Archive for Central Nervous System Agents

Parkinsons Disease and The Prescribed Drugs

Hyoscine is a natural plant product, helpful against tremor and to a lesser extent against rigidity. It causes considerable dryness of the mouth and blurring of vision. Benadryl, an antihistamine, is frequently employed for the control of tremor. It is a safe drug to use, except that patients who experience marked drowsiness must not employ it while driving a car.

Since the tremor of Parkinson’s disease becomes greatly aggravated by embarrassment, nervousness and excitement, especially when in the presence of strangers, various tranquilizing drugsprove helpful to some patients as a temporary alleviant. They are more effective when not used too often and preferably in small doses, since they can cause mental fogginess and drowsiness. Alcohol if used in small amount helps to alleviate excitement and tremor in some patients, hence should not be prohibited where it proves useful.

For patients that suffer from insomnia, there is a wide assortment of remedies. The doctor will usually find the remedy that will best serve the needs and tolerance of the patient.

Swelling of the ankles is a frequent occurrence among the very rigid and frozen Parkinson patients, especially those who spend many hours of the day sitting, which leads water to gravitate down to the ankles. A number of very effective drugs are available for swelling or edema of the legs and ankles.

For patients who suffer from marked slowness of movement, sluggishness, fatigue, depression, inactivity and drowsiness by day, and who fail to respond to previously mentioned drugs, there is a wide assortment of stimulants available. Various amphetamine stimulants prove helpful to some patients, and yet in other patients they tend to produce cardiac excitation, palpitations, and shortness of breath and have to be discontinued or used in very small amount. Thyroid in small dosage two or three times a day provides the extra energy that some patients require, although in some it tends :0 aggravate tremor and leads to over­excitement.

Vitamins are needed for patients who are undernourished or have difficulty in swallowing, hence give on erratic diets. Sometimes injections of B-12 prove helpful, also liver injections. However, people should not be gullible about reports of “miracle injections” or “miracle cures.” Some patients, desperate for something new and different, turn to exotic drugs and treatments, not realizing that the most effective medications are well known to doctors.

The most common side reactions from the use of drugs for Parkinson’s disease are dryness of the mouth and throat, blurring of vision, nausea and indigestion, and constipation. Mild forms of dryness of the mouth can be counteracted by sips of water, or the use of hard candies or chewing gum. However, instances of dryness that are severe enough to interfere with swallowing of food and with speech should be called to the attention of the doctor for changes in medication. Blurred vision is corrected by changes in the lens of the glasses to render reading easier, since Parkinson remedies blur only close vision.

Indigestion and nausea caused by pills can often be prevented by swallowing them with milk or buttermilk instead of water. Patients who gag and have difficulty in swallowing large pills and capsules will find it easier to do so if the capsule is pressed into the bottom of a teaspoon of applesauce or Jello. Vomiting is never caused by the standard drugs for Parkinson’s disease and should it occur, all drugs are to be stopped and the doctor called. Parkinson remedies do not cause bladder retention, but they may slow the urinary stream among the male patients who have enlarged and obstructing prostate glands. Constipation can be aggravated by the above remedies, but rarely constitutes a serious problem.


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Nefazodone Information – Side Effects, Uses and Benefits

Type of Drug:

Antidepressant; mood elevating agent.

How the Nefazodone Product Works:

The exact mechanism is unknown. Nefazodone appears to block the uptake of serotonin and norepinephrine (chemicals found in the brain). The effect may take a few weeks to be noticed.

Uses of The Nefazodone:

To treat mental depression in patients 18 years of age and older.

Unlabeled Uses: Occasionally, doctors may prescribe nefazodone for posttraumatic stress disorder (PTSD).

Precautions:

Liver abnormalities: Life-threatening liver failure has been reported in patients taking nefazodone. Notify your doctor if you experience yellowing of the skin or eyes, appetite loss, or tiredness.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and potential benefits outweigh the possible hazards to the fetus.

Breastfeeding: It is not known if nefazodone appears in breast milk. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness in patients younger than 18 years of age have not been established.

Elderly: Lower initial does or recommended for patient older than 65 years of age.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take any over­the-counter or prescription medications while taking this drug. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with this drug:

  • buspirone (eg, BuSpar)
  • carbamazepine (eg, Tegretol)
  • cyclosporine (eg, Sandimmune)
  • digoxin (eg, Lanoxin)
  • haloperidol (eg, Haldol)

Side Effects of Nefazodone:

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Digestive Tract: Nausea; constipation; indigestion; diarrhea; appetite changes; vomiting; stomach pain; gas; dry mouth.

Nervous System: Dizziness; sleeplessness; weakness; drowsiness; light­headedness; confusion; headache; memory loss; incoordination; tremor; anxiety; unstable emotions; depression; abnormal dreams; decreased concentration; migraine; agitation.

Circulatory System: Low blood pressure; chest pain; pounding in the chest (palpitations); slow heartbeat.

Respiratory System: Cough; runny nose; difficulty breathing; sinus infection; bronchitis; sore throat.

Skin: Itching; rash; abnormal skin sensations; flushing; sweating; increasod sensitivity to touch.

Urinary and Reproductive Tract: Prolonged or inappropriate erections; decreased sexual drive; changes in urinary frequency; breast pain; painful menstruation; impotence; painful urination.

Other: Eye pain; flu syndrome; chills; fever; stiff neck; swelling in the arms and legs; joint, muscle, back, or neck pain; ringing in the ears; abnormal taste sensations; weight gain; swelling; cramping; blurred or abnormal vision; thirst.

Guidelines for Use:

  • Dosage is individualized. Take exactly as prescribed.
  • Take in 2 divided doses on an empty stomach, or as directed by your doctor.
  • Do not stop taking or change the dose unless instructed by your doctor.
  • Notify your doctor immediately if you develop a rash, hives, or other type of allergic reaction.
  • If a dose is missed, take it as soon as possible. If several hours have passed or it is nearing time for the next dose, do not double the dose to catch up, unless instructed by your doctor. If more than one dose is missed, or it is necessary to establish a new dosage schedule, contact your doctor or pharmacist.
  • Do not use in combination with MAOls (eg, phenelzine) or within 14 days of discontinuing treatment with an MAOI. After stopping this medicine, wait at least 1 week before starting an MAOI.
  • May impair judgment, thinking, or motor skills. Use caution while driving or performing other tasks requiring alertness, coordination, or physical dexterity until tolerance is determined.
  • Inform your doctor if you are pregnant, become pregnant, are planning to become pregnant, or are breastfeeding.
  • Avoid alcohol while using this medicine.
  • Improvement may not be seen for several weeks. Exams may be necessary. Be sure to keep appointments.
  • Store at room temperature (59° to 86°F) in a dry place.

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Paroxetine and Its Side Effects

Type of Drug:

Antidepressant (SSRI); mood-elevating agent.

How the Drug Works:

The actual antidepressant mechanism of paroxetine is not known. It is presumed that it works by blocking the uptake of serotonin, a chemical found in the brain.

Uses Paroxetine

Immediate-release: To treat obsessions and compulsions in patients with obsessive-compulsive disorder (OCD).

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits to the mother outweigh the possible hazards to the fetus.

Breastfeeding: Paroxetine appears in breast milk. Consult your doctor before breastfeeding.

Children: Safety and effectiveness in children have not been established.

Elderly: Initial dosage in the elderly should be reduced.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are planning to take any over-the-counter or prescription medications or dietary supplements while taking paroxetine. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with paroxetine:

  • Alcohol procyclidine (Kemadrin)
  • Antidepressants (eg, fluoxetine)
  • Phenobarbital (eg, Solfoton)
  • Phenytoin (eg, dilantin)
  • Quinidine (eg, Quinora)

Paroextine Side Effects:

Every drug is capable of producing side effects. Many paroxetine users experience no or minor side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Circulatory System: Chest pain; palpitations (pounding in the chest); high blood pressure; rapid heart rate.

Digestive Tract: Nausea; diarrhea; vomiting; constipation; gas; indigestion; appetite changes; dry mouth.

Nervous System: Drowsiness; sleeplessness; agitation; tremor; anxiety; weakness; headache; dizziness; nervousness; confusion; twitching; amnesia; inability to concentrate; abnormal dreams; depression; unstable emotions; vertigo (feeling of whirling motion).

Skin: Flushing; sweating; rash; itching.

Other: Abnormal ejaculation and other male genital disorders; back pain; joint pain; muscle weakness or pain; tightness in throat; abnormal skin sensations; decreased sex drive; blurred vision; runny nose; taste pervorslon; urinary frequency; urinary disorder; chills; general body discomfort changes; cough; congestion; ringing in the ears;

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed. Small doses are usually used at first and then gradually increased until the desired benefit is obtained. Dosage changes are usually made at intervals more than 1 week.

• Take once daily, preferably in the morning, without regard to meals. Take with food if stomach upset occurs.

• Do not change the dose or stop taking, unless directed by your doctor.

• Avoid alcohol when using this drug.

• Do not use in combination with MAOls or within 14 days of discontinuing treatment with an MAOI. Similarly, at least 2 weeks should be allowed after stopping paroxetine before starting an MAOI.

• May cause drowsiness or dizziness. Use caution while driving or performing other tasks requiring alertness, coordination, or physical dexterity.

• Improvement may be noticed in 1 to 4 weeks; continue therapy as directed.

• Shake oral suspension well before using.

• Do not chew or crush controlled-release tablets. Swallow whole.

• Consult your doctor or pharmacist before taking any nonprescription or prescription drugs while using paroxetine.

• Inform your doctor if you are pregnant, become pregnant, are planning to become pregnant, or are breastfeeding.

• Significant weight loss may be an undesirable effect of paroxetine therapy.

• Store tablets at controlled room temperature (59° to 86°F).

• Store controlled-release tablets and suspension at or below 77 F.


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Sertraline and its Side Effects

Type of Drug:

Antidepressant; SSRI; mood-elevating agent.

How the Sertraline Works:

The actual antidepressant mechanism of sertraline is not known. It is presumed that it works by blocking the uptake of serotonin, a chemical found in the brain.

Uses of The Sertraline:

To treat major depressive disorder, obsessions and compulsions in adult patients with obsessive-compulsive disorder (OCD), panic disorder with or without agoraphobia, posttraumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD).

Unlabeled Uses: Has been used to treat generalized social phobia.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits to the mother outweigh the possible hazards to the fetus.

Breastfeeding: It is not known if sertraline appears in breast milk. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness have not been established for uses other than OCD in children 6 years of age and older.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are planning to take many over-the-counter or prescription medications or dietary supplement with sertraline. Doses of one or both drugs may need to be modified or different drug may need to be prescribed.

  • Disulfiram (Antabuse)
  • Flecainide (Tambocor)
  • Hydantoins (eg, phenytoin)
  • Lithium (eg, Eskalith)
  • MAOls (eg, phenelzine)
  • Propafenone (Rythmol)
  • Sumatriptan (Imitrex)
  • Tolbutamide (eg, Orinase)
  • Tricyclic antidepressants (eg, doxepin)
  • Warfarin (eg, Coumadin)

Side Effects of Sertraline:

Every drug is capable of producing side effects. Many sertraline users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Digestive Tract: Nausea; vomiting; diarrhea; indigestion; constipation; gas; appetite changes.

Nervous System: Headache; dizziness; tremor; fatigue; nervousness; anxiety; drowsiness; agitation; sleeplessness; decreased or abnormal skin sensations.

Circulatory System: Pounding in the chest; chest pain.

Other: Dry mouth; vision disturbances; ringing in the ears; back pain; muscle pain; decreased sexual interest or performance; excessive sweating; rash; yawning; fatigue; weakness; general body discomfort; flushing.

Guidelines for Use:

  • Dosage will be individualized. Take exactly as prescribed.
  • Do not change the dose or stop taking, unless directed by your doctor.
  • Administer once daily, either in the morning or evening.
  • Shake oral concentrate well before using.
  • Do not use in combination with MAOls or within 14 days of treatment with an MAOl.
  • If a dose is missed, take it as soon as possible. If several hours have passed or it is nearing time for the next dose, do not double the dose to catch up, unless advised to do so by your doctor. If several doses are missed or it is necessary to establish a new dosage schedule, contact your doctor or pharmacist.
  • Avoid alcohol when using this drug.
  • May cause drowsiness, dizziness, or blurred vision. Use caution while driving or performing other tasks requiring alertness, coordination, or physical dexterity.
  • Significant weight loss or gain may be an undesirable effect of sertraline therapy.
  • Inform your doctor if you are pregnant, become pregnant, are planning to become pregnant, or are breastfeeding.
  • Store at room temperature (59 to 86 F).



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Tetracyclic Compounds – An Antedepressant Agent

Type of Drug:

Antidepressant; mood-elevating agent.

How the Drug Works:

The exact mechanism of action is not known. It is believed that tetracyclic antidepressants adjust or balance how the brain and nervous system produce and respond to natural chemicals (neurotransmitters) that elevate mood.

Uses:

Maprotiline: To treat depressive illness in patients with depressive neurosis (dysthymic disorder) and manic-depressive illness (major depressive episode).

Mirtazapine: To treat depression.

Unlabeled Uses: Maprotiline is also effective for the relief of anxiety associated with depression.

Precautions:

Do not use in the following situations:

Aallergy to the tetracyclic compound or any of its ingredients electroshock therapy, concurrent (maprotiline only)

Seizures: Maprotiline use has been associated with seizures. The risk is higher in patients with a history of seizures, in patients taking phenothiazines (eg, promethazine), or when benzodiazepines (eg, alprazolam) are being withdrawn.

Pregnancy: There are no adequate or well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits to the mother outweigh the possible hazards to the fetus.

Breastfeeding: Maprotiline appears in breast milk. It is not known if mirtazapine appears in breast milk. Consult your doctor before you begin breast­feeding.

Children: Safety and effectiveness in children (younger than 18 years of age for maprotiline) have not been established.

Elderly: The elimination of mirtazapine is reduced in elderly patients. In general, lower doses of maprotiline are recommended for patients older than 60 years of age. Use with caution in elderly patients.

Lab Tests: Lab test may be required periodically during treatment. Lab tests may include blood counts and enzyme levels.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or are planning to take any over-the-counter or prescription medications or dietary supplements while taking a tetracyclic compound. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with tetracyclic compounds:

  • Alcohol
  • Barbiturates (eg, phenobarbital)
  • Benzodiazepines (eg, alprazolam)
  • MAOI antidepressants (eg, phenelzine)
  • phenothiazines (eg, promethazine)

Side Effects:

Every drug is capable of producing side effects. Many tetracyclic com­pound users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Digestive Tract: Nausea; vomiting; constipation; dry mouth; thirst; increased appetite; stomach pain; indigestion.

Nervous System: Confusion; anxiety; agitation; abnormal thinking; nervous­ness; tremor; twitching; drowsiness; clumsiness; dizziness; vertigo (feeling of whirling motion); weakness; fatigue; tiredness; sleeplessness; headache; abnormal dreams; increased sensitivity; apathy; depression; memory loss; numbness or tingling in the hands or feet.

Respiratory System: Difficulty breathing; cough; sinus problems: wheezing.

Circulatory System: Rapid heart rate; irregular heartbeat; increased cholesterol and triglyceride levels; increased blood pressure; low blood pressure on arising.

Skin: Rash; itching; hives; acne; dry skin; flushing; redness; hair loss. Other: Flu syndrome; general body discomfort; swelling in the hands or feet; blurred vision; muscle, joint, or back pain; frequent urination; urinary tract infection.


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Trazodone – Uses and Side Effects

Type of Drug:

Antidepressant; mood-elevating agent.

How the Trazodone Works:

It is not known how trazodone works to relieve depression. It is believed trazodone modifies the chemical balance in the brain, which changes behavior. It does not stimulate the brain.

Uses of The Trazodone:

To relieve mental depression.

Unlabeled Uses: Occasionally doctors may prescribe trazodone for cocaine withdrawal, to manage aggressive behavior when used with other medications, and to treat patients with panic disorder or agoraphobia (fear of open or public places) with panic attacks.

Precautions:

Do not use in the following situations: Allergy to trazodone or any of its ingredients.

Priapism: If you experience prolonged or painful penile erection, discontinue use immediately and consult your doctor. Permanent damage of normal penis function and impotence have occurred.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and potential benefits to the mother outweigh the possible hazards to the fetus.

Breastfeeding: It is not known if trazodone appears in breast milk. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness in children younger than 18 years of age have not been established.

Lab Tests: Lab tastes may be required to monitor therapy. Tests include blood counts.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are planning to take any over-the-counter or prescription medications or dietary supplements with trazodone. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with trazodone:

  • Anesthetics CNS depressants (eg, alcohol, barbiturates, narcotics)
  • Digoxin (eg, Lanoxin)
  • Phenytoin (eg, dilantin)
  • Warfarin (eg, Coumadin)

Side Effects of Trazodone:

Every drug is capable of producing side effects. Many trazodone users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Digestive Tract: Upset stomach; nausea; vomiting; diarrhea; constipation; decreased appetite; dry mouth.

Nervous System: Anger; hostility; sleeplessness; nightmares or vivid dreams; confusion; disorientation; decreased concentration; dizziness; drowsiness; excitement; fatigue; headache; tremor; impaired memory; nervousness; incoordination; lightheadedness.

Circulatory System: Changes in blood pressure; pounding in the chest; fast heartbeat.

Senses: Ringing in the ears; blurred vision; red, tired, itching eyes; nasal or sinus congestion.

Other: Shortness of breath; weight changes; swelling; aches and pains; fainting; bad taste in the mouth; abnormal skin sensations; general body discomfort; feeling of heaviness or fullness in the head; prolonged painful erection; decreased sex drive; clamminess; sweating; orthostatic hypotension (dizziness or lightheadedness when rising from a sitting or lying position).

Guidelines for Use:

  • Dosage is individualized.
  • Dosage will be initiated at a low level and increased gradually by your doctor.
  • Take shortly after a meal or snack.
  • If a dose is missed, take it as soon as possible. If several hours have passed or if it is nearing time for the next dose, do not double the dose to catch up, unless advised to do so by your doctor. If more than one dose is missed, or it is necessary to establish a new dosage schedule, contact your doctor or pharmacist.
  • May cause drowsiness, dizziness, or blurred vision. Use caution while driving or performing other tasks requiring alertness, coordination, or physical dexterity.
  • Avoid alcohol or other drowsiness-causing medications (eg, antihistamines, barbiturates, narcotic pain relievers) while taking trazodone.
  • Notify your doctor if you experience drowsiness, sore throat, fever, or any signs of infection.
  • Male patients with prolonged and painful erections (priapism) should immediately discontinue the drug and consult their doctor.
  • Lab tests may be required to monitor therapy. Be sure to keep appointments.
  • Store at controlled room temperature (59 0 to 86°F).



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Some Tricyclic Antidepressants and Their Recommended Dosage

Mipramine HCI:

  • Usual initial adult dose for outpatients is 75 mg/day increased to 150 mg/day. Doses over 200 mg/day are not recommended. Maintenance dose is 50 to 150 mg/day.
  • For hospitalized patients, usual initial adult dosage is 100 mg/day in divided doses gradually increased to 200 mg/day as required. If no response occurs after 2 weeks, increase dose to 250 to 300 mg/day.
  • For adolescents and elderly patients, usual initial dose is 30 to 40 mg/day, not to exceed 100 mg/day.
  • Childhood bed wetting – An oral dosage of 25 mg/day given 1 hour before bedtime should be tried in children 6 years of age and older.
  • If satisfactory response does not occur within 1 week, increase the dose to 50 mg nightly in children younger than 12 years of age; children older than 12 may receive up to 75 mg nightly.
  • Doses larger than 75 mg do not work better and tend to incense the side effects.

Imipramine HCI (cant.):

  • Consider instituting a drug-free period following an adequate therapeutic trial with a favorable response.
  • To reduce the tendency to relapse, taper dosage gradually rather than discontinue abruptly.

Imipramine pamaate:

  • Initiate adult dose for outpatients at 75 mg/day and increase to 150 mg/day, which is the dose level at which optimum response is usually obtained. If necessary, dose may be increased to 200 mg/day. Doses higher than 75 mg/day may also be administered on a once-a­day basis at bedtime after the optimum dosage and tolerance have been determined.
  • Maintenance dosage is usually 75 to 150 mg/day administered on a once-a-day basis, preferably at bedtime.

Nortriptyline:

  • Usual adult dosage is 25 mg 3 to 4 times daily. As an alternative regimen, the total daily dose may be given once a day.
  • Doses above 150 mg/day per day are not recommended.
  • Usual dosage in elderly patients is 30 to 50 mg/day in divided doses.

Protriptyline:

  • Usual adult dosage is 15 to 40 mg/day divided into 3 or 4 doses. If necessary, dose may be increased to 60 mg/day. Make dose increases with the morning dose.
  • Doses above 60 mg/day are not recommended.
  • For elderly patients, the usual dosage is 5 mg 3 times a day initially and is increased gradually. The cardiovascular system must be monitored closely if the daily dose exceeds 20 mg.

Trimipramine:

  • Usual initial adult dosage for outpatients is 75 mg/day in divided doses. May be increased to 150 mg/day if needed.
  • Doses over 200 mg/day are not recommended.
  • Hospitalized patients may be given 100 mg/day initially in divided doses, increased gradually in a few days to 200 mg/day. If improvement does not occur in 2 to 3 weeks, the dose may be increased to the maxi­mum recommended dose of 250 to 300 mg/day.
  • Usual initial dose for adolescents and elderly patients is 50 mg/day, increasing in gradual increments up to 100 mg/day.

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Tricyclic Antidepressants – Uses and Precautions

Type of drug:

Antidepressants; mood-elevating agents.

How the Drug Works:

Tricyclic antidepressants (TCAs) appear to adjust or rebalance the brain’s own natural chemicals (neurotransmitters), which control mood, feelings, and behaviors. The effect may take a few weeks (1 to 4) to be noticed.

Uses:

For the relief of symptoms of depression (except clomipramine).

Clomipramine: Only for the treatment of obsessive-compulsive disorder.

Doxepin: To treat anxiety.

Imipramine: For the treatment of bedwetting in children 6 years of age and older after possible organic causes have been excluded by appropriate tests.

Unlabeled Uses: Occasionally doctors may prescribe doxepin, clomipramine, imipramine, or amitriptyline to control chronic pain and to treat bulimia. Imipramine, clomipramine, nortriptyline, and other tricyclic anti­depressants have also been used to treat panic disorder. Amitriptyline has been used to prevent the onset of cluster and migraine headaches and to treat pathologic weeping and laughing secondary to forebrain disease. Protriptyline has been used in the treatment of obstructive sleep apnea. Trimipramine and doxepin have been studied in the treatment of peptic ulcer disease and to treat skin disorders. Desipramine has been used to facilitate cocaine withdrawal and to treat bulimia. Clomipramine and nortriptyline have been used to treat panic disorder. Nortriptyline has also been used to treat skin disorders and premenstrual depression.

Precautions:

Tardive Dyskinesia: Involuntary and uncontrollable movements may develop in patients treated with these drugs. Occurrence is highest among the elderly, especially women. The risk of developing these involuntary movements and the likelihood that they will become permanent are increased as the length of treatment and the total amount of drug given increases. However, it is possible to develop these symptoms after short-term treatment at low doses.

Neuroleptic Malignant Syndrome (NMS) Is a potentially fatal syndrome associated with use of tricyclic antidepressants. Symptoms include increased body heat, muscle rigidity, altered mental abilities including catatonia, irregular pulse or irregular blood pressure, increased heart rate, sweating, and irregular heart rhythm.

Withdrawal Symptoms: Stopping abruptly after prolonged therapy may pro­duce nausea, headache, dizziness, nightmares, and malaise. Clomipramine may also cause vomiting, sleep disturbances, hyperthermia (abnormally high temperature), and irritability. Gradual dose reduction may produce, within 2 weeks, transient symptoms including irritability, restlessness, dreams, and sleep disturbances.

Sensitivity to sunlight: May occur. Avoid prolonged exposure to the sun. Use sunscreens and wear protective clothing until tolerance is determined. These drugs may reduce tolerance to hot weather.

Pregnancy: Adequate studies have not been done in pregnant women. Use only if clearly needed and potential benefits outweigh the possible hazards to the fetus. There have been a few reports of birth defects associated with use of imipramine and amitriptyline. Withdrawal symptoms have been seen in newborns of mothers who have taken clomipramine, desipramine, or imipramine until delivery.

Breastfeeding: Tricyclic antidepressants appear in breast milk. Because of the potential for adverse reactions, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother. Consult your doctor before you begin breastfeeding.

Children: Amitriptyline and doxepin are not recommended for patients younger than 12 years of age. Safety and effectiveness have not been established for amoxapine in children younger than 16 years of age. Imipramine HCI use in bed wetting should be limited to children 6 years of age or older. The safety and effectiveness of imipramine HCI in children with conditions other than bed wetting have not been established. Safety and effectiveness have not been established for clomipramine in children younger than 10 years of age. Trimipramine, nortriptyline, desipramine, imipramine pamoate, and protriptyline are not recommended for use in children.

Elderly: Elderly patients are particularly sensitive to the anticholinergic effects (eg, constipation; difficulty urinating; confusion) of tricyclic antideprossants and may be at increased risk for falls. Lower than normal adult doses are generally used when starting therapy.


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Venlafaxie – Benefits and Uses

Type of Drug:

Antidepressant; mood-elevating agent
How the Venlafaxie Product Works:

Venlafaxine inhibits neuronal uptake of serotonin and norepinephrine in the central nervous system, which is believed to combat depression and other behavioral disorders.
Uses of The Venlafaxie:

The treatment of depression. The extended-release form is also used to treat generalized anxiety disorder.

Pregnancy: Adequate studies have not been done in pregnant women. Use only if clearly needed and potential benefits to the mother outweigh the possible hazards to the fetus.

Breastfeeding: Venlafaxine appears the breast milk. A decision should be made to either discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.

Children: Safety and effectiveness in children younger than 18 years of age have not been established.
Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are planning to take any over-the-counter or prescription medications or dietary supplements with venlafaxine HCI. Doses of one or both drugs may need to be modified or a different drug may need to be prescribod. The following drugs and drug classes interact with venlafaxino HCl.

*

MAOls (eg, phenelzine)
* Sibutramine (Meridia)

Side Effects:

Every drug is capable of producing side effects. Many venlafaxine HCI users experience no or minor side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Circulatory System: Increased blood pressure; increased heart rate; decreased blood pressure upon rising; flushing.

Digestive Tract: Nausea; constipation; appetite loss; diarrhea; vomiting; indigestion; stomach pain; gas; difficulty swallowing; dry mouth;belching.

Nervous System: Drowsiness; sleeplessness; dizziness; nervousness; headache; vertigo (feeling of whirling motion); migraine; anxiety; tremor; abnormal dreams; abnormal skin sensations; agitation; confusion; impaired memory; depression; abnormal thinking; unstable emotions; lockjaw; twitching; depersonalization; decreased sex drive; muscle stiffness.

Respiratory System: Yawning; bronchitis; difficulty breathing; runny nose; cough.

Senses: Blurred vision; taste changes; ringing in the ears; dilated pupils; ear pain; vision changes.

Skin: Sweating; rash; itching; flushing.

Urinary and Reproductive Tract: Abnormal ejaculation or orgasm; impotence; impaired urination; urinary frequency; menstrual disorders; blood in the urine; painful or difficult urination; irregular bleeding between periods; inflammation of the vagina with itching or abnormal discharge; urinary retention.

Other: Weakness; infection; chills; chest pain; weight gain or loss; accidental injury; general body discomfort; neck pain; muscle pain; joint pain; swelling of hands or feet; unusual bruising.
Guidelines for Use:

*

Tablets – Usual adult starting dose is 75 mg/day, taken in 2 or 3 divided doses. Dosage may be gradually increased to achieve the desired effect.
*

Extended-release capsules – Usual adult starting dose is 75 mg/day taken as a single dose.
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Take each dose with food.
*

Do not crush, chew, or dissolve extended-release capsules in water. Swallow extended-release capsules whole, with fluid.
*

If a dose is missed, take it as soon as possible. If several hours have passed or if it is nearing time for the next dose, do not double the dose to catch up, unless advised to do so by your doctor. If several doses are missed or it is necessary to establish a new dosage schedule, con­tact your doctor or pharmacist. Use exactly as prescribed.
*

Do not change the dose or stop taking venlafaxine unless advised to do so by your doctor.
*

If venlafaxine therapy is discontinued, the dose should be gradually reduced over a 2-week period.
*

Smaller doses should be used in patients with moderate liver or kidney impairment.
*

Venlafaxine should not be used in combination with an MAOI, or within at least 14 days of discontinuing treatment with an MAOI. After stop­ping venlafaxine, at least 7 days should elapse before starting an MAOI.
*

Because any psychoactive drug may impair judgment, thinking, or motor skills, do not operate hazardous machinery, including automobiles, until you are reasonably certain that venlafaxine does not adversely affect your ability to engage in such activities.
*

Inform your doctor if you are pregnant, become pregnant, are planning to become pregnant, or if you are breastfeeding during therapy.
*

Notify your doctor if rash, hives, or other allergic reactions occur.
*

Blood pressure will be monitored during treatment.
*

Notify your doctor or pharmacist if you are taking other prescription drugs, over-the-counter drugs, or supplements.
*

Avoid alcohol use during venlafaxine therapy.
*

Store at room temperature (68 to 77°F). Keep container tightly closed.


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Leading Drugs Dealing Company For Your Rescue

Amongst the top generic drug makers, tevausa is the most celebrated name, which has won acclaim as topmost drug dealing company in the world. Being a subsidiary of Teva Pharmaceutical Industries Ltd, one of the top pharmaceutical companies across the globe, tevausa holds a successful track record for a great range of products available on the online store of this company.

The company shares association with top ranking brands of drugs like Aldomet, Amoxin, Biotin, Cipro, Glucosamine, Lidex, Niacin and many more. The product line offered by this company consists of various forms like injections, oral, solid and dose. The company holds the hugest database of as many as 300 products in the form of tablets, capsules, creams, ointments, solutions and suspensions.

The company also aims at providing health education to customers as well as pharmacists, through its education programs under the section of Teva University. The health related news and events also find space on this web portal. Thus, it happens to be the complete health guide for people with varied interests.

The company is in constant process of introducing more effective new generic drugs in the market to revolutionize the health treatment practices. Thus, there are no two opinions in declaring this company as top drug marketing company, which is strengthening its roots with each passing day.


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