| Over the Counter Depression & Anxiety Products |
[Jun. 25th, 2009|08:59 am] |
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As promised I'm gonna type up what I have on my little cheat sheet from our workshop and then info I found online to kinda back it up. Plus just simplify it. there are a lot of technical terms. There are 3 products. I'm also doing this to help me learn the stuff better myself lol.
St. Johns Wart
*Used to treat depression
* It's an OTC(over the counter) SSRI (Selective serotonin reuptake inhibitor)
*Significant drug-drug interactions
OK so what the hell is an SSRI? I know that's what I thought when I first heard it lol. To explain it I first need to give a brief overview of what causes depression.
People with depression usually have problems with poor sleep, low mood and appetite, loss of energy and interest or pleasure etc. It is a common illness, affecting 3% of the population per year. The main theory about why this happens is the so-called "monoamine hypothesis".
We know that serotonin and noradrenaline in the brain are involved with control of sleep/wake, emotions, mood, arousal, emotion, drive, temperature regulation, feeding etc. Thus, if a person has too little serotonin and noradrenaline in the part of the brain that controls mood, this will produce too little activity, and that part of the brain become slower and less effective. This will lower mood.
In depression, it is known that there are reduced levels of serotonin and noradrenaline. These reduced levels lead to a lowering of mood. The full reasons are not fully known but stress may well play a part in causing this.
"Normal" communication between cells:
"Less" communication between cells e.g. as in depression:
There are lots of other theories about how depression occurs e.g. genetics, how the brain develops, stress etc. There may in fact be many causes and in each person there may be a combination of these. Stress may in fact cause changes in the brain which then result in reduced levels of serotonin and noradrenaline. Transmitters other than much serotonin and noradrenaline are probably also involved.
How SSRI's Work
If too little serotonin (or noradrenaline) produces the symptoms of depression then correcting this should help to reduce the symptoms. One way of doing this is to block the reuptake (recycling) of transmitters. This is just what an SSRI antidepressant does. They block the reuptake of serotonin, so the next time an impulse comes along, there is more transmitter, a stronger message is passed, and activity in that part of the brain is increased.
"Normal" nerve activity:
"Reduced" nerve activity e.g. as in depression:
"Reduced" nerve activity but with recycling blocked, and increased messages passes:
The important thing to remember is that SSRI antidepressants probably mainly work by correcting the effect of having too little transmitter. They are NOT JUST STIMULANTS. They have a much more specific way of working than just stimulating you.
What about Side Effects?
SSRI antidepressants mainly block the reuptake of just serotonin. This why they are called the SSRIs ie. Selective Serotonin Reuptake Inhibitors.
Many other antidepressant drugs also affect other transmitter systems e.g. acetylcholine, dopamine, histamine etc. and have many side effects. SSRIs really only block the reuptake of serotonin, and so have less side effects. However, they still have some side effects ;-
* Too much serotonin in some parts of the brain can make you feel sick, less hungry and get headaches or migraines
Some key facts about SSRI antidepressants;-
* The symptoms of depression are caused by an imbalance of chemicals in the brain, probably reduced levels of serotonin and noradrenaline
* Antidepressants help correct this imbalance in the brain
* Antidepressants are not stimulants
* They do not alter personality
* They are not addictive and are not habit forming (but you should not stop taking them suddenly)
* They do not lose their effect if you keep taking them
Info on St. John's Wort it's self
St. John's wort is today most widely known as an herbal treatment for depression. According to the Cochrane Review, a key resource in evidence-based medicine, "the available evidence suggests that the hypericum extracts tested in the included trials are superior to placebo in patients with major depression; are similarly effective as standard antidepressants; and have fewer side effects than standard antidepressants."
SAM-e
*Use to treat depression(serotonin effects)
As Depression Treatment
There have been a number of studies on the use of SAMe for depression. It has been hypothesized that SAMe increases the availability of neurotransmitter serotonin and dopamine.
A 1999 book, "Stop Depression Now" by Brown, Bottiglieri, and Colman trumpets on its front cover: "The breakthrough supplement that works as well as prescription drugs in half the time ... with no side effects."
Sound too good to be true? We are told SAM-e has been prescribed in Europe for more than twenty years and that in Italy it outsells Prozac. One of the authors of "Stop Depression Now", a psychiatrist at Columbia University, claims he has used the supplement on his patients with successful results for five years and another author has dedicated his life to research it.
SAM-e - short for S-adenosylmethionine - is a molecule found in our bodies and is vital to a process called methylation, where one molecule passes a methyl group (one carbon and three hydrogen atoms) to another molecule. It's a transaction essential to more than a hundred processes in the body, from the brain to the bones. Levels of SAM-e are notably lower amongst depressed people of all ages.
Because of the universal nature of methylation, SAM-e has also been found to work well for arthritis and the liver, and may have other yet-to-be discovered uses. As to how the process applies to the brain, scientists still don't know. Their best guess is that SAM-e may affect neurotransmitters such as serotonin and dopamine or their receptors, but then again they could be wrong.
A 2002 meta-anaylasis of 28 studies commissioned by the Agency for Healthcare Research and quality, part of the US Department of Health and Human Services, found that SAM-e reduced HAM-D depression scores by 5.6 points, equating to a "clinically significant" partial response. The same analysis found that 11 studies that compared SAM-e to antidepressants lacked sufficient evidence to determin whether SAM-e was superior or inferior in efficacy to an antidepressant,
The authors of Stop Depression Now are quick to note that SAM-e may not be for everyone, and that deeply depressed or suicidal people should only take the supplement under a doctor's supervision. But they do set out a program for self-treatment for the rest of the population, especially for those who are not inclined to seek help in the first place. Perhaps easy access to SAM-e is a boon to these people, particularly if their other option is to suffer in silence, but for the purposes of this article anyone who acts as his own doctor has a fool for a patient.
Side Effects and Safety Concerns
The safety of SAMe during pregnancy and during breastfeeding is unknown.
People with bipolar disorder, anxiety disorders and other psychiatric conditions should only use SAMe under the supervision of their healthcare provider. SAMe has been associated with hypomania and mania.
The most common side effects are digestive complaints, particularly nausea. Other side effects include skin rash, lowered blood sugar, dry mouth, blood in the stool, thirst, increased urination, headache, hyperactivity, anxiety and insomnia.
People with Parkinson's disease should avoid SAM-e.
Benadryl(Diphenhydramine hydrochloride)
*It's a antihistamine
*Used to treat Anxiety
Antihistamines
Antihistamines are often sedating and so are sometimes used for the treatment of anxiety disorders; the sedation has a quick onset, and rapid relief from anxiety symptoms is observed. However, antihistamines have not been evaluated effectively for the treatment of anxiety disorders in controlled clinical trials.
Histamine is a neurotransmitter that plays an important role in arousal. The arousing effect is mediated through the histamine H1 receptor and is attenuated by antihistamines. Antihistamines induce drowsiness, sedation and, in high dosages, impair psychomotor performance of complex tasks (Schwartz et al, 1991). Mild tolerance to the sedative effects may occur with long term use. The effects of antihistamines on the autonomic nervous system are mixed. They have anticholinergic properties, causing dry mouth, increased heart rate and decreased gastro intestinal activity. They have no direct effect on the muscular system (Hoehn-Saric, 1998). Antihistamines appear predominantly to affect hyperarousal. They decrease vigilance and hyper-alertness, but have little effect on psychic anxiety.
Antihistamines have many potential side effects, including disturbed co-ordination, weakness, inability to concentrate, urinary frequency, palpitations and hypotension. In addition, their anticholinergic properties make them poor choices for patients taking other anticholinergic agents, such as TCAs, neuroleptics and anti-arrhythmic agents.
Antihistamines have weaker anxiolytic effects than the BZDs(Benzodiazepines), and effective dosages of antihistamines may produce marked adverse effects. However, they remain popular because they have no abuse potential. They have an immediate effect in relieving acute anxiety symptoms, and can be administered in single doses or as a longer term prescription.
Just wanted to add I got some Benadryl (a generic version) yesterday. I was surper stressed pretty much having an anxiety attack and I have to say it worked pretty well. Very calming and sedating. It's not something I would use every day. But when it gets really bad I will for sure use it again.
I also think I may look in to trying some St. John's Wart.
I hope this was informative and helpful. |
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