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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 11 th 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.
Our DF Members
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Atypical Antidepressants
Atypical antidepressants may be prescribed when SSRIs or TCAs have not worked. Atypical antidepressants include bupropion (Wellbutrin, Wellbutrin SR, Wellbutrin XL), duloxetine (Cymbalta), maprotiline (Ludiomil), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and venlafaxine (Effexor).
How do atypical antidepressants work? Each of these drugs inhibit uptake of the various neurotransmitters in the brain.
Who should not use these medications?
* Individuals with a prior allergic reaction to any atypical antidepressant
* Individuals with seizure disorders (Do not use bupropion and maprotiline.)
* Individuals taking MAOIs (Do not use duloxetine, maprotiline, and venlafaxine.)
* Other contraindications include the following:
o Bupropion: Individuals with bulimia or anorexia nervosa, or those in the process of withdrawal from alcohol or sedatives should not take bupropion.
o Duloxetine: Individuals with uncontrolled narrow-angle glaucoma should not take duloxetine.
o Maprotiline, mirtazapine, nefazodone, and trazodone: Individuals who have experienced a recent heart attack should not take these medications.
o Nefazodone: Individuals should not take nefazodone if they have liver impairment or are currently using cisapride (Propulsid), pimozide (Orap), carbamazepine (Tegretol), or triazolam (Halcion).
Use
* Atypical antidepressants are administered orally.
* Mirtazapine (Remeron SolTab) is a tablet that dissolves when placed in the mouth instead of swallowing with water.
* Some atypical antidepressants are available as sustained-release tablets or capsules and should only be swallowed whole (do not crush, divide, or chew).
* Abrupt discontinuation of some atypical antidepressants, such as duloxetine, may cause withdrawal-like symptoms such as agitation, anxiety, confusion, dizziness, headache, and insomnia. Ask a doctor or pharmacist if the medication dose should be gradually tapered down to avoid these symptoms.
Children: Safety and efficacy of duloxetine, bupropion, maprotiline, mirtazapine, nefazodone, and trazodone have not been established in children younger than 18 years.
Drug or food interactions: Tell the doctor what medications are currently being taken because many drugs interact with atypical antidepressants. Do not take any nonprescription or herbal medications without first consulting the doctor or pharmacist. The following are examples of interactions, but they do not represent a complete list.
* Bupropion
o Bupropion may increase the blood levels and/or risk of toxicity of the following drugs:
+ Alcohol or other drugs that depress the central nervous system such as drugs taken for insomnia
+ SSRIs
+ TCAs
+ Beta blockers such as propranolol (Inderal)
+ Antiarrhythmic drugs such as flecainide (Tambocor) or propafenone (Rythmol)
+ Warfarin (Coumadin)
o The following drugs may increase bupropion blood levels or toxicity:
+ Other drugs that increase seizure risk
+ Amantadine (Symmetrel)
+ Levodopa (Sinemet)
+ Carbamazepine (Tegretol)
+ MAOIs
+ Ritonavir (Norvir)
* Duloxetine
o Duloxetine may increase the blood levels and/or risk of toxicity of the following drugs:
+ Alcohol or other drugs that depress the central nervous system such as drugs taken for insomnia
+ Antiarrhythmic drugs such as flecainide (Tambocor) or propafenone (Rythmol)
+ Phenothiazines such as thioridazine (Mellaril)
+ TCAs
+ MAOIs
+ Warfarin (Coumadin)
o The following drugs may increase duloxetine blood levels or toxicity:
+ Fluvoxamine (Luvox)
+ Fluoxetine (Prozac)
+ Paroxetine (Paxil)
+ Quinidine (Cardioquin, Quinaglute)
+ Quinolone antibiotics such as ciprofloxacin (Cipro) and levofloxacin (Levaquin)
* Maprotiline and mirtazapine
o Maprotiline may increase the blood levels and/or risk of toxicity of the following drugs:
+ Alcohol or other drugs that depress the central nervous system such as drugs taken for insomnia
+ Drugs with similar side effects such as TCAs or antihistamines (Benadryl)
o The following drugs may increase maprotiline blood levels or toxicity:
+ Thyroid medication may add to the risk of increased heart rate and abnormal rhythm.
+ Phenothiazines and benzodiazepines (such as Valium) increase risk for seizures.
* Nefazodone
o Nefazodone may increase the blood levels and/or risk of toxicity of the following drugs:
+ Alcohol or other drugs that depress the central nervous system such as drugs taken for insomnia
+ Buspirone (Buspar)
+ Carbamazepine (Tegretol)
+ Cisapride (Propulsid)
+ Cyclosporine (Neoral, Sandimmune)
+ Digoxin (Lanoxin)
+ Pimozide (Orap)
+ Thioridazine (Mellaril)
+ Triazolam (Halcion)
+ St. John’s wort
+ SSRIs
+ TCAs
+ Drugs that may cause abnormal heart rhythms (check with the doctor or pharmacist)
+ Drugs indicated to treat high cholesterol such as simvastatin (Zocor) or atorvastatin (Lipitor)
o The following drugs may increase nefazodone blood levels or toxicity:
+ Buspirone (Buspar)
+ Sibutramine (Meridia)
+ Sumatriptan (Imitrex) or other similar drugs for migraine headache
* Trazodone
o Trazodone may alter the blood levels and/or risk of toxicity of the following drugs:
+ Alcohol or other drugs that depress the central nervous system such as drugs taken for insomnia
+ Clonidine (Catapres) (enhances blood pressure lowering effect)
+ Digoxin (Lanoxin)
+ MAOIs
+ Phenytoin or fosphenytoin (Dilantin, Cerebyx)
+ Warfarin (Coumadin)
o The following drugs may increase trazodone blood levels or toxicity:
+ Antifungal agents such as itraconazole (Sporanox) or ketoconazole (Nizoral)
+ Carbamazepine (Tegretol)
+ Phenothiazines such as thioridazine (Mellaril)
+ Ritonavir (Norvir)
+ SSRIs, sibutramine (Meridia), sumatriptan (Imitrex), trazodone (Desyrel), venlafaxine (Effexor), and St. John’s wort (These medications may increase the risk for serotonin syndrome—symptoms include hypertension, fever, muscle tremor, or confusion.)
+ Drugs that may cause abnormal heart rhythms (check with the doctor or pharmacist)
* Venlafaxine
o Venlafaxine may alter the blood levels and/or risk of toxicity of the following drugs:
+ Clozapine
+ Desipramine
+ Haloperidol (Haldol)
+ Indinavir
+ SSRIs, sibutramine (Meridia), sumatriptan (Imitrex), trazodone (Desyrel), and St. John’s wort (These medications may increase the risk for serotonin syndrome—symptoms include hypertension, fever, muscle tremor, or confusion.)
+ Warfarin
o The following drugs may increase venlafaxine blood levels or toxicity:
+ Cimetidine (Tagamet)
* MAOIs
* SSRIs, nefazodone (Serzone), St. John’s wort, and venlafaxine (These medications may increase the risk for serotonin syndrome—symptoms include hypertension, fever, muscle tremor, or confusion.)
Side Effects: This is NOT a complete list of side effects reported with atypical antidepressants. The doctor, health care provider, or pharmacist can discuss a more complete list of side effects.
*
Manic episodes in persons with bipolar disorder (If not combined with a mood-stabilizing drug, atypical antidepressants may induce manic episodes in individuals with bipolar disorder.)
*
Seizures (Atypical antidepressants may lower the threshold for seizures; that is, seizures may occur more easily. Caution is advised for individuals prone to seizures or those who have a history of seizures.)
*
Drowsiness (Caution is advised when operating machinery, driving, or performing other tasks that require alertness.)
*
Bupropion
o Contains the same active ingredient found in Zyban, which is used as an aid in smoking cessation treatment (Do not use bupropion with Zyban or other medications containing bupropion.)
o More likely to cause seizures than other antidepressants, especially with doses above 450 mg/day (Seizures are also more likely in patients who have bulimia or anorexia nervosa and are treated with bupropion.)
o Caution in narrow-angle glaucoma
o Caution in slow gastric emptying (often present in diabetes)
* Maprotiline and mirtazapine
o May increase appetite and cause weight gain
o May decrease white blood cell count (The doctor will monitor this throughout the therapy.)
o May cause urinary retention, blurred vision, heart rhythm abnormalities, dizziness, or constipation
o Caution in heart disease and abnormal heart rhythms
* Nefazodone
o May cause liver impairment (Contact the doctor immediately if dark urine, anorexia, stomach or abdominal pain, or yellowing of the skin or eyes occurs.)
o Caution in heart disease and abnormal heart rhythms
o Lightheadedness or fainting when standing up from a sitting or lying position (Stand up gradually from lying down or sitting positions.)
* Trazodone
o Caution in heart disease and abnormal heart rhythms
* Venlafaxine
o May cause sustained increases in blood pressure
o May cause weight loss
o May cause anxiety and insomnia
o Decreased dose required for individuals with kidney or severe liver impairment
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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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