writing_prescriptionQ. Why do so many antidepressants seem to cause sexual dysfunction?
A. In addition to its antidepressant effects, serotonin is a rather powerful vasoconstrictor. It can restrict blood flow to sexual organs and negatively impact sexual performance, libido and the ability to reach orgasm.

Q. Is Prozac’s long half-life a drawback to its action?
A. Yes and no. Prozac’s long half-life can be an advantage to the individual prone to forget doses, but a disadvantage to those taking additional medications (and not only psychotropics). For example, Prozac has been reported to increase the effect of the cyclic antidepressant Norpramin (desipramine) by 400-fold in some subjects! It can also increase the effects of some benzodiazepines.

Q. Is Deplin an antidepressant?
A. No, Deplin is actually a methylfolate preparation. Depressed patients consistently have lower serum folate concentrations. Deplin helps normalize amounts of the neurotransmitters norpinephrine, serotonin and dopamine, thus enabling antidepressants to be more effective.

Q. In relationship to OCD, what is “PANDAS?”
A. PANDAS is the acronym for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. This is actually a subtype of pediatric OCD, triggered by strep throat, in which the body’s own immune cells attack the basal ganglia within the brain rather than the strep. PANDAS OCD is usually consistent with the sudden onset of OCD symptoms.