Anti-Depressants & Hypnosis Overview
The decade of the 1990’s was the time when anti-depressant research produced a whole new cadre of drugs to treat depression. In fact, the 1990’s have been referred to as the Prozac decade. The popularity of anti-depressants became widespread by advertising media coverage. Consequently, people began seeking treatment with anti-depressants for non-clinical depressive disorders. The practice of prescribing anti-depressants for non-clinical depressive disorders is common. Some of this practice is justifiable and warranted for other medical conditions treated by anti-depressants, but a significant portion of this practice is aimed at “mood brightening.” We live in a society that values feeling good…instantly and without effort. However, because the “mood-enhancing” qualities of these drugs are very subtle and often require weeks of use to be noticed, they are rarely of interest to the serious drug abuser.SSRIs
A new class of anti-depressants, the selective serotonin reuptake inhibitors (SSRIs), gained so much popularity in the 1990’s that many people began to use them to help brighten their moods and manage the challenges of stress in every day life. The SSRIs and other newer medications that affect neurotransmitters such as dopamine or norepinephrine generally have fewer side effects than older anti-depressants. Common SSRIs are Paxil, Prozac, Luvox, Zoloft, and Celexa. SSRIs have fewer side effects than older medications, but they can compromise libido and sexual performance. Other possible adverse reactions or side effects include depression, diarrhea, nervousness, drowsiness, headache, increased sweating, insomnia and anxiety. Some of these side effects are temporary until the body adjusts to the medication. They can also flatten feelings by diminishing the intensity of felt emotions. Some SSRIs like Paxil are now known to cause withdrawal symptoms that may be very uncomfortable and challenging for some people to endure.
Tricyclics
An older class of anti-depressants, the tricyclics have numerous side effects. Common tricyclics are Elavil, Pamelor, Tofranil and Desipramine. Possible adverse reactions and side effects are tremors, headaches, dry mouth, blurred vision, weakness, dizziness, drowsiness and gastrointestinal disturbances. Some tricyclics can reach toxic levels in the body, so with some of these medications, patients undergo regular blood tests to monitor drug levels. In some instances tricyclics are combined with SSRIs to treat symptoms of depression, anxiety and insomnia.
MAO Inhibitors
Another older class of anti-depressants is the monoamine oxidase inhibitors (MAOIs). Nardil and Parnate are the brand names of these drugs. Possible adverse reactions and side effects are fatigue, weakness, dizziness, tremors, dry mouth, constipation, difficult urination, blurred vision and “sweet tooth.” Many people taking these medications gain weight. Prolonged use may be toxic to the liver. Regular blood tests to monitor drug levels are often necessary to check blood pressure and liver function. Some dietary changes are necessary when taking MAOIs to eliminate foods with tyramine in them to avoid blood pressure increases.
ANTI-DEPRESSANTS
Addiction Potential of Anti-depressants
While anti-depressants are not generally regarded addictive, people can and do become dependent on them. Withdrawal from anti-depressants needs to be managed by a physician. Physicians often take two to three weeks gradually decreasing the dosage to minimize or eliminate possible withdrawal effects. Individual differences in health, anti-depressant(s) being used, other medications being used and dosage all impact the management of withdrawal. In many instances, patients return to their physicians after being taken off an anti-depressant because they prefer how they feel on the drug.
Lithium
Lithium is the drug of choice for treating bi-polar depression. Lithium is in a classification of drugs called mood stabilizers. Possible adverse reactions or side effects include lethargy, slowed cognitive skills, dizziness, diarrhea, nausea, vomiting, shakiness, tremor, dry mouth, thirst, decreased sexual ability, weight gain and increased urination. Today, Lithium’s efficacy is again being questioned. Individuals taking this medication must have regular blood tests to monitor the level of the drug in the body. Toxicity can lead to serious consequences and can be fatal. A new drug, valproic acid (Divalproex) is being increasingly recommended over Lithium for the treatment of mania in bi-polar disorder.
St John’s Wort
St. John’s Wort is an herb used extensively in the treatment of both depression and anxiety. St. John’s Wort is the treatment of choice for depression in Germany and in other parts of Europe. Because of the widespread interest in St. John’s Wort, the National Institutes of Health (NIH) is conducting a 3-year study sponsored by three NIH components: the National Institute of Mental Health, the National Center for Complementary and Alternative Medicine, and the Office of Dietary Supplements. The Food and Drug Administration (FDA) issued a Public Health Advisory on February 10, 2000. It stated that St. John’s Wort appears to affect an important metabolic pathway that is used by many drugs prescribed to treat conditions such as heart disease, depression, seizures, certain cancers, and rejection of transplants.
Therefore, health care providers have been directed to alert their patients about these potential drug interactions. Any herbal supplement should be taken only after consultation with a physician or holistic health practitioner.
SAMe
SAMe is an increasingly popular supplement for treating depression and for mood brightening. SAMe is s-adenosylmethionine, discovered in 1952 and used commercially in Europe since the 1970’s. It is available by prescription in Europe and over-the-counter in America. It is quite expensive. SAMe is a natural compound found in every cell of the body, supporting important biological processes. It has been researched extensively and has been clinically found to improve moods and emotional well being, assist in maintaining a healthy liver and promote joint health in terms of comfort and mobility. Research has shown it to have a very high safety level with few, if any side effects and withdrawal symptoms. People with bi-polar depression should not take this medication because it can induce mania. It should not be used in conjunction with other anti-depressants without the advice and supervision of a physician. Since SAMe is relatively new in the United States many physicians are unaware of it.