Are There Any New Topics As Of 2011 Meds Change So Fast ?
Posted 16 March 2012 - 05:44 AM
Posted 17 March 2012 - 01:00 AM
This is what I found in the literature:
Reducing impulsivity in repeat violent offenders: an open label trial of a selective serotonin reuptake inhibitor
If you're dealing with a TBI, great strides have been made in research in that arena, primarily (unfortunately) due to war injuries:
Pharmacological interventions for traumatic brain injury
Despite potentially severe consequences, post-TBI psychiatric sequelae are underdiagnosed and undertreated. Fortunately, current evidence suggests that antidepressants can be used to manage both neuropsychiatric and additional neurological deficits persisting from brain injury.
Selective serotonin reuptake inhibitors (SSRIs) have been found useful in treating behavioral syndromes in TBI patients, particularly in the subacute stages of recovery but also in chronic settings.
The majority of studies suggest that SSRIs improve neurobehavioral, neurocognitive, and neuropsychiatric deficits, specifically agitation, depression, psychomotor retardation, and recent memory loss; however, most data originates from nonrandomized trials.
Sertraline administered at an average dose of 100 mg daily for 8 weeks has been found to be beneficial for agitation, depressed mood, and deficits in psychomotor speed and recent memory; shorter treatment durations have demonstrated no benefit.
Similarly, 60 mg daily of fluoxetine for 3 months was shown to be effective in the treatment of obsessive-compulsive disorder caused by brain injury. Finally, paroxetine or citalopram, at a dose of 10 to 40 mg daily, was shown by another study to be equally effective in the treatment of pathological crying. None of the reviewed studies addressed neurocognitive deficits.
The highest concentration of serotonergic and adrenergic fibres is located near the frontal lobes, the most common site of traumatic contusion.
Consequently, these fibres are commonly injured in TBI, suggesting that newer antidepressants with effects on both norepinephrine and serotonin, such as mirtazapine and venlafaxine, may also be effective in the treatment of TBI sequelae; however, clinical data with these agents in TBI is lacking.
Similarly, bupropion increases both dopamine and norepinephrine levels and is a weak inhibitor of serotonin reuptake. At 150 mg daily, this agent has been useful in treating restlessness.
Non–stimulant medications in the treatment of ADHD
Referencing Strattera and TCAs, but not SSRIs
There are lots of studies out there discussing the utilization of SSRIs or SNRIs for individuals with comorbid depression and ADD/ADHD or ADD/ADHD that presents primarily with symptoms often seen in depression (irritability, aggression, anger, low self-esteem, etc.), but vanilla ADD/ADHD treated with SSRIs? No.
Please ask a clearer qustion.
Yes, my name really is Dymphna.
I'm not a doctor, nurse, pharmacist, or therapist.
I can find you an answer and I won't blow smoke up your ass.
St. Dymphna is the Patron for brain maladies.
I'm the Enforcer.
In these epistles there are certain things difficult to understand, which the unlearned and the unstable distort,
just as they do the rest of the Scriptures also, to their own destruction.
(II Peter 3:16)
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