Depression No More

Destroy Depression

Destroy Depression is written by James Gordon, a former sufferer of depression from the United Kingdom who was unhappy with the treatment he was being given by medical personnell to fight his illness. Apparently, he stopped All of his medication one day and began to search for answers on how to cure himself of depression in a 100% natural way. He spent every waking hour researching all he could on the subject, making notes and changing things along the way until he had totally cured his depression. Three years later, he put all of his findings into an eBook and the Destroy Depression System was born. The Destroy Depression System is a comprehensive system that will guide you to overcome your depression and to prevent it from injuring you mentally and physically. Read more here...

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Major depression with psychotic features

Mood-congruent psychotic features can be considered as a severe degree of symptoms such as guilt and hypochondriasis. Among the case histories selected to illustrate the ICD-10 diagnoses, that of a 35-year-old male patient referred to as the 'Night Walker', illustrates severe depression with mood-congruent psychotic symptoms ( l6)

Tricyclic and tetracyclic antidepressants

Neurovegetative Symptoms Depression

Maprotiline, a tetracylic compound, and the large group of tricylic antidepressants ( Table, 1) effectively treat the neurovegetative signs of depression. Potential sites of action are at the level of receptors (desensitization of presynaptic a 2 -receptors, subsensitivity of b-adrenergic receptors), reuptake transporters (block of monoamine reuptake), and intracellular second-messenger systems. Table 1 Treatment indices and side-effect profiles of common antidepressants The cyclic compounds do not have significantly different efficacy in treating depression but do show a variety of side-effect profiles. Adverse effects are closely related to their chemical structure and their affinity for postsynaptic receptors. Amitriptyline, clomipramine, and doxepin have a high affinity for muscarinic cholinergic receptors and cause more anticholinergic side-effects (dryness of mouth, blurred vision, constipation, urinary retention) than the other cyclic compounds.

Psychotic features of combat related chronic posttraumatic stress disorder and antipsychotic treatment

Canada Suicide Rate Statistics

Epidemiologic and clinical studies have shown that posttraumatic stress disorder (PTSD) commonly occurs with other psychiatric disorders 1-5 . The rate of comorbidity is especially high in combat-related PTSD. A recent epidemiological survey indicated that approximately 80 of combat veterans with PTSD meet criteria for at least one psychiatric diagnosis. The most frequent diagnoses are major depressive disorder, other anxiety disorders, substance abuse, somatization, personality disorders, and dissociative disorders 6 . Some studies show different subtypes of PTSD with depressive, psychotic, and panic features. Levels of cognitive, emotional, and behavioral disturbances in patients with comorbid PTSD and psychotic disorders exceed those seen in patients with PTSD without psychosis, or in patients with only another psychotic disorder. The question is whether a patient had any psychotic episode before his current diagnosis, i.e.

The Self-Defeating Masochistic Personality

Masochistic personalities are vulnerable to a number of Axis I disorders. As always, it is important to remember that there is a logic that connects the personality pattern with its associated Axis I syndromes. As with depressives, masochists frequently experience the chronic gloom of dysthymia. Following rejection, these feelings may escalate into a major depression and then seem to subside again into the slow torment characteristic of the personality.

The Evolutionary Neurodevelopmental Perspective Atp

The fear of social situations characteristic of generalized social phobia is so much a part of the avoidant that it is difficult to determine where the personality disorder ends and the clinical syndrome begins. The association is so close, in fact, that many researchers have questioned whether the two are separate syndromes (e.g., Fahlen, 1997) or whether they may represent points on the same continuum, both manifesting personality dimensions and clinical syndromes such as shyness, depressive symptoms, neu-roticism, introversion, social phobic avoidance, and social or occupational impairment (e.g., Rettew, 2000 van Velzen, Emmelkamp, & Scholing, 2000). Some (e.g., J. Reich, 2000) find extensive diagnostic criteria and treatment approach overlap and advocate reconceptualization of the Axis I and II constructs according to empirical findings. Still others argue that their overlap is an artifact of the committee process through which the DSM is revised.

Depressive Personality Disorder Dsmivtr Appendix B

The appearance of the Depressive Personality Disorder in DSM-IV was not unheralded (Coolidge & Segal, 1998). The DSM-II, published in 1968, had at least two personality disorders with many of the features of Depressive Personality Disorder. Whereas the cyclothymic personality included many of the same depressive symptoms as the current depressive personality, the symptoms alternated with periods of elation in the cyclothymic type. But the worry, pessimism, and general sense of futility are nearly identical to current criteria. The DSM-II also included the asthenic personality, with such symptoms as lack of enthusiasm and marked incapacity for enjoyment. The latter symptom is nearly identical to a feature listed in DSM-IV-TR for the Depressive Personality Disorder, and the lack of enthusiasm symptom is similar to other currently listed features. B. Does not occur exclusively during Major Depressive Episodes and is not better accounted for by Dysthymic Disorder.

The Evolutionary Neurodevelopmental Perspective Ypr

Overall, the defensive self-inflation of the narcissistic personality pattern offers surprising resilience against depressive disorders. After all, narcissists excel at minimizing shortcomings and exaggerating real achievements. Given their skill at manipulating those who cater to their needs, narcissists must have multiple layers of defenses broken down before feeling helpless or hopeless. It may not be surprising that low-grade depressive symptoms are probably more common than major depressive episodes. Major depression may occur after such public and irreparable blows to self-esteem.

Variations of the Avoidant Personality

A clear example of the influence of different personality domains is found in this last subtype of avoidant patterns. Self-deserting avoidants combine the social (interpersonal) retreating of the avoidant with the ruminative (cognitive) self-devaluation of the depressive personality. These individuals immerse themselves in a surrogate fantasy existence to avoid the discomfort of having to relate to others. They are not, however, unaware of their use of these tactics (unless, for example, they are concurrently experiencing a major depressive episode with psychosis), and this makes them painfully aware of their perceived inadequacies. Fantasy gradually becomes less effective, and their thoughts center more and more on the misery of their lives and the anguish of past experiences. Waking dreams are displaced by painful ruminations.

Drugs That Interfere With Norepinephrine Storage

The most troublesome untoward effects of treatment with reserpine involve the CNS. Sedation and depression are the most common, although nightmares and thoughts of suicide also occur. Reserpine treatment, therefore, is contraindicated in patients with a history of severe depression. The occasional report of re-serpine-induced extrapyramidal symptoms, which are similar to those seen in patients with Parkinson' s disease, is believed to be a result of dopamine depletion from neurons in the CNS.

Autosomal Dominant Inheritance

Depression can be treated with classical antidepressants. Deep brain stimulation of the globus pallidus internus has been performed experimentally, and has been reported to provide temporary benefit in single cases, but it cannot stop neurodegeneration 59 . Multiple drug trials are currently being carried out in the hope of finding neuroprotective agents. Tricyclic antidepressants

The Depressive Personality

Almost imperceptibly at first, then more and more, you begin to feel sad, empty, or irritable. Gradually, things that used to fascinate you are no longer interesting. Hobbies, favorite recreations, and spending time with the ones you love are no longer pleasurable and may even seem burdensome. The day becomes dominated by feelings of lethargy, being tired, run down, or overwhelmed by life. Your movements and mental processes may seem to move in slow motion, thoughts crawling like molasses. Concentration can be difficult. Problems that used to be solved quickly are no longer as easily thought through. You may spend hours worried about whether life will ever return to normal. You may have problems going to sleep at night or with waking up too early the next morning. You might even seem to sleep all the time. You might gain weight or be so caught up in brooding that you forget to eat. You might feel worthless or guilty far in excess of what the circumstances should warrant.

The Cognitive Behavioural Model Of Bipolar Disorder

Many authors have argued that there is a marked lack of a coherent psychological model of bipolar disorder (e.g., Jones, 2001 Scott, 2001a). Recent research, however, highlights the role of cognitive and psychosocial factors in the development and course of bipolar disorder, and the first treatment manuals were published in recent years, delineating the application of CBT principles to bipolar disorders (Basco & Rush, 1996 Lam et al., 1999 Newman et al., 2002 Scott, 2001b). A body of research focused on cognitive factors such as attributional styles (Alloy et al., 1999) perfectionism, deficits in problem-solving skills, and elevated scores of sociotropy and autonomy (Lam et al., 2000) and maladaptive schemata (Young, 1999).

Sleep Disturbances in Diseased States Associated with Altered Cytokine Profile

Cytokines And Sleep

Sleep disturbances are an integral part of depressive disorder. Insomnia is a particularly frequent complaint, and it is reported by more than 90 of depressed patients (Thase 1999). Depressive disorders have multiple etiologies and might be well characterized as conditions of immune activation, especially hyperactivity of innate immune inflammatory responses. Increasing amounts of data suggest that inflammatory responses play an important role in the pathophysiology of depression. Depressed patients have been found to have higher levels of proinflammatory cytokines, acute phase proteins, chemokines and cellular adhesion molecules (Maes et al. 1991, 1995 Wichers and Maes 2002). Major depression and the stress response share a number of similar phenomena, mediators and circuitries.

Narcissistic Personality Disorder

Another problem is that the continuous streams of praise required by the narcissist usually diminish with advancing age, frequently leading to severe depression. This pattern is especially noteworthy in cases where the narcissistic person did manage to achieve some measure of prestige and success in the occupational sphere. At an earlier stage in life, the person may have been bolstered by the ability to wield power over subordinates and also to reap praise from them. With retirement, the aging narcissist often begins to feel powerless and deflated, and in reaction, responds with even greater demands for admiration which often go unheeded. Imagine the loss of prestige and power likely to be experienced by Donald Trump, who in later life, will no longer be able to espouse his business acumen fire people on his television show, The Apprentice and direct his massive conglomeration.

The structural theory the dualdrive theory and the Oedipus complex The id infantile sexuality and the Oedipus complex

The introduction of the idea of an aggressive or 'death' drive, arrived at later in Freud's writing, (78 ) stemmed from his observations of the profound self-destructive urges particularly manifest in the psychopathology of major depression and suicide, and of the 'repetition compulsion' of impulse-driven behaviour that frequently seemed to run counter to the pleasure principle that supposedly governed unconscious drives. He never spelt out the details of the aggressive drive as to its origins. This issue was taken up later by Melanie Klein,(9) Fairbairn 10 Winnicott,(11) Edith Jacobson,(12) and Margaret Mahler and her colleagues .13 ) Freud described drives as intermediate between the body and the mind the only thing we knew about them, Freud suggested,(14) were 'representations and affects'.

The Case ofThelma Histrionic Personality Disorder

Soon after her husband had recovered and returned to work and their customary geographically separated relationship, Thelma began an affair with a recently widowed man that continued over several winter seasons. This was a secret from her husband, but not from most others. When her lover found a new partner, and became engaged to be married, he broke off the relationship with Thelma. She became absolutely enraged, feeling at once both abandoned and humiliated by the rejection. She had never considered that her lover might, in time, want something more than a winter affair. Thelma had her first major depressive episode around that time. She was treated by her internist who prescribed initially a tricyclic anti-depressant. As the episode resolved, she was prescribed an anxi-olytic (described by Thelma as a mother's little helper ) that was popular at the time. Psychotherapy or counseling was not suggested to Thelma. The treatment incorporated psychopharmacology.

Variations of the Dependent Personality

Dependent Personality Disorder

Unfortunately, most accommodating dependents are accommodating for a reason Agreeableness is designed to encourage others to take control, thereby compensating for their incompetence. They always have a smile and a friendly word, but rarely follow through on adult responsibilities. In fact, they usually feel helpless whenever autonomy or initiative is required. The loss of a significant source of support or identification may prompt severe depression. Open displays of guilt, illness, anxiety, and depression are common but serve the purpose of deflecting criticism and transforming threats of

Pharmacokinetic Interactions

Other drugs which are similarly affected by cimetidine are benzodiazepines, -adrenoceptor blockers, tricyclic antidepressants, theophylline, phenytoin and oral anticoagulants. Although few of these drug-drug interactions are of clinical significance (Sax, 1987), caution is indicated when cimetidine is given concomitantly with drugs that have a narrow range of therapeutic concentration such as warfarin, theophylline and phenytoin in one study, two days of cimetidine therapy decreased theophylline clearance by 39 (Jackson et al., 1981). Other common inhibitors of one or more CYP isoenzymes include amiodarone, fluconazole, erythromycin, clarithromycin, sulphonamides, ci-profloxacin, omeprazole and paroxetine. Occasionally, clinically severe interactions occur as has been shown recently with combined administration of terfenadine and ketoconazole (Honig et al., 1993 Monaghan et al., 1993), erythromycin (Honig et al.,

Complications and comorbidities

Depressive symptoms are widespread in newly admitted, recently drinking alcoholics of all ages, including elderly people, and are much more common than comorbid depressive disorders, which occurred in 12 per cent of one large hospital admitted series of elderly patients. ( 19 Depression in recently drinking patients resolves in a majority of cases during the first 3 to 4 weeks of abstinence without specific antidepressant therapy, and probably represents an alcohol-induced mood disorder. Continuing depression after 3 weeks of sobriety suggests a comorbid mood disorder. Functional impairment caused by heavy drinking ranges from mild to very severe, presenting in extreme cases as senile squalor or Diogenes syndrome. The major comorbid substance use disorder in elderly alcoholics is tobacco dependence, with current smoking reported in 50 to 70 per cent of cases, four to five times the rate of tobacco dependence found in the general elderly population.

Recurrent brief depression

The symptoms of recurrent brief depression, which was first described by Angst, (2 1) are similar to those of major depression (Table 1) with regard to both number and Reccurrent brief depression occurs in some patients with Parkinson's disease. In contrast, post-stroke depression is similar to major depression. (22) Seasonal depression Seasonal depression is seen most frequently in winter, and less frequently in summer. In DSM-IV, seasonal depression has been adopted as a specifier (rather than a diagnostic category) which can be applied not only to recurrent depression but also to bipolar disorder. The seasonal episodes (e.g. winter depression) have to outnumber any non-seasonal depressive episodes in the same patient. In ICD-10 only seasonal depression is briefly mentioned, and that in an annex for disorders under consideration. According to DSM-IV, the symptoms of seasonal depression are similar to those of major depression.

Pathophysiology of bulimia nervosa

Comorbid major depression is commonly noted. There is an increased incidence of rapid cycling mood disorders and anxiety and substance-related disorders. Substance abuse involving alcohol and stimulants, occurs in one third of patients with bulimia nervosa. Between 2 and 50 percent of women with bulimia nervosa have borderline, antisocial, histrionic or narcissistic personality disorder.

Jonathan Rottenberg and Ian H Gotlib

Major depressive disorder (MDD) is a psychiatric syndrome characterized by impaired functioning in multiple domains, including biology, behavior, emotion, and cognition. Investigators working within each of these domains face an ever-expanding corpus of theory, methodology, and empirical findings. Perhaps in part due to these burgeoning literatures, different groups of researchers have typically focused on only one of these domains of functioning. While understandable, the consequence of this situation is that there is a lack of integrative theory and research in which the range of dysfunctions that are associated with depression are synthesized to form a meaningful overall pattern (Gotlib & Hammen, 1992, 2002). Certainly, the formulation of a socioemotional linkage in MDD is not entirely novel. Several well-validated interventions for depression, such as interpersonal therapy (IPT) (Klerman et al., 1984), social skills training (Becker et al.

The Application Of Cbt In The Treatment Of Bipolar Disorder

The following section will outline the four main components of cognitive behavioural psychotherapy for bipolar disorder psychoeducation early warning signs and coping with prodromal symptoms cognitive behavioural strategies for dealing with manic, hypomanic, or depressive symptoms and finally the targeting of associated difficulties in psychosocial functioning, especially interpersonal difficulties.

Contraindications And Cautions

Individuals with untreated open-angle glaucoma, cardiac disease, hyperthyroidism, or prostatic hypertrophy. Muscarinic antagonists can aggravate reflux esophagitis by decreasing the tone of the lower esophageal sphincter. Infants and children are especially sensitive to the hyperthermic action of muscarinic blockers. Elderly patients are especially sensitive to antimuscarinic effects in the CNS, such as impairment of memory. Pheno-thiazines and tricyclic antidepressants have antimus-carinic activity and can produce effects that are additive to those of the muscarinic blocking drugs. Anti-muscarinics should not be given to patients with gastrointestinal infections because the drug will slow gastric motility and cause the patient to retain the infectious organisms in the gastrointestinal tract.

Millon Clinical Multiaxial InventoryIn

The MCMI-III includes 11 Clinical Personality Patterns scales Schizoid, Avoidant, Depressive, Dependent, Histrionic, Narcissistic, Antisocial, Aggressive Sadistic, Compulsive, Nega-tivistic (Passive-Aggressive), and Self-Defeating Personality Disorder. Three Severe Personality Pathology scales are also included and these are Schizotypal, Borderline, and Paranoid Personality Disorder. Each represent more advanced stages of personality pathology with episodes of psychosis. Additionally, 7 Clinical Syndromes scales (Axis I related) are provided, covering moderate clinical presentations (e.g., Anxiety, Somatoform, Dysthymia, Alcohol Dependence) whereas 3 Severe Syndromes scales denote more serious clinical disorders (Thought Disorder, Major Depression, and Delusional Disorder).

Neurotransmitter Systems

Specific serotonin reuptake inhibitors (SSRIs) are a mainstay of pharmacotherapy in the treatment of depressive phases of bipolar disorder. It is logical that their substrate, the human serotonin reuptake transporter (hSERT), and its gene on the long arm of chromosome 17 have been the focus of intensive study. A polymorphism (a variable number tandem repeat VNTR ) affects the function of the gene, and there is evidence that the 12-repeat allele modestly increases the susceptibility to bipolar disorder in Caucasian populations (Craddock et al., 2001). The effect is relatively small, but studies have been consistent, and the concept of a secondary push on top of another more substantial genetic weighting factor (or factors) could explain some of the variability in the penetrance of the condition.

Dysfunctional attitudes

Lam Bipolar Disorder Cognitive Model

Beck (1983) proposed that individuals in a manic phase can exhibit an autonomous tendency and individuals in a depressive state can exhibit a tendency towards over-dependence upon others. Within the cognitive model framework, it is also postulated by Lam et al. (1999) that extreme achievement-orientated attitudes in bipolar affective disorder might lead to extreme striving behaviour and irregular daily routine. Lam et al. (in press) carried out a principal component analysis of the Dysfunctional Attitude Scale for 143 bipolar 1 patients. Four factors were derived (1) goal-attainment , (2) dependency , (3) achievement and (4) antidependency . No significant differences were found when the validation sample was compared with 109 patients suffering from unipolar depression in any of the four factors. However, the DAS scores correlated significantly with the depression scores.

Alpf Medical Research Personality Disorders

For depressive personalities, being depressed is more than a symptom. Like a person suffering from depression, depressive personalities feel sad and guilty, but their emotional state is indicative of an entire matrix of pervasive and long-standing characteristics of feeling worthless and inadequate. On the continuum toward normality, people with depressive traits may be reflective of negative aspects but are not overcome by them and are self-conscious of their standing but able to take criticism constructively. There are several variations of the depressive personality that mix with other personality traits. The ill-humored depressive is a mixture with the negativistic personality that complains endlessly and is chronically irritable. The voguish depressive is a mixture with histrionic or narcissistic features that sees suffering as noble. Self-derogating depressives possess some dependent features where they feel guilt and must discharge it though self-punishment.

Psychiatric morbidity

Depressive symptoms (irritability, poor concentration, low mood, and anxiety) are commonly reported. In cross-sectional studies they are present in about 50 per cent of patients.(28 The lifetime prevalence for depression is also around 50 per cent. Few studies have assessed the effect of antidepressants in patients with multiple sclerosis. Early studies have suggested that tricyclic antidepressants can be helpful, and clinical experience suggests that the same applies to SSRIs. In any given patient, the side-effects of psychotropic drugs need to be carefully considered for their potential to aggravate or improve neurological symptoms. Emotional lability responds well to small doses of tricyclic antidepressants (e.g. amitriptyline 75 mg) or to SSRIs, but tends to recur when these drugs are discontinued. b-Interferon has been reported to increase the severity of depressive symptoms so that patients at risk for depression should be carefully monitored.

Management Of Hypotension

Patients chronically receiving tricyclic antidepressants. Administration of Lasix may decrease responsiveness to norepinephrine. Norepinephrine should be administered in the lowest effective dose for the shortest period of time. Generally 2-4 mg min titrated to blood pressure is recommended.

Minnesota Multiphasic Personality Inventory2

The Minnesota Multiphasic Personality Inventory-2 (MMPI-2 Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) is unarguably the most widely used self-report measure of adult psychopathology and personality. In the original MMPI, Hathaway and McKinley (1943) revolutionized the field of personality assessment by creating the inventory through the novel empirical method at that time called criterion-keying. In criterion-keying, an item was assigned to a scale if it effectively discriminated a criterion group (e.g., people with clinical depression) from the normative sample (e.g., healthy relatives of patients at the University of Minnesota hospitals). To create the MMPI-2, the original MMPI was significantly revised and restandardized on 2,600 individuals who were generally representative of the U.S. Census. Although the sample included persons up to 85 years of age, older adults were somewhat underrepresented (about 5 of the sample Graham, 2006).

Prevention and treatment: Strengthen your immune system and cheat the flu

John's wort This plant, whose oil is traditionally used to treat burns and skin irritation occurs, it is natural calming agent that helps with mood swings. There was also evidence that St. John's wort works for patients with mild depression. Preparations of St. John's wort has been recently in some EU countries are issued only with a doctor's prescription because it was observed that may alter the effects of some contraceptives preparations.

The 12 Most Dangerous Cancer Causing Products In Your Home Toda

A natural alternative to conventional air fresheners is the use of essential oils. Not only are they effective at creating pleasant aromas, but they have also been proven to be able to provide numerous health benefits as well. One study found that inhaling rosemary oil could improve your mood and stimulate the nervous system.

Common Myths About Irritable Bowel Syndrome

My family member's, friend's, IBS was cured by intervention , so yours can be cured too. Every person with IBS is different, and because many things contribute to IBS symptoms, there are many possible treatments. Mebeverine, the antispasmodic I use on occasion, has few side effects, but also is not very effective with most people. I am lucky that it helps me somewhat, but others wll not find relief from their symptoms with it. Same for diet, lifestyle changes, other medications (eg. antidepressants), psychological interventions, etc. They work for some but not othes.

Nootropic Brain Chemistry 101 - Homeostasis & Neurotransmitters

Serotonin has less of an impact on focus and motivation and more of a connection with memory and learning than Dopamine does. It is less of a nootropic neurotransmitter and more of a mood regulator than Dopamine. Although it has been a target for many antidepressant medications like SSRI's, it generally has a stabilization effect. These drugs and supplements can also have a range of side effects.

Top 5 Mood Boosting Nootropics OTC

The good news is that there are many drugs and supplements that may help augment your mood. Everyone is different and this article focuses on some of the most common and well researched nootropics for possible aid in helping with mood. Some people find that increasing Serotonin and Dopamine receptor efficiency will yield the best results for depression. Others often find they need a central nervous system stimulant that is only offered in certain stimulant drugs. Adrafinil is not really a nootropic in the sense that it is slightly toxic (especially on the liver). We do not recommend that you take Adrafinil but regardless it has been added to the list of OTC nootropics. If the above nootropics do not seem to help your mood, Adrafinil may help. Adrafinil is really the same as Modafinil, which is a prescription wakefulness promoter . Adrafinil affects the dopamine and serotonin systems and is great from promoting productivity enhancement.

6 Nootropics Show Promise In Combating Anxiety And Depression

Disclaimer Nootropics are not antidepressants. This article only covers the research that has been provided. Nootropics are not to replace your current antidepressants unless advised by a registered doctor. Coluracetam, a nootropic agent of the racetam family and choline uptake enhancer, was initially developed and clinically tested by the Mitsubishi Tanabe Pharma Corporation. The Mitsubishi team postulated that it could show promise in the treatment of Alzheimer's disease. When the drug didn't achieve this end in the studies, it was then clinically tested as a potential treatment for primary depressive disorders. Results from the trial yielded success as a possible medication in humans for the comorbid major depressive disorder with generalized anxiety disorders. This nootropic has been looked at primarily as a possible treatment for dementia and Parkinson's disease.

High Affinity Choline Uptake Mechanisms - Coluracetam & Pramiracetam

Pramiracetam and coluracetam have both been shown to be very powerful cholinergic nootropics. They put typical ACh positive allosteric modulators like piracetam in the dust. The strong effects are likely to be primarily from their effects of High Affinity Choline Uptake. The method of action of coluracetam and pramiracetam may prevent certain mood side effects seen with other cholinergic such as piracetam. Depressive symptoms can be observed in some people taking piracetam and related racetams. While the research is few and far between, pramiracetam and coluracetam have been suggested to have some mild anti-depressant qualities.

Guanethidine

The tricyclic antidepressants (e.g., desipramine and amitriptyline) and some phenothiazines block the sympathetic neuronal amine uptake system they thereby would also block the uptake of guanethidine and thus reduce its hypotensive effectiveness. Conversely, guanethidine competitively inhibits the uptake of drugs that are substrates for neuronal uptake, such as the indirectly acting adrenomimetics, or sympathomimetics (see Chapter 10).

Delayed ejaculation

Diseases associated with delayed ejaculation include spinal cord injury and a variety of neurological conditions. Additionally, many classes of drugs are associated with ejaculatory delay, including antihypertensive agents, serotonin-selective reuptake inhibitors, tricyclic antidepressants, phenothiazines, and the benzodiazepines 7 ,7 .6 .)

Cushings syndrome

Hypersecretion of cortisol by the adrenal gland can result in Cushing's syndrome. Cushing's syndrome can also be due to exogenous ACTH or glucocorticoid administration, or endogenous hyperproduction of these hormones. Because a physiological release of cortisol occurs during periods of stress or duress, it is not surprising to see elevations of serum cortisol during the courses of many psychiatric disorders, including major depressive disorder, alcoholism, anorexia nervosa, panic disorder, and psychoactive substance-withdrawal syndromes. The more common clinical signs and symptoms of Cushing's syndrome include fat redistribution, menstrual irregularities, dysphoria, thin skin, moon facies, increased appetite, sleep disturbances, hypertension, hypercholesterolaemia, hypertriglyceridaemia, poor concentration, impaired memory, euphoria, glucose intolerance, striae, and hirsutism.

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