Category Archives: Psychiatric Medication

Trazodone medication: Is this medicine safe and effective?




Brand-name: Desyrel

Generic name: Trazodone hydrochloride

Trazodone medication: Why is this medication prescribed?

Trazodone medication is prescribed for treatment of depression. In addition to its antidepressant properties, sometimes it is also prescribed to assist people with their sleep.

Trazodone medication: What are some important things for me to know?

Trazodone medication does not give immediate relief, but may take up to four weeks before you actually begin to feel better. Most patients notice some improvement within approximately 2 weeks however.

When should trazodone medication not be prescribed?

If you’ve ever been sensitive or allergic to trazodone or similar medications, you should probably not take this antidepressant. You should always make sure that your doctor is aware of any drug reactions you experience when on this or any medications.

What if I am pregnant or breast-feeding?

The effects of trazodone medication have not been adequately studied during pregnancy. If you’re pregnant or planning on becoming pregnant in the near future, you should talk to your physician immediately. This medicine may appear in breast milk. If trazodone medication is absolutely essential to your health, your doctor may recommend that you discontinue breast-feeding your baby until your treatment with trazodone medication is complete.

Trazodone side effects: An overview

Trazodone side effects usually cannot be anticipated. If you notice any Trazodone side effects however, you should notify your physician immediately. Along with the benefits of any medicine, there are almost always some unwanted effects. While many or most of these effects may not occur, if they do you should call your physician or get medical attention immediately.

Trazodone side effects that require immediate attention:

Rare

Painful and inappropriate erection of the penis continuing for an extended period of time. In this case you should stop taking this medicine and check with your doctor immediately.




You need to check with your doctor as soon as possible if any the following Trazodone side effects occur:

Less Common

Fainting; muscle tremors; confusion

Rare

Unusual excitement; skin rash: fast or slow heartbeat

Symptoms of overdosage of Trazodone

Loss of muscle coordination; nausea and vomiting; drowsiness

While many other Trazodone side effects may occur that usually do not require medical attention, these side effects may go away as treatment progresses and your body adjusts to the medicine. However, you should check with your doctor if the following Trazodone side effects continue or become more bothersome:
More common
Unpleasant taste; nausea and vomiting; dryness of mouth; dizziness or lightheadedness; drowsiness
Less common
Unusual tiredness or weakness; muscle aches or pains; constipation; blurred vision; diarrhea
While other Trazodone side effects not listed above may also occur in some patients, if you notice any other side effects while taking Trazodone or any other medicine you need to check with your doctor immediately.

Trazodone dosage: How much is too much?

Trazodone dosage: Important information

Your Trazodone dosage should be taken with or shortly after a meal or snack to reduce any dizziness or lightheadedness or to lessen stomach upset. Your Trazodone dosage should always be taken precisely as recommended by your doctor without deviation to gain the maximum benefit of this depression medicine. Some patients have reported that it may take as long as four weeks before you begin to feel better although some report improvement within two weeks.

Trazodone dosage: Specific amounts

Although your dose of Trazodone may be different from other individuals, you need to follow your doctor’s orders or the directions on the label of your medication. The following information includes only the average Trazodone dosages. If your dose is different always follow exactly what your doctor tells you to do.

Adult Trazodone dosage

The usual starting dosage is 50 mg per dose taken three times a day or 75 mg per dose taken two times a day. Your physician may increase the dosage as he or she believes will benefit your condition.

Children’s dosage

For children up to the age of six years old, dosage should be determined by your doctor. For children between the ages of six and 18 years old, your doctor will determine the oral dosage to be taken based upon your body weight.

Trazodone dosage for the elderly

The usual starting dosage is 25 mg per dose taken three times a day. Your doctor may than increase your dosage as needed.

Storage of Trazodone:

Always keep this depression medication out of the reach of children, away from heat and direct sunlight. You should never store this medicine in the bathroom or other damp area or near any type of heat or moisture, which may cause this medication to break down. Also, you should never keep this or any other medication any longer than needed. Be sure that any discarded medicine is out of the reach of children.

Missed Trazodone dosage:

If you ever miss your Trazodone dosage you need to take it as soon as possible. However, if it is within four hours of your next dosage you will need to get back on your regular routine schedule. Never take double doses of Trazodone or any other medication for that matter.

Trazodone medication: What are some of the special precautions?

Trazodone medication: Special precautions

The use of Trazodone medication will require regular visits to your doctor to monitor your progress. Your physician will continue to check the effects of your Trazodone medication and adjust the dosage as necessary. You should never quit taking this medication without checking with your doctor first. Frequently the doctor will reduce the amount of this medication gradually before you stop it completely.

Trazodone medication- Other special precautions:

While taking Trazodone medication, always let your doctor or dentist know before having any emergency, dental or medical surgery. Taking this medicine while having surgical or dental treatments may interact negatively with medicines that are used during dental or emergency services and increase the depressant effects on the central nervous system.

Trazodone medication has also been known to cause people to become irritable and agitated, as well as to have suicidal thoughts and tendencies, and to actually become more depressed. If you or your family members notice these effects you should notify your doctor immediately.

This depression medicine will add to the effects of alcohol or other central nervous system depressants, possibly causing drowsiness. Common examples of central nervous system depressants are antihistamines or medicines for allergies, colds, tranquilizers, and sleeping medicines. Other very common central nervous system depressants also include pain medicines or narcotics, medicine for seizures, muscle relaxants, anesthetics and barbiturates.
Trazodone may cause some people to become drowsy or less alert than normal. You should always make sure you know how you will react to this medication before you drive or operate heavy machinery or do anything that may be dangerous if you’re not completely alert. Dizziness, fainting or lightheadedness may occur when you attempt to get up from a lying or sitting position. Many doctors recommend getting up slowly to help with this sensation. If this lightheadedness or dizziness problem continues or gets worse you should talk to your doctor immediately.
Trazodone medication has also been known to cause dryness of the mouth. Sugar, gum, hard candy or small pieces of ice may provide some relief for you. However, if your mouth remains dry for more than two weeks, you should talk to your physician or dentist immediately. A continuing dryness of the mouth may result in dental disease, tooth decay, gum disease or other fungus infections as a result of taking Trazodone medication.

Information adapted from Consumer Reports Consumer Drug Reference

Additional information by Paul Susic Ph.D. Licensed Psychologist


Prozac Medication: The Benefits, Side Effects and Dosages




Prozac Medication: An Overview

Prozac is a medication used to treat depression, obsessive-compulsive disorder, bulimia, and frequently severe symptoms of premenstrual syndrome. Prozac is within the drug classification referred to as selective serotonin reuptake inhibitors (SSRI’s), which is believed to help maintain a elevated level of the neurotransmitter serotonin in the brain.

Serotonin is a neurotransmitter in the brain which is believed to affect moods. This neurotransmitter is usually quickly reabsorbed after its initial release from neurons in the brain. It is believed that excess serotonin between the neurons is blocked by medications such as Prozac from being taken back up into the releasing neurons resulting in increased levels of serotonin in the brain.

Prozac is most often prescribed to treat depression of the moderate to severe variety which interferes with daily functioning and most often is referred to as major depression. The symptoms of major depression include low mood and low energy, changes in sleeping habits and appetite, decreased sex drive, feelings of guilt or worthlessness, difficulty concentrating, slowed thinking, and suicidal thoughts. However, Prozac can be taken for a variety of other mental health disorders including obsessive-compulsive disorder, premenstrual dysphoric disorder as well as others. It is most often prescribed for adolescents, adults and the elderly but may occasionally be prescribed for children.

Prozac Medication for Obsessive- Compulsive Disorders:

In addition to being used for the treatment of depression, Prozac is also used to treat obsessive-compulsive disorder. Obsessions are thoughts that won’t go away, and compulsions are repetitive behaviors and actions which are done to relieve anxiety often associated with the obsessions. Prozac is used at times to also treat bulimia which is a binge eating disorder which involves deliberate vomiting and has also been used to treat other eating disorders including obesity.

Premenstrual Dysphoric Disorder:

Under the brand name Serafem which includes the active ingredients in Prozac, this depression medication is sometimes prescribed for premenstrual dysphoric disorder (PMDD), which is often referred to as premenstrual syndrome (PMS) including mood changes such as anxiety, depression, persistent anger, irritability, and mood swings. There are various physical problems associated with PMDD, including bloating, breast tenderness, headache and joint muscle pain. Symptoms usually tend to begin about 1 to 2 weeks before a woman’s premenstrual period. They are frequently severe enough to interfere with a woman’s daily activities, functioning and relationships.

Prozac Medication: Precautions

You should always be open and honest with your doctor when your taking Prozac. Always give a complete medical history, including liver problems, kidney disease, seizures, heart problems, allergies and history of diabetes. This depression medication has been known to make individuals dizzy or drowsy, making it necessary to be cautious when engaging in activities that require alertness such as driving or using heavy machinery. Alcohol should be limited when on this medication. Caution is also advised if you have diabetes, alcohol dependence or liver disease. Also, caution should be taken when this medication is being used by the elderly as they are more sensitive to the effects of the drug. This drug should only be used if necessary if an individual is pregnant as the medication passes into the breast milk. Because of the possible risk to the infant, breast-feeding while on this medication is not recommended. Consultation with your physician about the benefits and risks of Prozac used during pregnancy and breast-feeding is imperative. Obviously, you should never share your Prozac with others.




Important Facts About This Depression Medication

It has been noted that there can be some very serious and at times even fatal reactions to occur when Prozac is taken at the same time as some other antidepressants such as the MAO inhibitors. Also, you need to be careful when taking high doses of Prozac over a prolonged period of time. If you are taking any other medications for depression or any other prescription or nonprescription drugs you need to notify your physician before beginning on Prozac.

Prozac Side Effects:

Although the Prozac side effects seem to be less than some of the earlier generation antidepressant medications such as desipramine, amitriptyline and nortriptyline, there are still side effects that you need to be aware of. Some of the more common side effects of Prozac are sweating, dry mouth, drowsiness, headache, insomnia and nausea. Some of the side effects that are less likely but at times even more severe are loss of appetite and unusual weight loss, uncontrollable movements such as tremors, decreased interest in sex, flu-like symptoms, and either unusual or severe mood changes. Even less likely but even more potentially serious Prozac side effects include trouble swallowing, vision changes, white spots and swelling on the mouth and tongue, painful and/or prolonged erection and changes in sexual ability. The most severe side effects associated with Prozac are irregular and fast heartbeat, and fainting. Allergic reactions to Prozac are relatively rare but may include itching, rash, swelling, trouble breathing and dizziness. If you notice any reactions after beginning treatment with Prozac, you need to notify your pharmacist or physician immediately. A more complete listing of Prozac side effects follows.

The Most Common Prozac Side Effects:

Abnormal vision, abnormal ejaculation, abnormal dreams, increased anxiety, reduced sex drive, dry mouth, dizziness, flushing, flulike symptoms, headache, gas, impotence, itching, insomnia, loss of appetite, nervousness, nausea, sinusitis, rash, sleepiness, sweating, sore throat, upset stomach, tremors, yawning, vomiting, weakness

Less Common Prozac Side Effects:

Agitation, abnormal taste, weight gain, sleep disorders, bleeding problems, confusion, chills, weight gain, ringing in the ears, palpitations, loss of memory, increased appetite, high blood pressure, frequent urination, ear pain, emotional instability

There have been other very rare side effects reported while taking Prozac. If you develop any unexplained or new symptoms after initiating treatment with this depression medication you need to contact your physician immediately.

Drug Interactions:

In addition to the Prozac side effects mentioned above, there are also concerns for negative food and drug interactions when taking this antidepressant medication. As mentioned previously, Prozac should never be taken at the same time as you are taking MAO inhibitors. This can cause a very serious medication interaction. Also, when Prozac is taken with other medications the effect may be increased, decreased or altered in other ways. You should always check with your doctor when Prozac is taken with the following medications:

Alprazolam (Xanax)
Carbamazepine (Tegretol)
Clozapine (Clozaril)
Diazepam (Valium)
Digitoxin (Crystodigin)
Drugs that impair brain function, such as sleep aids and narcotic painkillers
Flecainide (Tambocor)
Haloperidol (Haldol)
Lithium (Eskalith)
Other antidepressants (Elavil)
Phenytoin (Dilantin)
Pimozide (Orap)
Tryptophan
Vinblastine (Velban)
Warfarin (Coumadin)

Special Warnings if You are Pregnant or Breast-feeding:

Prozac has not been adequately studied for its effects on pregnancy. If you are pregnant or plan to become pregnant in the near future, you need to talk with your physician as soon as possible to determine whether you should continue taking this depression medication. Prozac is known to appear in breast milk, so breast-feeding is obviously discouraged when taking this drug.

Prozac Dosage:

It is most common for your Prozac dosage to be taken once or twice a day and should be taken exactly as prescribed by your physician. It needs to be taken regularly to be effective. If it is possible, you should take your Prozac dosage at the same time every day.

Some patients have found that it can take as much as four weeks to feel any significant effects and get some relief from their depression. Doctors will also commonly maintain the treatment regimen for about nine months after the first initial three-month treatment trial. Some individuals who experience obsessive-compulsive disorder may not feel the full effects for as much as five weeks.

The Recommended Prozac Dosage:

The most common starting dosage of Prozac is 20 mg daily taken in the morning. Your physician may increase your dose after several weeks if there has been no improvement in symptoms. Elderly people with kidney and liver disease, and any other individual taking other medications may have their dosage adjusted by their doctor.

When taking a dosage of Prozac over 20 mg, the doctor may ask you to take it once a day in the morning or may ask that you to take two smaller doses in the morning and also at noontime.

The usual Prozac dosage for depression ranges between 20 mg and 60 mg. For obsessive-compulsive disorder, the usual dosage of Prozac ranges from 20 mg to 60 mg per day, although at times a maximum of 80 mg may be prescribed. The usual dosage of Prozac for bulimia nervosa is 60 mg taken in the morning. As with other disorders, the doctor may start at a lower dosage and increase to this level over a period of time. The most common Prozac dosage for premenstrual dysphoric disorder is 20 mg per day.

For some individuals who have been treated successfully with the daily form of Prozac, their doctor may switch them to a long acting form sometimes referred to as Prozac weekly. Your physician may ask you to skip your daily doses for seven days and then take your first weekly capsule.

If you miss your dose of Prozac you should take it as soon as you remember. If a significant time has passed however, you should skip that dosage and resume your normal dosage schedule.

Over dosage of Prozac:

Prozac like all medications, needs to be taken as recommended. Dosages more than the recommended amount can be dangerous and even fatal. Also, combining Prozac with certain other medications or drugs may cause symptoms of over dosage. If you suspect an overdose, you need to contact your doctor or go to an emergency room immediately.

The most common symptoms of Prozac over dosage include rapid heartbeat, nausea, seizures, vomiting and sleepiness. Some of the less common symptoms of Prozac over dosage include stupor, sweating, rigid muscles, low blood pressure, mania, coma, delirium, fainting, high fever and irregular heartbeat.

By Paul Susic Ph.D. Licensed Psychologist


Lexapro Medication: Side Effects, Dosages and Indications




Lexapro Medication: Side Effects and Dosages: Overview

Lexapro medication side effects and dosages are absolutely essential to know before you begin taking this antidepressant medication. Lexapro is a medication usually prescribed for major depression which is a low mood that persists for at least several weeks duration, and interferes with daily functioning. Major depression must occur nearly every day for at least two weeks, and must include either (1) low mood or (2) loss of interest in your usual activities and interests, as well as at least five of the following symptoms of depression: significant changes in weight or appetite, changes in your pattern of sleep, lethargy or agitation, feelings of guilt or worthlessness, fatigue, difficulty concentrating and slowed thinking and thoughts of suicide. If the symptoms of depression persist over a period of several weeks you may have major depressive disorder, which may make Lexapro a good choice for an antidepressant. If that is the case, it is essential to understand Lexapro medication, side effects, dosages, indications and contraindications.

Lexapro is a medication that increases the levels of serotonin in the brain. Serotonin is a necessary chemical in the brain referred to as a neurotransmitter, which is involved in things such as establishing biological processes associated with sleeping and eating. Lexapro is also a close cousin of Celexa, which is also a medication used to treat depression. There are several medications that focus on increasing the level of serotonin in the brain including Zoloft, Prozac and Paxil.




Lexapro Medication Important Information:

Lexapro is an effective and very popular medication. However, this is a medication in which you could possibly get a very bad reaction if you have been taking some other medications, such as those of the medication classification of monoamine oxidase inhibitors (MAOI’s). Some of the MAOI’s include Parnate, Marplan and Nardil. Many psychiatrists recommend that you never take Lexapro within two weeks of having taken these medications. When combined with Lexapro, these medications can cause some very serious and even fatal reactions. These negative symptoms include twitching and agitation, fever, and rigidity, which have been known at times to even lead to delirium and even coma.

Lexapro Medication Side Effects:

Specific Lexapro medication side effects cannot really be anticipated but if any develop or intensify, you should contact your doctor immediately. Only your physician can decide if you should continue taking this medication for depression if you experience any of the following symptoms below.

Some of the more common Lexapro side effects include:

Decreased appetite, sweating, sleepiness, sinusitis, runny nose, nausea, insomnia, indigestion, impotence, flu-like symptoms, fatigue, ejaculation disorder, dry mouth, dizziness, diarrhea, decreased sex drive, constipation

Some of the less common Lexapro side effects may also include:

Yawning, weight changes, vomiting, vertigo, urinary problems, tremors, toothache, tingling, stomachache, sinus headache, sinus congestion, ringing in the ears, rash, palpitations, pain in arms or legs, pain in the shoulder and neck, nasal congestion, muscle pain, migraine, menstrual cramps, lightheadedness, lack of orgasm, lack of energy, lack of concentration, joint pain, irritability, increased appetite, hot flashes, high blood pressure, heartburn, fever, coughing, chest pain, bronchitis, blurred vision, allergic reactions, abnormal dreaming, abdominal pain

In addition to these Lexapro side effects, others have been reported but are very rare. You should always check with your physician if you develop any new or unusual symptoms when taking this depression medication.

Lexapro side effects and additional special warnings:

This medication can make you sleepy. Until you know how you react to this drug, you should use it with caution when driving a car or operating any potentially hazardous machinery or tools. In some rare cases, Lexapro has been known to trigger manic episodes, which are unreasonably high levels of energy, that can become very risky or hazardous to your health. Also, you should let your doctor know if you have had any problems with your kidneys or liver. Your physician may need to adjust your medication accordingly.

Possible drug and food interactions when taking Lexapro:

You should never take Lexapro when taking the similar drug Celexa. Also, as referred above, you should always be careful to avoid any of the MAO inhibitor medications such as Nardil, Parnate and Marplan. Lexapro is not known to interact negatively with alcohol, but the manufacturer recommends avoiding alcoholic beverages while taking this depression medication. If Lexapro is taken with other medications, the combination may increase, decrease or otherwise alter the effects in some way. It is highly recommended that you consult your physician before taking the following medications:

• Carbamazepine (Tegretol)
• Cimetidine (Tagamet)
• Desipramine (Norpramin)
• Other drugs that act upon the brain including antidepressants, sedatives, tranquilizers and painkillers
• Ketaconazole (Nizoral)
• Lithium (Eskalith)
• Metoprolol (Lopressor)
• Narcotic painkillers
• Sumatriptan (Imitrex)

Special information if you happen to be pregnant or breast-feeding:

If you are currently pregnant or plan to become pregnant in the future, you should let your physician know before taking Lexapro. This medication should only be taken if the benefits outweigh the risks. Lexapro appears in breast milk and could possibly affect the nursing infant. In most cases it is not recommended to breast-feed while taking this medication.

Lexapro medication dosage overview:

Your Lexapro medication dosage should be taken exactly as recommended by your physician even if you begin to feel better. The correct dosage of Lexapro should result in feeling better in one to four weeks, although it is recommended that you continue with this medication for at least several months. This medication can be taken with or without food.

If you miss your usual Lexapro medication dosage…

You should take your missed dosage as soon as possible. If it is almost time for your next dosage however, you should skip the missed dose and resume your regular medication routine. You should never take more than one dose of Lexapro at a time.

Lexapro medication dosage for adults:

The recommended dosage of Lexapro is 10 mg once a day. If necessary, the doctor may increase the dosage to 20 mg after a minimum of one week. The higher dosage will probably not be recommended for senior adults and people who have liver problems.

Lexapro Overdosage:

Taking massive amounts of Lexapro can be fatal. If you suspect a Lexapro overdosage, you should seek medical attention immediately.

Typical symptoms of Lexapro medication overdosage:

Seizures, rapid heartbeat, drowsiness, vomiting, tremors, nausea, sweating, dizziness
There have also been some rare cases of Lexapro overdosage causing memory loss, confusion, breathing problems, muscle wasting, irregular heartbeat

Storage of Lexapro

This medication should be stored at room temperature.

Summary of Lexapro medication side effects and dosages:

Lexapro is a medication with well-known side effects and effective dosages. Always follow your physician’s recommendations and pay attention to the physiological changes in your body as your specific Lexapro medication side effects cannot really be anticipated and dosages may need to be adjusted accordingly.

Some information adapted from the PDR Pocket Guide to Prescription Drugs (Sixth Edition) by Paul Susic Ph.D. Licensed Psychologist




See Related Posts:

Panic Disorder Medications: Side Effects, Pros and Cons






Panic Disorder Medications: An Overview

Researchers and clinicians have found that the most effective panic disorder medications include the tricyclic antidepressants (see depression medications: tricyclic), monoamine oxidase inhibitors (see depression medications: MAOI’s), benzodiazepines (see anxiety medications), and the selective serotonin reuptake inhibitors (see depression medications: SSRI’s). These medications all have similar effects on panic disorder, although some doctors conclude that the SSRI’s tend to be a little more effective over the long-term. These medications do differ in relation to their side effects and also their contraindications, which are other medications and food that they may interact poorly with. Some have anticholinergic effects which include such side effects as dry mouth and blurred vision, which seem to be more common with the tricyclic antidepressants. These medications are also contraindicated for people with comorbid cardiac disorders. There are also significant dietary restrictions when using the MAOI’s in which you may be asked to abstain from any foods containing tyramine. The benzodiazepines may cause sedation and impairment in motor coordination as well as have some addictive qualities and a tendency to develop a tolerance to the medications. Obviously, panic disorder medications include several choices but also include a variety of side effects and negative interactions with other medications and foods and require careful consideration by both patients and doctors.





Panic Disorder Medications: Are the SSRI’s really the best choice?

Many doctors have concluded that when looking at both the efficacy and side effects, selective serotonin reuptake inhibitors (SSRI’s) may be the most promising choice for panic attacks and panic disorder. But like all medications, SSRI’s have side effects also that may make them unappealing, such as you may feel a short-term increase in arousal-related sensations. To assist with this however, SSRI’s may be started at a very low dosage (for e.g. 12.5 mg/d for sertraline; 5-10 mg./d for paroxetine) and then gradually increased (up to 25-200 mg/d for sertraline and up to 10-50 mg/d for paroxetine). The choice of a specific SSRI is based upon a variety of factors including personal preference and an individual’s history of response or nonresponse, and the related side effect profile.

What other medications are used in the treatment of panic disorder?

For some individuals who do not respond to SSRI’s or for any other reason, a combination of medications may be used for the treatment of panic disorder. One example may be when SSRI’s are combined with benzodiazepines. The benzodiazepines in this situation may be used to lessen the side effects of the SSRI’s. Despite some preliminary positive effects, this strategy has not been used often and may need to be more properly evaluated. Another alternative strategy may be to simply change the individual’s medication. The newer non-SSRI antidepressants may be considered such as gabapentin, bupropion, nefazodone or venlafaxine. The problem with using some of these newer medications is that there’s not as much clinical experience and research data to back up the use of the strategy. Some clinicians use benzodiazepines for panic disorder and panic attacks.

Panic Disorder and Use of Benzodiazepines:

Some of the primary drugs that have historically been marketed to treat anxiety and panic disorders have been the benzodiazepines. The name benzodiazepine is derived from its chemical structure. This medication changes the way the body handles chemical messengers in the brain. It connects to receptors in the brain that monitor your awareness level, coordination, memory, muscle tone and suppresses the electrochemical transmission of nerve impulses in the brain. The benzodiazepines are very serious medications that are capable of producing anything from mild to very serious sedation of the central nervous system. Sometimes they are referred to as “sedative hypnotics” in that they cause sedation and sometimes may cause the user to feel like even while they are awake, that their routine communication almost has the feel of being somewhat of a “hypnotic command.”

Another problem with benzodiazepines is that psychological and physical dependence can become a real concern for the future, as there is risk of dependence even after a relatively short period of use at their most common dosage levels. That is why these medications are considered to be controlled substances and are dispensed only in limited amounts, ideally for a short duration of time. Stopping these medications suddenly can cause serious withdrawal symptoms due to the feeling of dependency. Tolerance to these medications also is known to occur requiring increased amounts to get the same therapeutic benefit.

Panic Disorder Medications: A Summary

As should be fairly obvious, the use of a specific medication for the treatment of panic attacks and panic disorders, requires significant clinical judgment by a physician well aware of the benefits and side effects of each specific medication. At the present time, antidepressants (especially the SSRI’s) seem to be eclipsing somewhat the use of benzodiazepines for the long-term treatment of panic disorder and generalized anxiety disorder. Another approach to treatment of the drug refractory individual is to use a psychosocial treatment such as cognitive behavioral therapy as an adjunctive or alternative treatment to panic disorder medications.

Some information adapted by Paul Susic Ph.D. Licensed Psychologist from DSM/IV/TR Mental Disorders: Diagnosis, Etiology and Treatment by Michael B. First and Allen Tasman and the No-Nonsense Guide to Psychiatric Drugs by Moira Dolan



Zoloft Medication Benefits, Side Effects and Dosage




Zoloft Medication Overview:

Zoloft is easily one of the most popular medications prescribed for major depressive disorder, a persistently low mood which intrudes in a senior’s daily life. Symptoms often include loss of interest in your normal activities, disturbances in sleep, appetite changes, fidgeting and/or lethargic movement, fatigue, guilt or feelings of worthlessness, and problems with thinking and concentrating. Zoloft has also been prescribed for premenstrual dysphoric disorder. This problem is often characterized by low mood, anxiety or tension, emotional instability, and anger or irritability in the two weeks prior to menstruation. Other symptoms may include loss of interest in normal activities, difficulty concentrating, lack of energy, changes in appetite or sleep patterns, and feeling out of control.

Zoloft is also effective in treating obsessive-compulsive disorder, which includes symptoms of unwanted thoughts that won’t go away (obsessions) and an irresistible urge to repeat certain actions, such as counting and hand washing (compulsions). Zoloft may also be prescribed for the treatment of panic disorder, and post-traumatic stress disorder.

Zoloft is actually an antidepressant and is referred to as a selective serotonin uptake inhibitor. The neurotransmitter serotonin is believed to regulate mood. Usually, serotonin is reabsorbed after its release back into the releasing neuron (nerve cell). Zoloft, as well as other similar medications block the process of “reuptake”, allowing an increase in serotonin to be absorbed by the receiving neurons.

Important Precautions:

It is usually recommended that you don’t take Zoloft within two weeks of taking any medication classified as an MAO inhibitor. Marplan, Nardil and Parnate are drugs within this medication category. When serotonin boosters such as Zoloft are combined with these medications, serious and sometimes fatal reactions have occurred. Also, this drug should be avoided if it causes any allergic reaction.




Special precautions should be taken if you have liver disorder or have had seizures. Zoloft should always be taken under the close supervision of a doctor, and especially when you have the above conditions.
This drug has not usually been found to effect the operation of automobiles or other machinery. However, as with all medications, you should find out how you are effected by Zoloft before you attempt these operations. Also, if you have a sensitivity to latex, you may want to use precaution when you handle the dropper provided with the oral concentrate.

Zoloft: Benefits and Information:

How is Zoloft taken and what should I expect?

This drug should be taken exactly as prescribed, which most often means once a day, either in the morning or the evening.

Zoloft is available in both capsule or oral concentrate forms. You should use the dropper provided when taking the Zoloft oral concentrate. Measure out the amount of concentrate prescribed by your physician and then mix it with 4 oz. of water, ginger ale, lemon/lime soda, lemonade, or orange juice. (You should not mix the concentrate with any other type of beverage.) You should drink the mixture immediately and not save it for later use. A slight haze has been noticed at times after mixing, but is not a problem.

It usually takes several days to a few weeks to see some improvement from Zoloft. Most doctors recommend that you take it for a minimum of at least several months. It has been found to make your mouth dry at times. Many people have found that sucking on hard candy, chewing gum, or chewing on ice may provide some temporary relief.

What If I miss a dose of Zoloft?

You should take the missed dose as soon as you remember unless several hours have passed, at which time you should just skip that dose and try to get back into the usual dosing routine as soon as possible. You should never double up on your dose of Zoloft.

Zoloft storage instructions…

You should always store Zoloft at room temperature.

Zoloft – Possible food and drug interactions:

It is recommended that you not drink alcohol when taking this drug. Also, the use of over-the-counter medications should be used with caution. Although none of these over-the-counter remedies have been found to cause a negative interaction with Zoloft, interactions always remain a possibility.

If Zoloft is taken with other medications, the effects may be increased, decreased or otherwise altered. It is especially important for you to check with your doctor when combining Zoloft with any of the following:

• Cimetidine(Tagamet)
• Diazepam (Valium)
• Digitoxin (Crystodigin)
• Flecaimide (Tambocor)
• Lithium (Eskalith, Lithobid)
• MAO inhibitor drugs such as the antidepressants Nardil and Parnate
• Other serotonin-boosting drugs such as Paxil and Prozac
• Other antidepressants such as Elavil and Serzone
• Over-the-counter drugs such as cold remedies
• Propafenone (Rythmol)
• Sumatriptan (Imitrex)
• Tolbutamide (Orinase)
• Warfarin (Coumadin)

If you are using the oral concentrate form of Zoloft, do not take the medicine disulfiram (Antabuse).

If you are pregnant or breast-feeding:

Zoloft has not been adequately tested during pregnancy. If you are pregnant or plan to become pregnant in the near future, consult your doctor immediately. Zoloft should only be taken during pregnancy when you are extremely depressed and the benefits significantly outweigh the risks. It’s not presently known whether Zoloft appears in breast milk and caution is advised when using this medication during breast-feeding.

Zoloft Side Effects

Zoloft Side Effects: What do I need to know?

Zoloft side effects cannot really be anticipated but, if any develop or change in intensity, you should notify your doctor immediately. Only your physician will be able to tell you whether you should continue taking this medication.

Some of the more common Zoloft side effects may include:

Abdominal pain, agitation, anxiety, constipation, decreased sex drive, diarrhea or loose stools, difficulty with ejaculation, dizziness, dry mouth, fatigue, gas, headache, and decreased appetite are some of the more common Zoloft side effects. And, they also may include increased sweating, indigestion, insomnia, nausea, nervousness, rash, pain, sleepiness, sore throat, tingling or pins and needles, tremor, vision problems and vomiting.

Less common and much rarer Zoloft side effects may include:

Acne, allergic reaction, altered taste, back pain, blindness, breast development in males, breast pain or enlargement, breathing difficulties, bruise-like marks on the skin, cataracts, changeable emotions, chest pain, cold, clammy skin, conjunctivitis (pinkeye), coughing, difficulty breathing, difficulty swallowing, double vision, dry eyes, eye pain, fainting, feeling faint upon arising from a sitting or lying position, feeling of illness, female and male sexual problems, and fluid retention. Other less common Zoloft side effects may include blushing, frequent urination, hair loss, heart attack, hemorrhoids, hiccups, high blood pressure, high pressure within the eye (glaucoma), hearing problems, hot flushes, impotence, inability to stay seated, increased appetite, increased salivation, increased sex drive, inflamed nasal passages, inflammation of the penis, intolerance to light, irregular heartbeat, itching, joint pains, kidney failure, lack of coordination, lack of sensation, leg cramps, menstrual problems, low blood pressure, migraine, movement problems, muscle cramps or weakness, need to urinate during the night, nosebleed, pain upon urination, prolonged erection, purplish spots on the skin, racing heartbeat, rectal hemorrhage, respiratory infection/lung problems, ringing in the ears, rolling eyes, sensitivity to light, sinus inflammation, skin eruptions or inflammation, sleepwalking, sore on tongue, speech problems, stomach and intestinal inflammation, swelling of the face and throat, swollen wrist and ankles, thirst, throbbing heartbeat, twitching, vaginal inflammation, hemorrhage or discharge, and yawning.

Zoloft side effects may also include mental symptoms such as:

Abnormal dreams or thoughts, aggressiveness, exaggerated feeling of well-being, depersonalization (unreal feeling), hallucinations, impaired concentration, memory loss, paranoia, rapid mood shifts, thoughts of harming yourself, tooth grinding, and worsening depression.

It may also include the loss of several pounds for some people taking this medication. This usually doesn’t pose much of a problem, but could be a concern if your depression has already caused significant weight loss.
In a few people, Zoloft side effects may also trigger manic or hypomanic episodes which include sensations of high energy, lack of need for sleep, grandiose thoughts and feelings and generally inappropriate and out-of-control behavior.

Zoloft Dosage: What is the right amount?


General Zoloft Dosage Information

Adults

Zoloft dosage for Depressive or Obsessive Compulsive Disorder
The usual starting Zoloft dosage is 50 mg once a day, taken either in the morning or in the evening. Your doctor may increase the amount depending upon your response to the medication. The maximum Zoloft dosage is 200 mg in one day.

Zoloft dosage for Premenstrual Dysphoric Disorder

Zoloft may be prescribed throughout the menstrual cycle or limited to the two weeks preceding menstruation. The starting Zoloft dosage is 50 mg a day. If this is insufficient the doctor may increase the amount in 50 mg steps at the start of each menstrual cycle up to the maximum of 100 milligrams per day in the 2-week regimen, or 150 mg per day in the full-cycle regimen.(During the first three days of the two-week regimen, doses are always limited to 50 mg).

Zoloft dosage for Panic Disorder and Post-Traumatic Stress Disorder

The most common Zoloft dosage during the first week is 25 mg once a day. After that, the dose may be increased to 50 mg once a day. Depending upon your response, your doctor may continue to increase your Zoloft dosage up to a maximum of 200 mg a day.

Children

Zoloft dosage for Obsessive-Compulsive Disorder

The initial Zoloft dosage for children aged 6 to 12 is 25 mg, and for adolescents aged 13 to 17, is 50 mg per day. Your physician should adjust the dose as needed. The safety and effectiveness have not been established for children under the age of six.

Zoloft Overdosage

Many medications taken in excess of the recommended dosage can have serious consequences. An overdose of Zoloft can possibly be fatal. If you suspect an overdose seek medical attention immediately.

Common symptoms of Zoloft overdose include:

Agitation, dizziness, nausea, rapid heartbeat, sleepiness, tremor, and vomiting
Other less common symptoms include coma, stupor, fainting, convulsions, delirium, hallucinations, mania, high or low blood pressure, and slow, rapid, or irregular heartbeat.

Information adapted from the The PDR Pocket Guide to Prescription Drugs – Sixth Edition By Paul Susic Ph.D. Licensed Psychologist




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Buspar for anxiety relief ?





Generic name: Buspirone Hydrochloride

Brand Name: Buspar

Buspar is referred to as a minor tranquilizer and has become very popular in providing relief from anxiety. Buspar is most often used to treat anxiety disorders, but is also prescribed at times for the aches, pains, fatigue, and cramps of premenstrual symptom (PMS). However, this and other anxiety medications are not usually prescribed for treating the anxiety or tension caused by the stress of everyday life.

Buspar: Basic General Information

Buspar or buspirone hydrochloride is a potent anti-anxiety medication that has become increasingly popular since its approval by the FDA for the relief of anxiety. It was approved by the Food and Drug Administration (FDA) for the short-term treatment of anxiety, but it has been used safely for more than four weeks at a time, as contrasted to several of the other popular anxiety drugs. It is not actually known how Buspar works at the present time, but has become very popular due to the lack of addiction and some of the other dangerous side effects frequently associated with other anti-anxiety medications, such as the benzodiazepines. It is believed to work by decreasing the amount and actions of the neurotransmitter serotonin in certain parts of the brain. It is not believed to depress the nervous system nor act as an anticonvulsant or muscle relaxant, as some of the other anti-anxiety medicines do. Minor improvement will frequently be apparent after about 7 – 10 days of starting treatment with Buspar, but its maximum effect usually does not occur for approximately three to four weeks. This medication is only available by doctor’s prescription in an oral form (tablets) in both Canada and the United States.

What are some of the special precautions and warnings?

You should not take Buspar if you have ever had any history of an allergic reaction or sensitivity to this drug. It should be used with caution by people with kidney or liver disease. It does not have any antipsychotic effects and should never be taken when experiencing symptoms of psychosis. Although it is not believed to have much potential for abuse, you should always be aware of this possibility. If you believe you will be using Buspar for a prolonged period of time, your physician should check your progress at regular visits to make sure the medicine does not cause unwanted side effects.




Other Considerations When Taking Busbar

When taking this or similar anti-anxiety medicines, you obviously will need to weigh the risk against the good it may possibly do. This is a decision you and your doctor will need to make. Before starting Buspar, the following factors should be considered:

Allergies and Reactions:

You should tell your doctor if you have ever had any unusual or allergic reactions to Buspar. You should also tell your doctor or nurse if you have ever had an allergic reaction to any other substances such as foods, preservatives or dyes.

Pregnancy:

This medicine has not been studied for use with pregnant women. However, this drug has not been shown to cause birth defects or other similar problems in animal studies.

Breast-feeding:

It has not been determined whether Busbar passes into the breast milk of humans.

Children:

Studies of this medication have been done only in adult patients, and it has not been determined whether it should be used in children under the age of 18.

Older adults:

This anxiety medication has only been tested in a limited number of older adults and has not been shown to cause side effects any different than those experienced by younger adults.

Other Medicines:

In some cases, certain drugs should never be used with other medications, while in other cases, two medicines may be taken together although an interaction might occur. In these cases, your physician may want to change the dosage, or take other precautions as necessary. If you are taking Buspar, it is very important that your doctor or nurse know if you’re taking any of the following medications:

• Erythromycin
• Itraconazole (e.g. Sporanox) -higher blood levels of Buspar may occur, increase the chance of side effects. Your physician may want to change the dosage of this anti-anxiety medication.
• Monoamine Oxidase Inhibitors (MAOI’s) (Marplan, Nardil, Parnate) taking Buspar when your taking monoamine oxidase (MAO) inhibitors may cause high blood pressure.

Other medical Concerns:

The presence of other medical issues may affect the use of Buspar. Make sure you tell your doctor if you have any of the following medical problems:

• Kidney disease
• Liver disease-Buspar may be removed from your body more slowly, which may increase the risk of side effects. Your doctor may need to adjust your dosage.

What are some of the Buspar side effects?

The side effects of Buspar cannot really be anticipated, but if any should occur or increase in intensity you should notify your doctor immediately. If you anticipate taking this anti-anxiety medicine for a long period of time, your physician will need to monitor its effectiveness as well as for its side effects. Buspar can make some people feel dizzy, lightheaded, drowsy or less alert than they normally feel. You should always make sure you know how you react to this medication before driving, operating machinery or any other activities that require concentration and being alert. Below are some of the major busbar side effects.

Along with the wanted effects, this medicine will cause some related side effects. Although not all of these Buspar side effects may occur, if they do, you should seek medical attention immediately.

Rare Buspar Side Effects:

Chest pain; confusion; fast or pounding heartbeat; fever; lack of coordination; mental depression; muscle weakness; numbness, tingling, pain, weakness in hands or feet; skin rash or hives; stiffness of arms or legs; sore throat; uncontrolled movements of the body.

There are other Buspar side effects which may occur that usually do not require medical attention. They may go away during your treatment as your body adjusts to the medicine. However, you should check with your doctor if any of the side effects continue or become bothersome.

Common Buspar Side Effects:

Lightheadedness and dizziness, especially when getting up from a sitting or lying position; headache; nausea; restlessness or excitement

Less Common or Rare Side Effects:

Blurred vision; sweating; decreased concentration; diarrhea; drowsiness (more common with doses of more than 20 mg. per day); dryness of the mouth; muscle pain, spasms, cramps or stiffness; ringing in the ears; trouble sleeping, nightmares, or vivid dreams; unusual tiredness or weakness.

There are some other Buspar side effects not listed above which may also occur in some individuals, however, if you notice any unwanted effects you should check with your physician immediately.

Buspar Dosage: What is the proper amount?

Your dosage of Buspar should be taken as directed by your doctor. You should never take more than your physician recommends. Also, you should never take it for a longer period of time than your physician has prescribed. Doing so may increase the risk of unwanted side effects.

After you begin taking buspar (buspirone), you should probably give it at least one to two weeks to feel some anxiety relief.

Buspar Dosage: General Information:

The Buspar dosage will vary for different patients. You should always follow your physician’s orders or the directions on the label. The following information refers only to the most common Buspar dosage. If your dose of Busbar is different however, you should not change it unless your doctor tells you to do so. The number of tablets you take depends upon your specific requirements.

Buspar Dosage Oral Form (tablets):

Adults

Usually start at 5 mg. two or three times a day, or 7.5 mg. two times a day. Your physician may increase your Buspar dosage by 5 mg. a day every few days if needed. However, the dose is usually not more than 60 mg. per day.

Children up to 18 years of age.

The use and dosage must be determined by your doctor.

Older Adults:

Usually start your dosage of Busbar at 5 mg., two or three times a day, or 7.5 mg. two times a day. Your doctor may increase your individual dosage by 5 mg. a day every few days if necessary.

Missed doses:

If you miss your dosage of Buspar you should take it as soon as possible. However, if it is almost time for you to take your next dose, you should go back your regular dosing schedule. You should never take two doses of Buspar.

Symptoms of Overdosage from Busbar:

Lightheadedness or dizziness; drowsiness (severe) or loss of consciousness; stomach upset, including nausea or vomiting; very small pupils in the eyes.

Any medication taken in excess of the dosage recommended can have serious side effects. If you suspect an overdose of Busbar you should seek medical attention immediately.

Storage:

You should obviously keep Busbar out of the reach of children. Store it away from heat and direct light, and try not to store it in the bathroom, near the kitchen sink or other damp places. Heat or moisture has been known to break this medicine down.

You should never keep outdated medicine or medication that is no longer needed. Be sure that any discarded medicine is out of the reach of children.

Information adapted from The PDR Pocket Guide to Prescription Drugs and the Consumer Reports Consumer Drug Reference

Additional information and webpage by Paul Susic Ph.D. Licensed Psychologist (Health and Geriatric Psychologist)




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Librium medication: Your choice for anxiety disorders?





Brand Name: Librium

Generic Name: Chlordiazepoxide

Why is Librium prescribed?

Librium is most frequently prescribed for anxiety disorders. It is often prescribed for short-term relief of anxiety symptoms, withdrawal from acute alcoholism as well as for anxiety and apprehension prior to surgery. This medication belongs to the family of anxiety medications commonly referred to as benzodiazepines.

Important facts related to this drug:

This medication is habit-forming and you can become dependent upon it. You should make sure not to quit taking Librium abruptly as you may experience withdrawal symptoms. You should always be careful not to discontinue this medication or change your dosage without the approval of your physician.

When should Librium not be prescribed?

This drug should not be prescribed if you are sensitive to or have ever had an allergic reaction to this medication or similar tranquilizers. If you’re experiencing everyday stress or anxiety you should probably not take these types of medications. You should always discuss your symptoms with your doctor.

If I am pregnant or breast-feeding what do I need to know?

You should not take Librium if you’re pregnant or planning to become pregnant as there may be an increased risk of birth defects. This drug may appear in breast milk and could affect a nursing infant. If the medication is essential to your health, your physician may advise you to discontinue breast-feeding until your treatment with Librium and has finished.




Librium Dosage:

Librium dosage: How do you take this anti-anxiety medication?

You should take Librium exactly as prescribed.

What if I miss my Librium dosage?

You should take your dosage of Librium as soon as you remember. If it is within an hour or so of when you’re scheduled to take your next dose, you should skip the missed dose and get back to your normal schedule as soon as possible. You should never double up on your dosage of Librium.

Storage instructions:

You should always store your medications away from heat, moisture and light.

Recommended Librium dosages:

Librium Dosages : Adults

Mild or moderate anxiety- The usual dosage of Librium is 5 – 10 mg, three to four times per day.

Severe anxiety– The usual dose is 20 – 25 mg three or four times per day.

Anxiety and apprehension before surgery- On days before surgery, the usual dosage is 5 – 10 mg three or four times per day.

Acute symptoms of alcohol withdrawal- The usual starting Librium dosage is 50 – 100 mg. The physician will usually repeat this dose up to 300 mg per day, until the level of agitation has been adequately controlled.
The doctor may then reduce the dosage as much as possible.

Children- Librium dosage :

The usual Librium dosage for children six years of age or older is 5 mg, anywhere from two to four times per day. Some children may need to take as much as 10 mg two or three times per day. Librium is not usually recommended for children under the age of six.

Dosage for older adults

Your doctor will usually limit or minimize your Librium dosage in order to avoid sedating elderly individuals too much, or otherwise negatively effecting their level of coordination. For senior adults, the usual Librium dosage is 5 mg two to four times per day

Librium overdosage:

Any medication taken in excess of the prescribed dosage may have serious negative effects. If you suspect an overdosage of this medication you should seek medical attention immediately. Some of the symptoms of overdosage include coma, confusion, sleepiness and slow reflexes.

What Librium side effects may possibly be expected?

Specific Librium side effects cannot realistically be anticipated, but if any develop or change in intensity you should contact your doctor immediately. Only your physician can determine if you need to continue taking this medication in spite of your side effects.

Additional Librium side effects may include:

Confusion, constipation, drowsiness, fainting, increased or decreased sex drive, liver problems, lack of muscle coordination, minor menstrual irregularities, nausea, skin rash or eruptions, swelling due to fluid retention, yellow eyes and skin

Side effects of Librium that may be due to rapid decrease or abrupt withdrawal include:
Abdominal muscle cramps, convulsions, exaggerated feeling of depression, sleeplessness, sweating, tremors and vomiting

Special warnings and concerns:

Librium can possibly make you drowsy or less alert, therefore you should not drive or operate heavy machinery until you are well aware of how you are effected by the side effects of Librium. If you are depressed or have a history of depression, you should contact your doctor prior to taking this anxiety medication. Also, this drug may cause children to be less alert as well. If you have a hyperactive or aggressive child taking this medication, you should talk to your physician immediately if you notice negative reactions such as excitement, stimulation or acute rage. Also, you should contact your physician immediately before taking Librium if you’re being treated for porphyria, (a rare metabolic disorder), or liver or kidney disease.


Food and drug interactions possible in addition to Librium side effects:

This medication will intensify or cause an additive effect when taken while drinking alcohol as it is a central nervous system depressant. You should never drink alcohol when taking this drug. If Librium is taken with other medications, the effects of the medications can be increased, decreased or in other ways possibly altered. You should always talk with your physician prior to taking or combining Librium with the following:

• Antacids such as Maalox and Mylanta
• Antidepressant drugs known as MAO inhibitors including Nardil and Parnate
• Antipsychotic medications such as chlorpromazine and trifluoperazine
• Barbiturates such as Phenobarbital
• Blood thinning drugs such as Coumadin
• Cimetidine (Tagamet)
• Disulfiram (Antabuse)
• Levodopa (Larodopa)
• Narcotic pain medicines such as Demerol and Percocet
• Oral contraceptives

Librium side effects should always be noted and reported to your doctor immediately. Never disregard the negative interactions with other medications or any specific Librium side effects.

Some information adapted from The PDR Pocket Guide to Prescription Drugs – Sixth Edition

Additional Information and webpage by Paul Susic Ph.D. Licensed Psychologist (Health and Geriatric Psychologist)




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Ativan Medication: Everything You Need to Know





Generic Name: Lorazepam.

What is Ativan prescribed for?

Ativan is an anxiety medication which is used for the treatment of anxiety disorders for the short-term relief of anxiety symptoms. This anxiety medication belongs to the class of drugs known as benzodiazepines.
What do I need to know about this anxiety medication?
When using Ativan you should always be aware of the fact that tolerance and dependence can develop with its use. You should also be very concerned about withdrawal symptoms which you may experience if you stop using this medicine abruptly. You should follow your doctor’s recommendations if you decide to discontinue or change your dosage.

How should you take this anxiety medication?

You should always take Ativan exactly as it is prescribed by your physician.

What if you miss a dose of this anxiety medication?

If it is within an hour or so of your usual scheduled time you should take the missed dose as soon as you remember. If not, you should skip the dose and go back your regular schedule. You should never take two doses at once.

How is it stored?

You should store this and similar anxiety medications at room temperature in a tightly closed container away from the light.

When should Ativan not be prescribed?

This anxiety medication should not be prescribed if you are sensitive to or have ever had an allergic reaction to this or similar antianxiety medications such as Valium. You should also avoid Ativan if you have had the eye disease acute narrow-angle glaucoma. Do not take Ativan to relieve the symptoms of normal everyday tension or anxiety. Everyday stress and worry does not require treatment with Ativan. You should discuss your anxiety symptoms thoroughly with your physician before trying Ativan or similar anxiety medications.

Ativan side effects:

What Ativan side effects may be expected?

Ativan side effects cannot really be anticipated, but if any develop or a change in intensity you should notify your doctor immediately. Only your physician can determine if it is safe to continue taking this anxiety medication.




If you experience any side effects to Ativan, they will usually appear at the beginning of your medication treatment. They will usually disappear as you continue to take this drug or if you reduce the dosage.

Ativan side effects may also include:

Dizziness, memory problems, sedation, transient amnesia, unsteadiness, weakness
Side effects of Ativan due to a rapid decrease in dosage or abrupt withdrawal:
Abdominal muscle cramps, convulsions, depressed mood, inability to fall or stay asleep, sweating, tremors, vomiting

What are some of the other special concerns related to Ativan?

Ativan and similar medications may cause you to become drowsy or less alert. You should never drive or operate dangerous machinery or participate in hazardous activities which require full mental attention when taking this medication. Also, if you suffer from depression you should consult your doctor before taking Ativan. If you have decreased kidney or liver function the use of this antianxiety drug should be discussed with your physician. If you’re an elderly individual, or if you have been using Ativan for a prolonged period of time, your physician may want to monitor you closely for stomach and upper intestinal problems.

What are some the possible food and drug interactions when taking this drug?

This and other similar anxiety medications are known to increase the effects of alcohol. You should always avoid alcohol when taking these anti-anxiety medications. When taken along with some other drugs, the effects of either could be increased, decreased or otherwise altered. It is very important to consult your doctor before combining Ativan with barbiturates (Phenobarbital, Seconal, and Amytal) or sedative-type medications such as Valium and Halcion.

Can you take this medication if you’re pregnant or breast-feeding?

You should not take Ativan if you’re pregnant or planning to become pregnant. Clinical experience and research has identified an increased risk of birth effects. Also, is not known if Ativan shows up in breast milk. If this medication is essential to your health, your doctor may advise you to discontinue breast-feeding until your medication treatment is finished.

Ativan dosages recommended for adults and children:

Ativan dosage for adults:

The common Ativan dosage recommended for adults is a total of 2mg to 6 mg per day divided into smaller doses. Usually, the largest dose is taken around bedtime. The total daily Ativan dosage may vary from 1mg to 10 mg per day.

Dosage for Insomnia due to anxiety:

Ativan is usually taken at bedtime in doses of 2mg to 4 mg.

For anxiety:

The usual starting Ativan dosage is a total to 3 mg per day taken in two or three smaller doses.

Ativan dosage for children:

The safety and effectiveness has not been established for using Ativan for children under the age of 12 years of age.

For older adults:

The usual starting Ativan dosage for the elderly and for those in a weakened condition should not exceed a total of 1mg to 2 mg per day, evenly divided into smaller doses to avoid oversedation. This dose can be adjusted by your doctor as necessary.

Ativan overdosage:

All medications taken in excess of the recommended amounts may have very serious consequences. An overdose of Ativan can be fatal, although this is relatively rare. If you suspect an overdose, you should seek medical attention immediately.

Symptoms of an overdose may include:

Coma, confusion, drowsiness, hypnotic state, lack of coordination, low blood pressure, sluggishness.

Information adapted from The PDR Pocket Guide to Prescription Drugs – Sixth Edition

Additional Information and webpage by Paul Susic  Ph.D. Licensed Psychologist  (Health and Geriatric Psychologist)




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Valium: What is this medication used for?





Valium 101: An Overview

Valium, falls within the medication classification referred to as benzodiazepines.The benzodiazepines including Valium are by far the drugs most often prescribed to treat anxiety disorders. Also in addition to being good for anxiety, Valium is frequently used as a muscle relaxant and for sleeping difficulties. Sometimes the benzodiazepines are also used to treat seizures in some patients with epilepsy. It is considered a long-acting benzodiazepine, in that you may take one dosage to last all day. Valium is frequently prescribed for individuals with generalized anxiety disorder, problems with muscle relaxation (such as if you have back problems), and even for a condition called night terrors that occurs with children.


Do I take any tests before I take Valium, or when I am on it?

No tests are required prior to receiving a prescription or while you’re on Valium. No blood test or x-rays are required to monitor the effects. Valium can be given to patients with very serious medical problems, and has no ill effects on the heart, lungs, or kidneys. It is not recommended if you have a history of alcohol abuse or have misused other drugs, or if you have liver disease, are pregnant or are nursing.

Valium: Why is this anti-anxiety medicine prescribed??

Valium is an anti-anxiety medicine used in the treatment of anxiety disorders and for the short-term relief of general symptoms of anxiety. Valium is from the anti-anxiety medicine classification known as benzodiazepines. Valium is also used at times to treat the acute symptoms of alcohol withdrawal, to relieve uncontrolled muscular movements caused by cerebral palsy and paralysis of the lower body and limbs, to relax muscles, to control involuntary movement of the hands, to relax tight aching muscles, and it is sometimes used with other medications to treat epilepsy and other convulsive disorders.

Most important fact about this anti-anxiety medicine:

It is especially important to be cautious with this anti-anxiety medication as it can be habit-forming or addictive. You may experience withdrawal symptoms from Valium if you discontinue its use abruptly. You should only change the dosage or discontinue its use under the supervision of a medical doctor.

How should Valium be taken?

You should only take this anti-anxiety medicine as prescribed. If you’re taking Valium for epilepsy or convulsive disorders you should make sure to take it at the same time every day.

If you miss a dose of valium…

Take the missed dose as soon as you think about it if it is within an hour or two of the scheduled dosage time. If you do not remember until much later you should skip the missed dose and go back to your normal schedule. You should never take two doses of this medicine at once.

Storage instructions…

You should store Valium away from heat, light, and moisture.




When should Valium not be prescribed?

If you’re sensitive to or have ever had an allergic reaction to Valium you should probably not take it. Also, you should not take this medication if you’ve ever had an eye condition called narrow-angle glaucoma. Every day tension and stress does not usually require anti-anxiety medicines such as Valium. You should always discuss your anxiety symptoms thoroughly with your physician before taking any medicine for it. Finally, Valium should never be taken for mental disorders considered to be more serious than anxiety.

Valium Side Effects and Special Concerns

What are the main Valium side effects that may be expected?

In many cases side effects cannot really be anticipated, but if they do develop or increase in intensity you should contact your doctor immediately. Only your physician can determine if the specific side effects may make it difficult to continue or make it prohibitive.

The most common Valium side effects include the following:

Drowsiness, fatigue, light-headedness, loss of muscle coordination

Some of the less common side effects include:

Anxiety, blurred vision, changes in salivation, changes in sex drive, confusion, constipation, depression, difficulty urinating, dizziness, double vision, hallucinations, headache, inability to hold urine, low blood pressure, nausea, over-stimulation, rage, seizures (mild changes in brainwave patterns), skin rash, sleep disturbances, slow heartbeat, slurred speech and other speech problems, stimulation, tremors, vertigo, yellowing of eyes and skin

Some of the following side effects of Valium are strictly due to rapid decrease in dosage or abrupt withdrawal from this medication:

Abdominal muscle cramps, convulsions, sweating, tremors, vomiting

Are there any additional special concerns about this medication?

This medication is known to cause drowsiness or inhibit an individual’s ability to pay full attention to activities which require concentration. You should never drive or operate dangerous machinery until you’re sure of how you respond to this type of medication. Also, you should always take special precautions if you have ever had any kidney or liver problems.

In addition to the Valium side effects there are also possible food and drug interactions while taking this medication.

In addition to the side effects associated with this medication, there are also interactions with foods and various other medications. This medication has a slowing effect on the central nervous system and also may magnify the effects of alcohol. You should obviously not drink when taking this medication. If Valium is taken with other medications, the effects of these medicines may be increased, decreased or may be altered in some other way. You should always talk with your doctor prior to taking Valium with any of the following medications:

• Anti-seizure drugs such as Dilantin
• Antidepressant drugs such as Elavil and Prozac
• Barbiturates such as Phenobarbital
• Cimetidine (Tagamet)
• Digoxin (Lanoxin)
• Disulfiram (Antabuse)
• Fluoxetine (Prozac)
• Isoniazide (Rifamate)
• Levodopa (Larodopa, Sinemet)
• Major tranquilizers such as Mellaril and Thorazine
• MAO Inhibitors (antidepressant drugs such as Nardil)
• Narcotics such as Percocet
• Omeprazole (Prilosec)
• Oral contraceptives
• Propoxyphene (Darvon)
• Ranitidine (Zantac)
• Rifampin (Rifadin)

Should you be concerned about the Valium side effects if you are pregnant or breast-feeding?

You should never take Valium or any similar medications if you’re pregnant or planning on becoming pregnant sometime in the near future as there could be an increased risk of birth defects. If your doctor decides that it is actually necessary to continue taking this medication in spite of the side effects, you should probably discontinue breast-feeding until your medication treatment is finished.

Final comments on Valium side effects:

Valium is an effective short-term medication for anxiety disorders and overall is one of the more popular prescribed medications. However, there are significant side effects that need to be considered with this medication as with all medicines. You should always be in consultation with your physician when taking this antianxiety medication.

Valium dosage: How much should I really take?

Valium dosage and overall effects:

Valium is referred to as a long acting benzodiazepine because one 5 mg dose may possibly last the entire day. The most common Valium dosages are between 5 mg and 20 mg per day, with the doses usually evenly divided and taken in the morning and evening, rather than being taken all at once. Because this medication works more quickly than most other benzodiazepines, relief can often occur within 30 minutes to an hour after taking the first dose. Many patients with generalized anxiety disorder who take Valium regularly feel substantial improvement within one week of their first dosage. Once you get to the right dosage that seems to control your anxiety, you may remain at that dose indefinitely often without experiencing new anxiety symptoms. If the medicine doesn’t seem to work, that may indicate that the diagnosis may be inaccurate. Also, other psychological symptoms such as depression may be present. This medicine will not help with depression. Also, there are often times in which the difficulties in an individual’s life may be more effectively handled without medication through the use of other treatments such as psychotherapy. Changing to other benzodiazepines usually does not help. Most doctors attempt to use the smallest dosage possible before increasing to a higher amount for the elimination of anxiety symptoms. It does not appear that there are any known medical risks associated with remaining on this medication for your entire life, although the longer you take it the harder it may be to stop or reduce its usage.

Valium dosage: What is the recommended amount for the treatment of anxiety disorders or short-term relief of anxiety symptoms?

The usual dosage of Valium is dependent upon the severity of symptoms but is usually between 2 mg and 10 mg taking 2 to 4 times per day.

Dosage associated with alcohol withdrawal:

The usual dosage of this medication when utilized for alcohol withdrawal is 10 mg, three or four times during the first 24 hours, and then 5 mg three or four times per day as needed.

For relief of muscle spasms:

The usual amount of Valium for the relief of muscle spasms is 2 mg. to 10 mg, three or four times per day.

Convulsive disorders:

The usual dosage utilized for treatment of compulsive disorders is 2 mg. to 10 mg,, 2 to 4 times daily.

Children:

This medication should not be given to children under the age of six months of age. The most often used dosage to start children over six months old is 1 mg. to 2.5 mg three or four times per day. Only your doctor should increase this medication as necessary.

Older adults:

The usual starting dosage of Valium is 2 mg. to 2.5 mg once or twice per day. Your doctor will usually limit the dosage to the smallest effective amount possible, as older individuals are more apt to become over sedated and may be at a much higher risk of falling, and have other difficulties associated with the lack of coordination.

Valium Overdosage

All medicines including anxiety medications, if taken in excess of the prescribed amount can be very dangerous and have serious consequences. If you have any reason to suspect an overdose, you should seek medical attention immediately. The symptoms of a Valium overdosage may include, confusion, diminished reflexes and/or sleepiness.

If you miss your Valium dosage,,,,

If you miss your usual dosage you should take it as soon as possible it if it is within an hour or two of the schedule dosage. If you don’t remember until much later you should skip the missed dose and go back to your normal dosage schedule. You should never take two doses of this medication at once.

By Paul Susic Ph.D. Licensed Psychologist





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Namenda (Memantine): A cure for Alzheimer’s Disease?




Namemda- An Introduction to one of the newest Alzheimer’s medications.

Namenda (Memantine) was approved by the FDA in October as the newest treatment option for sufferers of Alzheimer’s disease. Memantine is marketed in the United States by Forest Laboratories and will be sold under the brand name of the Namenda, for patients with moderate to severe Alzheimer’s Disease. Forest Laboratories has stated that Namenda should be on the pharmacy shelves in January, 2004. Namenda has been sold for quite some time in Germany and Canada, and many U.S. families have been purchasing it over the internet for awhile. It is estimated that approximately 4 million Americans have Alzheimer’s disease, and about one million of them are believed to suffer severe symptoms. This will be the first time in which a medication is being offered for patients in the moderate to severe stage of the disease.

How will Namenda help?

Namenda has been found to help improve the memories and thinking skills of some patients who have moderate to severe impairments in their cognition (ability to think). However for the vast majority, the drug has been found to slow the pace of deterioration, allowing some patients to maintain their abilities to function somewhat independently for a longer period of time, which may benefit the patient and caregivers in some very important ways.




How is Namenda different from other Alzheimer’s medications?

While there are a few similarities between Namenda and other Alzheimer’s medications currently on the market, there are many more differences. Namenda is similar in that like the other Alzheimer’s medications (Aricept, Exelon, Reminyl and Cognex) it does not usually improve functioning as much as it retards the deterioration, allowing individuals to maintain independent functioning for a longer period of time. The most prominent difference is that these other medications are known to only be effective in the early stages of the disease, while Namenda is the first to have demonstrated effectiveness in the moderate to severe stages of Alzheimer’s. These other drugs delay the breakdown of another brain chemical called acetylcholine, which is necessary in the communication between nerve cells. Namenda naturally blocks excess amounts of another brain chemical called glutamate, which has been found to damage or kill nerve cells. Ultimately, doctors may eventually be able to prescribe combinations of medications in the hopes of better results.

Why should we feel hopeful about Namenda?

As just mentioned, doctor’s may be able to possibly use Aricept, Exelon, Reminyl or Cognex in the early stage the disease and possibly transition to a medication such as Namenda as the disease progresses to a more severe level of disability. It is recommended by the FDA’s scientific advisors whom have evaluated the drug, to recognize that Namenda does not offer miraculous benefits, and should not be a source of false hope to families of the most severely ill patients with Alzheimer’s. However, it is just another step in the progression of the development of medications which forestall the progressive deterioration of memory, and eventually may be an avenue toward a cure.

Namenda Side Effects: Special Warnings

What Namenda side effects may occur?

Although Namenda side effects cannot be anticipated, if any develop or change in intensity you need to contact your doctor immediately. Only your doctor can determine if it is still safe to continue taking this memory drug in spite of the Namenda side effects.

The Namenda side effects may include:

Confusion, constipation, coughing, dizziness, hallucinations, headache, high blood pressure, pain, sleepiness, vomiting

Namenda side effects and special warnings:

Namenda is not recommended for patients who have severe kidney impairment. There are various disease conditions that may alter the alkaline balance of the urine, which then may cause a build up of this medication in your body. You should always tell your physician about any major dietary changes, kidney problems such as renal acidosis, or urinary tract infections.

You should always make sure your doctor has information about any history of seizures that you may have. In addition to the previously mentioned Namenda side effects, this medication has not been formally studied among people with seizure disorders.

Namenda side effects and food and drug interactions:

In addition to the Namenda side effects, this medication should not be taken with certain other drugs as the effects can either be increased, decreased or altered in some other way. It is always important to check with your physician when combining Namenda with any of the following medications:

Amantadine (Symmetrel)
Cimetidine (Tagamet, Tagamet HB)
Cough suppressants that contain dextromethorphan (usually denoted as “DM”)
Glaucoma drug such as Diamox and Neptazane
Hydrochlorothiazide (HydroDIURIL)
Ketamine (Ketalar)
Nicotine (Nicoderm patch, Nicorette gum)
Quinidine (Quinidex)
Ranitidine (Zantac)
Sodium bicarbonate (baking soda, Alka-Seltzer)
Triamterene (Dyrenium DM)
You always need to be very sensitive to the combination of medications in addition to an awareness of any Namenda side effects.

Namenda Dosage: What is the recommended amount?


Namenda dosage for adults:

The recommended Namenda dosage is 10 mg twice a day. The Namenda dosage at the initiation of therapy is usually recommended to be 5 mg once a day for seven days, and then gradually increased by 5 mg every seven days up to a maximum Namenda dosage of 20 mg.

If side effects occur, your doctor may want to wait for about a week to increase the dose. Also, people who have impaired kidney function may also require lower doses.

Namenda dosage: How do you take this memory drug?

Namenda should be taken exactly as prescribed by your physician. The usual Namenda dosage is increased gradually in one-week intervals. Most physicians wait at least one week before increasing the dose. Dosages above the recommended amount have no additional benefit. This medication may be taken with or without food.

If you miss your dose…
You should take your forgotten dosage as soon as you remember, however, if it is almost time for your next dose, you should skip the missed one and continue on your regular schedule. You should never take two doses of Namenda at the same time.

Storage instructions…

You should always store this medication at room temperature.

Namenda Overdosage:

If your Namenda dosage is taken in excess of the recommended amount it may have serious consequences. If you suspect that you have taken too much, you should seek emergency treatment immediately.

Symptoms of Namenda overdosage may include…

Hallucinations, loss of consciousness, psychosis, restlessness, sleepiness, stupor

Taking the correct Namenda dosage is absolutely essential for the effective treatment of Alzheimer’s disease.

By Paul Susic Ph.D. Licensed Psychologist