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... s of yet. Prozac acts on Serotonin levels, where as Reboxetine acts on the noradrenaline levels. Some experts believe that drive and motivation are related to noradrenaline, and mood states are associated with serotonin. Like the SSRIs (specific serotonin reuptake inhibitors), the noradrenaline reuptake inhibitor Reboxetine does not have the major adverse side effects as the trycilic antidepressants, such as sexual dysfunction. Reboxetine has been shown to take effect much faster than any other antidepressant, like Prozac.
Has also been seen to be particularly effective in the severe depression group. (I think that this could be due to the quicker results, and that its usage in the severely affected patients should be closely monitored. ) 2. Hypericum Perforatum A new drug on the market as an organic substitute Prozac, which is usually prescribed to treat mild depression. Its name Hypericum is derived from the Greek and means over an apparition. (A reference to its resinous smell. ) Commonly know as St. Johns Wort, it is a stalky plant with yellow leaves that has anti-depressant qualities. It is a herbaceous perennial with four-hundred species that grows extremely well and wild except in extreme conditions.
The yellow flowers are used. Although it is new to the North American market, it is licensed for treatment of depression, anxiety and sleeplessness in Germany. A study in the British Medical Journal showed that the extract is as effective as conventional anti-depressants, but is cheaper and has fewer side effects. No long term study has been done on the effects of long term usage. Since no research has been done on the long-term effects of usage, this medical trend poses the same potential disaster as was found in the usage of fenfluramine and phentermine (damage to cardio-valves). 3. Lithium Carbonate A medication usually prescribed for the treatment of an acute manic episode (bipolar depression).
It acts as an antidepressant by altering the excitability of the central nervous system. How it works as an antidepressant: The mechanism whereby lithium controls manic episodes is not yet known. Lithium is a monovalent cation which belongs to the group of alkali metals together with sodium, potassium and other elements with which it shares some of its properties. There is evidence that lithium alters sodium transport and may interfere with ion exchange mechanisms and nerve conduction. Fluid and electrolyte metabolism are believed to be altered in affective disorders and this may be related to the therapeutic action of lithium. Lithium can replace sodium in extracellular fluid and during the process of depolarization it has an extremely rapid intracellular influx.
However, it is not effectively removed by the sodium pump, thereby preventing the cellular reentry of potassium. As a result, it interferes with electrolyte distribution across the neuronal membrane, leading to a fall in membrane potential and changes in conduction and neuronal excitability. Then, it is important to note that the sodium intake of the patient being treated has his sodium intake monitored, so that it is normal, and stable. (The intake level of sodium should not increase or decrease. ) Usage: Some common brand names of Lithium Carbonate are: Carbolith, Cibalith-S, Duralith, Eskalith, Lithane, Lithizine, Litho bid, Lithonate, Lithotabs The therapeutic dose for the treatment of acute mania should be based primarily on the patient's clinical condition. It must be individualized for each patient according to blood concentrations and clinical response. After the acute manic episode subsides, (usually within a week), the dosage is rapidly reduced because there is then a decreased tolerance to the drug in the patient. Lithium may be used concomitantly with neuroleptic drugs, but additional studies are required to determine the relative advantage of single, combined or sequential treatment of manic episodes.
Periodic review and monitoring of kidney and cardiovascular function is essential for safe therapy with lithium carbonate. The formation of nontoxic goiters has been reported during lithium therapy. Hypercalcemia, (associated with lithium induced hyper- parathyroid ism), has also been reported. Recent research indicates that: lithium may produce a transitory diuresis with increase in sodium and potassium excretion. therapeutic doses of lithium decrease the 24 -hour exchangeable sodium.
a possible intracellular retention of lithium may be occurring. lithium may affect the metabolism of potassium, magnesium and calcium. lithium may increase the incidence of cardiac and other anomalies, especially Eastern's anomaly. new research (reported to the Clinical Psychology Seminar 1996 - 1997) points to Lithium's adverse effects on pregnancy. (In particular, Lithium passes into the mothers milk, and breast feeding is optional and can be avoided. ) Adverse Affects: The most frequent adverse effects are the initial post absorptive symptoms, believed to be associated with a rapid rise in serum lithium concentrations.
They include: gastrointestinal discomfort nausea vertigo muscle weakness a dazed feeling The more common and persistent adverse reactions are: fine tremor of the hands fatigue thirst pyuria neurogenic diabetes insipidus Career Profiles 1. Neurologist A neurologist may focus on researching the causes, prevention and treatments of depressive disorders. Duties and Working Conditions: Research laboratories of hospitals, universities, or most likely commercial pharmaceutical corporations. Research of the disorders basis, causes, prevention and possible treatments.
Educational Qualifications: A bachelors degree, or two to four years of pre-medical school. Four years of medical school. A internship of 12 - 16 months. 2. Psychiatrist The Psychiatrist is needed to diagnose, assess and prescribe medical treatments to individuals affected by a depressive disorder. Psychiatrists may also conduct psychotherapy with an affected patient.
Duties and Working Conditions: Psychiatric ward or hospital to diagnose and assess the disorder in individuals. Private practice to treat affected patients and family members. Research of the disorders basis, causes, prevention and possible treatments. Educational Qualifications: A bachelors degree, or two to four years of pre-medical school. Four years of medical school. A internship of 12 - 16 months.
A license to practice psychiatric medicine. 3. Psychologist The field of psychology is broad and growing. In the treatment of both Major and Bipolar Depressive Disorder, a clinical psychologist will analyze, diagnose, and assess the disorder in an affected patient. Also, a psychologist may conduct psychotherapy with an affected patient. Duties and Working Conditions: Psychiatric ward or hospital to diagnose and assess the disorder in individuals. Private practice to treat affected patients and family members.
Research of the disorders basis, causes, prevention and possible treatments. Educational Qualifications: Four years of undergraduate study in clinical psychology at university. Four years of graduate study in clinical psychology at university. A internship of 12 - 16 months. A license to practice psychological analysis and therapy. Conclusion Up to 15 % of patients with severe Major Depressive Disorder die by suicide.
Over age 55, there is a quadruple increase in death rate. 10 - 25 % of patients with Major Depressive Disorder have preexisting Dysthymic Disorder. These "double depressions" (i. e. , Dysthymia + Major Depressive Disorder) have a poorer prognosis. There are no laboratory findings that are diagnostic for this disorder. Males and females are equally affected by Major Depressive Disorder prior to puberty. After puberty, this disorder is twice as common in females as in males.
The highest rates for this disorder are in the 25 - to 44 -year-old age group. The lifetime risk for Major Depressive Disorder is 10 % to 25 % for women and from 5 % to 12 % for men. At any point in time, 5 % to 9 % of women and 2 % to 3 % of men suffer from this disorder. Prevalence is unrelated to ethnicity, education, income, or marital status. Onset And Course: Average age at onset is 25, but this disorder may begin at any age. Stress appears to play a prominent role in triggering the first 1 - 2 episodes of this disorder, but not in subsequent episodes. (An average episode lasts about 9 months. ) Recurrence: The risk of recurrence is about 70 % at 5 year follow up and at least 80 % at 8 year follow-up.
After the first episode of Major Depressive Disorder, there is a 50 %- 60 % chance of having a second episode, and a 5 - 10 % chance of having a Manic Episode (i. e. , developing Bipolar I Disorder). After the second episode, there is a 70 % chance of having a third. After the third episode, there a 90 % chance of having a fourth. The greater number of previous episodes is an important risk factor for recurrence. Recovery: For patients with severe Major Depressive Disorder, 76 % on antidepressant therapy recover, whereas only 18 % on placebo recover.
For these severely depressed patients, significantly more recover on antidepressant therapy than on interpersonal psychotherapy. For these same patients, cognitive therapy has been shown to be no more effective than placebo. Familial Pattern And Genetics: Individuals who have parents or siblings with Major Depressive Disorder have a 1. 5 - 3 times higher risk of developing this disorder. The concordance for major depression in monozygotic twins is substantially higher than it is in dizygotic twins. However, the concordance in monozygotic twins is in the order of about 50 %, suggesting that factors other than genetic factors are also involved. Children adopted away at birth from biological parents who have a depressive illness carry the same high risk as a child not adopted away, even if they are raised in a family where no depressive illness exists.
Interestingly, families having Major Depressive Disorder have an increased risk of developing Alcoholism and Attention-Deficit Hyperactivity Disorder. British Medical Journal (abstract on the effectiveness of Hypericum Perforatum) No. 7052 Volume 313, August 1996. Judith Michelle, notes by Abbey Strauss, M. D. , A Laypersons Short Classification Of Psychotherapeutic Drugs, Online Psychological Services.
Stuart Yudofsky, Psychiatric Drugs, American Psychiatric Press, 1991. D. F. Ken and P. F.
Wonder, Understanding Depression: A Complete Guide To Its Diagnosis And Treatment, 1993. Bibliography: wastes
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Research essay sample on British Medical Journal Depressive Disorder
