Archives for December, 2009
Mental Illness and Impotence
Posted By Kelly On Wednesday, December 16th 2009 under: Question - Answer Tags: Antidepressants, Drugs, Prozac, Wellbutrin, Zoloft
Question. What mental illnesses may cause impotence? What psychotropics may contribute to the problem?
Answer. Impotence, or erectile dysfunction , is usually not due to psychiatric disorders, contrary to the conventional view of twenty or thirty years ago. In most cases, ED is due to an underlying medical condition, ranging from diabetes to liver disease to nerve damage. Low levels of the hormone testosterone may also be involved.
Among psychiatric causes of ... Read More
SSRI (Prozac – fluoxetine) Use and Suicidal Behavior
Posted By Kelly On Tuesday, December 15th 2009 under: Prozac (Fluoxetine) Tags: Antidepressants, Drugs, Prozac, Suicide
There has been continuing speculation about a relationship between fluoxetine (Prozac) use and increased suicidal behavior since six cases were reported in 1990, which were followed by several other similar case reports. However, subsequent retrospective analyses of large patient samples, surveys of psychiatrists, and re-analysis of many clinical studies of fluoxetine and other newer antidepressant drugs failed to find such a relationship.
In 1999, Leon et al. reported a prospective, naturalistic ... Read More
Depression and Psychosis: Improving Outcomes
Posted By Kelly On Monday, December 14th 2009 under: Depression Tags: Antidepressants, Depression, Drugs, Selective serotonin reuptake inhibitors (SSRIs), Wellbutrin, Zyprexa
The following is the question and answer session from the Depression and Psychosis: Improving Outcomes. The presenters were Richard G. Petty, M.D., and Jack M. Gorman, M.D.
Question: What's the latest on quetiapine and slit lamp examinations?
Dr. Petty: As many of you will know, quetiapine was associated with the development of cataracts in dogs during the clinical studies and there have also been case reports of humans getting cataracts. My own ... Read More
Antidepressants Exacerbating Hypertension
Posted By Kelly On Sunday, December 13th 2009 under: Question - Answer Tags: Antidepressants, Desyrel, Drugs, Effexor, Prozac, Wellbutrin, Zoloft
Question. I have a problem with antidepressants exacerbating my hypertension. Are there any that don't increase blood pressure? Are there new antidepressants that might soon be available?
Answer. There are many antidepressants that do not increase blood pressure for MOST adults, but there are always exceptions. For example, the older tricyclic antidepressants (such as imipramine or nortriptyline) typically result in decreased blood pressure. (Children can sometimes have hypertensive reactions to some ... Read More
Ruling out symptoms
Posted By Kelly On Saturday, December 12th 2009 under: Question - Answer Tags: Antidepressants, Celexa, Depression, Drugs, Effexor, Luvox, Prozac, Wellbutrin, Zoloft
Question. I have a diabetic patient in her early 30s who is also exhibiting signs of anxiety and depression. She's on 100mg Glucophage as well as 100u Humulin Ultralente and 100-150u Humalog (extreme insulin resistance). I am aware that some of her symptoms of anxiety may be related to the gastric side effects of the Glucophage and that her mood problem may be tied to the diabetes itself, but how ... Read More
How are 5-HT2 selective antagonists different from current drug therapy in schizophrenia?
Posted By Kelly On Friday, December 11th 2009 under: Pharmacology Tags: Antidepressants, Drugs, Risperdal, Serotonin, Zyprexa
There a two major classes of agents currently used to treat schizophrenia - the older neuroleptics (typical antipsychotics) and the newer atypical antipsychotics such as clozapine, olanzapine (Zyprexa) and risperidone (Risperdal). The first class of agents is comprised of predominantly dopamine-2 (D2) receptor antagonists, with haloperidol being the prototype. These neuroleptics have little, if any, direct effects on serotonin systems; e.g., haloperidol does not interact appreciably with serotonin-2 (5-HT2) receptors. ... Read More
What is the role of serotonin in psychotic disorders?
Posted By Kelly On Thursday, December 10th 2009 under: Pharmacology Tags: Prozac, Psychiatric Illnesses, Serotonin
The precise role of serotonin (5-HT) in psychotic disorders is not fully understood. However, a variety of preclinical and clinical data suggest that 5-HT is closely connected with both psychotic symptoms and the mechanism of newer atypical antipsychotic agents. The serotonin-2A receptor (5-HT2A) in particular seems to play a pivotal role. For example, certain psychotomimetic substances, such as psilocybin, appear to act as agonists at the 5-HT2A receptor. Conversely, 5-HT2A ... Read More
The Psychology of Depression. Part 10. Summary
Posted By Kelly On Wednesday, December 9th 2009 under: Manuscripts Tags: Depression, Psychiatric Illnesses, Treatment
Depression is an affect which appears either in response to the loss of a love object or in anticipation of some act which would result in the loss of a love object. The characteristic psychic and physical components of the depression syndrome can be understood as devices to compel protective acts on the part of those who love the patient. When depression follows an externally imposed significant loss, it may ... Read More
The Psychology of Depression. Part 9. Management
Posted By Kelly On Tuesday, December 8th 2009 under: Manuscripts Tags: Depression, Psychiatric Illnesses, Treatment
There are several forms of psychotherapy. In depression the simplest form of psychotherapy consists of the therapist's offering himself to the patient as a substitute for the lost love object. In a few cases of depression which are not too severe and which are about to remit, this procedure alone may suffice. However, most cases of pathologic depression do not wait for a love object to appear; when they are ... Read More
The Psychology of Depression. Part 8. Management
Posted By Kelly On Tuesday, December 8th 2009 under: Manuscripts Tags: Depression, Psychiatric Illnesses, Treatment
Cases of normal depression require no specific treatment since they usually resolve spontaneously in a period of a few weeks or months. The methods by which recovery is accomplished include those listed above, namely, dissolution of ties, substitution of objects, identification with the object, undoing guilt and fantasies of rebirth. When a certain amount of the work of mourning has been accomplished, consolation and assistance from others are usually welcome ... Read More