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Brain Meds 3/2/2019 Scientistmel.com Twitter.com/scientistmel Patreon.com/scientistmell 3/2/2019

Brain meds What are the classes? Anti-anxiety vs Antidepressant? Side Effects? Potential issues?

Classes Breakdown Selective Serotonin Reuptake Inhibitors Serotonin-Norepinephrine Reuptake Inhibitors Benzodiazepines Tricyclic Antidepressants Ketamine Antihistamines and Beta blockers The anxiety and depression association of America has a very thorough website discussing the different types of medications…some of the information I am presenting comes from that site!

NP Selective Serotonin Reuptake Inhibitors (SSRIs) SSRIs relieve symptoms by blocking the reabsorption, or reuptake, of serotonin by certain nerve cells in the brain. This leaves more serotonin available, which improves mood. SSRIs (citalopram, escitalopram, fluoxetine, paroxetine, and sertraline) generally produced fewer side effects when compared with tricyclic antidepressants.  However, common side effects include insomnia or sleepiness, sexual dysfunction, and weight gain. They are considered an effective treatment for all anxiety disorders, although the treatment of obsessive-compulsive disorder, or OCD, typically requires higher doses. Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) The serotonin-norepinephrine reuptake inhibitor, or SNRI, class (venlafaxine and duloxetine) is notable for a dual mechanism of action: increasing the levels of the neurotransmitters serotonin and norepinephrine by inhibiting their reabsorption into cells in the brain. As with other medications, side effects may occur, including stomach upset, insomnia, headache, sexual dysfunction, weight gain and minor increase in blood pressure. These medications are considered as effective as SSRIs, so they are also considered a first-line treatment for the treatment of anxiety disorders, but not for obsessive compulsive disorder ,where SSRI’s are the preferred first line treatment.  

NP Benzodiazepines This class of drugs is frequently used for short-term management of anxiety and as an add on treatment, in treatment resistant anxiety disorders.They are not recommended as a treatment for Post Traumatic Stress Disorder. Benzodiazepines (alprazolam, clonazepam, diazepam, and lorazepam) are highly effective in promoting relaxation and reducing muscular tension and other physical symptoms of anxiety. Long-term use may require increased doses to achieve the same effect, which may lead to problems related to tolerance and dependence. Tricyclic Antidepressants Concerns about long-term use of the benzodiazepines led many doctors to favor tricyclic antidepressants (amitriptyline, imipramine, and nortriptyline). Although effective in the treatment of some anxiety disorders(but not Social Anxiety Disorder), they can cause significant side effects, including orthostatic hypotension (drop in blood pressure on standing), constipation, urinary retention, dry mouth, and blurry vision.  

NP Contact your physician if you experience side effects, even if you are not sure a symptom is caused by a medication. Do not stop taking a medication without consulting with the prescribing physician; abrupt discontinuation may cause other health risks. Medications will work only if they are taken according the explicit instructions of your physician, but they may not resolve all symptoms of an anxiety disorder. Ketamine Clinical trials have shown that low doses of ketamine, a FDA approved anesthetic drug, can lift depression in hours, or even minutes. This rapid antidepressant effect is much faster than the most commonly used antidepressant medications available today, which often take several weeks or longer to work. For some individuals, the antidepressant effects of a single dose of ketamine can last for a week or longer. But ketamine also has properties that make it a potential drug of abuse, and it is a Scheduled drug by the Food and Drug Administration. Currently this treatment is generally reserved for treatment- resistant depression, anxiety, and PTSD, and is considered an experimental treatment. Clinical trials in treatment-resistant depression have also supported the efficacy of an intranasal spray variant of ketamine called esketamine, which is in late-stage testing for FDA approval.  

NP Antihistamines like Hydroxizine (Visteril) have calming side effects through blocking histamine receptors. While Hydroxizine is primarily used to treat itching from allergies, the calming effects it has is often used to help patients prior to surgery, to treat mild anxiety. It is non habit forming but not meant to be used as a regular form of treatment for generalized anxiety. Betablockers in the form of propranolol while customarily used for heart conditions provide relief for mild anxiety much like antihistamines…these mild symptoms of anxiety can be performance anxiety and social anxiety. More studies are needed to determine long term effectiveness.  

Brain Meds Side effects Depends on medication Some have sexual side effects Some have insomnia Some have appetite effects

NP Benzodiazepines like Ativan have been linked to increased risk of suicide. Doctors tend to not use these medications for long term as they can become addictive and higher dosage is needed over time Discuss Chris Cornell.  

Brain meds What are the classes? Anti-anxiety vs Antidepressant? Side Effects? Potential issues?

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Brain Meds 3/2/2019 Scientistmel.com Twitter.com/scientistmel Patreon.com/scientistmell 3/2/2019