What About Vagus Nerve Stimulation?
Vagus Nerve Stimulation, or VNS, has been available for the treatment of epilepsy since 1997 and was approved by the FDA for the adjunctive treatment of refractory depression in 2005. VNS relies upon the use of a surgically implanted device which delivers periodic stimulation to the vagus nerve. How VNS therapy works is not completely understood; however, several studies have suggested that this technique may be effective for some patients with treatment-resistant depression.
How to Treat Anxiety Symptoms During Pregnancy
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Interaction Between Birth Control Preparations and Anti-Epileptic Medications
The interaction between specific birth control preparations and anti-epileptic medications should always be taken into consideration when developing a treatment approach, as taking the two simultaneously may decrease the birth control pill's effectiveness.
Can Paxil (Paroxetine) Be Used While Breastfeeding?
All medications are secreted into the breast milk, although concentrations appear to vary. There is a fair amount of information on the use of Paxil (paroxetine) in nursing women. While Paxil may be detected in the breast milk, there have been no reports of adverse events in the nursing infant. The only situation where one may want to avoid breastfeeding is when the baby is premature or has signs of hepatic immaturity, which may make it more difficult for the infant to metabolize the medication to which he or she is exposed. Premature babies are also probably more vulnerable to the toxic effects of these medications.
Cognitive Therapy versus Medication in the Treatment of Depression
Both antidepressant medications and cognitive therapy have been shown to be effective for the treatment of depression; however, the question remains as to whether one treatment is preferred over the other. Subjects enrolled in The Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study (men and women with major depression, ages 18-75) were initially treated with citalopram, an SSRI. Those who had unsatisfactory outcomes after initial treatment were eligible for a randomized second-step treatment trial in which they switched to a new treatment (either cognitive therapy or a different antidepressant) or augmented the citalopram regimen with either cognitive therapy or a different antidepressant.
Treatment of Insomnia During Pregnancy
Most women experience some degree of sleep disturbance during pregnancy, and for a significant number of women sleep disruption may be quite severe. There are many different causes for sleep disturbance during pregnancy, and choosing the appropriate intervention relies on an accurate diagnosis of the problem.
Can Estrogen Be Used to Treat Posptartum Depression?
After delivery, women experience a dramatic drop in estrogen hormone levels. Many have hypothesized that this decline in estrogen levels may precipitate postpartum depression (PPD) in susceptible individuals, and several studies have explored the use of estrogen for the treatment of depression after delivery.
Oral Contraceptives for the Treatment of Premenstrual Mood Symptoms
Oral contraceptives are commonly prescribed for the treatment of premenstrual symptoms and premenstrual dysphoric disorder (PMDD); however, the evidence supporting the use of oral contraceptives in this setting is limited. While most studies have shown that oral contraceptives are not effective for the treatment of premenstrual symptoms, there is preliminary evidence that a new oral contraceptive pill, Yaz, which contains low-dose estrogen and a novel progestin called drospirenone, may alleviate the symptoms of PMDD.
Paroxetine CR May Be Helpful for Menopausal Women Discontinuing Hormone Therapy
Estrogen was first approved by the FDA for the treatment of menopausal symptoms in 1942, and for many decades estrogen replacement therapy had been widely prescribed for peri- and post-menopausal women. In 2002, however, data from the Women’s Health Initiative (WHI) suggested that hormonal therapy may be associated with an increased risk of breast cancer and cardiovascular disease. These findings have led to a dramatic decrease in the use of hormone replacement therapy (HRT), with many women abruptly discontinuing its use.