Are They Safe For Children
Despite the rapid rise in use of SSRIs, their use in young people has raised many questions. After examining the results of a 2004 study, the FDA mandated that drug manufacturers include a black box warning that the antidepressants can increase suicidal thoughts and behavior in children and teens. Critics of the black box warning argue that it scares parents and youths away from potentially helpful treatments. In fact, not enough is known about the way the drugs affect childrens bodies versus adults to make them a first-choice treatment. Some experts also worry about the overprescribing of SSRIs when normal sadness gets mistaken for depression.
Special Benzodiazepine Risk Factors
Anyone who takes benzodiazepines can experience unpleasant or dangerous side effects. But certain individuals are at a higher risk:
People over 65. Older adults are more sensitive to the sedating effects of benzodiazepines. Even small doses can cause confusion, amnesia, loss of balance, and cognitive impairment that looks like dementia. Benzodiazepine use in the elderly is associated with an increased risk of falls, broken hips and legs, and car accidents. Long-term benzodiazepine use also increases the risk of Alzheimers disease and dementia.
People with a history of substance abuse. Because theyre physically addicting and on their own and dangerous when combined with alcohol and other drugs, anyone with a current or former substance abuse problem should use benzodiazepines only with extreme caution.
Pregnant and breastfeeding women. Benzodiazepine use during pregnancy can lead to dependence in the developing baby, with withdrawal following birth. Benzodiazepines are also excreted in breast milk. Therefore, pregnant women need to have a thorough discussion about the risks and benefits of these medications with their prescribing doctor. If medication is necessary, the goal is the smallest effective dose.
The connection between benzodiazepines and accidents
How Long Will My Child Need To Take Medication
The goal of treatment is to fully eliminate all symptoms of depression and anxiety and help your child get back to feeling well every day. It will take at least a few weeks for this to happen, and some symptoms may get better faster than others.
Once the medication is working well, your child or teen will need to stay on the medication for at least 6 to 12 months to help reduce the chance of a relapse. Never stop your childs medication suddenly.
You should only start to reduce your childs medication with the help of your doctor. They will tell you how to decrease the dose slowly and over time. Its best to do this during a period of time that is as stress-free as possible for your child or teen.
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With All These Options How Can You Choose
Your doctor can recommend the best medication to help control your anxiety. There are different types of anxiety disorders, so different medications may be better choices for your type. Your doctor will also consider your other health conditions and medications, and whether you have a family history of responding better to a certain medication. Since you might be taking medication long-term, you may want to factor in affordability.
Antidepressants And The Teenage Brain
How do SSRIs work? When it comes to antidepressants and the teenage brain, we are talking about dramatic cerebral changes. These changes can take place very quickly after a teen begins using an SSRI. In fact, researchers have observed changes in the functional structure of the brain after a single dose of SSRI medication.
This is especially significant for adolescents, because the teenage brain is still immature. In particular, the prefrontal cortex, which controls reasoning and self-regulation, is not fully developed. Hence, introducing pharmaceuticals during this growth process can hinder healthy brain maturation. Research on how SSRIs work indicates that the teen brain is especially vulnerable to disruption by SSRIs and other antidepressant medications.
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Stopping Ssris And Snris
SSRIs and SNRIs are not habit-forming or addictive. However, missing doses or stopping treatment abruptly can cause withdrawal-like symptoms. Withdrawal-like symptoms may include nausea, lack of energy, dizziness, headache, and generally feeling off. It is best to wean off SSRIs and SNRIs gradually after discussing with a healthcare professional such as a physician or pharmacist.
Are There Any Side Effects Of Taking An Ssri
Most side effects are mild and temporary. Your child may:
- have an upset stomach,
- notice changes to sleep ,
- feel unusually restless,
- have headaches, or
- have appetite changes.
In most cases, these side effects should decrease over time. If you have any other problems, or if these side effects become a problem, talk to your doctor.
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What Is The Rationale For Using Drugs That Affect Serotonin
The monoamine theory of depression has long been influential. It holds that depression results from a deficit of one or more neurotransmitters in the brain. It links the neurotransmitters to specific groups of symptoms. For example, serotonin-dependent signals affect sleep, digestion, mood, and behavior regulation norepinephrine drives the fight-flight-freeze response and dopamine has been linked to motivation, movement, and the capacity for pleasure. However, the notion that a chemical imbalance in the brain generates depression has given way to newer ideas that reflect a greater understanding of how the brain works.
How Well Do Ssris Work For Depression
For the past five years, and in my recent book Obsession: A History, I have been questioning the effectiveness of Prozac-like drugs known as SSRIs. I’ve pointed out that when the drugs first came out in the early 1990s there was a wildly enthusiastic uptick in the prescribing of such drugs. Doctors were jubilantly claiming that the drugs were 80-90 percent effective in treating depression and related conditions like OCD.
In the last few years those success rates have been going down, with The New York Times pointing out that the initial numbers had been inflated by drug companies suppressing the studies that were less encouraging. But few if any doctors or patients were willing to hear anything disparaging said about these “wonder” drugs.
Now the tune has changed.
Reason One: A study in the Journal of the American Medical Associationsays that SSRIs like Paxil and Prozac are no more effective in treating depression than a placebo pill. That means they are 33 per cent effective, which is the percent of patients who will respond well to a sugar pill. The article goes on to say that although SSRIs are effective to some degree in treating severe depression, they don’t have any effect on the routine type of depressions they are most often used to treat.
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Learn More About Treating Anxiety
Anxiety disorders are extremely common, with data from the National Institute of Mental Health indicating that an estimated 31.1 percent of American adults will experience an anxiety disorder at some point in life.
Our guide to coping with anxiety goes into more detail about the treatments that are available for anxiety disorders, from cognitive behavioral therapy to meditation and more.
Strategy No : When Needed Use Inexpensive Treatments
One barrier to adequate treatment of panic disorder is the potentially high cost of therapy .1,46 The monthly cost of SSRI therapy can exceed $100 for the higher dosages of medication that are often required.21 Imipramine has proven efficacy in treating panic disorder, depression, and generalized anxiety disorder. The monthly cost of therapy can be as low as $8.21 Generic benzodiazepines are also inexpensive .1,46
Formal CBT programs can cost more than $1,000 for one course of treatment. Anecdotally, self-help groups like Agoraphobics in Motion, 1719 Crooks Rd., Royal Oak, MI 48067 telephone: 248-547-0400, can be inexpensive and helpful.
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Treatment Options For Generalized Anxiety Disorder
Generalized anxiety disorder can dominate your life, and often lasts a long time. But there are a number of different treatment approaches that can help you learn to better manage your anxiety and lead a normal life again. Some medications are also effective.
People who have generalized anxiety disorder aren’t afraid of specific things or situations, but of a wide range of things, which is why it is referred to as generalized anxiety. This can take a great emotional toll and also cause a number of physical symptoms such as drowsiness, muscle tension and a racing heartbeat. Being in a state of constant worry is exhausting, but there are different treatments that can help reduce the anxiety down to a tolerable level.
Unlike other kinds of anxiety disorders, generalized anxiety disorder often first develops in middle-aged people. But anxiety disorders can affect people of all ages.
Do Ssris Cause Sexual Dysfunction
Approximately 70 percent of people taking SSRIs experience some form of sexual dysfunction, including the loss of orgasm. Even as SSRIs increase serotonin levels, they have a dampening effect on the neurotransmitter dopamine, which is associated with the elation of falling in love. Patients should be aware of the potential for some SSRIs to cause problems with sexual desire and performance. In some cases, these issues can be addressed by changing antidepressants, lowering the dosage, or taking a brief, physician-directed medication hiatus
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What To Watch For When A Teen Is On Ssris
During the first few months when a teen or young adult is on an SSRI, parents should be particularly vigilant about watching for signs of an increased suicide risk:
- Talking about suicide or expressing suicidal thoughts
- Increased depression symptoms
- Manic behavior
- Any unusual change in behavior.
If a teen has suicidal thoughts when taking an antidepressant , they need to receive immediate attention at a doctors or clinicians office or in an emergency room.
Can You Drink Alcohol On Ssris
While some doctors advise against drinking alcohol while taking SSRIs, many people find it difficult to completely stop their alcohol consumption during treatment.
A key reason doctors advise against drinking is because both SSRIs and alcohol may influence your mood, and may also make you drowsy and less alert.
Its also possible that consuming too much alcohol regularly could disrupt the effectiveness of your SSRIs.
The consensus seems to be: If you want to drink while taking SSRIs, its important to drink in moderation. That means approximately one drink a day for most people, which translates into:
- 12 oz. of beer
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Anxiety: The Conventional Approach
If your anxiety is starting to interfere with your daily life, you might consider seeking treatment. Most psychiatrists recommend a combination of medication and talk therapy for anxiety conditions.
The medications that may come to your mind first are the SSRI and SNRI medications, which include Prozac, Zoloft, and Paxil. These work by addressing the chemical imbalance that is thought to underlie anxiety disorders. Specifically, they increase the availability of serotonin, the feel-good neurotransmitter.
While these medications are well-known and commonly prescribed, you may be hesitant to start them without being offered any understanding about the underlying cause of your anxiety. Perhaps you or someone you know tried them and didnt respond well or couldnt tolerate the side-effects. Maybe you feel like youve exhausted all of the possibilities. In a clinical climate where SSRIs and SNRIs are presented as state-of-the-art options, its easy to feel like youve failed treatment if you dont improve on these medications.
If Depression Isnt A Chemical Imbalance What Is It
Modern thinking suggests that depression is a problem of circuitry, not chemistry. In this view, symptoms of depression result from failure of synapse formation and changes in the activity level of various emotional signaling centers, set in motion by overactivity of the stress response system, often in response to early adverse experience. Mental health conditions such as depression and anxiety can be seen as aversive yet adaptive responses to adversity.
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Going Off Ssri Medication
Medication is not the only approach for addressing teen depression. In fact, studies show that clinical and holistic methods for decreasing teen anxiety and depression can be equally or more effective than prescription medication.
However, because SSRIs impact the brain, it can be dangerous to stop taking them suddenly. Going off the drug all at once can lead to a condition called discontinuation syndrome. The syndrome causes withdrawal-like symptoms, including nausea, dizziness, uneasiness, fatigue, and lethargy.
Therefore, teens and young adults should get advice from a qualified clinical professional on how to safely discontinue the medication.
What Are Ssris And Do They Work
Theres a very good chance youve heard of the selective serotonin reuptake inhibitors, or SSRIs: Prozac, Zoloft, Paxil, Lexapro, and so on. These drugs, most commonly used for major depressive disorder, have been gradually introduced since the late 1980s. Existing drugslike the MAOIs and tricyclicsrequired close attention to diet or had more severe side effects, respectively. So SSRIs quickly became the most commonly prescribed antidepressant medications, as total antidepressant use rose by 64% in the US from 1999-2014. As of 2017, 12.7% of Americans over age 12 were taking antidepressants.
Although most of these prescriptions are still written for depression, a significant portion of the rapid increase comes from a much broader application of SSRIs. Theyre now prescribed for obsessive-compulsive disorder, generalized anxiety, panic disorder, phobias, PTSD, and a number of other mental health conditions. Its important to note that many experts say theyre being too prescribed too oftenespecially by primary care physicians without any kind of detailed assessment. But SSRIs are helpful for many people with anxiety-related disorders.
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Antidepressants For Anxiety: What Medication Options Exist
Medically reviewed by Kristin Hall, FNP
If youve been diagnosed with an anxiety disorder, your healthcare provider may recommend one of several medications, including anti-anxiety medications, beta-blockers and, for certain types of anxiety, antidepressants.
Although antidepressants are typically viewed as treatments for depression, several modern antidepressants are approved to treat anxiety disorders such as generalized anxiety disorder and panic disorder.
Below, weve explained how antidepressants may help to treat anxiety, as well as the specific antidepressants your healthcare provider may prescribe if you have an anxiety disorder.
Weve also discussed how long it usually takes for anxiety to improve, the side effects you may experience while using antidepressants to treat anxiety and more.
How Do Ssris Work
Serotonin is a neurotransmitter
Serotonin stabilizes our mood, thinking, memory, sleep, and digestion. Its one of our happy chemicals.
Nerve cells naturally produce serotonin, which releases into the space between two nerve cells . From here, it can bind to the second nerve cell , allowing the signal to be received. Alternatively, it can be reabsorbed and recycled through a transporter and back into the nerve cell that released it , making it inactive. In healthy people, this process is well-balanced, so their mood remains stable.
However, people with anxiety can have lower serotonin levels or abnormalities in the way it functions.
SSRIs prevent serotonin from being reabsorbed in the presynaptic nerve cell that produces and releases it by inhibiting the transporter that reabsorbs it. This naturally increases serotonin levels in the space between the two nerve cells, keeping it active so it can bind to the postsynaptic cell and send more signals to regulate our mood. They may also improve your response to psychological treatments.
As SSRIs are selective, they dont impact the reuptake of other neurotransmitters.
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