A recent research paper published in the British Medical Journal reported that taking serotonin reuptake antidepressants (SSRIs) like fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft) during the second half of a woman’s pregnancy could more than double the risk that babies will develop persistent pulmonary hypertension of the newborn (PPHN).

This finding supports a warning issued by the FDA during 2006 that alerted women that those taking SSRIs were six times more likely to deliver babies with PPHN.

PPHN is high blood pressure in the arteries of the lungs.  It causes the right ventricle of the heart—which must pump blood through the lungs to pick up oxygen—to work harder too hard.  This can ultimately cause weakening of the heart and heart failure.

Pulmonary hypertension affects about 1 in 1,000 newborns, but more than double that number of newborns of mothers taking antidepressants in the second half of their pregnancies seem to be affected.  and an increased risk—though lower—appears to be present in those babies born to mothers who take the antidepressants in the first half of their pregnancies, too.

Antidepressants of one kind or another have been implicated in—but not proven to be absolutely responsible for—increasing the risk of low birth weight, prematurity and low blood sugar.

So, women should stop antidepressants when they learn they are pregnant, right?  not exactly.  There are reasons to stop and there are reasons to continue.

First of all, the British Medical Journal data is unreliable.  The study did not exclude other causes of pulmonary hypertension that might, for some reason, be more common in depressed women taking antidepressants but not be due to the antidepressants themselves.  Mothers who are overweight, diabetic or asthmatic also deliver children at increased risk.  some studies suggest children of mothers who deliver by cesarean section are, too.  is it possible that these mothers are also more likely to use antidepressants and that their other characteristics are the concerning ones—not the medicine itself?

Secondly, the study also found that having been psychiatrically hospitalized prior to pregnancy increased the risk of pulmonary hypertension in newborns, whether or not a mother was no taking antidepressants before delivering.  could it be that depression in mothers causes pulmonary hypertension in newborns?

Third, it is not clear whether stopping antidepressants during pregnancy might lead to withdrawal affects in women and their fetuses, with unknown consequences.

And, fourth, it is not clear at all what the toll of untreated maternal depression might be on fetuses and newborns.

So, my advice is this:  1) If you are a woman considering pregnancy, try to stop or not to start antidepressants—as long as your symptoms are relatively mild.  If you require treatment for depression, try psychotherapy or transcranial magnetic stimulation (rTMS), which treats depression with magnetic pulses delivered to the head and which has no known contraindications in pregnancy.  But if you have serious symptoms of depression, use SSRIs, with the advice and under the care of your physician.

2) If you find out you are pregnant while you are already taking antidepressants, talk to your doctor about very slowly stopping them, but only if you can do so safely, without severe symptoms of depression returning.

3) Never stop antidepressants all of a sudden.  This can cause serious symptoms that affect you and your unborn child.  and do not stop antidepressants if the consequences will be moderate to severe symptoms like low mood, tearfulness, sleeplessness or decreased or increased appetite.

4) do not stop antidepressants during pregnancy if you have become suicidal while depressed in the past and antidepressants have been necessary to ward off thoughts of harming yourself.

As a final note, while many obstetricians and many primary care doctors are comfortable treating depression, I believe it is best to be seen by a psychiatrist if you are taking antidepressants and want to have a baby.  

Dr. Ablow is the author of “Inside the Mind of Casey Anthony.” He is a psychiatrist and member of the Fox News Medical A-Team. Dr. Ablow can be reached at . His team of Life Coaches can be reached at .

Question: You recently wrote about a woman who was angry that her body couldn’t do what it used to do. As the younger wife of an 82-year-old man, I can understand her anger. In my husband’s case there is an accompanying depression that was not relieved by a brief attempt at taking antidepressants, which caused a multitude of side effects. how are older people expected to deal with anger and depression? Are there support groups or counseling for them? how do they reach a level of acceptance? Thank you.

- T.R.

Dear T.R.:

You’ve raised an important issue.

Let’s start with the subject of anger. In our younger years, we may have become angry when someone cut us off on the freeway or got a raise when we didn’t. In later life, reasons for anger may be different. often it’s when our bodies betray us and don’t permit us to do what we want to do – in the same ways we have always done it.

It’s easy to get angry.

The aging process is not always idyllic. Late life events such as an inability to participate in once-cherished activities or suffering from chronic debilitating diseases can take a heavy toll on an older person’s emotional well-being – to say the least.

Failing eyesight, health loss and other physical changes can cause sadness, anxiety, loneliness, withdrawal and apathy.

Yet anger is a normal emotion; excessive anger is not.

A more serious outcome of personal loss is chronic depression that can have alarming physical effects on older adults. we know the mortality rate for older men and women suffering from depression and loneliness is higher than for those reporting satisfaction with their lives.

Note that depression is not part of the normal aging process although, according to the nonprofit group Mental Health America, more than half of older Americans think it is. that is one reason it is ignored.

According to the National Institute on Aging (NIA), signs of depression are more varied among older adults than among the younger population.

Symptoms can appear as increased tiredness and being grumpy or irritable. Depression also can be manifested as confusion or attention problems that resemble symptoms of Alzheimer’s disease or other brain disorders.

The NIA further reports that for most people, depression will get better with treatment: “You do no need to suffer.”

The first step is to get help. In general, men are more reluctant then women to seek professional services.

If you have not already done this, begin with your family doctor. The NIA suggests that a physician should check to determine if the depression is caused by a health issue such as hypothyroidism, a vitamin B-12 deficiency or a medication.

Next, consider speaking with a mental health professional. Doctors who are specially trained to treat depression in older adults are called geriatric psychiatrists.

Antidepressant drugs can help, and yes, there are side effects for some drugs for some people. if one drug creates a problem, it may be worthwhile to try another. It can take up to 12 weeks before it feels like an antidepressant is working.

Physical exercise, to the extent possible, and good nutrition, also play a role.

How to reach a level of acceptance is difficult. One approach is to emphasize what is working well and capitalizing on that. In a deep depression, however, it’s hard to even think about that. but as one feels better, that approach has a good chance to work.

The late Natalie Kaufman, who was legally blind due to macular degeneration and had limited mobility, used her ears, voice and soul extremely well. She listened to NPR, the news, classical music and books on tape. Additionally, each Friday morning she telephoned those facing losses and problems to wish them a good Sabbath.

Kaufman welcomed many people of all ages into her home, especially for her birthday parties.

This is just one example of making the best of what you have.

Support groups can be helpful both for you and your husband. Contact Beach Cities Health District at 310-374-3426, Ext. 155.

For a mental health professional, contact Bridges Psychiatric Services of Providence Little Company of Mary Medical Center San Pedro, at 310-514-5359. Bridges has a list of geriatric psychiatrists who evaluate and treat older adults with depression or other emotional difficulties.

T.R., best wishes in finding some relief for your husband.

Remember the message from the National Institute on Aging – one need not suffer. There are resources available in our community to make life better – even good.

Helen Dennis is a specialist in aging, with academic, corporate and nonprofit experience. Send her your questions and concerns in care of the Daily Breeze, 21250 Hawthorne Blvd., Torrance, CA 90503, or e-mail to helendenn@aol.com.

Drug trade name- Effexor, Effexor XR

Generic name- Venlafaxine

Group- Selective Serotonin and Norepinephrine Reuptake Inhibitors (SSNRIs)

Introduction and quick Information about Effexor:

Effexor (venlafaxine) is one of the effective antidepressants, which is included in the class of drugs known as SSNRIs (Selective Serotonin and Norepinephrine Reuptake Inhibitors). it is approved for the treatment of generalized anxiety disorder, major depressive disorder (MDD), and comorbid indications in certain anxiety disorders with depression.

Effexor works by affecting the chemical messengers. These chemical messengers are called neurotransmitters. These neurotransmitters can travel to the close by nerve cells and can make them less or more active. most of the experts believe that any imbalance in these neurotransmitters can lead to depression and anxiety. Venlafaxine is supposed to work by affecting the neurotransmitters.

Is Effexor Approved by FDA?

On 28 June, the U.S. FDA (Food and Drug Administration) had approved the very first generic version of Effexor XR capsules for the treatment of major depressive disorder.

Usage and Benefits of Effexor:

Effexor (venlafaxine hydrochloride) is a prescription medication, which has been licensed for the treatment of depression. Depression is something more than just “feeling sad”. Common depression symptoms include:

• Sleep changes (sleeping not enough or too much)
• Eating too little or too much (weight loss or weight gain)
• Physical pain
• Suicidal thoughts
• Feeling worthless or hopeless

Effexor is proven to help those adults who are suffering from depression. However, you should keep one thing in your mind that most of the antidepressants including Effexor generally take several weeks to show its effectivity. Hence, it is quite important to give this medication a chance to work before you become discouraged.

Although this fact is not properly clear how Effexor works to treat the nerve pain, it seems that Effexor can help to block the signals of nerve pain in the brain or spinal cord. this further assists in relieving the pain associated with peripheral diabetic neuropathy.

Occasionally, your medical practitioner may recommend this drug for the treatment of something, which is other than the above-mentioned conditions. this is known as the “off-label” use. some of the off-label uses of Effexor may involve the treatment of:

• Diabetic neuropathy
• Hot flashes during menopause
• Fibromyalgia
• Obesity
• Generalized anxiety disorder (GAD)
• Migraines
• Social anxiety disorder (social phobia)
• Obsessive-compulsive disorder (OCD)

However, before taking drug off-label, you need to first confirm whether this drug can actually treat the condition or not. so always consult a doctor for this purpose.

Side Effects of Effexor:

These are some of the possible side effects associated with Effexor. if you encounter any of the above mentioned side effects, then call for the emergency medical help to prevent serious health complications.

General Recommended Dosages of Effexor:

Always use Effexor in the exact amount as the healthcare provider recommends it. Taking double dose or dose in larger quantity may aggravate your present health condition. the directions mentioned on the prescription label should be followed properly.

Just take this drug with one full glass of water. you can also take it with or without your meals.

If you are taking the controlled-release capsule i.e. Effexor XR, then take it as a whole without chewing, breaking or crushing. To make this drug easy to swallow, you can open the capsule form and then sprinkle the inside-stuff into a small quantity of apple sauce.

It may require around four weeks or more for the symptoms to get improve. keep on taking Effexor as directed by the doctor and tell your doctor if your symptoms do not improve even after four or five weeks of treatment. Also, do not stop the use of Effexor abruptly; otherwise, you may have to face unpleasant symptoms.

In case I Miss my Dose?

In case you have missed your dose, then you can simply take it the time you remember it. However, if it is almost the time to take the scheduled dose, then you can miss the missed one. But don’t take any extra medicine to make up for the missed dose.

In case I take Overdose?

Overdose symptoms of this drug include fast heart rate, vomiting, extreme drowsiness, blurred vision or seizure. Look for medical assistance in case you have taken the medicine in extra amounts, may be by mistake or intentionally.

Drug Interactions of Effexor:

Before using Effexor, inform your doctor if you are using any other medicines, which make you feel sleepy like in case of allergies, or cold medicine, narcotic pain medicine, sedatives, muscle relaxers, sleeping pills and medicine for anxiety or seizures.

Also inform your healthcare provider if you are using:

• ketoconazole (Nizoral)
• cimetidine (Tagamet HB, Tagamet)
• linezolid (Zyvox)
• tramadol (Ultracet, Ultram)
• lithium (LithoBid, Eskalith)
• risperidone (Risperdal) or haloperidol (Haldol)
• warfarin (Coumadin)
• tryptophan
• frovatriptan (Frova), almotriptan (Axert), naratriptan (Amerge), sumatriptan (Imitrex), zolmitriptan (Zomig) or rizatriptan (Maxalt)
• any antidepressant like amoxapine (Asendin), amitriptyline (Elavil), citalopram (Celexa), desipramine (Norpramin), clomipramine (Anafranil), escitalopram (Lexapro), fluvoxamine (Luvox), fluoxetine (Prozac), nortriptyline (Pamelor), imipramine (Tofranil), protriptyline (Vivactil), paroxetine (Paxil), trimipramine (Surmontil) or sertraline (Zoloft)

This is not a complete list of medications, which can interact with Effexor. there might be many other drugs, so you should tell your physician about all the medicines and prescriptions you take. After all, safety is in your hands.

Life style and Food Habits you must follow when on Effexor:

If you really want that your treatment should work properly, then you need to opt for a healthy lifestyle. if you always remain on a healthy tract, then you will certainly come out from your health problems soon. But, if you are living a life which is full of unhealthy habits, especially during Effexor treatment, you will be in a mess. Drinking too much of alcohol is included in the list of unhealthy habits. Well, it is not known whether alcohol can make the health condition worst or not, but yes, it will affect the treatment. After all, excess of anything is harmful.

Also, inform your doctor if you have seizures or epilepsy, kidney disease, cirrhosis or other liver disease, glaucoma, high blood pressure or bipolar disorder (manic depression). Remember that precautions and prevention are in your hand; hence, be cautious while dealing with this treatment.

How safe is Effexor for Pregnant Women or Nursing mothers?

Effexor can do harm to the nursing baby or pregnant lady. Hence, you should inform your healthcare provider in advance if you are expecting a baby, breast-feeding or planning to become pregnant.

Complications and Conditions possible due to Prolonged use of Effexor:

It is not known whether Effexor has habit-forming ability or not, but generally, it is seen that the prolonged use of any drug can make people addicted. Hence, you should not stop the use of Effexor suddenly after using it for long. first consult your doctor then take any step further.

Availability of the Effexor:

You can buy this drug from several FDA-approved drugstores as well as from internet too. you can come across lots of authorized online drug companies, which target to offer the specific drug along with its complete information so that you get the drug information before purchasing that.

I have been having anxiety, bad thoughts, anger, aggression. My neck and back hurts all the time and have bad headaches daily without relief. I was on celexa and vyvanze 50mg. Has anyone experienced this?

adderall and antidepressants BOTH made me aggressive, but the adderall was worse.

some people think that adderall and antidepressants are CAUSING bipolar disorder – go to madinamerica.com and read more about stimulants and antidepressants. In any case, it is well known that adderall and antidepressants can cause extreme anxiety and also cause aggression. i got panic attacks on antidepressants, and had constant, grinding anxiety while on adderall.

It seems your medications are causing these problems. There are behavioral interventions for ADHD. They aren't a quick fix, but in the long term, these interventions supposedly work better than medication. you would see a therapist for this help.

I was just wondering if anyone knows of a good herb over the counter, for symptoms of perimenopause and menopause symtoms that really helps. and do you know if it's safe? I'm so afraid to take anything, but my hot flashes at night are pretty bad. I can't take hrt yet because I still get my period. I"m actually pretty young for this. I'm not quite 41 yet and this has been going on for about 2 years. my dr. put me on antidepressants because they help with hot flashes, but I weaned off of them recently because I heard they can age your face. anyway if anyone personally knows of anything that can help please let me know. and is it safe?!
Thanks!

Q. Is it safe to take antidepressants during pregnancy?

A. It’s estimated that between 14 percent and 23 percent of women experience symptoms of depression during pregnancy, so many women have to decide whether or not to take antidepressant medications. The issue has also sparked a great deal of scientific debate. But the research so far has not been able to tease apart whether an increased risk of some health problems in women who take antidepressants during pregnancy and in their newborns is tied to the drugs or to the depression.

Some studies have linked antidepressant use to a higher risk of rare birth defects as well as preterm birth and lower birth weight, but the evidence is conflicting. Women with severe untreated depression may be prone to behaviors that put them and their newborns in jeopardy. “The challenge for women and physicians is to balance the risks of using medication during pregnancy with the risk of untreated depression,’’ says Sengwee Darren Toh, an instructor of medicine at Harvard Medical School and the Harvard Pilgrim Health Care Institute who has researched this subject.

He emphasizes that women should discuss with their doctor the right strategy based on their specific health situation and risks. Women with mild depression can often avoid medications, but the risk of letting moderate or severe depression go unchecked may be too high.

In 2009, the American Psychiatric Association and The American College of Obstetricians and Gynecologists issued a joint set of recommendations on the issue. according to these guidelines, women who have been taking antidepressants and experienced only mild or no symptoms for six months before pregnancy should consider gradually stopping medication. Women who still have symptoms, have recurrent depression, or who become depressed during pregnancy and want to avoid drug treatment may choose psychotherapy, alone or as a supplement to medication. Women with severe depression are advised to stay on medication, and any woman with suicidal or psychotic symptoms should seek treatment immediately.

© Copyright 2010 Globe Newspaper Company.

Ive had a couple of panic attacks for the past month and have some symptoms. One of them is that I have loss my appetite, but its weird because I can eat things that I really enjoy eating. I get sweaty hands all the time but its not like im having a panic attacks at the time. Also when I go outside or something it feels like the world outside looks like a dream. I get panicky sometimes when that happens. I dont know what to do anymore, any help would be appreciated THANKS

Negative emotions (like sadness, stress, anger, etc.) causes your Serotonin production to be low; when your Serotonin level is low, you are more prone to getting Anxiety, Panic Attacks, Depression, etc.

Medication like Antidepressants (SSRI – Selective Serotonin Reuptake Inhibitor) helps to boost Serotonin level.
But there are natural ways to do it without medication. There's this strange herb called "St John's Wort" – it is said to be more effective than Prozac. no, it is not for mild depression only and ignore those sayings. In fact, it does help anxiety and panic-attacks as St John's Wort works like prozac. other natural ways will be exercise, diet, more exposure to light, etc.

The problem is that, even if your Serotonin is balanced… you have that "learned behavior" in your mind. You need to break that initial cycle to destroy that learned behavior – Cognitive Behavior Therapy (CBT) does this. A technique that you can use without CBT will be Distraction… There are several other techniques to help cope them!
Ok, to use Distraction: Firstly, try to….

Extracted from Source.

Hi
I did a little research and discovered this great resource (ebook) that addresses this issue in detail.
You can thank me after you've read it.