calling |
||||||
|
News for 01-Nov-25 Source: MedicineNet High Blood Pressure General Source: MedicineNet High Blood Pressure General Source: MedicineNet High Blood Pressure General Source: MedicineNet High Blood Pressure General Source: MedicineNet Diabetes General Source: MedicineNet Diabetes General Source: MedicineNet High Blood Pressure General Source: MedicineNet Diabetes General Source: MedicineNet Diabetes General Source: MedicineNet High Blood Pressure General
|
The Best calling websiteAll the calling information you need to know about is right
here. Presented and researched by http://www.mdnewscast.net. We've searched
the information super highway far and wide to provide you with the
best calling site on the internet today. The links below will
assist you in your efforts to find the information that you are looking
for about
calling
You can spend a few hours looking on the Net for information about calling or you can take advantage of the research we have done for you. There are literally hundreds of thousands of web pages with some kind on information on calling but much is of little value. Jeeves is a good source for information about calling but you must filter through the commercials for calling and determine if that is really what you want. This means you must make a decision on the value from this particular calling store. You are welcome to spend your valuable time in this research or you can rely on the fact that we have done it for you and click the links on the left side of this page. calling
If you follow one of the above calling hyperlinks, or take a look at the website that might have popped up when you entered my, not yet so fantastic site, you'll see what I mean. These calling sites are so useful that they put my little effort to shame. Seeing I'm not exactly flushed with content yet, you may as well leave my little website now to visit one of the calling sites I've linked to. But before you do go I'd just like to say that I'm putting lots of work and effort into this calling place of mine and I'd be pleased if you'd remember it and come back again one day soon. Depression Series (Part 2): My Antidepressant Doesn't Work. What Can My Psychiatrist Do? by: Michael G. Rayel, MD
Maria has been increasingly depressed for the past few years. She has tried at least four newer antidepressants but so far, she doesn't seem to respond. Unable to work, she's now feeling helpless and hopeless. Likewise, her family is discouraged. Frustrated and baffled by Maria's lack of progress, the family doctor refers her to a psychiatrist. What can the psychiatrist do to help Maria? The psychiatrist has several options in dealing with a treatment-resistant or refractory depression. First, Maria's psychiatrist can optimize the dose of her antidepressant. Maria has been taking low doses of antidepressants. In spite of her lack of response, the medication dosage has not been increased. To obtain a clinical response, her psychiatrist should increase the dose every two to three weeks. The antidepressant can be adjusted up to the maximum allowable dose if no or only partial response is observed. Second, her psychiatrist can choose to augment the effect of her antidepressant with another medication such as lithium, triiodothyronine (T3), or buspirone. Among augmenters, lithium and triiodothyronine have the best support from the literature. Despite lithium's efficacy, some doctors avoid this drug because it requires regular blood monitoring and has unfavorable side effect profile such as acne, tremors, and thyroid and renal dysfunction. Recently, studies have shown atypical neuroleptics such as olanzapine and risperidone to be good augmenters. In my opinion, further studies are necessary to establish these two drugs as standard augmenter. Indeed, research studies and clinical experience have found augmentation strategy to be effective. Third, combination strategy is worthwhile to try. Maria's psychiatrist can add another antidepressant to boost the effect of her current antidepressant. For instance, trazodone can be added to an SSRI (serotonin reuptake inhibitor e.g. citalopram). Literature suggests that combining two drugs with different mechanisms of action and drugs that involve several brain chemicals has resulted in clinical improvement. In this scenario, one antidepressant plus another antidepressant is equal to three, or four or even ten, not two. Fourth, the psychiatrist can switch from one antidepressant to another. Previous studies have shown that when making a switch, a drug should be replaced by a drug from a different class e.g. from SSRI to SNRI (serotonin and norepinephrine reuptake inhibitor e.g. venlafaxine), or from TCA (tricyclic agent e.g. nortriptyline) to SSRI. But recent studies show that switching drugs within the same class (e.g. SSRI to another SSRI) is just as effective. Fifth, Maria's psychiatrist can also treat other ongoing symptoms or drug-related problems that further complicate her depression. If she is anxious and agitated, then her psychiatrist should prescribe antianxiety drug (e.g. lorazepam) or if Maria is psychotic then adding an antipsychotic drug should help. Moreover, medication side effects (such as insomnia, dryness of mouth, constipation, etc.) that negatively affect Maria's compliance to the drug should be addressed promptly. Lastly, if despite above measures Maria doesn't respond to antidepressants, then electroconvulsive therapy should be entertained. Of course, this procedure should be done with her consent. In summary, Maria's psychiatrist can optimize the dose, augment or combine treatment, switch the medication, treat side effects and ongoing symptoms, or use electroconvulsive therapy for treatment-resistant or refractory depression.
|
|||||
|
http://www.medmeet.com/ |
||||||
| Medical Meetings Medical Meetings Medical Meetings On The Net |