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Medications

Below is basic information about some of the most common medications prescribed in helping to treat some sufferers of Eating Disorders. Be aware that not all respond to medication. Patients who do respond best are also in support groups and/or one-on-one therapy -- it is important to understand that there is no "magic pill" -- those in recovery and on medication should also be in some type of therapy.

Prozac
Paxil
Zoloft
Effexor
Remeron
Wellbutrin
Luvox
Lithium
Desipramine
Imipramine
Xanax
*Naltrexone
*Zyprexa

Read information on a new medication known as Zofran (ondansetron HCL) in the treatment of Bulimia Nervosa (March, 2000)

NO MEDICATION is an all-in-one cure. It is a valuable tool in a treatment program which includes therapy and support.


Prozac

(fluoxetine hydrochloride) - An antidepressant (SSRI - selective serotonin reuptake inhibitor) for oral administration. It is usually prescribed in 10mg or 20mg capsules in doses of 20mg to 80mg per day.

Indications: Depression, symptomatic relief of depressive illness, Bulimia Nervosa, Obsessive-Compulsive Disorder (OCD)

Considerations: Patients with kidney or liver disease should be monitored closely. Pregnant or nursing mothers should not take this medication unless the benefits significantly outweigh the risks. No serious adverse reactions in babies have been reported, but pregnant or nursing mothers on this medication should be very closely monitored. Fluoxetine should also be given to people who have seizures with caution.

Side Effects: (most common) - Anxiety, nervousness, headache, drowsiness, fatigue, dry mouth, upset stomach, appetite loss, nausea, vomiting, diarrhea, stomach gas, rash and itching. (less common) - changes in sex drive, abnormal ejaculation, impotence, abnormal dreams, difficulty concentrating, increased appetite, acne, hair loss, dry skin, chest pains, runny nose, abnormal heart rhythms, blood pressure changes, double vision, urinary pain, eye or ear pain, and low blood sugar.

Drug Interaction: MAOI (Monoamine Oxidase Inhibitors) Warning - There have been reports of serious, sometimes fatal, reactions in patients receiving fluoxetine in combination with a MAO inhibitor and in patients who have recently discontinued fluoxetine and then started on a MAO inhibitor. Therefore, fluoxetine should not be used in combination with a MAO inhibitor or within 14 days of discontinuing therapy with a MAO inhibitor. Since fluoxetine and its major metabolite have very long elimination half-lives, at least 5 weeks should be allowed after stopping fluoxetine before starting a MAO inhibitor.

link: Prozac.com

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Paxil

(paroxetine hydrochloride) - An antidepressant (SSRI - selective serotonin reuptake inhibitor) for oral administration. It is usually prescribed in 10mg, 20mg, 30mg or 40mg tablets in doses of 20mg to 50mg per day.

Indications: Depression, symptomatic relief of depressive illness. It is not indicated for Obsessive-Compulsive Disorder (OCD) but has been prescribed in helping to treat it.

Considerations: Patients with kidney or liver disease should be monitored closely. Pregnant or nursing mothers should not take this medication as adverse effect to the fetus or baby can occur. A small number of manic or hypomanic people may experience an activation of their condition while taking paroxetine. Paroxetine should also be given to people who have seizures with caution.

Side Effects: (most common) - most of the minor side effects that occur do so in the first few weeks while the body adjusts to the medication. They include nausea, tiredness, increased sweating, tremors, weakness, dry mouth, constipation, dizziness, decreased sex drive, abnormal ejaculations, blurred vision, headache and weight gain. (less common) - flushing, pinpoint pupils, increased saliva, cold and clammy skin, dizziness when rising quickly from a sitting or lying position, blood-pressure changes, swelling around the eyes, fainting, rapid heartbeat, unusual walk, muscle pain, cramps and weakness, joint pains, memory loss, apathy, delusions, a feeling of detachment, aggressiveness, abnormal dreaming or thinking patterns, euphoria, hallucinations, neurosis, paranoia, suicide attempts, teeth grinding, menstrual cramps, coughing, double visions, facial swelling, feeling ill, weight changes, lymph swelling, and breathing difficulty.

Drug Interaction: MAOI (Monoamine Oxidase Inhibitors) Warning - There have been reports of serious, sometimes fatal, reactions in patients receiving paroxetine in combination with a MAO inhibitor and in patients who have recently discontinued paroxetine and then started on a MAO inhibitor. Therefore, paroxetine should not be used in combination with a MAO inhibitor or within 14 days of discontinuing therapy with a MAO inhibitor. It is also recommended that alcohol be avoided while taking this medication.

People taking Warfarin or Digoxin may experience an increase in the drug's effect when taken in conjunction with paroxetine. If paroxetine is taken with lithium, it may effect the levels of lithium in the blood. Because of these drug interactions, doctors need to monitor their patients on paroxetine closely.

link: Paxil.com

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Zoloft

(sertraline hydrochloride) - An antidepressant (SSRI - selective serotonin reuptake inhibitor) for oral administration. It is usually prescribed in 50mg capsules in doses of 50mg to 200mg per day.

Indications: Depression, symptomatic relief of depressive illness, Obsessive-Compulsive Disorder (OCD) and Panic Disorder, with or without agoraphobia.

Considerations: Patients with kidney or liver disease should be monitored closely. Pregnant or nursing mothers should not take this medication as adverse effect to the fetus or baby can occur. A small number of manic or hypomanic people may experience an activation of their condition while taking sertraline. Sertraline should also be given to people who have seizures with caution.

Side Effects: (most common) - Dry mouth, sweating, heart palpitations, chest pain, headache, dizziness, tremors, tingling or numbness in the hands or feet, twitching, muscle spasms, confusion, rash, nausea, diarrhea or loose stools, constipation, upset stomach, stomach gas, appetite changes, abdominal pains, muscle aches, sleeplessness or sleepiness, male or female sexual dysfunction, agitation, nervousness, anxiety, yawning, loss of concentration, menstrual disorders, sore throat, runny nose, vision changes, ringing or buzzing in the ears, urinary frequency or disorders, fatigue, hot flushes, fever, back pain, thirst and weakness. (less common) - flushing, increased saliva, cold and clammy skin, dizziness when rising quickly from a sitting or lying position, blood pressure changes,, swelling around the eyes and in the arms or legs, coldness in the hands or feet, fainting, rapid heartbeat, loss of coordination, unusual walk, changes in the general level of activity, migraines, droppy eyelids, acne, hair loss, dry skin, difficulty in swallowing, joint pains, cramps, aggressiveness, abnormal dreams or thoughts, memory loss, apathy, delusions, a feeling of detachment, worsened depression, emotional instability, euphoria (feeling "high"), hallucinations, neurosis, paranoia, suicide attempts, menstrual cramps and pain, bleeding between periods, breathing difficulty, nose bleeds, double vision, sensitivity to bright light, feel ill, weight changes and lymph swelling.

Drug Interaction: MAOI (Monoamine Oxidase Inhibitors) Warning - There have been reports of serious, sometimes fatal, reactions in patients receiving sertraline in combination with a MAO inhibitor and in patients who have recently discontinued sertraline and then started on a MAO inhibitor. Therefore, sertraline should not be used in combination with a MAO inhibitor or within 14 days of discontinuing therapy with a MAO inhibitor.

Sertraline may prolong the effects of Diazepam and other bezodiazepine-type drugs in your body. It may decrease the rate at which Tolbutamide (for diabetes) is released from your body. People taking Warfarin or Digoxin may experience an increase in the drug's effect when taken in conjuntion with sertraline. If sertraline is taken with lithium, it may effect the levels of lithium in the blood. Because of these drug interactions, doctors need to monitor their patients on sertraline closely.

link: Zoloft.com

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Effexor

(venlafaxine hydrochloride) - An antidepressant for oral administration. It is usually prescribed in 25mg, 37.5mg, 50mg, 75mg, or 100mg tablets in doses of 75mg to 225mg per day.

Indications: For the symptomatic relief of depressive illness.

Considerations: Patients with kidney or liver disease should be monitored closely. Pregnant or nursing mothers should only take this medication if benefits significantly outweigh the risks. Mothers taking venlafaxine should bottle feed babies. A small number of manic or hypomanic people may experience an activation of their condition while taking venlafaxine. Venlafaxine should also be given to people who have seizures with caution.

Side Effects: (most common) - Dry mouth, sweating, heart palpitations, chest pain, headache, dizziness, tremors, tingling or numbness in the hands or feet, twitching, muscle spasms, confusion, rash, nausea, diarrhea or loose stools, constipation, upset stomach, stomach gas, appetite changes, abdominal pains, muscle aches, sleeplessness or sleepiness, male or female sexual dysfunction, agitation, nervousness, anxiety, yawning, loss of concentration, menstrual disorders, sore throat, runny nose, vision changes, ringing or buzzing in the ears, urinary frequency or disorders, fatigue, hot flushes, fever, back pain, thirst and weakness. (less common) - flushing, increased saliva, cold and clammy skin, dizziness when rising quickly from a sitting or lying position, blood pressure changes,, swelling around the eyes and in the arms or legs, coldness in the hands or feet, fainting, rapid heartbeat, loss of coordination, unusual walk, changes in the general level of activity, migraines, droopy eyelids, acne, hair loss, dry skin, difficulty in swallowing, joint pains, cramps, aggressiveness, abnormal dreams or thoughts, memory loss, apathy, delusions, a feeling of detachment, worsened depression, emotional instability, euphoria (feeling "high"), hallucinations, neurosis, paranoia, suicide attempts, menstrual cramps and pain, bleeding between periods, breathing difficulty, nose bleeds, double vision, sensitivity to bright light, feel ill, weight changes and lymph swelling.

Drug Interaction: MAOI (Monoamine Oxidase Inhibitors) Warning - There have been reports of serious, sometimes fatal, reactions in patients receiving venlafaxine in combination with a MAO inhibitor and in patients who have recently discontinued venlafaxine and then started on a MAO inhibitor. Therefore, venlafaxine should not be used in combination with a MAO inhibitor or within 14 days of discontinuing therapy with a MAO inhibitor.

You should ask the pharmacist for the latest information about drug interactions with venlafaxine.

link: Effexor.com

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Remeron

(mirtazapine) - An antidepressant for oral administration.

Indications: For the symptomatic relief of depressive illness.

Considerations: mirtazapine is a new medication which may relieve the symptoms of depression better than SSRIs or TCAs. This medication is thought to be particularly useful in reducing anxiety and sleep problems which often accompany depression. However, in clinical studies, 54% of patients have reported drowsiness (Arky, 1998). The cholesterol and/or triglyceride levels of individuals taking Remeron was noticed in clinical trials. Consult your physician if this potential side effect is troublesome. Alcohol is recommended to be avoided when taking this medication due to the enhancing effects Remeron may have on cognitive and motor ability.

If a women is pregnant, plans to become pregnant, or plans to breast feed their child, she should consult their physician before taking Remeron. The effects of Remeron on pregnancy has not been adequately studied, so caution should be taken before taking this medication.

Side Effects: (most common) - dizziness, drowsiness, weight gain, increased appetite, weakness, dry mouth, constipation, abnormal dreams and/or thinking, "flu-like" symptoms. (less common) - back pain, confusion, frequent urination, nausea, tremors, swelling of ankles or hands, fluid retention, difficult breathing, muscle pain. (rare) - agranulocytosis (decrease in white blood cells), hypomania.

Drug Interaction: MAOI (Monoamine Oxidase Inhibitors) Warning - There have been reports of serious, sometimes fatal, reactions in patients receiving mirtazapine in combination with a MAO inhibitor and in patients who have recently discontinued mirtazapine and then started on a MAO inhibitor. Therefore, mirtazapine should not be used in combination with a MAO inhibitor or within 14 days of discontinuing therapy with a MAO inhibitor.

Diazepam (Valium) should also be avoided due to the addictive motor skill impairment when taken with Remeron.

link: Remeron.com

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Wellbutrin / Zyban

(bupropion hydrochloride) - An antidepressant for oral administration. It is usually prescribed in 75mg, 100mg or 150mg tablets in doses of 150mg to 600mg per day. Bupropion is generally not prescribed for the treatment of severe or major depression until after other drugs have been tried because of the higher-than-usual chance of developing seizures while taking it.

Indications: Wellbutrin - Depression. Zyban - Quit smoking.

Considerations: People with seizure disorders, who have had a seizure, and people with eating disorders should be extremely cautious when taking bupropion because of the greatly increased chance of having a seizure while taking it. The chance of developing a seizure increases by about 10 times when the dosage is between 450 and 600 milligrams per day. People at risk for heart disease or a heart attack should thake this drug with caution and be closely monitored. Patients who suffer from liver or kidney disease should be closely monitors by their doctor. Pregnant or nursing mothers should not take this medication unless the benefits significantly outweigh the risks.

Side Effects: (most common) - Dry mouth, dizziness, rapid heartbeat, headaches (including migraines), excessive sweating, nausea, vomiting, constipation, loss of appetite and weight loss, sedation, agitation, blurred vision, sleeplessness and tremors. (less common) - upset stomach, diarrhea, menstrual complaints, impotence, urinary difficulties, slowing of movements, salivation, muscle spasms, warmth, uncontrolled muscle movements, abnormal heart rhythms, blood pressure changes, heart palpitations, fainting, itching, redness and rash, confusion, hostility, loss of concentration, reduced sex drive, anxiety, delusions, euphoria, fatigue, joint pains, fever or chills, respiratory infections, and visual, taste and hearing disturbances.

Drug Interaction: Bupropion may increase the rate at which the body breaks down Carbazepine, Cimetidine, Pheobarbital, or Phenytoin. Dosage adjustments may be needed if the combination continues to be used. People taking Levodopa experience more bupropion side effects than other people. Levodopa users should have their bupropion dosages increased more slowly and gradually. Phenelzine, an MAOI antidepressant, incrases the toxic effects of bupropion. The combination of bupropion and any other drug that can increase the chance of seizures should be avoided.

link: Wellbutrin.com

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Luvox

(fluvoxamine) - An antidepressant for oral administration. It is usually prescribed in 50mg or 100mg tablets and can be gradually increased in increments of 50mg (according to individual response).

Indications: It is used in the treatment of depression and for the symptomatic relief of depressive illness. Fluvoxamine has been shown to significantly reduce the symptoms of obsessive-compulsive disorder.

Considerations: Convulsions have been reported rarely during fluvoxamine administration. Caution is recommended when the drug is administered to patients with a history of seizures. If seizures occur during fluvoxamine administration, the drug should be discontinued. Patients with hepatic or renal insufficiency should begin treatment with a low dose and be carefully monitored. Treatment with fluvoxamine has been rarely associated with increases in hepatic enzymes, usually accompanied by symptoms. Fluvoxamine administration should be discontinued in such cases. Pregnancy and Lactation - Safe use of fluvoxamine during pregnancy and lactation has not been established. Therefore, it should not be administered to women of childbearing potential or nursing mothers unless, in the opinion of the treating physician, the expected benefits to the patient outweigh the possible hazards to the child or fetus.

Side Effects: (most common) - sleepiness, nausea with and without vomiting, constipation, loss of appetite, diarrhea, constipation, dry mouth, nervousness, dizziness, insomnia, abdominal pain, headache, tremors and delayed ejaculation (with men). (less common) - weight loss or gain, abnormal thinking, depression, abnormal dreams, decrease in libido, twitching, delirium, drug dependence, paranoia, hysteria, psychosis, reflexes decreased, neuropathy, palpitations, gastritis, flatulence, hepatitis, gingivitis, jaundice, mouth soars, tongue discoloration, tooth disorders, rashes or acne, abnormal vision, eye pain, tinnitis, and leg cramps.

Drug Interaction: MAOI (Monoamine Oxidase Inhibitors) Warning - There have been reports of serious, sometimes fatal, reactions in patients receiving fluvoxamine in combination with a MAO inhibitor and in patients who have recently discontinued fluvoxamine and then started on a MAO inhibitor. Therefore, fluvoxamine should not be used in combination with a MAO inhibitor or within 14 days of discontinuing therapy with a MAO inhibitor. People taking drugs such as warfarin, phenytoin and theophylline should be closely monitored as Fluvoxamine may prolong the elimination of these drugs.

link: Info @ MentalHealth.com

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Lithium

(lithium carbonate) - An antipsychotic/antimanic for oral administration. It is usually prescribed in 300mg capsules or 450mg tablets in doses of 1800mg to 300mg per day (starting at a higher dosage and working down).

Indications: In the treatment of acute manic episodes in patients with manic-depressive disorders. Maintenance therapy has been found useful in preventing or diminishing the frequency of subsequent relapses in patients with bipolar disorder. It has also been used to treat migraine headaches, bulimia and alcoholism.

Considerations: Lithium should not be given to anyone with heart or kidney disease, dehydration, low blood-sodium, or to those taking diuretic drugs. If such people require lithium they must be very closely monitored by their doctors and hospitalization may be needed. Long term use of this drug can lead to the development of structural changes in the kidneys and reduced kidney function. It may also lead to reduced thyroid activity. Pregnant or nursing mothers should not take lithium unless absolutely necessary; it can cause heart and thyroid birth defects, especially if taken in the first 3 months of pregnancy. Lithium passes directly into breast milk and can effect nursing infants, so mothers taking lithium after the birth of their baby should bottle-feed.

Side Effects: all side effects of lithium are dependent on how much is in the blood stream. Depending on how much is present, patients may develop a fine hand tremor, thirst, or excessive urination. Mild nausea and discomfort may be present during the first few days of treatment. At higher levels, diarrhea, vomiting, drowsiness, muscle weakness, poor coordination, giddiness, ringing or buzzing in the ears and blurred vision may occur. The more lithium that is in your blood stream the more risk for the following side effects: blackouts, seizures, dizziness, incontinence, slurred speech, diarrhea, nausea, vomiting, heart problems and kidney problems.

Toxicity: Toxic blood levels of lithium are only slightly above the levels required for usual treatment. Early signs of drug toxicity are diarrhea, vomiting, nausea, tremors, poor coordination and drowsiness, and with increasing toxicity, giddiness, weakness, blurred vision, ringing or buzzing in ears, fainting, confusion, loss of bladder or bowel control, worsening of manic symptoms, and painful muscles and joints - if any of these symptoms occur, stop taking the medication and contact your doctor immediately - be sure to bring the bottle with you when you go to the hospital emergency room or back to your doctor.

Drug Interaction: If lithium is combined with Haloperidol, weakness, tiredness, fever, or confusion may result. In some people, these symptoms have been followed by permanent brain damage. Chlorpromazine and lithium may interact to reduce chlorpromazine's effectiveness, while increasing lithium's effectiveness. Lithium is counteracted by sodium barcarbonate, acetazolamind, urea, mannitol and theophylline drugs, which increase the rate at which lithium is released from the body. Lithium can also increase the effects of tricyclic antidepressant medications.

Food Interactions: Patients MUST maintain a normal diet, including sodium (salt) and fluid intake. Lithium should be taken right after meals or with food or milk.

link: Info @ MentalHealth.com

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Norpramin / Desipramine

(desipramine hydrochloride) - A tricyclic antidepressant for oral administration. It is usually prescribed in 10mg, 25mg, 50mg, 75mg, 100mg or 150mg tablets in doses of 75mg to 300mg per day for adults, and 25mg to 150mg per day for adolescents.

Indications: Treatment of endogenous depressive illness, including the depressed phase of manic depressive illness, involutional melancholia and psychotic depression. It may also be indicated in the management of depression of a nonpsychotic degree such as in selected cases of depressive neurosis. Patients with transient mood disturbances or normal grief reaction are not expected to benefit from tricyclic antidepressants. Though not indicated, it has also been used to treat cocaine withdrawal, panic disorder and Bulimia Nervosa.

Considerations: Patients with a history of heart disease, convulsive disorders (seizures), glaucoma, liver disease, or hyperthyroidism should take this drug with caution. People who are schizophrenic or paranoid may get worse and manic depressives may switch phase. Desipramine should never be taken by pregnant or nursing mothers. Birth defects have been reported. Nursing mothers should bottle-feed their babies.

Side Effects: (most common) - sedation, blurred vision, disorientation, confusion, hallucinations, muscle spasms or tremors, seizures and/or convulsions, dry mouth, constipation, difficulty urinating, worsening glaucoma, and sensitivity to bright light or sunlight. (less common) - blood pressure changes, abnormal heart rates, heart attack, anxiety, restlessness, excitement, numbness and tingling in the extremities, poor coordination, rash, itching, retention of fluids, fever, allergy, changes in composition of blood, nausea, vomiting, loss of appetite, stomach upset, diarrhea, enlargement of breasts (both sexes), changes in sex drive,and blood sugar changes. (infrequent) - inability to sleep, nightmares, feelings of panic, weird taste in mouth, stomach cramps, black discoloration of the tongue, changes in liver function, flushing, drowsiness, dizziness, weakness, headache, loss of hair, nausea, and feeling ill.

Drug Interaction: Make sure to tell your doctor if you take any blood pressure medication - desipramine interacts with guanethidine and clonidine. It also increases the effects of barbiturates, tranquilizers, other sedative drugs and alcohol. Taking thyroid medication and desipramine will enhance the effectiveness of both and can cause abnormal heart rhythms. Oral contraception and estrogen can reduce the effectiveness of desipramine. Drugs such as Bicarbonate of Soda, acetazolamide, quinidine, or procainamide will increase the effect of desipramine. Cimetidine, Methylphenidate and phenothiazine drugs (like Thorazine and Compazine) block the liver metabolism of desipramine, causing it to stay in the body longer, which can cause severe drug side effects.

Avoid alcohol and other depressants while taking desipramine. Abruptly stopping this medication may cause nausea, headache and a sickly feeling, so patients should not decide to stop taking desipramine without a doctor's guidance.

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Tofranil / Imipramine

(imipramine hydrochloride) - A tricyclic antidepressant for oral administration. It is usually prescribed in 10mg, 25mg, or 50mg tablets or 75mg, 100mg, 125mg or 150mg capsules in doses of 75mg to 200mg per day for adults, and 30mg to 40mg per day for adolescents.

Indications: Symptomatic relief of depressive illness. Though not indicated it is also prescribed for panic disorder, chronic pain (from migraines, tension headaches, diabetes, cancer, arthritis), and Bulimia Nervosa.

Considerations: Patients with a history of heart disease, convulsive disorders (seizures), glaucoma, liver disease, or hyperthyroidism should take this drug with caution. People who are schizophrenic or paranoid may get worse and manic depressives may switch phase. Imipramine should never be taken by pregnant or nursing mothers. Birth defects have been reported. Nursing mothers should bottle-feed their babies.

Side Effects: (most common) - sedation, blurred vision, disorientation, confusion, hallucinations, muscle spasms or tremors, seizures and/or convulsions, dry mouth, constipation, difficulty urinating, worsening glaucoma, and sensitivity to bright light or sunlight. (less common) - blood pressure changes, abnormal heart rates, heart attack, anxiety, restlessness, excitement, numbness and tingling in the extremities, poor coordination, rash, itching, retention of fluids, fever, allergy, changes in composition of blood, nausea, vomiting, loss of apetite, stomach upset, diarrhea, enlargement of breasts (both sexes), changes in sex drive,and blood sugar changes. (infrequent) - inability to sleep, nightmares, feelings of panic, weird taste in mouth, stomach cramps, black discoloration of the tongue, changes in liver function, flushing, drowsiness, dizziness, weakness, headache, loss of hair, nausea, and feeling ill.

Drug Interaction: Make sure to tell your doctor if you take any blood pressure medication - imipramine interacts with guanethidine and clonidine. It also increases the effects of barbiturates, tranquilizers, other sedative drugs and alcohol. Taking thyroid medication and imipramine will enhance the effectiveness of both and can cause abnormal heart rhythms. Oral contraception and estrogen can reduce the effectiveness of imipramine. Drugs such as Bicarbonate of Soda, acetazolamide, quinidine, or procainamide will increase the effect of imipramine. Cimetidine, Methylphenidate and phenothiazine drugs (like Thorazine and Compazine) block the liver metabolism of imipramine, causing it to stay in the body longer, which can cause severe drug side effects.

Avoid alcohol and other depressants while taking imipramine. Abruptly stopping this medication may cause nausea, headache and a sickly feeling, so patients should not decide to stop taking imipramine without a doctor's guidance.

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Xanax

(alprazolam) - An medication for anxiety for oral administration. It is usually prescribed in .25mg, .5mg and 1mg tablets, and Xanax TS 2mg tablets and should be taken in the lowest possible effective dose.

Indications: For the management of Anxiety Disorders or the short-term symptomatic relief of symptoms of excessive anxiety. It is also indicated for the treatment of Generalized Anxiety Disorder (GAD), and Panic Disorder with or without agoraphobia. It may sometimes be used for depression and premenstrual syndrome (PMS).

Considerations: Alprazolam is not effective in patients with personality disorders. Alprazolam is not recommended for the management of mood or psychotic disorders. It should be avoided in cases of severe depression, severe lung disease, sleep apnea, liver and kidney disease. The safety of the use of alprazolam in pregnancy has not been established, therefore alprazolam is not recommended for use during pregnancy. It should not be taken by nursing mothers. Alprazolam has a depressive effect therefore caution should be taken in situations requiring mental alertment, judgment and physical coordination. Alcohol and other depressant drugs should be avoided.

Side Effects: (most common) - sleepiness, loss of appetite, weakness, and confusion. (less common) - seizures, loss of coordination, concentration difficulties, memory loss, irritability, fatigue, sedation, depression, lowered blood pressure, rash, hiccups, insomnia, diarrhea, coated tongue, soar gums, stuffed nose, tingling in the hands and feet, palpitations, upset stomach, increased salivation, slurred speech, changes in the libido, weakness, menstrual irregularities, urinary retention, abnormal liver function, and jaundice.

Drug Interaction: Alprazolam may produce an addictive depressant effect when combined with psychotropic medication, alcohol, narcotics, bartiturates, antihistimines, anticonvulsants or MAO inhibitors. If alprazolam is to be used with the treatment of other drugs of this nature careful consideration and monitoring is needed. Smoking may reduce the effectiveness of Alprazolam. The effects of Alprazolam may be prolonged when taken together with Cimetidine, oral contraceptives, Disulfiram, Fluoxetin, Isoniazid, Ketoconazole, Metoprolol, Probenecid, Propoxyphene, Propranolol, Rifampin and Valproic Acide.

Withdrawal: Physical dependence with withdrawal symptoms can occur and may be mild to severe (including seizures in some patients) if it is suddenly discontinued. Even after relatively short-term use there is a risk of dependence. This risk is higher with persons prescribed dosages of 3mg or higher (as often needed with treating Panic Disorder). Some of the withdrawal side effects can include headache, dizziness, sweating, muscle tension, cramps, tremors, feeling uncomfortable, confusion, depersonalization, paranoid delusions, hallucinations, psychotic reactions, muscle twitching, seizures and memory loss.

link: Xanax.com

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Naltrexone / Revia *The use of Naltrexone in the treatment of Eating Disorders has not yet been approved by the FDA. This does not mean that it will not work for some individuals, but research outcomes are still pending. If you think Naltrexone might help you, you should talk to your doctor about it and provide them with further information (see below).

(naltrexone hydrochloride) - Naltrexone HCI for oral administration prescribed in 50mg tablets. Can be taken daily or prescribed in a more flexible approach (such as a higher dosage 3 times per week).

Indications: For the treatment of Alcoholism
Wayne State and St. John Hospital are conducting a study of the drug Naltrexone, which may block the addiction to dieting. Further research of Naltrexone hopes to prove the drug helpful in the treatment of those with binge-related Eating Disorders.

Naltrexone may also be useful in treating those who are "cutters" or who practice in self-mutilation (SIV - Self Inflicted Violence).

Considerations: Naltrexone should be avoided in cases of active hepatitis, acute liver and kidney disease. Naltrexone can cause liver damage when taken in excessive doses. The safety of the use of Naltrexone in pregnancy has not been established, therefore Naltrexone is not recommended for use during pregnancy. It should not be taken by nursing mothers. The safe use of naltrexone in subjects younger than 18 years of age has not been established. Patients on naltrexone should carry a wallet card to alert physicians and other emergency health-care providers to instruct them on pain management.

Side Effects: (most common) - loss of appetite, diarrhea, constipation, increased thirst, increased energy, feeling down, irritability, dizziness, skin rash, delayed ejaculation, decreased potency and chills. (less common) - Respiratory: nasal congestion, itching, rhinorrhea, sneezing, sore throat, excess mucus or phlegm, sinus trouble, heavy breathing, hoarseness, cough, shortness of breath, nose bleeds, phlebitis, edema, increased blood pressure, nonspecific ECG changes, palpitations, tachycardia, excessive gas, hemorrhoids, diarrhea, ulcer, painful shoulders, legs or knees, tremors, twitching, increased frequency of, or discomfort during urination, increased or decreased sexual interest, oily skin, pruritus, acne, athlete's foot, cold sore, alopecia, depression, paranoia, fatigue, restlessness, confusion, disorientation, hallucinations, nightmares, bad dreams.

Drug Interaction: Patients receiving opioid analgesics. Opioid dependent patients. Patients in acute opioid withdrawal. Any individual who has failed to pass the Narcan challenge. Any individual who has a positive urine screen for opioids. Naltrexone will block the effects of narcotics including codeine in cough or pain preparations.

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Zyprexa / Olanzapine *The use of Zyprexa in the treatment of Eating Disorders has not yet been approved by the FDA. This does not mean that it will not work for some individuals, but research outcomes are still pending. If you think Zyprexa might help you, you should talk to your doctor about it and provide them with further information (see below).

(Olanzapine) - Olanzapine for oral administration, reaching peak plasma concentrations within 5 to 8 hours, administered in doses from 2.5mg to 20mg.

Indications: For the acute and maintenance treatment of schizophrenia and related psychotic disorders. In controlled clinical trials, olanzapine was found to improve both positive and negative symptoms. In its off-label use, it may be administered to patients with Anorexia to help control obsessive thinking.

Considerations: Zyprexa tablets contain lactose.
As with other drugs that have high alpha-1 adrenergic receptor blocking activity, olanzapine may induce orthostatic hypotension, tachycardia, dizziness, and sometimes syncope, especially at the initiation of treatment. Potential Effect on Cognitive and Motor Performance: Because olanzapine may cause somnolence, patients should be cautioned about operating hazardous machinery, including motor vehicles, until they are reasonably certain that olanzapine therapy does not affect them adversely. Seizures: Conventional neuroleptics are known to lower seizure threshold. In clinical trials, seizures have occurred in a small number of olanzapine-treated patients. Olanzapine should be used cautiously in patients who have a history of seizures or have conditions associated with seizure or have a lowered seizure threshold. Precautions should be exercised when using olanzapine in patients with pre-existing hepatic disorders, in patients who are being treated with potentially hepatotoxic drugs, or if treatment-emergent signs or symptoms of hepatic impairment appear. Uric Acid: In the premarketing clinical trial database, olanzapine was associated with mild elevations of uric acid in some patients. Weight Gain: Olanzapine was associated with weight gain during clinical trials. Patients treated at higher doses had the greatest mean weight gain. Antiemetic Effect: Consistent with its dopamine antagonist effects, olanzapine may have an antiemetic effect. Such an effect may mask signs of toxicity due to overdosage of other drugs or may mask symptoms of disease such as brain tumor or intestinal obstruction. The possibility of suicide or attempted suicide is inherent in psychosis, and thus close supervision and appropriate clinical management of high-risk patients should accompany drug therapy.

Side Effects: (most common) - drowsiness, dry mouth, feelings of weakness, dizziness, constipation, upset stomach, increased appetite, weight gain, ALT increased, akathesia and postural hypotension. (less common) - ECG changes, vital sign changes, seizures

If you are pregnant or planning to become pregnant, you and your doctor should discuss whether changes to your treatment plan are necessary. The effects of ZYPREXA have not been studied in pregnancy, so you and your doctor should consider the benefits versus the risks of staying with treatment. You should not take ZYPREXA if you are breast-feeding or planning to breast-feed a child.

Drug Interaction: Given the primary CNS effects of olanzapine, caution should be used when it is taken in combination with other centrally-acting drugs and alcohol. As it exhibits in vitro dopamine antagonism, olanzapine may antagonize the effects of levodopa and dopamine agonists. Because of its potential for inducing hypotension, olanzapine may enhance the effects of certain antihypertensive agents.
The metabolism of olanzapine may be induced by concomitant smoking, or carbamazepine therapy.
Agents that induce CYP1A2 such as omeprazole may increase clearance of olanzapine. Conversely, inhibitors of CYP1A2 (e.g., fluvoxamine) could potentially inhibit elimination of olanzapine. However, as olanzapine is metabolized by multiple enzyme systems, inhibition of a single enzyme may not appreciably decrease olanzapine clearance.

link: Zyprexa.com

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Link: More Info on Medications from RxMed


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