One of the most common side effects of anti psychotic drugs is weight gain. Even the newer anti psychotics like olanzapine and risperidol have been associated with weight gain. There are a number of individuals who will not take their anti psychotic medications because of this disturbing side effect.
Over the years, it has become known that individuals who take anti psychotics do develop a multitude of complications related to weight gain and in fact, these individuals do have a higher death rate than the average population. Why weight gain occurs with these anti psychotic drugs is not full known but is believed to be related to genes or a biochemical change in the brain.
There is evidence that some individuals may have genetic make-up, which causes the drugs to influence their eating habits. This is just speculation because the majority of individuals who take anti psychotics put on weight. The anti psychotics do not discriminate against any gene(s), race, gender, age, color, or ethnicity- everyone gain weight.
A few recent animal studies have shown that anti psychotics drugs can increase the activity of an enzyme known as the appetite-regulating enzyme commonly known as AMPK. Further, all anti psychotics also limit the ability of insulin to work; the resulting insulin resistance has also been associated with weight gain.
So what are the treatment options for these individuals?
Well to begin with, all individuals who take anti psychotics should be encouraged to eat healthy and enter into an exercise program. A decrease in calorie consumption is important.
A single study from China showed that the anti diabetic drug, metformin, did reverse the weight gain induced by anti psychotics. These effects were observed in diabetics who were on anti psychotic drugs. Metformin should not be taken by individuals with normal blood sugar because this can lead to a severe lowering of blood sugars, that can be life threatening. This may not be of great importance in China but in North America prescribing a diabetic drug to a non-diabetic is one “great method” of generating a medical malpractice claim.
Unfortunately, all anti psychotics induce weight gain, so switching to a different medication is useless.
For the time being, there is no magic bullet to solve weight gain induced by anti psychotics. Adhering to a strict diet and exercise is probably the best advice- the point is that many people simply are not motivated.
Sunday, March 8, 2009
Pristiq- a newer antidepressant
Recently the FDA approved a new anti depressant called Pristiq. Known as desvenlafaxine, it has been in use for about 10 months. It works like the other anti depressant medications and brings back the balance of certain neurotransmitters in the brain. Pristiq is quite long acting and is taken once a day. Just like the earlier generation of anti depressants, it also has a few side effects that include:
Nausea
Lightheaded
Excess sweating
Constipation
Generalized tiredness
Diminished appetite
Anxiety, apprehension
Decrease libido in men
While Pristiq does not cure depression, it remains an option for individuals who do not respond to the older anti depressants. The other advantage of Pristiq is that it has been shown to be an excellent drug for treatment of melancholia that occurs during menopause.
From recent clinical trials, it has been shown that about 70% of individual with major depression do respond to Pristiq. Further, the trials also showed that remission rates for Pristiq were much lower than the older anti depressants. Whether the drug works for chronic depression has not been fully evaluated.
Nausea
Lightheaded
Excess sweating
Constipation
Generalized tiredness
Diminished appetite
Anxiety, apprehension
Decrease libido in men
While Pristiq does not cure depression, it remains an option for individuals who do not respond to the older anti depressants. The other advantage of Pristiq is that it has been shown to be an excellent drug for treatment of melancholia that occurs during menopause.
From recent clinical trials, it has been shown that about 70% of individual with major depression do respond to Pristiq. Further, the trials also showed that remission rates for Pristiq were much lower than the older anti depressants. Whether the drug works for chronic depression has not been fully evaluated.
Wednesday, March 4, 2009
Herbs and Anxiety
Anxiety can be a troublesome disorder often associated with both physiological and psychological changes in the body. The emotional and behavioural symptoms can be very unpleasant and typically include apprehension, excessive worry or a feeling of impending doom. In most people, anxiety is a typical response to stress and helps one cope with a difficult situation. However, in some individuals the symptoms do become excessive and start to dictate behavior.
The majority of individuals who have chronic anxiety are referred to a psychiatrist or a psychologist. The treatment of anxiety is often a combination of drug therapy and cognitive behavior counseling. However, a number of individuals do poor with conventional medical therapies and have started to seek out alternative health care remedies. One of these therapies is the use of herbs.
There have been a number of herbs which have been evaluated for their role in treating anxiety. The most common herbs used to treat anxiety are kava, passion flower, valerian and theanine.
Kava has been the most studied and is probably the one which is the most sold in health food stores. Several short term studies have shown that it can reduce anxiety in within a few days after starting the herb. The majority of individuals who have taken kava are now unwilling to take any conventional medications.
However, recently there have been reports of Kava and liver damage. There are reports in the literature that after short term use Kava can induce a form of hepatitis and liver failure. In Europe, Kava has been banned from health food stores. In the USA, the FDA has issued warnings to health stores about this herb. Kava is currently widely available in the USA and the FDA is still deciding on its future.
Passion flower, valerian and theanine have also been shown to reduce anxiety and are considered safe. So far the side effects reported have been mild and of a short duration.
One of the major problem with herbs is that the quality and quantity is variable in each formulation. Herbs are sold as dietary supplements and thus often do not undergo the strict quality control required of a drug. Recent reports also indicate that many herbal products from the orient have contaminants; and fake products are not unheard of.
So if you are considering taking a herbal supplement for your anxiety, discuss this with your health care provider. Even though herbs are cheaper than pharmaceutical medications, you do not want to end up paying more to treat complications of these natural remedies.
The majority of individuals who have chronic anxiety are referred to a psychiatrist or a psychologist. The treatment of anxiety is often a combination of drug therapy and cognitive behavior counseling. However, a number of individuals do poor with conventional medical therapies and have started to seek out alternative health care remedies. One of these therapies is the use of herbs.
There have been a number of herbs which have been evaluated for their role in treating anxiety. The most common herbs used to treat anxiety are kava, passion flower, valerian and theanine.
Kava has been the most studied and is probably the one which is the most sold in health food stores. Several short term studies have shown that it can reduce anxiety in within a few days after starting the herb. The majority of individuals who have taken kava are now unwilling to take any conventional medications.
However, recently there have been reports of Kava and liver damage. There are reports in the literature that after short term use Kava can induce a form of hepatitis and liver failure. In Europe, Kava has been banned from health food stores. In the USA, the FDA has issued warnings to health stores about this herb. Kava is currently widely available in the USA and the FDA is still deciding on its future.
Passion flower, valerian and theanine have also been shown to reduce anxiety and are considered safe. So far the side effects reported have been mild and of a short duration.
One of the major problem with herbs is that the quality and quantity is variable in each formulation. Herbs are sold as dietary supplements and thus often do not undergo the strict quality control required of a drug. Recent reports also indicate that many herbal products from the orient have contaminants; and fake products are not unheard of.
So if you are considering taking a herbal supplement for your anxiety, discuss this with your health care provider. Even though herbs are cheaper than pharmaceutical medications, you do not want to end up paying more to treat complications of these natural remedies.
Collectors of Garbage- Hoarding Part 1
One typical feature of hoarding that immediately leads one to suspect hoarding is the amount of clutter and junk surrounding the home. A common scenario that almost all compulsive hoarders display is the inability to get around/sleep in their own bedroom because of the amount of junk. Hoarding is not only limited to the bedroom or the home. Most hoarders store items in cars, garages, at friend’s homes, in the shed and even in rental spaces.
Many individuals who compulsively hoard items, have improbable fears relating on whether to dispose of their useless belongings. These deceptive beliefs include anxiety, guilt and embarrassment. There is some evidence that indicates that hoarders use the accumulated junk as a form of reassurance and safety.
Hoarding may sound like a harmless thing but it is far more serious and can affect daily living. The diagnosis of hoarding is relatively easily made by a mental health care expert.
The treatment of hoarding unfortunately is quite difficult.
Most of these individuals do not believe they are hoarding and stubbornly refuse to seek help. The two types of treatments currently available to treat hoarding include psychotherapy and medications. Both Cognitive behavior therapy and various serotonin reuptake inhibitors have made some difference in the lives of hoarders but relapse rates are high. Cessation of treatment is often associated with relapse.
Because the disorder is so poorly understood, there is no preventive method.
Many individuals who compulsively hoard items, have improbable fears relating on whether to dispose of their useless belongings. These deceptive beliefs include anxiety, guilt and embarrassment. There is some evidence that indicates that hoarders use the accumulated junk as a form of reassurance and safety.
Hoarding may sound like a harmless thing but it is far more serious and can affect daily living. The diagnosis of hoarding is relatively easily made by a mental health care expert.
The treatment of hoarding unfortunately is quite difficult.
Most of these individuals do not believe they are hoarding and stubbornly refuse to seek help. The two types of treatments currently available to treat hoarding include psychotherapy and medications. Both Cognitive behavior therapy and various serotonin reuptake inhibitors have made some difference in the lives of hoarders but relapse rates are high. Cessation of treatment is often associated with relapse.
Because the disorder is so poorly understood, there is no preventive method.
Collectors of Garbage- Hoarding Part
Hoarding is the repetitive compilation of excessive amounts of impractical items which are of little or no value. The hoarder never discards any items. The exact cause of hoarding remains a puzzle but has been linked to disturbances in emotional and obsessive compulsive disorders (OCD).
While most people collect inanimate objects, there are some hoarders who also collect animals like dogs and pets; and simply let the filth pile up.
Even though hoarding has been observed for centuries, detailed research on the topic was not done until the 90s. Hoarding is also seen in a variety of mental health disorders like schizophrenia, dementia and some eating disorders.
The vast majority of normal people who hoard items have obsessive compulsive disorder. Of course, not all patients with OCD exhibit hoarding but research indicates that at least 25% of these adults with OCD exhibit some degree of hoarding practices. Hoarding is twice as more common in males than in females.
While most people collect inanimate objects, there are some hoarders who also collect animals like dogs and pets; and simply let the filth pile up.
Even though hoarding has been observed for centuries, detailed research on the topic was not done until the 90s. Hoarding is also seen in a variety of mental health disorders like schizophrenia, dementia and some eating disorders.
The vast majority of normal people who hoard items have obsessive compulsive disorder. Of course, not all patients with OCD exhibit hoarding but research indicates that at least 25% of these adults with OCD exhibit some degree of hoarding practices. Hoarding is twice as more common in males than in females.
Sunday, March 1, 2009
Bulimia -- A Serious Eating Disorder
Bulimia is a complex eating disorder which is associated with a preoccupation with body weight and shape. Individuals afflicted with bulimia judge themselves unsympathetically and find apparent faults with every feature of their body.
The desire to create an aesthetically pleasing body leads one to engage in episodes of binging and purging. This usually means eating huge amounts of food and then disposing the food by self-induced vomiting or extremes of exercise. Bulimia is a disorder where one is ensnared in a secret inner world of disgrace, shame, disgust and a bizarre relationship with food.
Bulimia is not a trivial eating disorder and can be associated with potentially a life threatening complications.
The individual may have a preoccupation with food, but this is ultimately related to the disturbance in self image that can cause serious long term problems. Over time, most individuals with bulimia develop physical symptoms like damaged teeth and gums, recurrent sores in the mouth, excessive fatigue, dry skin and menstrual irregularities. The behavior symptoms may vary from constant eating, excessive exercising, hoarding foods, depression, anxiety and a preoccupation with body shape. The majority of these individual have a distorted negative image about their body.
The cause of bulimia remains unknown but has been linked to socio-cultural issues and a desire to be thin.
The treatment of bulimia is complex and multidisciplinary. Most individuals require a combination of psychotherapy, anti depressant medications and nutritional therapy. The disorder is challenging and many individuals with bulimia are not able to fully recover despite maximum therapy. Cycles of binging and purging may come and go throughout life.
To prevent relapse, it is essential that one learn methods to cope with body image, develop healthy family relationships and manage stress in an effective way.
The desire to create an aesthetically pleasing body leads one to engage in episodes of binging and purging. This usually means eating huge amounts of food and then disposing the food by self-induced vomiting or extremes of exercise. Bulimia is a disorder where one is ensnared in a secret inner world of disgrace, shame, disgust and a bizarre relationship with food.
Bulimia is not a trivial eating disorder and can be associated with potentially a life threatening complications.
The individual may have a preoccupation with food, but this is ultimately related to the disturbance in self image that can cause serious long term problems. Over time, most individuals with bulimia develop physical symptoms like damaged teeth and gums, recurrent sores in the mouth, excessive fatigue, dry skin and menstrual irregularities. The behavior symptoms may vary from constant eating, excessive exercising, hoarding foods, depression, anxiety and a preoccupation with body shape. The majority of these individual have a distorted negative image about their body.
The cause of bulimia remains unknown but has been linked to socio-cultural issues and a desire to be thin.
The treatment of bulimia is complex and multidisciplinary. Most individuals require a combination of psychotherapy, anti depressant medications and nutritional therapy. The disorder is challenging and many individuals with bulimia are not able to fully recover despite maximum therapy. Cycles of binging and purging may come and go throughout life.
To prevent relapse, it is essential that one learn methods to cope with body image, develop healthy family relationships and manage stress in an effective way.
Post Partum Blues - Common But Not Serious
It is estimated that 50%-80% of all new mothers go through a phase which is described as post partum blues. The disorder is quite well known, but only recently has the magnitude of the problem been realized among health care professionals. Unlike post partum depression, post partum blues is much milder in the intensity of symptoms and is short lived.
Post partum blues typically presents several days after giving birth and lasts about 2 weeks. The symptoms appear and disappear without any premonition. The typical symptoms one may experience include:
- irritability
- anxiety
- crying without reason
- mood swings which vary from sadness to loneliness
- impatience
- difficulty sleeping
Post partum blues are said to occur because of the abrupt decline in levels of sex hormones after delivery. The symptoms may also be aggravated by the physical stress of a long pregnancy and childbirth. Postpartum blues is also more pronounced in women who develop anxiety over the responsibility of looking after the baby.
In general, there is no treatment required for postpartum blues; the disorder simply disappears on its own. However, in the mean time, it is essential that one eat healthy, exercise and join a social support group. A change in scenery or lifestyle may also help the recovery. For all women, if the symptoms of post partum blues persist beyond 2-3 weeks and interfere with your lifestyle or daily activities, it is important to see a health care professional.
Post partum blues typically presents several days after giving birth and lasts about 2 weeks. The symptoms appear and disappear without any premonition. The typical symptoms one may experience include:
- irritability
- anxiety
- crying without reason
- mood swings which vary from sadness to loneliness
- impatience
- difficulty sleeping
Post partum blues are said to occur because of the abrupt decline in levels of sex hormones after delivery. The symptoms may also be aggravated by the physical stress of a long pregnancy and childbirth. Postpartum blues is also more pronounced in women who develop anxiety over the responsibility of looking after the baby.
In general, there is no treatment required for postpartum blues; the disorder simply disappears on its own. However, in the mean time, it is essential that one eat healthy, exercise and join a social support group. A change in scenery or lifestyle may also help the recovery. For all women, if the symptoms of post partum blues persist beyond 2-3 weeks and interfere with your lifestyle or daily activities, it is important to see a health care professional.
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