Psychiatric Drugs »» Antidepressants | Antipsychotics | Antianxiety | Antimanic Agents | Stimulants | Prescription Drugs » lithium

Lustral

admin — Wed, 04 Aug 2010 15:28:41 +0000

LUSTRAL
How does it work?

Lustral tablets contain the active ingredient sertraline hydrochloride, which is a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI). (NB. Sertraline tablets are also available without a brand name, ie as the generic medicine.)

Antidepressant medicines act on nerve cells in the brain. In the brain there are numerous different chemical compounds called neurotransmitters. These act as chemical messengers between the nerve cells. Serotonin is one such neurotransmitter and has various functions that we know of.

When serotonin is released from nerve cells in the brain it acts to lighten mood. When it is reabsorbed into the nerve cells, it no longer has an effect on mood. It is thought that when depression occurs, there may be a decreased amount of serotonin released from nerve cells in the brain.

SSRIs work by preventing serotonin from being reabsorbed back into the nerve cells in the brain. This helps prolong the mood lightening effect of any released serotonin. In this way, sertraline helps relieve depression.

Sertraline may also be used in the treatment of obsessive compulsive disorder and post-traumatic stress disorder. It is not fully understood how it works in these conditions.

It may take between two to four weeks for the benefits of this medicine to appear, so it is very important that you keep taking it, even if it doesn’t seem to make much difference at first. If you feel your depression has got worse, or if you have any distressing thoughts or feelings in these first few weeks, then you should talk to your doctor.
What is it used for?
Depression in adults
A psychiatric disorder in which tasks are excessively repeated (obsessive-compulsive disorder) in adults and children aged six years and over
Post-traumatic stress disorder in adult women
Warning!
Depression and other pschiatric illnesses are associated with an increased risk of suicidal thoughts, self-harm, and suicide. You should be aware that this medicine may not start to make you feel better for at least two to four weeks. However, it is important that you keep taking it in order for it to work properly and for you to feel better. If you feel your depression or anxiety has got worse, or if you have any distressing thoughts, or feelings about suicide or harming yourself in these first few weeks, or indeed at any point during treatment or after stopping treatment, then it is very important to talk to your doctor.
This medicine may reduce your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won’t affect your performance.
It is recommended that you avoid drinking alcohol while taking this medicine.
SSRI antidepressants have been associated with the development of unpleasant or distressing restlessness and the need to move, often accompanied by an inability to sit or stand still. This is most likely to occur within the first few weeks of treatment. If you experience these symptoms you should consult your doctor.
Antidepressants may cause the amount of sodium in the blood to drop – a condition called hyponatraemia. This can cause symptoms such as drowsiness, confusion, muscle twitching or convulsions. Elderly people may be particularly susceptible to this effect. You should consult your doctor if you develop any of these symptoms while taking this medicine, so that your blood sodium level can be checked if necessary.
If you experience seizures (convulsions or fits) while taking this medicine, consult your doctor immediately, as you will need to stop treatment with this medicine. This also applies if you suffer from epilepsy and experience more seizures than normal after starting this medicine.
You should not suddenly stop taking this medicine, as this can cause withdrawal symptoms such as dizziness, sleep disturbances (including intense dreams), nausea, headache, a feeling of weakness, pins and needles and anxiety. Withdrawal symptoms are temporary and are not due to addiction or dependence on the medicine. They can usually be avoided by stopping the medicine gradually, usually over a period of weeks or months, depending on your individual situation. Follow the instructions given by your doctor when it is time to stop treatment with this medicine. On very rare occasions some people have experienced withdrawal symptoms after accidentally missing a dose of this medicine.
Following a review of the safety and efficacy of SSRIs to treat depression in children under 18 years of age (unlicensed use), the Committee on Safety of Medicines (CSM) has concluded that the risks of sertraline outweigh the benefits for treating depressive illness in this age group. If you are under 18 and taking sertraline for depression you should consult your doctor for advice, but do not suddenly stop taking it as this can cause withdrawal symptoms. Sertraline may be used for obsessive-compulsive disorder in children aged six years and over, but is not recommended for younger children.
Use with caution in
Elderly people
Young adults
History of suicidal behaviour or thoughts
History of mania or hypomania
People also receiving electroconvulsive therapy (ECT)
Decreased kidney function
Decreased liver function
Diabetes
Epilepsy
History of bleeding disorders
People taking medicine that affects blood clotting (eg anticoagulants such as warfarin)
Not to be used in
Children and adolescents under 18 years of age for the treatment of depressive illness
People who have taken a monoamine-oxidase inhibitor antidepressant (MAOI) in the last 14 days
Manic episodes of manic depression (bipolar affective disorder)
Severely decreased liver function
Uncontrolled epilepsy
People taking the antipsychotic medicine pimozide

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
The safety of this medicine in pregnancy has not been established. It should therefore be used with caution during pregnancy, and only if the benefits to the mother outweigh any risks to the foetus. Seek medical advice from your doctor.
This medicine passes into breast milk, however the effect of this on the nursing infant is unknown. For this reason women who need to take this medicine should consider not breastfeeding. Seek medical advice from your doctor.
Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
Disturbances of the gut such as nausea, vomiting, diarrhoea or abdominal pain
Indigestion (dyspepsia)
Loss of appetite
Shaking, usually of the hands (tremor)
Dizziness
Difficulty in sleeping (insomnia)
Sleepiness (somnolence)
Increased sweating
Dry mouth
Sexual problems
Headache
Anxiety and agitation
Pins and needles (paraesthesia)
Changes in blood pressure
Seizures
Loss of memory (amnesia)
Liver disorders

The side effects listed above may not include all of the side effects reported by the drug’s manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.

Sertraline should not be taken at the same time as monoamine oxidase inhibitor medicines (MAOIs). These include monoamine oxidase inhibitor antidepressants such as phenelzine, tranylcypromine and moclobemide, the antibiotic linezolid and the anti-Parkinson’s medicine selegiline. Sertraline should not be started until at least at least a day after stopping moclobemide or linezolid, and at least two weeks after stopping other monoamine oxidase inhibitors. Similarly, treatment with any MAOIs should not be started until at least two weeks after stopping treatment with sertraline.

Sertraline must not be taken with the antipsychotic medicine pimozide.

Sertraline should not be taken in combination with benzodiazepines or other tranquilisers by people who need to drive or operate machinary.

There may be an increased risk of side effects if sertraline is taken with the following medicines, which also enhance the activity of serotonin in the brain:
lithium
triptans for migraine, eg sumatriptan
tramadol
tryptophan.

The herbal remedy St John’s wort should not be taken with sertraline for the same reason.

Sertraline may increase the blood levels of the following medicines:
clozapine
some tricyclic antidepressants (imipramine, desipramine, nortriptyline and possibly amitriptyline).

Sertraline may increase the effect of anti-blood-clotting medicines (anticoagulants) such as warfarin, and this may increase the risk of bleeding. If you are taking an anticoagulant with this medicine, your blood clotting time should be regularly monitored.

As SSRIs have been associated with bleeding abnormalities, the following medicines, which are known to affect the ability of the blood to clot, should be used with caution with sertraline:
tricyclic antidepressants
some antipsychotic medicines
some antisickness medicines, eg prochlorperazine
aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen
ticlopidine
dipyridamole.

Treatment with this medicine may alter control of blood sugar in people with diabetes, who may need an adjustment in their dose of insulin or antidiabetic tablets. People with diabetes should discuss this with their doctor.

Sertraline blood levels may be increased by cimetidine and this may increase the risk of sertraline side effects.
Other medicines containing the same active ingredient

Sertraline tablets are available without a brand name, ie as the generic medicine.

Source: http://www.netdoctor.co.uk/medicines/100001555.html

Tags: antidepressant, Clozapine, Desipramine, Difficulty in sleeping, dipyridamole, elective serotonin reuptake inhibitor, imipramine, lithium, Lustral, nortriptyline, obsessive-compulsive disorder, post-traumatic stress disorder, self-harm, serotonin, Sertraline, sertraline hydrochloride, SSRI antidepressants, suicidal thoughts, suicide

Health Risks of Psychiatric Drugs

admin — Fri, 19 Dec 2008 21:43:06 +0000

Making a decision about coming off psychiatric drugs means evaluating as best you can the risks and benefits involved, including important information missing or suppressed from most mainstream accounts. Some risks may be worth taking, some risks may not be worth taking, but all risks should be taken into consideration. Because each person is different and drug effects can vary widely, the uncertainty involved should be met with your own best judgment and observations of how your body and mind are responding. This list cannot be comprehensive, and new risks are being uncovered regularly. Check a watchdog group (like www.ahrp.org) for the latest information.
Physical Health Risks
Psychiatric drugs are toxic and can damage the body. Neuroleptic “anti-psychotics” can cause the life-threatening toxic reaction called neuroleptics malignant syndrome, as well as Parkinson’s disease-like symptoms. Regular blood level tests are required of some drugs such as lithium and Clozaril to protect against dangerous organ damage. Many drugs can lead to obesity, diabetes, sudden heart attack, kidney failure, serious blood disorder, and general physical breakdown. Other toxic effects are numerous, and include interfering with the menstrual cycle, threats to pregnancy, and life-threatening “serotonin syndrome” when anti-depressants are mixed with other drugs.
• Psychiatric drugs can injure the brain. The rate of tardive dyskinesia, a serious neurological disease that can disfigure a person with facial tics and twitching, is very high for long-term patients on neuroleptic anti-psychotic drugs, and even short-term use carries some risk. Anti-depressants can also cause brain injury. Other effects can include memory damage and cognitive impairment.
• Pharmaceutical company effectiveness and safety studies, as well as FDA regulation, are extensively corrupted and fraud is widespread. There are few long-term studies, or studies of how drugs combine together. The real extent of psychiatric drug dangers may never be accurately known. Taking psychiatric drugs is in many ways society-wide experimentation, with patients as guinea pigs.
• Combining with alcohol or other drugs can dramatically increase dangers.
• Drug effects can lower the quality of life, including impaired sexuality, depression, agitation, and overall health deterioration.
• Drug-induced body changes such as restlessness or stiffness can alienate you from others and increase isolation.
• Lithium interacts with salt and water in the body, and when these levels change, such as from exercise, heat, or diet, potency can fluctuate. Even with regular blood tests and dosage adjustments, this means people taking lithium are sometimes at risk of exposure to damaging levels.
• ADHD drugs such as Adderall and Ritalin can stunt growth in children, and present other unknown dangers to brain and physical development. Like any amphetamines, they can cause psychosis and heart problems, including sudden death.
• ADHD stimulants, sleeping aids, and benzodiazepine tranquilizers are physically addictive like street drugs, and benzodiazepenes are more addictive than heroin.
Mental Health Risks
Mental health risks are some of the least understood aspects of psychiatric medications, and can make drug decisions and the withdrawal process very complicated. Here are some things that your doctor may not have told you:
Psychiatric drugs can make psychotic symptoms worse and increase the likelihood of having psychotic symptoms. Drugs can change receptors for such neurotransmitters as dopamine, making a person “supersensitive” to becoming psychotic, as well as increasing sensitivity to emotions and experiences in general. Some people report some of their first psychotic symptoms occurred after starting to take psychiatric drugs.
• Many drugs now carry warnings about the increased risk of suicide and violent behavior.
• Many people experience negative personality changes, including not feeling themselves, feeling drugged, emotional blunting, diminished creativity, and reduced psychic/spiritual openness.
• People who take psychiatric drugs, especially anti-psychotics, are often more likely to become long-term and chronic mental patients. People in poor countries that use less medication recover much faster than in rich countries that use a lot of medication. Many people recover faster and do much better without drugs.
• Once you are on the drug, your personality and critical thinking abilities may be very changed. It might be difficult to properly evaluate the drug’s usefulness. You may need to get off the drug, but not realize it because of how the drug is affecting your thinking.
• Psychiatric drugs can interrupt and impair the mind’s natural ability to regulate and heal emotional problems. Many people report having to “re-learn” how to cope with difficult emotions when they come off psychiatric drugs.
• Some people, even experiencing the worst depths of madness, say that by going through their experiences rather than suppressing them, they emerge stronger and healthier in the end. Sometimes “going crazy” can be the doorway to personal transformation, and some people are thankful for even the most painful suffering they have been through. Drugs can obscure this possible positive side. Artists, philosophers, poets, writers and healers often attribute tremendous value to the insights gained from “negative” emotions and extreme states.
Other Drug Risks and Considerations
Understanding the coming off drugs process means taking into account many different factors you may not have considered before:
While not publicized widely by a culture dominated by pharmaceutical companies, alternative treatments, talk therapy, and even the placebo effect can often be more effective than psychiatric drugs, without the risks.
• Keeping up with taking pills every day is difficult for anyone. Missing doses of psychiatric drugs can be dangerous because of the withdrawal effects, making you vulnerable if the drug is interrupted.
• Doctors typically see patients infrequently for short visits, making it less likely to spot potentially serious adverse drug reactions.
• People with a mental disorder diagnosis frequently have difficulty getting insurance.
• Taking psychiatric drugs often means giving up control to the judgments of a doctor, who may not make the best decisions for you.
• Taking psychiatric drugs can mean being seen as mentally ill in society and starting to see yourself in that role. The stigma, discrimination, and prejudice can be devastating, and even create a self-fulfilling prophecy. Diagnostic labels cannot be stricken from the record the way criminal histories can. Studies show that trying to convince people that “mental illness is an illness like any other” is a counterproductive strategy that actually contributes to negative attitudes.
• Psychiatric drugs can convey the false view that “normal” experience is productive, happy, and well adjusted all the time, without mood shifts, bad days or suffering. This encourages a false standard of what it is to be human.
• Taking psychiatric drugs can put a passive hope in a “magic bullet” cure rather than taking personal and community responsibility for action to change.

Source: http://theicarusproject.net/downloads/ComingOffPsychDrugsHarmReductGuide1Edonline.pdf

Tags: ADHD drugs, drug effects, Health Risks, lithium, Mental Health Risks, Physical Health Risks, ritalin

Tegretol

admin — Sun, 14 Sep 2008 11:13:23 +0000

TEGRETOL Novartis
Carbamazepine

Use:
Anticonvulsant, antimanic agent. Epilepsy: Adults and children > 12 years – initially, 100-200 mg once or twice a day; increased in divided doses until best response obtained. Optimal daily dosage: 800-1200 mg. Rarely, some adults may require 1600 mg/day. As soon as disappearance of seizures has been obtained and maintained, reduce dosage very gradually to minimum effective dose. Children 6-12 years: Initially, 100 mg in divided doses on first day; increased by 100mg/day until best response obtained. Maximum daily dosage: 1000mg.

Trigeminal neuralgia: Initially, 100 mg twice daily; increased by 200 mg/day until pain is relieved, usually at 200-800 mg/day (occasionally, 1200 mg/day). Reduce or discontinue Tegretol, if possible, at intervals of not more than 3 months.

Mania and bipolar disorders: Initially, 200-400 mg/day in divided doses (400-600 mg/day may be used in acute mania); increased gradually until symptoms are controlled or a total daily dose of 1600 mg is achieved. Usual dose is 400-1200 mg/day in divided doses.

With lithium, neuroleptics: start with 100-200 mg/day and increase gradually. Daily dose > 800 mg is rarely required.

Tegretol tablets, Chewtabs and suspension: Take in 2-4 divided doses daily, with food. CR tablets may be divided or swallowed unchewed with liquid during or after a meal. Suspension: Start with low doses and increase slowly to avoid adverse reactions. When switching from tablets to suspension, give the same amount of drug daily, but in smaller, more frequent doses (i.e. twice daily tablets could be switched to 3 times daily suspension).

Contraindications:
AV block, hepatic disease, a history of bone marrow depression, acute intermittent porphyria or serious blood disorders. Hypersensitivity to carbamazepine or tricyclics. Not to be given with, or within 14 days of starting or stopping MAOI therapy.

Precautions:
Pregnancy, lactation: Weigh possible risks vs. potential benefits. Elderly patients. Urinary retention, increased intraocular pressure, cardiovascular disorders, activation of behavioral disorders, exacerbation of seizures. Perform periodic ophthalmic examinations, evaluations of renal, hepatic and bone marrow function. Abrupt cessation of Tegretol may precipitate seizures. Cross-hypersensitivity with phenytoin and oxcarbazepine.

Side effects:
Drowsiness, headache, ataxia, vertigo, fatigue, diplopia, dizziness, nausea, vomiting, allergic skin reactions, edema, fluid retention, dry mouth, leucopenia, eosinophilia. Rarely, serious hematologic, hepatic, cardiovascular and dermatologic reactions (stop therapy).

Interactions:
Se Contraindications. Plasma levels of carbamazepine increased by macrolide antibiotics, isoniazid, verapamil, danazol, fluvoxamine, grapefruit juice, azole antifungals, loratadine, ritonavir, diltiazem, fluoxetine, cimetidine. Carbamazepine may lower plasma levels of anticonvulsants, oral contraceptive, oral anticoagulants, digoxin, cyclosporine, levothyroxine, dehydropyridine calcium channel blockers, doxycycline, TCAs, estrogens/progestrogens, corticosteroids, benzodiazepines, haloperidol, protease inhibitors for HIV treatment, olanzapine, risperidone. Plasma levels of carbamazepine may be reduced by phenytoin, Phenobarbital, rifampin, oxcarbazepine, St.John’sWort, valproic acid, phesuximide. Combined use of carbamazepine with lithium or haloperidol may increase risk of neurotoxic side effects.

Patient tips:
Avoid alcoholic beverages. Call physician immediately if seizures worsen. Caution re drowsiness, dizziness (NB driving).

Supplied:
200 mg tablets, 100 mg and 200 mg Chewtabs, 200 mg and 400 mg CR (controlled-release) tablets, 100 mg/5mL oral suspension.

Source: http://www.mentalhealth.com/drug/p30-t01.html

Tags: allergic skin reactions, Anticonvulsant, antimanic agent, ataxia, bipolar disorders, cardiovascular, dermatologic reactions, diplopia, dizziness, Drowsiness, dry mouth, edema, eosinophilia. Rarely, fatigue, fluid retention, headache, hepatic, leucopenia, lithium, mania, nausea, neuroleptics, serious hematologic, Tegretol, vertigo, vomiting

Psychiatric Drugs »» Antidepressants | Antipsychotics | Antianxiety | Antimanic Agents | Stimulants | Prescription Drugs » lithium

Lustral

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