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Friday, 12 March 2021 20:29

SSRIs for depression and generalized anxiety disorder

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Selective serotonin reuptake inhibitors (SSRIs) are the first-line intervention for many psychiatric disorders including major depressive disorder (MDD) and generalized anxiety disorder (GAD). These drugs work by inhibiting the reuptake of serotonin leading to increased serotonin transmission. Enhanced serotonin transmission improves mood and personality. The Food and Drugs Administration (FDA) has approved several SSRIs for treating depression in adolescents and adults. These drugs include fluoxetine, sertraline, citalopram, and paroxetine. Some of these drugs are also approved for treating GAD.

            Patients diagnosed with MDD exhibit a persistent pattern of low mood and loss of interest in usual activities (anhedonia). The common characteristics of low mood include persistent feelings of sadness, emptiness, or worthlessness. Other common symptoms of depression include sleeping difficulties, persistent fatigue or lack of energy, poor appetite, frequent anger outbursts, and impaired thinking and concentration. On the other hand, patients with GAD exhibit a persistent pattern of excessive worrying and anxiety regarding everyday activities. A person with GAD will exhibit restlessness, difficulty concentrating, indecisiveness, and perceiving usual situations as threatening.

            Fluoxetine (Prozac) and Sertraline (Zoloft) are commonly prescribed to treat MDD and GAD, respectively. For depression, the recommended fluoxetine starting dose is 20mg taken once daily. The daily dose should not exceed 80mg. The therapeutic range for many is between 20 and 40 mg/day. The primary goal of treatment is for the patient to attain at least a 50 percent reduction of the core depressive symptoms or complete remission. For GAD, the recommended sertraline starting dose is 25 mg once daily for adults. Dose increments of between 25 and 50mg/day at weekly intervals to a maximum of 200mg/day may be necessary to achieve optimal therapeutic gains.

            Patients taking SSRIs either for depression or anxiety should expect a delay of between 2 to 4 weeks before they can experience the therapeutic benefits of the drugs. Some patients may require subsequent dose increments before they can achieve optimal therapeutic gains. Patients who have not attained any significant therapeutic gains by 6 to 8 weeks of treatment should discuss with their health care provider the need for an augmenting therapy or switching to a different psychopharmacological agent.

            The common side effects of SSRIs include insomnia, gastrointestinal disturbance characterized by nausea, diarrhea, and dry mouth, sexual dysfunction, and central nervous problems including headaches, sedation agitation, and dizziness. Although adverse side effects are rare, some patients may develop seizures and activation of mania and suicidal thoughts. Antidepressants can aggravate suicidal behavior, especially in adolescent patients. For additional information on psychopharmacology for mental health disorders, visit

Thursday, 31 March 2016 09:27

My personal battle with anxiety

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My name is Charlotte, I am 28 years old and was diagnosed with anxiety at the age of 13. I can remember having panic attacks long before I was “diagnosed”. I believe it started at a very young age. Every family has their issues, being the youngest, I always thought it was my job to “keep the peace” in my house. This puts a lot of stress on a child. When my parents got divorced at the age of 12, and my older sister had moved out of state things got a lot worse. I was lashing out in school and having more and more anxiety issues.


I started smoking marijuana very very young, by 14 it became a daily routine. I recall days where I had worse panic attacks because the THC was too much for my body. Not knowing that then, I just smoked more hoping the panic attacks would go away. At 15, I started seeing therapists and getting put on mood stabilizer medications. For 12 years I battled myself and the drugs, going on and off drugs against doctor recommendations. Switching doctors, switching meds and stopping medications more times than I can count. As I got into my early twenties, I experimented with drugs and began drinking alcohol with friends. What I didn't realize was the amount of “self medicating” that was really going on. Things got worse, I would have panic attacks in normal day to day situations, driving to work, paying bills, standing in line at the grocery store. You name it, it caused me to panic.


At 26 my life changed. I happened to land a job working as a budtender at a recreational dispensary in Colorado. This job literally changed and saved my life. For the first time I learned about CBD, which is the non psychoactive chemical found in Marijuana. I started taking CBD products; chocolate bars, candy, gummies, drinks, and found Marijuana that was high in CBD. All of a sudden my panic attacks were manageable. 6 months after working at the dispensary, I packed up and moved to Florida which had always been a dream of mine. I started working in a Smoke shop that happened to sell CBD oil to be vaped in an E Cigarette. This was my saving grace. I was able to get LEGAL CBD in a state that wasn't a Medical Marijuana state. Because the CBD came from Hemp that was grown outside the country making the product legal in all 50 states. Using a combination of CBD Vape Liquid and Nicotine Vape Liquid I was able to quit smoking cigarettes, which I had been addicted to since I was about 12 years old. I know very young to start smoking, but this is me and my story, please don't judge.


A few months after quitting smoking and using CBD I decided it was time for the true test. I decided to stop my mood stabilizer meds (without consulting a doctor, something I have done for years) and see how I felt. During the first few weeks everything was fine, no panic attacks and feeling great. This was a common thing for me, every time I felt better I would stop my meds and test the waters, it never went well, I always ended up back in a doctor's office. This time was different. I am happy to say it has been over a year since I stopped my “mood stabilizers” and have had less than a handful of panic attacks. This is HUGE for me!


When I have panic attacks (which are far and few between) I grab CBD. I have become partial to one brand in particular because it seems to be the best quality I have found. I have done so much research and found out that CBD can help so many things, not just seizures (which is what you hear about on the news) but things like anxiety, cramps, muscle pain, PTSD and even Alzheimer's.


I am extremely happy to say CBD helped me and is helping people I know and love. No one should be in pain, everyone deserves to be happy. Anxiety causes so many problems in life. I hope more people learn about CBD and how it helps you. It's not weed, it's a natural alternative to pharmaceuticals. It offers a lot of help without the zombie like side effects I would experience from drugs given to me by a doctor.  

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we are a community of people struggling with mental health issues, you are not alone!


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We are a community of people struggling with mental health issues, you are not alone!