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Coffee - A Healthy Blend
Coffee – A Healthy Blend Coffee has joined the ranks of red wine and chocolate as a guilty pleasure that may actually be good for you. As much as it is a great way to get that “fix” in the morning, recent studies have shown that coffee has been...
Common Drugs and Their Uses
The five drugs that are discussed in this article are Ibuprofen which is a non-steroidal anti-inflammatory drug (NSAID) that is commonly used for relief of Arthritis, Warfarin which is an anticoagulant drug commonly prescribed by doctors to treat...
Solving The World's Problems by Eating Dinner
It sounds just too simple. You might think I've lost my mind. But I think I figured out how to solve the world's problems! Just eat dinner with your family regularly. How will that solve the world's problems? Let's take a closer look. ...
The Real Mayo Clinic Diet
For over thirty years, the Mayo Clinic has been combating the rumor that they recommend a version of a quick weight loss diet that touts the consumption of grapefruit, vegetables, fruits and unlimited portions of meat and fat. The clinic has...
Truths about Diet, Obesity, and $75 Billion
Sensible diet prevents obesity! Healthy living prevents most diseases! (Unfortunately, old age is not a disease.) These truths should be self evident. Yet recent shock headlines tell us that "medical problems caused by obesity are costing U.S....
 
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

 

American Diabetes Association Home Page
Their mission is to prevent and cure diabetes and to improve the lives of all people affected by this disease. Available in English and Spanish.
www.diabetes.org
 
Diabetes Information - American Diabetes Association
The American Diabetes Association recommends the FPG because it is easier, ... Take the first steps toward better diabetes care by visiting the Diabetes ...
www.diabetes.org
 
Diabetes UK home page - Diabetes UK
Diabetes UK is the largest organisation in the UK working for people with diabetes, funding research, campaigning and helping people live with the ...
www.diabetes.org.uk
 
Canadian Diabetes Association
To promote the health of Canadians through diabetes research, education, service, and advocacy.
www.diabetes.ca
 
Diabetes information including treating type 2 diabetes at ...
Offers dietary recommendations, including recipes and tips on managing blood sugar levels. From GlaxoSmithKline.
www.diabetes.com
 
Diabetes
Web site for Diabetes. ... publishes Diabetes. Stanford University Libraries' HighWire Press ® assists in the publication of Diabetes Online ...
diabetes.diabetesjournals.org
 
CDC Diabetes Public Health Resource
The diabetes information homepage of the US Centers for Disease Control and Prevention, provided by the CDC’s Division of Diabetes Translation.
www.cdc.gov
 
CDC - Health Topic: Diabetes
Diabetes · Diabetes and Research Diagnostics · Diabetes Surveillance Report · FAQ's on Diabetes · Physical Activity and Health: A Report of the Surgeon ...
www.cdc.gov
 
National Diabetes Information Clearinghouse
Provides educational materials to increase knowledge and understanding about diabetes among patients, health care professionals, and the general public.
diabetes.niddk.nih.gov
 
Diabetes mellitus - Wikipedia, the free encyclopedia
For diabetes mellitus in pets, see diabetes in cats and dogs. ... Type 1 diabetes mellitus - formerly known as insulin-dependent diabetes (IDDM), ...
en.wikipedia.org
 
MedlinePlus: Diabetes
(National Institute of Diabetes and Digestive and Kidney Diseases) - Links to PDF ... Select services and providers for Diabetes in your area. ...
www.nlm.nih.gov
 
MedlinePlus Medical Encyclopedia: Diabetes
Diabetes affects about 18 million Americans. There are many risk factors for ... These levels are considered to be risk factors for type 2 diabetes and its ...
www.nlm.nih.gov
 
Diabetes
What to expect from your diabetes diagnosis? Get up-to-the-minute information about medications, insulin, blood sugar management, nutrition requirements, ...
diabetes.about.com
 
WebMD Diabetes Health Center - Information on Type 1 and Type 2 ...
Find in-depth information here about diabetes prevention, diet, ... Study Shows Burned-Out Staffers More Likely to Get Type 2 DiabetesGo To Article ...
www.webmd.com
 
WebMD Health - 404 Error
Allergies|Anxiety Disorders|Arthritis|Asthma|Back Pain|Bipolar Disorder|Cancer|Children's Health|Cholesterol|Depression| Diabetes|Diet & Nutrition|Erectile ...
www.webmd.com
 
Diabetes Overview
Defines diabetes, including the various types and treatments. Provides information on the impact and cost of the disease, its increasing prevalence, ...
www.niddk.nih.gov
 
Diabetes News - The New York Times
A free collection of articles about diabetes published in The New York Times.
topics.nytimes.com
 
children with DIABETES Online Community
An online community for kids, families, and adults with diabetes, featuring message boards, chat rooms, and questions/answers from medical professionals.
www.childrenwithdiabetes.com
 
International Diabetes Institute - Diabetes Research, Education ...
The International Diabetes Institute is the leading national and international centre for diabetes research, diabetes education and diabetes care.
www.diabetes.com.au
 
Diabetes New Zealand
Educates and informs people about diabetes, its treatment, prevention, and cure of diabetes.
www.diabetes.org.nz
 
 

 
Content Menu
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