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QUOTE (Infidel @ Jun 20 2008, 05:15 AM) * These forums have been absolutely invaluable in being able to help my Pdoc direct my care. Reading people's experiences here gives me the info I need to suggest possible solutions to my Pdoc, and fortunately he is willing to do whatever I want until we find the solution.
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Depression & Mental Health FAQs
US Centers for Disease Control and Prevention (CDC) estimated 40 million
Americans living today will suffer from major depressive illness during their lives.

Seasonal affective disorder is major depression that appears in the fall or winter and goes away in spring, thought to be caused by lack of sunlight.



Postpartum depression occurs within four weeks of a women giving childbirth. Most new mothers suffer from some form of the �baby blues.� Postpartum depression, by contrast, is major depression, thought to be triggered by changes in hormonal flows associated with childbirth.

Catatonic depression is a rare form of major depression characterized by (at least two): Stupor, excessive motor activity, extreme negativism, peculiarities in voluntary movement, and repetition of other people's words or actions. - mcmanweb.com



Psychotic depression is a rare form of depression characterized by delusions or hallucinations, such as believing you are someone you are not and hearing voices.


According to the National Institute of Mental Health, approximately 18.8 million American adults, or about 9.5 percent of the US population age 18 and older in a given year, have a depressive disorder.
Depression is a chronic illness that exacts a significant toll on America's health and productivity.  It affects more than 21 million American children and adults annually and is the leading cause of disability in the United States for individuals ages 15 to 44.


Lost productive time among U.S. workers due to depression is estimated to be in excess of $31 billion per year.  Depression frequently co-occurs with a variety of medical illnesses such as heart disease, cancer, and chronic pain and is associated with poorer health status and prognosis.  It is also the principal cause of the 30,000 suicides in the U.S. each year.  In 2004, suicide was the 11th leading cause of death in the United States, third among individuals 15-24.


According to the World Health Organization, depression is presently on track to becoming the world's second-most disabling disease (after heart disease) by the year 2020.

Depression is responsible for some $87 billion a year in lost productivity in the US (a conservative estimate), and according to Bank One, is responsible for most lost work days in its employees after pregnancy and childbirth.

Additionally, one million people worldwide die by their own hand, most as a result of a mood disorder. Finally, the linkage between depression and a host of physical illnesses makes it arguably the world's greatest killer.

Research presented at the 56th Annual Conference of the Canadian Psychiatric Association shows a marked link between bipolar disorder and migraines.

The odds of migraine in persons with bipolar disorder were 40% higher than the general population.

Data obtained from 36,984 people aged 15 and over, who screened positive for manic or depressive episodes with migraine, were compared against those who screened positive for mania but who didn�t suffer from migraines.

Amongst males, 14.9% of those with manic episodes were also diagnosed with migraines compared with 5.8% of the general population. Amongst females, 34.7% had both migraines and bipolar disorder compared with 14.7% who only had migraines.unquote.gif

While the research was skewed towards persons who were already diagnosed with bipolar disorders, what does it mean for people who suffer from migraines but who may have an undiagnosed bipolar disorder?



Migraines and headaches aren�t fully understood but the manifestations are very real and debilitating for their sufferers:

Throbbing pain
Nausea
Heightened sensitivity to light or sound
Seeing dots, wavy lines, flashing lights, or blind spots
Difficulty with speech, sensation, or movement

 


An estimated 2.1 million American adolescents have experienced major depression within the last year, according to a new comprehensive government study.  Researchers surveyed more than 67,000 young people ages 12 to 17 and found that one in 12 had suffered from serious depression in the previous year.Nearly 13 percent of girls had struggled with depression, compared to less than 5 percent of boys. Odds of depression increased with age -- just 4 percent of 12-year-olds experienced depression but that climbed to 11 percent for older teens.

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Emsam (Selegiline) patch

By Lindsay
FDA OKs Patch to Treat Depression

Using Emsam in Lower Doses May Avoid Concerns About Drug Interactions
By Miranda Hitti
WebMD Medical News

Reviewed By Louise Chang, MD
on Tuesday, February 28, 2006

Feb. 28, 2006 -- The FDA has approved the first skin patch for use in treating major depression .

The once-a-day patch, called Emsam, works by delivering selegiline, a monoamine oxidase inhibitor or MAOI, through the skin and into the bloodstream.

Selegiline isn't a new drug. It was initially approved in capsule form for use in Parkinson's disease.

Like other MAOIs, selegiline has carried warnings about possible dangerous interactions with certain foods and drinks, including aged cheeses and tap beer. The new patch's lowest dose may avoid some of those interactions.

"At its lowest strength, Emsam can be used without the dietary restrictions that are needed for all oral MAO inhibitors that are approved for treating major depression," states an FDA news release.

However, higher doses of the patch require dietary restrictions, and all of the doses carry other cautions.

FDA's Comments

The FDA's Steven Galson, MD, MPH, commented on the new patch, in a news release.

"Emsam provides a significant advance because at least in its lowest dose patients can use the drug without the usual dietary restrictions associated with these types of drugs known as MAO inhibitors," says Galson, who directs the FDA's Center for Drug Evaluation and Research.

Major depression is common in the U.S. Depression can often be treated by methods including counseling and antidepressants, which come in several forms including MAOIs. Depression symptoms can include sadness, fatigue, insomnia, changes in weight or appetite, loss of interest in usual activities, restlessness, suicide attempts, and suicidal thinking.

How MAOIs Work

MAOIs usually require specific dietary restrictions because when combined with certain foods they can cause a sudden, large increase in blood pressure. That problem, called "hypertensive crisis," can lead to a stroke and death.

Here's how hypertensive crisis can happen.

MAOIs block an enzyme called monoamine oxidase (MAO). Blocking MAO in the brain is thought to have antidepressant effects by preventing the breakdown of certain brain chemicals. But the body also uses MAO to break down a protein called tyramine, which we get from consuming aged cheeses, tap beer, and other foods and drinks.

If tyramine isn't broken down, the body may absorb too much of it. The result can be a hypertensive crisis -- in other words, a dangerous spike in blood pressure.

Symptoms of Hypertensive Crisis

Symptoms of a hypertensive crisis include sudden onset of severe headache, nausea, blurry vision, a fast heartbeat or a change in the way your heart beats (palpitations), sweating, and confusion.

"Patients who have these symptoms should get medical care right away," states the FDA.

The lowest dose of the MAOI patch, which delivers 6 milligrams of the medication over a 24-hour period, can be used without such dietary restrictions.

About the New Patch

The Emsam patch will be made available in three sizes that deliver 6 milligrams, 9 milligram, or 12 milligrams of selegiline per 24 hours. The patch sandwiches the drug between two lining layers.

Emsam has been shown to be safe and effective for treatment of major depressive disorder in two six- to eight-week studies and also in a longer-term study of patients, states the FDA.

The data for the lowest dose of Emsam support the recommendation that a modified diet is not required at this dose. Patients are advised to change the patch once a day.

The more-limited data available for Emsam 9-milligram/24-hour and 12-milligram/24-hour don't rule out food effects. Patients receiving those higher doses should follow dietary restrictions that advise them to avoid certain foods or beverages, such as aged cheese and wine.

Side Effects

The only common side effect of Emsam detected in placebo-controlled trials was a mild skin reaction where the patch is placed. There may be mild redness at the site when a patch is removed.

If the redness does not go away within several hours after removing the patch or if irritation or itching continues, patients are advised to contact their doctor.

A less common side effect was light-headedness related to a drop in blood pressure.

Avoid Direct Heat

Although the effects of heat on the patch are not known, the drug labeling advises doctors and patients about the possible effects of direct heat applied to the Emsam patch.

Direct heat may result in an increased amount of the drug absorbed from the patch. Patients should avoid exposing the patch to heating pads, electric blankets, heat lamps, saunas, hot tubs, or prolonged sunlight.

Like all approved antidepressants, this product carries a warning of increased suicidality in children and adolescents.

Emsam was developed by Somerset Pharmaceuticals, Inc. In December 2004, Bristol-Myers Squibb and Somerset entered into an agreement that provides Bristol-Myers Squibb with distribution rights to market Emsam after approval in the U.S.

Next Steps

Bristol-Myers Squibb and Somerset Pharmaceuticals have planned an educational campaign for patients and prescribers to ensure that advice on dietary modifications for the higher patch strengths is adhered to.

The companies plan to conduct both patient and health care provider surveys to assess the effectiveness of the educational campaign. They will also closely track reports of adverse events, and follow up on those that might represent hypertensive crises, to further ensure the patch's safe use.

In a news release, the drug companies list other cautions with Emsam, including interactions with various prescription drugs, as well as alcohol. The patch should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus, the companies state.

SOURCES: News release, FDA. News release, Bristol-Myers Squibb Company and Somerset Pharmaceuticals.





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Non-Invasive Treatment For Depression - Rush University Medical Center Psychiatrist Led Clinical Trials Of Transcranial Magnetic Stimulation
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Depression & Mental Health FAQs 2
What is Clinical Depression?

Clinical depression can affect your body, mood, thoughts, and behavior. It can change your eating habits, how you feel and think about things, your ability to work and study, and how you interact with people.

Clinical depression is not a passing mood, a sign of personal weakness or a condition that can be willed away. Clinically depressed people cannot "pull themselves together" and get better.

Depression can be successfully treated by a mental health professional or certain health care providers. With the right treatment, 80 percent of those who seek help get better. And many people begin to feel better in just a few weeks.

Depression a Big Factor in Poor Health
World Health Organization Finds Depression Often Goes Untreated
By Salynn Boyles
WebMD Medical News
Reviewed by Louise Chang, MD

Sept. 6, 2007 -- Depression has a greater impact on overall health than arthritis, diabetes, angina, and asthma, but it all too often goes unrecognized and untreated, a report from the World Health Organization (WHO) suggests.
more...Depression a Big Factor in Poor Health

For Additional Information About Depression Write To:
The National Institute of Mental Health (NIMH)
6001 Executive Boulevard, Room 8184, MSC 9663
Bethesda, MD 20892-9663
 

For free brochures on depression and its treatment call:  1-800-421-4211.
or visit: http://www.nimh.nih.gov
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