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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.
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Geodon (ziprasidone)
FDA ALERT Geodon® is a type of medicine called an atypical antipsychotic. FDA has found that older patients treated with atypical antipsychotics for dementia had a higher chance for death than patients who did not take the medicine. This is not an approved use.
What is Geodon® ?
Geodon® (ziprasidone) is an antipsychotic medication—one of a group called "atypical" to distinguish these newer drugs from older medications. The FDA approved Geodon as a treatment for schizophrenia in 2001. It helps manage schizophrenia’s "positive" symptoms, such as auditory hallucinations, delusions, and thought disturbances. Geodon may also help in treating the "negative" symptoms of schizophrenia, which include social withdrawal, apathy, lack of motivation, and an inability to experience pleasure. Geodon is presently being studied for the treatment of bipolar disorder.
How does Geodon work?
As with other atypical antipsychotic medications, Geodon may reduce symptoms of schizophrenia by blocking the action of serotonin and dopamine, two neurotransmitter chemicals, at specific receptors in the brain. Geodon may also inhibit the reuptake of serotonin and norepinephrine into brain cells, which may improve depressive symptoms in people with schizophrenia.
Is Geodon safe?
Several years ago, the FDA became concerned about the possibility that Geodon and a number of other drugs might increase the very small possibility of a specific, potentially fatal heart–rhythm irregularity called torsade de pointes. The FDA did not approve Geodon in 1998 because there was some evidence that it could cause a lengthening of the so–called QT interval of the heart beat, a change associated with torsade. The FDA asked for specific safety data, which were submitted in 1999. Although "QT prolongation" is still a concern, thousands of consumers have been treated without evidence of the heart–rhythm irregularity. And the overall mortality rate during the trials was similar to that of placebo and with other antipsychotic drugs. Since its introduction to US consumers in 2001, there have been no reported fatalities due to Geodon induced torsade.
The FDA labeling does not include a "black box warning", usually included when there is a significant risk that the doctor and consumer must be aware of and take into account when prescribing/taking such a medication. The FDA labeling for Geodon also does not recommend an EKG prior to or during treatment. However, the labeling warns physicians and consumers about QT prolongation and the possible risk of sudden death. The FDA labeling suggests that doctors use their best judgment , based on the health status of the individual, when considering the use of ziprasidone as a first–line medication or only after other medications have failed. There are no requirements that consumers have regular heart check–ups while taking this medication.
It is important to note that your risk of dangerous heart–rhythm changes can be increased by other medications you may be taking and any other heart conditions you may have. Therefore, you should tell your doctor about all your medications (including dietary supplements, non–prescription medicines, and herbal medicines) and any heart problems you have now or have had. If you faint, lose consciousness, or have heart palpitations while taking Geodon, contact your doctor immediately.
Talk with you doctor about all decisions relating to using medications. All medication decisions should be tailored to the individuals needs and
involve a benefit/risk assessment.
What are the common side effects caused by Geodon?
Some of the most common side effects associated with Geodon are feeling unusually tired, nausea, constipation, dizziness, restlessness, diarrhea, rash, cough and runny nose, and abnormal muscle movements, including tremor, shuffling, and uncontrollable movements. Geodon is associated with little or no weight gain in most consumers. Geodon also appears to infrequently cause increases in glucose, cholesterol, or triglyceride blood levels.
Does Geodon cause tardive dyskinesia?
Tardive dyskinesia (TD) is a disorder characterized by abnormal movements of the mouth, limbs, or body that occur in some people taking antipsychotic drugs. Researchers believe that atypical antipsychotics like Geodon are less likely to cause TD than the older antipsychotics.
Because it may take years until researchers can fully assess the risk of TD when taking Geodon, this drug should be prescribed at the lowest effective dose to minimize that risk. If you develop symptoms of TD while taking Geodon—symptoms such as grimacing, sucking and smacking of your lips, or other abnormal movements of the body or limbs—you and your doctor should consider switching medications. Keep in mind, though, that some people may need to continue taking Geodon to most effectively control their symptoms of schizophrenia despite developing TD.
What should you tell your doctor if you are considering taking Geodon?
Your physician should decide if Geodon is the best treatment for you. If you are thinking about taking Geodon, be sure to tell your doctor if you:
* Have had any problems with your heart, have heart disease or have a family history of heart disease
* Have had any problems with fainting or dizziness
* Have had any liver problems
* Are pregnant or plan to get pregnant
* Are breastfeeding
* Are taking any prescription or non–prescription medications
*
Are allergic to any medications
How does Geodon interact with other medications?
There are some medications that may be unsafe to use when taking Geodon, and there are some that can affect how well Geodon works. Always tell your doctor about all drugs that you are taking, including non–prescription drugs, supplements, and herbal medicines.
• Geodon should not be taken with any drug that affects the QT interval of the heart rhythm, such as Mellaril (thioridazine), Quinidex (quinidine), Avelox (moxifloxicin), Orap (pimozide), and Zagam (sparfloxicin).
• Certain high blood pressure medications that cause low blood levels of potassium or magnesium may increase a person’s risk for QT prolongation.
• Because Geodon has a direct effect on the central nervous system, people taking this drug should be cautious when taking other drugs that affect the central nervous system.
• Studies have shown that carbamazepine (Tegretol; an anticonvulsant commonly used as a mood stabilizer to treat bipolar disorder) can decrease the amount of Geodon in the body. Medications with similar effects to carbamazepine include: Sustiva (efavirenz), Fulvicin (griseofulvin), Mysoline (primidone), Rezulin (troglitazone).
• Studies have shown that ketoconazole (Nizoral; a medication used to treat fungal infections) can increase the amount of Geodon in the body. Medications with similar effects to ketoconazole include: Biaxin (clarithromycin), erythromycin, Cardizem (diltiazem), Luvox (fluvoxamine), Prozac (fluoxetine), Calan (verapamil), Accolate (zafirlukast).
What is the standard dose for Geodon?
The lowest effective dose of any medication should always be used to reduce the risk of troublesome and potentially harmful side effects. The recommended initial dose of Geodon is 20 mg per day, but this dose may be increased to as much as 80 mg twice a day, depending on its effectiveness in each individual. Increasing the dose beyond 80 mg twice a day is not recommended. Your physician should watch for improvement of your symptoms for several weeks before adjusting the dose because it may take that long for the drug to produce its full effect.
What else should I keep in mind when taking Geodon?
Geodon is available in capsules that should be swallowed whole and taken with food. Women who are planning to become pregnant or who are pregnant should discuss both the benefits and risks with their doctor before taking Geodon. Because dizziness caused by a drop in blood pressure can occur while taking Geodon, be careful when standing up and tell your doctor immediately if you feel dizzy.
Updated by Charles F. Caley, Pharm.D., BCPP
(April 2004)
Image
NAMI wishes to thank the College of Psychiatric and Neurological Pharmacists for producing this fact sheet.
For further information please contact the pharmaceutical company listed below.
Pfizer, Inc.
235 East 42nd St.
New York, NY 10017-5755
800-438-1985
www.pfizer.com
Free or low-cost medications provided by pharmaceutical companies
Some pharmaceutical companies offer medication assistance programs to low-income individuals and families. These programs typically require a doctor’s consent and proof of financial status. They may also require that you have either no health insurance, or no prescription drug benefit through your health insurance. Please contact the pharmaceutical company directly for specific eligibility requirements and application information.
Geodon Rx Assistance Program: 1-866-443-6366® ®
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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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