Monday, November 5, 2012

Major Depression

The most prominent symptom of major depression is a severe and persistent low mood, profound sadness, or a sense of despair. The mood change can sometimes appear as irritability. Or the person suffering major depression may not be able to take pleasure in activities that usually are enjoyable.

Major depression is more than just a passing blue mood, a "bad day" or temporary sadness. The mood changes that occur in major depression are defined as lasting at least two weeks but usually they go on much longer — months or even years.

A variety of symptoms usually accompany the mood change, and the symptoms can vary significantly among different people.

Many people with depression also have anxiety. They may worry more than average about their physical health. They may have excessive conflict in their relationships and may function poorly at work. Sexual functioning may be a problem. People with depression are at more risk for abusing alcohol or other substances.

Depression probably involves changes in the areas of the brain that control mood. Neuroscientists are continuing to work out the details, but there are several places where problems can occur. Chemical reactions inside nerve cells may be altered. Communication between nerve cells or nerve circuits can make it harder for a person to regulate their mood. Changes in hormones may play a role. An individual's life experience certainly affects these processes. And how vulnerable a person is to breakdowns in these functions is almost certainly influenced by genetic makeup.

An episode of depression can be triggered by a stressful life event, such as the death of a loved one. But in many cases, depression does not appear to be related to a specific event.

Major depression may occur just once in a person's life or may return repeatedly. Some people who have many episodes of major depression also have a background pattern of a milder depressed mood called dysthymia.

Some people who have episodes of major depression also have episodes of relatively high energy or irritability. They may sleep far less than normal, and may dream up grand plans that could never be carried out. The person may develop thinking that is out of step with reality — psychotic symptoms — such as false beliefs (delusions) or false perceptions (hallucinations). The severe form of this is called "mania" or a manic episode. If a person has milder symptoms of mania and does not lose touch with reality, it is called "hypomania" or a hypomanic episode.

If a woman has a major depressive episode within the first two to three months after giving birth to a baby, it is called postpartum depression. Depression that occurs mainly during the winter months is called seasonal affective disorder, or SAD.

Episodes of depression can occur at any age. Depression is diagnosed in women twice as often as in men. People who have a family member with major depression are more likely to develop depression or drinking problems.
A depressed person may gain or lose weight, eat more or less than usual, have difficulty concentrating, and have trouble sleeping or sleep more than usual. He or she may feel tired and have no energy for work or play. Small burdens or obstacles may appear impossible to manage. The person can appear slowed down or agitated and restless. The symptoms can be quite noticeable to others.

A particularly painful symptom of this illness is an unshakable feeling of worthlessness and guilt. The person may feel guilty about a specific life experience or may feel general guilt not related to anything in particular.

If pain and self-criticism become great enough, they can lead to feelings of hopelessness, self-destructive behavior, or thoughts of death and suicide. The vast majority of people who suffer severe depression do not attempt or commit suicide, but they are more likely to do so than people who are not depressed.

The thoughts of people with major depression are often colored by their dark mood. For example, pessimistic ideas may be out of proportion with the reality of the situation. Sometimes, the depressed thinking is distorted enough to be called "psychotic;" that is, the person has great difficulty recognizing reality. Sometimes, depressed people develop delusions (false beliefs) or hallucinations (false perceptions).

Symptoms of major depression include:

Distinctly depressed or irritable mood

Loss of interest or pleasure

Decreased or increased weight or appetite

Increased or decreased sleep

Appearing slowed or agitated

Fatigue and loss of energy

Feeling worthless or guilty

Poor concentration


Thoughts of death, suicide attempts or plans
A primary care physician or a mental health professional usually can diagnose depression by asking questions about medical history and symptoms. By definition, major depression is diagnosed when a person has many of the symptoms listed above for at least two weeks.

Many people with depression do not seek evaluation or treatment because of society's attitudes about depression. The person may feel the depression is his or her fault or may worry about what others will think. Also, the depression itself may distort a person's ability to recognize the problem.

There are no specific tests for depression. However, it is important to be evaluated by a primary care physician to make sure the problems are not being caused by a medical condition or medication.

Celexa and insomnia

I just started Celexa and have had horrible insomnia followed by heart palps at night and horrible anxiety. When I was on Effexor for 3 weeks, I got the same thing. Is Celexa better and will the insomnia go away with this one? Are Effexor and Celexa similar which is why I'm getting the insomnia? Being up at 1am when I have to get up at 6 for work is no fun and it almost doesn't seem worth being on anything.
I'm 21 years old and relatively inexperienced with my anxiety and taking medications for it. For the last two years my anxiety started to have a negative effect on my life. It progressively got worse to the point that I had trouble with everyday activities. I finally went to a doctor and he prescribed Celexa. I'm on 10mg a day and it has been wonderful. Slight side-effects at first like occasional dizziness and unusual sleeping patterns but these were very minimal. After two weeks of being on the medication the side-effects TOTALLY subsided. I have been taking Celexa now for 9 months and have a great life. School performance improved, relationship with friends and family are better than ever, and most importantly I'm happier than ever.
If you are having these side effects, especially the heart palpitations, please call your doc!! That is potentially dangerous. I'm sure you are fine, but do call your doc.
You may adjust to the med, or you may need a different type of antidepressant.
Best wishes and I hope you feel great very soon,

Lexapro: An Isomer of Celexa

Lexapro is the product of a relatively new approach that involves the removal of one of two enantiomers from Celexa to create a single-enantiomer drug. Celexa is a racemic mixture of two mirror-image halves called the S- and R-enantiomers. With Lexapro, the R-enantiomer (that does not contribute to Celexa's antidepressant activity) has been removed, leaving only the therapeutically active S-enantiomer.

Forest Laboratories licensed Lexapro from the Danish pharmaceutical firm H. Lundbeck A/S, which developed both citalopram and escitalopram in Europe. Escitalopram is currently approved for marketing in several European countries, including Sweden, Switzerland, Denmark, Belgium, Great Britain, France, Ireland, and Austria, under the name Cipralex.

So far Celexa has been great. I was very hesitant to start a medicine for depression/anxiety. But after being extremely low, hostile and moody for months it was time to go to the doctor. I was angry and depressed all the time. I just wish I went for help sooner. Also, I used to get panic pains in my chest and throat probably 100 times a day. Sudden scared and nervous little panics over anything! It has helped that a lot too. No side effects for me except good ones! The only reason I cannot give this a 10 is that I have only been on it for a month. Hopefully these results last!

 I've been taking Celexa 20mg for almost six months, and it has helped me with my social anxiety. It's a lot easier to use the strategies that my psychologist talks about. However, a warning must be given. Celexa has not been a 'magic bullet'. I still have to do a lot of work to not be anxious. However, it has helped me so much that I can't think about quitting any time soon.

Celexa May Not Help Kids With Autism

In contrast to the assumptions of some doctors, new research suggests that the antidepressant Celexa does not help relieve repetitive behaviors often seen in children and teens with autism.

But the findings still need to be confirmed by other studies, and at least one autism specialist said the drug has worked well in his patients of preschool age, who are younger than those in the study.

"The jury is still out on how autism should be treated," said the specialist, Dr. Andrew Zimmerman, a pediatric neurologist and director of medical autism research at the Kennedy Krieger Institute in Baltimore.

Antidepressants known as selective serotonin reuptake inhibitors, or SSRIs, are a common treatment for autism and given to perhaps 30 percent of children with the condition, said Dr. Bryan King, lead author of the study. Other common treatments, he said, include antipsychotic drugs, which calm people who use them, and stimulants such as Ritalin, which reduce hyperactivity and impulsive behaviors.

Celexa, also known by the generic name citalopram, is lesser known than similar antidepressants such as Prozac and Paxil. But it's easier to prescribe to autistic children because it comes in a liquid form, meaning that parents don't have to force their children to take pills, said King, a researcher and director of psychiatry and behavioral medicine at Seattle Children's Hospital and the University of Washington.

Also, the drug spends less time in the body before being flushed out, making it easier for doctors to quickly adjust the dosage, he said.

King's research team assumed that Celexa reduces symptoms of autism in children, such as repetitive motions, but they wanted to understand more about its powers.

"We didn't expect it to work for everyone, but we were hoping that we'd be able to drill down into the population for whom it was very helpful and begin to identify the predictor of what a positive response would be," he said.

They randomly gave either 16.5 milligrams, on average, of Celexa or a placebo to 149 children with autism who were 5 to 17 years old. The children took the drug or fake drug for three months, and 123 of them finished the study.

The number of children who improved -- defined as not engaging in as many repetitive behaviors -- was about a third in both groups.

In other words, Celexa appeared to make no difference compared with a placebo. And children on Celexa were more likely to suffer from apparent side effects such as diarrhea, insomnia, hyperactivity and repetition of movements, the study found.

In a statement, Forest Laboratories, the maker of Celexa, said that it "was not involved in this study and therefore cannot provide comment."

The results are in the June issue of Archives of General Psychiatry.

The finding raises questions about whether similar antidepressants are also not providing benefit, or as much benefit as doctors had assumed, King said.

Zimmerman, the Baltimore autism specialist, said he's successfully treated younger autistic children, ages 3 to 5, with the drug. He added that he uses smaller doses, which appear to not create as many side effects.

Celexa: No Increased Risk of Birth Defects

Taking antidepressant Celexa (citalopram) during pregnancy does not raise the risk of adverse outcomes of pregnancy, including birth defects and neonatal complications, according to a recent Canadian study.

The study, by Anna Sivojelezova and colleagues from the Hospital for Sick Children in Toronto and the University of Toronto was published in the American Journal of Obstetrics and Gynecology (December issue) and reported by on 21 December 2005.

The study also showed an approximately four-fold increased risk of admission to the neonatal intensive-care unit for infants of mothers who took citalopram in the third trimester. However, the researchers said that the reasons for this increased risk require further investigation.

Sivojelezova et al. evaluated 396 pregnant women, in three groups of 132 women each. These women had contacted Motherisk, a Toronto-based teratogen information center, to ask questions about citalopram's safety for use during pregnancy.

A total of 125 women took citalopram at least during the first trimester, and 71 women continued taking citalopram throughout pregnancy.

The researchers reported that 114 women had live births, 14 miscarried, two underwent elective abortions and two had stillbirths. Of the 108 infants born alive to mothers who took citalopram during the first trimester of pregnancy, one male infant was born with a "major" birth defect.

Average birth-weights, fetal-survival rates and gestational lengths were statistically consistent among the three groups of women.

Statistical analysis of these study data showed that taking citalopram in the third trimester posed no risk of additional birth defects.

However, there was a 4.2-fold increase in the incidence of admission to the neonatal intensive-care unit for infants exposed to citalopram in the third trimester, compared with infants who were not exposed.

The researchers noted that this increase might have been caused by late exposure to citalopram, but that additional research is required to prove this theory.

The authors wrote, "In summary, our findings do not support an association between citalopram [and] any major teratogenic risk in humans."
This medication has wiped out almost all of my daily bouts of depression. For the longest time I would have depression daily and now to be free of this burden, this weight, it's like living in a different body. I love feeling more up beat, even the days when its simply a good casual uneventful day. I am happy and content.

 I had started with Celexa, then changed to citalopram when it became available. (No changes whatsoever, both meds helped me exactly the same. Citalopram was just cheaper.) I had been in a severely bad personal situation, one that included some abuse. I was in a very bad way, and my anxiety level was at times paralyzing. When I started taking Celexa, my anxiety calmed down considerably, and I was able to see my bad situation for what it was, and I was able to actually deal with it. It's now years later, and my life is fine now, though I believe my personal situation damaged me enough to where I'm too stressed if I try to go off the medicine, so I stay on it, and that's fine with me. I believe Celexa quite literally saved my life.

Before using Celexa:

Some medical conditions may interact with Celexa. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
if you are pregnant, planning to become pregnant, or are breast-feeding
if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
if you have allergies to medicines, foods, or other substances
if you or a family member has a history of bipolar disorder (manic depression), other mental or mood problems, suicidal thoughts or attempts, or alcohol or substance abuse
if you have a history of seizures, liver problems, kidney problems, heart problems (eg, heart failure, slow or irregular heartbeat), high blood pressure, stroke, bleeding problems, stomach or bowel bleeding, or metabolism problems
if you have a condition or take medicine that may increase your risk of low potassium or magnesium levels. Check with your doctor if you are not sure if any of your conditions or medicines may increase this risk
if you are dehydrated, have low blood volume or low blood sodium levels, or drink alcohol
if you will be having electroconvulsive therapy (ECT)
if you take any medicine that may increase the risk of a certain type of irregular heartbeat (prolonged QT interval). Check with your doctor or pharmacist if you are unsure if any of your medicines may increase the risk of this type of irregular heartbeat
if you are taking a medicine that contains methylene blue

Some MEDICINES MAY INTERACT with Celexa. Tell your health care provider if you are taking any other medicines, especially any of the following:
Fenfluramine derivatives (eg, dexfenfluramine), fentanyl, linezolid, lithium, MAOIs (eg, phenelzine, selegiline), meperidine, metoclopramide, nefazodone, serotonin 5-HT1 receptor agonists (eg, sumatriptan), sibutramine, SNRIs (eg, duloxetine, venlafaxine), other SSRIs (eg, fluoxetine, paroxetine), St. John's wort, trazodone, or tryptophan because severe side effects, such as a reaction that may include fever, rigid muscles, blood pressure changes, mental changes, confusion, irritability, agitation, delirium, and coma, may occur
Anticoagulants (eg, warfarin), aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) because the risk of bleeding, including stomach bleeding, may be increased
Diuretics (eg, furosemide, hydrochlorothiazide) because the risk of low blood sodium levels may be increased
Tramadol because the risk of seizures may be increased
Antiarrhythmics (eg, quinidine, procainamide, amiodarone, sotalol), arsenic, certain antibiotics (eg, gatifloxacin, moxifloxacin), cimetidine, halofantrine, levomethadyl, methadone, nilotinib, omeprazole, ondansetron, pentamidine, phenothiazines (eg, chlorpromazine, thioridazine), pimozide, or vandetanib because the risk of irregular heartbeat may be increased
Carbamazepine or cyproheptadine because they may decrease Celexa's effectiveness
Aripiprazole, beta-blockers (eg, propranolol), clozapine, risperidone, or tricyclic antidepressants (eg, amitriptyline) because the risk of their side effects may be increased by Celexa

This may not be a complete list of all interactions that may occur. Ask your health care provider if Celexa may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
I have been taking Celexa for only three weeks but I've already noticed a difference in my mood. I feel a bit more relaxed and the panic attacks are null if any. I started with 10mg for 4 days then up to 20mg which proved to be way too much for me so I backed down to 10mg and have felt great since. Side effects: some slight yawning here and there but not a big deal. I recommend this medicine for those with mild anxiety/depression.
 I like Celexa so much better than Zoloft. With Zoloft I had trouble sleeping, nausea and it did not help my anxiety and depression symptoms. I have had a great experience with Celexa. So much so that I am uncertain if I would ever want to be taken off of it.

Do NOT use Celexa if:

you are allergic to any ingredient in Celexa or to escitalopram
you have a certain type of irregular heartbeat (long QT syndrome), slow heartbeat, severe heart failure, a recent heart attack, or uncorrected low blood potassium or magnesium levels, unless your doctor tells you otherwise
you are taking escitalopram
you are taking or have taken linezolid, a monoamine oxidase inhibitor (MAOI) (eg, phenelzine, selegiline), or St. John's wort within the last 14 days
you are taking certain antiarrhythmics (eg, quinidine, procainamide, amiodarone, sotalol), certain antibiotics (eg, gatifloxacin, moxifloxacin), a fenfluramine derivative (eg, dexfenfluramine), levomethadyl, methadone, nefazodone, pentamidine, phenothiazines (eg, chlorpromazine, thioridazine), pimozide, serotonin-norepinephrine reuptake inhibitors (SNRIs) (eg, duloxetine, venlafaxine), sibutramine, other SSRIs (eg, fluoxetine, paroxetine), or tryptophan

 I began taking Celexa 10 mg tablet 3 years ago - one every evening. I find that it helps a lot with low moods and mood swings especially around the time of my period. I've always had mood swings but didn't quite understand why I felt so bad on some days and felt pretty good other days. This pill helps to regulate my moods so that I'm feeling good most of the time!
I have taken Celexa (started at 40 mg now at 20 mg) since I was 18 and have learned that it has been very beneficial in helping me maintain a positive mood. Along with a healthy diet and exercise I know that Celexa will probably be a part of my life forever. The only side effects I experience are frequent yawning and occasional sleepiness. Sleepiness is less of an issue if I take the medication at the same time of day consistently (late afternoon.)