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.
DRUG CLASS AND MECHANISM:
Sertraline belongs to a class of drugs called selective serotonin reuptake
inhibitors (SSRIs). Other drugs in this class are Prozac (fluoxetine), Paxil
(paroxetine), Celexa (citalopram) and Luvox (fluvoxamine). Serotonin is a
neurotransmitter (a chemical messenger) produced by nerve cells in the brain
that is used by the nerves to communicate with one another. A nerve releases the
serotonin it produces into the space surrounding it. The serotonin either
travels across the space and attaches to receptors on the surface of nearby
nerves or it attaches to receptors on the surface of the nerve that produced it,
to be taken up by the nerve and released again (a process referred to as
re-uptake). A balance is reached for serotonin between attachment to the nearby
nerves and reuptake. Selective serotonin inhibitors block the reuptake of
serotonin and therefore change the level of serotonin in the brain.
It is
believed that some illnesses such as depression are caused by disturbances in
the balance between serotonin and other neurotransmitters. The leading theory is
that drugs such as sertraline restore the chemical balance among
neurotransmitters in the brain. The FDA approved sertraline in December 1991.
DOSING: The recommended dose of sertraline is 25-200 mg once daily.
Treatment of depression, OCD, panic disorder, PTSD, and social anxiety disorder
is initiated at 25-50 mg once daily. Doses are increased at weekly intervals
until the desired response is seen.
The recommended dose for PMDD is 50-150 mg
every day of the menstrual cycle or for 14 days before menstruation.
Sertraline
may be taken with or without food.
DRUG INTERACTIONS: Serious reactions such as hyperthermia,
fluctuations in blood pressure and rigidity of muscles may occur when SSRIs are
used in combination with monoamine oxidase inhibitors (MAOI) such as phenelzine,
tranylcypromine (Parnate) and isocarboxazid. Therefore, SSRIs should not be used
in combination with MAOIs. In addition, SSRIs and MAOIs should not be used
within 14 days of each other.
Cimetidine (Tagamet) may increase the levels in blood of sertraline by reducing the
elimination of sertraline by the liver. Increased levels of sertraline may lead
to more side effects.
Sertraline increases the blood level of
pimozide (Orap) by 40%. High levels
of pimozide can affect electrical conduction in the heart and lead to sudden
death. Therefore, patients should not receive treatment with both pimozide and
sertraline.
Through unknown mechanisms, sertraline may increase the blood thinning action
of warfarin (Coumadin). The effect of warfarin should be monitored when sertraline is
started or stopped.
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.
Huntington's disease is the result of degeneration of neurons in areas of the brain. Huntington's disease is an inherited disorder. Early symptoms include mood swings, apathy, depression, and anger uncharacteristic of the individual. Judgement, memory, and other cognitive functions may become impaired. Presymptomatic testing is available for individuals who have a family history of Huntington's disease. Treatment includes medication and therapy for symptoms.
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.
Attention deficit hyperactivity disorder (ADHD) is a behavioral disorder characterized by the symptoms hyperactivity, impulsivity, and inattention. Treatment for ADHD may involve behavioral therapy and psychostimulant or antidepressant medication.
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.
Fragile X syndrome is the most common inherited form of mental retardation. It's caused by a mutation on the X chromosome. People with Fragile X syndrome suffer from physical, social, emotional, speech, language, sensory, intelligence, and learning impairments. There is no definitive treatment for Fragile X, though there are ways to minimize the symptoms.
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.
Depressive disorders have been with mankind since the beginning of recorded history. In the Bible, King David, as well as Job, suffered from this affliction. Hippocrates referred to depression as melancholia, which literally means black bile. Black bile, along with blood, phlegm, and yellow bile were the four humors (fluids) that described the basic medical physiology theory of that time. Depression, also referred to as clinical depression, has been portrayed in literature and the arts for hundreds of years, but what do we mean today when we refer to a depressive disorder? In the 19th century, depression was seen as an inherited weakness of temperament. In the first half of the 20th century, Freud linked the development of depression to guilt and conflict. John Cheever, the author and a modern sufferer of depressive disorder, wrote of conflict and experiences with his parents as influencing his development of depression.
Depression RSS
Healthy Living Tips
