Medical topics and articles from Armenian Medical Network

Depression Treatment

The American Psychiatric Association estimates that 80 to 90 percent of all Depression can be treated. The first step is an accurate diagnosis. Along with a physical and lab tests to rule out causes such as reduced thyroid activity, a complete psychiatric history should be taken.

And because Depression and other major psychiatric problems are side effects of many medications, a good work-up will also include a review of the patient’s medications and any illicit drug use.

Is It Clinical Depression or Sadness?

Although Depression is often thought of a being an extreme state of sadness, there is a vast difference between clinical Depression and sadness. Sadness is a part of being human, a natural reaction to painful circumstances. All of us will experience sadness at some point in our lives.

Depression, however, is a physical illness with many more symptoms than an unhappy mood. The person with clinical Depression finds that there is not always a logical reason for his dark feelings. Exhortations from well-meaning friends and family for him to “snap out of it” provide only frustration for he can no more “snap out of it” than the diabetic can will his pancreas to produce more insulin. Sadness is a transient feeling that passes as a person comes to term with his troubles.

First Person Description of Major Depression

It takes the greatest effort to get out of bed in the morning.
I am tired all day, yet when night comes, sleep evades me.
I stare at the ceiling, wondering what has happened to my
life, and what will become of me. Nothing is getting done
at work. I have projects to complete, but I can’t think. I try
to focus on my work, and I get lost. I keep wondering when
the boss will discover how little I have accomplished. My wife
does not understand. She keeps telling me to “snap out of it.”
I’m irritable all the time, and yell at the kids, then I feel
terrible later. Nothing is fun any more. I can’t read, and the
music I used to enjoy so much does nothing for me. I am bored,
but I feel like doing nothing. There are times, when I’m alone,
that I think that life is hopeless and meaningless, and I can’t
go on much longer.

Selective Serotonin Reuptake Inhibitors (SSRI)

Whenever an adolescent attempts or commits suicide there is always the question of “Why?”
Parents should be aware that depressed children 18 and under are at an increased risk of suicide when prescribed selective serotonin reuptake inhibitors (SSRI’s). SSRI’s are a class of antidepressants that act within the brain to increase the amount of the neurotransmitter serotonin by inhibiting its re-uptake at synapses. SSRIs were specifically designed to treat Depression.

Signs & Symptoms of Early Pregnancy

Morning Sickness

This lovely affliction affects many pregnant women, but by no means all. It’s estimated that only 50% of women will experience morning sickness.

It is not very well named either. Any variation of sickness is applicable. Some women are sick only in the night, some are sick all day, other women it comes and goes with its own pattern. There is also a difference in whether it’s merely a queasy feeling or actual vomiting.

Ectopic pregnancy

Although the incidence of ectopic pregnancy has increased during the past 30 years, early diagnosis and treatment have reduced the death rate by 90 percent. The development of sensitive urine and blood pregnancy tests, along with vaginal ultrasound, result in early diagnosis. Despite improved diagnostic methods, however, ectopic pregnancy remains the leading cause of pregnancy-related death (3.8 deaths per 10,000 cases) during the first 12 weeks of pregnancy and accounts for about 10 percent of all pregnancy related deaths.

Ectopic pregnancy occurs when the embryo implants at a site other than the lining of the uterus. Approximately 98 percent of ectopic pregnancies occur in the fallopian tube and the remainder are in the ovary, abdominal cavity or cervix.

What Happens in the Depressed Brain?

You’ve probably probably heard the term “neurotransmitter” before, but what does this really mean? Neurotransmitters are chemical messengers within the brain that facilitate communication between nerve cells. Let’s illustrate with serotonin. Figure 1 depicts the junction between two nerve cells.

Packets of serotonin molecules are released from the end of the presynaptic cell (the axon) into the space between the two nerve cells (the synapse). These molecules may then be taken up by serotonin receptors of the postsynaptic nerve cell (the dendrite) and thus pass along their chemical message. Excess molecules are taken back up by the presynaptic cell and reprocessed.

Antidepressant Classes

There are three basic molecules, known chemically as monoamines, which are thought to play a role in mood regulation: norepinephrine, serotonin and dopamine. Antidepressants are categorized by how they affect these chemicals. The following are the major classes of antidepressants.

Monoamine Oxidase Inhibitors

Oral treatments for Erectile dysfunction

Sildenafil (Viagra)
Sildenafil (Viagra) is now prescribed in over 90% of erectile dysfunction cases. Studies indicate that it helps 70% of patients achieve sexual function. In one 1999 study, overall male satisfaction was 65%. Not surprisingly, the best results occurred in men who had the fewest sexual problems before treatment, but even men with severe erectile dysfunction had a 41% satisfaction rate. A 2000 study of men who had responded well initially to sildenafil found that 96% of them were satisfied with the treatment after two to three years.

Administration and Effect. Sildenafil is effective within 20 to 40 minutes. The drug works only when the man experiences some sexual arousal. Patients usually take 50 mg, although lower doses (eg, 25 mg) may be appropriate in some groups, such as elderly patients. Sildenafil should not be used more than once a day and the dose should not exceed 100 mg. Used alone or in combination with penile injections, it may help men who did not respond to initial therapy with penile injections alone, but side effects can be quite intense when the combination is used.

Cialis - New Generation PDE5 Inhibitors

Researchers are investigating a newer version of drugs that inhibit the enzyme targeted by Viagra, phosphodiesterase-5 (PDE5).

Cialis. Cialis (IC351) is a potent and highly-selective PDE5 inhibitor and may not affect other parts of the body, including the brain, heart, kidney and eyes. Clinical trials are reporting significant success rates in up to 88% of patients. It appears to take effect in 15 minutes and the effects last up to 24 hours. Improved results were reported in men suffering from erectile dysfunction of varying severity and causes. Common side effects include headache, muscle pain, stomach upset following meals, and back pain.

Vardenafil (Levitra). Levitra is another PDE5 inhibitor currently being investigated. A small study concluded that it increased penile rigidity and tumescence. Further evaluation is warranted.