54%–75% of adolescents "wish for more sleep" It is widely recognized that many older Americans suffer from a variety of sleep disorders. In fact, more than half of all Americans older than age 65 have a sleep problem, and disturbed sleep is among the most frequently cited problems affecting institutionalized older Americans. As the population ages, it is estimated that at the end of this decade nearly 80 million Americans will ... Read More

Question. I recently heard of the use of a low dose of Thorazine for the treatment of depression. Are you familiar with this treatment? Answer. I am not aware of any controlled, persuasive evidence that Thorazine (chlorpromazine) or any standard antipsychotic - in low doses or high - is particularly effective as an antidepressant. The exception to this claim may be in so-called delusional depression, in which psychotic features are present; ... Read More

Brand Name: Vestra Active Ingredient: reboxetine mesylate Indication: Treatment of depression Company Name: Pharmacia & Upjohn Vestra: Introduction As a selective norepinephrine reuptake inhibitor (SNRI), Vestra is the first of a new class of antidepressant drugs. This new mechanism of action appears to produce fewer side effects, such as nausea, headache, and sexual dysfunction, compared with traditional antidepressants. Vestra also possesses a faster onset of action compared to selective serotonin reuptake inhibitors (SSRI), tricyclics, and ... Read More

Question. I am a mental health professional. However, I also find myself searching for information to console me personally. I have been diagnosed with major depression. I go regularly to a psychiatrist and I am currently taking Wellbutrin SR. What is the potential for recurrence of depressive symptoms while taking a prescribed medication that has worked well for over three years? Can you give me some information about the number ... Read More

Question. My patient is in the second trimester of her pregnancy. She has panic disorder and depression. In the past, she responded well to Zoloft and Klonopin. What are the safest medications for the next few months? Answer. The short, no-frills answer to your question is that any of the major antidepressants or anxiolytics are probably safe, now that the most vulnerable period of organ-formation (the first trimester) has passed. I ... Read More

Question. Do you have a list of drugs for depression, and non-addictive medications for anxiety? Tricyclics of the older vintage would be helpful. Answer. I am providing you with a list of commonly used antidepressants, as well as their usual doses: Maintenance Dosage and Tablet Size for Non-MAOI Antidepressants Antidepressant Tablet/capsule sizes Usual daily adult dose Amitriptyline (Elavil, Endep) 10, 25, 50, 75, 100, 150 mg 75-250 mg Amoxapine (Asendin) 25,50, 100, 150 mg 200-300 mg Bupropion (Wellbutrin) 75, 100 ... Read More

Question. I am a 40-year-old mother of two. A year ago I began taking Zoloft 150 mg per day. This medication has been a miracle for me. I am considering having another child and wonder if any studies have been done on the effects of Zoloft on the fetus/mother/pregnancy. Answer. There is unfortunately very little known about the effects of sertraline in human pregnancy. The standard medical advice is to ... Read More

Question. I am on Prozac and suffer severe lower back pain and general aches and pains throughout the body especially the joints. Is there any link? Answer. I can't tell you with any degree of confidence whether, in your case, there is a "link" between your taking Prozac and the pain you describe. (Did the aches and pains begin soon after you started the Prozac? This would be an important question ... Read More

Atypical Antipsychotics Most initial published data on atypical antipsychotic drugs in the elderly are clinical trials in nondemented patients with schizophrenia or Parkinson's disease. In the last two to three years, controlled trials evaluating risperidone (Risperdal) and olanzapine (Zyprexa) in patients with dementia have been published. There is now evidence that these two atypical antipsychotic drugs offer efficacy in this patient population with fewer adverse effect concerns than the typical antipsychotic ... Read More

Patients with dementia display a broad range of cognitive impairments and behavioral and psychotic symptoms. Common behavioral symptoms include verbal and physical aggression, hyperactivity, disinhibition, and pacing and wandering; common psychotic symptoms include paranoia, delusions and hallucinations. These behavioral and psychotic symptoms are the leading cause for the use of more restrictive supervised environments, including institutionalization. Effective pharmacologic and nonpharmacologic treatment of these symptoms is desirable and, in addition, might delay ... Read More