Mental & Emotional Health

Misleading research is often published in major medical journals and doctors are lending their names to it, the editor of the Journal of the American Medical Association said on Tuesday. (Misleading Medical Research Common, Maggie Fox, WASHINGTON, Apr. 15, 2008 )

I imagine that’s been going on for a while. A doctor put me on an antidepressant that she said would help when I was going back to college. I’m already laid back but the meds made me zombified. When it came time to do one of my flash projects, it looked like a bad acid trip.

I did get off of it and managed to get my diploma but I think she was getting kick backs from the pharmaceutical company since it was a new drug at the time. Many antidepressants help people and I don’t mean to discourage anyone from going on them but this one wasn’t for me. Oh yeah, also no sex drive. Some of the side effects can be depressing on their own.

If I was deeply depressed I do think the trade off would be worth it but at the time it just seemed inconvenient. It got me thinking about how many people have medications suggested to them that are not necessary or appropriate by their doctors.

Everyone reacts differently to meds so what might not work for one may work for another. It does seem that if the doctors were being paid more prescribing certain medications it would be bound to make them more biased.

Do you think drug companies influencing doctors and patients is a problem? If so, do you have any suggestions, experiences or solutions to share?

Terra, of Eating Disorder Talk asked me about medication interactions for the recent question contest I ran. While her question was specific with regards to the types of medication she is taking/has taken for her cyclothymia, obsessive-compulsive & attention-deficit disorders, I am going to provide some resources for you that will help you check your own medication interaction risks.

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Antidepressants to Get U.S. Warning on Suicide Risks - The Food and Drug Administration asked the makers of 36 antidepressants to extend an existing precaution for children and adolescents to cover people ages 18 to 24 when they first use the drugs, the agency said in a statement today. Wyeth, Eli Lilly & Co. and other drugmakers must revise their labels within 30 days.

Analysis: Gulf War vets’ brains shrink - “We found that two regions of the brain had significant shrinking compared with other soldiers who have lower levels of symptoms,” Roberta White, chairman of environmental health at the Boston University School of Public Health, said at the 59th annual meeting of the American Academy of Neurology in Boston.

Alzheimer’s reversed in mice - In a new study, mice bioengineered to mimic the fading memory of Alzheimer’s patients got their memories restored - either by being placed in stimulating environments or by receiving a drug most commonly used to fight cancer.

Bipolar disorder harder to diagnose in children - In the new study, researchers found that adults whose first bipolar symptoms arose in childhood typically waited years for a diagnosis — and far longer than those whose symptoms began in late adolescence or early adulthood.

Hormones may ward off dementia in women - New research suggests that hormone therapy taken soon after menopause may help protect against dementia, even though it raises the risk of mental decline in women who do not take the drugs until they are older.

Perfectionists more stressed by social pressure - In a study of 50 middle-aged men, those who measured highest on tests of perfectionism also secreted more of the stress hormone cortisol while undergoing a stressful public speaking task, Dr. Petra H. Wirtz of the University of Zurich in Switzerland and colleagues found.

Migraines can boost teen suicide risk - They said young teens with migraines, a debilitating kind of headache, are also at higher risk for other psychiatric disorders, such as depression and panic disorder.*

Migraines may be tied to brain damage - People with migraines also may be suffering from some brain damage as brain cells swell and become starved of oxygen — a finding that may help explain why migraine sufferers have a higher risk of stroke, researchers reported on Sunday.**

*I connected with this news story personally as I’ve lived all my life with migraines and ended up with depression and a panic disorder as well. Interesting.

**Does this mean I can use the handicapped parking places? I may be brain damaged! I shouldn’t jokoe about stuff like this though. Shame on me!

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I’ve had a couple of readers ask me the same two main questions lately that I think I shall address this morning!

1. [You’re going back to school,] so what would you be studying? Right now my goal is to go into international HIV/AIDS education & prevention through the public health field. I have a degree in German and while it will come in handy for that “international” part of my career goals, most Master of Public Health (MPH) programs want you to have some sort of public health background before they’ll admit you. So, I’m going back to study a social science; psychology (which I was 3 credits shy of minoring in), sociology, anthropology, something of the like. I’m still debating which field I want to concentrate on, but I’ll add another liberal arts degree to the one I already have.

2a. Do you have a job yet? It’s not official, but unofficially, yes! Last night I met with the Hatfields* and we clicked immediately. MrTee and MrArr are both adorable little boys and they took to me like most children do. (Children and small dogs seem to really like me … just like a close family friend … if he and I were really related I could pull the genetics card, but that doesn’t explain it.) I spent 2 1/2 hours with the family getting to know them and playing with the boys. MrTee is a 3-year-old bundle of brains and energy; he didn’t sit for more than two minutes the entire time I was there. I reveled in his energy and went back to my car FULL of pep. MrArr is about to turn 1 and just beginning to creep/crawl. He pushes himself along the wood floor with one of his fat little legs and enjoys being the center of attention. They essentially offered me the job while I was still there, but until I see it in writing, or hear it on the phone, I’m not 100% counting on it … just at 98% for now. My email account has been acting up (Gmail apparently suspended it!!!!!) and so I had to create a new one and get in touch with MrsCee to pass that information to her.

2b. So you’ll be working full time? No, nannying wouldn’t technically be full time since they only need me from 8am to 2pm. This leaves me absolutely open to find an afternoon/evening job and I plan on looking for something. I may spend my summer working my butt off just to keep myself busy and out of trouble.

2c. But you’re going to lose your health insurance, right? Yup, I’ll be without insurance but I will survive. I have insurance until May 13th and so I will have all my meds refilled and get everything taken care of before then. I won’t stop taking my meds and I won’t stop seeing Scuba Steve. I’ll take care of myself … otherwise this blog could get really interesting! LOL

2d. Are you only going to talk about kids now? No, I’ll find good things to talk about, still and you’ll probably still get to hear lots of silly stories about the children. Their names or photographs will never be on this blog, (we’ll stick to The Hatfields, DadE, MrsC, MrTee and MrArr as their names) but eventually those will become their names (to you). Get used to it. (And those of you who know me in real life will probably see them in my life over the summer anyway. Speaking of that, KIWI, this new job means a lot more freedom when BabyD decides to make his appearance and I will be able to “escape” work easier to get to the hospital!!!)

*they live across the street from the McCoy’s, right?

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FDA Wants Stronger Warnings on Sleep Disorder Drugs
Drugs Can Cause “Sleep Driving” Incidents

The U.S. Food and Drug Administration wants tougher language on drugs for sleep disorders, beefing up the warnings to consumers about potential risks. The sedative-hypnotic drug products - a class of drugs used to induce and maintain sleep - carry risks of severe allergic reactions and complex sleep-related behaviors, which may include sleep-driving, the agency said.

Sleep driving is defined as driving while not fully awake after ingestion of a sedative-hypnotic product, with no memory of the event. A year ago Rep. Patrick Kennedy (D-RI) was involved in a highly publicized mishap, crashing his car into a barricade at the U.S. Capitol. He was taking the sleep disorder drug Ambien at the time. My question is, why would you DRIVE after you’ve taken a sleeping pill!?!?

“There are a number of prescription sleep aids available that are well-tolerated and effective for many people,” said Steven Galson, M.D., MPH, director of FDA�s Center for Drug Evaluation and Research. “However, after reviewing the available post-marketing adverse event information for these products, FDA concluded that labeling changes are necessary to inform health care providers and consumers about risks.”

In December 2006, FDA sent letters to manufacturers of products approved for the treatment of sleep disorders requesting that the whole class of drugs revise product labeling to include warnings about the following potential adverse events:
• Anaphylaxis (severe allergic reaction) and angioedema (severe facial swelling), which can occur as early as the first time the product is taken.
• Complex sleep-related behaviors which may include sleep-driving, making phone calls, and preparing and eating food (while asleep). On Ambien I had a conversation with the bathtub once … that stuff is not for me!

FDA said it has been working with the product manufacturers over the past three months to update labeling, notify health care providers and inform consumers of these risks. The guides will contain FDA-approved information such as proper use and the recommendation to avoid ingesting alcohol and/or other central nervous system depressants. Although all sedative-hypnotic products have these risks, the agency said there may be differences among products in how often they occur. For this reason, FDA has recommended that the drug manufacturers conduct clinical studies to investigate the frequency with which sleep-driving and other complex behaviors occur in association with individual drug products.

The medications that are the focus of the revised labeling include the following 13 products:
Ambien/Ambien CR (Sanofi Aventis)
Butisol Sodium (Medpointe Pharm HLC)
Carbrital (Parke-Davis)
Dalmane (Valeant Pharm)
Doral (Questcor Pharms)
Halcion (Pharmacia & Upjohn)
Lunesta (Sepracor)
Placidyl (Abbott)
Prosom (Abbott)
Restoril (Tyco Healthcare)
Rozerem (Takeda)
Seconal (Lilly)
Sonata (King Pharmaceuticals)

sleeping aids, sleep-driving, sleep-walking, FDA, Ambien, Ambien CR, Butisol Sodium, Carbrital, Dalmane, Doral, Halcion, Lunesta, Placidyl, Prosom, Restoril, Rozerem, Seconal, Sonata

Once again, HealthyDay News has given me some interesting information from the January 22nd edition of the Archives of Internal Medicine. This time it has to do with the fact that both male & female patients taking an antidepressant (SSRIs such as Prozac and Paxil in particular) have twice the risk of fracturing bones! “There is good scientific evidence that serotonin is involved in bone physiology, and if you alter the system, you can get low bone density,” Goltzman said.

For five years, Goltzman and his fellow researches followed information from 137 patients (average age of 65) who took antidepressants. He measured the bone density of them as their baseline and they were tracked for five years. Every year patients reported any fractures they incurred and how they happened. Goltzman learned that fractured forearms, ankles and feet were high as well as rib, back, femur & hip fracturing. Perhaps this is due to an increased risk in falling (my meds say “may cause dizziness!).

Dr. Robert P Heany, a professor of medicine a the Osteoporosis Research Center at Creighton University in Omaha, Nebraska does claims the study still does not prove that there is a correlation between SSRIs and fractures. “These findings are hard to interpret,” said Dr. Robert P. Heaney, a professor of medicine at the . “Increased fracture risk has been associated with depression for years,” he added. A study of depressed patients taking only SSRIs compared to depressed patients taking other medications needs to be done before this can be settled. “Then you could see if it was the depression causing the fractures or if it were the SSRIs. It may not be the SSRI at all,” he said.

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I was doing a little reading and therefore a little resarch and learned that there are nine major antidepressants & antianxiety meds that are prescribed to patients. I have taken at least one drug from each of the nine major bases. This made me laugh … and I don’t really know why. I think that just means I’m one of those few patients who is not as sensitive as most in regards to SSRI’s and SNRI’s. I have no shame when it comes to my depression so I underlined all of the drugs that I have taken/tried to treat my illness.

1. sertraline - Zoloft, Lustral, Asentral, Serlift (was on for over two years before settling out at a level too low to function, one of the medications I had the fewest side effects with)
2. escitalopram - Lexapro, Cipralex (did not work for my anxiety although it made my depression lighter)
3. fluoxetine - Prozac, Sarafem, Fontex, Fludep, Lovan (current medication, one I don’t mind taking actually)
4. venlafaxine - Effexor XR, Effexor
5. citalopram - Celexa, Cipramil, Taohexane (did not work for any of my symptoms)
6. paroxetine - Paxil, Seroxat, Aropax (did not work, even after three months, for any of my symptoms)
7. trazadone - Desyrel (and learned the hard way that this is the one drug I am highly sensitive to and cannot take)
8. amitriptyline - Elavil (used intially to treat my migraines but worked well for chronic sleeplessness and pain)
9. bupropion - Wellbutrin, Zyban (caused me to lose too much weight to remain on it safely)

My pharmacist knows I’m crazy; well he knows that I take Prozac, Neurontin, Tetracycline and a half-different migraine medications. Still, Hans D. Pills asked me out. About two months ago, I noticed that Hans was being a little more friendly than the normal patient-pharmacist relationship is. I’m recently divorced and although Hans is an attractive man, I still told him that I wasn’t ready to date; as I don’t feel I am. He was sweet, gave me his number and told me to call him “when you are ready to date.” I see Hans twice a month (for some reason I can’t get my pills on a “schedule” so that I only refill once a month) and thankfully, nothing has been weird with it. He’s still just as friendly and still won’t give me any “deals” on my meds.

Since I’m writing for mental & emotional health, I might as well talk about what I’m actually taking to help me be the Libelle that I always wanted & needed to be. : )

In the morning I take 10mg of Prozac (generic: fluoxetine) for my depression and moderate to severe Generalized Anxiety Disorder. Scuba Steve & his attending Eyebrows, want to bump me up to a much higher dose (between 40mg & 60mg) to help with the GAD. I’m nervous about it because of Prozac’s side effects including nausea, diarrhea, insomnia, abnormal dreams and sweating. These are some of the more “normal” side effects, some of which I am already dealing with. Eyebrows let me know that the insomnia and diarrhea will probably “pass,” but I’ll be dealing with nausea & abnormal dreams for a long while. I’m not looking forward to possibly quadrupling my dose.

I also take 300 mg of neurontin (generic: gabapentin) to stave off migraines and it also helps as a mood stabilizer; even though I’m taking a VERY small dose.

At lunch time I take another 300 mg of Neurontin. I am thankful for Neurontin. It has reduce my migraines from 3 or 4 a week (yes, a week) to 2 or 3 a month, and a incapacitating one every other month or so. My migraines are bad. It’s as simple as that. Between elementary & high school, I functioned as an A-student with migraines because I thought everyone’s head hurt like that. In college, my primary doc was kind enough to put me on a medication that made me relalize migraines are not normal. Thank you Dr. Dee.

Before bedtime I take another 300mg of Neurontin, 500mg of tetracycline for my skin. Since stopping my birth control pills and using an IUD, my skin hasn’t been as happy. I’m okay with taking a low dose of antibiotics to help my skin - I was promised that it wouldn’t aid in the creation of any resistant bacteria.

Overall, I’m okay with taking all these medications; they make me who I am and who I need to be. Sometimes, when I struggle thinking about why I have to take them all, my friend Princess reminds me that she has to take pills for her Cystic Fibrosis so that she can eat, and I have to take pills for my illnesses so that I can function. It is socially unacceptable for me to take my drugs, but it’s socially unacceptable for her to not take her drugs. The duality of society and the thoughts they have about what pills you take for what often pisses me off.

I’m no longer afraid to tell people I have depression or anxiety and that I take medications for them; the more we talk about our illnesses, the more it becomes “normal” and socially acceptable. I think everyone needs to think about this phenomenon.