health |
||||||
|
News for 09-Jun-25 Source: MedicineNet Prevention and Wellness General Source: MedicineNet Prevention and Wellness General Source: MedicineNet Prevention and Wellness General Source: MedicineNet Prevention and Wellness General
|
The Best health websiteAll the health information you need to know about is right
here. Presented and researched by http://www.md-news.net. We've searched
the information super highway far and wide to provide you with the
best health site on the internet today. The links below will
assist you in your efforts to find the information that you are looking
for about
health
Passion -- OK, I know you have heard this before but if you really care about health then you want to be sure you get the highest value for your money. There are numerous sites dealing with health and some may or may not have anything to teach you. That will not happen here. We are here to really stimulate your passion and make sure you get just what you need. It all starts with something you know and love and that is health. Please don't say a word. Just listen. And remember, don't share this with anyone. This is just between us. This is the single best source of finding the very best health information on the Internet. health
The time for standing in place is gone and anyone who wants the best in health should understand that. There are many people who want to know more about health and since you are here you must be one of them. Anyway we are happy to have you as a visitor and want to make your visit worthwhile. There are a number of health websites on the Internet as you surely know. Some are worthwhile and others are completely worthless. We pride ourselves on providing only the most valuable information on health available. Depression Series (Part 2): My Antidepressant Doesn't Work. What Can My Psychiatrist Do? by: Michael G. Rayel, MD
Maria has been increasingly depressed for the past few years. She has tried at least four newer antidepressants but so far, she doesn't seem to respond. Unable to work, she's now feeling helpless and hopeless. Likewise, her family is discouraged. Frustrated and baffled by Maria's lack of progress, the family doctor refers her to a psychiatrist. What can the psychiatrist do to help Maria? The psychiatrist has several options in dealing with a treatment-resistant or refractory depression. First, Maria's psychiatrist can optimize the dose of her antidepressant. Maria has been taking low doses of antidepressants. In spite of her lack of response, the medication dosage has not been increased. To obtain a clinical response, her psychiatrist should increase the dose every two to three weeks. The antidepressant can be adjusted up to the maximum allowable dose if no or only partial response is observed. Second, her psychiatrist can choose to augment the effect of her antidepressant with another medication such as lithium, triiodothyronine (T3), or buspirone. Among augmenters, lithium and triiodothyronine have the best support from the literature. Despite lithium's efficacy, some doctors avoid this drug because it requires regular blood monitoring and has unfavorable side effect profile such as acne, tremors, and thyroid and renal dysfunction. Recently, studies have shown atypical neuroleptics such as olanzapine and risperidone to be good augmenters. In my opinion, further studies are necessary to establish these two drugs as standard augmenter. Indeed, research studies and clinical experience have found augmentation strategy to be effective. Third, combination strategy is worthwhile to try. Maria's psychiatrist can add another antidepressant to boost the effect of her current antidepressant. For instance, trazodone can be added to an SSRI (serotonin reuptake inhibitor e.g. citalopram). Literature suggests that combining two drugs with different mechanisms of action and drugs that involve several brain chemicals has resulted in clinical improvement. In this scenario, one antidepressant plus another antidepressant is equal to three, or four or even ten, not two. Fourth, the psychiatrist can switch from one antidepressant to another. Previous studies have shown that when making a switch, a drug should be replaced by a drug from a different class e.g. from SSRI to SNRI (serotonin and norepinephrine reuptake inhibitor e.g. venlafaxine), or from TCA (tricyclic agent e.g. nortriptyline) to SSRI. But recent studies show that switching drugs within the same class (e.g. SSRI to another SSRI) is just as effective. Fifth, Maria's psychiatrist can also treat other ongoing symptoms or drug-related problems that further complicate her depression. If she is anxious and agitated, then her psychiatrist should prescribe antianxiety drug (e.g. lorazepam) or if Maria is psychotic then adding an antipsychotic drug should help. Moreover, medication side effects (such as insomnia, dryness of mouth, constipation, etc.) that negatively affect Maria's compliance to the drug should be addressed promptly. Lastly, if despite above measures Maria doesn't respond to antidepressants, then electroconvulsive therapy should be entertained. Of course, this procedure should be done with her consent. In summary, Maria's psychiatrist can optimize the dose, augment or combine treatment, switch the medication, treat side effects and ongoing symptoms, or use electroconvulsive therapy for treatment-resistant or refractory depression.
|
|||||
|
http://www.medmeet.com/ |
||||||
| Take It Right RX Right! Medical Meetings |