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ANTIDEPRESSANT MEDICATIONS - HYPE OR HELP IHOR MAGUN, M.D. Recently, there has been much interest and information about antidepressant medications, the so-called "happy pills". First introduced in the 1950's, the medications have changed dramatically over the last four decades and part of the change has been in the number and variety of those available. The current choices of treatment are variable and a rational approach in selecting a proper one is determined by numerous factors -- type of depression, side-effect profiles, co-existing illnesses, drug interactions, past response to the medication or even a family member's response to a medication. There is no ideal antidepressant and it is important for patients to recognize that they take a minimum of two weeks to become effective. Every case is different and careful selection of the appropriate type of antidepressant medication must be made. Before a medication can be deemed "working", it should be used for four to six weeks. If no response is evident, options include switching to a different medication or adding another type or class of medication. Long term maintenance is often indicated. Once treatment is deemed successful, the medication should be continued for at least six months. Certain medical conditions require gradual dose reduction before the me dication is discontinued. The new medications that are increasingly prescribed by physicians are known as selective serotonin reuptake inhibitors (SSRI's). They include the most commonly prescribed Prozac and Zoloft and other, lesser known, medications. SSRI's create a chemical reaction that corrects the chemical imbalance which is the principle cause of depression. They sometimes produce side effects: gastrointestinal discomfort, insomnia and some sexual dysfunction. One possible problem may be the "serotonin syndrome" which can cause hyperstimulation of the brain and produce strange behavior. The incidence of this side effect is ex tremely rare but has, unfortunately, been po pularized on television magazine format programs which may suggest that the occurrence of this side effect is more general than it is. Despite the possible side reactions and potential problems, antidepressant medications, when taken as directed, have produced remarkable improvements and are safe to take when properly described. Extensive studies done in the United States have shown that antidepressants can be quite successful. Antidepressants have been shown to be effective in 60-80% of patients using them compared to a 30-40% response rate in those who have been given placebos (sugar pills). Obviously, not everyone who is "blue" needs to be on medication, but when the need is deemed appropriate by a physician and combined with psychotherapy, antidepressants can be the most effective intervention in individuals who ma nifest depression to a significant degree. TO THINK ABOUT ETERNITY by MYKOLA RIABCHUK (1989) To think about eternity - to think about Egyptian pyramids, bronze Buddahs, marble columns with Doric capitals, dolmens, burial mounds, Mayan calendars, or simply - about winter, trees covered with ice to the very tops, ski slopes, the chatter of sparrows, the sparkle of the sun in the warm yarn of a sweater, but comparing snowdrifts with Egyptian Pyramids, and the pines with the columns of the Parthenon, is not to understand that eternity - isn't what lasts forever, but what is repeated again and again. Translated from the Ukrainian by Virlana Tkacz & Wanda Phipps. First published in Visions International 41 (Spring 1993). Видання C оюзу Українок A мерики - перевидано в електронному форматі в 2012 році . A рхів C У A - Ню Йорк , Н . Й . C Ш A.
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