Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Paroxetine may increase the effect of the blood thinner,
warfarin (Coumadin), leading to excessive bleeding. Therefore, warfarin therapy should be
monitored more frequently in patients who are also taking paroxetine. Combining
SSRIs such as paroxetine with aspirin, nonsteroidal anti-inflammatory drugs or
other drugs that affect bleeding may increase the likelihood of upper
gastrointestinal
bleeding. Phenytoin (Dilantin) and phenobarbital may decrease the amount of
paroxetine in the body and possibly reduce its effectiveness.
PREGNANCY: Use of paroxetine
during pregnancy may result in congenital heart defects. Paroxetine should not
be administered to pregnant women unless
the need justifies the risk.
NURSING MOTHERS: Paroxetine
is secreted in breast milk. Mothers who are taking paroxetine should consider
not breastfeeding.
SIDE EFFECTS: Paroxetine can
cause nausea,
headaches, anxiety, insomnia, drowsiness, constipation, weakness,
dry mouth, sweating, diarrhea and loss of appetite. Increased blood pressure can
occur, and blood pressure should be monitored during treatment.
Seizures have
been reported. Sexual dysfunction
has been associated with paroxetine. Some patients may experience withdrawal
reactions upon stopping paroxetine. Symptoms of withdrawal include anxiety,
nausea, nervousness, and insomnia. The dose of paroxetine should be gradually
reduced when therapy is discontinued.
Antidepressants increased the risk of suicidal thinking
and behavior (suicidality) in short-term studies in children and adolescents
with depression and other psychiatric disorders. Anyone considering the use of paroxetine or any
other antidepressant in a child or adolescent must balance this risk with the
clinical need. Patients who are started on therapy should be closely observed
for clinical worsening, suicidality, or unusual changes in behavior.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Panic attacks are sudden feelings of terror that strike without warning. These episodes can occur at any time, even during sleep. A person experiencing a panic attack may believe that he or she is having a heart attack or that death is imminent. The fear and terror that a person experiences during a panic attack are not in proportion to the true situation and may be unrelated to what is happening around them. Most people with panic attacks experience several of the following symptoms: racing heartbeat, faintness, dizzyness, numbness or tingling in the hands and fingers, chills, chest pains, difficulty breathing, and a feeling of loss or control. There are several treatments for panic attacks.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Post-traumatic stress disorder (PTSD), a psychiatric condition, can develop after any catastrophic life event. Symptoms include nightmares, flashbacks, sweating, rapid heart rate, detachment, amnesia, sleep problems, irritability, and exaggerated startle response. Treatment may involve psychotherapy, group support, and medication.
Bipolar disorder (or manic depression) is a mental illness characterized by depression, mania, and severe mood swings. Treatment may incorporate mood stabilizer medications, antidepressants, and psychotherapy.
Obsessive compulsive disorder (OCD) is an anxiety disorder that causes a person to suffer repeated obsessions and compulsions. Symptoms include irresistible impulses despite a person's realization that the thoughts are irrational, excessive hand washing, skin picking, lock checking, or repeatedly rearranging items. People with OCD are more likely to develop trichotillomania, muscle or vocal tics, or an eating disorder. Treatment for OCD includes psychotherapy, behavioral therapy, and medication.
Premenstrual syndrome (PMS) is a combination of physical and emotional disturbances that occur after a woman ovulates and ends with menstruation. Common PMS symptoms include depression, irritability, crying, oversensitivity, and mood swings. For some women PMS symptoms can be controlled with medications and lifestyle changes such as exercise, nutrition, and a family and friend support system.
Agoraphobia is a fear of being outside or of being in a situation from which escape would be impossible. Symptoms include anxiety, fear, disorientation, rapid heartbeat, diarrhea, or dizziness. Treatment may incorporate psychotherapy, self-exposure to the anxiety-causing situation, and medications such as SSRIs, benzodiazepines, and beta blockers.
Seasonal affective disorder is a type of depression that tends to occur as the days grow shorter in the fall and winter. Symptoms of seasonal affective disorder include tiredness, fatigue, depression, irritability, body aches, poor sleep and overeating.
Phobias are unrelenting fears of activities (social phobias), situations (agoraphobia), and specific items (arachnophobia). There is thought to be a hereditary component to phobias, though there may be a cultural influence or they may be triggered by life events. Symptoms and signs of phobias include having a panic attack, shaking, breathing troubles, rapid heart beat, and a strong desire to escape the situation. Treatment of phobias typically involves desensitization, cognitive behavioral therapy, and medications such as selective serotonin reuptake inhibitors and beta blockers.
Separation anxiety disorder is a common childhood anxiety disorder that has many causes. Infants, children, older kids and adults can suffer from symptoms of separation anxiety disorder. Common treatment methods include therapy and medications.
Premenstrual dysphoric disorder (PMDD) is considered to be a severe form of premenstrual syndrome (PMS). PMDD has also been referred to as late luteal phase dysphoric disorder. The cause of PMDD is unknown. Some of the common symptoms of PMDD (not an inclusive list) include: mood swings, bloating, fatigue, headache, irritability, headache, breast tenderness, acne, hot flashes and more. Treatment for PMDD is with medication to treat the symptoms of PMDD.
Narcolepsy, a chronic disease of the central nervous system causes have not been fully determined. Some theories include abnormalities in hypocretin neurons in the brain or an autoimmune disorder. Symptoms of narcolepsy include excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, sleep paralysis, disturbed nocturnal sleep, and automatic behavior. Diagnosis of narcolepsy is based on a clinical evaluation, specific questionnaires, sleep logs or diaries, and the results of sleep laboratory tests. Treatments of narcolepsy symptoms include medication and lifestyle changes.
Dysthymia is a less severe form of chronic depression. Symptoms and signs include insomnia, suicidal thoughts, guilt, empty feeling, loss of energy, helplessness, sluggishness, and persistent aches and pains. Treatment may involve psychotherapy, electroconvulsive therapy, and antidepressants.
Though the holidays are a fun time for most, for others, they're a sad, lonely and anxiety-filled time. Get tips on how to avoid depression and stress during the holiday season.
Body dysmorphic disorder (BDD) is an illness where a person is overly preoccupied with some minor or imaginary flaw. People with BDD tend to have cosmetic surgery. BDD can be treated with SSRIs and cognitive behavioral therapy.
Postpartum depression is a form of depression that occurs within a year after delivery. It is thought that rapid hormone changes after childbirth may lead to depression. Symptoms of postpartum depression include crying a lot, headaches, chest pains, eating too little or too much, sleeping too little or too much, withdrawal from friends and family, and feeling irritable, sad, hopeless, worthless, guilty, and overwhelmed. Treatment typically involves talk therapy and medication.
Bipolar disorder, or manic-depressive illness, is a disorder that causes unusual and extreme mood changes. Symptoms of bipolar disorder in children and teens include having trouble concentrating, behaving in risky ways and losing interest in activities they once enjoyed. Treatment for bipolar disorder in children and teenagers incorporates psychotherapy and medications.