|Step out of depression||Sep. 4, 2001|
|Provided by: CANOE|
|Written by: DR. GIFFORD-JONES|
|Are you working more slowly? Finding it more difficult to concentrate on the task at hand? Becoming more annoyed at co-workers or boss? Falling asleep unexpectedly at work?
If so, you may be suffering from depression.
Dr. Michael E. Thase, Professor of psychiatry at the University of Pittsburgh School of Medicine, says getting "down in the dumps" is a part of living. But if you no longer find joy in a good movie or a visit from friends you may have what Winston Churchill described as "the black dog of depression."
It's not often patients blurt out ,"I'm depressed." Rather, they complain of sleep disturbances, lack of interest in sex, intestinal complaints, chronic pain, weight loss or gain.
A psychiatrist recently told me about a depressed woman who had refused to leave her home for 30 years. Finally, convinced to take antidepressant medication, she was soon going out dancing!
Now, we know that depression can be related to biochemical reactions in the brain and correctable by medication.
It wasn't until the 1950's that psychiatrists obtained their own specific drugs. But the initial drugs produced troublesome side effects such as dry mouth and lightheadedness.
Then, in 1987, ELI Lilly pharmaceutical hit the bull's eye. Its drug Prozac, like a single bullet, was able to affect one single neurotransmitter in the brain, called serotonin. Since then two other Prozac-like drugs, Pacil and Zoloft, have been developed. Unfortunately, these three drugs often take up to six weeks before they become effective. That's a long time for severely depressed patients to wait.
A "beyond Prozac" drug called Remeron helps to solve this problem. This antidepressant drug has been available in Europe and the U.S. for several years and has now been approved for use in Canada.
Remeron's major advantage is its rapid onset of action. A speedy start has several benefits. It works to quickly restore a normal sleep pattern. And when depressed patients see speedy improvement, they're more likely to continue with the medication.
Remeron's quick action also diminishes the risk that a depressed patient will encounter job, marital or other problems. It also lessens the risk of suicide.
In the past, many antidepressant drugs have caused sexual dysfunction. This can be of major concern to depressed patients. The best way to avoid this complication is to use a drug such as Remeron, which is devoid of sexual side effects.
In my practice I see many depressed menopausal women. The majority of these patients can obtain relief by the use of estrogen. But if their depression is not related to menopause Remeron has been found to give relief.
What about safety? Six million depressed patients worldwide have now used Remeron and its track record has been good. In Germany it's the antidepressant most often prescribed by psychiatrists.
The usual dose is 30 milligrams taken once a day. Since it has a mild sedative effect during the first week it's best taken at bedtime. But it is not affected by food. Nor does it have any effect on cardiovascular organs or intestinal tract.
Remeron is relatively free of side effects. One in eight patients gains a small amount of weight. This occurs during the first six to eight weeks. But studies show that in the long run, weight gain is not a problem. In fact, for some depressed patients who have lost weight, increased appetite is desirable.
My advice is to see your doctor if your symptoms suggest depression. Don't make the mistake of the woman who didn't leave her home for 30 years.
|MORE COLUMNS BY DR. GIFFORD-JONES|