Health News and Information » Anti Depressants-Sleeping Aid

ADOLESCENT ALCOHOLISM TREATMENT: GETTING ADOLESCENTS INTO TREATMENT

admin — Thu, 14 Jul 2011 18:44:40 +0000

Although occasionally adolescents will spontaneously request treatment, more often they come to treatment under some duress. In working with them it is important to make it clear that your task is to help them, and that you are not an agent of their parents, of the law, or of the school system. At the same time, part of helping them may involve an intervention, which entails confrontation, and, as was mentioned earlier, total confidentiality cannot be assured.In dealing with adolescents, the importance of working with the family cannot be overemphasized. The parents need to deal with their child’s alcohol/substance abuse. And they must consider their behaviors which may have protected, covered up, or excused the problem. When it is clear that there is a significant problem, and all efforts to involve the adolescent in treatment have failed, the parents may need to seek legal help. Most states allow for parents to request state assistance if they feel they cannot enforce safe limits for their child. Although this is a very drastic and difficult step to take, it can be important when alcohol-abusing adolescents are acting in ways that endanger their lives. Probation can also be a way of mandating treatment for adolescents, but again this only works if the parents can stop protecting the adolescent from the consequences of his behavior.*152\331\2*

SLEEP PATTERNS: THE ROLE OF CIRCADIAN RHYTHMS – FACTORS THAT CAN ALTER THE CIRCADIAN RHYTHMS

admin — Sun, 19 Dec 2010 09:14:14 +0000

There are a number of factors that can alter the circadian rhythms and disrupt the normal pattern of body functions. Illness is one major factor. Adjusting to daylight saving time is another: we arbitrarily begin operating on a longer or shorter day. It may take a few days for our systems to become entrained to the new cycle. Similarly, at the conclusion of a weekend, many people (like the advertising representative I described earlier) may say they are suffering from “Monday morning blues,” known technically as acute circadian phase disruption. Their self-prescribed therapy is to ingest massive doses of caffeine in the form of coffee, in an attempt to jump-start their mental and physical motors. Aging also affects the internal clock as the organs begin failing to work in harmony. People who have retired or who have fewer social contacts may lack the social time cues to which they had grown accustomed.
Shift workers are particularly prone to phase disruption. One of my patients, a fifty-year-old dispatcher for a taxi company, preferred to work the midnight shift because it suited his wife, a nurse who also worked at night. He found that every two or three weeks or so he went through a period when he was virtually unable to stay awake on the job. I scoured medical literature on the subject and was surprised to learn that people in his situation frequently go through phases of extreme and disabling sleepiness. One solution, discussed in greater detail in Chapter 2, involves rotating shifts on a weekly basis: working midnight to 8:00 one week, then 8:00 A.M. to 4:00 P.M., then 4:00 to midnight. Although many workers dislike rotating shifts, preferring to maintain a constant work pattern, my patient tried this approach successfully; there were some difficulties with his wife, but she too was eventually able to adjust her schedule. It is more often the case, however, that shift workers lack the power to structure their own schedules, and other solutions must be found.
*101\226\8*

SEASONAL AFFECTIVE DISORDER (SAD): USING ST JOHN’S WORT IN SAD

admin — Wed, 29 Apr 2009 08:42:07 +0000

Interestingly, the earliest systematic 20th-century study of the effects of St John’s Wort on depression was inspired by the observation that Hypericum is a light-sensitive substance and that rats given Hypericum and then placed in bright light appeared to become more activated. To date there is only one study on the use of St John’s Wort in SAD patients. In this study, Dr Siegfried Kasper’s group in Vienna compared two groups of 10 SAD patients, one exposed to bright light in the morning for two hours a day for four weeks and one to much dimmer light for the same amount of time. Both groups received St John’s Wort 900 mg per day, and both groups responded very well over the four-week interval.

Given the way in which the study was designed, it is difficult to draw definite conclusions from it. Because there was no placebo group, the evidence for a specific effect for St John’s Wort was not completely clear-cut. Nevertheless, the anti-depressant results of St John’s Wort were promising. In addition, light therapy enhances the effects of the anti-depressant and the antidepressant cuts down the amount of time needed in front of the light box. There is no reason to suppose that the same beneficial interaction will not occur when it comes to the use of St John’s Wort. In my opinion, Sarah’s happy experience with using these two treatments in conjunction will prove to be the norm.

There are different ways in which light therapy and St John’s Wort can be combined. You could reason that since light therapy is the more established of the two treatments for SAD, it would make sense to begin to use light treatment as you enter the usual season of risk. As soon as it feels as though the light therapy is not fully doing the job, you could then add St John’s Wort. Another approach would be to start with St John’s Wort and add in light therapy only if it is necessary.

Although Kasper’s group found no harmful effects to the eye after four weeks of light therapy used in conjunction with St John’s Wort, there is a theoretical concern that the light-sensitizing effects of the herbal anti-depressant may produce harmful effects to the eyes over the long haul. Since such speculations by definition involve watching people over long periods, it will not be possible to answer them definitively for years to come. Even so, it is good to be aware of this possible interaction and to use less light if you are also taking St John’s Wort than you would if you were only using the light treatment. This should be easily managed as you will be benefiting from two remedies rather than just one. In addition, we have a natural inclination to do with as little light therapy as is needed to obtain an anti-depressant response.

One tip worth bearing in mind whenever you use an antidepressant to treat SAD or the winter blues is that the dosage needed usually varies depending on the season. For example, 300 to 600 mg of St John’s Wort might be sufficient in the autumn and spring, but larger doses may be necessary to combat the more severe symptoms that may occur in the depths of winter.

*29\75\2*

THE ILLNESS CAUSED BY TRANQUILLIZER WITHDRAWAL

admin — Tue, 21 Apr 2009 05:18:42 +0000

This can be severe if a careful reduction plan is not followed. So many people throw their pills down the lavatory when they realize they are dependent. They then have to rush off to the doctor for more when they cannot cope with the withdrawal symptoms. This is not because they lack willpower, nor because they imagine they need the support of the drugs, it is because they are chemically dependent.

If a steady reduction plan is followed, the symptoms will be much less severe. The aim is to avoid sudden drops in the level of the drug in the blood. This is when the symptoms are at their worst. Slow withdrawal is safe. Whilst there still may be some discomfort, and you may get impatient, the results will be worth your efforts.

The symptoms mentioned on pages 28 to 75 are mainly the experiences of people who have tried to reduce too quickly without medical help. If you understand what is temporarily happening to your body and mind, you will not get so anxious about withdrawal. The support of your doctor and family is most important at this time.

Dependence on any substance can be degrading, but you must remember that this is a therapeutic dependence, and therefore you should not feel ashamed. These drugs were given to you as a medicine. Suppose penicillin had dependence-producing properties, and it was given to you for some life-threatening disease. Would you feel guilty about the resulting dependence?

It is a sad fact that many people feel guilty, not only about their dependence on the drugs, but also about the nervous illness for which the drug was originally prescribed.

Some of the ‘addicts’ do not have a history of nervous illness. It may be they were prescribed for a temporary life problem, or back injury, and were then given years of un-queried repeat prescriptions. So many times a tearful person will say, ‘What can I do? I feel confused and emotionally dead on the pills, but I am afraid to stop them in case my original illness comes back.’ The truth is that if the drugs have been taken continuously for more than 3-4 months, they may be having very little therapeutic effect on the original symptoms. The user may only be avoiding withdrawal symptoms by continuing medication, and still suffer the toxic effects of the drugs into the bargain!

*4\49\8*