Paxil

Older adults who take antidepressants may be at greater risk for bone fractures, studies suggest.

In one of the most recent studies, published in the May issue of the Journal of General Internal Medicine, researchers found that antidepressant use in postmenopausal women - with an average age of 64 - was associated with an increased risk of certain bone fractures, including those of the spine.

The study did not, however, find any strong association between antidepressant use and wrist or hip fractures.

The women had a 30% increased risk of spine fracture, with an overall increased risk of 20% for any type of fracture.

While study author Leslie Spangler says that no definitive cause-and-effect relationship has been established between antidepressants and bone loss, older patients taking antidepressants should consider seeing their physician to be evaluated for osteoporosis, according to Dr. David Goltzman, director of the McGill Centre for Bone and Periodontal Research at McGill University in Montreal. Dr. Goltzman further advises that you should not stop taking your antidepressant if you really need it.

To reduce your risk for bone loss, regardless of whether you are taking antidepressants, Mayo Clinic experts advise:

* Get at least 1500 mg of calcium per day.
* Get at least 800 IU of vitamin D per day.
* Do strength building as well as weight bearing exerise on a regular basis.
* Get soy in your diet.
* Don’t smoke.
* Don’t drink excessive alcohol.

buy paxil antidepressant free prescription pills
FedEx overnight shipping free prescription online pharmacy

A new Canadian study published on July 21 indicates that deep brain stimulation (DBS) - which involves implanting tiny electrodes in areas of the brain with abnormal function in order to stimulate these areas and block the activity - is a safe and promising new therapy for treatment resistant depression.

Twenty patients participated in the study, lead by Dr. Andres Lozano, Neurosurgeon at Krembil Neurosciences Centre - Toronto Western Hospital and Canada Research Chair in Neuroscience, which involved targeting an area in the brain which is known to be overactive in those with depression.

“Our research confirmed that 60% of patients have shown a clinically significant response to the surgery and the benefits were sustained for at least one year,” said Dr. Lozano.

Dr. Lozano first published research regarding DBS in 2005, when his team had used the new treatment with just six patients. This new report expands upon that research by adding 14 new patients.

According to Psychiatric Secrets, 2nd ed., treatment resistance is frequently defined as failure to respond to an adequate trial of at least two standard antidepressants. Treatment resistant patients may also initially respond to an antidepressant, but quickly develop a tolerance to it.

buy paxil antidepressant free prescription pills
FedEx overnight shipping free prescription online pharmacy

Gordon’s Unstuck Program consists of seven stages and a variety of self-care techniques to treat depression. He tells patients to stay on antidepressants initially and work with their doctors and other health professionals with the program. The seven stages, as Gordon has titled them, include:

* The Call. Gordon notes that one has to become aware that he or she is depressed and decide that change is necessary.

* Guides on the Journey. The Unstuck Program suggests finding people, such as health professionals, who can help the patient through the process.

* Surrender to Change. This stage involves letting go of those issues that may constrain us, and move into the current of life.

* Dealing with Demons. Gordon discusses facing the challenges to the process, such as procrastination, pride, resentment, and fear, among others.

* Dark Night of the Soul. This stage involves allowing freedom to emerge as participants move through despair along the process.

* Spirituality: the Blessing. The Program discusses connecting with something or someone larger than ourselves.

* The Return. This stage involves learning to live every day joyously, deeply and consciously in the light of what participants have experienced.

buy paxil antidepressant free prescription pills
FedEx overnight shipping free prescription online pharmacy

Using a combination of cognitive behavioral therapy and Pfizer’s antidepressant dramatically reduced the severity of anxiety disorders in children compared with either treatment alone, according to a study in The New England Journal of Medicine.

The findings are likely to add to the ongoing controversy about giving antidepressants to children. In 2004, the FDA required drugmakers to add Black Box warnings to antidepressants concerning suicide and suicidal thoughts in children. That led to yet another controversy that some doctors stopped prescribing the meds as often, leading to a rise in teen suicides (back story).

In the study, which was funded by the National Institutes of Mental Health and involved 488 kids between ages 7 and 17, none of the children committed suicide, and there was no significant increase in suicidal thoughts among those taking Zoloft (here is the study).

Some kids also underwent cognitive behavioral therapy, or CBT, which is not the same as traditional psychotherapy. Instead, CBT is usually for a shorter length of time and tries to help a patient develop strategies to obliterate negative thoughts. In the study, patients received 14 sessions of CBT that each lasted an hour. Of patients receiving Zoloft and CBT, 81 percent showed improvement, compared to 60 percent for CBT alone, 55 percent on Zoloft, and 24 percent on a placebo.

buy paxil antidepressant free prescription pills
FedEx overnight shipping free prescription online pharmacy

Dr. Ronald Dworkin has a clear opinion regarding the current state of depression treatment, which, as already stated, includes $12 billion spent on antidepressants in the US alone. Dworkin, a senior fellow at Washington’s Hudson Institute, is the author of “Artificial Unhappiness: The Dark Side of the New Happy Class.” “Doctors are now medicating unhappiness,” said Dworkin. “Too many people take drugs when they really need to be making changes in their lives.”

Unstuck - A New Book That Challenges $20 billion in Drug Company Advertising and the Mainstream Treatment of Depression

Pharmaceutical companies spent almost $20 billion in advertising in 2001; the largest amount was spent to promote antidepressant drugs. A new book by integrative medicine pioneer James S. Gordon, M.D. criticizes our current system of treating depression so extensively and quickly with antidepressants and offers a comprehensive and largely self-directed program for those afflicted by depression. “Unstuck: Your Guide to the Seven Stage Journey Out of Depression” is Gordon’s first effort to write about the program he has developed and used for thirty five years to treat depression, extreme stress, and anxiety.

Gordon, the Founder and Director of the non-profit Center for Mind-Body Medicine (CMBM) in Washington, DC, developed the foundation of the program over forty years ago and has been using it with patients and teaching it to health professionals during that period. He also served as the Chairman of the White House Commission on Complementary and Alternative Medicine Policy under President Bill Clinton.

Gordon believes that depression is not a disease, but a sign that one’s life is out of balance, or “stuck”. He asserts that, while there are biological changes associated with depression, they are inconsistent among patients and are more likely to be the result of feelings of hopelessness, loss and helplessness than their cause. A core aspect of Gordon’s approach is that antidepressants are significantly over-prescribed and they are less effective than other less-toxic approaches. According to Gordon, writing prescriptions for antidepressants has become a well-intentioned, but ill-informed and quick option for doctors, who have little time to spend with patients due to our current medical reimbursement system that encourages short patient visits. Their use has ballooned as a result. Gordon’s comprehensive approach which emphasizes self-care techniques, including dietary change, nutritional supplements, meditation and exercise, represents a significant - and controversial - departure from typical modern medical approaches to depression treatment, which are based primarily on prescription drugs and only secondarily on the use of supportive and cognitive therapy.

buy paxil antidepressant free prescription pills
FedEx overnight shipping free prescription online pharmacy

We’re in the Depression Era…And It’s Getting Worse

According to the World Health Organization (WHO), major depression is the leading cause of disease burden in North America and high-income countries. It is the fourth leading cause worldwide; by 2030, it is expected to be the second leading cause of disease burden worldwide.

“Depression” generally refers to chronic or severe levels of sadness, anxiety, perceived helplessness, insomnia and disinterest, among other related feelings. Depression can be moderate to severe. “Dysthymia” involves long-term symptoms that keep one from feeling good or functioning well, but will not disable the person affected by the condition. “Major Depression” interferes with a person’s ability to function normally and enjoy life; this includes the ability to sleep, work, eat, and socialize. “Bipolar disorder,” also known as manic-depressive illness, is marked by wide mood changes, including severe highs (mania) and lows (severe depression). Bipolar disorder is not as common as other forms of depression.

Antidepressants have become the most commonly prescribed drugs in the United States, prescribed more often than drugs for high cholesterol, high blood pressure, asthma, or headaches. The U.S. Centers for Disease Control and Prevention (CDC) reviewed 2.4 billion drugs prescribed in visits to doctors and hospitals in 2005. 118 million were for antidepressants (high blood pressure drugs were the second most common, with 113 million prescriptions). Almost 232 million prescriptions for antidepressants were written last year, a large increase. Approximately 30 million patients in the US spent $12 billion on antidepressants in 2007. The average time a general practitioner (MD) will spend with each patient to determine the best approach to treat a patient for the condition at issue during a visit? About 15 minutes.

The use of antidepressants and other related drugs have ballooned over the last decade and that trend is projected to continue. Are more people receiving previously unaddressed yet needed treatment for depression? Are more people becoming depressed and require treatment? Are more people being treated for symptoms that reflect depressive symptoms, such as general unhappiness, with prescription drugs?

These are crucial questions regarding our healthcare system’s approach to depression, particularly considering new research addressing the effectiveness of prescription drugs.

buy paxil antidepressant free prescription pills
FedEx overnight shipping free prescription online pharmacy

A combination of a treatment known as cognitive behavioral therapy and an antidepressant greatly reduced the severity of anxiety disorders in children compared with either treatment alone, researchers found.

The new research is sure to add to the already fierce debate about giving antidepressants to children.

In 2004, the U.S. Food and Drug Administration ordered drug makers to put a strong “black-box” warning on antidepressant labels, saying the medications can lead to suicidal thoughts in children. The warning led many doctors to shy away from prescribing the drugs. Since then, teen suicides have risen, leading some researchers to say the increase could be associated with lower use of antidepressants.

In the new study, released Thursday by the New England Journal of Medicine, none of the children committed suicide, and researchers said they found no significant increase in suicidal thoughts among those taking an antidepressant. The study was government funded and examined 488 children, ages 7 to 17. Some received sertraline, an antidepressant sold both in generic form and under the brand name Zoloft by Pfizer Inc.

For adults, the FDA has approved the drug to treat conditions including depression and anxiety. For children, it is approved only to treat obsessive-compulsive disorder, a kind of anxiety disorder. But psychiatrists widely use sertraline “off label” to treat depression and a range of anxiety disorders in children. The children in the study, whose average age was about 11, had a primary diagnosis of separation anxiety, generalized anxiety disorder or social phobia.

Some children in the study also underwent cognitive behavioral therapy, or CBT. Unlike conventional psychotherapy, CBT is often short term and focused on helping patients develop specific strategies to change negative thought processes. Of patients receiving both sertraline and CBT, 80.7% showed improvement, compared to 59.7% for CBT alone, 54.9% for sertraline alone and 23.7% given a placebo, the study found.

Louis Kraus, chief of child and adolescent psychiatry at Rush University Medical Center in Chicago, who wasn’t involved in the study, called the effectiveness of combination treatment “incredible.” But he said that patients are facing a severe shortage both of child psychiatrists and professionals trained in CBT, a situation that could make it difficult for children to get the treatment they need. Studies have estimated that 10% to 20% of children suffer from anxiety disorders.

The new study comes amid a congressional inquiry into financial ties between drug companies and medical researchers, including those studying psychiatric drugs given to children.

The National Institute of Mental Health, part of the federal government’s National Institutes of Health, funded the study. Pfizer provided free sertraline and matching placebo. The researchers, led by John Walkup, deputy director of Johns Hopkins’ Division of Child and Adolescent Psychiatry, said Pfizer wasn’t involved in other aspects of the study. The researchers listed on the study reported receiving a variety of payments from drug companies, including Pfizer. Dr. Walkup reported consulting fees from Eli Lilly & Co., Jazz Pharmaceuticals Inc. and GlaxoSmithKline PLC, all of which market antidepressants.

buy paxil antidepressant free prescription pills
FedEx overnight shipping free prescription online pharmacy

Large numbers of women are being inappropriately treated with antidepressants when they actually have premenstrual syndrome (PMS), a British nonprofit has warned.

“[PMS] can make you feel depressed or even suicidal” said Jackie Howe, head of the National Association for Premenstrual Syndrome (NAPS). “But anti-depressant drugs can be strong and addictive, and anyone who takes them could end up with a record of mental health problems on their National Health Service file. Too many general practitioners spot that women are extremely down and emotional when they come in to see them, and hand out anti-depressant prescriptions without digging any deeper.”

According to NAPS, thousands of women have been misdiagnosed with clinical depression when actually their moods are linked to their menstrual cycles and do not last all month.

“For the rest of the month, these women are happy and positive people,” said Dr Nick Panay, who specializes in menstrual problems.

Many other women are correctly diagnosed, but doctors prescribe antidepressants anyway as a “quick fix.” According to Sarah Jarvis, women’s health spokesperson for the World College of General Practitioners, the demand for an easy solution comes from patients just as often as doctors.

“Women very often say ‘I need something to help me, and I need it now,’” Jarvis said. “They are very busy, they want answers and they want solutions straight away. So doctors do reach for the prescription pad.”

Jarvis said that diet, exercise and changes in birth control drugs can be more effective at treating PMS in the long-term. She advises women suffering from severe PMS to visit their doctors when they are feeling calm, rather than emotional or vulnerable.

“The most important thing [for women with severe PMS] is support from friends and family,” Panay said. “Because many women get mild [PMS], those with more severe symptoms are often dismissed as people who can’t cope. The reality is they are having a horrific time.”

buy paxil antidepressant free prescription pills
FedEx overnight shipping free prescription online pharmacy

Black patients with heart disease are only half as likely as white patients to receive treatment for depression, says a Duke University Medical Center study.

“This is an important finding because we know that depression is associated with a 2- to 4-fold increase in the risk of complications and death from heart disease. Under-treatment of depression is a serious clinical issue,” study co-author and psychologist James Blumenthal said in a Duke news release.

The study of 727 white and 137 black patients with heart disease found that 35 percent of black patients and 27 percent of white patients had elevated symptoms of depression. About 21 percent of the white patients were receiving treatment for depression, compared with 11.7 percent of the black patients.

The researchers also noted important gender differences. Among patients with the most severe symptoms of depression, 43 percent of white men were taking antidepressants, compared with 22 percent of black men. In comparison, 67 percent of black women and 64 percent of white women were taking antidepressants.

“These findings suggest that depression in heart disease is under-treated, and it appears that black men are suffering the most,” study author and cardiologist Dr. Silvina Waldman said in the news release. “It is sobering to realize that large numbers of patients are missing out on important and readily available therapeutic options.”

The disparity in treatment rates may be due to a number of factors, Blumenthal said. He noted that some doctors may not be adept at recognizing depression in minority patients and some patients may not feel comfortable talking about depressive symptoms with their doctor. Insurance coverage and patients’ ability to pay out-of-pocket expenses may also play a role.

“We clearly need to do a better job of recognizing and treating depression, especially in heart patients,” Blumenthal said. “We need treatments that work, treatments that are acceptable to patients, and treatments that are actually incorporated into medical practice.”

buy paxil antidepressant free prescription pills
FedEx overnight shipping free prescription online pharmacy

A Leading Swansea GP has blamed the credit crunch for the soaring rate of anti- depressants prescriptions across the region.

Ian Millington (pictured), secretary of Morgannwg Local Medical Committee, said he was unsurprised at the prescribing levels because depression went hand-in-hand with poverty and unemployment.

More prescriptions have been handed out for medication including Prozac and Seroxat, during the last year compared to the previous 12 months.

Figures for Swansea Local Health Board alone show a total of 215,248 anti-depressants were dispensed during 2007/08 to around 16,557 patients.

Meanwhile, between 2006/07, around 15,084 patients were prescribed a total of 196,092 anti-depressants.

Dr Millington said he believed it was a sign of the times.

But a spokeswoman for Swansea Local Health Board pointed out that the figures were based on monthly, rather than weekly, prescriptions, implying the anti-depressants rates being prescribed could be less.

Dr Millington said: “It is probably a reflection of the stress of life, as we are in a high unemployment area.

“There is not much doubt that depression goes with unemployment and poverty, and the increase is not surprising if that is the case.

“There is evidence in recession that depression goes up.

“It’s the reality of what is going on. People end up staying in unhappy jobs because they do not want to move.”

Dr Millington said he believed the increase in prescriptions also underlined that the diagnosis of depression had improved.

“Modern anti-depressants work for depression — they do not work for unhappiness or general stress,” he added.

“We are making the diagnosis of depression more now, and, most importantly, there is very little option to do anything else as there is not enough cognitive behaviour therapies — the services are there but they are overstretched.”

The secretary of Morgannwg Local Medical Committee said it would not be fair to compare the picture in Wales with the rest of the UK, because there was a 14.1 per cent higher prevalence of disease than elsewhere.

In Neath Port Talbot during 2007/08 a total of 139,033 items were dispensed at a cost of £924,692, compared to 126,423 anti-depressants during 2006/07 at a cost of £988,338.

Meanwhile, in Carmarthenshire, a total of 155,053 anti- depressants were prescribed during 2007/08, costing £1,262,651 compared to 147,469 items, totalling £1,426,414, between 2006 and 2007.

Amy Kent, Carmarthenshire Local Health Board’s head of prescribing and medicines management, added: “Although the prescribing of antidepressants has increased by a small percentage, costs have actually decreased as prescribers are using more cost effective drugs first choice, in line with National Institute for Clinical Excellence guidance.”

buy paxil antidepressant free prescription pills
FedEx overnight shipping free prescription online pharmacy