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Causes of Hair Loss
The normal cycle of hair growth and loss means that some amount of hair loss will occur in every individual’s life. It is said that at any given point in time, about 10% of the hair on our scalp is in a resting phase which sheds after a couple of...
Foot Fetish: A look at the use of silver in footwear.
Foot Fetish: A look at the use of silver in footwear. Article
by: James Fowler www.footdefense.com
While foot odor is rarely discussed around the water cooler, it
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Sleep Deprivation - Alarming New Studies
There have been several studies recently that link sleep deprivation with an increased risk of developing diabetes, obesity, heart disease and cancer.
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Type II Diabetes - Insulin-Dependent Diabetes
The term diabetes refers to higher than normal levels of sugar, or glucose, in the blood. Type II diabetes, also known as insulin-dependent diabetes, was commonly referred to as adult onset diabetes until recently when the name no longer accurately...
Vitamin And Mineral Supplement Benefits
Extensive research studies show that taking vitamin and mineral supplements can potentially improve your health, protect against disease and provide you with the energy you need to live a healthy life. Although each contribute differently to your...
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Depression Series (Part 3): What to Do with Those Antidepressant Side Effects?
Maria’s depression was difficult to treat. As you can recall, various medications had been tried to no avail. But after several months of treatment, Maria has eventually become stable on a combination of two antidepressants.
She’s now able to do her usual activities and is motivated to go back to work — something she has struggled to do for a while. Despite her improvement, antidepressant side effects have emerged and are bothersome. Maria begins to consider discontinuing her medications prematurely.
Antidepressant side effects are real and negatively affect patient’s compliance. Many patients like Maria consider stopping the medication even at the risk of relapse because of distressing side effects.
How do you deal with some of the common antidepressant side effects?
Insomnia
Some antidepressants e.g. SSRIs (serotonin-reuptake inhibitor) are highly stimulating that they cause insomnia when taken in the afternoon or at bedtime. Take this type of medication in the morning. Discuss with your physician the use of a sedating medication such as trazodone or sedative-hypnotic drug along with the antidepressant. If you want to take only one pill, talk to your doctor about switching to a sedating antidepressant such as mirtazapine.
Moreover, sleep hygiene should be practiced. Avoid naps and intake of caffeinated drinks such as coffee and soda in the afternoon and evening. Involve in regular exercise and physical activities during the day. Moreover, use the bedroom only for sleep and sex and not for recreational activities.
Weight gain
Regular exercise is weight gain’s antidote. If no medical contraindication, you may consider jogging, walking, or swimming. To reduce some excess and unwanted fat, keep yourself busy with physical and recreational activities.
How about diet? Diet has always been a part of any weight control regimen. Monitor your carbohydrate intake. Ice cream, chocolates, and other high-caloric foods should be reduced. If none of the above works, talk to your doctor about switching pills.
Sexual dysfunction
Sexual dysfunction happens too often but is rarely asked or discussed in the clinic. Some physicians and patients feel embarrassed about this subject. When you have concerns, be open to your physician. Discuss the possibility of switching medication to an antidepressant (such as bupropion or mirtazapine) that doesn’t significantly impair sexual functioning. Also, talk to your doctor about adding another drug such as bupropion, yohimbine, or even mirtazapine to counteract the sexual side effect.
How do you know if the sexual dysfunction is from the pill rather than from depression? If the dysfunction persists despite successful remission of depression, then you should consider other causes such as drug-induced dysfunction or other medical causes e.g. diabetes.
Dry mouth
Tricyclic antidepressants (TCA e.g. amitriptyline) are notorious for causing dry mouth. Why? These drugs have distressing anticholinergic side effects. Avoid this type of drugs. If TCA is still considered, talk about the use of desipramine or nortriptyline. Compared to other TCAs, these two drugs have less anticholinergic effects.
Moreover, try ice chips. Frequent sips of water should also help. To avoid dental cavities, try sugarless candy or sugar-free gum.
Constipation
Like dry mouth, constipation is usually caused by TCAs. To prevent it from happening, drink enough water and eat high fiber foods such as vegetables and fruits. Consider stool softeners if the above interventions fail. If possible, avoid TCAs.
Nausea and vomiting
Patience is the key in dealing with these side effects. Frequently, patients develop tolerance within two weeks. Take the medication with food. If ineffective, talk to your doctor about possibly reducing the dose of your medication or trying antacid or bismuth salicylate (Pepto-Bismol)
Memory lapses
If given permission by your doctor, try to reduce the dose. Also, discuss with your physician about switching antidepressant (especially if dose reduction doesn’t alleviate your concern) and avoiding drugs with anticholinergic side effects.
Moreover, don’t mix the antidepressant with alcohol. The alcohol-drug interaction can only worsen the memory and cognitive functioning. While on psychotropic drugs, be careful driving and using mechanized equipment.
Dizziness
While still in bed, sit up for 30 seconds, then stand up for another 30 seconds while holding a rail, a table, or a chair before walking. Take the medication at bedtime. Some people use support hose with success.
Agitation or anxiety
Some people benefit from a brief use of benzodiazepine such as lorazepam. Breathing exercises and progressive muscle relaxation should also help.
In general, some side effects such as gastrointestinal upset and insomnia may resolve in a few days. Patience is the key. However, be on guard. When they occur, address them promptly. I’m not however suggesting that you should be your own doctor.
Collaborating with your doctor is an effective way to cope with mental illness and medication problems. Treatment options such as the need to switch or reduce medications should be discussed in an open and accepting manner.
About the Author
Copyright © 2003. All rights reserved. Dr. Michael G. Rayel – author (First Aid to Mental Illness–Finalist, Reader’s Preference Choice Award 2002), speaker, workshop leader, and psychiatrist. Through the CARE approach, Dr. Rayel helps individuals recognize the early signs of mental illness and provide early intervention. To receive free newsletter, visit www.drrayel.com. His books are available at major online bookstores
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