fever; nausea, vomiting, and diarrhea.
* Abnormal bleeding. Tell your doctor if you notice any increased or unusual bruising or bleeding while taking Symbyax, especially if you take one of these medications: the blood thinner warfarin (Coumadin, Jantoven), a nonsteroidal anti-inflammatory drug (NSAID), aspirin.
* Low salt (sodium) levels in the blood (hyponatremia). Call your doctor right away if you become severely ill and have some or all of these symptoms: headache, feel weak, confusion, problems concentrating, memory problems, feel unsteady.
* Decreased blood pressure when you change position, with symptoms of dizziness, fast or slow heart beat, or fainting.
* Decreases in white blood cells (infection fighting cells) have been reported in some patients taking antipsychotic agents, including SYMBYAX. Patients with a history of a significant decrease in white blood cell (WBC) count or who have experienced a low WBC count due to drug therapy should have their blood tested and monitored during the first few months of therapy.
* Seizures.
* Trouble swallowing.
* Problems with control of body temperature. You could become very hot, for instance when you exercise a lot or stay in an area that is very hot. It is important for you to drink water to avoid dehydration. Call your doctor right away if you become severely ill and have some or all of these symptoms of dehydration: sweating too much or not at all, dry mouth, feeling very hot, feeling thirsty, not able to produce urine.
Common possible side effects of Symbyax include:
* Tiredness
* Feeling weak
* Increased appetite
* Sleeping for long periods of time
* Blurred vision
* Tremors (shakes)
* Dry mouth
* Swelling of your hands and feet
This is not a complete list of possible side effects. If you have questions or if you have any side effects that concern you, talk with your doctor and/or pharmacist.
Who should not take Symbyax?
* Do not take Symbyax if you already take a Monoamine Oxidase Inhibitor (MAOI) or if you stopped taking an MAOI in the last 2 weeks. Do not take an MAOI within 5 weeks of stopping Symbyax. People who take Symbyax close in time to an MAOI can have serious and life-threatening side effects, with symptoms including: high fever, continued muscle spasms that you cannot control, rigid muscles, changes in heart rate and blood pressure that happen fast, confusion, unconsciousness. Ask your doctor or pharmacist if you are not sure if your medicine is an MAOI.
* Do not take Symbyax if you already take Mellaril (thioridazine) or within 5 weeks of stopping Symbyax. Mellaril can cause serious heart rhythm problems and you could die suddenly.
* Do not take Symbyax if you take the antipsychotic medicine pimozide (Orap).
Other important safety information
Tell your doctor if you are pregnant or may become pregnant while taking Symbyax. It is not known if Symbyax will harm your unborn baby. You should not breast-feed if you are taking Symbyax.
Tell your doctor if you are taking, or plan to take, any prescription or over-the-counter drugs including vitamins and herbal supplements. Symbyax and some medicines may interact with each other and may not work as well, or cause possible serious side effects. Do not start or stop any medicine while taking Symbyax without talking to your doctor first.
Symbyax may not be right for you. Before starting Symbyax, tell your doctor about all of your medical conditions.
If you take Symbyax, you should not take any other medicines that contain olanzapine (Zyprexa or Zyprexa Zydis) or fluoxetine hydrochloride (Prozac, Prozac Weekly, or Sarafem). You could take too much medicine.
Take Symbyax exactly as prescribed. To prevent serious side effects, do not stop taking Symbyax suddenly. If you need to stop taking Symbyax, your doctor can tell you how to safely stop taking it.
Symbyax can cause sleepiness and may affect your ability to make decisions, think clearly, or react quickly. You should not drive, operate heavy machinery, or do other dangerous activities until you know how Symbyax affects you.
Avoid the use of alcohol while taking Symbyax.
It is not known if Symbyax is safe and works in children under 18 years of age.
Worldwide, it's estimated that more than 121 million people are affected by depression. For some, finding the right treatment for their depression can be more difficult.
There are many medicines that help to treat depression. But some people have a type of depression called Treatment-Resistant Depression (TRD). A person may have TRD if, during an episode of depression, he or she has had little or no response to treatment with 2 different antidepressants. This may happen even when the person takes the right dose for the right amount of time.
The Impact of TRD
If you are living with TRD, the condition can make your life more difficult. You may even feel that you are the source of your problems, and not your condition. After several unsuccessful attempts to treat your depression, you may feel skeptical that anything will be able to help. But without treatment, your TRD symptoms may continue to have an impact on your life.
Seeking Help
If you are affected by the condition, the first steps toward getting relief can be learning more about TRD and talking to your healthcare professional about TRD. You can also learn more about Symbyax, the first antidepressant approved by the FDA for acute treatment of TRD.
To help you talk to your healthcare professional about your depression experience and to learn if you could have TRD, complete and print the online Doctor Discussion Guide.
Next Article:
Important Safety Information about Symbyax® (olanzapine and fluoxetine HCl)
Please read the Medication Guide that comes with Symbyax before you start taking it and each time you get a refill
What are the possible side effects of Symbyax?
Like all medicines, Symbyax is associated with possible side effects. Tell your doctor about any side effect that concerns you.
Symbyax may be associated with the following serious risks:
* Antidepressants may increase suicidal thoughts or behaviors in some children, adolescents and young adults especially within the first few months of treatment or when changing the dose. No increased risk has been shown for adults over age 24, and risk decreased for those over age 65. All patients starting therapy should be monitored appropriately and observed closely for new or worsening depression symptoms, suicidal thoughts or behavior, or unusual changes in behavior. Symbyax is not approved for children and adolescents.
* Elderly people with psychosis related to dementia (a brain disorder that lessens the ability to remember, think, and reason) are at increased risk of death when taking certain mental health medicines (such as Symbyax) compared with a sugar pill. Symbyax is not approved for these patients.
* Suicidal thoughts or actions. Persons taking Symbyax may be more likely to think about killing themselves or actually try to do so, especially when Symbyax is first started or the dose is changed. People close to patients taking Symbyax can help by paying attention to changes in patient's mood or actions. Contact the doctor right away if someone using Symbyax talks about or shows signs of killing him or herself or has sudden changes in mood, behaviors, thoughts, or feelings. If you are taking Symbyax yourself and you start having any of these symptoms, tell your doctor about this right away.
* Strokes and "mini-strokes" called transient ischemic attacks (TIAs). These are more common in elderly people with psychosis related to dementia. Symbyax is not approved for these patients.
* Severe allergic reactions. Tell your doctor right away if you get red itchy welts (hives) or a rash alone or with fever and joint pain, while taking Symbyax. Call your doctor right away if you become severely ill and have swelling of your face, eyes or mouth, and/or trouble breathing.
* Neuroleptic malignant syndrome (NMS). This is a rare but very serious condition that can happen in people who take certain medicines for mental health problems, including Symbyax. NMS can cause death and must be treated in a hospital. The symptoms include high fever; excessive sweating; rigid muscles; confusion; and changes in breathing, heartbeat, and blood pressure. Call your doctor right away if you become severely ill and have some or all of these symptoms.
* High blood sugar (hyperglycemia). High blood sugar can occur if you have diabetes already or even if you have never had diabetes. In rare cases, this could lead to ketoacidosis (build up of acid in the blood due to ketones), coma, or death. Your doctor should do lab tests to check your blood sugar before you start taking Symbyax and during treatment. In people who do not have diabetes, sometimes high blood sugar goes away when Symbyax is stopped. People with diabetes and some people who did not have diabetes before taking Symbyax need to take medicine for high blood sugar even after they stop taking Symbyax. If you have diabetes, follow your doctor's instructions about how often to check your blood sugar while taking Symbyax.
Call your doctor if you have any of these symptoms of high blood sugar (hyperglycemia) while taking Symbyax:
o feel very thirsty
o need to urinate more than usual
o feel very hungry
o feel weak or tired
o feel sick to your stomach
o feel confused, or your breath smells fruity.
* High cholesterol and triglyceride levels in the blood (fat in the blood). These have been observed in patients treated with Symbyax, especially in teenagers (13-17 years old) who received olanzapine, one of the components of Symbyax. Symbyax is not approved for use in patients less than 18 years old. You may not have any symptoms, so your doctor should do blood tests to check your cholesterol and triglyceride levels before you start taking Symbyax and during treatment.
* Increase in weight (weight gain). Weight gain is very commonly seen in patients who take Symbyax. Teenagers (13-17 years old) who received olanzapine, one of the components of Symbyax, were more likely to gain weight and to gain more weight than adults. Symbyax is not approved for use in patients less than 18 years old. Some patients may gain a lot of weight while taking Symbyax, so your doctor should check your weight regularly. Talk to your doctor about ways to control weight gain, such as eating a healthy, balanced diet, and exercising.
* Tardive dyskinesia. This condition causes body movements that keep happening and that you cannot control. These movements usually affect the face and tongue. Tardive dyskinesia may not go away, even if you stop taking Symbyax. It may also start after you stop taking Symbyax. Tell your doctor if you get any body movements that you cannot control.
* Serotonin syndrome. This is a condition that can be life threatening. Call your doctor right away if you become severely ill and have some or all of these symptoms: agitation; hallucinations; problems with coordination; racing heart beat; over-active reflexes; fever; nausea, vomiting, and diarrhea.
* Abnormal bleeding. Tell your doctor if you notice any increased or unusual bruising or bleeding while taking Symbyax, especially if you take one of these medications: the blood thinner warfarin (Coumadin, Jantoven), a nonsteroidal anti-inflammatory drug (NSAID), aspirin.
* Low salt (sodium) levels in the blood (hyponatremia). Call your doctor right away if you become severely ill and have some or all of these symptoms: headache, feel weak, confusion, problems concentrating, memory problems, feel unsteady.
* Decreased blood pressure when you change position, with symptoms of dizziness, fast or slow heart beat, or fainting.
* Decreases in white blood cells (infection fighting cells) have been reported in some patients taking antipsychotic agents, including SYMBYAX. Patients with a history of a significant decrease in white blood cell (WBC) count or who have experienced a low WBC count due to drug therapy should have their blood tested and monitored during the first few months of therapy.
* Seizures.
* Trouble swallowing.
* Problems with control of body temperature. You could become very hot, for instance when you exercise a lot or stay in an area that is very hot. It is important for you to drink water to avoid dehydration. Call your doctor right away if you become severely ill and have some or all of these symptoms of dehydration: sweating too much or not at all, dry mouth, feeling very hot, feeling thirsty, not able to produce urine.
Common possible side effects of Symbyax include:
* Tiredness
* Feeling weak
* Increased appetite
* Sleeping for long periods of time
* Blurred vision
* Tremors (shakes)
* Dry mouth
* Swelling of your hands and feet
This is not a complete list of possible side effects. If you have questions or if you have any side effects that concern you, talk with your doctor and/or pharmacist.
Who should not take Symbyax?
* Do not take Symbyax if you already take a Monoamine Oxidase Inhibitor (MAOI) or if you stopped taking an MAOI in the last 2 weeks. Do not take an MAOI within 5 weeks of stopping Symbyax. People who take Symbyax close in time to an MAOI can have serious and life-threatening side effects, with symptoms including: high fever, continued muscle spasms that you cannot control, rigid muscles, changes in heart rate and blood pressure that happen fast, confusion, unconsciousness. Ask your doctor or pharmacist if you are not sure if your medicine is an MAOI.
* Do not take Symbyax if you already take Mellaril (thioridazine) or within 5 weeks of stopping Symbyax. Mellaril can cause serious heart rhythm problems and you could die suddenly.
* Do not take Symbyax if you take the antipsychotic medicine pimozide (Orap).
Other important safety information
Tell your doctor if you are pregnant or may become pregnant while taking Symbyax. It is not known if Symbyax will harm your unborn baby. You should not breast-feed if you are taking Symbyax.
Tell your doctor if you are taking, or plan to take, any prescription or over-the-counter drugs including vitamins and herbal supplements. Symbyax and some medicines may interact with each other and may not work as well, or cause possible serious side effects. Do not start or stop any medicine while taking Symbyax without talking to your doctor first.
Symbyax may not be right for you. Before starting Symbyax, tell your doctor about all of your medical conditions.
If you take Symbyax, you should not take any other medicines that contain olanzapine (Zyprexa or Zyprexa Zydis) or fluoxetine hydrochloride (Prozac, Prozac Weekly, or Sarafem). You could take too much medicine.
Take Symbyax exactly as prescribed. To prevent serious side effects, do not stop taking Symbyax suddenly. If you need to stop taking Symbyax, your doctor can tell you how to safely stop taking it.
Symbyax can cause sleepiness and may affect your ability to make decisions, think clearly, or react quickly. You should not drive, operate heavy machinery, or do other dangerous activities until you know how Symbyax affects you.
Avoid the use of alcohol while taking Symbyax.
It is not known if Symbyax is safe and works in children under 18 years of age.
Wednesday, August 11, 2010
food for mood
Foods to Help You Feel Better
6 ways to add mood-boosting foods to your diet.
Reviewed by Laura J. Martin, MD
Are you feeling down in the dumps? Are you irritated at how often you’ve been irritable?
Perhaps it’s time to look at the foods and drinks you consume to see if they are trashing your mood. Nutrition experts say that the foods you eat can help you feel better -- or feel worse -- in the short-term and the long-term.
- on a roller-coaster ride -- hitting highs and lows from too much sugar and refined flour – you are more likely to feel out of sorts. This is also true if your gastrointestinal system is distressed due to intense hunger from a fad diet or constipation because you aren’t getting enough fiber and water.
- Week-to-week and month-to-month, keeping your body healthy and disease-free makes good moods more likely. For example, key nutrients you get in certain foods can influence the levels of feel-good hormones such as serotonin. Other nutrients can help prevent inflammation so blood circulates well to all of your organs.
“Eating a heart healthy diet -- high in fiber and low in saturated fat -- is a great place to start to boost your mood. There isn’t any question about it, says Diane M. Becker MPH, ScD, director of the Center for Health Promotion at the Johns Hopkins School of Medicine.
Conversely, “a high-fat, high-glycemic load meal can make you physically feel dysfunction in your body. People who eat this type of meal tend to feel bad and sleepy afterwards,” she says.
6 Tips for Foods and Beverages That Help You Feel Good
1. Seek out foods rich in vitamin B12 and folic acid (folate).
What’s special about chili made with kidney beans and lean beef? Or a light chicken Caesar salad made with skinless chicken breast and romaine lettuce? Or grilled salmon with a side of broccoli?
All these dishes feature one food that is rich in folic acid (folate) and another that is rich in vitamin B12. These two vitamins appear to help prevent disorders of the central nervous system, mood disorders, and dementias, says Edward Reynolds, MD, at the Institute of Epileptology, King’s College, London.
The link between higher food intakes of folate and a lower prevalence of depressive symptoms crosses cultures, too. A recent study confirmed this association in Japanese men.
Folic acid is usually found in beans and greens. Vitamin B12 is found in meats, fish, poultry, and dairy.
Other dishes that feature B-12 and folic acid-rich foods include:
- A burrito or enchilada made with black beans plus beef, chicken, or pork
- A spinach salad topped with crab or salmon
. Enjoy fruits and vegetables in a big way.
Fruits and vegetables are packed with key nutrients and antioxidant phytochemicals, which directly contribute to your health and health-related quality of life.
In a one study, eating two more servings of fruits and vegetables a day was associated with an 11% higher likelihood of good functional health. People who ate the highest amount of fruits and vegetables felt better about their health.
3. Eat selenium-rich foods every day.
Selenium is a mineral that acts like an antioxidant in the body. What do antioxidants have to do with feeling better and minimizing bad moods? Research suggests that the presence of oxidative stress in the brain is associated with some cases of mild to moderate depression in the elderly population.
One study evaluated the depression scores of elderly people whose daily diet was either supplemented with 200 micrograms of selenium a day or a placebo. Although more research is needed to confirm the findings, the group taking selenium had higher amounts of selenium circulating in their blood and significant decreases in their depression symptoms.
Try to get at least the recommended daily allowance for selenium: 55 micrograms a day for men and women.
Whole grains are an excellent source of selenium. By eating several servings a day of whole grains such as oatmeal, whole-grain bread, and brown rice, you can easily get 70 micrograms of selenium. Other foods rich in selenium include:
- Beans and legumes
- Lean meat (lean pork or beef, skinless chicken or turkey)
- Low-fat dairy foods
- Nuts and seeds (especially Brazil nuts)
- Seafood (oysters, clams, crab, sardines, and fish)
4. Eat fish several times a week.
Several recent studies have suggested that men and women have a lower risk of having symptoms of depression if they eat a lot of fish, particularly fatty fish like salmon, which is high in omega-3 fatty acids.
Omega-3s from fish seem to have positive effects on clinically defined mood swings such as postpartum depression, says Jay Whelan, PhD, head of the department of nutrition at the University of Tennessee.
Good sources of omega-3 fatty acids include:
- Herring
- Rainbow trout
- Salmon
- Sardines
5. Get a daily dose of vitamin D.
Does a little time in the sun seem to make you feel better? The sun’s rays allow our bodies to synthesize and regulate vitamin D.
Four recent studies showed an association between low serum levels of vitamin D and higher incidences of four mood disorders: PMS, seasonal affective disorder, nonspecified mood disorder, and major depressive disorder.
Researcher Pamela K. Murphy, PhD, at the Medical University of South Carolina says people can help manage their moods by getting at least 1,000 to 2,000 IU of vitamin D a day.
That’s significantly more than the RDA for vitamin D, which is 200 IU for adults under 50, 400 IU for ages 51 to 70, and 600 IU for people over 70.
Very few foods naturally contain vitamin D. So she recommends we get vitamin D from a variety of sources: short periods of sun exposure, vitamin D supplements, and foods.
Vitamin D can be found in:
- Fatty fish such as salmon, tuna, and mackerel
- Beef liver
- Cheese
- Egg yolks
But our primary source of dietary vitamin D is fortified foods, such as breakfast cereals, breads, juices, and milk.
6. Treat Yourself to 1 oz of Chocolate
“Small amounts of dark chocolate can be a physical upper,” says Becker at Johns Hopkins. “Dark chocolate has an effect on the levels of brain endorphins,” those feel-good chemicals that our bodies produce. Not only that, but dark chocolate also seems to have a heart-healthy anti-clogging effect in our blood vessels.
In one study from the Netherlands, Dutch men who ate 1/3 of a chocolate bar each day had lower levels of blood pressure and lower rates of heart disease. The chocolate also boosted their general sense of well-being.
How Foods and Beverages May Make You Feel Bad
Just as some foods can help you feel better, others can make you feel down. Here are ways to reduce the harmful effects of three foods that can drag you down.
1. Reduce foods high in saturated fat.
Saturated fat is well known for its role in promoting heart disease and some types of cancer. Now researchers suspect saturated fat also play a role in depression.
The link was found in a study called the Coronary Health Improvement Project, which followed 348 people between the 24 and 81. A decrease in saturated fat over a six-week period was associated with a decrease in depression.
2. Limit alcohol carefully.
That “feel-good” drink, alcohol, is actually a depressant. In small doses, alcohol can produce a temporary feeling of euphoria. But the truth is that alcohol is a chemical depressant to the human brain and affects all nerve cells.
Depending on the amount of alcohol consumed, people can go quickly from feeling relaxed to experiencing exaggerated emotions and impaired coordination.
It’s no coincidence that depressive disorders often co-occur with substance abuse, and one of the main forms of substance abuse in this country is alcohol.
. Don’t go crazy with caffeine.
Caffeine can increase irritability a couple of ways.
- If the caffeine you consume later in the day disrupts your nighttime sleeping, you are likely to be cranky and exhausted until you get a good night’s rest.
- Caffeine can also bring on a burst or two of energy, often ending with a spiral into fatigue.
Some people are more sensitive than others to the troublesome effects of caffeine. If you are sensitive to caffeine, decrease the amount of coffee, tea, and sodas you drink to see if this helps uplift your mood and energy level, particularly in the latter part of the day.
serotonin and depression
Serotonin: 9 Questions and Answers
Reviewed by Brunilda Nazario, MD
1. What is serotonin?
Serotonin acts as a neurotransmitter, a type of chemical that helps relay signals from one area of the brain to another. Although serotonin is manufactured in the brain, where it performs its primary functions, some 90% of our serotonin supply is found in the digestive tract and in blood platelets.
2. How is serotonin made?
Serotonin is made via a unique biochemical conversion process. It begins with tryptophan, a building block to proteins. Cells that make serotonin use tryptophan hydroxylase, a chemical reactor which, when combined with tryptophan, forms 5-hydoxytryptamine, otherwise known as serotonin.
3. What role does serotonin play in our health?
As a neurotransmitter, serotonin helps to relay messages from one area of the brain to another. Because of the widespread distribution of its cells, it is believed to influence a variety of psychological and other body functions. Of the approximately 40 million brain cells, most are influenced either directly or indirectly by serotonin. This includes brain cells related to mood, sexual desire and function, appetite, sleep, memory and learning, temperature regulation, and some social behavior.
In terms of our body function, serotonin can also affect the functioning of our cardiovascular system, muscles, and various elements in the endocrine system. Researchers have also found evidence that serotonin may play a role in regulating milk production in the breast, and that a defect within the serotonin network may be one underlying cause of SIDS (sudden infant death syndrome).
4. What is the link between serotonin and depression?
There are many researchers who believe that an imbalance in serotonin levels may influence mood in a way that leads to depression. Possible problems include low brain cell production of serotonin, a lack of receptor sites able to receive the serotonin that is made, inability of serotonin to reach the receptor sites, or a shortage in tryptophan, the chemical from which serotonin is made. If any of these biochemical glitches occur, researchers believe it can lead to depression, as well as obsessive-compulsive disorder, anxiety, panic, and even excess anger.
One theory about how depression develops centers on the regeneration of brain cells -- a process that some believe is mediated by serotonin, and ongoing throughout our lives. According to Princeton neuroscientist Barry Jacobs, PhD, depression may occur when there is a suppression of new brain cells and that stress is the most important precipitator of depression. He believes that common antidepressant medications, such as Celexa, Lexapro, Prozac, and Paxil -- designed to boost serotonin levels -- help kick off the production of new brain cells, which in turn allows the depression to lift.
Although it is widely believed that a serotonin deficiency plays a role in depression, there is no way to measure its levels in the living brain. Therefore, there have not been any studies proving that brain levels of this or any neurotransmitter are in short supply when depression or any mental illness develops. And while blood levels of serotonin are measurable -- and have been shown to be lower in people who suffer from depression -- what doctors still don't know for certain is whether or not the dip in serotonin causes the depression, or the depression causes serotonin levels to drop.
Antidepressant medications that work on serotonin levels -- medications known as SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin and norepinephrine reuptake inhibitors) are believed to reduce symptoms of depression, but exactly how they work is not yet fully understood.
5. Can diet influence our supply of serotonin?
It can, but in a roundabout way. Unlike calcium-rich foods, which can directly increase your blood levels of this mineral, there are no foods that can directly increase your body's supply of serotonin. That said, there are foods and some nutrients that can increase levels of tryptophan, the amino acid from which serotonin is made.
Protein-rich foods, such as meat or chicken, contain high levels of tryptophans. Tryptophan appears in dairy foods, nuts, and fowl. Ironically, however, levels of both tryptophan and serotonin drop after eating a meal packed with protein. Why? According to nutritionist Elizabeth Somer, when you eat a high-protein meal, you "flood the blood with both tryptophan and its competing amino acids," all fighting for entry into the brain. That means only a small amount of tryptophan gets through -- and serotonin levels don't rise.
But eat a carbohydrate-rich meal, and your body triggers a release of insulin. This, Somer says, causes any amino acids in the blood to be absorbed into the body -- but not the brain. Except for, you guessed it -- tryptophan! It remains in the bloodstream at high levels following a carbohydrate meal, which means it can freely enter the brain and cause serotonin levels to rise, she says.
What can also help: Getting an adequate supply of vitamin B-6, which can influence the rate at which tryptophan is converted to serotonin.
6. Can exercise boost serotonin levels?
Exercise can do a lot to improve your mood -- and across the board, studies have shown that regular exercise can be as effective a treatment for depression as antidepressant medication or psychotherapy. In the past, it was believed that several weeks of working out was necessary to see the effects on depression, but new research conducted at the University of Texas at Austin found that just 40 minutes of regular exercise can have an immediate effect on mood.
That said, it remains unclear of the exact mechanism by which exercise accomplishes this. While some believe it affects serotonin levels, to date there are no definitive studies showing that this is the case.
7. Do men and women have the same amount of serotonin -- and does it act the same way in their brain and body?
Studies show that men do have slightly more serotonin than women, but the difference is thought to be negligible. Interestingly, however, a study published in September 2007 in the journal Biological Psychiatry showed there might be a huge difference in how men and women react to a reduction in serotonin -- and that may be one reason why women suffer from depression far more than men.
7. Do men and women have the same amount of serotonin -- and does it act the same way in their brain and body? continued...
Although studies are still in their infancy, researchers say defining these differences may be the beginning of learning why more women than men experience anxiety and mood disorders, while more men experience alcoholism, ADHD, and impulse control disorders.
There is also some evidence that female hormones may also interact with serotonin to cause some symptoms to occur or worsen during the premenstrual time, during the postpartum period, or around the time of menopause. Not coincidentally, these are all periods when sex hormones are in flux. Men, on the other hand, generally experience a steady level of sex hormones until middle age, when the decline is gradual.
8. Since both dementia and Alzheimer's disease are brain-related conditions, does serotonin play a role in either problem?
In much the same way that we lose bone mass as we age, some researchers believe that the activity of neurotransmitters also slows down as part of the aging process. In one international study published in 2006, doctors from several research centers around the world noted a serotonin deficiency in brains of deceased Alzheimer's patients. They hypothesized that the deficiency was because of a reduction in receptor sites -- cells capable of receiving transmissions of serotonin -- and that this in turn may be responsible for at least some of the memory-related symptoms of Alzheimer's disease. There is no evidence to show that increasing levels of serotonin will prevent Alzheimer's disease or delay the onset or progression of dementia. However, as research into this area continues, this could also change.
9. What is serotonin syndrome -- and is it common or dangerous?
SSRI antidepressants are generally considered safe; however, a rare side effect of SSRIs is serotonin syndrome. Serotonin syndrome is a condition that occurs when levels of this neurochemical in the brain rise too high. It happens most often when two or more drugs that affect serotonin levels are used simultaneously. For example, if you are taking a category of migraine medicines called triptans, at the same time you are taking an SSRI drug for depression, the end result can be a serotonin overload. The same can occur when you take SSRI supplements, such as St. John's wort.
Problems are most likely to occur when you first start a medication or increase the dosage. Problems can also occur if you combine the older depression medications (known as MAOIs) with SSRIs.
Finally, recreational drugs such as ecstasy or LSD have also been linked to serotonin syndrome.
Symptoms can occur within minutes to hours and generally include restlessness, hallucinations, rapid heartbeat, increased body temperature and sweating, loss of coordination, muscle spasms, nausea, vomiting, diarrhea, and rapid changes in blood pressure .
Although not a common occurrence, it can be dangerous and is considered a medical emergency. Treatment consists of drug withdrawal, IV fluids, muscle relaxers, and drugs to block serotonin production.
Treatments for Depression
The good news about depression is that you have a number of excellent treatments to choose from. More than 80% of people who get treatment for depression say that it helps them feel better.
Here's a rundown of some of the most common approaches. Many people use a mix. For instance, you might try medicine and therapy at the same time. Some studies show that using both together is better than using either one alone.
Talk Therapy for Depression
Talking with a trained therapist is one of the best treatments for depression. Many studies show that it helps. Some people choose to be in therapy for several months to work on a few key issues. Other people prefer to stay in therapy for years, gradually working through larger problems. The choice is up to you. Here are some common types of therapy.
* Cognitive behavioral therapy helps you see how behaviors -- and the way you think about things -- play a role in your depression. Your therapist will help you change some of these unhealthy patterns.
* Interpersonal therapy focuses on your relationships with other people and how they affect you. Your therapist will also help you identify and change unhealthy behaviors.
* Problem solving therapy focuses on the specific problems you currently face, and on helping you find solutions to those problems.
Antidepressant Medicines
Medicines are the other key treatment for depression. There are now dozens of antidepressants that your health care provider can choose from. They include:
* SSRIs (selective serotonin reuptake inhibitors.) These common medicines include some well-known names, like Lexapro, Paxil, Prozac, and Zoloft. Side effects are generally mild. They include stomach upset, sexual problems, insomnia, dizziness, weight change, and headaches.
* Researchers have developed many types of antidepressants in recent years. These include drugs like Remeron, Wellbutrin, Cymbalta, and Effexor. Cymbalta and Effexor may also ease chronic pain in people with depression. Side effects are usually mild. They include stomach upset, sleep problems, sexual problems, dizziness, and weakness.
* Tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs) were some of the first medicines used to treat depression. While they work well, they can cause serious side effects and interact with some drugs and foods. Because newer medicines work just as well, these drugs aren't used as often anymore. But if you can't take newer medicines for some reason, your health care provider may suggest these.
ECT (Electroconvulsive Therapy) for Depression
This is a safe and effective treatment for people with depression that is resistant to medication. It's typically used on people who haven't been helped by medicines or therapy.
In ECT, your doctor will use electric charges to create a controlled seizure. These seizures seem to change the chemical balance of the brain. It may sound scary. But during the procedure, you'll be unconscious, so you won't feel anything.
ECT tends to work very quickly. It also works well -- about 80%-90% of people who receive it show improvement. The most common side effect is temporary memory loss.
You might have up to 12 sessions over a few weeks. Some people get "maintenance" therapy with ECT to prevent depression from returning.
Vagus Nerve Stimulation (VNS) for Depression
Vagus Nerve Stimulation (VNS) is a new option for people with severe, treatment-resistant depression. Approved by the FDA in 2005, it's used only on people who haven't been helped by at least four antidepressants.
VNS involves implanting a small electrical generator in your chest, like a pacemaker. The device is attached with wires to the vagus nerve, which runs from the neck into the brain. Once implanted, the device sends electrical pulses to the vagus nerve every few seconds. The pulses are then delivered via the vagus nerve to the area of the brain thought to regulate mood. The electrical charges may change the balance of chemicals in your brain and relieve depression.
The device must be implanted by a surgeon, but patients can usually go home the same day.
Alternative Treatments for Depression
Some people use herbs, supplements, and other alternative therapies for depression. However, none of these approaches has been proven to work. Herbs and supplements -- like St. John's wort -- can have side effects and cause interactions with other medicines. Never start taking an herb or supplement without talking to your doctor first.
Other alternative treatments -- like acupuncture, hypnosis, and meditation -- may help some people with their symptoms. Since they have few risks, you might want to try them, provided that your health care provider says it's OK.
Drugs to Treat Depression
Drugs to Treat Depression
There are several types of depression medications (antidepressants) used to treat depression and conditions that have depression as a component of the disease, such as bipolar disorder. These drugs improve symptoms of depression by increasing the availability of certain brain chemicals called neurotransmitters. It is believed that these brain chemicals can help improve emotions.
Major types of antidepressants include:
- Tricyclic antidepressants (TCAs) are some of the first antidepressants used to treat depression. They primarily affect the levels of two chemical messengers (neurotransmitters), norepinephrine and serotonin, in the brain. Although these drugs are effective in treating depression, they have more side effects, so they usually aren't the first drugs used.
- Monoamine oxidase inhibitors (MAOIs) are another early form of antidepressant. These drugs are most effective in people with depression who do not respond to other treatments. They are also effective for other mental illnesses. Substances in certain foods, like cheese, beverages like wine, and medications can interact with an MAOI, so these people taking this medication must adhere to strict dietary restrictions (see below). For this reason these antidepressants also aren't usually the first drugs used.
- Selective serotonin reuptake inhibitors (SSRIs) are a newer form of antidepressant. These drugs work by altering the amount of a chemical in the brain called serotonin.
- Serotonin and norepinephrine reuptake inhibitors (SNRIs) are another newer form of antidepressant medicine. They treat depression by increasing availability of the brain chemicals serotonin and norepinephrine.
Examples of effective and safe medications commonly prescribed for depression or depression-related problems are listed in the chart below.
| Drug Name | Type of medication | Potential Side Effects |
| Anafranil
| These medicines are tricyclic antidepressants (TCAs) which work by increasing the available amount of serotonin and/or norepinephrine in the brain. | Dry mouth, blurred vision, increased fatigue and sleepiness, weight gain, muscle twitching (tremors), constipation, bladder problems such as urine retention, dizziness, daytime drowsiness, increased heart rate, sexual problems. |
| Parnate
| Monoamine oxidase inhibitors (MAOIs) increase the amount of norepinephrine and serotonin in the brain | Must avoid certain foods and medications to avoid dangerous interactions* Serious side effects may include: headache, heart racing, chest pain, neck stiffness, nausea and vomiting. If you experience any of these symptoms, seek medical care immediately. |
| Celexa
| Selective serotonin reuptake inhibitors, or SSRIs, work by increasing the amount of serotonin, a neurotransmitter found in the brain. | Sexual problems including low sex drive or inability to have an orgasm are common but reversible, dizziness, headaches, nausea right after a dose, insomnia, feeling jittery. |
| Wellbutrin | Wellbutrin may increase the amounts of the neurotransmitters norepinephrine and dopamine in the brain. | Weight loss, decreased appetite, restlessness, insomnia, anxiety, constipation, dry mouth, diarrhea, dizziness Wellbutrin is much less likely to cause the weight gain or sexual problems seen with other antidepressants. |
| Effexor
| These drugs increase the levels of the neurotransmitters serotonin and norepinephrine in the brain. | Drowsiness, blurred vision, lightheadedness, strange dreams, constipation, fever/chills, headache, increased or decreased appetite, tremor, dry mouth, nausea. Remeron can be sedating. Cymbalta may increase sweating and blood pressure and also cause fatigue and reduced energy. |
| Desyrel (trazodone)
| These drugs block various neurotransmitter chemicals to some degree. | Desyrel may cause drowsiness, fatigue, tremor, headache, dry mouth, nausea and vomiting. Ludiomil may cause headache, dizziness, dry mouth, fatigue, daytime sleepiness, sweating. |
It is important to note that you should not drink alcoholic beverages while taking antidepressant medicines, since alcohol can seriously interfere with their beneficial effects.
In October 2004, the FDA determined that antidepressant medications may increase the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders. If you have questions or concerns, discuss them with your health care provider.Symptoms of Depression
Most of us know about the emotional symptoms of depression. But you may not know that depression can be associated with many physical symptoms, too.
In fact, many people with depression suffer from chronic pain or other physical symptoms. These include:
* Headaches. These are fairly common in people with depression. If you already had migraine headaches, they may seem worse if you're depressed.
* Back pain. If you already suffer with back pain, it may be worse if you become depressed.
* Muscle aches and joint pain. Depression can make any kind of chronic pain worse.
* Chest pain. Obviously, it's very important to get chest pain checked out by an expert right away. It can be a sign of serious heart problems. But depression can contribute to the discomfort associated with chest pain.
* Digestive problems. You might feel queasy or nauseous. You might have diarrhea or become chronically constipated.
* Exhaustion and fatigue. No matter how much you sleep, you may still feel tired or worn out. Getting out of the bed in the morning may seem very hard, even impossible.
* Sleeping problems. Many people with depression can't sleep well anymore. They wake up too early or can't fall asleep when they go to bed. Others sleep much more than normal.
* Change in appetite or weight. Some people with depression lose their appetite and lose weight. Others find they crave certain foods -- like carbohydrates -- and weigh more.
* Dizziness or lightheadedness.
Because these symptoms occur with many conditions, many depressed people never get help, because they don't know that their physical symptoms might be caused by depression. A lot of doctors miss the symptoms, too.
These physical symptoms aren't "all in your head." Depression can cause real changes in your body. For instance, it can slow down your digestion, which can result in stomach problems.
Depression seems to be related to an imbalance of certain chemicals in your brain. Some of these same chemicals play an important role in how you feel pain. So many experts think that depression can make you feel pain differently than other people.
Treating Physical Symptoms
In some cases, treating your depression -- with therapy or medicine or both -- will resolve your physical symptoms.
But make sure to tell your health care provider about any physical symptoms. Don't assume they'll go away on their own. They may need additional treatment. For instance, your doctor may suggest an antianxiety medicine if you have insomnia. Those drugs help you relax and may allow you to sleep better.
Since pain and depression go together, sometimes easing your pain may help with your depression. Some antidepressants, such as Cymbalta and Effexor, may help with chronic pain, too.
Other treatments can also help with painful symptoms. Certain types of focused therapy -- like cognitive behavioral -- can teach you ways to cope better with the pain.Depression: Recognizing the Emotional Symptoms
Common symptoms of depression can make work and daily life almost impossible. Depression can skew your view of the world, making everything seem hopeless. Depression can make you feel utterly alone.
But you're not. Major depression affects about 14 million American adults, or about 6.7% of the population 18 or older in any given year. This guide will help you recognize some of the symptoms of depression.
Depression: Your Path to Recovery
?
You may already know some of the emotional and psychological effects of depression. They include:
* Feeling sad, empty, hopeless, or numb. These feelings are with you most of the day, every day.
* Loss of interest in things you used to enjoy. You might no longer bother with hobbies that you used to love. You might not like being around friends. You might lose interest in sex.
* Irritability or anxiety. You might be short-tempered and find it hard to relax.
* Trouble making decisions. Depression can make it hard to think clearly or concentrate. Making a simple choice can seem overwhelming.
* Feeling guilty or worthless. These feelings are often exaggerated or inappropriate to the situation. You might feel guilty for things that aren't your fault or that you have no control over. Or you may feel intense guilt for minor mistakes.
* Thoughts of death and suicide. The types of thoughts vary. Some people wish that they were dead, feeling that the world would be better off without them. Others make very explicit plans to hurt themselves. One of the best ways to prevent suicide in someone that is depressed is to recognize the warning signs of suicide. Take these signs seriously.
The good news is that depression is a treatable condition that responds to a variety of treatments.
"natural depression treatments"
15 ways to help treat depression naturally.
By R. Morgan Griffin
WebMD Feature
Reviewed by Brunilda Nazario, MD
While therapy and medication are key in controlling depression, there’s also a lot you can do on your own to fight back. Making changes to your own behavior -- your physical activity, diet, and lifestyle -- can be effective natural depression treatments.
“Lifestyle changes are a very important part of treatment,” says Ian A. Cook, MD, director of the Depression Research Program at the University of California Los Angeles.
On their own, Cook says, natural depression treatments can beat back milder forms of disease. For more severe depression, they can complement other approaches. When medication and therapy aren’t enough, treating depression naturally through lifestyle can help push people toward full recovery.
“Fighting depression is a war that’s waged day to day, not just over weeks and months while you wait for other treatments to take effect,” says Dean F. MacKinnon, MD, associate professor of psychiatry at the Johns Hopkins Hospital in Baltimore.
So as bleak as things might seem, there are things that you can do, right now, that will help you feel better. Here’s what you need to know about natural depression treatments.
Get in a Routine to Treat Depression Naturally
If you’re depressed, or have been depressed, you need a routine. Depression can strip away the structure from your life, letting one day bleed into the next. That absence of order can also make your depression worse.
“It’s extremely stressful to wake up in the morning and have no idea what you’re going to do with the day,” says MacKinnon.
Cook agrees. “Having a routine gives you a sense of control over the day,” says Cook. “We know that helps, and we know that not having a sense of control makes people feel worse.”
What should you build into your schedule to help fight depression naturally?
1. Exercise. Study after study has found that physical activity can boost mood, says Cook. How much? You don’t need to run marathons to get a benefit. “It seems like half an hour several times a week may be enough,” Cook says. “More than that may not have a further effect on mood. There seems to be a plateau.”
The type of exercise you use as a natural depression treatment doesn’t seem to matter. “Your cardiologist might want you getting a lot of aerobic exercise for your heart,” says MacKinnon. “But for your mental health, just getting out and walking can be enough.”
2. Diet. There is no depression diet, but there are great benefits to healthy eating. “I don’t think there’s any particular dietary regimen you need to follow,” says MacKinnon. “A basic healthy eating plan should do.”
Nutrition is an important element in your effort to help treat your depression, MacKinnon says. “Healing from depression is a physiological process, just like healing from a physical injury,” he tells WebMD. He says that without good nutrition, medications for depression can’t work as effectively.
There are some other things to keep in mind. Ask your doctor if your medication might cause weight gain. If so, you may want to take special care with your diet. If your depression is associated with an eating disorder -- like anorexia or binge eating -- you need to be working with an expert.atural Depression Treatments
15 ways to help treat depression naturally.
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Get in a Routine to Treat Depression Naturally continued...
3. Sleep. While sleep problems are a symptom of depression, they can also make it worse. Some people with depression sleep excessively. Many more depressed people suffer from insomnia. Either way, you need to do something.
Lying in bed and willing yourself to sleep won’t work. But one natural depression treatment is to make your life more conducive to getting a good sleep. Go to bed and get up at the same time every day. Try not to nap. Take all the distractions out of your bedroom -- no computer and no TV.
4. Goals. To help yourself during treatment for depression, it’s important to meet goals that you set for yourself. The trick here is to come up with realistic goals -- ones that you can really accomplish in a day. Drafting a 20-page to do list is not going to help. If you’re having trouble setting goals, Cook recommends working with a therapist, family member, or friend. Someone who can help you prioritize what’s most important and break larger tasks into smaller, more manageable ones.
5. Responsibilities. When you’re depressed, a natural inclination is to pull back -- to give up all your responsibilities at home and at work. It’s a feeling you should fight against. Staying active and having daily responsibilities can work as a natural depression treatment. They help ground you and give you a sense of accomplishment.
Obviously, don’t push yourself too far. If you’re not ready to go back to work or school, that’s fine. Think about part-time. If that seems like too much, consider a little volunteer work.
“If you’re volunteering to help clean up a playground, you’re still doing something,” says MacKinnon. “You’re getting out of the house, and at the end of the day you know that you accomplished something.”
6. Relaxation. Don’t assume that fun or relaxing things will happen naturally. They only way to make them happen is to plan them.
Cognitive Ways to Cope With Depression Naturally
In your fight against depression, a lot of the work is mental -- changing how you think.
“When you’re depressed, you become trained to see the world and yourself in a negative way,” says MacKinnon. These patterns of thought can have a lasting impact. They can linger on months or years after you’ve resolved the biological cause of the depression, MacKinnon says.
Automatic negative thoughts are particular sources of trouble. These thoughts occur spontaneously when you encounter a situation and affect how you feel. They can link to one another in a chain, dragging you downward.
An example: Your boss asks you to rewrite the opening of a proposal you worked on. Rather than just doing it, you dwell on it. In your mind, this incident becomes symptomatic of deeper problems. You’re incompetent. You’re going to be fired. You’ll be penniless. You’ll lose your house. Your family will hate you. You’re a complete screw-up. You don’t deserve to live. In seconds, your good mood disappears and you’re plunged into miseryognitive Ways to Cope With Depression Naturally continued...
How can you battle automatic negative thinking?
7. Reflect. At first, it’s very hard to catch yourself engaging in automatic thinking, says Cook. By definition, you’re not completely aware that it’s happening. Instead, Cook says it’s often easier to look back on a bad day and figure out what happened in hindsight. How did you get from feeling pretty good in the morning to feeling horrible by noon? What events -- and what thoughts -- led you to such a depressive state of mind?
By reconstructing what happened, you learn how your mind works and what automatic thinking you’re prone to. Then you can do something about it. “In time, you get a lot better at recognizing automatic thoughts in the moment,” says Cook, “so you can stop them before they get out of control.”
8. Take a break. When you find yourself engaging in automatic thinking, clear your head. Cook recommends breathing exercises or simply getting up and walking around. “Taking a break from whatever you’re doing physically can create a break in the mental process,” he tells WebMD.
9. Use logic. The next time some problem is making you feel terrible about yourself, try to use logic as a natural depression treatment. Depression can make you think bad things about yourself that are grotesquely exaggerated. “Try to impose some reason,” says Cook. “Inject some reality.” Is it really true that no one likes you? Is there real evidence for that? Sure, you might feel like the most stupid and hateful person on the planet, but really, what are the odds?
Other Natural Depression Treatments
In addition to getting in a routine and making cognitive changes, there are other natural depression treatments you should consider. Here’s a rundown.
10. Reach out to friends and family. To get through a depression, you need the support of trusted family and friends. Talking about what you’re going through can be a good natural depression treatment. Try to develop a network of supports. That way, you’re not putting too much pressure on a single person.
A friend shouldn’t only be a shoulder to cry on. Sometimes, you might want to set aside your feelings for a few hours. “Taking a break from thinking about your depression can be helpful,” says Cook. “You can just try to enjoy being with that other person.”
MacKinnon agrees. “If you were recovering from pneumonia, you wouldn’t feel obligated to regale everyone with details about what you were coughing up,” says MacKinnon. “It’s OK not to talk to everybody about what you’ve been through with your depression.”
11. Get support. In addition to relying on your friends and family, joining a support group can also be a good natural depression treatment. There, you’ll meet people who really understand what you’ve been through – perhaps in a way that your family and friends can’t. 12. Check with your doctor before using supplements. While lots of supplements, like St. John’s wort, have been promoted as depression cures, the research has been mixed. One supplement that has shown some promise is fish oil, which is rich in omega-3 fatty acids. Always check with your doctor before starting any supplement, especially if you’re already on other medications.
13. Watch out for substance abuse. Lots of people deal with depression by relying on alcohol and other substances. Don’t. After a few hours, these substances only leave you feeling worse. If you think you have a substance abuse problem, don’t wait until your depression is resolved to deal with it. Get help now.
14. Do something new. When you’re depressed, you’re in a rut. A typical day might be spent cycling between the bed, the television, and the computer. Cook recommends that people push themselves to do something different and new as a natural depression treatment. Go to a museum. Pick up a used book and read it on a park bench. Volunteer at a soup kitchen. Take a language class.
15. Don’t ignore serious signs of depression. While using natural depression treatments on your own can help a lot, they have limits. “People are amazingly resourceful when it comes to helping themselves,” says Cook. “But when they become so depressed that they can no longer function, or they’re feeling like the world would be better without them, they need to get professional help.”
Don’t Forget: Make Time for Things You Enjoy
Experts agree: If you’re depressed, you have to make time for things you enjoy. You have to relax. You have to do things that are fun.
This may be advice you’ve heard before. And there’s a problem with this natural depression treatment. When you’re depressed, or recovering from depression, having fun can seem impossible. Things that used to be fun don’t feel fun anymore. So why bother?
It’s a common problem, experts say. “One of the insidious aspects of depression is that it trains you to become hopeless about finding anything in life pleasurable,” says MacKinnon.
But this is just another unhealthy thought pattern that depression instills in us. The key is to unlearn it. While we assume that having fun is supposed to be effortless, it isn’t. You’ve gotten out of practice.
So as perverse as it might sound, you may have to work at having fun. Schedule things you used to enjoy. Even if it feels like a chore, keep going out with friends. Keep going to the movies and keep playing tennis.
“Sometimes, you really have to take a leap of faith and force yourself to do these things,” says MacKinnon. The act of doing them is itself a form of rehab, he says. You’re retraining yourself. In time, fun things really will feel fun again.
Tuesday, August 10, 2010
weight loss supplements
osing weight can dramatically improve your emotional and physical health, but it can be a slow process. So it’s no wonder that 15% of American adults use diet supplements to boost weight loss, opting for a range of products that claim to decrease appetite, block fat absorption, or increase metabolism.
Currently, most weight loss experts do not recommend many products marketed as weight loss supplements because of a lack of evidence. Also certain diet supplements, including ephedra, may cause heart attack and stroke. (Ephedra, also known as ma huang, was banned by the FDA in 2004 for sale in the U.S.)
However, there are some proven weight loss supplements available. Which weight loss supplements may be safe and helpful during a diet? Here’s a rundown on six products you can buy at most health food or drugstores that have some weight loss evidence behind them:
- Calcium
- Fiber
- Conjugated linoleic acid (CLA)
- Green tea extract
- Meal replacements
- Orlistat, an over-the-counter weight loss drug
Remember, of course, that you should always check with your doctor before taking any type of supplement. Even supplements can have side effects and may interfere with medications you take. And, when it comes to weight loss, there are no quick fixes. A healthy eating plan and regular physical exercise should be the foundation of any weight loss program.
Weight Loss Supplements: Calcium
Bone health may be the first thing that comes to mind when you hear the word calcium, but this mineral may also help you lose fat while preserving muscle.
Research is mixed. Some studies have not found a relationship between calcium intake and weight loss.
However, “there have been several studies that have shown benefits from three daily servings of low-fat dairy foods, including weight loss,” says Toby Smithson, RD, national spokesperson for the American Dietetic Association. Those studies “showed more weight loss from low-fat dairy foods combined with a reduced-calorie diet than from calcium supplements,” Smithson notes.
That’s not to say calcium supplements might not help you in your weight loss efforts. In one analysis, researchers found that dieting women who received 1,000 mg of calcium supplements each day lost, on average, more weight and more body fat than women taking a placebo. Although the differences in the amount of weight and fat lost by the two groups were not significant, the trend suggests there could be a relationship between calcium supplements and weight loss.
Because calcium and weight loss studies have found conflicting results, you can expect a lot more research on this subject. Researchers who have found a connection between calcium and weight loss hypothesize that dietary calcium might play a role in the breakdown and storage of fat. Additionally, the weight loss that has sometimes been observed in people who eat dairy may have something to do with specific dairy proteins and magnesium, another important mineral abundant in dairy products. But so far, these hypotheses are unproven.
Weight Loss Supplements: Conjugated Linoleic Ccid (CLA)
Using a type of fat as a weight loss supplement might sound counterintuitive, but it might work, too. Conjugated linoleic acid, a fatty acid that occurs naturally in dairy products and red meat, is a diet supplement that may hold promise for dieters.
Some studies have found that CLA diet supplements can help you lose body fat and increase lean body mass. When a group of overweight people took 3.2 grams of CLA each day for six months, they lost more body fat than people taking a placebo and gained less holiday weight during the winter months.
Many experts are calling for more clinical studies to learn more about the effectiveness and safety of CLA as a weight loss supplement. What’s the best way for people to reap the benefits of this diet supplement? Can you take too much?
Although conjugated linoleic acid generally has few side effects, it can cause stomach upset with diarrhea and nausea. Be sure to talk with your doctor before taking CLA as a diet supplement.
Weight Loss Supplements: Fiber
When it comes to dropping pounds, weight loss supplements that help keep you full can make it easier to cut back on the amount of food you eat. And when it comes to feeling full, fiber is your friend.
“Things that delay gastric emptying and stay in the stomach longer theoretically will make you feel fuller for a longer period of time,” says Sasha Stiles, MD, an obesity expert at Tufts Medical Center. “There’s enough fairly good research to show that an appropriate amount of fiber, such as bran or psyllium, can do this. Don’t take too much, though, because it can stop you up.”
A recent study found that overweight and obese people who took a fiber diet supplement each day reported less hunger after meals than people taking a placebo, and there was a trend for those using a fiber supplement to lose more weight.
If you decide to increase your fiber intake from food or diet supplements, be sure to add fiber to your diet slowly. Drink plenty of fluids to avoid becoming constipated.
The National Academy of Sciences Institute of Medicine recommends that men under age 50 consume 38 grams of fiber a day, and 30 grams a day after age 50. Women under age 50 should consume 25 grams of fiber per day, and 21 grams per day after age 50. Most people only get about half of this amount.
Weight Loss Supplements: Green Tea Extract
You may have already heard that green tea is loaded with healthy antioxidants, but did you know it might help you lose weight, too?
Although Smithson cautions that there are not enough human studies to prove the effectiveness of green tea extract as a weight loss supplement, she tells WebMD “…there is some thought that regular consumption may promote weight loss by adjusting resting energy usage and increasing the use of energy. The components in green tea extract that have shown some effect on lowering body weight are catechins, caffeine and theanine.”
Not all studies agree. But one recent report found that daily green tea extract supplements helped obese men and women lose weight and lower their body mass index (BMI – an indicator of body fat). Green tea extract also helped reduce amounts of dangerous belly fat, which has been linked to an increased risk of death. Not only that, green tea extract lowered blood pressure and LDL, or “bad,” cholesterol at the same time.
Proven Weight Loss Supplements
Which weight loss supplements really work?
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Weight Loss Supplements: Meal Replacements
Experts agree: The most proven weight loss supplements are meal replacements, including bars and shakes.
But, they only work when used as directed. In many plans, this means substituting a calorie-controlled meal replacement for breakfast and lunch, perhaps with the addition of fresh fruit. Then enjoy a portion-controlled dinner of around 500 calories.
“There’s very good scientific literature around meal replacements that is encouraging -- this is a strategy for some people that is efficient and safe,” says Steven R. Smith, MD, professor and assistant to the executive director for clinical research at the Pennington Biomedical Research Center.
“For folks who adopt that strategy, there’s pretty good long-term success,” says Smith. “The reason for that is that it’s simple, it’s structured and it allows people to continue to enjoy food with their evening meal.”
Weight Loss Supplements: Over-the-Counter Orlistat
Technically, Orlistat is a medicine, not a supplement. However, it’s approved by the FDA for sale without a prescription (brand name Alli), thus many people consider it a diet supplement.
“This is the one that has the data behind it,” says Caroline Apovian, MD, the director of the Center for Nutrition and Weight Management at Boston Medical Center. “It blocks 25% of the fat calories eaten from being absorbed. You can hang your hat on this data.”
Orlistat helps people lose weight as long as they also follow a diet and exercise. But it can have some unpleasant intestinal side effects. Be sure to follow the product’s recommendations to limit fat intake to minimize potentially embarrassing problems with anal leakage and gas.
General Suggestions for Using Weight Loss Supplements
If you do use weight loss supplements, be aware that the vast majority of products sold as diet supplements are not regulated by the FDA. To make sure that the product you are purchasing has undergone quality control testing, look for diet supplements that bear a United States Pharmacopeia (USP) seal.
Be sure to ask your doctor about taking weight loss supplements before you use them. Avoid products with excessive levels of caffeine, which can cause side effects, such as increased heart rate and blood pressure.
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