COSIG CONFERENCE BROCHURE.pdf - Drexel University College ...

COSIG Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006
Anti-depressants and MISA
•SSRIs
– better side-effect profile; leads to
better compliance
– reduce impulsive/compulsive behaviors
– reduce anxiety
–safer when mixing with drugs/ETOH
–not more effective than TCAs
– does not mix with OTC cold remedies
–may produce slight to moderate
stimulation
Anti-depressants & MISA
•Novel anti-depressants
–Serzone: 5-HT2a receptor blocker &
blocks 5-HT reuptake
–Wellbutrin: weak 5-HT/NE reuptake
inhibitor; may act to inhibit DA reuptake
–Remeron: enhances brain 5-HT and NE;
has a strong anti-histamine action (similar
to Desyrel)
–Cymbalta (duloxetine; see next slide)
Anti-depressants & MISA
•Duloxetine (Cymbalta): the “new Effexor”
–Does not induce hypertension (sometimes seen
with drugs that increase NE)
–No significant effects on body weight?
–Can reduce anxiety levels
–No differences in female sexual functioning (as
compared to Paxil)
–Comparable delay in orgasm in men as
compared to Paxil
–Reduction in pain severity
The
Hypothalamic-
Pituitary Axis
& Depression
Anxiolytics and MISA
Treating Anxiety
•Benzodiazepines (BZDs)
– are psychoactive, mood altering and
reinforcing
– should be used in certain situations
•withdrawal/detox. from alcohol or other
CNS depressants
•Acute psychosis/paranoid symptoms
•Extreme agitation
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