What were treatments for depression in the 1950s?… by margarita_girl_7
I have a research project due Friday March 17 and I'm having trouble finding credible information.
Best Answer:
In the 1950's and 60's, depression was divided into two types, endogenous and neurotic. Endogenous means that the depression comes from within the body, perhaps of genetic origin, or comes out of nowhere. Neurotic or reactive depression has a clear environmental precipitating factor, such as the death of a spouse, or other significant loss, such as the loss of a job. In the 1970's and 80's, the focus of attention shifted from the cause of depression to its effects on the afflicted people. That is to say, whatever the cause in a particular case, what are the symptoms and impaired functions that experts can agree make up a depressive disorder? Although there is some argument even today (as in all branches of medicines), most experts agree that:
A depressive disorder is a syndrome (group of symptoms) that reflects a sad mood exceeding normal sadness or grief. More specifically, the sadness of depression is characterized by a greater intensity and duration and by more severe symptoms and functional disabilities than is normal.
Depression symptoms are characterized not only by negative thoughts, moods, and behaviors, but also by specific changes in bodily functions (e.g., eating, sleeping, and sexual activity). The functional changes are often called neurovegetative signs.
Certain people with depressive disorder, especially bipolar depression (manic depression), seem to have an inherited vulnerability to this condition.
Depressive disorders are a huge public health problem.
Tricyclic antidepressants (TCAs) were developed in the 1950's and 60's to treat depression. They are called tricyclic antidepressants because their chemical structures consist of three chemical rings. TCAs work mainly by increasing the level of norepinephrine in the brain synapses, although they also may affect serotonin levels. Doctors often use TCAs to treat moderate to severe depression. Examples of tricyclic antidepressants are amitriptyline (Elavil), protriptyline (Vivactil), desipramine (Norpramin), nortriptyline (Aventyl, Pamelor), trimipramine (Surmontil), and perphenazine (Triavil).
Tetracyclic antidepressants are similar in action to tricyclics, but their structure has four chemical rings. Examples of tetracyclics include maprotiline (Ludiomil) and mirtazapine (Remeron), a drug that was discussed above under dual action antidepressants.
TCAs are safe and generally well tolerated when properly prescribed and administered. However, if taken in over-dose, TCAs can cause life-threatening heart rhythm disturbances. Some TCAs can also have anti-cholinergic side effects, which are due to the blocking of the activity of the nerves that are responsible for control of the heart rate, gut motion, and saliva production. Thus, some TCAs can produce dry mouth, constipation, and dizziness upon standing. The dizziness results from low blood pressure that occurs upon standing (orthostatic hypotension). Anti-cholinergic side effects can also aggravate narrow angle glaucoma, urinary obstruction due to benign prostate hypertrophy, and cause delirium in the elderly. TCAs should also be avoided in patients with seizure disorders and a history of strokes.
Stimulants such as methylphenidate (Ritalin) or dextroamphetamine (Dexedrine) are used primarily for the treatment of depression that is resistant to other medications. The stimulants are most commonly used along with other antidepressants or other medications, such as mood stabilizers, anti-psychotics, or even thyroid hormone. They are sometimes used alone, but rarely. The reason they are usually used with other medications for depression is that unlike the other medications, they induce a rush and a high in both depressed and non-depressed people. Therefore, the stimulants are highly addictive drugs.
Electroconvulsive therapy (ECT)
In the ECT procedure, an electric current is passed through the brain to produce controlled convulsions (seizures). ECT is useful for certain patients, particularly for those who cannot take or are not responding to antidepressants, have severe depression, or are at a high risk for suicide. ECT often is effective in cases where antidepressant medications do not provide sufficient relief of symptoms. This procedure probably works, as previously mentioned, by a massive neurochemical release in the brain due to the controlled seizure. Highly effective, ECT relieves depression within 1 to 2 weeks after beginning treatments. After ECT, some patients will continue to have maintenance ECT, while others will return to antidepressant medications.
In recent years, the technique of ECT has been much improved. The treatment is given in the hospital under anesthesia so that people receiving ECT do not feel pain. Most patients undergo 6 to 10 treatments. An electrical current is passed through the brain to cause a controlled seizure, which typically lasts for 20 to 90 seconds. The patient is awake in 5 to 10 minutes. The most common side effect is short-term memory loss, which resolves quickly. After the initial course of treatment, ECT can be safely done as an outpatient procedure.
Psychotherapies
Many forms of psychotherapy are effectively used to help depressed individuals, including some short-term (10 to 20 weeks) therapies. Talking therapies help patients gain insight into their problems and resolve them through verbal give-and-take with the therapist. Behavioral therapists help patients learn how to obtain more satisfaction and rewards through their own actions. These therapists also help patients to unlearn the behavioral patterns that contribute to their depression.
Interpersonal and cognitive/behavioral therapies are two of the short-term psychotherapies that research has shown to be helpful for some forms of depression. Interpersonal therapists focus on the patient's disturbed personal relationships that both cause and exacerbate the depression. Cognitive/behavioral therapists help patients change the negative styles of thinking and behaving that are often associated with depression.
Psychodynamic therapies are sometimes used to treat depression. They focus on resolving the patient's internal psychological conflicts that are typically thought to be rooted in childhood. Long-term psychodynamic therapies are particularly important if there seems to be a life-long history and pattern of inadequate ways of coping (maladaptive coping mechanisms) in negative or self-injurious behavior.
http://www.medicinenet.com/depression/page4.htm
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How to keep your skin clear and pimple free?… by
Is there anything you should definitely stay away from eating/drinking? What facial cleansers should you use to keep your skin clear? What product vanishes pimples the fastest?
Best Answer:
drink lots of liquids….water and fresh juices…avoid oily foods like fish and meat..
CLEAN!
Wash your face with a gentle, oil- and fragrance-free cleanser; preferably a nondetergent one labeled pH balanced.
If you have oily skin all over your face, use a cleanser that contains benzoil peroxide or salicylic acid.
Don't scrub – irritated skin swells around the pores, which can cause breakouts.
Skip toner unless your face is very oily, otherwise it might dry out the skin.
TREAT!
Apply a topical acne treatment containing benzoyl peroxide, glycolic acid, or salicylic acid over your entire face, not just where blemishes have already erupted.
At night, use a drying spot-treatment product and dab oil-free moisturizer on dry areas.
In the morning, apply an oil-free sunscreen gel over the entire face.
CONCEAL!
Use a small makeup brush to dab concealer or cream foundation (in the exact same shade as your skin) directly onto the blemish. Use a fingertip to wipe away excess concealer around the blemish and, if necessary, apply another coat of concealer.
If the makeup becomes cakey, carefully wipe it off and start over. gently brush powder (in the exact same shade as your skin) on top of the concealer.
Tricks Of The Trade:
* If you have oily skin and feel that you need toner, apply it only on the T-zone, and rinse it off afterward (leaving it on can dry the skin). Use a clay mask as often as every three days to absorb excess oil.
* To stop redness and swelling in an emergency situation (job interview, wedding), ask your doctor for a cortisone injection. It calms down a pimple almost instantly.
* If you can't get to your dermatologist (or needles make you squemish), temporarily reduce redness and swelling by dabbing on a drop of drugstore cortisone cream, Preparation H, or Vasocon-A eyedrops.
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Trying to understand the effects Depakote has on the human body?… by tammyjackl
15 yr old girl with epilepsy.
Has been on Depakote for 9 years.
Weight 101 pounds/Height 5'6
Taking 2,000 mg daily and still testing only a level 10 in blood work. Also on Lamictal for 1 year.
Why are the blood levels still testing this low?
The bone lose, what can be done to revert it, while still taking the drug?
Best Answer:
Common side effects
Dose-related side effects
Depakote is one of the standard epilepsy medicines, and many people who take Depakote (and the other forms of valproate) experience few side effects and enjoy improved control of their seizures. The most common side effects include:
tiredness
dizziness
nausea
vomiting
tremor
hair loss
weight gain
behavioral changes (depression in adults, irritability in children)
Some other side effects mentioned even less often are:
elevated blood ammonia levels, suggested by sleepiness, headache, confusion, or nausea
reduced attentiveness and response accuracy
Tiredness occurs in many individuals and is often associated with high doses and blood levels. Tiredness can include a range of effects, including slower mental processing speed and less “perkiness” and “spontaneity” in behavior. Large reductions in mental processing speed are uncommon. Effects on “motivation” and “perkiness” are very hard to measure, but they are usually mild and are not common. Patients with new prescriptions for Depakote should be advised to be careful with driving and similar activities until they know whether their abilities are affected.
Nausea is common when therapy begins but is usually less troublesome with Depakote or Depakote ER than with Depakene. Starting at a very low dosage or taking the medicine on a full stomach may help to reduce nausea. Vomiting is less common but occurs in susceptible individuals. Stomach upset from Depakote is more likely when another medication with similar side effects (for example, carbamazepine or felbamate) is also being used.
Tremor is related to blood level and individual susceptibility. Usually the tremor is a fine, rapid intention tremor. Large, slow tremors can also occur, however, sometimes at rest. The tremors tend to fluctuate widely over the course of the day, probably reflecting fluctuations in valproate blood levels as well as other factors that worsen tremor, such as anxiety, caffeine, or low blood sugar. If Depakote is critical for achieving seizure control in a particular patient but the tremor is troublesome, drugs to treat tremor (such as propranolol or primidone [Mysoline]) may be used. These may contribute to other side effects, however.
Weight gain is one of the most vexing side effects of Depakote, affecting 30% to 50% of patients. It is more common in adult women but it also affects men and sometimes even children. Studies suggest that both increased appetite and decreased metabolism can contribute. The average gain for adults is 15 pounds. Exercise and a reduced-calorie diet can be very helpful. It remains uncertain whether weight gain is greater when higher doses of Depakote are taken.
Hair loss occurs in 5% to 10% of patients taking Depakote. It is uncertain whether more hair is lost when higher doses of Depakote are taken. The hair almost always grows back after the Depakote is stopped, but it often has a different texture. (For example, it may grow in curly instead of straight.) Taking selenium (10-20 mcg per day) and zinc (25-50 mg per day) helps some people to prevent hair loss.
Long-term use of valproate has been linked to bone loss, ankle swelling, irregular menstruation, and polycystic ovary syndrome (PCOS). Taking supplements of both calcium and vitamin D may help to prevent bone loss. Patients who have taken Depekote or other forms of valproate for more than 5 years may be advised to have a bone density test. If the test shows significant thinning of the bones, referral to a bone metabolism specialist may be indicated.
Idiosyncratic reactions
Allergic reactions such as rashes are less common with Depakote and other forms of valproate than with most other antiepileptic drugs. Patients should be advised to report rashes, however, especially early in the course of treatment.
Some other rare but life-threatening disorders do occur with the use of this medication. Children younger than 2 years of age and those taking other seizure medications in addition to Depakote are at highest risk. See Serious side effects
Serious side effects of Depakote
Most side effects from taking Depakote go away with no lasting harm. But a few people have serious reactions that can even be life-threatening.
Here's a list of symptoms that may be the start of one of these problems. Advise patients to call immediately if they notice any of these symptoms:
weakness, lethargy, facial edema, anorexia, vomiting, jaundice, especially in a child under 2 years of age (possible liver failure)
abdominal pain, nausea, vomiting, and/or loss of appetite (possible pancreatitis)
easy bruising, nosebleed, other abnormal bleeding (problems with clotting)
The best-known and most feared serious reaction is liver damage, which has been fatal in some patients. This damage usually occurs within the first 6 months of treatment. The risk of liver failure is much higher in children under 2 years of age, especially if they are also taking other antiepileptic drugs or if they have a congenital metabolic disorder, a severe seizure disorder with mental retardation, or other brain disease. Consult a pediatric epileptologist before prescribing Depakote for a child who meets these criteria. The risk of liver failure is much lower in children between 2 and 10 and is very low in older children and adults, perhaps 1 in 50,000. This is similar to the frequency of liver failure when taking other medications such as phenytoin. Depakote can deplete the liver's stores of carnitine, and some believe that taking extra carnitine can help prevent the rare cases of liver damage. There is no clear evidence of this effect. Carnitine supplements should be considered only for those at highest risk. There is no evidence that long-term use of Depakote will cause gradual, progressive damage to liver function.
Another rare but potentially life-threatening reaction to Depakote is pancreatitis, which occasionally progresses to bleeding and death. This reaction may occur in both children and adults, even after several years of therapy with Depakote. Advise patients to report promptly the symptoms listed above.
Clotting problems-thrombocytopenia or impaired platelet function-are more likely to occur when high doses of Depakote are taken. Sometimes these problems return to normal without stopping the medication. A complete blood count, thrombocyte count, and coagulation testing should be performed before and after the initiation of treatment with Depakote and before elective surgery.
When a patient presents with a serious and/or unexpected adverse reaction from a medication or device, you should consider reporting this event to Medwatch (http://www.fda.gov/medwatch/report/hcp.htm). To download Medwatch reporting forms click here (http://www.fda.gov/medwatch/getforms.htm).
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