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Antidepressants |
| Depression is a psychiatric syndrome consisting
of dejected mood, psychomotor retardation, and insomnia and weight loss.
Behavior is governed by pessimistic or despairing beliefs. It is sometimes
associated with guilt feelings and somatic preoccupations. Treatment of
depression is with antidepressant drugs or psychotherapy, while very severe
cases may require electroconvulsive therapy. Anxiety is generalized pervasive
fear, a form of neurosis in which anxiety dominates the patients life. It
is characterized by a feeling of apprehension and uncertainty and is associated
with physiological changes (tremor, sweating, etc.). It can be treated with
psychotherapy, behavior therapy and tranquillizing drugs. Panic disorder
is a disorder where the patient experienced panic attacks during which there
is extreme and unreasoning fear and anxiety. |
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PAXIL (SEROXAT)
Substance: Paroxetine
Manufacturer: SKB Pharma
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Dosage |
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20 mg |
30 tab |
USD 59.00 |
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20 mg |
90 tab |
USD 159.00 |
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Dosage |
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Price |
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20 mg |
100 tab |
USD 99.00 |
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30 mg |
100 tab |
USD 129.00 |
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RHODIOLA ROSEA
(dry roots)
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28 g |
USD 12.00 |
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Preparation of tea:
cut fine 5g of Rhodiola rosea roots. 1 cup of boiling water pour in roots
and leave for (brew) at least 4 hours. Than filter. Daily dosage: 1/5 cup - 3-5
times per day. For better taste dilute Rhodiola rosea tea with juice, tonic or
other herbal tea.
Preparation of tincture for personal usage: Mill
30 g of Rhodiola Rose roots in a coffee-grinder no less than 5-10 mm, add 150
ml of light spirits (30-40%), agitate and steep 3-5 days at room temperature.
Separate and filter the extract. Dosage: ? tsp. x 3 times per day.
RHODIOLA ROSEA
(dry extract tablets, total rosavins 40%)
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Health information and news
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50 mg |
60 tab |
USD 49.00 |
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Dosage: 2 tablets 3 times daily
Course: 30 days, 180 tablets
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Dosage |
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37.5 mg |
100 tab |
USD 59.00 |
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75 mg |
100 tab |
USD 94.00 |
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Research articles
on Antidepressants Agents |
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Drug Saf. 2005;28(2):137-52.
The safety of newer antidepressants in pregnancy and breastfeeding.
Gentile S.
Department of Mental Health, ASL Salerno 1, District n. 4, Cava de' Tirreni
(Salerno), Italy. salvatore_gentile@aliceposta.it
The pregnancy and postpartum periods are considered to be relatively
high risk times for depressive episodes in women, particularly for those
with pre-existing psychiatric illnesses. Therefore, it may be necessary
to start or continue the pharmacological treatment of depression during
these two timeframes. Hence, the aim of this review is to examine the
effects on the fetus and infant of exposure, through the placenta and
maternal milk, to the following drugs: fluoxetine, fluvoxamine, paroxetine,
sertraline, citalopram, escitalopram, mirtazapine, venlafaxine, reboxetine
and bupropion. The teratogenic risks, perinatal toxicity and effects on
the neurobehavioural development of newborns associated with exposure
through the placenta or maternal milk to these medications need to be
carefully assessed before starting psychopharmacological treatment in
pregnant or lactating women. In spite of the limitations of some of the
studies reviewed, the older selective serotonin-reuptake inhibitors (SSRIs)
[as we await further data regarding escitalopram] and venlafaxine seem
to be devoid of teratogenic risks. By contrast, the data concerning possible
consequences related to exposure to SSRIs via the placenta and breastmilk
on neonatal adaptation and long-term neurocognitive infant's development
are still controversial. Nevertheless, a number of reports have shown
that an association between placental exposure to SSRIs and adverse but
self-limiting effects on neonatal adaptation may exist. In addition, the
information on both teratogenic and functional teratogenic risks associated
with exposure to bupropion, mirtazapine and reboxetine is incomplete or
absent; at present, these compounds should not be used as first-line agents
in the pharmacological treatment of depression in pregnancy and breastfeeding.
Untreated depression is not without its own risks since mothers affected
by depression have a negative impact on the emotional development of their
children and major depression, especially when complicated by a delusional
component, may lead to the mother attempting suicide and infanticide.
Consequently, clinicians need to help mothers weigh the risks of prenatal
exposure to drugs for their babies against the potential risks of untreated
depression and abrupt discontinuation of pharmacological treatment. Given
these situations, we suggest that choosing to administer psychopharmacological
treatment in pregnant or breastfeeding women with depression will result
primarily from a careful evaluation of their psychopathological condition;
currently, the degree of severity of maternal disease appears to represent
the most relevant parameter to take this clinical decision. |
Pharmacoepidemiol
Drug Saf. 2005 Mar 1; [Epub ahead of print] Related Articles, Links
Newer antidepressants in pregnancy and rates of major malformations: a meta-analysis
of prospective comparative studies.
Einarson TR, Einarson A.
Faculty of Pharmacy, Department of Clinical Pharmacology, Faculty of Medicine,
University of Toronto, Ont., Canada.
BACKGROUND: A substantial number of women of childbearing age suffer
from depression. Despite this, relatively little is known about the safety
of antidepressant use during pregnancy. PURPOSE: We conducted a meta-analysis
of prospective comparative cohort studies to quantify the relationship
between maternal exposure to the newer antidepressants and major malformations.
METHODS: We searched Medline, Embase and Reprotox from 1996 to the present
for studies comparing outcomes in first trimester exposures to citalopram,
escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, reboxetine,
venlafaxine, nefazodone, trazodone, mirtazapine and bupropion to those
of non-exposed mothers. Data were combined using a random effects model;
heterogeneity was tested with chi(2), and publication bias with a funnel
plot and the Begg-Mazumdar statistic. RESULTS: Twenty-two studies were
identified, 15 were rejected (4 reviews, 4 without comparison groups,
2 third trimester exposures, 2 retrospective database studies, 2 case
reports and 1 duplicate); 7 studies (n = 1774) met inclusion criteria.
Effects were not heterogeneous (chi(2) = 2.04, p = 0.92); funnel plot
and test (tau = -0.24, p = 0.45) indicated no publication bias. The summary
relative risk was 1.01 (95%CI: 0.57-1.80). CONCLUSIONS: As a group, the
newer antidepressants are not associated with an increased risk of major
malformations above the baseline of 1-3% in the population. |
Bipolar Disord. 2003
Dec;5(6):421-433.
Antidepressants in bipolar disorder: the case for caution.
Ghaemi SN, Hsu DJ, Soldani F, Goodwin FK.
Bipolar Disorder Research Program, Cambridge Hospital, Cambridge, MA
and Harvard Medical School, Boston, MA, USA Center on Neuroscience, Medical
Progress, and Society and Department of Psychiatry and Behavioral Sciences,
George Washington University, Washington, DC, USA.
The 2002 American Psychiatric Association (APA) guidelines for the treatment
of bipolar disorder recommended more conservative use of antidepressants.
This change in comparison with previous APA guidelines has been criticized,
especially from some groups in Europe. The Munich group in particular
has published a critique of assumptions underlying the conservative recommendations
of the recent APA treatment guidelines. In this paper, we re-examine the
argument put forward by the Munich group, and we demonstrate that indeed,
conceptually and empirically, there is a strong rationale for a cautious
approach to antidepressant use in bipolar disorder, consistent with, and
perhaps even more strongly than, the APA guidelines. This rationale is
based on support for the following four propositions: (i) The risk of
antidepressant induced mood-cycling is high, (ii) Antidepressants have
not been shown to definitively prevent completed suicides and reduce mortality,
whereas lithium has, (iii) Antidepressants have not been shown to be more
effective than mood stabilizers in acute bipolar depression and have been
shown to be less effective than mood stabilizers in preventing depressive
relapse in bipolar disorder and (iv) Mood stabilizers, especially lithium
and lamotrigine, have been shown to be effective in acute and prophylactic
treatment of bipolar depressive episodes. We therefore draw three conclusions
from this interpretation of the evidence: (i) There are significant risks
of mania and long-term worsening of bipolar illness with antidepressants,
(ii) Antidepressants should generally be reserved for severe cases of
acute bipolar depression and not routinely used in mild to moderate cases
and (iii) Antidepressants should be discontinued after recovery from the
depressive episode, and maintained only in those who repeatedly relapse
after antidepressant discontinuation (a minority we judge to represent
only about 15-20% of bipolar depressed patients).
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Acta Psychiatr Scand.
2003 Jul;108(1):24-31.
Antidepressants: psychiatrists' opinions and clinical practice.
Depont F, Rambelomanana S, Le Puil S, Begaud B, Verdoux H, Moore N.
Departments of Pharmacology and Adult Psychiatry, Public Health Research
Institute IFR99, Universite Victor Segalen, Bordeaux, France.
OBJECTIVE: To describe and compare psychiatrists' opinion on antidepressant
drugs and their prescriptions to depressed patients. METHOD: Between January
and September 1999 a representative sample of French psychiatrists was
asked their opinion of the 15 most prescribed antidepressants, and then
to describe the treatments of the current depressive episode of four depressive
patients each, their changes and the reason thereof. RESULTS: A total
of 232 psychiatrists and 935 patients participated. The best ranked antidepressants
were clomipramine, paroxetine and amitriptyline for efficacy, tianeptine,
paroxetine and citalopram for tolerability. In patients, the most often
prescribed were paroxetine, fluoxetine and venlafaxine. Those least often
stopped for intolerance were tianeptine (2.9%), citalopram (5.2%), venlafaxine
(3.3%) and amitriptyline (5.7%) for lack of efficacy. There was no difference
in stopping rates for inefficacy of tricyclics and serotonin-selective
agents. CONCLUSION: The best predictors for the prescribed antidepressants
were the psychiatrists' overall rankings and opinions of the tolerability
of the drug.
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Cochrane Database
Syst Rev. 2003;2:CD003592.
Antidepressants for generalized anxiety disorder (Cochrane Review).
Kapczinski F, Lima MS, Souza N, Js N, Schmitt N, R N.
Department of Psychiatry, Federal University of Rio Grande do Sul - UFRGS,
Departamento de Medicinal Legal e Psiquiatria - HCPA - UFRGS, Rua Ramiro
Barcelos, 2350, Porto Alegre, RS, BRAZIL, 90035-003.
BACKGROUND: Pharmacological treatments have been successfully used to
treat Generalized Anxiety Disorder (GAD). The mainstay for the pharmacological
treatment of GAD in past decades has been the use of benzodiazepine and
non benzodiazepine anxiolytics. Data emerging over the last two decades
have shown that antidepressants may be equally effective to anxiolytics
for treating GAD. The use of antidepressants for treating GAD may be advantageous,
due to the fact that GAD presents a high co morbidity ratio with major
depressive disorder (62%) and dysthymia (37%). OBJECTIVES: To assess the
efficacy and acceptability of antidepressants for treating generalized
anxiety disorder. SEARCH STRATEGY: Cochrane Collaboration Depression,
Anxiety and Neurosis Controlled Trials Register - CCDANCTR (up to May
2002), Anxiety Neurosis (up to May 2002) and Cochrane Controlled Trials
Register (CENTRAL/CCTR) (up to May 2002), MEDLINE (1966 to May 2002),
LILACS (1982 to May 2002); reference searching; personal communication;
conference abstracts and book chapters on the treatment of generalized
anxiety disorder. SELECTION CRITERIA: Randomised controlled trials were
included. Exclusion criteria were: non randomised studies; studies which
included patients with generalized anxiety disorder and another Axis I
co-morbidity. DATA COLLECTION AND ANALYSIS: The data from studies were
extracted independently by two reviewers and relative risks, weighted
mean difference and number needed to treat were estimated. People who
died or dropped out were regarded as having had no improvement. MAIN RESULTS:
Antidepressants (imipramine, venlafaxine and paroxetine) were found to
be superior to placebo in treating GAD. The calculated NNT for antidepressants
in GAD is 5.15. Dropout rates did not differ between antidepressants.
Only one study presented data on imipramine and trazodone. Imipramine
was chosen as the reference drug and, therefore, data on trazodone could
not be included in the meta analysis. Only one study was conducted among
children and adolescents (~~Rynn 2001~~). The latter study showed very
promising results of sertraline in children and adolescents with GAD,
which warrants its replication in larger samples. REVIEWER'S CONCLUSIONS:
The available evidence suggests that antidepressants are superior to placebo
in treating GAD. There is evidence from one trial suggesting that paroxetine
and imipramine have a similar efficacy and tolerability. There is also
evidence from placebo-controlled trials suggesting that these drugs are
well tolerated by GAD patients. Further trials of antidepressants for
GAD will help to demonstrate which antidepressants should be used for
which patients.
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