Health Issues is a general health based blog concentrating on multiple health topics.

HOW DOES PROZAC AFFECT SUBCLINICAL DEPRESSION?

Monday, March 23rd, 2009

With the help of Prozac or other antidepressants, people can come out of the subclinical depressions hidden within personality disorders and feel better than they’ve ever felt before. This is particularly possible for patients who are given Prozac or other SSRIs, since the side effects are much milder than those associated with the traditional tricyclics and MAOIs. Like Prozac and the other SSRIs, the TCAs and MAOIs may also quickly eliminate the symptoms of depression. But the typical side effects of dry mouth, constipation, blurred vision, and weight gain are troublesome. With Prozac, the worst side effects—temporary nausea, insomnia for two to three days, or a jittery reeling—are temporary, and most patients find that their painful symptoms disappear in one to two weeks. When that happens, the distinctions between before and after become so crystal clear that these people may claim to feel better than they’ve ever felt in their lives-”better than normal,” thanks to the antidepressant’s effects on the hidden depressive symptoms. The therapist may call this a complex personality transformation. It has nothing to do with defense mechanisms, transference, or interpretation of dreams; it’s the antidepressant working effectively and biochemically on the serotonergic system at the synapses of the brain, a process which can alter symptoms of the unrecognized subclinical depression.

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Tags: Anti Depressants
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WHAT ARE THE MAJOR SCIENTIFIC FINDINGS REGARDING ANY POSSIBLE CONNECTION BETWEEN PROZAC AND SUICIDE?

Monday, March 23rd, 2009

An important study undertaken in 1991 by two Harvard psychiatrists analyzed the data of twenty-seven psychiatrists who had treated a total of 1017 depressed patients with various antidepressants. They recorded how many patients were given each kind of antidepressant; how many patients in each group were suicidal before beginning therapy (the total for the entire population was about 17%); how many in each group were not suicidal; and how many in each group were not suicidal before therapy but became so afterwards. This latter finding was the real purpose of this survey. The survey reported that:

* of the 231 non-suicidal patients who took Prozac, 3.5% became suicidal after initiating therapy;

* of the 62 non-suicidal patients who took Prozac in combination with a tricyclic antidepressant (TCA), 6.5% became suicidal;

* of the 385 non-suicidal patients who took a TCA alone or in combination with lithium, 1.3% became suicidal;

* of the 63 non-suicidal patients who took a Monoamine Oxidase Inhibitor (MAOI) antidepressant, not one became suicidal;

* of the 101 non-suicidal patients who took other antidepressants, 3% became suicidal.

The differences between these groups were not statistically significant except for the group given a combination of Prozac and a TCA.

An even more extensive study investigating the possible association between Prozac and suicidal acts and thoughts was published in the British Medical Journal. This report presented a retrospective analysts of data from seventeen double-blind trials involving 3065 patients with major depressive disorder. (This included data from my original research study on 120 depressed patients.) For five or six weeks, 1765 patients were put on Prozac, 731 received a tricyclic antidepressant, and 569 were given a placebo. These trials clearly showed that Prozac

was not associated with an increased risk of suicide or suicidal thoughts. The findings include the following:

• substantial suicidal thinking emerged in 1.2% of the patients taking Prozac, 3.6% of those on a TCA, and 2.6% of those taking a placebo;

• suicidal thinking became worse with 153% of those on Prozac, 16.3% of those on a TCA, and 17.9% of those who were given a placebo;

• in most patients, suicidal thinking lessened considerably with both antidepressants. 72.0% improved on Prozac compared to 54.8% on the placebo, and 72.5% improved on the TCA vs. 69.8% on the placebo;

• the pooled incidence of suicidal acts was 03% for Prozac, 0.4% for the TCAs, and 0.2% for the placebo;

• none of these differences were considered statistically significant.

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Tags: Anti Depressants
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CAN PROZAC BE SAFELY TAKEN DURING PREGNANCY? WILL IT HARM UNBORN CHILD?

Monday, March 23rd, 2009

A patient on Prozac who is pregnant or intends to become pregnant should notify her physician immediately. While studies in animals show that even with a dose of Prozac ten times larger than what is normally considered the maximum there is no evidence of harm to the fetus, adequate well-controlled studies have not yet been done with pregnant women. Since animal studies are not always predictive of what occurs in humans, it is a safer policy to avoid Prozac (and other antidepressants) while trying to conceive, or to withdraw from it if already pregnant. Only if a severe depressive relapse occurs should Prozac or other antidepressants be considered during pregnancy.

However, one substance requires a specific warning: lithium. Most studies, except one recent publication, have shown that lithium therapy throughout the first trimester of pregnancy and beyond may be associated with birth defects, especially in the cardiovascular system. Consequently, women who are taking lithium are advised to discontinue immediately if they are actively trying to become pregnant or have just conceived.

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Tags: Anti Depressants
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HOW LONG DOES PROZAC LAST IN THE BODY?

Monday, March 23rd, 2009

One way of answering this question is to look at the half-life. The pharmacologic term “half-life” is used to describe the time it takes for the drug in the blood to decrease by half of its original administered amount The half-life of Prozac is approximately one to three days, while the half-life of its breakdown metabolic product (metabolite), norfluoxetine, ranges from seven to fifteen days, meaning that Prozac and its metabolite leave the system gradually. In comparison with other antidepressants, including the SSRIs Paxil and Zoloft, the half-life of Prozac is extended. The half-life of Zoloft is about twenty-six hours and mat of Paxil about twenty-one hours.

The extended half-life of Prozac may have several advantages. First of all, upon discontinuation it is less likely to precipitate withdrawal symptoms man an antidepressant with a short half-life. Within only twelve hours after suddenly discontinuing a large dose of a tricyclic antidepressant or an MAOI medication, a patient may experience nausea, dizziness, vomiting, sleep disturbance, symptoms of rapid withdrawal, and even rebound hypomania or mania in bipolar depressions not simultaneously treated with lithium. Prozac’s extended half-life prevents these acute withdrawal symptoms.

The stable blood levels associated with an extended half-life may help prevent relapse when the dose is lowered or when the patient simply forgets to take the medication for a day or two.

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Tags: Anti Depressants
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