medications – Page 8 – Broken Believers

Double Trouble: A Dual Diagnosis

What is the relationship between drug abuse and mental illness?

Many chronic drug abusers–the individuals we commonly regard as addicts–often simultaneously suffer from a serious mental disorder. Drug treatment and medical professionals call this condition a co-occurring disorder or a dual diagnosis.

What is chronic drug abuse?

Chronic drug abuse is the habitual abuse of licit or illicit drugs to the extent that the abuse substantially injures a person’s health or substantially interferes with his or her social or economic functioning. Furthermore, any person who has lost the power of self-control over the use of drugs is considered a chronic drug abuser.

What are some serious mental disorders associated with chronic drug abuse?

Chronic drug abuse may occur in conjunction with any mental illness identified in the American Psychiatric Association (DSM-IV). Some common serious mental disorders associated with chronic drug abuse include schizophrenia, bipolar disorder, manic depression, attention deficit hyperactivity disorder (ADHD), generalized anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder, panic disorder, and antisocial personality disorder. Many of these disorders carry with them an increased risk of drug abuse.

Disorders With Increased Risk of Drug Abuse

Antisocial personality disorder 15.5%
Manic episode 14.5%
Schizophrenia 10.1%
Panic disorder 04. 3%
Major depressive episode 04.1%
Obsessive-compulsive disorder 03.4%
Phobias 02.1%

Source: National Institute of Mental Health.

How prevalent are co-occurring disorders?

Co-occurring disorders are very common. In 2002 an estimated 4.0 million adults met the criteria for both serious mental illness and substance dependence or abuse in the past year.

Which occurs first–chronic drug abuse or serious mental illness?

It depends. In some cases, people suffering from serious mental disorders (often undiagnosed ones) take drugs to alleviate their symptoms–a practice known as self-medicating. According to the American Psychiatric Association, individuals with schizophrenia sometimes use substances such as marijuana to mitigate the disorder’s negative symptoms (depression, apathy, and social withdrawal), to combat auditory hallucinations and paranoid delusions, or to lessen the adverse effects of their medication, which can include depression and restlessness.

In other cases mental disorders are caused by drug abuse. For example, MDMA or Ecstasy, produces long-term deficits in serotonin function in the brain, leading to mental disorders such as depression and anxiety. Chronic drug abuse by adolescents during formative years is a particular concern because it can interfere with normal socialization and cognitive development and thus frequently contributes to the development of mental disorders.

Finally, chronic substance abuse and serious mental disorders may exist completely independently of one another.

Can people with co-occurring disorders be treated effectively?

Yes, chronic drug abusers who also suffer from mental illness can be treated. Researchers currently are investigating the most effective way to treat drug abusers with mental illness, and especially whether or not treating both conditions simultaneously leads to better recovery. Currently, the two conditions often are treated separately or without regard to each other. As a result, many individuals with co-occurring disorders are sent back and forth between substance abuse and mental health treatment settings.

Source: http://www.justice.gov/ndic/pubs7/7343/index.htm

For more info on the Dual Diagnosis see: http://bipolar.about.com/cs/dualdiag/a/0008_dual_diag.htm

Lithium: Help for the Afflicted

Lithium (brand names Eskalith, Lithobid, Lithonate, and Lithotabs) is the most widely used and studied medication for treating bipolar disorder. Lithium helps reduce the severity and frequency of mania. It may also help relieve bipolar depression. Studies show that lithium can significantly reduce suicide risk. Lithium also helps prevent future manic episodes. As a result, it ma y be prescribed for long periods of time (even between episodes) as maintenance therapy.

Lithium acts on a person’s central nervous system (brain and spinal cord). Doctors don’t know exactly how lithium works to stabilize a person’s mood. However, it helps people with bipolar disorder have more control over their emotions and reduce the extremes in behavior. It usually takes one to two weeks for lithium to begin working.

Your doctor will want to take regular blood tests during your treatment because lithium can affect kidney function. Lithium works best if the amount of the drug in your body is kept at a constant level. Your doctor will also probably suggest you drink eight to 12 glasses of water or fluid a day during treatment and use a normal amount of salt in your food. Both salt and fluid can affect the levels of lithium in your blood, so it’s important to consume a steady amount every day.

The dose of lithium varies among individuals and as phases of their illness change. Although bipolar disorder is often treated with more than one drug, some people can control their condition with lithium alone.

Lithium Side Effects About 75% of people who take lithium for bipolar disorder have some side effects, although they may be minor. They may become less troublesome after a few weeks as your body adjusts to the drug. Sometimes side effects of lithium can be relieved by tweaking the dose. However, never change your dose or drug schedule on your own. Do not change the brand of lithium without checking with your doctor or pharmacist first. If you are having any problems, talk to your doctor about your options.

Common side effects of lithium can include:

Hand tremor (If tremors are bothersome, an additional medication can help.)
Increased thirst
Increased urination
Diarrhea
Vomiting
Weight gain
Impaired memory
Poor concentration
Drowsiness
Muscle weakness
Hair loss
Acne
Decreased thyroid function (which can be treated with thyroid hormone)

Notify your doctor if you experience persistent symptoms from lithium or if you develop diarrhea, vomiting, fever, unsteady walking, fainting, confusion, slurred speech, or rapid heart rate. Tell your doctor about history of cancer, heart disease, kidney disease, epilepsy, and allergies. Make sure your doctor knows about all other drugs you are taking. Avoid products that contain sodium, such as certain antacids. While taking lithium, use caution when driving or using machinery and limit alcoholic beverages.

If you miss a dose of lithium, take it as soon as you remember it — unless the next scheduled dose is within two hours (or six hours for slow-release forms). If so, skip the missed dose and resume your usual dosing schedule. Do not “double up” the dose to catch up. There are a few serious risks to consider. Lithium may weaken bones in children. The drug has also been linked to birth defects and is not recommended for pregnant women, especially during the first three months. Breastfeeding isn’t recommended if you are taking lithium. Also, in a few people, long-term lithium treatment can interfere with kidney function.

A word of encouragement. I’ve been taking 12oo mg of Lithium twice a day for over three years now, with just minor side effects. (Mostly a bad hand tremor.) Taking Lithium has stabilized me and protected me from my more bizarre behavior.

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Reviewed by the doctors at The Cleveland Clinic Department of Psychiatry and Psychology.

http://www.webmd.com/bipolar-disorder/bipolar-disorder-lithium

“Let There Be Zoloft!”

A “tongue in cheek” evaluation of Zoloft, my personal fav as I work through my own depression.

“Seeking to broaden the customer base of the popular drug, Pfizer announced the launch of a $40 million “Zoloft For Everything” advertising campaign Monday. “Zoloft is most commonly prescribed for the treatment of depression and anxiety disorders, but it would be ridiculous to limit such a multi-functional drug to these few uses,” Pfizer spokesman Jon Pugh said. “We feel doctors need to stop asking their patients if anything is wrong and start asking if anything could be more right.”

Continued Pugh: “How many millions of people out there are suffering under the strain of a deadline at work or pre-date jitters, but don’t realize there’s a drug that could provide relief? Zoloft isn’t just for severe anxiety or depression. Got the Monday blues? Kids driving you nuts? Let Zoloft help. Zoloft.” Zoloft (sertraline hydrochloride) was originally introduced as a means of treating depression, post-traumatic stress disorder, panic disorder, and obsessive-compulsive disorder.

In January of this year, however, Pfizer won FDA approval for use of Zoloft to treat premenstrual dysphoric disorder, as well as social-anxiety disorder, or “social phobia.” Last week, the FDA okayed Zoloft for treatment of “the entire range of unpleasant or otherwise negative social, physical, and mental feelings that an individual may experience in the course of a human life.” “At first, Zoloft was only used to treat depression,” Pugh said. “But what is depression, really? Who died and gave doctors the authority to dictate who is and isn’t depressed? One man’s hangnail could be another man’s darkest depths of despair. Isn’t medication a tool to help people lead better, happier lives? Access to drugs should not be restricted to those the medical community officially deems ‘sick.'”

Pfizer president James Vernon said the “Zoloft For Everything” campaign will employ print and TV ads to inform potential users about the “literally thousands” of new applications for Zoloft. Among the conditions the drug can be used to treat: anxiety associated with summer swimsuit season, insecurity over sexual potency and performance, feelings of shame over taking an antidepressant, and a sense of hollowness stemming from losing an online auction. A Zoloft ad is slated to run in next week’s issue of People.

In today’s fast-paced world, Vernon said, people don’t have time to deal with mood changes. “Zoloft has always helped clinically depressed people modulate serotonin levels and other chemical imbalances that make life unlivable for them,” Vernon said. “But now, Zoloft can also help anyone who needs their emotions leveled off. Do you find yourself feeling excited or sad? No one should have to suffer through those harrowing peaks and valleys.”

Anita White of Yuma, AZ, sought out Zoloft after seeing one of the new commercials. “I was sitting on the couch, just watching TV, and, for the life of me, I couldn’t motivate myself to go down to the basement to do the laundry,” White said. “Luckily, a Zoloft ad came on right at that moment went to their web site and, sure enough, one of the ‘Is Zoloft Right For You?’ quiz questions was, ‘Are you unable to motivate yourself to go down to the basement to do the laundry?’ That’s when I knew.”

Other pharmaceutical companies are following Pfizer’s lead. On Tuesday, Paxil manufacturer GlaxoSmithKline unveiled its new ad slogan, “Paxil… Give It A Try.” Eli Lilly, maker of Prozac, is slated to launch a similar campaign built around the slogan, “Pot Roast Burnt? Husband Home With The Flu? You’re Having One Of Those Prozac Days.” “We are letting consumers know that if they suspect Zoloft might improve the quality of their lives, they should contact their doctor,” Pugh said.

“And remember, you’ll need to take Zoloft for at least eight weeks to make sure it’s working.” Pugh warned that Zoloft use may cause side effects such as agitation, erratic behavior, restlessness, difficulty speaking, or shaking of hands and fingers. He added that Zoloft can help those suffering from agitation, erratic behavior, restlessness, difficulty speaking, and shaking of hands and fingers.

http://www.theonion.com/content/node/28349