Antidepressant Side Effects Hinder Long-Term Treatment
A Review of Side Effects and Alternative
Depression is the leading cause of
disability in the United States, affecting more than 20 million
people, or nearly 10 percent of all adult Americans aged
18-years or older. Depressive disorders occur nearly twice as
often in women (12 percent) as men (7 percent), and in financial
terms, ranks as one of the
10 most costly illnesses in the US, with cost estimates ranging
upwards of $465 billion per year. Left untreated, depression is
a serious medical disorder that can interfere with normal daily
functions, erode friendships and family bonds, and severely
Standard Antidepressant Treatment
Current medical treatment for depression favors prescription
antidepressant drugs that work by altering the function of brain
neurotransmitters, such as serotonin and norepinephrine. The
older classes of antidepressant medications--the tricyclic
antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs)--were
effective for some people, but carried a high risk of side
effects, including tiredness, drowsiness, dry mouth,
constipation, light headedness, low blood pressure, sweats,
palpitations, and memory loss. Risk of toxic overdose with TCAs
was also a serious problem.
The next generation of antidepressants, known as selective
serotonin reuptake inhibitors (SSRIs), were safer and more
effective, but still caused unpleasant side effects in
some people, such as nervousness, nausea, mild constipation,
inhibition of sexual orgasm, loss of sexual desire, and partial
impotence. Now, researchers are developing a new generation of
antidepressants--dual-action drugs known as serotonin and
norepinephrine reuptake inhibitors (SNRIs)--that is hoped will
have fewer side effects than current medications.
Side Effects Interfere with Treatment
While currently available antidepressants are often quite
effective, a number of recent surveys reveal that unpleasant
side effects can sometimes be serious enough to interfere with
successful long-term treatment. In one survey conducted by the
National Depressive and Manic-Depressive Association (National
DMDA), the nations largest patient-led, advocacy organization,
the majority of people being treated for depression reported
unpleasant side effects and only modest improvement in their
condition. The online survey, conducted on the National DMDA
website during the summer of 1999, screened for participants who
had been treated for depression. Members of all adult age ranges
were represented, and three out of four respondents were female.
Of the 1,370 participants, less than one-third reported
satisfaction with their treatment. In fact, side effects of
current antidepressants were experienced by 80 percent of those
surveyed. In fact, 17 percent of those surveyed stopped taking
their medication due to side effects, and eight percent missed
at least one dose per week. The most commonly reported side
effect of medication was drowsiness, with 60 percent of
medication-takers feeling tired. Other side effects include
headaches, sleeplessness, agitation, nausea or other
gastrointestinal problems and sexual dysfunction.
Most depressing was the finding that, despite treatment, 81
percent of those surveyed reported that depression still
impaired their social life, 79 percent said it affected their
family life, and 72 percent reported problems with their work
performance. 'This survey gives a voice to many depression
sufferers who cannot tolerate their antidepressant medication or
arent satisfied with the improvement in symptoms,' said Lydia
Lewis, executive director of the National DMDA. 'While we know
that treatment works for more than 80% of those suffering from a depressive
illness, we still urgently need new strategies for managing depression.
A second DMDA survey released this past January has turned up
even more problems with antidepressant medication. The survey of
1,001 patients and nearly 900 primary care physicians found that
47 percent of patients reported side effects from medications.
More startlingly, of those reporting side effects, 55 percent
reported that they had stopped using prescribed drugs, and 17
percent reported skipping doses.
Clearly, the suffering caused by depression places a huge burden
on individuals, families, and society. Faced with the ongoing
problem of undesirable side effects from
current medical treatments, researchers continue to search for
safer alternative approaches for treating depression and
Conventional medicine has traditionally viewed human health as a
steady state. Recent scientific evidence suggests instead that
the human body is in a constantly changing
and integrated state of flux, balanced by the rhythmic ebb and
flow of hormones, neurotransmitters, enzymes, and receptor
Every living creature has normal daily (circadian) rhythms, such
as the sleep/wake cycle, that are keyed to the earths day and
night phases. Daily rhythms also affect the function of the
lungs, cardiovascular system, kidneys, blood flow, muscular
activity, and cognitive function. Humans also experience weekly,
monthly and yearly cycles that subtly affect reproduction,
immune function, and other systems.
Depression and anxiety often are the result of a disturbance (dysregulation)
of multiple neurochemical and neuroendocrine systems. Although
many neurochemicals are
secreted throughout the day, the amount secreted varies, with
high peaks and low valleys occurring at regular intervals
throughout the day and night.
Any imbalance in the normal amount or timing of neurochemical
release can lead to a disruption of the internal biological
clock (chronobiological desynchrony). This, in
turn, can lead to clinical depression and anxiety, and can
contribute to migraine headaches, hypertension (high blood
pressure), neurologic diseases, myopathy, and premature aging.
Syncholamine and Positrol
Our increasing awareness of the importance of chronobiologic
factors in the normal functioning of the body is the basis for a
natural approach to mental health based on rebalancing our
biological rhythms. This is the thinking behind a revolutionary
new form of chronotherapy for depression, anxiety, and bipolar
disorders, sleep disturbances and other affective disorders.
This approach consists of two different chronobiotic complexes
designed to be used together to balance and restore normal
circadian hormonal rhythms: Syncholamine
Syncholamine is designed to be taken during the early part of
the day, when its ingredients help restore the neurohormone
peaks that normally occur during this time. It contains the
stimulatory amino acid catecholamine precursors L-phenylalanine
and L-tyrosine, along with nutrient cofactors to synthesize
norepinephrine, epinephrine, L-DOPA, and dopamine (Fig. 1).
These nutrients also increase the concentrations of the
endogenous (built-in) stimulant/antidepressant phenethylamine
and the natural pain
relievers known as enkephalins.
Syncholamine also contains extracts of St. Johns wort (Hypericum
perforatum), one of the most popular and effective natural
antidepressant nutrients in use today. Many studies have shown
that St. Johns wort can be effective in the treatment of
depression, anxiety, apathy, sleep disturbances, insomnia,
anorexia, and feelings of worthlessness. Even more impressive is
the fact that St. Johns wort produces these results with minimal
St. Johns wort seems to work primarily by potentiating the
effects of the catecholamines and indoleamines by its
MAO-inhibiting properties. St. Johns worts MAO-inhibiting
activity prevents monoamine oxidase from breaking down
norepinephrine and serotonin, thus helping to amplify the
cyclical peak that occurs during the morning hours. St. Johns
wort also improves the signal produced by serotonin after it
binds to its appropriate receptor site, an effect that is even
more important in the evening. In still
another action, St. Johns wort mimics benzodiazepine
anti-anxiety drugs (like Valium and Ativan) by binding gamma-aminobutyric
acid (GABA) receptors.
Other ingredients in Syncholamine include pyroxidol-5-phosphate,
the active form of vitamin B6 in the body, folic acid, and
vitamin B12. The body requires vitamin B6 to
manufacture norepinephrine, dopamine, and serotonin, and to
produce phenylethylamine from phenylalanine. Vitamin B6 levels
have been found to be low in depressed patients. Moreover,
studies show that supplementing vitamin B6 in people with
affective disorders is associated with increased levels of NE
and serotonin and relief of depression.
Folic acid and vitamin B12 are necessary for the synthesis of S-adenosylmethionine
(SAMe), which is vital for neurotransmitter metabolism. A
deficiency of either folic
acid or vitamin B12 may cause similar neurologic and psychiatric
disturbances, including depression, dementia, and demyelinating
myopathy. A folate deficiency, in particular, may specifically
affect the metabolism of catecholamines and indoleamines and
aggravate depressive disorders.
Folic acid and vitamins B6 and B12 are also required for the
conversion of homocysteine to methionine. This prevents the
accumulation of homocysteine, which has been
linked to the formation of atherosclerotic plaque in arteries as
well as to neurotoxic effects that can produce neurologic and
Positrol is designed to be taken in the evening, when its
ingredients help boost the normal nocturnal indoleamine peaks.
It contains the neurotransmitter precursor 5-HTP, plus nutrient
cofactors to synthesize serotonin and melatonin. Positrol also
contains melatonin itself and St. Johns wort.
The body makes 5-HTP from the essential amino acid tryptophan
and turns it into serotonin. Taking supplements containing 5-HTP
raises the level of serotonin in the
brain, which can have profound effects on mood, behavior, and
sleep patterns. Because serotonin is a circadian rhythm
regulator, raising its levels at night promotes circadian
synchrony. 5-HTP also boosts the levels of beta-endorphin and
Numerous studies have demonstrated that the ingredients in
Positrol can help relieve depression, anxiety, and
obsessive-compulsive disorder. In one important comparative
study, 5-HTP was found to be as effective as an SSRI drug (fluvoxamine)
in reducing depression, with fewer adverse effects. 5-HTP can
also help counteract other symptoms of a serotonin deficiency,
such as insomnia, overeating, SAD, and fibromyalgia. Taking
Positrol in the evening helps maintain the bodys temporal
organization, coordinating its individual endogenous
oscillations with the environment. The result is the relief of
major affective disorders, such as depression, bipolar disorder,
anxiety and dementia.
Resynchronizing Mood Cycles
The combination of Syncholamine and Positrol represent a safe
and natural approach to mental health, based on circadian
synchronism and control of homeostasis. Taking
Syncholamine in the early part of the day, and Positrol toward
the end of the day, produces a greater benefit than taking
either product alone. Together these formulas act as timekeepers
to resynchronize the bodys circadian rhythms, while promoting
the proper circadian switching and functioning of the daytime
energy production pathway and the nighttime sleep and repair
pathway. In addition, these formulas may have anti-aging effects
by normalizing neurotransmitter balance, thereby improving
hypothalamic receptor sensitivity.
source of nutrients and supplements.
did we qualify them ?
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