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Convolvulus pluricaulis (Shankhpushpi) and Erythroxylum coca (Coca plant)
Published in Azamal Husen, Herbs, Shrubs, and Trees of Potential Medicinal Benefits, 2022
Sashi Sonkar, Akhilesh Kumar Singh, Azamal Husen
Coca has definite mood-lifting qualities, particularly when the set and environment are helpful. The impact is felt within minutes of ingestion and does not cause patients to feel drugged or inebriated. Current antidepressant medicines (tricyclics), on the other hand, may not show an effect for weeks, have considerable toxicity, and may cause patients to feel intoxicated (Weil, 1981).
The types of conditions
Published in Jane Hanley, Mark Williams, Fathers and Perinatal Mental Health, 2019
The treatment is antipsychotic medication or valproate for a manic state, with lithium or carbamazepine as the drugs of choice. Clonazepam or lorazepam are recommended for insomnia. Tricyclic antidepressants are often prescribed for depressive symptoms. Sometimes, in severe cases, where the symptoms fail to react to medication and there is a high element of suicidal ideation, electroconvulsive therapy is an option. The effect is often rapid and allows functions to return more quickly.
Neurotic disorders
Published in Bhaskar Punukollu, Michael Phelan, Anish Unadkat, MRCPsych Part 1 In a Box, 2019
Bhaskar Punukollu, Michael Phelan, Anish Unadkat
Treatment: Single debriefing sessions are not thought to be useful. Eye movement desensitization (EMDS) is increasingly used. SSRIs and CBT are recommended. Tricyclic antidepressants may reduce the intrusive anxiety causing thoughts.
Epigenetic modulation: Research progress on histone acetylation levels in major depressive disorders
Published in Journal of Drug Targeting, 2023
Yuan Meng, Juan Du, Ning Liu, Yuanyuan Qiang, Lifei Xiao, Xiaobing Lan, Lin Ma, Jiamei Yang, Jianqiang Yu, Guangyuan Lu
Current depression treatments mainly involve psychological, physical, and drug therapies [5], among which drug therapy is the first choice for major depressive disorder. Monoamine deficiency is an important factor in the pathogenesis of depression [6], and the currently available therapeutic antidepressant drugs are mainly designed to target the serotonergic and/or noradrenergic systems in the brain [7], with selective serotonin reuptake inhibitors being the most widely used. Blocking norepinephrine and serotonin reuptake in the brain boosts the concentration of transmitters at the receptor site and decreases the reuptake of norepinephrine and serotonin by the presynaptic membrane of nerve terminals. Tricyclic antidepressants are one of the first-choice treatments for depression; however, they have important shortcomings, such as a low effective rate, considerable side effects, slow action onset, and easy recurrence after drug withdrawal. Therefore, it is crucial to develop new therapeutic targets based on an understanding of their pathophysiological mechanisms.
Depression during pregnancy amidst COVID-19
Published in Hospital Practice, 2021
Balaji Subramanian Srinivasa Sekaran, Steven Lippmann
The most commonly recommended SSRI medications during pregnancy are sertraline, citalopram, fluvoxamine, paroxetine, escitalopram, and fluoxetine; less data is documented for others in this class [7]. Concerns about the cardiac development-safety of prescribing paroxetine are not fully understood, but it is sometimes considered as a possible pharmacotherapeutic option [7]. Prescribing duloxetine and venlafaxine NSRIs is reported to be safe [8]. Yet, there remain issues, changes in indications or efficacy, safety ratings, and restrictions involving SSRI and NSRI prescribing; drugs within each class have different actions. QT prolongation remains a concern with citalopram and escitalopram, questions about the effectiveness of duloxetine, and there are numerous reviews about these medicines [7,9–11]; these have sometimes resulted in changing patterns of prescribing, for example, with more reliance on sertraline and venlafaxine and less for paroxetine. Tricyclic antidepressant medicines have a long-known efficacy. Monotherapy with any of these agents is preferred. Higher dosages are sometimes needed later in pregnancy. Sustained, consistent management and follow-up is important throughout.
Developments in treating the nonmotor symptoms of stroke
Published in Expert Review of Neurotherapeutics, 2020
Treatment depends on the cause. Treatment of pain caused by spasticity can be treated by reducing spasticity (e.g. with baclofen 5–20 mg four times daily), tizanidine (2–6 mg up to four times daily), botulinum injections every 3 months, massage, strapping, slings, or other physical and occupational therapy interventions [90]. Common side effects of medications for spasticity include weakness, fatigue, headache, and nausea. Intrathecal baclofen may be more effective that oral antispasmodic medications [91]. Other interventions for post-stroke pain include the minimization of glenohumeral subluxation, nerve blocks, and electrical stimulation [90]. Shoulder-hand syndrome is generally treated with physical and occupational therapy, although acupuncture has been used as an adjunct [92]. Treatment of Dejerine–Roussy syndrome is very difficult, but is sometimes ameliorated by stereotactic thalamotomy, deep brain stimulation, or less completely with tricyclic antidepressants, gabapentin, pregabalin, or duloxetine. These last four medications are used to treat a variety of neuropathic pain symptoms. However, effectiveness and side effects increase with the dose. Common side effects of tricyclic antidepressants are discussed in Section 1.1. Common side effects of gabapentin and pregabalin include tingling, sedation, and lower extremity edema. Common side effects of duloxetine include light-headedness, visual changes, eye pain, swelling, or redness, and easy bruising.