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Micromanaging Insomnia

Reaffirming the notion that there is indeed a pill for every ill, on November 23rd of this month the US Food and Drug Administration approved Intermezzo® (zolpidem tartrate sublingual tablets) for use as needed for the management of insomnia associated with middle-of-the-night awakenings and difficulty returning to sleep. This is the first time the FDA has approved a drug specifically for this indication. The agency warns that Intermezzo® should be used only when there are at least four hours of [...]

2011-11-28T21:13:32+00:00

Generalized Anxiety Disorder

Anxiety is a normal human response to uncertainty. It’s simply a part of the human condition to have occasional “fight-or-flight” moments that we find difficult to control or manage. For people with Generalized Anxiety Disorder however, nearly every aspect of life invokes a thought of “what if,” leading to a state of chronic worry often accompanied by sensations of doom and gloom. Literally, these are folks who: (1) worry all of the time, (2) worry about what they worry about [...]

2012-09-21T16:09:53+00:00

Omega-3 Fatty Acids

While fat has become a bad word in our society, a particular type of fat is so essential, our body’s cells can literally collapse without it. Fish oil – with its singular component omega-3 fatty acids, and in conjunction with other types of fat in the membranes that surround the cells – literally control cell behavior. Fish oils are made up of EPA (eicosapentaenoic acid), critical in heart function, and DHA (docosahexaenoic acid), critical in brain function. These oils are [...]

2011-10-15T13:46:36+00:00

Antihistamine Use for Insomnia

Antihistamines are used primarily to counter the effects of histamine, a neurochemical involved in allergic reactions. They also can reduce anxiety through their sedative effects and are sometimes used to treat insomnia. If you’ve ever taken a Benadryl (diphenhydramine), you know what I mean. Although not FDA-approved for insomnia, antihistamines promote drowsiness which in turn can influence sleep induction. They will not help with sleep maintenance, nor will they prevent early morning awakenings. Vistaril (hydroxyzine pamoate) and Atarax (hydroxyzine hydrochloride) [...]

2011-10-15T13:39:01+00:00

Saphris (asenapine) Linked to Potentially Severe Allergic Reactions

The US Food and Drug Administration (FDA) has issued a warning regarding possible severe allergic reactions to the second-generation antipsychotic Saphris. According to this FDA warning, reported signs and symptoms include anaphylaxis, angioedema (swelling below the surface of the skin), hypotension, tachycardia, swollen tongue, difficulty breathing and rash. The FDA also indicates that the drug’s label has been modified to include information about this risk. My concern with these atypical antipsychotics is what will unfold from an adverse event standpoint [...]

2011-10-09T17:04:29+00:00

Unapproved Use of Antipsychotics: An Ever-Growing Concern

In 1996, the three second-generation antipsychotics FDA approved at that time – Clozaril, Risperdal and Zyprexa – were prescribed for patients with anxiety disorders in 10 percent of office visits. The bulk of the prescribing for anxiety was with Risperdal and Zyprexa because Clozaril was not (and still isn’t) considered a first-line agent of choice due to potentially serious concerns with agranulocytosis. A decade later, in 2006, prescribing had more than doubled for the treatment of anxiety despite absolutely no [...]

2011-09-06T01:12:59+00:00

Social Phobia

Social phobia is an irrational fear of social or performance situations. Those with social phobia – also known as social anxiety disorder – suffer from an intense fear of doing or saying something that will embarrass them in social settings such as eating in public, attending parties, dating, taking exams, and public speaking.  Fear of humiliation, rejection and separation may lead them to refrain from any of the situations just mentioned. Sufferers typically experience the triad of worry, avoidance and [...]

2011-08-25T19:33:34+00:00

Treating Performance Anxiety with Beta-Blockers

Beta-blockers, which include Inderal (propranolol), Toprol (metoprolol) and Tenormin (atenolol) among others, have been used in general medicine since 1965. These drugs block beta- receptors in the heart, and by doing so, blood pressure, heart rate and cardiac output are decreased. This led to beta-blocker use in the treatment of hypertension, angina and cardiac arrhythmias. In psychiatry, beta-blockers are used in the treatment of anxiety disorders with manifestations such as palpitations, sweating and tremor. As such, performance anxiety that may [...]

2011-08-19T17:27:31+00:00
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