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Antidepressant. Antidepressant side effects. Antidepressant solutions, antidepressant alternatives. Full list of antidepressant medications. Antidepressant Celexa, antidepressant Cymbalta, antidepressant Effexor, antidepressant Lexapro, antidepressant Paxil, antidepressant Prozac, antidepressant Wellbutrin, antidepressant Zoloft.
Antidepressants Listed by Brand Name If you are currently taking or thinking of starting psychiatric medication, this is a must read. "Certain kinds of antidepressants can double the risk of developing breast cancer, according to a landmark Canadian study." Celexa (Citalopram) Action and Clinical Pharmacology Adverse Reactions
Citalopram hydrobromide is a highly selective and potent serotonin Citalopram has no or very low affinity for a series of receptors including serotonin 5-HT1A, 5-HT2, dopamine D1, and D2, a1-, a2-, b-adrenergic, histamine H1, muscarinic cholinergic, benzodiazepine, gamma aminobutyric acid (GABA) and opioid receptors.
PharmacokineticsAbsorption Distribution Steady-state Metabolism Elimination Special Populations: Back to top of pageElderly Patients Reduced Hepatic Function Reduced Renal Function Indications and Clinical Use Back to top of pageCitalopram hydrobromide is indicated for the symptomatic relief of depressive illness. The relapse rate was significantly lower in citalopram-treated patients than in placebo-treated patients in two placebo-controlled studies, that were conducted over a 24-week period in patients who responded to 6 or 8 weeks of acute treatment with citalopram (see CLINICAL TRIALS under ACTION AND
CLINICAL PHARMACOLOGY.) Nevertheless, the physician who elects to use citalopram for extended periods should periodically reevaluate the long-term usefulness of the drug for the individual patient. Contraindications Back to top of pageCitalopram hydrobromide is contraindicated in patients with known hypersensitivity to citalopram hydrobromide or the excipients of the drug product.Monoamine Oxidase Inhibitors Precautions Back to top of pageSuicide Activation of Mania/Hypomania Seizures Serotonin Syndrome 5-HT1 Agonists Hyponatremia Pregnancy and Nursing Mothers Pediatric Use Geriatric Use
Hepatic Impairment Renal Impairment Use in Patients with Cardiac Disease In clinical trials, citalopram caused small but statistically significant decreases in heart rate (see ECG under ADVERSE REACTIONS) Consequently, caution should be observed when citalopram is initiated in patients with pre-existing slow heart rate. Use in Diabetic Patients Interference with Cognitive and Motor Performance Electroconvulsive Therapy (ECT) Abrupt Discontinuation Back to top of pageAfter 8 weeks of treatment with citalopram, abrupt discontinuation of treatment caused a higher incidence of anxiety, emotional indifference, impaired concentration, headache, migraine, paresthesia, and tremor than was seen in patients who continued on citalopram. These symptoms are not indicative of addiction. Although it is not known whether gradual discontinuation will prevent the discontinuation symptoms, it is recommended that the dosage of citalopram should be tapered off over 1 to 2 weeks. Additional Adverse Events Observed During the Premarketing Evaluation of Citalopram Back to top of pageThe events listed below include all adverse events that were reported in the overall development program of citalopram (n=3652). All reported events are included except those already listed in Table 1 and those events which occurred in only one patient. It is important to emphasize that, although the events reported occurred during treatment with citalopram, they were not necessarily caused by it. The events are enumerated using the following criteria: frequent: adverse events that occurred on one or more occasions in at least 1/100 patients; infrequent: adverse events that occurred in less than 1/100 patients but at least in 1/1000 patients; rare: adverse events that occurred in fewer than 1/1000 patients. Body as a Whole - General Disorders Cardiovascular Disorders Central and Peripheral Nervous System Disorders Collagen Disorders Endocrine Disorders Gastrointestinal System Disorders Hematopoietic and Lymphatic Disorders Liver and Biliary System Disorders. Metabolic and Nutritional Disorders Musculo-Skeletal System Disorders Neoplasm Psychiatric Disorders Reproductive Disorders, Female Reproductive Disorders, Male Resistance Mechanism Disorders Respiratory System Disorders Skin and Appendage Disorders Special Senses, Vision, Hearing and Vestibular Disorders Urinary System Disorders Events Observed During the Post-Marketing Evaluation of Citalopram Back to top of pageIt is estimated that approximately 8 million patients have been treated with citalopram since market introduction. The following adverse events have been reported to be temporarily associated with citalopram treatment in at least 3 patients and are not described elsewhere in labeling. Abnormal hepatic function, aggravated condition, aggravated migraine, angioedema, asthma, choreoathetosis, decreased drug level, decreased prothrombin time, dyskinesia, eosinophilia, erythema multiforms, gynecological problems, hepatitis, hyperprolactinemia, hyponatremia, increased drug level, increased prothrombin time, mydriasis, neuroleptic malignant syndrome, neuropathy, pancreatitis, pancytopenia, postural hypotension, serotonin syndrome, SIADH, spontaneous abortion/fetal death, thrombocytopenia, ventricular arrhythmia, Torsade de pointes, withdrawal syndrome. Adverse ReactionsDuring the premarketing clinical development, 3652 patients received Citalopram hydrobromide for the treatment of depression. Of these patients, 66% were females and 34% were males. The mean age of the patients was 50 years, with 70% being <60 years old (30% <40 years old, 40% 40 to 59 years old) and 30% being >=60 years old. Adverse Findings Observed in Short-Term, Placebo-Controlled TrialsAdverse Reactions Associated with Discontinuation of Treatment The events associated with discontinuation of citalopram in 1% or more of patients at a rate of at least twice that of placebo, were as follows: Nausea (4.1% versus 0.0%), insomnia (2.4% versus 12%), somnolence (2.4% versus 1.2%), dizziness (2.3% versus 0.7%), vomiting (1.3% versus 0.0%), agitation (1.2% versus 0.0%), asthenia (11% versus 0.5%), and dry mouth (1.1% versus 0.2%). Incidence of Adverse Events in Placebo-controlled Studies The prescriber should be aware that these figures cannot be used to predict the incidence of adverse events in the course of usual medical practice where patient characteristics and other factors differ from those which prevailed in the clinical trials. Similarly, the cited frequencies cannot be compared with figures obtained from other clinical investigations involving different treatments, uses, and investigators. The cited figures, however, do provide the prescribing physician with some basis for estimating the relative contribution of drug and non-drug favors to the adverse event incidence rate in the population studied. TABLE 1 - TREATMENT-EMERGENT ADVERSE EVENTS*
*Events included are those occurring in 2% or more of patients treated with citalopram, and for which the incidence in patients treated with citalopram was greater than the incidence in placebo-treated patients. The following events had an incidence on placebo >= citalopram: asthenia, back pain, headache, dizziness, constipation, palpitation, insomnia, abnormal vision. Most Frequent Adverse Events Dose Dependency of Adverse Events Male and Female Sexual Dysfunction with SSRIs In placebo-controlled, short-term clinical trials, the reported incidence of decreased libido, ejaculation disorders (primarily ejaculation delay and ejaculation failure), and impotence in male depressed patients receiving citalopram (n=404) was 3.7%, 6.2%, and 3.2%, respectively. In female depressed patients receiving citalopram (n=623), the reported incidence of decreased libido and anorgasmia was 1.3% and 1.1%, respectively. The reported incidence of each of these adverse events was <=1% among male and female depressed patients receiving placebo. Weight Changes ECG In the 6-week, fixed dose, dose-response study, the mean decreases in heart rate ranged between 2-6 bpm in the 20-60 mg/day dose range, but the effect did not seem to be dose-related and was independent of gender. In placebo-treated patients heart rates remained unaffected. The differences in heart rates between citalopram and placebo-treated patients were statistically significant. ECG parameters, including QT interval, remained unaffected. Clinical Trials, Drug Interactions, Over dosage, Dosage, Pharmaceutical Information Clinical TrialsThe efficacy of citalopram in the treatment of depression was established in five placebo-controlled studies in patients who met the DSM III or DSM-III-R criteria for major depression. Response to treatment was evaluated by the Hamilton Depression Rating Scale (HAMD) and/or the Montgomery Asberg Depression Rating Scale (MADRS) as well as the Clinical Global Impression (CGI) Severity Scale. On the HAMD and MADRS, total scores, selected single items, and percentage of responders (defined as patients whose HAMD/MADRS total score decreased by at least 50% versus baseline) were assessed.In a 6-week fixed dose, dose-response study, patients received citalopram at doses of 10, 20, 40, or 60 mg/day or placebo (n=129 to 131 per group). The 40 and 60 mg day doses were titrated, with patients reaching these designated doses within 4 and 8 days, respectively. The study showed that the 40 and 60 mg/day doses were significantly more effective than placebo, although the 60 mg/day dose was not more effective than the 40 mg/day dose. The lower doses did not show statistically significant superiority over placebo, except on the MADRS: on this scale the percent of responders was significantly higher in all the citalopram-treated groups than in the placebo-treated group. The second study was a 4-week flexible dose study in which 85% of the depressed patients met the criteria for melancholia. At entry, 89 and 91 patients were randomized to the citalopram and placebo groups, respectively. This was the only study in which more male than female patients participated (64% versus 36%). The initial dose of citalopram, 20 mg/day, could be titrated to the maximal tolerated dose or a maximum dose of 80 mg/day. Patients treated with citalopram showed significantly greater improvement than patients treated with placebo. At week 4, the average daily dose was 63 mg, with 52% of patients receiving the 80 mg/day dose. In a 6-week fixed-dose study, patients received citalopram, 20 or 40 mg/day, or placebo (n=64 to 70 per group). Patients treated with citalopram 40 mg/day, showed significantly greater improvement than placebo-treated patients. The difference between the lower dose of citalopram and placebo was not significant. In another 6-week fixed-dose study, patients received citalopram 20 or 40 mg/day or placebo (n=88 to 97 per group). Although citalopram-treated patients improved to a somewhat greater degree than the placebo-treated patients, the differences between drug and control groups did not reach statistical significance due to a high placebo response, i.e. substantial improvement in the placebo group. A 6-week, flexible dose study was conducted in elderly, depressed patients (the mean age of male and female patients was 75 and 77 years, respectively) to determine the antidepressant effect and safety of citalopram in this subpopulation. The number of patients who received citalopram and placebo was 98 and 51, respectively. The study allowed patients to enter with lower baseline HAMD scores than are usually acceptable (>=18 in clinical trials). However, only a small percentage of patients had HAMD scores of less than 18 at entry. The dose of citalopram was titrated from a starting dose of 10 mg day to a maximum dose of 30 mg day. Patients treated with citalopram showed significantly greater improvement than patients treated with placebo. The final dose of citalopram was 10, 20 and 30 mg/day in 5%, 51% and 44% of patients, respectively. The effectiveness of citalopram in preventing relapse was assessed in two long-term studies. Depressed patients who responded to citalopram during an initial 6 or 8 weeks of acute treatment (fixed doses of 20 or 40 mg/day in one study and flexible doses of 20-60 mg/day in the second study) were randomized to continue on citalopram or receive placebo. The number of patients who received citalopram and placebo was 257 and 116, respectively. In both studies, patients who continued on citalopram experienced significantly lower relapse rates over the subsequent 6 months compared to those receiving placebo. In the fixed-dose study, the relapse rates were similar at the 20 and 40 mg/day doses, namely 10% and 12%, respectively. Of the placebo-treated patients, 31% experienced relapse. In the flexible-dose study, the relapse rates were 14% and 24% in the citalopram- and placebo-treated patients, respectively. While the majority of patients (76%) were maintained on 20 or 40 mg/day of citalopram during most of the study, some patients received 60 mg/day, while a few patients were maintained on less than 20 mg/day. Drug Interactions: Back to top of pageMonoamine Oxidase Inhibitors (MAOI) General Metoprolol Warfarin Digoxin Imipramine Levomepromazme Lithium Cimetidine Carbamazepine Cytochrome P450 Isozymes Alcohol Other Drugs Symptoms and Treatment of Overdosage Back to top of pageCitalopram hydrobromide has a wide margin of safety in overdose. Cases of overdoses involved the ingestion of citalopram either alone or in combination with other drugs and/or alcohol. In clinical trials, with overdoses of citalopram ranging from 180 mg to 2000 mg, all patients recovered. One patient, ingesting over 1500 mg citalopram, had reversible ECG abnormalities, the most important of which was prolongation of QTc. Of the cases reported postmarketing, six were fatal. The doses of citalopram in these patients ranged from 840 mg to 1960 mg. All but one of these patients had concomitant drugs and/or alcohol. Serum levels of citalopram in patients who ingested 2000 mg, 4000 mg and 5200 mg of the drug were 2900 ng/mL, 3800 ng/mL and 10,040 ng/mL citalopram, respectively. All these patients recovered. Three fatal cases of serotonin syndrome have been reported in patients who took overdoses of moclobemide (Manerix) and citalopram. The plasma concentrations of moclobemide were between 16 and 90 mg/L (therapeutic range: 1 to 3 mg/L) and those of citalopram between 0.3 and 1.7 mg (therapeutic concentration: 0.3 mg/L). This indicates that a relatively low dose of citalopram, given with an overdose of moclobemide represents a serious risk for the patient. Symptoms most often accompanying citalopram overdose included dizziness, sweating, nausea, vomiting, tremor, and somnolence. In more rare cases, observed symptoms included confusion, loss of consciousness, convulsions, coma, sinus tachycardia, cyanosis, hyperventilation and rhabdomyolysis. Management of Overdose Back to top of pageEstablish and maintain an airway to ensure adequate ventilation and oxygenation. Gastric lavage and use of activated charcoal should be considered. Cardiac and vital sign monitoring are recommended, along with general symptomatic and supportive measures. There are no specific antidotes for citalopram. Due to the large volume of distribution of citalopram, forced diuresis, dialysis, hemoperfusion and exchange transfusion are unlikely to be of benefit. In managing overdosage, the possibility of multiple drug involvement must be considered. Dosage and Administration Back to top of pageGeneral Adults Elderly Patients Hepatic Impairment Renal Impairment Maintenance Treatment Switching Patients to or from a Monoamine Oxidase Inhibitor (MAOI)At least 14 days should elapse between discontinuation of a MAOI and initiation of therapy with citalopram. Similarly, at least 14 days should be allowed after stopping citalopram before starting a MAOI (see CONTRAINDICATIONS). Discontinuation of Citalopram Treatment Back to top of pageSince some patients may experience discontinuation symptoms when citalopram is stopped abruptly, the dose of citalopram should be tapered off over 1 to 2 weeks. Pharmaceutical Information
Composition: Stability and Storage:
What
is Cymbalta? Cymbalta is a new antidepressant manufactured by Eli Lilly and Company, the approval of which Has finally been granted by the U.S. Food and Drug Administration. This happens on the heals of one suicide of a 19 year-old, in perfect health, no mental disorder, hanging herself at the Eli Lilly complex, after taking Cymbalta. This is approved when pressure is being put on all of the pharmaceutical firs to fully disclose their clinical trials. Did the FDA feel a little pressure from the current Administration? If you have an adverse event or commit suicide while taking Cymbalta, odds are the current Administration will pay for and support Eli Lilly to beat you in court. The current administration admits this. August 11, 2004 - The FDA states Cymbalta had nothing to do with the hanging death at the Eli Lilly facility. Let's look at the known data here:
August 4, 2004 - Now that Cymbalta is approved by the FDA will Eli Lilly disclose all of their clinical trials? With a high profile suicide occurring during the clinical trial, will the pressure be enough on Eli Lilly? When a healthy volunteer, with no known mental illness or physical problem commits suicide on Cymbalta, will Eli Lilly disclose all of the facts? Eli Lilly, I know you are on this Web Site daily, especially when it comes up first on most search engines for your new antidepressant Cymbalta, what are you going to do? Disclose all of the facts or not? If you work with Eli Lilly and feel it is time for you to come clean and disclose all you know about Cymbalta hidden information, Click here and send an e-mail. Click here for Cymbalta Adverse Reactions and more What is
Cymbalta? Cymbalta is a brand-name for a
drug called duloxetine. It is in a
class of drugs known as dual uptake inhibitors.
So what is a dual uptake inhibitor -- or an uptake
inhibitor, for that matter?
The way a neurotransmitter works is, it is passed along from one nerve to
another. A bit of it is sent out at
a time from one nerve to the next. After
a bit is sent out and received by the next nerve, any of the neurotransmitter
remaining between the nerves is taken back by the first nerve, a process called
reuptake.
A
reuptake inhibitor prevents this reuptake process from occurring, which means
that, when Cymbalta is active, certain neurotransmitters are transmitted in
steady streams from one nerve ending to the next, instead of being sent in bits
periodically, which they normally are. The
neurotransmitters affected by Cymbalta are known as serotonin and
norepinephrine. And now we can
explain what "dual uptake inhibitor" means -- it simply means a drug
that affects the reuptake of two neurotransmitters instead of one.
Does
Cymbalta cure depression?
Good
question. If depression has never
been proven to be caused by neurotransmitters (or the lack of them), that
question cannot obviously be answered conclusively.
Apparently,
Eli Lilly and Company knows this. According
to a recent news release from Eli Lilly regarding Cymbalta:
"Many experts believe treating the complete spectrum of
depression symptoms is intrinsic to a lasting recovery. As well, combined action through two key neurotransmitters - serotonin
and norepinephrine - may provide a more rapid and sustained clinical
effect." Note the subtle uncertainties
in these statements, for there is absolutely no scientific proof behind them.
"Many experts believe treating the complete spectrum of
depression symptoms..." "...combined
action through two key neurotransmitters - serotonin and norepinephrine - may
provide..." Translation:
They don't know how, why, or if their drug works.
This is evident in the numerous -- and serious -- side effects provided
by other antidepressants. Lilly's
press release did not even address side effects, but another of their releases
regarding Cymbalta's clinical trials revealed three of the exact same side
effects as other antidepressants: Dizziness,
anxiety, and nausea. In that Cymbalta has the exact
same action as Wyeth's drug Effexor, one could assume the same side effects. (See "Precautions" section on Effexor
page). (Opens new
browser) What
is Depression? Depression is defined by the
Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the
American Psychiatric Association, this way: The essential feature of a
Major Depressive Episode is a period of at least 2 weeks during which there is
either depressed mood or the loss of interest or pleasure in nearly all
activities. In children and
adolescents, the mood may be irritable rather than sad.
The individual must also experience at least four additional symptoms
drawn from a list that includes major changes in appetite or weight, sleep, and
psychomotor [of or relating to movement or
muscular activity associated with mental processes] activity; decreased
energy; feelings of worthlessness or guilt; difficulty thinking, concentrating,
or making decisions; or recurrent thoughts of death or suicidal ideation, plans,
or attempts." While these elements can
certainly be seen to exist and have been experienced by many, labeling
"depression" as an illness has been criticized by many as simply
labeling part of life itself as a physical "disease" which must be
"cured". This could be debated
endlessly, however, and whole long texts have been written on the subject.
Depression as a state of mind certainly does exist, and can be
painful. The question to be
addressed here, though, is, does depression truly have a physical cause that can
be addressed with medication? For the answer, let's go back
to the DSM. The only information
given there as to physical causes of depression is: Neurotransmitters implicated
in the pathophysiology [study of the physical
effects of a disease] of a Major Depressive Episode include
norepinephrine, serotonin, acetylcholine All right, what does all that
mean? Here's a simple explanation.
A neurotransmitter is a chemical that helps transmit nerve
impulses through the nervous system. There
are many different neurotransmitters used by the body.
What the DSM definition is saying is that, by some method, the
neurotransmitter chemicals known as norepinephrine,
serotonin, acetylcholine Note carefully the use of the
word implicated in the DSM definition, however.
And therein is the first clue, for it has never been clinically proven
that depression is based in neurotransmitters.
We repeat: Never.
And believe it or not, there is not a doctor on Earth that will disagree
with that statement. Which leads to the conclusion
that a physical cause for depression has never been isolated.
Why, then, is Eli Lilly and Company, Cymbalta's manufacturer, so
insistent that Cymbalta is a great treatment for depression? For the answer to this, let's
turn to Eli Lilly and find out exactly what Cymbalta is, and how it works. Should
You Take Cymbalta? The answer is, of course, up
to you. Before you do, however,
become fully informed of the dangers from the manufacturer.
As yet the full list of side effects have not been published. You should also be aware of a dangerous metabolism issue that may affect you, and for which you should be tested before you take such a drug. (duloxetine hydrochloride) PharmacokineticsCYMBALTA has an elimination half-life of about 12 hours (range 8 to 17 hours) and its pharmacokinetics are dose proportional over the therapeutic range. Steady-state plasma concentrations are typically achieved after 3 days of dosing. Elimination of CYMBALTA is mainly through hepatic metabolism involving two P450 isozymes, CYP2D6 and CYP1A2. Absorption and Distribution – Orally administered CYMBALTA is well absorbed. There is a median 2-hour lag until absorption begins (T lag), with maximal plasma concentrations C max) of CYMBALTA occurring 6 hours post dose. Food does not affect the Cmax of CYMBALTA, but delays the time to reach peak concentration from 6 to 10 hours and it marginally decreases the extent of absorption (AUC) by about 10%. There is a 3-hour delay in absorption and a one-third increase in apparent clearance of CYMBALTA after an evening dose as compared to a morning dose. The apparent volume of distribution averages about 1640 L. CYMBALTA is highly bound (>90%) to proteins in human plasma, binding primarily to albumin and ą1-acid glycoptrotein. Plasma protein binding of CYMBALTA is not affected by renal or hepatic impairment. Metabolism and Elimination – Biotransformation and disposition of CYMBALTA in humans have been determined following oral administration of 14C-labeled CYMBALTA. CYMBALTA comprises about 3% of the total radiolabeled material in the plasma, indication that it undergoes extensive metabolism to numerous metabolites. The major biotransformation pathways for CYMBALTA involve oxidation of the naphthyl ring followed by conjugation and further oxidation. Both CYP2D6 and CYP1A2 catalyze the oxidation of the naphthyl ring in vitro. Metabolites found in plasma include 4 –hydroxy duloxetine glucuronide and 5-hydroxy, 6-methoxy duloxetine sulfate. Many additional metabolites have been identified in urine, some representing only minor pathways of elimination. Only trace (1% of the dose) amounts of unchanged CYMBALTA are present in the urine. Most (about 70%) of the CYMBALTA dose appears I the urine as metabolites of CYMBALTA; about 20% is excreted in the feces. Smoking Status – CYMBALTA bioavailability (AUC) appears to be reduced by about one-third in smokers. Dosage modifications are not recommended for smokers. Back to top of page Race – No specific pharmacokinetic study was conducted to investigate the effects of race. Renal Insufficiency – Limited data are available on the effects of CYMBALTA in patients with end stage renal disease (ESRD). After a single 60-mg dose of CYMBALTA, Cmax and AUC values were approximately 100% greater inpatients with end stage renal disease receiving chronic intermittent hemodialysis than in subjects with normal renal fuction. The elimination half-life, however, was similar in both groups. The AUC’s of the major circulation metabolites, 4-hydroxy duloxetine glucuronide and 5-hydroxy, 6-methoxy duloxetine sulfate, largely excreted in urine, were approximately 7 – to 9 – fold higher and would be expected to increase further with multiple dosing. For this reason, CYMBALTA is not recommended for patients with ESRD (see DOSAGE AND ADMINISTATION). Studies have not been conducted in patients with a moderate degree of renal dysfunction, but population PK analyses suggest that mild renal dysfunction has no significant effect on CYMBALTA apparent clearance. Hepatic Insufficiency – Patients with clinically evident hepatic insufficiency have decreased CYMBALTA metabolism and elimination. After a single 20-mg dose of CYMBALTA 6 cirrhotic patients with moderate liver impairment (Child-Pugh Class B) had a mean plasma CYMBALTA clearance about 15% that of age- and gender-matched healthy subjects, with a 5-fold increase in mean exposure (AUC). Although Cmax was similar to normals in the cirrhotic patients, the half-life was about 3 times longer (see PRECAUTIONS). It is recommended that CYMBALTA no be administered to patients with any hepatic insufficiency (see DOSAGE AND ADMINISTRATION). Back to top of page Drug-Drug Interactions (also see PRECAUTIONS, Drug Interactions) Potential for Other Drugs to Affect CYMBALTA. Both CYP1A2 and CYP2D6 are responsible for CYMBALTA metabolism. INDICATIONS AND USAGECYMBALTA is indicated for the treatment of major depressive disorder (MDD). CONTRAINDICATIONSHypersensitivityCYMBALTA is contraindicated in patients with a known hypersensitivity to the product. WARNINGS Back to top of pageClinical Worsening and Suicide Risk – Patients with major depressive disorder, both adult and pediatric, may experience worsening of their depression and/or the emergence of suicidal ideation and behavior (suicidality), whether or not they are taking antidepressant medications, and this risk may persist until significant remission occurs. Although there was been a long-standing concern that antidepressants may have a role in inducing worsening of depression and the emergence of suicidality in certain patients, a causal role for antidepressants in inducing such behaviors has not been established. Nevertheless, patients being treated with antidepressants should be observed closely for clinical worsening and suicidality, especially at the beginning of a course of drug therapy, or at the time of dose changes, either increases of decreases. Consideration should be given to changing the therapeutic regimen, including possibly discontinuing the medication, in patients whose depression is persistently worse or whose emergent suicidality is severe, abrupt in onset, or was not part of the patient’s presenting symptoms. Because of the possibility of co-morbidity between major depressive disorder and other psychiatric and nonpsychiatric disorders, the same precautions observed when treating patients with major depressive disorder should be observed when treating patients with other psychiatric and nonpsychiatric disorders. The following symptoms – anxiety, agitation, panic attacks, insomnia, irritability, hostility (aggressiveness), impulsivity, akathisia (psychomotor restlessness), hypomania, and mania – have been reported in adult and pediatric patients being treated with antidepressants for major depressive disorder as well as for other indications, both psychiatric and nonpsychiatric. Although a causal link between the emergence of such symptoms and either the worsening of depression and/or the emergence of suicidal impulses has not been established, consideration should be given to changing the therapeutic regimen, including possibly discontinuing the medications, in patients for whom such symptoms are severe, abrupt in onset, or were not part of the patient’s presenting symptoms. Families and caregivers of patients being treated with antidepressants for major depressive disorder or other indications, both psychiatric and nonpsychiatric, should be alerted about the need to monitor patients for the emergence of suicidality, and to report such symptoms immediately to health care providers. Prescriptions for CYMBALTA should be written for the smallest quantity of capsules consistent with good patient management, in order to reduce the risk of overdose. If the decision has been made to discontinue treatment, medication should be tapered, as rapidly as is feasible, but with recognition that abrupt discontinuation can be associated with certain symptoms (see PRECAUTIONS and DOSAGE AND ADMINISTRATION, Discontinuing CYMBALTA (duloxetine hydrochloride), for a description of the risks of discontinuation of CYMBALTA). Information of Patients Back to top of pagePhysicians are advised to discuss the following issues with patients for whom they prescribe CYMBALTA. Patients and their families should be encouraged to be alert to the emergence of anxiety, agitation, panic attacks, insomnia, irritability, hostility, impulsivity, akathisia, hypomania, mania, worsening of depression, and suicidal ideation, especially early during antidepressant treatment. Such symptoms should be reported to the patient’s physician, especially if they are severe, abrupt in onset, or were not part of the patient’s presenting symptoms. Any psychoactive drug may impair judgment, thinking, or motor skills. Drug Interactions (also see CLINICAL PHARMACOLOGY, Drug – DrugInteractions) Inhibitors of CYP2D6 – Because CYP2D6 is involved in CYMBALTA metabolism, concomitant use of CYMBALTA with potent inhibitors of CYP2D6 may result in higher concentrations of CYMBALTA. Paroxetine (20 mg QD) increased the concentration of CYMBALTA (40 mg QD) by about 60%, and greater degrees of inhibition are expected with higher doses of Paroxetine. Similar effect would be expected with other potent CYP2D6 inhibitors (e.g., fluoxetine, quinidine). ADVERSE REACTIONS Back to top of page CYMBALTA has been evaluated for safety in 2418 patients diagnosed with major depressive disorder who participated in multiple-dose premarketing trials, representing 1099 patient-years of exposure. Among these 2418 CYMBALTA treated patients, 1139 patients participated in eight 8- or 9- week, placebo-controlled trials at doses ranging from 40 to 120 mg/day, while the remaining 1279 patients were followed for up to 1 year in an open-label safety study using flexible doses from 80 to 120 mg/day. Two placebo-controlled studies with doses of 80 to 120 mg/day had 6- month maintenance extensions. Of these 2418 patients, 993 CYMBALTA-treated patients were exposed for at least 180 days and 445 CYMBALTA-treated patients were exposed for at least 1 year. Adverse reactions were assessed by collecting adverse events, results of physical examinations, vital signs, weights, laboratory analyses, and ECGs. Clinical investigators recorded adverse events using descriptive terminology of their own choosing. To provide a meaningful estimate of the proportion of individuals experiencing adverse events, grouping similar types of events into a smaller number of standardized event categories is necessary. In the tables and tabulations that follow, MedDRA terminology has been used to classify reported adverse events. The stated frequencies of adverse events represent the proportion of individuals who experienced, at least once, a treatment-emergent adverse event of the type listed. An event was considered treatment-emergent if it occurred for the first time or worsened while receiving therapy following baseline evaluation. Events reported during the studies were not necessarily caused by the therapy, and the frequencies do not reflect investigator impression (assessment) of causality. The cited figures provide the prescriber with some basis for estimating the relative contribution of drug and non-drug factors to the adverse event incidence rate in the population studied. The prescriber should be aware that the figures in the tables and tabulations cannot be used to predict the incidence of adverse events in the course of usual medical practice where patient characteristics and other factors differ from those that prevailed in the clinical trials. Similarly, the cited frequencies cannot be compared with figures obtained from other clinical investigations involving different treatments, uses, and investigators. Adverse Events Reported as Reasons for Discontinuation of Treatment in Placebo-Controlled Trials Approximately 10% of the 1139 patients who received CYMBALTA in the placebo-controlled trials discontinued treatment due to an adverse event, compared with 4% of the 777 patients receiving placebo. Nausea (CYMBALTA 1.4%, placebo 0.1%) was the only common adverse event reported as reason for discontinuation and considered to be drug-related (i.e., discontinuation occurring in at least 1% of the CYMBALTA-treated patients and at a rate of at least twice that of placebo). Adverse Events Occurring at an Incidence of 2% or More Among CYMBALTA-Treated Patients in Placebo-Controlled Trials Back to top of page Table 1 gives the incidence of treatment-emergent adverse events that occurred in 2% or more of patients treated with CYMBALTA in the acute phase of MDD placebo-controlled trials and with an incidence greater than placebo. The most commonly observed adverse events in CYMBALTA-treated MDD patients (incidence of 5% or greater and at least twice the incidence in placebo patients) were nausea; dry mouth; constipation; decreased appetite; fatigue; somnolence; and increased sweating. Effects on Male and Female Sexual FunctionAlthough changes in sexual desire, sexual performance and sexual satisfaction often occur as manifestations of a psychiatric disorder, they may also be a consequence of pharmacologic treatment. Reliable estimates of the incidence and severity of untoward experiences involving sexual desire, performance and satisfaction are difficult to obtain, however, in part because patients and physicians may be reluctant to discuss them. Accordingly, estimates of the incidence of untoward sexual experience and performance cited in product labeling are likely to underestimate their actual incidence. Other Adverse Events Observed During the Premarketing Evaluation of CYMBALTA Following is a list of modified MedDRA terms that reflect treatment-emergent adverse events as defined in the introduction to the ADVERSE REACTIONS section reported by patients treated with CYMBALTA at multiple doses throughout the dose range studied during any phase of a trial within the premarketing database. The events included are those not already listed elsewhere in ADVERSE REACTIONS and not considered in the WARNINGS and PRECAUTIONS sections, that were reported with an incidence of greater than or equal to 0.05%, are not common as background events and were considered possibly drug related (e.g., because of the drug’s pharmacology) or potentially important. Back to top of page It is important to emphasize that, although the events reported occurred during treatment with CYMBALTA, they were not necessarily caused by it. Events are further categorized by body system and listed in order of decreasing frequency according to the following definitions: frequent adverse events are those occurring in at least 1/100 patients (only those not already listed in the tabulated results from placebo-controlled trials appear in this listing); infrequent adverse events are those occurring in 1/100 to 1/1000 patients; rare events are those occurring in fewer than 1/1000 patients. Blood and Lymphatic System Disorders – Infrequent: anemia, leukopenia, increased whit blood cell count, lymphadenopathy, and thrombocytopenia. Gastrointestinal Disorders – Frequent: gastritis: Infrequent: blood in stool, colitis, dysphagia, esophageal stenosis acquired, gastric ulcer, gingivitis, irritable bowel syndrome, and lower abdominal pain. Psychiatric Disorders – Frequent: initial insomnia, irritability, lethargy, nervousness, nightmare, restlessness, and sleep disorder; Infrequent: completed suicide, mania, mood swings, pressure of speech, sluggishness, and suicide attempt. Renal and Urinary Disorders – Frequent: dysuria; infrequent: micturition urgency, urinary hesitation, urinary incontinence, urinary retention, and urine flow decreased. Skin and Subcutaneous Tissue Disorders – Frequent: night swats, pruritus, and rash; Infrequent: acne, alopecia, cold sweat, ecchymosis, eczema, erythema, face edema, increased tendency to bruise, and photosensitivity reaction. Vascular Disorders – Infrequent: peripheral edema and phlebitis. Discontinuing CYMBALTA (duloxetine hydrochloride) Back to top of page Symptoms associated with discontinuation of CYMBALTA and other SSRIs and SNRIs have been reported (see PRECAUTIONS). Patients should be monitored for these symptoms when discontinuing treatment. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate. Cymbalta - Side Effects Defined
8. Bundle Branch Block Right – These are specialized cells in the upper right heart chamber and are the heart’s pacemaker. They send electrical signals to the heart that keeps it beating or contracting regularly. Normally the signal goes to the lower heart chambers at the same time through the bundle of His (hiss) on both the left and right sides of the heart, so the lower chambers contract at the same time. When the bundle is damaged on the right side, the signal does not fire at the same time as the left, which changes the pace of blood flow. This can lead to a person fainting.
Triglycerides are three fatty acids bound together in one molecule stored by the body and available to create high levels of energy when used.
Venlafaxine Pharmacology
Venlafaxine is a phenethylamine bicyclic derivative, chemically unrelated to tricyclic, tetracyclic or other available antidepressant agents. The mechanism of venlafaxine's antidepressant action in humans is believed to be associated with its potentiation of neurotransmitter activity in the CNS. Preclinical studies have shown that venlafaxine and its major metabolite, O-desmethylvenlafaxine (ODV), are potent inhibitors of neuronal serotonin and norepinephrine reuptake and weak inhibitors of dopamine reuptake. Venlafaxine and ODV have no significant affinity for muscarinic, histaminergic, or alpha1-adrenergic receptors in vitro. Pharmacologic activity at these receptors is hypothesized to be associated with the various anticholinergic, sedative, and cardiovascular effects seen with other psychotropic drugs. Venlafaxine and ODV do not possess monoamine oxidase (MAO) inhibitory activity. Pharmacokinetics: Multiple-Dose Pharmacokinetic Profile: Venlafaxine and ODV exhibited linear kinetics over the dose range of 75 to 450 mg total daily dose administered t.i.d. The mean +/- SD steady-state plasma clearances of venlafaxine and ODV are 1.3+/-0.6 and 0.4+/-0.2 L/h/kg, respectively; elimination half-life is 5+/-2 and 11+/-2 hours, respectively. Venlafaxine and ODV renal clearances are 49+/-27 and 94+/-56 mL/h/kg, respectively, which correspond to 5+/-3.0% and 25+/-13% of an administered venlafaxine dose recovered in urine as venlafaxine and ODV, respectively. Similar steady-state volumes of distribution are exhibited for venlafaxine (7+/-4 L/kg) and ODV (6+/-2 L/kg). Venlafaxine and ODV are less than 35% bound to plasma proteins. Therefore, protein-binding-induced drug interactions with venlafaxine are not expected. Food has no significant effect on the absorption of venlafaxine. When equal daily doses of venlafaxine were administered either b.i.d. or t.i.d., drug exposure (AUC) and fluctuation in plasma levels were comparable. Age and Gender: Hepatic Disease: Renal Disease:
IndicationsFor the symptomatic relief of depressive illness.The effectiveness of venlafaxine in long-term use (i.e., for more than 4 to 6 weeks) has not been systematically evaluated in controlled trials. Therefore, the physician who elects to use venlafaxine for extended periods should periodically reevaluate the long-term usefulness of the drug for the individual patient.
ContraindicationsPatients with known hypersensitivity to venlafaxine or to any of the components of the formulation.MAO Inhibitors:
WarningsSustained Hypertension:Treatment with venlafaxine was associated with modest but sustained increases in blood pressure during premarketing studies. Sustained hypertension, defined as treatment-emergent supine diastolic blood pressure (SDBP) >= 90 mm Hg and 10 mm Hg above baseline for 3 consecutive visits, showed the following incidence and dose-relationship in Table I. -----------------------------------------------
Table I
Probability of Sustained Elevation in SDBP
(Pool of Premarketing Studies with venlafaxine)
-----------------------------------------------
Treatment Group Incidence of Sustained
Elevation in SDBP
-----------------------------------------------
Venlafaxine
<100 mg/day 3%
101-200 mg/day 5%
201-300 mg/day 7%
>300 mg/day 13%
Placebo 2%
-----------------------------------------------
An analysis of the blood pressure increases in patients with sustained hypertension and in the 19 patients who were discontinued from treatment because of hypertension (<1% of total venlafaxine-treated group) showed that most of the blood pressure increases were in the range of 10 to 15 mm Hg, SDBP. Since in individual patients sustained increases of this magnitude could have adverse consequences, it is recommended that patients receiving venlafaxine have their blood pressure monitored regularly. For patients who experience a sustained increase in blood pressure during treatment with venlafaxine, either a dose reduction or discontinuation of venlafaxine should be considered.
PrecautionsGeneral: Seizures: Activation of Mania/Hypomania: Patients with Concomitant Illness: Cardiac Disease: Hepatic and Renal Disease: Occupational Hazards: Pregnancy, Labor and Delivery: Lactation: Children: Geriatrics: Discontinuation Symptoms: Drug Interactions: Lithium: Diazepam: Cimetidine: However, for patients with pre-existing hypertension, for elderly patients and for patients with hepatic or renal dysfunction, the interaction associated with the concomitant use of cimetidine and venlafaxine is not known and potentially could be more pronounced. Therefore, caution is advised in these patients. Other CNS-Active Drugs: Electroconvulsive Therapy: Cytochrome P450 IID6: Drug Abuse and Dependence: While venlafaxine has not been systematically studied in clinical trials for its potential for abuse, there was no indication of drug-seeking behaviour in the clinical trials. However, it is not possible to predict on the basis of premarketing experience the extent to which a CNS active drug will be misused, diverted, and/or abused once marketed. Consequently, physicians should carefully evaluate patients for history of drug abuse and follow such patients closely, observing them for signs of misuse or abuse of venlafaxine (e.g., development of tolerance incrementation of dose, drug-seeking behaviour).
Adverse EffectsCommonly Observed Adverse Reactions: Adverse Reactions Associated with Discontinuation of Treatment: ---------------------------------------------------------------
Table II
Adverse Reactions Associated with Discontinuation of Treatment
---------------------------------------------------------------
Venlafaxine Placebo
---------------------------------------------------------------
CNS
Somnolence 3% 1%
Insomnia 3% 1%
Dizziness 3% --
Nervousness 2% --
Dry Mouth 2% --
Anxiety 2% 1%
Gastrointestinal
Nausea 6% 1%
Urogenital
Abnormal Ejaculation* 3% --
Other
Headache 3% 1%
Asthenia 2% --
Sweating 2% --
* percentages based on the number of males.
-- Less than 1%
---------------------------------------------------------------
Incidence in Controlled Trials: Dose Dependency of Adverse Events: -------------------------------------------------------------------------
Table III
Treatment-Emergent Adverse Experience Incidence in 4-to 8-Week
Placebo-Controlled Clinical Trials (Percentage)
-------------------------------------------------------------------------
Effexor Placebo
Body System Preferred Term (n=1033) (n=609)
-------------------------------------------------------------------------
Body as a whole
Headache 25 24
Asthenia 12 6
Infection 6 5
Chills 3 --
Chest Pain 2 1
Trauma 2 1
Cardiovascular
Vasodilatation 4 3
Increased blood/pressure
hypertension 2 --
Tachycardia 2 --
Postural hypotension 1 --
Dermatological
Sweating 12 3
Rash 3 2
Pruritus 1 --
Gastrointestinal
Nausea 37 11
Constipation 15 7
Anorexia 11 2
Diarrhoea 8 7
Vomiting 6 2
Dyspepsia 5 4
Flatulence 3 2
Metabolic
Weight loss 1 --
Nervous
Somnolence 23 9
Dry mouth 22 11
Dizziness 19 7
Insomnia 18 10
Nervousness 13 6
Anxiety 6 3
Tremor 5 1
Abnormal Dreams 4 3
Hypertonia 3 2
Paraesthesia 3 2
Libido decreased 2 --
Agitation 2 --
Confusion 2 1
Thinking abnormal 2 1
Depersonalization 1 --
Depression 1 --
Urinary retention 1 --
Twitching 1 --
Respiration
Yawn 3 --
Special Senses
Blurred vision 6 2
Taste perversion 2 --
Tinnitus 2 --
Mydriasis 2 --
Urogenital
Abnormal ejaculation/
orgasm 12 [2] 2
Impotence 6 [2] 2
Urinary frequency 3 2
Urination impaired 2 --
Orgasm disturbance 2 [3] -- [3]
Menstrual disorder 1 [3] -- [3]
-------------------------------------------------------------------------
[1] Events reported by at least 1% of patients treated with Effexor are
included, and are rounded to the nearest %. Events for which the
Effexor incidence was equal to or less than placebo are not listed
in the table, but included the following: abdominal pain, pain, back
pain, flu syndrome, fever, palpitation, increased appetite, myalgia,
arthralgia, amnesia, hypaesthesia, rhinitis pharyngitis, sinusitis
cough increased urinary tract infection and dysmenorrhoea [3]
-- Incidence less than 1%
[2] Incidence based on number of male patients.
[3] Incidence based on number of female patients.
-------------------------------------------------------------------------
Adaptation to Certain Adverse Events: Vital Sign Changes: Laboratory Changes: -----------------------------------------------------------------
Table IV
Treatment-Emergent Adverse Experience Incidence
in a Dose Comparison Trial
-----------------------------------------------------------------
Effexor (mg/day)
Body System/ Placebo 75 225 375
Preferred Term (n=92) (n=89) (n=89) (n=88)
-----------------------------------------------------------------
Body as Whole
Abdominal pain 3.3% 3.4% 2.2% 8.0%
Asthenia 3.3% 16.9% 14.6% 14.8%
Chills 1.1% 2.2% 5.6% 6.8%
Infection 2.2% 2.2% 5.6% 2.3%
Cardiovascular
Hypertension 1.1% 1.1% 2.2% 4.5%
Vasodilatation 0.0% 4.5% 5.6% 2.3%
Digestive System
Anorexia 2.2% 14.6% 13.5% 17.0%
Dyspepsia 2.2% 6.7% 6.7% 4.5%
Nausea 14.1% 32.6% 38.2% 58.0%
Vomiting 1.1% 7.9% 3.4% 6.8%
Nervous
Agitation 0.0% 1.1% 2.2% 4.5%
Anxiety 4.3% 11.2% 4.5% 2.3%
Dizziness 4.3% 19.1% 22.5% 23.9%
Insomnia 9.8% 22.5% 20.2% 13.6%
Libido decreased 1.1% 2.2% 1.1% 5.7%
Nervousness 4.3% 21.3% 13.5% 12.5%
Somnolence 4.3% 16.9% 18.0% 26.1%
Tremor 0.0% 1.1% 2.2% 10.2%
Respiratory
Yawn 0.0% 4.5% 5.6% 8.0%
Skin and Appendages
Sweating 5.4% 6.7% 12.4% 19.3%
Special Senses
Abnormality of
accommodation 0.0% 9.1% 7.9% 5.6%
Urogenital System
Abnormal ejaculation/
orgasm 0.0% 4.5% 2.2% 12.5%
Impotence 0.0% 5.8% 2.1% 3.6%
(number of men) (n=63) (n=52) (n=48) (n=56)
-----------------------------------------------------------------
ECG Changes: Other Events Observed During the Premarketing Evaluation of Venlafaxine: In the tabulations that follow, reported adverse events were classified using a standard COSTART-based dictionary terminology . The frequencies presented, therefore, represent the proportion of the 2,181 patients exposed to multiple doses of venlafaxine who experienced an event of the type cited on at least one occasion while receiving venlafaxine. All reported events are included except those already listed in Table III and those events for which a drug cause was remote. If the COSTART term for an event was so general as to be uninformative, it was replaced with a more informative term. It is important to emphasize that, although the events reported occurred during treatment with venlafaxine, they were not necessarily caused by it. Events are further classified by body system and listed in order of decreasing frequency according to the following definitions: frequent adverse events are those occurring on one or more occasions in at least 1/100 patients (only those not already listed in the tabulated results from placebo controlled trials appear in this listing); infrequent adverse events are those occurring in 1/100 to 1/1000 patients; rare events are those occurring in fewer than 1/1000 patients. The frequent adverse events have been provided below. Body as a whole: accidental injury, malaise, neck pain. * Based on the number of male or female patients as appropriate.
OverdoseSymptoms and Treatment: Human Experience: Overdosage Management: In managing overdosage, consider the possibility of multiple drug involvement. The physician should consider contacting a poison control centre on the treatment of any overdose.
DosageAdults: Maximum: Patients With Hepatic Impairment: Patients with Renal Impairment: Geriatrics: Discontinuing Venlafaxine: Lexapro Side EffectsPlease keep in mind while reviewing the Lexapro side effects below, these Lexapro side effects are usually constant.Example, most adults have had diarrhea at one time or another in their life. It was uncomfortable for a short time and the end was usually in sight.
With
an SSRI, the side effects are constant. Diarrhea is different when it is each
and every day.
Although
Forest Pharmaceutical plays the Lexapro side effects down, here are the Lexapro side effects they
are required by law to warn you about:
Insomnia Lexapro Side Effects "Defined" BodyDry Mouth - The usual amount to moisture in the mouth is noticeably less. Sweating Increased - A large quantity of perspiration that is medically caused. Cardiovascular (Involving the heart and the blood vessels)Palpitation - Unusual and not normal heartbeat, that is sometimes irregular, but rapid and forceful thumping or fluttering. It can be brought on by shock, excitement, exertion, or medical stimulants. A person is normally unaware of his/her heartbeat. Hypertension - is high blood pressure, which is a symptom of disease in the blood vessels leading away from the heart. Hypertension is known as the “silent killer”. The symptoms are usually not obvious, however it can lead to damage to the heart, brain, kidneys and eye, and even to stroke and kidney failure. Treatment includes dietary and lifestyle changes. Bradycardia - The heart rate is slowed from 72 beats per minute, which is normal, to below 60 beats per minute in an adult.
Tachycardia - The heart rate is
speeded up to above 100 beats per minute in an adult. Normal adult heart rate
is 72 beats per minute. Flushing - The skin all over the body turns red. Varicose Vein - Unusually swollen veins near the surface of the skin that sometimes appear twisted and knotted, but always enlarged. They are called hemorrhoids when they appear around the rectum. The cause is attributed to hereditary weakness in the veins aggravated by obesity, pregnancy, pressure from standing, aging, etc. Severe cases may develop swelling in the legs, ankles and feet, eczema and/or ulcers in the affected areas. Gastrointestinal (Involving the stomach and the intestines)Abdominal Cramp/Pain - Sudden, severe, uncontrollable and painful shortening and thickening of the muscles in the belly. The belly includes the stomach as well as the intestines, liver, kidneys, pancreas, spleen, gall bladder, and urinary bladder. Belching - Noisy release of gas from the stomach through the mouth; a burp. Bloating - Swelling of the belly caused by excessive intestinal gas.
Constipation
-
Difficulty in
having a bowel movement where the material in the bowels is hard due to a lack
of exercise, fluid intake, and roughage in the diet, or due to certain drugs. Diarrhea - Unusually frequent and excessive, runny bowel movements that may result in severe dehydration and shock. Dyspepsia - Indigestion. This is the discomfort you experience after eating. It can be heartburn, gas, nausea, a bellyache or bloating. Flatulence - More gas than normal in the digestive organs. Gagging - Involuntary choking and/or involuntary throwing up. Gastritis - A severe irritation of the mucus lining of the stomach either short in duration or lasting for a long period of time. Gastroenteritis - A condition where the membranes of the stomach and intestines are irritated. Gastroesophageal Reflux - A continuous state where stomach juices flow back into the throat causing acid indigestion and heartburn and possibly injury to the throat. Heartburn - A burning pain in the area of the breastbone caused by stomach juices flowing back up into the throat. Hemorrhoids - Small rounded purplish swollen veins that either bleed, itch or are painful and appear around the anus.
Increased Stool frequency - Diarrhea. Indigestion - Unable to properly consume and absorb food in the digestive tract causing constipation, nausea, stomach ache, gas, swollen belly, pain and general discomfort or sickness. Nausea - Stomach irritation with a queasy sensation similar to motion sickness and a feeling that one is going to vomit. Polyposis Gastric - Tumors that grow on stems in the lining of the stomach, which usually become cancerous. Swallowing Difficulty - A feeling that food is stuck in the throat or upper chest area and won’t go down, making it difficult to swallow. Toothache - Pain in a tooth above and below the gum line. Vomiting - Involuntarily throwing up the contents of the stomach and usually getting a nauseated, sick feeling just prior to doing so. GeneralAllergy - The extreme sensitivity of body tissues triggered by substances in the air, drugs, or foods causing a reaction like sneezing, itching, asthma, hay fever, skin rashes, nausea and/or vomiting. Anaphylaxis - A violent, sudden, and severe drop in blood pressure caused by a re-exposure to a foreign protein or a second dosage of a drug that may be fatal unless emergency treatment is given right away. Asthenia - A physically weak condition. Chest Pains - Severe discomfort in the chest caused by not enough oxygen going to the heart because of narrowing of the blood vessels or spasms. Chills - Appearing pale while cold and shivering; sometimes with a fever. Edema of Extremities - Abnormal swelling of the body’s tissue caused by the collection of fluid. Fall - To suddenly lose your normal standing upright position as if you were shot. Fatigue - Loss of normal strength so as to not be able to do the usual physical and mental activities. Fever - Abnormally high body temperature, the normal being 98 degrees Fahrenheit or 37 degrees Centigrade in humans, which is a symptom of disease or disorder in the body. The body is affected by feeling hot, chilled, sweaty, weak and exhausted. If the fever goes too high, death can result. Hot Flashes - Brief, abnormal enlargement of the blood vessels that causes a sudden heat sensation over the entire body. Women in menopause will sometimes experience this. Influenza-like Symptoms - Demonstrating irritation of the respiratory tract (organs of breathing) such as a cold, sudden fever, aches and pains, as well as feeling weak and seeking bed rest, which is similar to having the flu. Leg Pain - A hurtful sensation in the legs that is caused by excessive stimulation of the nerve endings in the legs and results in extreme discomfort. Malaise - The somewhat unclear feeling of discomfort you get when you start to feel sick. Pain in Limb - Sudden, sharp and uncontrolled leg discomfort. Syncope - A short period of light headedness or unconsciousness (black-out) also know as fainting caused by lack of oxygen to the brain because of an interruption in blood flowing to the brain. Tightness of Chest - Mild or sharp discomfort, tightness or pressure in the chest area (anywhere between the throat and belly). The causes can be mild or seriously life-threatening because they include the heart, lungs and surrounding muscles. Hemic and Lymphatic Disorders (Involving the blood and the clear fluids in the tissues that contain white blood cells)Bruise - Damage to the skin resulting in a purple-green-yellow skin coloration that’s caused by breaking the blood vessels in the area without breaking the surface of the skin. Anemia - A condition where the blood is no longer carrying enough oxygen, so the person looks pale and easily gets dizzy, weak and tired. More severely, a person can end up with an abnormal heart, as well as breathing and digestive difficulties. The causes of anemia are not enough protein in the red blood cells, or missing and chemically destroyed red blood cells, as well as diseased or destroyed bone marrow. Nosebleed - Blood lost from the part of the face that has the organs of smell and is where the body takes in oxygen. Hematoma - Broken blood vessels that cause a swelling in an area on the body. Lymphadenopathy Cervical - The lymph nodes in the neck, which are part of the body’s immune system get swollen and enlarge by reacting to the presence of a drug. The swelling is the result of the white blood cells multiplying in order to fight the invasion of the drug. Metabolic and Nutritional Disorders (Energy and health)Arthralgia - Sudden sharp nerve pain in one or more joints. Arthropathy - Having joint disease or abnormal joints. Arthritis - Painfully inflamed and swollen joints. The reddened and swollen condition is brought on by a serious injury or shock to the body either from physical or emotional causes. Back Discomfort - Severe physical distress in the area from the neck to the pelvis along the backbone. Bilirubin Increased - Bilirubin is a waste product of the breakdown of old blood cells. Bilirubin is sent to the liver to be made water-soluble so it can be eliminated from the body through emptying the bladder. A drug can interfere with or damage this normal liver function creating liver disease. Decreased Weight - Uncontrolled and measured loss of heaviness or weight. Gout - A severe arthritis condition that is caused by the dumping of a waste product called uric acid in the tissues and joints. It can become worse and cause the body to develop a deformity after going through stages of pain, inflammation, severe tenderness, and stiffness. Hepatic Enzymes Increased - An increase in the amount of paired liver proteins that regulate liver processes causing a condition where the liver functions abnormally. Hypercholesterolemia - Too much cholesterol in the blood cells. Hyperglycemia - An unhealthy amount of sugar in the blood. Increased Weight - A concentration and storage of fat in the body accumulating over a period of time caused by unhealthy eating patterns, that can predispose the body to many disorders and diseases. Jaw Pain - The pain due to irritation and swelling of the nerves associated with the mouth area where it opens and closes just in front of the ear. Some of the symptoms are pain when chewing, head aches, losing your balance, stuffy ears or ringing in the ears, and teeth grinding. Jaw Stiffness - The result of squeezing and grinding the teeth while asleep that can cause your teeth to deteriorate as well as the muscles and joints of the jaw. Joint Stiffness - A loss of free motion and easy flexibility where any two bones come together. Muscle Cramp - When muscles contract uncontrollably without warning and do not relax. The muscles of any of the body’s organs can cramp. Muscle Stiffness - Tightening of muscles making it difficult to bend. Muscle Weakness - Loss of physical strength. Myalgia - A general widespread pain and tenderness of the muscles. Thirst - A strong, unnatural craving for moisture/water in the mouth and throat.Nervous System (Sensory channels)Carpal Tunnel Syndrome - A pinched nerve in the wrist that causes pain, tingling, and numbing. Coordination Abnormal - A lack of normal, harmonious interaction of the parts of the body when it is in motion. Dizziness - Losing one’s balance while feeling unsteady and lightheaded which may lead to fainting. Disequilibrium - Lack of mental and emotional balance. Faintness - A temporary condition where one is likely to go unconscious and fall. Headache - A sharp or dull persistent pain in the head Hyperreflexia - A not normal and involuntary increased response in the tissues connecting the bones to the muscles. Light-headed Feeling – Uncontrolled and usually brief loss of consciousness caused by lack of oxygen to the brain. Migraine - Reoccurring severe head pain usually with nausea, vomiting, dizziness, flashes or spots before the eyes, and ringing in the ears Muscle Contractions Involuntary - Spontaneous and uncontrollable tightening reaction of the muscles caused by electrical impulses from the nervous system. Muscular Tone Increased - Uncontrolled and exaggeration muscle tension. Muscles are normally partially tensed and this is what gives us muscle tone. Paresthesia - Burning, prickly, itchy, or tingling skin with no obvious or understood physical cause. Restless Legs - A need to move the legs without any apparent reason. Sometimes there is pain, twitching, jerking, cramping, burning, or a creepy-crawly sensation associated with the movements. It worsens when a person is inactive and can interrupt one’s sleep so one feels the need to move to gain some relief. Shaking - Uncontrolled quivering and trembling as if one is cold and chilled. Sluggishness - Lack of alertness and energy, as well as being slow to respond or perform in life. Tics - A contraction of a muscle causing a repeated movement not under the control of the person usually on the face or limbs. Tremor - A nervous and involuntary vibrating or quivering of the body. Twitching - Sharp, jerky and spastic motion sometimes with a sharp sudden pain. Vertigo - A sensation of dizziness with disorientation and confusion. Psychiatric Disorders (Mental and emotional)Aggravated Nervousness - A progressively worsening, irritated and troubled state of mind. Agitation - Suddenly violent and forceful, emotionally disturbed state of mind. Amnesia - Long term or short term, partial or full memory loss created by emotional or physical shock, severe illness, or a blow to the head where the person was caused pain and became unconsciousness. Anxiety Attack - Sudden and intense feelings of fear, terror, and dread physically creating shortness of breath, sweating, trembling and heart palpitations. Apathy - Complete lack of concern or interest for things that ordinarily would be regarded as important or would normally cause concern. Appetite Decreased - Having a lack of appetite despite the ordinary caloric demands of living with a resulting unintentional loss of weight. Appetite Increased - An unusual hunger causing one to overeat. Auditory Hallucination - Hearing things without the voices or noises being present. Bruxism - Grinding and clenching of teeth while sleeping. Carbohydrate Craving - A drive and craving to eat foods rich in sugar and starches (sweets, snacks and junk foods) that intensifies as the diet becomes more and more unbalanced due to the unbalancing of the proper nutritional requirements of the body. Concentration Impaired - Unable to easily focus your attention for long periods of time. Confusion - Not able to think clearly and understand in order to make a logical decision. Crying Abnormal - Unusual and not normal fits of weeping for short or long periods of time for no apparent reason. Depersonalization - A condition where one has lost a normal sense of personal identity. Depression - A hopeless feeling of failure, loss and sadness that can deteriorate into thoughts of death. Disorientation - A loss of sense of direction, place, time or surroundings as well as mental confusion on personal identity. Dreaming Abnormal - Dreaming that leaves a very clear, detailed picture and impression when awake that can last for a long period of time and sometimes be unpleasant. Emotional Lability - Suddenly breaking out in laughter or crying or doing both without being able to control the outburst of emotion. These episodes are unstable as they are caused by things that normally would not have this effect on an individual. Excitability - Uncontrollably responding to stimuli. Feeling Unreal - The awareness that one has an undesirable emotion like fear but can’t seem to shake off the irrational feeling. For example, feeling like one is going crazy but rationally knowing that it is not true. The quality of this side effect resembles being in a bad dream and not being able to wake up. Forgetfulness - Unable to remember what one ordinarily would remember. Insomnia - Sleeplessness caused by physical stress, mental stress or stimulants such as coffee or medications; it is a condition of being abnormally awake when one would ordinarily be able to fall and remain asleep. Irritability - Abnormally annoyed in response to a stimulus. Jitteriness - Nervous fidgeting without an apparent cause. Lethargy - Mental and physical sluggishness and apathy that can deteriorate into an unconscious state resembling deep sleep. A numbed state of mind. Libido Decreased - An abnormal loss of sexual energy or desire. Panic Reaction - A sudden, overpowering, chaotic and confused mental state of terror resulting in being doubt ridden often accompanied with hyperventilation, and extreme anxiety. Restlessness Aggravated - A constantly worsening troubled state of mind characterized by the person being increasingly nervous, unable to relax, and easily angered. Somnolence - Feeling sleepy all the time or having a condition of semi-consciousness. Suicide Attempt - An unsuccessful deliberate attack on one’s own life with the intention of ending it. Suicidal Tendency - Most likely will attempt to kill oneself. Tremulousness Nervous - Very jumpy, shaky, and uneasy while feeling fearful and timid. The condition is characterized by thoughts of dreading the future, involuntary quivering, trembling, and feeling distressed and suddenly upset. Yawning - involuntary opening of the mouth with deep inhalation of air. Reproductive Disorder FemaleBreast Neoplasm - A tumor or cancer, of either of the two milk-secreting organs on the chest of a woman.Menorrhagia - Abnormally heavy menstrual period or a menstrual flow that has continued for an unusually long period of time.Menstrual Cramps - Painful, involuntary uterus contractions that women experience around the time of their menstrual period, sometimes causing pain in the lower back and thighs.Menstrual Disorder - A disturbance or derangement in the normal function of a woman’s menstrual period.Pelvic Inflammation - The reaction of the body to infectious, allergic, or chemical irritation, which in turn causes tissue irritation, injury, or bacterial infection characterized by pain, redness, swelling, and sometimes loss of function. The reaction usually begins in the uterus and spreads to the fallopian tubes, ovaries, and other areas in the hipbone region of the body.Premenstrual Syndrome - Various physical and mental symptoms commonly experienced by women of childbearing age usually 2 to 7 days before the start of their monthly period. There are over 150 symptoms including eating binges, behavioral changes, moodiness, irritability, fatigue, fluid retention, breast tenderness, headaches, bloating, anxiety, and depression. The symptoms cease shortly after the period begins, and disappear with menopause.Spotting Between Menses - Abnormal bleeding between periods. Unusual spotting between menstrual cycles.RESPIRATORY SYSTEM (Organs involved in breathing)Asthma - A disease of the breathing system initiated by and allergic reaction or a chemical with repeated attacks of coughing, sticky mucus, wheezing, shortness of breath, and a tight feeling in the chest. The disease can reach a state where it stops a person from exhaling, leading to unconsciousness and death.Breath Shortness - Unnatural breathing using a lot off effort resulting in not enough air taken in by the body.Bronchitis - Inflammation of the two main breathing tubes leading from the windpipe to the lungs. The disease is marked with coughing, a low-grade fever, chest pains, and hoarseness, caused by an allergic reaction.Coughing - A cough is the response to an irritation, such as mucus, that causes the muscles controlling the breathing process to expel air from the lungs suddenly and noisily to keep the air passages free from the irritating material.Laryngitis - Inflammation of the voice box characterized by hoarseness, sore throat, and coughing. It can be cause by straining the voice or exposure to infectious, allergic or chemical irritation.Nasal Congestion - The presence of an abnormal amount of fluid in the nose.Pneumonia Tracheitis - Bacterial infection of the air passageways and lungs that causes redness, swelling and pain in the windpipe. Other symptoms are high fever, chills, pain in the chest, difficulty in breathing, and coughing with mucus discharge.Rhinitis - Chemical irritation causing pain, redness and swelling in the mucus membranes of the nose.Sinus Congestion - The mucus-lined areas of the bones in the face that are thought to help warm and moisten air to the nose. These areas become clogged with excess fluid or infected.Sinus Headache - The abnormal amount of fluid in the hollows of the face bone area especially around the nose. This excess fluid creates pressure, causing pain in the head.Sinusitis - The body reacting to chemical irritation causing redness, swelling and pain in the area of the hollows in the facial bones especially around the nose.SKELETALNeck/Shoulder Pain - Hurtful sensations of the nerve endings caused by damage to the tissues in the neck and shoulder signaling danger of disease. SKIN and APPENDAGES DISORDERS (Skin, legs and arms)Acne - Eruptions of the oils glands of the skin, especially on the face, marked by pimples, blackheads, whiteheads, bumps, and more severely, by cysts and scarring.Alopecia - The loss of hair or baldness. Eczema - A severe or continuing skin disease marked by redness, crusting and scaling with watery blisters and itching. It is often difficult to treat and will sometimes go away only to reappear again.Dermatitis - Generally irritated skin that can be caused by any of a number of irritating things such as parasites, fungus, bacteria, or foreign substances causing an allergic reaction. It is a general inflammation of the skin.Dry Lips - The lack of normal moisture in the fleshy folds that surround the mouth.Dry Skin - The lack of normal moisture/oils in the surface layer of the body. The skin is the body’s largest organ.
Folliculitis - Inflammation of a follicle (small body sac) especially a hair follicle. A hair follicle contains the root of a hair.
Furunculosis - Skin boils that show up repeatedly.
Lipoma - A tumor of mostly fat cells that is not health endangering.
Pruritus - Extreme itching of often-undamaged skin.
Rash - A skin eruption or discoloration that may or may not be itching, tingling, burning, or painful. It may be caused by an allergy, an skin irritation, a skin disease.
Skin Nodule - A bulge, knob, swelling or outgrowth in the skin that is a mass of tissue or cells.
SPECIAL SENSES
Conjunctivitis - Infection of the membrane that covers the eyeball and lines the eyelid, caused by a virus, allergic reaction, or an irritating chemical. It is characterized by redness, a discharge of fluid and itching.
Dry Eyes - Not enough moisture in the eyes.
Earache - Pain in the ear.
Eye Infection - The invasion of the eye tissue by a bacteria, virus, fungus, etc, causing damage to the tissue, with toxicity. Infection spreading in the body progresses into disease.
Eye Irritation - An inflammation of the eye.
Metallic Taste - A range of taste impairment from distorted taste to a complete loss of taste.
Pupils Dilated - Abnormal expansion of the blace circular opening in the center of the eye.
Taste alteration - Abnormal flavor detection in food.
Tinnitus - A buzzing, ringing, or whistling sound in one or both ears occurring from the internal use of certain drugs.
Vision Abnormal - Normal images are seen differently by the viewer.
Vision Blurred - Eyesight is dim or indistinct and hazy in outline or appearance.
Visual Disturbance - Eyesight is interfered with or interrupted. Some disturbances are light sensitivity and the inability to easily distinguish colors.
URINARY SYSTEM DISORDERBlood in Urine - Blood is present when one empties liquid waste product of the kidneys through the bladder by urinating in the toilet turning the water pink to bright red. Or you could see pots of blood in the water after urinating.Dysuria - Difficult or painful urination.Kidney Stone - Small hard masses of salt deposits that the kidney forms.Urinary Frequency - Having to urinate more often than usual or between unusually short time periods.Urinary Tract Infection - An invasion of bacteria, viruses, fungi, etc., of the system in the body that starts with the kidneys and eliminates urine from the body. If the invasion goes unchecked it can injure tissue and progress into disease.Urinary Urgency - A sudden compelling urge to urinate, accompanied by discomfort in the bladder.UROGENITAL (Urinary tract and genital structures or functions)Anorgasmia - Failure to experience an orgasm.Ejaculation Disorder - Dysfunction of the discharge of semen during orgasm.Menstrual Disorder - Dysfunction of the discharge during the monthly menstrual cycle.SIDE EFFECTS REPORTED
AFTER CLINICAL TRIALS Acute Renal Failure - The kidneys stop functioning properly to excrete wastes. Angioedema - Intensely itching and swelling welts on the skin called hives caused by an allergic reaction to internal or external agents. The reaction is common to a food or a drug. Chronic cases can last for a long period of time. Toxic Epidermal Necrolysis - An abnormal condition where a large portion of skin becomes intensely red and peels off like a second-degree burn. Often the symptoms include blistering.Gastrointestinal Hemorrhage - Stomach and intestinal excessive internal bleeding.Grand Mal Seizures (or Convulsions) - A recurring sudden violent and involuntary attack of muscle spasms with a loss of consciousness. Neuroleptic Malignant Syndrome - A life threatening, rare reaction to an anti-psychotic drug marked by fever, muscular rigidity, changed mental status, and dysfunction of the autonomic nervous system.
Pancreatitis - Chemical irritation with redness, swelling, and pain in the pancreas where digestive enzymes and hormones are secreted.
QT Prolongation - A very fast heart rhythm disturbance that is too fast for the heart to beat effectively so the blood to the brain falls causing a sudden loss of consciousness and may cause sudden cardiac death.
Rhabdomyolysis - The breakdown of muscle fibers that releases the fibers into the circulatory system. Some of the fibers are poisonous to the kidney and frequently result in kidney damage.
Serotonin Syndrome - A disorder brought on by excessive levels of serotonin caused by drugs and can be fatal as death from this side effect can come very rapidly.
Thrombocytopenia - An abnormal decrease in the number of blood platelets in the circulatory system. A decrease in platelets would cause a decrease in the ability of the blood to clot when necessary.
Torsades de Pointes - Unusual rapid heart rhythm starting in the lower heart chambers. If the short bursts of rapid heart rhythm continue for a prolonged period it can degenerate into a more rapid rhythm and can be fatal. Weight
Gain/Weight Loss
Although
not reported as a side-effect of this particular SSRI, weight gain has been
reported to us on many occasions as a side-effect of Lexapro. Weight loss
is also a possibility due to digestion disorders caused by the drug.
This is a very dangerous way to lose weight, however, and we emphatically
don't recommend it.
Should
You Take Lexapro?
The
answer is, of course, up to you. Bear
in mind the dangers and side-effects listed above. You should also be tested for a dangerous drug metabolism issue before consumption of this or similar drugs. Lexapro Side Effects, as described by people that have taken Lexapro
Back
to top of page
Can
Lexapro Treat Depression? What
is Depression? Depression is defined
by the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by
the American Psychiatric Association, this way: The essential
feature of a Major Depressive Episode is a period of at least 2 weeks during
which there is either depressed mood or the loss of interest or pleasure in
nearly all activities. In children
and adolescents, the mood may be irritable rather than sad.
The individual must also experience at least four additional symptoms
drawn from a list that includes major changes in appetite or weight, sleep, and
psychomotor* activity; decreased
energy; feelings of worthlessness or guilt; difficulty thinking, concentrating,
or making decisions; or recurrent thoughts of death or suicidal ideation, plans,
or attempts."
----------------------------------------- * Of or relating to movement or muscular activity associated with mental processes.
----------------------------------------- While these elements
can certainly be seen to exist and have been experienced by many, labeling
"depression" as an illness has been criticized by many as simply
labeling part of life itself as a physical "disease" which must be
"cured". This could be debated
endlessly, however, and whole long texts have been written on the subject.
Depression as a state of mind certainly does exist, and can be
painful. The question to be
addressed here, though, is, does Depression truly have a physical cause that can
be addressed with medication? For the answer, let's
go back to the DSM. The only
information given there as to physical causes of depression is: Neurotransmitters
implicated in the pathophysiology* of a Major Depressive Episode include
norepinephrine, serotonin, acetylchlorine, dopamine, and gamma-aminobutryric
acid.
----------------------------------------
*Pathophysiology
-- study of the physical effects of a disease.
---------------------------------------- All right, what does
all that mean? Here's a simple
explanation. A neurotransmitter
is a chemical that helps transmit nerve impulses through the nervous system.
There are many different neurotransmitters used by the body.
What the DSM definition is saying is that, by some method, the
neurotransmitter chemicals known as norepinephrine,
serotonin, acetylchlorine, dopamine, and gamma-aminobutryric acid seemed to be
lower in some depressed people, or higher in non-depressed people. Note carefully the
use of the word implicated in the DSM definition, however.
And therein is the first clue, for it has never been clinically proven
that depression is based in neurotransmitters.
We repeat: Never.
And believe it or not, there is not a doctor on Earth that will disagree
with that statement. Which leads to the
conclusion that a physical cause for depression has never been isolated.
Why, then, are psychiatrists and drug companies so insistent that Lexapro
is a great treatment for depression? That leads us to our
next question. What
is Lexapro? Lexapro is a
brand-name for a drug called escitalopram oxalate, and is technically classified
as a Selective Serotonin Reuptake Inhibitor, or SSRI. So what does all that
mean? Serotonin
is a type of neurotransmitter. We
defined neurotransmitter in the last section.
The
way a neurotransmitter works is, it is passed along from one nerve to another.
A bit of it is sent out at a time from one nerve to the next.
After a bit is sent out and received by the next nerve, any of the
neurotransmitter remaining between the nerves is taken back by the first nerve,
a process called reuptake.
An
SSRI prevents this reuptake process from occurring, which means that, when
Lexapro is active, the neurotransmitter serotonin is transmitted in a steady
stream from one nerve ending to the next, instead of being sent in bits
periodically, which it normally is.
The
word selective
in Selective Serotonin
Reuptake Inhibitor simply means
that the drug "selects" only serotonin as a target, instead of
neurotransmitters in general or a number of them. There are a number of SSRIs on the market, and these are all classified, along with Lexapro, as "anti-depressants." Does
Lexapro Cure Depression?
Good
question. If depression has never
been proven to be caused by neurotransmitters (or the lack of them), that
question cannot obviously be answered conclusively.
In
fact, it cannot even be answered conclusively by Forest
Pharmaceutical,
manufacturers and marketers of Lexapro. In
the Lexapro section of their Web site, under "Lexapro FAQs", is
written: "It [depression]
is
believed to be caused by an imbalance of certain chemicals in the brain that
affect mood." "Lexapro
helps to restore the brain's chemical balance by increasing the available supply
of serotonin, a substance in the brain believed to influence mood."
Please
note the assumptions in this text. "It
is believed to be caused by an imbalance of certain chemicals in the
brain that affect mood." "Lexapro
helps to restore the brain's chemical balance by increasing the available supply
of serotonin, a substance in the brain believed to influence mood."
Translation:
Forest Pharmaceutical playing
a major guessing game with your mental health, and prescribing a highly dangerous drug to
"treat" it. So again, why does Forest Pharmaceutical assert that Lexapro is such a great treatment for depression? The answer, unfortunately, probably lies in the neighborhood of the dollar bill. The first SSRI on the market was Eli Lilly and Company's Prozac, and Prozac became the best-selling drug of all-time. When you announce broadly to the world that a common malady such as depression has been isolated as a "disease", and that there is now a drug to "cure" it, people are going to buy it. But money talks, the drug sold enormously, and hence numerous other drug companies followed suit and developed their own SSRIs. They are still doing so, and Lexapro is just the next "new" treatment for depression. You can tell a lot about medication with how the pharmaceutical company's stock is doing. It looks like Wall Street is getting wise to Lexapro early. "NEW YORK, July 16 (New Ratings) -
Analysts at First Albany maintain their "neutral" rating on Forest
Laboratories (FRX), while lowering their estimates for the company. The
target price has been reduced from $61 to $57. The performance of Lexapro is sagging even with the push of the physicians and their drug reps. You know how Lexapro was pushed on you. Even with that, their market share is dropping. "NEW YORK, July 18 (Reuters) - Can a pill be the answer for shoppers who go out to buy a battery and come home, quite inexplicably, with a plasma TV? Forest Laboratories Inc. (NYSE:FRX - News) is sponsoring a trial at California's Stanford University designed to show that its antidepressants Celexa and Lexapro can cut down on compulsive shopping. Both these drugs, part of a class known as selective serotonin reuptake inhibitors, or SSRIs, were first approved to treat depression. But makers of SSRIs, which include Pfizer Inc. (NYSE:PFE - News), GlaxoSmithKline Plc (London:GSK.L - News) and Eli Lilly and Co.(NYSE:LLY - News), are seeking ever wider definitions of diseases that might accommodate their products." Paxil CR - Seroxat (Paroxetine)
Side
Effects
Body
as a Whole: Infrequent were anaphylactoid
reaction (allergic reaction), chills, flu
syndrome, malaise (a vague feeling of bodily discomfort);
also observed were adrenergic syndrome (one
organ or body part mimicking the pain or distress of another body part),
face edema (excessive fluid buildup in the face),
neck rigidity, sepsis (a range of conditions which can run
up to and include multiple organ failure and death).
Cardiovascular
System (heart and blood vessel system):
Frequent
were hypertension (high blood pressure),
hypotension (low blood pressure); infrequent were
angina pectoris (heat attack), bradycardia (abnormal
slowing of the heartbeat), bundle branch
block (a blocking of
nerve impulses through the heart, causing it to malfunction),
palpitation (speeding up of heartbeat), postural
hypotension (decrease in blood pressure when sitting or
standing), syncope (sudden
loss of strength and/or fainting); also
observed were arrhythmia nodal (irregular
heartbeat), atrial fibrillation (loss
of coordiated rhythm between sections of the heart), cerebrovascular
accident (stroke), congestive heart failure (weakened
heart), hematoma (blood clot), low cardiac
output, myocardial infarct (failure
of the heart muscle due to a blockage of circulation to it),
myocardial ischemia (chest
pain resulting from a spasm or narrowing of coronary arteries),
pallor, phlebitis (inflammation
of the wall of a blood vein), pulmonary embolus (blockage
of an artery in the lungs),
supraventricular extrasystoles (irregular
contractions of the heart caused from a particular part of the heart),
thrombophlebitis (inflammation
of the wall of a blood vein preceding a blood clot),
thrombosis (blood clot in
a blood vessel or vein), vascular
headache (headache associated with abnormally
enlarging and shrinking of blood vessels in the head),
ventricular extrasystoles (irregular
contractions of the heart caused by a particular part of the heart). Digestive System: Infrequent were bruxism (clenching and grinding of teeth), dysphagia (difficulty in swallowing), eructation (belching), gastroenteritis (irritation and inflammation of the digestive tract), gastroesophageal reflux (heartburn), gingivitis (inflammation of the gums), glossitis (inflammation of the tongue), gum hyperplasia (an abnormal increase of cells in the gums), hemorrhoids, hepatosplenomegaly (enlargement of both the spleen and liver), increased salivation, intestinal obstruction, melena (blood in the stool), pancreatitis (inflammation of the pancreas), peptic ulcer (sore on the lining of the stomach), rectal hemorrhage (bleeding from the rectum), stomach ulcer, toothache, ulcerative stomatitis (inflammation of the mouth, with open sores); also observed were aphthous stomatitis (canker sores), bloody diarrhea, bulimia, cardiospasm (spasm of the passage to the stomach, blocking the stomach), cholelithiasis (gall stones), colitis (inflammation of the colon), duodenitis (inflammation of part of the small intestine), enteritis (inflammation of the intestines), esophagitis (inflammation of the esophagus, part of the throat), fecal impactions (clogged bowels), fecal incontinence (inability to control bowel movements), gastritis (inflammation of the stomach), gum hemorrhage (bleeding gums), hematemesis (vomiting of blood), hepatitis (inflammation of the liver), ileitis (inflammation of part of the small or large intestine), ileus (ceasing of bowel movements), jaundice, mouth ulceration (open sores in mouth), salivary gland enlargement, sialadenitis (salivary gland infection), stomatitis (mouth inflammation), throat tightness, tongue discoloration, tongue edema (over-buildup of fluid in the tongue).
Endocrine
System (system of glands in the body that regulate, among other things, body
weight):
Infrequent were
hyperthyroidism (overactive thyroid gland), ovarian
cyst (sac of fluid grown on an ovary or on ovaries),
testes pain; also observed were diabetes mellitus (a
condition of high blood sugar), goiter (swelling
of the thyroid gland, often seen as a large swelling in the front of the neck),
hypothyroidism (underactivity of the thyroid gland),
thyroiditis (inflammation of the thyroid gland). Hemic and Lymphatic System (blood and related systems): Infrequent were anemia (lack of red blood cells), eosinophilia (an abnormally high amount of a type of white blood cell), leukocytosis (abnormal increase in white blood cells), leukopenia (reduction of white blood cells), lymphadenopathy (a cancerous disorder of the lymph gland), thrombocytopenia (a decrease, within the blood, of a special type of cell called a platelet); also observed were anisocytosis (abnormal variation in the size of red blood cells), basophilia (an increase in the number of a certain type of white blood cells), bleeding time increased, hypochromic anemia (a reduction both in size and volume of red blood cells), lymphedema (an overabundance of a fluid called lymph, often resulting in swelling), lymphocytosis (excess of a particular type of white blood cells), lymphopenia (a condition in which there are a low number of a particular type of white blood cells in the blood -- cells vital for the fighting of infection), microcytic anemia (a disease characterized by blood elements called erythrocytes being smaller than normal), monocytosis (an abnormal increase in a particular type of cell in the blood), normocytic anemia (low number of red blood cells), thrombocythemia (an increase in platelets -- a special type of cell -- in the blood).
Metabolic and Nutritional Disorders (dealing with digestion and related areas): Infrequent were bilirubinemia (an elevated level in the blood of a substance called biliruben, causing jaundice, yellowing of the whites of the eyes, and other problems), dehydration, generalized edema (buildup of fluid in the tissues), hyperglycemia (an overabundance of sugar in the blood), hyperkalemia (abnormally high amount of potassium in the blood), hypokalemia (abnormally low amount of potassium in the blood), peripheral edema (buildup of fluid nearer the outside of the body) , SGOT increased (the results of a test on an enzyme called SGOT, which is used to measure the function of the liver, kidney, heart, pancreas, muscles, and red blood cells), SGPT increased (the results of a test on an enzyme known as SGPT, the presence of which in the blood indicates liver damage), thirst; also observed were alkaline phosphatase increased (an enzyme, the presence of which in the blood indicates liver damage), BUN (blood urea nitrogen) increased (indicates kidney malfunction), creatinine phosphokinase increased (increase of an enzyme which may indicate muscular distrophy, a disease which causes permanent muscle breakdown), gamma globulins increased (increase in a part of blood which carries antibodies), gout (inflammation of the joints, especially the big toe), hypercalcemia (excessive calcium in the blood), hypercholesteremia (an excess of cholesterol in the blood), hyperphosphatemia (a high amount of phosphate in the blood, leading to uncoordination of muscles and which can lead to severe organ failure), hypocalcemia (lowered calcium in the blood, which can lead to serious illness and even death), hypoglycemia (a lower amount of blood sugar, causing weakness, dizziness and confusion), hyponatremia (lowering of sodium in the body, which can cause nausea, muscle cramps, disorientation, slurred speech, confusion, and inappropriate behavior), ketosis (presence in the body of elements called ketones, which is under debate as to being good or bad), lactic dehydrogenase increased (a particular enzyme relating to milk increased), non-protein nitrogen (NPN) increased.
Musculoskeletal
(muscular and skeletal) System:
Infrequent
were arthritis, bursitis (inflammation
of a bursa, a pouch of lubricating fluid between a muscle and a bone),
myasthenia (debilitation
of a muscle or muscles), myopathy (diseased
muscles), myositis (muscle
inflammation), tendonitis (tendon
inflammation); also observed were generalized spasm, osteoporosis (bone
deterioration), tenosynovitis (inflammation
of the sheath which holds a tendon), tetany
(spasms of the wrist and ankle joints). Nervous System: Infrequent were amnesia, ataxia (inability to coordinate muscle movement), convulsion, diplopia (double vision), dystonia (muscle problems), emotional lability (instability), hallucinations, hypesthesia (partial loss of sensation), hypokinesia (decreased mobility), incoordination (inability to move the body correctly), neuralgia (sharp pain along a nerve), neuropathy (functional disturbances in the outer nervous system), nystagmus (unnatural and rapid movement of the eye), paralysis, paranoid reaction, vertigo (dizziness and loss of balance), withdrawal syndrome; also observed were abnormal gait (inability to walk properly), akathisis (nervous restlessness), akinesia (inability to move properly), aphasia (speech impediment), choreoathetosis (continuous and uncontrolled involuntary movement), circumoral paresthesia (strange sensations in the mouth), delirium (a state of mind which manifests itself in irrational talk and hallucinations), delusions, dysarthria (speech impediment), dyskinesia (involuntary muscle movement), euphoria, extrapyramidal syndrome (abnormal movements through certain parts of the nervous system), fasciculations (muscle contractions), grand mal convulsion (epileptic and heavy convulsion), hostility, hyperalgesia (excessive sensitivity to pain), irritability, libido increased (sex drive increased), manic reaction (great excitement, rage), manic-depressive reaction (great excitement and rage, followed by depression, which this drug is supposed to prevent; in fact, this drug is prescribed for manic-depression, otherwise known is bipolar syndrome), meningitis (inflammation of the membranes that protect the brain and spinal cord, resulting in serious and sometimes fatal illness), myelitis (inflammation of the spinal cord or of bone marrow), peripheral neuritis (inflammation of nerve endings), psychosis, psychotic depression (something this drug is supposed to treat and prevent), reflexes decreased, reflexes increased, stupor, torticollis (twisted state of the neck), trismus (lockjaw).
Respiratory
System (relating to lungs and breathing systems):
Infrequent were asthma, dyspnea (difficulty
breathing), epistaxis (nosebleed)
, laryngitis (inflammation of a portion of the throat
which makes it near-impossible to talk), pneumonia, stridor (high-pitched
sound when breathing is obstructed); also observed were dysphonia (impairment
of voice), emphysema (buildup of fluid in lungs),
hemoptysis (coughing up
blood), hiccups, hyperventilation, lung
fibrosis (growth of
excess fibrous matter in the lung),
pulmonary edema (excess fluid in the lungs),
respiratory flu, sputum (mixture of mucus and saliva, let
out through the mouth) increased. Skin and Appendages: Infrequent were acne, alopecia (loss of hair), dry skin, eczema (flaking, dry skin), exfoliative dermatitis (inflamed skin coming off in scales), furunculosis (painful sores), pruritus (skin inflammation), seborrhea (abnormally oily skin), urticaria (hives); also observed were angioedema (excess of fluid in the tissues of blood vessels), ecchymosis (bleeding under the skin), erythema multiforme (severe skin irritation), erythema nodosum (severe skin irritation), hirsutism (abnormal hairiness), maculopapular rash (rash consisting of blotches and bumps), skin discoloration, skin hypertrophy (skin swelling), skin ulcer (open sore on skin), sweating decreased, vesiculobullous (blisters on the skin) rash.
Special
Senses: Infrequent were abnormality of accommodation (trouble
seeing distances), conjunctivitis (inflammation
of the inner eyelids), earache,
keratoconjunctivitis (inflammation of both the inner
eyelid and the inner covering of the eye), mydriasis (extreme
enlargement of the pupil of the eye),
photophobia (inability to tolerate light), retinal
hemorrhage (bleeding from the eye), tinnitus (ringing
or clicking in the ears), visual field
defect (not having a normal field of vision); also
observed were amblyopia (dimness
of vision), anisocoria (having
pupils of different size), blepharitis (inflammation
of the eyelids), blurred
vision, cataract (cloudy
formation on the eye, often resulting in partial blindness),
conjunctival edema (excessive fluid built up in eyelids),
corneal ulcer (open sore on the eye covering),
deafness, exophthalmos (abnormal protrusion of the eyeball),
glaucoma (disease of the
eyes resulting in gradual loss of sight),
hyperacusis (abnormal hearing sensitivity), night
blindness, parosmia (altering of the sense of smell),
ptosis (drooping of the
eyelid), taste loss.
Urogenital
System (urine and reproductive systems): Infrequent were albuminuria (presence
in urine of albumin, a part of the blood),
amenorrhea (stopping of
menstrual cycle) , breast enlargement,
breast pain, cystitis (inflammation of the bladder),
dysuria (pain while
urinating), hematuria (blood
in urine), kidney calculus (kidney
stones), menorrhagia (menstrual distress), nocturia (excessive urination at night),
prostatitis (inflammation of the prostate), urinary
incontinence (inability to control urination),
urinary retention; also observed were breast atrophy (breast
diseased), ejaculatory disturbance (ejaculation too
soon, too late, not at all, etc.), endometrial disorder (disorder
with the lining of the uterus), epididymitis (inflammation
of the epididymus, a structure within the testes of males),
female lactation (leaking of milk from breasts),
fibrocystic breast (growths
within the breast), leukorrhea (vaginal
discharge), mastitis (inflammation
of the mammary gland), metrorrhagia (irregular
uterine bleeding), nephritis
(inflammation of
the kidney), oliguria (secretion
of a diminished amount of urine in relation to the fluid intake),
polyuria (passage of a
large volume of urine in a given period of time),
pyuria (presence of pus
in urine), salpingitis (inflammation
of the uterine tube in females),
urethritis (inflammation
of the urethra, the passage through which urine leaves the body),
urinary casts (mineral objects discharged with urine),
urinary urgency (having to urinate badly), urolith
(stones in the urinary tract),
uterine spasm, vaginal hemorrhage (bleeding from the
vagina).
Postmarketing
Reports Voluntary reports of adverse events in patients taking immediate-release paroxetine hydrochloride that have been received since market introduction and not listed above that may have no causal relationship with the drug include acute pancreatitis (temporary inflammation of the pancreas), elevated liver function tests (the most severe cases were deaths due to liver necrosis [complete failure of the liver], and grossly elevated transaminases [a type of enzyme] associated with severe liver dysfunction), Guillain-Barré syndrome (an acute disease of the peripheral nervous system in which the nerves in the arms and legs become inflamed and stop working, causing sudden weakness leading to limb paralysis, and a loss of sensation, sometimes with pain), toxic epidermal necrolysis (a life-threatening skin disorder characterized by a blistering and peeling of the top layer of skin), priapism (persistent painful erection of the penis), syndrome of inappropriate ADH secretion (a condition which causes water not to be absorbed by the body), symptoms suggestive of prolactinemia (a glandular disorder which can cause a wide variety of female organ problems) and galactorrhea (excessive or spontaneous flow of mother's milk), neuroleptic malignant syndrome (a very serious drug reaction which includes fever, rigidity and psychosis)-like events; extrapyramidal (dealing with a particular portion of the nervous system) symptoms which have included akathisia (restlessness; inability to sit still), bradykinesia (abnormally slow movements), cogwheel rigidity (rigidity of a muscle that gives way in a series of little jerks upon being stretched by another), dystonia (muscle problems), hypertonia (abnormal tension of arteries or muscles), oculogyric crisis (A spasmodic movement of the eyeballs into a fixed position, usually upward, that persists for several minutes or hours) which has been associated with concomitant (simultaneous) use of pimozide (an antipsychotic drug), tremor and trismus (lockjaw); serotonin syndrome (a state which is a very dangerous and a potentially fatal side effect of serotonin-related drugs -- of which Paxil is one -- which can have multiple psychiatric and non-psychiatric symptoms), associated in some cases with concomitant (simultaneous) use of other serotonergic drugs and with drugs which may have impaired paroxetine (Paxil) metabolism (note that Paxil itself can inhibit this metabolism) (symptoms have included agitation, confusion, diaphoresis [medically-induced heavy perspiration], hallucinations, hyperreflexia [usually only occurs with spinal injury and contains symptoms such as pounding headache and restlessness], myoclonus [sharp muscle contractions], shivering, tachycardia [extremely rapid heartbeat] and tremor); status epilepticus (a continuous seizure), acute renal failure (temporary failure of the kidneys), pulmonary hypertension (elevated blood pressure in a main artery of a lung), allergic alveolitis (inflammation of the areas behind teeth as an allergic reaction), anaphylaxis (life-threatening rapid allergic reaction), eclampsia (a condition in women in the late stages of pregnancy which includes high blood-pressure and fluid buildup. It may require emergency delivery of the baby), laryngismus (illness in which spasms of the larynx, part of the throat, occur) optic neuritis (inflammation of the optic nerve), porphyria (a disease which consists of a group of related diseases, during which the afflicted experiences abdominal pain, vomiting, constipation and cramps, and can be fatal), ventricular fibrillation (loss of coordiated rhythm between sections of the heart), ventricular tachycardia (extremely rapid heartbeat in part of the heart) (including torsade de pointes [a variant of ventricular tachycardia]), thrombocytopenia (a decrease, within the blood, of a special type of cell called a platelet), hemolytic anemia (a sickness and dying of red blood cells combined with an inability of the bone marrow to replace them), and events related to impaired hematopoiesis (formation of blood cells) (including aplastic anemia [failure of the bone marrow to produce red blood cells], pancytopenia [a deficiency of all types of blood cells], bone marrow aplasia [lack of bone marrow development], and agranulocytosis [lack of a particular type of white blood cells, lowering immunity to disease]) and vasculitic (dealing with inflammation of blood vessels) syndromes (such as Henoch-Schönlein purpura [inflammation of blood cells]). There has been a case report of an elevated phenytoin (an anti-convulsant drug) level after 4 weeks of immediate-release paroxetine (Paxil) and phenytoin (an anti-convulsive drug) co-administration. There has been a case report of severe hypotension (lowered blood pressure) when immediate-release paroxetine was added to chronic metoprolol (a drug used to treat high blood pressure) treatment.
*The Paxil - Seroxat side effects (underlined) listed below, are linked to case studies that have determined glutathione depletion and certain side effects go hand in hand. Almost all of the Paxil - Seroxat side effects listed below are a result of low glutathione in the cells of the body. Other case studies will be added ASAP. The chemical properties, in the structure of Paxil - Seroxat, lower glutathione levels in your cellular structure. A psychiatrist may have been the one to prescribe Paxil - Seroxat but a Chemist can easily determine why chemically induced Paxil - Seroxat side effects take place. Paxil - Seroxat (Paroxetine) Side Effects Frequent - Paxil - Seroxat (Paroxetine) Side Effects Infrequent - Paxil - Seroxat (Paroxetine) Side Effects Body as a Whole: Allergic reaction, chills, face edema (abnormal amount of fluid in the facial tissue), infection, moniliasis (infection caused by Candida (yeast like fungi), neck pain, overdose. Cardiovascular: Bradycardia (abnormal slowness of the heartbeat), conduction abnormalities (abnormal transfer of sound waves, heat, nerve influences, or electricity), ECG abnormal, hypotension (lowered blood pressure), migraine, ventricular extrasystoles (a premature contraction of the heart). Dermatological: Acne, alopecia (absence of hair from the body where it is normally present), dry skin, ecchymosis (blood under the skin, usually looks or appears like a bruise), eczema (an inflammatory skin disease characterized by lesions varying greatly in character, at times watery discharge and the development of scales and crust), furunculosis (a number of painful nodules formed in the skin, caused by bacteria, which enter through the hair follicles or glands, its formation is favored by digestive derangement and local irritation), herpes simplex, urticaria (reaction of the skin to certain drugs, marked by the appearance of smooth, slightly elevated patches, which are redder or paler than the surrounding skin and often includes severe itching). Gastrointestinal: Bruxism (grinding of the teeth especially during sleep), buccal cavity disorders (cavity running from the cheeks to the lips), dysphagia (inflammation of the esophagus), eructation (the act of belching or casting up wind from the stomach), gastroentertitis (inflammation of the stomach or intestines), gastrointestinal flu, glossitis (inflammation of the tongue), increased salivation, liver function test abnormal, mouth ulceration, vomiting and diarrhea, rectal hemorrhage. Hematologic and Lymphatic: Anemia, leukopenia (reduction in the number of leukocytes in the blood), lymphadenopathy (disease of the lymphnodes), purpura (condition charactized by the presence of blood just under the skin, can appear any where over the body), WBC abnormality (white blood cell abnormality). Musculoskeletal: Arthralgia (pain in the joint), arthritis, traumatic fracture. Nervous System: Akinesia (the temporary paralysis of a muscle, can include intense pain), alcohol abuse, amnesia, ataxia (failure of muscular coordination or irregularity of muscle action), convulsion, depersonalization, hallucinations, hyperkinesia (abnormally increased mobility, abnormally increased motor function or activity), hypertonia (a condition of excessive tone, tension or activity, can include increased blood pressure), incoordination, lack of emotion, manic reaction, paranoid reaction, thinking abnormal. Respiratory: Asthma, bronchitis, dyspnea (difficult or labored breathing), epistaxis (hemorrhage from the nose), hyperventilation, pneumonia, respiratory flu, sinusitis. Special Senses: Abnormality of accommodation, conjunctivitis, ear pain, eye pain, mydriasis (extreme or morbid dilation of the pupil), otitis media (inflammation of the ear which may be marked by pain, fever, abnormalities of hearing, deafness, tinnitus, and vertigo), tinnitus (a noise in the ear, as ringing, buzzing, roaring clicking etc). Urogenital: Abortion*, amenorrhea* (absence or abnormal stoppage of menses), breast pain*, cystitis (inflammation of the urinary bladder), dysmenorrhea* (painful menstruation), dysuria (painful or difficult urination), menorrhagia* (excessive uterine bleeding occurring at regular intervals), nocturia (excessive urination at night), polyuria (the passage of a large volume of urine in a given period), urinary incontinence, urinary retention, urinary tract infection, urinary urgency, vaginitis* (inflammation of the vagina). * Gender specific
Prozac
(Fluoxetine)
Side
Effects
While
Ely Lilly and Company, the manufacturers and marketers of Prozac, do issue a
full list of side effects, which they must do under law, there is,
unfortunately, no law that mandates that said list must be comprehensible by a
layman. We would venture to say
that many doctors could not make it through this list with full understanding.
It
could be argued that the list of side effects was deliberately made not
understandable. If there were any
reason for such, it would probably be that these potential side effects are
quite serious, including such items as psychosis, breakdown of muscle control,
heart attack, stroke, and even forms of cancer. Perhaps the manufacturer did not want patients to understand
it. And, as written, they certainly
would not.
We
have taken the time and trouble to put "plain English" translations
next to the more obscure medical terms below.
You'll probably be as shocked as we were as we "translated" the
list.
Frequent
- Prozac (Fluoxetine) Side Effects
Neurological
(referring to the nervous system and brain function):
Headache, Tremor, Dizziness, Asthenia (lack
or loss of strength).
Behavioral:
Insomnia, Anxiety, Nervousness, Agitation, Abnormal dreams, Drowsiness
and fatigue.
Autonomic
(referring to the nervous system that controls involuntary reactions):
Excessive sweating
Gastrointestinal
(referring to the digestive and intestinal systems):
Nausea,
Disturbances of appetite, Diarrhea.
Respiratory
(referring to lungs and breathing function): Bronchitis
(inflammation of lining of the bronchial tubes, the
two main tubes connecting the windpipe to the lungs),
Rhinitis (inflammation of nasal passages),
Yawning.
Endocrine
(referring to the system of glands in the body that regulate, among other
things, body weight):
Weight loss.
Musculoskeletal
(referring to the muscular and skeletal systems):
Muscle pain, Back pain, Joint pain.
Urogenital
(referring to the urine and reproductive systems):
Painful menstruation, Sexual dysfunction, Urinary tract infection, Frequent
micturition (urination).
Miscellaneous:
Chills
Infrequent
- Prozac (Fluoxetine) Side Effects
Allergic
or Toxic reactions: Chills
and fever, Urticaria (hives),
Maculopapular rash (rash consisting of blotches and
bumps).
Neurological
(referring to the nervous system and brain function): Abnormal
gait (abnormal walk),
Ataxia (inability to coordinate muscle movement),
Akathisia
(restlessness; inability to sit still),
Buccoglossal syndrome (another term for Tardive
Diskinesia, an incurable disease which causes uncontrolled movements of the body),
Hyperkinesia (excessive movement or restlessness),
Hypertonia (abnormal tension of arteries or muscles),
Incoordination, Neck rigidity, extrapyramidal syndrome (abnormal
movements through certain parts of the nervous system),
Convulsions, Photophobia (inability to tolerate
light), Myoclonus (sharp
muscle contractions), Vertigo (dizziness),
Migraine, Tinnitus (ringing or clicking in the ears),
Hypesthesia (a decreasing of sensitiveness of the
skin or other senses), Neuralgia (sharp
pain along a nerve), Neuropathy (functional
disturbances in the outer nervous system),
Acute brain syndrome (condition of short-term,
severe confusion).
Behavioral:
Confusion, Delusions, Hallucinations,
manic reaction (great excitement, rage),
Paranoid reaction (very fearful),
Psychosis (severe mental disorder),
Depersonalization (loss of sense of personal
identity, or of personal ownership of the parts of one's body),
Apathy, Emotional Lability (instability),
Euphoria,
Hostility, Amnesia, Increased libido (sex drive).
Autonomic
(referring to the nervous system that controls involuntary reactions):
Dry mouth, Constipation, Urinary
retention, Vision disturbance, Diplopia
(double vision),
Mydriasis (extreme enlargement of the pupil of the
eye), Hot
flushes.
Cardiovascular
(referring to the heart and blood vessel system):
Chest pain, Hypertension (high blood
pressure), Syncope (sudden
loss of strength and/or fainting), Hypotension
(lowered blood pressure),
Angina pectoris (heart attack),
Arrhythmia (irregular heartbeat),
Tachycardia (extremely rapid heartbeat)
. Gastrointestinal
(referring to the digestive and intestinal systems) : Vomiting,
Stomatitis (mouth inflammation),
Dysphagia (difficulty in swallowing),
Eructation
(belching),
Esophagitis (inflammation of the esophagus, part of
the throat), Gastritis (inflammation
of the stomach), Gingivitis (inflammation
of the gums), Glossitis (inflammation
of the tongue), Melena (blood
in the stool),
Thirst,
Abnormal liver function test.
Respiratory
(referring to lungs and breathing function):
Asthma, Dyspnea (difficulty breathing),
Hyperventilation, Pneumonia, Hiccups, Epistaxis (nosebleed).
Endocrine
(system of glands in the body that regulate, among other things, body weight):
Generalized edema (buildup of fluid in the
tissues), Peripheral edema (buildup
of fluid nearer the outside of the body), Face
edema (buildup of fluid in facial tissue),
Tongue edema (buildup of fluid in the tongue),
Hypoglycemia
(very low blood sugar, a condition which causes
weakness and fainting), Hyperprolactinemia (a
glandular disorder which can cause a wide variety of female organ problems),
Weight gain.
Hematoligic
(referring to blood):
Anemia (blood condition causing severe weakness),
Lymphadenopathy (a cancerous disorder of the lymph
gland), Hemorrhage.
Dermatologic
(referring to the skin):
Acne, Alopecia (loss of hair),
Dry skin, Herpes
simplex (a disease which consists of blisters on
the mouth, nose and genitals, often with a fever).
Musculoskeletal
(referring to the muscular and skeletal systems):
Arthritis, Bone
pain, Bursitis (inflammation of a bursa, a pouch of
lubricating fluid between a muscle and a bone),
Tenosynovitis (inflammation of the sheath which
holds a tendon), Twitching.
Urogenital
(referring to the urine and reproductive systems):
Abnormal ejactulation, Impotance, Menopause, Amenorrhea (stopping
of menstrual cycle), Menorrhagia
(menstrual distress),
Ovarian disorder (disorder of the ovaries),
Vaginitis
(inflammation of the vagina),
Leukorrhea (vaginal discharge),
Fibrocystic
breast (growths within the breast),
Breast pain, Cystitus (inflammation of the bladder),
Dysuria (pain while urinating),
Urinary urgency (having to urinate immediately),
Urinary incontinence (unable to control urination).
Miscellaneous:
Amblyopia (dimness of vision),
Conjunctivitis (inflammation of the inner
eyelids), Cyst (sac
of fluid), Ear pain, Eye pain, Jaw pain, Neck
pain, Pelvic
pain, Hangover effect, Malaise (general bodily
discomfort).
Rare
- Prozac (Fluoxetine) Side Effects
Allergic
or Toxic: Allergic
reaction, Erythema multiforme (sores on the skin),
Vesiculobullous (blisters on the skin),
Rash, Serum sickness (a form of delayed allergic
reaction), Contact dermatitis (allergic
reaction on the skin caused by contact of some sort of reaction-causing material),
Erthema nodosum (inflammatory skin disease which
lasts several weeks), Purpuric rash (a
type of rash), Leukocytoclastic vasculitis (combination
of splitting white blood cells and inflamed blood vessels),
Leukopenia (reduction of white blood cells),
Thrombocythemia (overproduction of a certain type
of cell, called platelets, in the blood),
Arthralgia (pain along a nerve, or joint pain),
Angioedema (excess of fluid in the tissues of blood
vessels), Bronchospasm (spasms
of bronchial, or breathing. tubes), Lung
fibrosis (growth of excess fibrous matter in the
lung), Allergic alveolitis (inflammation
of the areas behind teeth as an allergic reaction),
Larynx edema (excess of fluid in the tissues of the
larynx, part of the throat), Respiratory
distress.
Neurological:
Dysarthria (speech
impediment), Dystonia (muscle
problems), torticollis (twisted
state of the neck), Decreased reflexes,
Nystagmus (unnatural and rapid movement of the eye),
Paralysis, Paresthesia (unnatural sensations, such
as burning, prickling, or deadness), Carpal
tunnel syndrome (wrist pain, stiffness),
Stupor, Coma, Abnormal EEG (unusual output of
instrument used in measuring brain activity),
Chronic brain syndrome (insanity),
Dyskinesia (involuntary muscle movement)
and movement disorders (including worsening of
preexisting conditions or appearance in patients with risk factors {e.g.,
Parkinson's disease, treatment with neuroleptics (drugs that reproduce disorders
of the nervous system) or other drugs known to be associated with movement
disorders})
Behavioral:
Antisocial reaction, Hysteria, Suicidal
ideation (thoughts of suicide),
violent behaviors.
Cardiovascular
(referring to the heart and blood vessel system):
Bradycardia (abnormal
slowing of the heartbeat), Ventricular
arrhythmia (irregular heartbeat),
First degree A V block (blockage of nerve impulses
through the heart, causing it to malfunction),
Bundle branch block (a blocking of nerve
impulses through the heart, causing it to malfunction),
Myocardial infarct (failure of the heart muscle due
to a blockage of circulation to it), Cerebral
ischemia (deficiency of blood flow to the head,
usually resulting in a stroke), Cerebral
vascular accident (stroke),
Thrombophlebitis (inflammation of the wall of a
blood vein preceding a blood clot).
Gastrointestinal
(referring to the digestive and intestinal systems): Bloody
diarrhea, Hematemesis (the vomiting of blood),
Gastrointestinal hemorrhage (bleeding in the
intestinal and/or digestive tract), Duodenal
ulcer (open sore in the small intestine),
Stomach ulcer, Mouth ulceration (open sores in the
mouth), Hyperchlorhydria (high
excess of stomach acid), Colitis (inflammation
of the colon), Enteritis (inflammation
of the intestines), Cholecystitis (inflammation
of the gall bladder), Hepatitis (inflammation
of the liver), Hepatomegaly
(enlargement of the liver),
Liver tenderness, Jaundice, Increased
salivation, Salivary gland enlargement, Tongue discoloration, Fecal
incontinence (inability to control bowels),
Pancreatitis (inflammation of the pancreas).
Respiratory
(referring to lungs and breathing function):
Apnea (temporary stopping of breathing impulse),
Lung edema Hypoxia (an abnormal amount of fluid in
the lungs causing a lack of oxygen in the lungs),
Pleural effusion (accumulation of fluid in the
chest cavity), Hemoptysis (coughing
up blood).
Endocrine
(referring to the system of glands in the body that regulate, among other
things, body weight):
Dehydration, Gout (inflammation
of the joints, especially the big toe),
Goiter (swelling of the thyroid gland, often
seen as a large swelling in the front of the neck),
Hyperthyrodism (excessive activity of the thyroid
gland, resulting in nervousness, high metabolism, and often swelling of the
thyroid gland), Hypercholesteremia (an
excess of cholesterol in the blood), Hyperglycemia
(abnormal amount of blood sugar),
Hypothyroidism (underactivity of the thyroid,
usually resulting in low metabolic rate and sluggishness),
Weight gain.
Hematologic
(dealing with the blood):
Bleeding time increased, Leukocytosis (abnormal
increase in white blood cells), Lymphocytosis
(excess of a particular type of white blood cells),
Thrombocytopenia (a decrease, within the blood, of
a special type of cell called a platelet),
Thrombocytopenic purpura (bleeding under the
skin with a decreased platelet count),
Thrombocythemia (an increase in platelets in the
blood), Retinal
hemorrhage (bleeding from the retina of the eye),
Petechia
(blue or yellow spots on the skin caused by
bleeding under the skin), Purpura
(bleeding under the skin causing a rash-like
appearance on the skin), Sedimentation
rate increased (an increase in red blood cell count),
Aplastic anemia (failure of the bone marrow to
produce red blood cells), Pancytopenia (a
deficiency of all types of blood cells),
Immune-related hemolytic anemia (a sickness and
dying of red blood cells combined with an inability of the bone marrow to
replace them).
Dermatologic
(referring to the skin):
Eczema (flaking,
dry skin), Psoriasis (patches
of red, flaking, dry skin), Seborrhea (abnormally
oily skin), Skin hypertrophy (skin
swelling), Skin discoloration, Herpes zoster (painful
sores on the skin), Fungal dermatitis (inflammation
of the skin caused by fungus), Hirsutism (abnormal
hairiness, especially in women), Ecchymoses (bleeding
under the skin).
Musculoskeletal
(referring to the muscular and skeletal systems):
Bone
necrosis (bone death),
Osteoporosis (bone deterioration),
Pathological fracture (a fracture which occurs by itself), Chondrodystrophy (malformation
of bones), Myositis (muscle
inflammation), Rheumatoid arthritis (inflammation
and stiffening of joints), Muscle hemorrhage (bleeding
from muscles).
Urogenital
(referring to the urine and reproductive systems):
Breast enlargement, Galactorrhea (excessive
or spontaneous flow of mother's milk), Abortion,
Dyspareunia (painful sexual intercourse in women),
Uterine spasm, Vaginal
hemorrhage (bleeding from the vagina),
Metrorrhagia (irregular uterine bleeding),
Hematuria (blood in urine),
Albuminuria (presence in urine of albumin, a part
of the blood), Polyuria (passage
of a large volume of urine in a given period of time),
Pyuria (presence of pus in urine),
Epididymitis (inflammation of the epididymus, a
structure within the testes of males),
Orchitis (inflammation of a testis in males),
Pyelonephritis (inflammation of the kidney),
Salpingitis (inflammation of the uterine tube in
females), Urethritis (inflammation
of the urethra, the passage through which urine leaves the body),
Kidney calculus (kidney stones),
Urethral pain, Urolithiasis (formation of stones in
the urinary tract).
Miscellaneous:
Abdomen enlarged, Blepharitis (inflammation
of the eyelids), Cataract
(cloudy formation on the eye, often resulting in
partial blindness), Corneal
lesion (sore on the cornea of the eye),
Glaucoma (disease of the eyes resulting in gradual
loss of sight), Iritis (inflammation
of the iris of the eye), Ptosis
(drooping of the upper eyelid),
Strabismus (deviation of the eye),
Deafness,
Taste loss, moniliasis (eye infection),
Hydrocephalus (a condition in which an unusual
amount of fluid builds up in the skull, accompanied by enlargement of the head
and forehead, the brain malfunctioning, mental weakness, and convulsions),
LE syndrome (a superficial inflammation of the skin
beginning with reddish patches and leaving white scars).
Side Effects Zoloft (sertraline hydrochloride) Frequent Zoloft Side Effects
The above Zoloft side effects are FREQUENT. If you are thinking of taking Zoloft or prescribing Zoloft to a patient, please stop for a minute and evaluate what you are trying to cure with Zoloft. If you or your patient are currently depressed, how do you think it will be with all or most of the frequent side effects with you or your patient on a daily basis? Will it make things worse? The above Zoloft side effects are taken from the Pfizer Premarketing clinical trials. What Zoloft side effects can you expect after more than a few weeks of usage? The list below is taken from the Zoloft side effects (Postmarketing Evaluation)
The above list of Zoloft side effects from Postmarketing Evaluation is actually much longer than listed here. Deaths from Zoloft overdose have varied with the amounts taken. One patient ingested 13.5 grams and recovered while another ingested 2.5 grams and had a fatal outcome.
How
a home detox program can help restore your health. Click
here
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