The cerebrum is the largest part of the brain and is responsible for all voluntary activities of the body. It is the substances can move readily between the inside and the outside of the vessel. In the brain, however, the endothelial cells fit tightly together and substances cannot pass out of the bloodstream.
The functions of the BBB are to protect the brain from "foreign substances" in the blood that may injure the brain and to protect it from the hormones and neurotransmitters in the rest of the body. The BBB also maintains a constant environment for the brain.
Various conditions can cause a breakdown in the function of the BBB. These conditions are as follows:
• Hypertension (high blood pressure).
• Incomplete development of the BBB at birth.
• High concentrations of certain substances in the blood.
• Exposure to microwaves.
• Exposure to radiation.
• Infection.
• Trauma or injury to the brain.
The cerebrum is the functional area of language, personality, vision, memory, emotion, problem solving, initiative, inhibition, sense of smell, generalized and mass movements, motor skills, physical reaction, and libido (sexual urges).
The cerebrum is divided into two hemispheres, the left hemisphere and the right hemisphere. The three main areas of the brain are the cerebrum, the cerebellum, and the brain stem. Each region performs specific functions. The cerebrum, which includes the cerebral cortex, controls conscious activities, the cerebellum coordinates muscle movements, and the brain stem is responsible for vital body processes.
Sense of identity
Researchers have discovered that each side of the brain (hemisphere) is associated with different abilities.
Right Hemisphere Controls the left side of the body Creativity and artistic ability Left Hemisphere (the analytical hemisphere) Controls the right side of the body Produce and understand language Analytical and mathematical ability Finally, the cerebrum consists of two types of surfaces, an outer and an inner surface. The outer surface is called the cerebral cortex and consists of layers of neurons without myelin (fatty insulation). These layers appear to be gray in color and are therefore referred to as "gray matter". The inner surface is called the cerebral medulla, which consists of layers of myelinated neurons. The myelin is white and therefore these inner layers are referred to as "white matter".
Wednesday, November 18, 2009
Human Brain
The human brain is a complex organ that allows us to think, move, feel, see, hear, taste, and smell. It controls our body, receives information, analyzes information, and stores information (our memories).
The brain produces electrical signals, which, together with chemical reactions, let the parts of the body communicate. Nerves send these signals throughout the body.
The average human brain weighs about three pounds (1300–1400 grams). As a comparison, a half-gallon of water weighs about four pounds. The brain consists of gray matter (40%) and white matter (60%) contained within the skull. Brain cells include neurons and glial cells. Although the brain is only 2% of the body’s weight, it uses 20% of the oxygen supply and gets 20% of the blood flow. If brain cells do not get oxygen for 3 to 5 minutes, they begin to die.
The brain and spinal cord make up the central nervous system (CNS). The brain is connected to the spinal cord, which runs from the neck to the hip area. The spinal cord carries nerve messages between the brain and the body. The cells of the nervous system are quite fragile and need extensive protection from being crushed, infected by disease organisms, and other harm. The brain and spinal cord are covered by a tough, translucent membrane called the dura matter. Cerebrospinal fluid (CSF) is a clear, watery liquid that surrounds the brain and spinal cord and is also found throughout the ventricles (brain cavities and tunnels). CSF cushions the brain and spinal cord from jolts.
The cranium (the top of the skull) surrounds and protects the brain. The spinal cord is surrounded by vertebrae (hollow spinal bones) and also some muscles serve to pad and support
In the early 1900s, researchers discovered that when blue dye was injected into the bloodstream of an animal, all of the tissues and organs of the body turned blue except for the brain and spinal cord. This indicated that there was a special barrier that prevented some substances from entering the central nervous system through the bloodstream. This barrier is now called the blood brain barrier (BBB). The basic attributes of the BBB are as follows:
1. Large molecules do not pass through the BBB easily.
2. Lipid (fat) soluble molecules, such as barbiturate drugs, rapidly cross the BBB into the brain. However, low lipid soluble molecules do not.
3. Molecules that have a high electrical charge to them are slowed as they pass through the BBB.
The BBB is semi-permeable, which means it allows some materials to pass through it but prevents others from doing so. The smallest blood vessels in the body are called capillaries and are lined with endothelial cells. Endothelial tissue has small spaces between each individual cell so the spine. More subtly, the blood-brain barrier protects the brain from chemical intrusion from the rest of the body. Blood flowing into the brain is filtered so that many harmful chemicals cannot enter the brain. The brain has three main parts, the cerebrum, the cerebellum, and the brain stem. The brain is divided into regions that control specific functions.
The brain produces electrical signals, which, together with chemical reactions, let the parts of the body communicate. Nerves send these signals throughout the body.
The average human brain weighs about three pounds (1300–1400 grams). As a comparison, a half-gallon of water weighs about four pounds. The brain consists of gray matter (40%) and white matter (60%) contained within the skull. Brain cells include neurons and glial cells. Although the brain is only 2% of the body’s weight, it uses 20% of the oxygen supply and gets 20% of the blood flow. If brain cells do not get oxygen for 3 to 5 minutes, they begin to die.
The brain and spinal cord make up the central nervous system (CNS). The brain is connected to the spinal cord, which runs from the neck to the hip area. The spinal cord carries nerve messages between the brain and the body. The cells of the nervous system are quite fragile and need extensive protection from being crushed, infected by disease organisms, and other harm. The brain and spinal cord are covered by a tough, translucent membrane called the dura matter. Cerebrospinal fluid (CSF) is a clear, watery liquid that surrounds the brain and spinal cord and is also found throughout the ventricles (brain cavities and tunnels). CSF cushions the brain and spinal cord from jolts.
The cranium (the top of the skull) surrounds and protects the brain. The spinal cord is surrounded by vertebrae (hollow spinal bones) and also some muscles serve to pad and support
In the early 1900s, researchers discovered that when blue dye was injected into the bloodstream of an animal, all of the tissues and organs of the body turned blue except for the brain and spinal cord. This indicated that there was a special barrier that prevented some substances from entering the central nervous system through the bloodstream. This barrier is now called the blood brain barrier (BBB). The basic attributes of the BBB are as follows:
1. Large molecules do not pass through the BBB easily.
2. Lipid (fat) soluble molecules, such as barbiturate drugs, rapidly cross the BBB into the brain. However, low lipid soluble molecules do not.
3. Molecules that have a high electrical charge to them are slowed as they pass through the BBB.
The BBB is semi-permeable, which means it allows some materials to pass through it but prevents others from doing so. The smallest blood vessels in the body are called capillaries and are lined with endothelial cells. Endothelial tissue has small spaces between each individual cell so the spine. More subtly, the blood-brain barrier protects the brain from chemical intrusion from the rest of the body. Blood flowing into the brain is filtered so that many harmful chemicals cannot enter the brain. The brain has three main parts, the cerebrum, the cerebellum, and the brain stem. The brain is divided into regions that control specific functions.
About Alzheimer’s
There are several organizations dedicated to educating patients, families, and caregivers about Alzheimer’s, providing helpful insights into where to go for help and support. These organizations are listed in the Resources section of this book.
Researchers have been studying the AD brain, with all its complexities, since Alois Alzheimer presented his patient in 1907. Science is now closer to finding some answers about what may cause AD, and therefore gaining momentum on what may prevent or treat the disease.
The changes that occur in the brain in Alzheimer’s disease provide some background to the medications used in this disease. It is important to keep in mind that there is currently no definitive explanation as to why this disease process begins. First, it is essential to have some knowledge of the functions of the brain to understand Alzheimer’s and how the medications are developed and utilized.
Researchers have been studying the AD brain, with all its complexities, since Alois Alzheimer presented his patient in 1907. Science is now closer to finding some answers about what may cause AD, and therefore gaining momentum on what may prevent or treat the disease.
The changes that occur in the brain in Alzheimer’s disease provide some background to the medications used in this disease. It is important to keep in mind that there is currently no definitive explanation as to why this disease process begins. First, it is essential to have some knowledge of the functions of the brain to understand Alzheimer’s and how the medications are developed and utilized.
Sunday, October 25, 2009
The impact of Alzheimer’s
Alzheimer’s disease not only affects the patients but also the patient’s family. Almost one out of three households in the Figure 1.1 Alois Alzheimer (pictured here) is the German neurologist who is credited with discovering Alzheimer’s disease.
Defining Alzheimer’s Disease
United States is affected by AD. A little over half of the care provided to AD patients is at home; some estimates place the care at home closer to 75% (Figure 1.2). The combination of healthcare expenses and the loss of income of both the patient and the caregiver is approaching $100 billion nationwide. The Figure 1.2 Almost one out of three households in the United States is affected by Alzheimer’s disease. An estimated 75% of Alzheimer’s patients receive home care.
Over half of the nursing home residents in the United States have AD or some other form of dementia. The annual cost of caring for an AD patient ranges from $18,400 for mild symptoms to $36,132 for those with advanced symptoms. In addition, the average cost of nursing home care is almost $58,000 a year. Medicare and most health insurance plans do not cover the care of an AD patient since it is considered "custodial care".
Caregivers are a subset of the Alzheimer’s picture that is often overlooked. Stress and depression are reported frequently among caregivers: depression affects approximately 50% of caregivers, with stress occurring in at least 80%. Not surprisingly, the emotional, financial, and sometimes physical burden of witnessing a loved one decline mentally and physically is often overwhelming.
Defining Alzheimer’s Disease
United States is affected by AD. A little over half of the care provided to AD patients is at home; some estimates place the care at home closer to 75% (Figure 1.2). The combination of healthcare expenses and the loss of income of both the patient and the caregiver is approaching $100 billion nationwide. The Figure 1.2 Almost one out of three households in the United States is affected by Alzheimer’s disease. An estimated 75% of Alzheimer’s patients receive home care.
Over half of the nursing home residents in the United States have AD or some other form of dementia. The annual cost of caring for an AD patient ranges from $18,400 for mild symptoms to $36,132 for those with advanced symptoms. In addition, the average cost of nursing home care is almost $58,000 a year. Medicare and most health insurance plans do not cover the care of an AD patient since it is considered "custodial care".
Caregivers are a subset of the Alzheimer’s picture that is often overlooked. Stress and depression are reported frequently among caregivers: depression affects approximately 50% of caregivers, with stress occurring in at least 80%. Not surprisingly, the emotional, financial, and sometimes physical burden of witnessing a loved one decline mentally and physically is often overwhelming.
Defining Disease of Alzheimer
When Dr. Alzheimer’s patient died, he was able to study her brain at autopsy.
Alzheimer noted that the cerebral cortex, the outer layer of the brain responsible for numerous functions such as movement, perception, memory, and speaking, was thinner than normal and had severe atrophy. He also noted two other abnormalities. The first was “senile plaque” (now known as neuritic plaque) that had earlier been seen in the brains of the elderly. Second, there were neurofibrillary tangles within the cortex that had not been previously described. These hallmarks for which Alzheimer coined the term presenile dementia, are now known as Alzheimer’s disease (Figure 1.1). Neuritic plaques and neurofibrillary tangles will be discussed in more detail in Chapter 3. Interestingly, to this day, the only way to definitively know that a person has AD is at autopsy.
Who gets Disease of Alzheimer?
It is estimated that over 4 million Americans have Alzheimer’s disease. It is also estimated that by the year 2050, the number could increase to 14 million. One out of every ten persons 65 years of age and older develops AD, although some develop it in their 40s and 50s. Alzheimer’s affects approximately 20% of people between the ages of 75 and 84. The percentage of AD increases to almost 50% in Americans 85 years and older.
The clinical course of the disease is between 2 years and 20 years from the onset of symptoms until death, with an average of about 8 years. There are about 360,000 new cases of Alzheimer’s diagnosed every year and about 100,000 deaths each year from AD.1, 2 Alzheimer’s disease affects people from all walks of life.
The death of President Ronald Reagan from complications of AD has re-ignited an interest in finding a cure for the disease. Other famous people with Alzheimer’s include actors Charles Bronson, Rita Hayworth, Charlton Heston, Jack Lord, and James Doohan; sports stars Sugar Ray Robinson, Joe Adcock, Bill Quackenbush, and Tom Fears; E.B. White, the author of the children’s classic Charlotte’s Web, and Barry Goldwater, former senator of Arizona.
Alzheimer noted that the cerebral cortex, the outer layer of the brain responsible for numerous functions such as movement, perception, memory, and speaking, was thinner than normal and had severe atrophy. He also noted two other abnormalities. The first was “senile plaque” (now known as neuritic plaque) that had earlier been seen in the brains of the elderly. Second, there were neurofibrillary tangles within the cortex that had not been previously described. These hallmarks for which Alzheimer coined the term presenile dementia, are now known as Alzheimer’s disease (Figure 1.1). Neuritic plaques and neurofibrillary tangles will be discussed in more detail in Chapter 3. Interestingly, to this day, the only way to definitively know that a person has AD is at autopsy.
Who gets Disease of Alzheimer?
It is estimated that over 4 million Americans have Alzheimer’s disease. It is also estimated that by the year 2050, the number could increase to 14 million. One out of every ten persons 65 years of age and older develops AD, although some develop it in their 40s and 50s. Alzheimer’s affects approximately 20% of people between the ages of 75 and 84. The percentage of AD increases to almost 50% in Americans 85 years and older.
The clinical course of the disease is between 2 years and 20 years from the onset of symptoms until death, with an average of about 8 years. There are about 360,000 new cases of Alzheimer’s diagnosed every year and about 100,000 deaths each year from AD.1, 2 Alzheimer’s disease affects people from all walks of life.
The death of President Ronald Reagan from complications of AD has re-ignited an interest in finding a cure for the disease. Other famous people with Alzheimer’s include actors Charles Bronson, Rita Hayworth, Charlton Heston, Jack Lord, and James Doohan; sports stars Sugar Ray Robinson, Joe Adcock, Bill Quackenbush, and Tom Fears; E.B. White, the author of the children’s classic Charlotte’s Web, and Barry Goldwater, former senator of Arizona.
Alzheimerts Disease, History
A German neuropathologist and psychiatrist named Alois Alzheimer (see “Alois Alzheimer” box) studied a 51-year-old female patient with severe dementia. The woman started experiencing symptoms five years earlier, such as memory loss and trouble reading and writing. She rapidly declined to hallucinations and was unable to take care of herself.
Dr. Alois Alzheimer was born on June 14, 1864, in Bavaria.
He attended the universities of Aschaffenburg, Tubingen, Berlin, and Wurzburg, where he received a medical degree in 1887. The following year, Alzheimer joined the medical staff at the city mental asylum in Frankfurt, Germany. While he first began his career in psychiatry, Alzheimer quickly devoted himself to his great interest of neuropathology, the study of the causes, nature, and effects of brain diseases.
In 1903, he moved to the university psychiatric clinic in Munich. He recorded his findings on his first AD patient in 1907. For the next ten years, he studied patients with syphilis, Huntington’s disease, epilepsy, and a pseudosclerosis of the brain now known as Wilson’s disease. Alois Alzheimer died on December 19, 1915, at the age of 51, due to cardiac failure following endocarditis, inflammation of the membrane that lines the heart and forms part of the heart valves.
Dr. Alois Alzheimer was born on June 14, 1864, in Bavaria.
He attended the universities of Aschaffenburg, Tubingen, Berlin, and Wurzburg, where he received a medical degree in 1887. The following year, Alzheimer joined the medical staff at the city mental asylum in Frankfurt, Germany. While he first began his career in psychiatry, Alzheimer quickly devoted himself to his great interest of neuropathology, the study of the causes, nature, and effects of brain diseases.
In 1903, he moved to the university psychiatric clinic in Munich. He recorded his findings on his first AD patient in 1907. For the next ten years, he studied patients with syphilis, Huntington’s disease, epilepsy, and a pseudosclerosis of the brain now known as Wilson’s disease. Alois Alzheimer died on December 19, 1915, at the age of 51, due to cardiac failure following endocarditis, inflammation of the membrane that lines the heart and forms part of the heart valves.
Wednesday, October 14, 2009
Alzheimer’s disease
Did you ever briefly forget your friend’s name or have trouble recalling the name of a song on the radio? Many of us joke that it is an “early form of Alzheimer’s.” However, if you are younger than 60, the likelihood that you have Alzheimer’s disease is slim. The memory loss that most people experience can be attributed to many different reasons, such as lack of sleep, too much on their mind, anxiety, or depression. This memory loss tends to be brief, occasional, and has little impact on daily life.
Memory loss that occurs more frequently and that begins to impact a person’s life, however, is usually a type of dementia.
Dementias are usually irreversible and not curable.Dementia primarily affects the elderly and can have many origins. Alzheimer’s disease is the most common form of dementia, occurring about 65% of the time. However, it is also important to rule out other forms of dementia (differential diagnosis).
Some lists potential causes of dementia (sometimes referred to as "senility").
Neurologic disorders:
Stroke, Transient ischemic attack, Biswanger’s disease, Alzheimer’s disease, Lewy body dementia, Parkinson’s disease, Huntington’s disease, Pick’s disease, Creutzfeldt-Jakob disease.
Infections:
Encephalitis, Meningitis.
Metabolic disorders:
Thyroid, Pancreatic, Adrenal.
Cardiovascular disorders:
Vascular occlusion.
Medications:
• Anticholinergics—blocks action of acetylcholine, a nerve transmitter
• Sedative/hypnotic—sleeping pills
• Antihypertensives—blood pressure medicine
Toxins:
Heavy metals
Mental illness:
Schizophrenia, Depression, Substance abuse.
Vitamin deficiencies:
B12, Folate.
Intracranial causes:
Tumors, Subdural hematoma, Hydrocephalus, Abcesses.
Many of these causes, such as those listed under infections, metabolic disorders, medications, and vitamin deficiencies, can be treated and the dementia abates.
Since there are many possible reasons for dementia-like attributes, it is important to see a neurologist. A neurologist is a medical doctor who specializes in the brain and the disorders that affect the brain.
Neurologists often specialize in a particular brain disorder. For instance, one neurologist may treat primarily patients who have had a stroke (temporary or permanent loss of some body functioning),while other neurologists may treat primarily Alzheimer’s patients. Therefore, choosing an appropriate neurologist is one of the first steps in determining the correct diagnosis.
The neurologist will then assist in determining if a patient has a form of dementia. If it is concluded that it is dementia, the neurologist will further attempt to determine the likely cause.
Memory loss that occurs more frequently and that begins to impact a person’s life, however, is usually a type of dementia.
Dementias are usually irreversible and not curable.Dementia primarily affects the elderly and can have many origins. Alzheimer’s disease is the most common form of dementia, occurring about 65% of the time. However, it is also important to rule out other forms of dementia (differential diagnosis).
Some lists potential causes of dementia (sometimes referred to as "senility").
Neurologic disorders:
Stroke, Transient ischemic attack, Biswanger’s disease, Alzheimer’s disease, Lewy body dementia, Parkinson’s disease, Huntington’s disease, Pick’s disease, Creutzfeldt-Jakob disease.
Infections:
Encephalitis, Meningitis.
Metabolic disorders:
Thyroid, Pancreatic, Adrenal.
Cardiovascular disorders:
Vascular occlusion.
Medications:
• Anticholinergics—blocks action of acetylcholine, a nerve transmitter
• Sedative/hypnotic—sleeping pills
• Antihypertensives—blood pressure medicine
Toxins:
Heavy metals
Mental illness:
Schizophrenia, Depression, Substance abuse.
Vitamin deficiencies:
B12, Folate.
Intracranial causes:
Tumors, Subdural hematoma, Hydrocephalus, Abcesses.
Many of these causes, such as those listed under infections, metabolic disorders, medications, and vitamin deficiencies, can be treated and the dementia abates.
Since there are many possible reasons for dementia-like attributes, it is important to see a neurologist. A neurologist is a medical doctor who specializes in the brain and the disorders that affect the brain.
Neurologists often specialize in a particular brain disorder. For instance, one neurologist may treat primarily patients who have had a stroke (temporary or permanent loss of some body functioning),while other neurologists may treat primarily Alzheimer’s patients. Therefore, choosing an appropriate neurologist is one of the first steps in determining the correct diagnosis.
The neurologist will then assist in determining if a patient has a form of dementia. If it is concluded that it is dementia, the neurologist will further attempt to determine the likely cause.
The Use of Drugs
The problem that faces our society today is how to break the connection between our demand for drugs and the willingness of largely outside countries to supply this highly profitable trade. This is the same problem we have faced since narcotics and cocaine were outlawed by the Harrison Narcotic Act of 1914, and we have yet to defeat it despite current expenditures of approximately $20 billion per year on "the war on drugs". The first step in meeting any challenge is always an intelligent and informed citizenry. The purpose of this series is to educate our readers so that they can make informed decisions about issues related to drugs and drug abuse.
Drug Addiction
The issues associated with drug use and abuse in contemporary society are vexing subjects, fraught with political agendas and ideals that often obscure essential information that teens need to know to have intelligent discussions about how to best deal with the problems associated with drug use and abuse.
Drugs: The Straight Facts aims to provide this essential information through straightforward explanations of how an individual drug or group of drugs works in both therapeutic and non-therapeutic conditions; with historical information about the use and abuse of specific drugs; with discussion of drug policies in the United States; and with an ample list of further reading.
From the start, the series uses the word "drug" to describe psychoactive substances that are used for medicinal or nonmedicinal purposes. Included in this broad category are substances that are legal or illegal. It is worth noting that humans have used many of these substances for hundreds, if not thousands of years. For example, traces of marijuana and cocaine have been found in Egyptian mummies; the use of peyote and Amanita fungi has long been a component of religious ceremonies worldwide; and alcohol production and consumption have been an integral part of many human cultures’ social and religious ceremonies. One can speculate about why early human societies chose to use such drugs.
Perhaps, anything that could provide relief from the harshness of life—anything that could make the poor conditions and fatigue associated with hard work easier to bear—was considered a welcome tonic. Life was likely to be, according to the seventeenth century English philosopher Thomas Hobbes, "poor, nasty, brutish and short". One can also speculate about modern human societies’ continued use and abuse of drugs. Whatever the reasons, the consequences of sustained drug use are not insignificant—addiction, overdose, incarceration, and drug wars—and must be dealt with by an informed citizenry.
Drugs: The Straight Facts aims to provide this essential information through straightforward explanations of how an individual drug or group of drugs works in both therapeutic and non-therapeutic conditions; with historical information about the use and abuse of specific drugs; with discussion of drug policies in the United States; and with an ample list of further reading.
From the start, the series uses the word "drug" to describe psychoactive substances that are used for medicinal or nonmedicinal purposes. Included in this broad category are substances that are legal or illegal. It is worth noting that humans have used many of these substances for hundreds, if not thousands of years. For example, traces of marijuana and cocaine have been found in Egyptian mummies; the use of peyote and Amanita fungi has long been a component of religious ceremonies worldwide; and alcohol production and consumption have been an integral part of many human cultures’ social and religious ceremonies. One can speculate about why early human societies chose to use such drugs.
Perhaps, anything that could provide relief from the harshness of life—anything that could make the poor conditions and fatigue associated with hard work easier to bear—was considered a welcome tonic. Life was likely to be, according to the seventeenth century English philosopher Thomas Hobbes, "poor, nasty, brutish and short". One can also speculate about modern human societies’ continued use and abuse of drugs. Whatever the reasons, the consequences of sustained drug use are not insignificant—addiction, overdose, incarceration, and drug wars—and must be dealt with by an informed citizenry.
Wednesday, October 7, 2009
What is Accutane?
Accutane is a form of vitamin A. It reduces the amount of oil released by oil glands in your veneer, and helps your graze renew itself more speedily.
Alsou Accutane is prescribed for the treatment of wicked, disfiguring cystic acne that has not cleared up in retort to milder medications such as antibiotics. It works on the oil glands within the overlay, shrinking them and preventing deviant hardening of the skin.
Isotretinoin has been used to treat other skin disorders, including keratosis follicularis, pityriasis rubra pilaris, lamellar ichthyosis and leukoplakia.
Accutane is used for.
Treating critical acne in patients who do not pity to other medicines. It may also be in use accustomed to for other conditions as unhesitating by your doctor. The antiacne significance can last even after you be struck by finished your advance of medication.
Before using Accutane.
Some medical conditions may interact with Accutane. Certain your doctor or pill roller if you have any medical conditions, predominantly if any of the following apply to you: if you are in a family way, planning to become parturient, or are breast-feeding if you are alluring any prescription or nonprescription physic, herbal preparation, or dietary augment if you have allergies to medicines, foods, or other substances if you are broad and unable to use 2 effective forms of origination control or avoid carnal intercourse if you have diabetes, a children history of diabetes, grand blood cholesterol or triglyceride levels, psychiatric disorders, suicidal thoughts, liver cancer, pancreatitis, a bone breakdown condition (eg, osteoporosis), decreased bone density, an eating scramble, severe diarrhea, rectal bleeding, hearing problems, ringing in the ears, or desire pain.
How to use Accutane.
Take Accutane two times a day with a meal, unless your doctor tells you otherwise. Swallow the capsule. Don't suck or chew it. Take it with a full glass of water, milk, or other nonalcoholic liquid.
Accutane comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Accutane refilled.
Take Accutane by mouth with food.
Scuttle the capsule with a entire glass of water or other transparent. Do not break, crush, munch, or suck on the capsule in front swallowing. This leave help prevent the medication in jail the capsule from irritating your throat. For most talented results, take Accutane regularly.
You bequeath get no more than a 30-day afford of Accutane at a time to be unwavering you check in with your doctor each month to argue side effects. If you slip a dose of Accutane , guide it as soon as possible. If it is verging on time for your next amount, skip the missed measure and go back to your fortnightly dosing schedule. Do not stomach 2 doses at once.
After you winding up taking Accutane, there should be at least a 2-months "take one's repose period" during which you are off the psychedelic. This is because your acne may at to get better even while you are no longer taking the medication. Right away the 2 months are up, if your acne is to severe, your doctor may hope for to give you a second way of Accutane. If you are still growing, your doctor may commend a longer "rest space."
What should I converse about with my healthcare provider once taking Accutane?
Accutane is accessible only under a bosom program called iPLEDGE. You have to be registered in the program and flag documents stating that you twig the dangers of this medication and that you concede to use birth control as required by the program. Accutane can occasion severe, life-ominous birth defects if the natural takes the medication during pregnancy. Equivalent one dose of Accutane can justification major birth defects of the pet's ears, eyes, look out on, skull, heart, and perspicacity. Never use Accutane if you are charged.
Women of child-bearing potential should agree in writing to use two exact forms of birth switch and have regular pregnancy tests previous to, during, and after fetching Accutane. Unless you must had a total hysterectomy or participate in been in menopause for at least a year, you are considered to be of stripling-bearing potential.
If you organize certain conditions, you may lack a dose adjustment or one of a kind tests to safely apprehend this medication. Up front taking Accutane, aver your doctor if you are allergic to any foods or drugs, or if you attired in b be committed to:
a personal or family history of depression or mental illness;
heart disease, high cholesterol or triglycerides;
osteoporosis or other bone disorders;
diabetes;
asthma;
an eating disorder (anorexia nervosa); or liver disease.
Possible side effects of Accutane
Accutane may effect drowsiness or dizziness. These effects may be worse if you haul it with alcohol or a sure thing medicines. Use Accutane with admonition. Do not drive or perform other at all unsafe tasks until you recognize how you react to it. A surprising decrease in night hallucination may occur while you are delightful Accutane . Use caution when driving at Cimmerian dark and avoid driving at sundown if you experience decreased eventide vision. If you abrade contact lenses, you may be enduring difficulty wearing them during and after analysis. Do not give blood while attractive Accutane and for 1 month after stopping intriguing Accutane. Do not pledge alcohol while entrancing Accutane.
Worsening of acne may come to pass during the first leave of therapy. This does not present failure or a need to end the medicine. To inhibit cracking of lips, use a lip moisturizer or balm. Do not entertain cosmetic procedures to flat your skin, including waxing, dermabrasion, or laser procedures, while you are intriguing Accutane and for at least 6 months after you plug up. Accutane can increase your time of scarring from these procedures. Accutane may issue you to become sunburned more undoubtedly. Avoid the sun, sunlamps, or tanning booths until you recognize how you react to Accutane. Use a sunscreen or weary protective clothing if you have to be outside for more than a discourteous time.
All medicines may occasion side effects, but varied people have no, or paltry, side effects. Hindrance with your doctor if any of these most Non-private side effects persist or turn bothersome:
Abnormal hair growth; abnormal skin sensations; bleeding and redness or swelling of the gums;changes in menstrual flow; chapped lips; decreased tolerance to contact lenses; dizziness; dry eyes and mouth; dry nose that may lead to nosebleeds; dry or peeling skin; fatigue; flushing; general body discomfort; hair thinning; headache; itching; lack of energy; nervousness; respiratory tract infection; sleeplessness; sweating; temporary worsening of acne; voice changes.
Read more about Accutane for Acne
Alsou Accutane is prescribed for the treatment of wicked, disfiguring cystic acne that has not cleared up in retort to milder medications such as antibiotics. It works on the oil glands within the overlay, shrinking them and preventing deviant hardening of the skin.
Isotretinoin has been used to treat other skin disorders, including keratosis follicularis, pityriasis rubra pilaris, lamellar ichthyosis and leukoplakia.
Accutane is used for.
Treating critical acne in patients who do not pity to other medicines. It may also be in use accustomed to for other conditions as unhesitating by your doctor. The antiacne significance can last even after you be struck by finished your advance of medication.
Before using Accutane.
Some medical conditions may interact with Accutane. Certain your doctor or pill roller if you have any medical conditions, predominantly if any of the following apply to you: if you are in a family way, planning to become parturient, or are breast-feeding if you are alluring any prescription or nonprescription physic, herbal preparation, or dietary augment if you have allergies to medicines, foods, or other substances if you are broad and unable to use 2 effective forms of origination control or avoid carnal intercourse if you have diabetes, a children history of diabetes, grand blood cholesterol or triglyceride levels, psychiatric disorders, suicidal thoughts, liver cancer, pancreatitis, a bone breakdown condition (eg, osteoporosis), decreased bone density, an eating scramble, severe diarrhea, rectal bleeding, hearing problems, ringing in the ears, or desire pain.
How to use Accutane.
Take Accutane two times a day with a meal, unless your doctor tells you otherwise. Swallow the capsule. Don't suck or chew it. Take it with a full glass of water, milk, or other nonalcoholic liquid.
Accutane comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Accutane refilled.
Take Accutane by mouth with food.
Scuttle the capsule with a entire glass of water or other transparent. Do not break, crush, munch, or suck on the capsule in front swallowing. This leave help prevent the medication in jail the capsule from irritating your throat. For most talented results, take Accutane regularly.
You bequeath get no more than a 30-day afford of Accutane at a time to be unwavering you check in with your doctor each month to argue side effects. If you slip a dose of Accutane , guide it as soon as possible. If it is verging on time for your next amount, skip the missed measure and go back to your fortnightly dosing schedule. Do not stomach 2 doses at once.
After you winding up taking Accutane, there should be at least a 2-months "take one's repose period" during which you are off the psychedelic. This is because your acne may at to get better even while you are no longer taking the medication. Right away the 2 months are up, if your acne is to severe, your doctor may hope for to give you a second way of Accutane. If you are still growing, your doctor may commend a longer "rest space."
What should I converse about with my healthcare provider once taking Accutane?
Accutane is accessible only under a bosom program called iPLEDGE. You have to be registered in the program and flag documents stating that you twig the dangers of this medication and that you concede to use birth control as required by the program. Accutane can occasion severe, life-ominous birth defects if the natural takes the medication during pregnancy. Equivalent one dose of Accutane can justification major birth defects of the pet's ears, eyes, look out on, skull, heart, and perspicacity. Never use Accutane if you are charged.
Women of child-bearing potential should agree in writing to use two exact forms of birth switch and have regular pregnancy tests previous to, during, and after fetching Accutane. Unless you must had a total hysterectomy or participate in been in menopause for at least a year, you are considered to be of stripling-bearing potential.
If you organize certain conditions, you may lack a dose adjustment or one of a kind tests to safely apprehend this medication. Up front taking Accutane, aver your doctor if you are allergic to any foods or drugs, or if you attired in b be committed to:
a personal or family history of depression or mental illness;
heart disease, high cholesterol or triglycerides;
osteoporosis or other bone disorders;
diabetes;
asthma;
an eating disorder (anorexia nervosa); or liver disease.
Possible side effects of Accutane
Accutane may effect drowsiness or dizziness. These effects may be worse if you haul it with alcohol or a sure thing medicines. Use Accutane with admonition. Do not drive or perform other at all unsafe tasks until you recognize how you react to it. A surprising decrease in night hallucination may occur while you are delightful Accutane . Use caution when driving at Cimmerian dark and avoid driving at sundown if you experience decreased eventide vision. If you abrade contact lenses, you may be enduring difficulty wearing them during and after analysis. Do not give blood while attractive Accutane and for 1 month after stopping intriguing Accutane. Do not pledge alcohol while entrancing Accutane.
Worsening of acne may come to pass during the first leave of therapy. This does not present failure or a need to end the medicine. To inhibit cracking of lips, use a lip moisturizer or balm. Do not entertain cosmetic procedures to flat your skin, including waxing, dermabrasion, or laser procedures, while you are intriguing Accutane and for at least 6 months after you plug up. Accutane can increase your time of scarring from these procedures. Accutane may issue you to become sunburned more undoubtedly. Avoid the sun, sunlamps, or tanning booths until you recognize how you react to Accutane. Use a sunscreen or weary protective clothing if you have to be outside for more than a discourteous time.
All medicines may occasion side effects, but varied people have no, or paltry, side effects. Hindrance with your doctor if any of these most Non-private side effects persist or turn bothersome:
Abnormal hair growth; abnormal skin sensations; bleeding and redness or swelling of the gums;changes in menstrual flow; chapped lips; decreased tolerance to contact lenses; dizziness; dry eyes and mouth; dry nose that may lead to nosebleeds; dry or peeling skin; fatigue; flushing; general body discomfort; hair thinning; headache; itching; lack of energy; nervousness; respiratory tract infection; sleeplessness; sweating; temporary worsening of acne; voice changes.
Read more about Accutane for Acne
Sunday, August 16, 2009
Reboxetine; Adrafinil; Modafinil
Reboxetine (Edronax) is a well-tolerated , highly selective "noradrenergic" agent. Crudely, whereas serotonin plays a vital role in mood, noradrenaline is essential to maintaining drive and the capacity for reward. There's a fair bit of evidence that chronically depressive people have dysfunctional and atypical noradrenergic systems - particularly their alpha 2 and beta-adrenoceptors. Reboxetine itself doesn't have the disruptive effects on cognitive function or psychomotor performance so annoyingly typical of older clinical mood-brighteners. Indeed the new NorAdrenaline Reuptake Inhibitors (NARIs) are probably under-used and under-hyped. NARIs - and dopaminergics like amineptine (Survector) - may be especially good for drive-deficient "anergic" states where the capacity for sustained motivation is lacking; and for melancholic depressives with a poor ability to cope with stress. Perhaps surprisingly, preliminary studies suggest reboxetine can actually reverse tranylcypromine-induced hypertensive crises. The "cheese effect" is usually triggered by ingesting tyramine-rich foods. Thus NARIs plus MAOIs may prove a potent form of combination-therapy.
Depressive hypersomniacs who fare poorly on SSRIs, or can't get hold of amineptine or EC-licensed reboxetine, might consider trying a so-called eugeroic ("good arousal") agent instead; more adventurous souls may wish to combine the two. Alpha-1 adrenergic agonists like adrafinil and modafinil are centrally-acting stimulants which can brighten mood and sharpen mental focus. They stimulate the noradrenergic post-synaptic receptors and thereby boost alertness, activity and energy. At sensible dosages, they are remarkably free of side-effects. However, the approval process in the USA is so slow, costly and bureaucratic, and the marketing hurdles typically so formidable, that foreign companies are often deterred from seeking FDA acceptance. [modafinil was licensed by the FDA as Provigil for the treatment of narcolepsy in Dec 1998 ] So elderly people continue to suffer the prescription of mildly dementing anticholinergics like the dumb-drug tricylcic imipramine. Adrafinil, by contrast, is at least as successful as hepatotoxic Anglo-Saxon products at treating the cognitive and memory impairments of incipient senility.
Fortunately, a "French" drug like adrafinil can now be ordered over the Net; but it ought to be available at the local corner store. It has the commercial disadvantage of being very cheap.
Depressive hypersomniacs who fare poorly on SSRIs, or can't get hold of amineptine or EC-licensed reboxetine, might consider trying a so-called eugeroic ("good arousal") agent instead; more adventurous souls may wish to combine the two. Alpha-1 adrenergic agonists like adrafinil and modafinil are centrally-acting stimulants which can brighten mood and sharpen mental focus. They stimulate the noradrenergic post-synaptic receptors and thereby boost alertness, activity and energy. At sensible dosages, they are remarkably free of side-effects. However, the approval process in the USA is so slow, costly and bureaucratic, and the marketing hurdles typically so formidable, that foreign companies are often deterred from seeking FDA acceptance. [modafinil was licensed by the FDA as Provigil for the treatment of narcolepsy in Dec 1998 ] So elderly people continue to suffer the prescription of mildly dementing anticholinergics like the dumb-drug tricylcic imipramine. Adrafinil, by contrast, is at least as successful as hepatotoxic Anglo-Saxon products at treating the cognitive and memory impairments of incipient senility.
Fortunately, a "French" drug like adrafinil can now be ordered over the Net; but it ought to be available at the local corner store. It has the commercial disadvantage of being very cheap.
Bupropion; Amineptine
Bupropion (Wellbutrin) is possibly less effective than nomifensine. Yet it's useful because it lacks the adverse effects on sexual function characteristic of the SSRIs. In some subjects, in fact, libido, arousal, and the intensity and duration of orgasm may actually increase. Bupropion mildly blocks the reuptake, but diminishes the release, of dopamine. This may account for reports of its diminished propensity to induce mania in the genetically susceptible. Its active metabolites block the reuptake of noradrenaline. Chewed as a gum, bupropion is good for giving up smoking. Scandalously, it isn't licensed and marketed in Europe.
Amineptine (Survector) is a clean-ish, (relatively) selective dopamine reuptake blocker. Higher doses promote dopamine release too. Amineptine is liable occasionally to cause spontaneous orgasms. It is a mild but pleasant psychostimulant and a fast-acting mood-brightener. Unlike other tricyclics, it doesn't impair libido or cognitive function. Unlike typical stimulants and other activating agents, it may actually improve sleep architecture.
Scandalously, amineptine isn't licensed and marketed in Britain and America. For it is feared it might have "abuse-potential".
Amineptine (Survector) is a clean-ish, (relatively) selective dopamine reuptake blocker. Higher doses promote dopamine release too. Amineptine is liable occasionally to cause spontaneous orgasms. It is a mild but pleasant psychostimulant and a fast-acting mood-brightener. Unlike other tricyclics, it doesn't impair libido or cognitive function. Unlike typical stimulants and other activating agents, it may actually improve sleep architecture.
Scandalously, amineptine isn't licensed and marketed in Britain and America. For it is feared it might have "abuse-potential".
Sunday, August 9, 2009
Methylphenidate; Minaprine; Nomifensine
A SSRI can be combined ("augmented"; sounds more soothing to the official medical ear) with a dopaminergic such as methylphenidate. As "Ritalin", methylphenidate is prolifically dispensed to American schoolchildren for different purposes altogether. In spite of its structural relationship to amphetamine, methylphenidate resembles in many ways a benign version of cocaine, yet with a much longer half-life. It blocks the reuptake, but doesn't significantly release, the catecholamines noradrenaline and dopamine. If it is combined with an SSRI, all of which have anti-obsessive-compulsive properties too, the likelihood of dose-escalation is minimised.
Chewing coca leaves with a dash of powdered lime is a nutritious and energising way to sustain healthy mood.
Unfortunately, it is not very good for one's teeth.
A more cautious but still interesting option might be minaprine. Minaprine blocks the reuptake of both dopamine and serotonin. It is also in some degree cholinomimetic. Thus it may exhibit both mood-brightening and nootropic properties. Much more research is needed.
Nomifensine (Merital) showed great promise as a pleasantly stimulating dopaminergic which also inhibits the reuptake of noradrenaline and - to a much lesser extent - serotonin. It was withdrawn from licensed use after the discovery of its rare side-effect of precipitating a serious blood-disorder. For retarded melancholics, however, it was typically a very effective and well-tolerated mood-brightener with minimal side-effects. The risk/reward ratio of its carefully-monitored use may have been misjudged.
Chewing coca leaves with a dash of powdered lime is a nutritious and energising way to sustain healthy mood.
Unfortunately, it is not very good for one's teeth.
A more cautious but still interesting option might be minaprine. Minaprine blocks the reuptake of both dopamine and serotonin. It is also in some degree cholinomimetic. Thus it may exhibit both mood-brightening and nootropic properties. Much more research is needed.
Nomifensine (Merital) showed great promise as a pleasantly stimulating dopaminergic which also inhibits the reuptake of noradrenaline and - to a much lesser extent - serotonin. It was withdrawn from licensed use after the discovery of its rare side-effect of precipitating a serious blood-disorder. For retarded melancholics, however, it was typically a very effective and well-tolerated mood-brightener with minimal side-effects. The risk/reward ratio of its carefully-monitored use may have been misjudged.
Dopamine function
What's missing, crucially, is vigorous and prolonged stimulation of meso(cortico-)limbic dopamine function.
This is really much more fun than it sounds. The currently available experimental evidence has persuaded many - but not all - researchers that the mesolimbic dopamine system serves as the final common pathway for pleasure in the brain. Enhanced responsiveness of post-synaptic dopamine D2/D3 receptors is crucial to long-term emotional well-being. The otherwise anomalous mood-brightening effects of the serotonin-reuptake accelerator tianeptine, for instance, are probably explained by its tendency to increase extracellular concentrations of dopamine in the nucleus accumbens. All "serotonergic" and "noradrenergic" mood-brighteners eventually act on the mesolimic dopamine pathway, albeit in differing degrees and with varying delay. And new anti-Parkinsonian and anti-Alzheimer's agents, notably roxindole and pramipexole, owe their exciting potential role as fast-acting antidepressants to their dopaminergic action.
The full story is inevitably complex. Dopamine isn't itself the magic pleasure-chemical, though its functional role is crucial. Researchers into affective disorders readily get over-attached to a particular neurotransmitter, its receptor sub-types and their signal transduction cascades. Traditionally, serotonin and noradrenaline have attracted the fiercest rival partisans. "Dopaminergic" (and opioid) agents, by contrast, are suspect. They are politically incorrect since they are both potentially "abusable". Moreover safe and sustainable empathogens are arguably as morally urgent as safe and sustainable mood-boosters. At any rate, mesolimbic activation, exclusively or otherwise, enhances the intensity of experience; increases pleasure and libido, and boosts cognitive performance. Even better, certain dopamine-enhancing drugs may have neuro-protective properties too.
So what are the other contemporary options for chemical life-enhancement?
This is really much more fun than it sounds. The currently available experimental evidence has persuaded many - but not all - researchers that the mesolimbic dopamine system serves as the final common pathway for pleasure in the brain. Enhanced responsiveness of post-synaptic dopamine D2/D3 receptors is crucial to long-term emotional well-being. The otherwise anomalous mood-brightening effects of the serotonin-reuptake accelerator tianeptine, for instance, are probably explained by its tendency to increase extracellular concentrations of dopamine in the nucleus accumbens. All "serotonergic" and "noradrenergic" mood-brighteners eventually act on the mesolimic dopamine pathway, albeit in differing degrees and with varying delay. And new anti-Parkinsonian and anti-Alzheimer's agents, notably roxindole and pramipexole, owe their exciting potential role as fast-acting antidepressants to their dopaminergic action.
The full story is inevitably complex. Dopamine isn't itself the magic pleasure-chemical, though its functional role is crucial. Researchers into affective disorders readily get over-attached to a particular neurotransmitter, its receptor sub-types and their signal transduction cascades. Traditionally, serotonin and noradrenaline have attracted the fiercest rival partisans. "Dopaminergic" (and opioid) agents, by contrast, are suspect. They are politically incorrect since they are both potentially "abusable". Moreover safe and sustainable empathogens are arguably as morally urgent as safe and sustainable mood-boosters. At any rate, mesolimbic activation, exclusively or otherwise, enhances the intensity of experience; increases pleasure and libido, and boosts cognitive performance. Even better, certain dopamine-enhancing drugs may have neuro-protective properties too.
So what are the other contemporary options for chemical life-enhancement?
Sunday, August 2, 2009
Recreational drugs
The commonly recognised legal and illegal recreational drugs offer poor prospects for sustained biological mood-enhancement. So what about the heterogeneous group of compounds uninvitingly labelled as anxiolytics and antidepressants? Have they potentially anything significant to add to most people's quality of life? Official medical doctrine says no. Allegedly, only sufferers from clinically-sanctioned psychiatric disorders will benefit from such agents; though in recent years it has at last been formally recognised that depressive disorders are under-diagnosed and under-treated even by the twentieth century's abjectly poor standards of acceptable ill-being. Most of humanity, however, still doesn't fit any of the official diagnostic boxes. Can "diagnostic creep" triumph over therapeutic minimalism and enhance their quality of life? Yes. Must the goal of pharmacotherapy be as limited as Freud's aspiration for psychotherapy: "to transform hysterical misery into common unhappiness"? No.
First, the boring but crucial preliminaries. Optimal nutrition and exercise will increase the efficacy of all the potential life-enhancers touted here. A rich supply of precursor chemicals (e.g. tryptophan, the rate-limiting step in the production of serotonin) can also reduce their effective dosages. By choosing to eat an ideal "stone-age" diet rich in organic nuts, seeds, fruit and vegetables, and drastically reducing one's consumption of saturated fat (red meat, fried foods), sugar (sweets etc) and hydrogenated oils (found in margarine and refined vegetable oils), then one's baseline of well-being - or at least relative ill-being - can be sustainably lifted. Visitors to HedWeb probably don't expect to be assailed by sermons on the benefits of exercise any more than food-faddism. Yet regular and moderately vigorous physical exertion releases endogenous opiates, enhances serotonin function, stimulates nerve growth factors, and leads to a livelier, better-oxygenated brain.
Alas, clean living and wholesome thoughts typically aren't enough. We need stronger medicine to flourish. At first glance, however, the standard, State-rationed chemicals aren't a brilliant bunch.
The so-called minor tranquillisers, the benzodiazepines such as diazepam (Valium) and the shorter-acting temazepam, are sometimes useful but still dreadfully crude anti-anxiety agents. They act primarily on the GABA (gamma aminobutyric acid) receptor complex. GABA functions as the main inhibitory neurotransmitter in the central nervous system. The progress of molecular biology and neurogenetics in unravelling the fiendish complexity of GABA's receptor sub-types should eventually allow more targeted compounds to be developed. These more selective and site-specific drugs will lack the sedative and hypnotic properties of today's marketed brands. In the meantime, benzodiazepines in current use tend to induce dependence, dull consciousness and impair the intellect. So there's not much chance of radical life-enrichment here.
Buspirone (Buspar), is somewhat more promising. It acts on an autoreceptor subtype of serotonin. This means it has mood-brightening properties too; and hence it is useful in anxious depressive states. Buspirone lacks the intellect-clouding effects of other clinical and alcoholic anti-anxiety agents. Yet its weak and equivocal effects on sub-types of dopamine function, while useful for the purposes of commercially touting its lack of "abuse potential", mean it isn't very exciting or especially effective.
The so-called anti-depressants fall into several categories. Their mood-brightening effect is correlated with alterations in the concentration of catecholamines and/or serotonin in the central nervous system and the long-term receptor re-regulation these changes provoke.
The tricyclics, prototypically imipramine (Tofranil), and their allies are relatives of the neuroleptic drug chlorpromazine. Chlorpromazine is also known as Largactil, the notorious "chemical cosh". Tricyclics block to varying degrees the reuptake of serotonin and noradrenaline into the nerve cell terminals from where they are released. Perhaps unsurprisingly given their parentage, they are all dirty drugs, though some are dirtier than others.
Their anti-cholinergic effects harm memory and intellectual performance. Their anti-histamine action induces drowsiness and sedation. Their adverse effect on cardiac function makes them dangerous in overdose. Most "euthymic" volunteers on whom they have been tested don't like their dulling effects of consciousness. Unlike chlorpromazine, the tricyclic antidepressants don't noticeably block the dopamine receptors. But with one notable exception, they do precious little to stimulate dopamine function either. Hence they're not much fun even for the severely depressed people who can benefit from taking them. For three decades they were the mainstay of the treatment of clinically-acknowledged depression. They contributed to the widely-held medical opinion that anything classed as an antidepressant won't help "normal" people; unless of course they were "really" depressed. Basically, tricyclics are cheap, nasty and best avoided.
Much better, but still in some ways deeply flawed, are the selective serotonin reuptake inhibitors.
Serotonin, "the civilising neurotransmitter", plays a vital role in mood, memory, appetite, sleep, pain perception and sexual desire.
Fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), and citalopram (Cipramil, Celexa) are currently licensed and marketed. More of their "me-too" relatives are on the way from pharmaceutical companies eager for a lucrative piece of the action. The SSRIs all differ in their half-lives, chemical structure and precise specificities. Their functional effects are broadly similar. Their mood-brightening, resilience-enhancing and anti-anxiety properties really can make a modest percentage of the population feel "better than well". As a class, they don't have the physically unpleasant and cognitively debilitating anti-cholinergic effects of the tricyclics. A much larger section of the community - folk who daily knock back huge quantities of ethyl alcohol in the socially accepted fashion - could surely gain from the durably enhanced serotonin function SSRIs can yield. Such a switch would necessitate a big change in marketing strategy.
The beneficent properties of the SSRIs are celebrated in Peter Kramer's contemporary classic Listening to Prozac. Kramer has written a remarkably honest book. It's a discursive memoir by a therapist who is forced to admit that many of his clients seemed rapidly to fare far better on a pill than on his industrial-strength regimen of caring talk-therapy. Kramer's discussion of "cosmetic psychopharmacology" and "designer personalities", however, enraged traditionalists. For chemical Calvinist orthodoxy finds the notion that people should have a right pharmacologically to choose who and what they want to be profoundly offensive.
Two common problems limit the usefulness of SSRIs, at least when taken on their own. The problems stem from the indirect inhibitory effect of Prozac-style drugs on dopamine function, a consequence of deliberate selective targeting on the functional enhancement of subtypes of serotonin pathway.
First, SSRIs can compromise libido and sexual performance. This isn't always a disadvantage in over-excitable young males. It can still be a very distressing phenomenon for people too embarrassed to talk about it. Technical performance difficulties can sometimes be counteracted by taking (the alpha-2 adrenergic agonist) yohimbine; the phosphodiesterase inhibitor sildenafil (better known as the sexual rocket-fuel Viagra); or a dopamine agonist, licit or otherwise, before bedtime action. Yet this is scarcely an ideal solution.
Second, though some subjects may feel mildly euphoric, in other users the SSRIs serve more as mood-stabilisers and -flatteners in their lives. By increasing the user's emotional self-sufficiency, too, SSRIs may subtly change the "balance of power" in personal relationships - for good or ill. In some cases, SSRIs may even act as thymoanaesthetisers which diminish the intensity of felt emotion; by contrast, a mood-brightening serotonin reuptake-enhancer like tianeptine may intensify emotion instead. Affective flattening may be welcome to someone in the pit of unmitigated clinical depression. It is scarcely a life-enriching property for "normal" people who lack any convenient diagnostic category which acknowledges their malaise.
First, the boring but crucial preliminaries. Optimal nutrition and exercise will increase the efficacy of all the potential life-enhancers touted here. A rich supply of precursor chemicals (e.g. tryptophan, the rate-limiting step in the production of serotonin) can also reduce their effective dosages. By choosing to eat an ideal "stone-age" diet rich in organic nuts, seeds, fruit and vegetables, and drastically reducing one's consumption of saturated fat (red meat, fried foods), sugar (sweets etc) and hydrogenated oils (found in margarine and refined vegetable oils), then one's baseline of well-being - or at least relative ill-being - can be sustainably lifted. Visitors to HedWeb probably don't expect to be assailed by sermons on the benefits of exercise any more than food-faddism. Yet regular and moderately vigorous physical exertion releases endogenous opiates, enhances serotonin function, stimulates nerve growth factors, and leads to a livelier, better-oxygenated brain.
Alas, clean living and wholesome thoughts typically aren't enough. We need stronger medicine to flourish. At first glance, however, the standard, State-rationed chemicals aren't a brilliant bunch.
The so-called minor tranquillisers, the benzodiazepines such as diazepam (Valium) and the shorter-acting temazepam, are sometimes useful but still dreadfully crude anti-anxiety agents. They act primarily on the GABA (gamma aminobutyric acid) receptor complex. GABA functions as the main inhibitory neurotransmitter in the central nervous system. The progress of molecular biology and neurogenetics in unravelling the fiendish complexity of GABA's receptor sub-types should eventually allow more targeted compounds to be developed. These more selective and site-specific drugs will lack the sedative and hypnotic properties of today's marketed brands. In the meantime, benzodiazepines in current use tend to induce dependence, dull consciousness and impair the intellect. So there's not much chance of radical life-enrichment here.
Buspirone (Buspar), is somewhat more promising. It acts on an autoreceptor subtype of serotonin. This means it has mood-brightening properties too; and hence it is useful in anxious depressive states. Buspirone lacks the intellect-clouding effects of other clinical and alcoholic anti-anxiety agents. Yet its weak and equivocal effects on sub-types of dopamine function, while useful for the purposes of commercially touting its lack of "abuse potential", mean it isn't very exciting or especially effective.
The so-called anti-depressants fall into several categories. Their mood-brightening effect is correlated with alterations in the concentration of catecholamines and/or serotonin in the central nervous system and the long-term receptor re-regulation these changes provoke.
The tricyclics, prototypically imipramine (Tofranil), and their allies are relatives of the neuroleptic drug chlorpromazine. Chlorpromazine is also known as Largactil, the notorious "chemical cosh". Tricyclics block to varying degrees the reuptake of serotonin and noradrenaline into the nerve cell terminals from where they are released. Perhaps unsurprisingly given their parentage, they are all dirty drugs, though some are dirtier than others.
Their anti-cholinergic effects harm memory and intellectual performance. Their anti-histamine action induces drowsiness and sedation. Their adverse effect on cardiac function makes them dangerous in overdose. Most "euthymic" volunteers on whom they have been tested don't like their dulling effects of consciousness. Unlike chlorpromazine, the tricyclic antidepressants don't noticeably block the dopamine receptors. But with one notable exception, they do precious little to stimulate dopamine function either. Hence they're not much fun even for the severely depressed people who can benefit from taking them. For three decades they were the mainstay of the treatment of clinically-acknowledged depression. They contributed to the widely-held medical opinion that anything classed as an antidepressant won't help "normal" people; unless of course they were "really" depressed. Basically, tricyclics are cheap, nasty and best avoided.
Much better, but still in some ways deeply flawed, are the selective serotonin reuptake inhibitors.
Serotonin, "the civilising neurotransmitter", plays a vital role in mood, memory, appetite, sleep, pain perception and sexual desire.
Fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), and citalopram (Cipramil, Celexa) are currently licensed and marketed. More of their "me-too" relatives are on the way from pharmaceutical companies eager for a lucrative piece of the action. The SSRIs all differ in their half-lives, chemical structure and precise specificities. Their functional effects are broadly similar. Their mood-brightening, resilience-enhancing and anti-anxiety properties really can make a modest percentage of the population feel "better than well". As a class, they don't have the physically unpleasant and cognitively debilitating anti-cholinergic effects of the tricyclics. A much larger section of the community - folk who daily knock back huge quantities of ethyl alcohol in the socially accepted fashion - could surely gain from the durably enhanced serotonin function SSRIs can yield. Such a switch would necessitate a big change in marketing strategy.
The beneficent properties of the SSRIs are celebrated in Peter Kramer's contemporary classic Listening to Prozac. Kramer has written a remarkably honest book. It's a discursive memoir by a therapist who is forced to admit that many of his clients seemed rapidly to fare far better on a pill than on his industrial-strength regimen of caring talk-therapy. Kramer's discussion of "cosmetic psychopharmacology" and "designer personalities", however, enraged traditionalists. For chemical Calvinist orthodoxy finds the notion that people should have a right pharmacologically to choose who and what they want to be profoundly offensive.
Two common problems limit the usefulness of SSRIs, at least when taken on their own. The problems stem from the indirect inhibitory effect of Prozac-style drugs on dopamine function, a consequence of deliberate selective targeting on the functional enhancement of subtypes of serotonin pathway.
First, SSRIs can compromise libido and sexual performance. This isn't always a disadvantage in over-excitable young males. It can still be a very distressing phenomenon for people too embarrassed to talk about it. Technical performance difficulties can sometimes be counteracted by taking (the alpha-2 adrenergic agonist) yohimbine; the phosphodiesterase inhibitor sildenafil (better known as the sexual rocket-fuel Viagra); or a dopamine agonist, licit or otherwise, before bedtime action. Yet this is scarcely an ideal solution.
Second, though some subjects may feel mildly euphoric, in other users the SSRIs serve more as mood-stabilisers and -flatteners in their lives. By increasing the user's emotional self-sufficiency, too, SSRIs may subtly change the "balance of power" in personal relationships - for good or ill. In some cases, SSRIs may even act as thymoanaesthetisers which diminish the intensity of felt emotion; by contrast, a mood-brightening serotonin reuptake-enhancer like tianeptine may intensify emotion instead. Affective flattening may be welcome to someone in the pit of unmitigated clinical depression. It is scarcely a life-enriching property for "normal" people who lack any convenient diagnostic category which acknowledges their malaise.
Monday, June 29, 2009
Some dead drugs
One spectacularly incompetent route to a lifetime of happiness involves taking illegal psychostimulants such as cocaine or the amphetamines. In the short term, their activation of the sympathetic nervous system tends to elevate mood, motivation and energy. Users tend to talk a lot. Self-confidence is enhanced: these are "power drugs". Physical strength and mental acuity are variably increased. Whereas cocaine blocks the neuronal re-uptake of the catecholamines (noradrenaline; dopamine), amphetamine triggers to a much greater extent their synaptic release as well. It is thus more potent.
In either case, libertarian indignation that the State presumes to subject its citizens to totalitarian-style mind-control should not obscure the fact that for most purposes these are not useful drugs. This is because the central nervous system supports a web of mutually inhibitory feedback-mechanisms. In response to a short-term increase of mood-mediating monoamines in the synapses, the genes and neuronal receptors re-regulate. So at best no real long-term benefit is derived from the use of such compounds. Neither cocaine nor amphetamine yield the sustained activation of intracellular signal-transduction cascades needed to cheat the hedonic treadmill.
Some people continue to take psychostimulants casually for years without serious harm. Yet the potential risks of adverse physical, psychological and social ill-effects are high. Hence their use is best discouraged.
The depressant opioids are marginally more benign. They can be extremely pleasurable. Next century, their customised and site-selective successors may play a valuable role in promoting emotional superhealth. We could all do with having our native endorphin systems enriched. Unfortunately, the present crop are physiologically addictive They lose quite a bit of their euphoriant effect as tolerance sets in. Typically, they inspire a dreamily contented disengagement from the problems of the world. They diminish any drive to constructive activity. Sadly, too, their use impairs the release of endogenous opioids normally induced by social interaction with friends and family.
The physical risks of opioid use shouldn't be exaggerated. Most of the problems that users suffer ultimately derive less from their choice of drug itself than from the illegal status of exogenous opioids in contemporary society. Yet even if they were legal and given away in cereal packets, they wouldn't make a good choice of mood-booster - or at least not in their present, crudely non-specific guise. kappa- agonists, for instance, have dys phoric and psychotomimetic effects; one might as well drink ethyl alcohol spiced with meths. The paradise-engineers of posterity will surely weed out such adulterants from their elixirs altogether.
By contrast to today's opioids, marijuana isn't usually addictive in the traditional sense of the term. It can, however be habit-forming. It has euphoriant, psychedelic and sedative properties. Experiments with stoned rats suggest the drug reduces the amount of corticotrophin-releasing factor in the amygdala. Excess secretion of CRF is associated with abnormalities in the HPLA axis and depression. The rebound surge of CRF on ceasing cannabis-use is associated with increased vulnerability to stress and a withdrawal-reaction; arguably one good reason not to stop in the first instance.
The primary psychoactive ingredient in marijuana is THC, tetrahydrocannabinol. Smoking or eating marijuana and its complex cocktail of compounds may rarely trigger episodes of depersonalisation, derealisation and psychosis. Sometimes it can induce paranoia, particularly in advocates of The War Against Drugs. More commonly, it just leaves the user pleasantly and harmlessly stoned. It's fun. Sleepiness, pain relief and euphoria are typical responses. Indeed the first brain-derived substance found to bind to our cannabis receptors was christened "anandamide", a derivative of the Sanskrit word for internal contentment. Getting high may thus serve as an innocent recreational pastime in an uncaring world.
Yet marijuana is not a wonderdrug. Cognitive function in the user is often impaired, albeit moderately and reversibly. Marijuana interferes with memory-formation by disrupting long-term potentiation in the hippocampus. It seems that one of the functions of endogenous cannabinoids in the brain is to promote selective short-term amnesia.
Forgetting is not, as one might have supposed, a purely passive process. Either way, choosing deliberately to ingest an amnestic agent for long periods is scarcely an ideal life-strategy. It's especially flawed given the centrality of memory to human self-identity. Some artists and professional bohemians, it is true, apparently do find smoking grass an adjunct to creative thought. For persons of a more philistine temperament, on the other hand, it's hard to see such a drug as a major tool for life-affirmation or the self-development of the species. This does not, one ought scarcely need to add, suggest users should be persecuted and criminalised.
The empathogen "hug-drug", ecstasy (methylenedioxymethamphetamine; MDMA) offers a wonderfully warm, sensuous, loving, and empathetic peak experience to the first-time user. Distrust, suspicion and jealousy evaporate. They are replaced by a serene sense of universal love. The sensorium remains clear. Emotion is intensified. Much recreational drug-use tends to be self-centred. It is often branded as selfish. Yet here is a "penicillin of the soul" which promises to subvert our selfish-DNA-driven tendency to self-aggrandisement.
Disappointingly, whether due to enzyme-induction or other causes not fully understood, most users never fully recapture the magic of their first few trips. Moreover ecstasy is neurotoxic to serotonergic axons. It may even be harmful at sub-therapeutic doses. As the uncertain process of neural recovery sets in, heavy users in particular may experience the subtle long-drawn-out reversal of all the good effects they initially enjoyed from the drug. Taking a post-trip selective serotonin re-uptake inhibitor (SSRI) such as fluoxetine (Prozac) 2-6 hours afterward is prophylactic against the measurable post-E serotonin dip otherwise experienced some 48 hours later. Yet taking SSRIs on a regular basis largely nullifies the already attenuated benefits of prolonged ecstasy use. In any case, the duration of the peak experience is a mere 90 minutes. So taking ecstasy scarcely amounts to a full-scale strategy for life either. It does, on the other hand, deliver an exquisite foretaste of the beautiful forms of consciousness that ultimately await us.
Another tantalising and deliciously sensuous hint of the sublime is offered - infrequently and unpredictably - by gamma-hydroxybutyric acid (GHB). GHB usually takes the form of a clear, odourless, slightly salty-tasting liquid.
It's also an endogenous precursor and metabolite of the inhibitory neurotransmitter GABA. GHB is non-toxic; but it mustn't be mixed with alcohol or other depressants. It's metabolised quickly to carbon dioxide and water. GHB's steep dose-response curve means naive users run the severe risk of falling asleep. When used lightly in recreational rather than stuporific or anaesthetic doses, GHB is a touchy-feely compound which typically induces deep muscular relaxation, a sense of serenity, and feelings of emotional warmth. Often it enhances emotional openness and the desire to socialise. Tactile sensitivity and the appreciation of music are enriched. Most remarkably, the moderate user may awake refreshed after a deep restful sleep: GHB appears temporarily to inhibit dopamine-release while increasing storage, leading to the brightened mood and sharpened mental focus of a subsequent "dopamine-rebound". GHB acts both as a disinhibitor and an aphrodisiac. The intensity of orgasm is heightened. Hence GHB is potentially useful in relieving the psychopathologies of prudery and sexual repression. Unfortunately, its therapeutic value has been eclipsed by its demonization in the mass-media. Stories of chaste virgins turning into sex-crazed nymphomaniacs make great copy and poor medicine. Moreover GHB is sometimes confused with the amnestic "date-rape" benzodiazepine, flunitrazepam - better-known as the potent and fast-acting sedative-hypnotic "forget pill", Rohypnol. Bought on the street, GHB may be confused with all sorts of other substances too.
Yet even pure GHB is no magic elixir. Not everyone likes it. GHB's psychological effects are unpredictable and poorly understood. Nausea, dizziness, inco-ordination are common; reaction-time is slowed. GHB does not usually promote great depth of thought. Its very status as "an almost ideal sleep inducing-substance" makes it of limited use to those who aspire instead to be more intensely awake. The lack of any discernible body-count to fuel the periodic moral panics its use induces may allow a partial rehabilitation. Yet GHB evokes - at best - only a faint and fleeting parody of the life-long chemical nirvana on offer to our transhuman successors.
Alcohol - the traditional date-rape drug of choice - and, most insidiously of all, cigarettes are the really sinister mass-killers. With that poker-faced Alice-In-Wonderland logic popular amongst the world's sleazier governments, not merely do the authorities preserve the legal status of cigarette sales here in the UK on grounds of upholding personal liberty. The slickly expensive marketing and glamorisation of tobacco products to potential victims is sanctioned on similar grounds too. We ought to be as shocked at tobacco promotion as we'd certainly feel if instead the billboards urged kids to try heroin because it's cool. Yet familiarity breeds moral apathy. Youngsters are typically hooked before they are in any position to make an informed choice of poison - or even to abstain altogether.
Meanwhile a state-supported export drive targets the poor in vulnerable Third World countries. With a cynicism that almost beggars belief, one celebrated ex-British Prime Minister accepted a million-dollar bribe from a leading member of the drug-cartels for her services. Her party's ineffable Home Secretary then delivered himself of blood-curdling calls for a crack-down on evil drug-pushers(!). He went on to increase the draconian penalties already available for personal users of cannabis.
So long as our governments collude with the organised drug cartels to share out the billions of dollars of tax revenues mulcted from nicotine-addicts - thereby keeping direct taxes visibly down and themselves visibly in office - there seems little hope of a more intelligent approach to psychoactive drugs as a whole.
In either case, libertarian indignation that the State presumes to subject its citizens to totalitarian-style mind-control should not obscure the fact that for most purposes these are not useful drugs. This is because the central nervous system supports a web of mutually inhibitory feedback-mechanisms. In response to a short-term increase of mood-mediating monoamines in the synapses, the genes and neuronal receptors re-regulate. So at best no real long-term benefit is derived from the use of such compounds. Neither cocaine nor amphetamine yield the sustained activation of intracellular signal-transduction cascades needed to cheat the hedonic treadmill.
Some people continue to take psychostimulants casually for years without serious harm. Yet the potential risks of adverse physical, psychological and social ill-effects are high. Hence their use is best discouraged.
The depressant opioids are marginally more benign. They can be extremely pleasurable. Next century, their customised and site-selective successors may play a valuable role in promoting emotional superhealth. We could all do with having our native endorphin systems enriched. Unfortunately, the present crop are physiologically addictive They lose quite a bit of their euphoriant effect as tolerance sets in. Typically, they inspire a dreamily contented disengagement from the problems of the world. They diminish any drive to constructive activity. Sadly, too, their use impairs the release of endogenous opioids normally induced by social interaction with friends and family.
The physical risks of opioid use shouldn't be exaggerated. Most of the problems that users suffer ultimately derive less from their choice of drug itself than from the illegal status of exogenous opioids in contemporary society. Yet even if they were legal and given away in cereal packets, they wouldn't make a good choice of mood-booster - or at least not in their present, crudely non-specific guise. kappa- agonists, for instance, have dys phoric and psychotomimetic effects; one might as well drink ethyl alcohol spiced with meths. The paradise-engineers of posterity will surely weed out such adulterants from their elixirs altogether.
By contrast to today's opioids, marijuana isn't usually addictive in the traditional sense of the term. It can, however be habit-forming. It has euphoriant, psychedelic and sedative properties. Experiments with stoned rats suggest the drug reduces the amount of corticotrophin-releasing factor in the amygdala. Excess secretion of CRF is associated with abnormalities in the HPLA axis and depression. The rebound surge of CRF on ceasing cannabis-use is associated with increased vulnerability to stress and a withdrawal-reaction; arguably one good reason not to stop in the first instance.
The primary psychoactive ingredient in marijuana is THC, tetrahydrocannabinol. Smoking or eating marijuana and its complex cocktail of compounds may rarely trigger episodes of depersonalisation, derealisation and psychosis. Sometimes it can induce paranoia, particularly in advocates of The War Against Drugs. More commonly, it just leaves the user pleasantly and harmlessly stoned. It's fun. Sleepiness, pain relief and euphoria are typical responses. Indeed the first brain-derived substance found to bind to our cannabis receptors was christened "anandamide", a derivative of the Sanskrit word for internal contentment. Getting high may thus serve as an innocent recreational pastime in an uncaring world.
Yet marijuana is not a wonderdrug. Cognitive function in the user is often impaired, albeit moderately and reversibly. Marijuana interferes with memory-formation by disrupting long-term potentiation in the hippocampus. It seems that one of the functions of endogenous cannabinoids in the brain is to promote selective short-term amnesia.
Forgetting is not, as one might have supposed, a purely passive process. Either way, choosing deliberately to ingest an amnestic agent for long periods is scarcely an ideal life-strategy. It's especially flawed given the centrality of memory to human self-identity. Some artists and professional bohemians, it is true, apparently do find smoking grass an adjunct to creative thought. For persons of a more philistine temperament, on the other hand, it's hard to see such a drug as a major tool for life-affirmation or the self-development of the species. This does not, one ought scarcely need to add, suggest users should be persecuted and criminalised.
The empathogen "hug-drug", ecstasy (methylenedioxymethamphetamine; MDMA) offers a wonderfully warm, sensuous, loving, and empathetic peak experience to the first-time user. Distrust, suspicion and jealousy evaporate. They are replaced by a serene sense of universal love. The sensorium remains clear. Emotion is intensified. Much recreational drug-use tends to be self-centred. It is often branded as selfish. Yet here is a "penicillin of the soul" which promises to subvert our selfish-DNA-driven tendency to self-aggrandisement.
Disappointingly, whether due to enzyme-induction or other causes not fully understood, most users never fully recapture the magic of their first few trips. Moreover ecstasy is neurotoxic to serotonergic axons. It may even be harmful at sub-therapeutic doses. As the uncertain process of neural recovery sets in, heavy users in particular may experience the subtle long-drawn-out reversal of all the good effects they initially enjoyed from the drug. Taking a post-trip selective serotonin re-uptake inhibitor (SSRI) such as fluoxetine (Prozac) 2-6 hours afterward is prophylactic against the measurable post-E serotonin dip otherwise experienced some 48 hours later. Yet taking SSRIs on a regular basis largely nullifies the already attenuated benefits of prolonged ecstasy use. In any case, the duration of the peak experience is a mere 90 minutes. So taking ecstasy scarcely amounts to a full-scale strategy for life either. It does, on the other hand, deliver an exquisite foretaste of the beautiful forms of consciousness that ultimately await us.
Another tantalising and deliciously sensuous hint of the sublime is offered - infrequently and unpredictably - by gamma-hydroxybutyric acid (GHB). GHB usually takes the form of a clear, odourless, slightly salty-tasting liquid.
It's also an endogenous precursor and metabolite of the inhibitory neurotransmitter GABA. GHB is non-toxic; but it mustn't be mixed with alcohol or other depressants. It's metabolised quickly to carbon dioxide and water. GHB's steep dose-response curve means naive users run the severe risk of falling asleep. When used lightly in recreational rather than stuporific or anaesthetic doses, GHB is a touchy-feely compound which typically induces deep muscular relaxation, a sense of serenity, and feelings of emotional warmth. Often it enhances emotional openness and the desire to socialise. Tactile sensitivity and the appreciation of music are enriched. Most remarkably, the moderate user may awake refreshed after a deep restful sleep: GHB appears temporarily to inhibit dopamine-release while increasing storage, leading to the brightened mood and sharpened mental focus of a subsequent "dopamine-rebound". GHB acts both as a disinhibitor and an aphrodisiac. The intensity of orgasm is heightened. Hence GHB is potentially useful in relieving the psychopathologies of prudery and sexual repression. Unfortunately, its therapeutic value has been eclipsed by its demonization in the mass-media. Stories of chaste virgins turning into sex-crazed nymphomaniacs make great copy and poor medicine. Moreover GHB is sometimes confused with the amnestic "date-rape" benzodiazepine, flunitrazepam - better-known as the potent and fast-acting sedative-hypnotic "forget pill", Rohypnol. Bought on the street, GHB may be confused with all sorts of other substances too.
Yet even pure GHB is no magic elixir. Not everyone likes it. GHB's psychological effects are unpredictable and poorly understood. Nausea, dizziness, inco-ordination are common; reaction-time is slowed. GHB does not usually promote great depth of thought. Its very status as "an almost ideal sleep inducing-substance" makes it of limited use to those who aspire instead to be more intensely awake. The lack of any discernible body-count to fuel the periodic moral panics its use induces may allow a partial rehabilitation. Yet GHB evokes - at best - only a faint and fleeting parody of the life-long chemical nirvana on offer to our transhuman successors.
Alcohol - the traditional date-rape drug of choice - and, most insidiously of all, cigarettes are the really sinister mass-killers. With that poker-faced Alice-In-Wonderland logic popular amongst the world's sleazier governments, not merely do the authorities preserve the legal status of cigarette sales here in the UK on grounds of upholding personal liberty. The slickly expensive marketing and glamorisation of tobacco products to potential victims is sanctioned on similar grounds too. We ought to be as shocked at tobacco promotion as we'd certainly feel if instead the billboards urged kids to try heroin because it's cool. Yet familiarity breeds moral apathy. Youngsters are typically hooked before they are in any position to make an informed choice of poison - or even to abstain altogether.
Meanwhile a state-supported export drive targets the poor in vulnerable Third World countries. With a cynicism that almost beggars belief, one celebrated ex-British Prime Minister accepted a million-dollar bribe from a leading member of the drug-cartels for her services. Her party's ineffable Home Secretary then delivered himself of blood-curdling calls for a crack-down on evil drug-pushers(!). He went on to increase the draconian penalties already available for personal users of cannabis.
So long as our governments collude with the organised drug cartels to share out the billions of dollars of tax revenues mulcted from nicotine-addicts - thereby keeping direct taxes visibly down and themselves visibly in office - there seems little hope of a more intelligent approach to psychoactive drugs as a whole.
Drugs for mental health
Could we live happily ever after? Perhaps. One's interest in the genetically pre-programmed states of sublimity sketched in The Hedonistic Imperative is tempered by the knowledge that one is unlikely to be around to enjoy them.
It's all very well being told our descendants will experience every moment of their lives as a breathtakingly magical epiphany. For emotional primitives and our loved ones at present, most of life's moments bring nothing of the sort. In
centuries to come, our base-line of emotional well-being may indeed exceed anything today's legacy wetware can even contemplate. Right now, however, a future Post-Darwinian Era of paradise-engineering can seem an awfully long way off. Mainstream society today has a desperately underdeveloped conception of mental health.
There's clearly a strong causal link between the raw neurobiological capacity to experience happiness and the extent to which one's life is felt to be worthwhile. High-minded philosophy treatises should complicate but not confuse the primacy of the pleasure-pain axis. So one very practical method of life-enrichment consists in chemically engineering happier brains for all in the here-and-now. Yet how can this best be done?
Any strategy which doesn't subvert our in-built hedonic treadmill of inhibitory feedback mechanisms in the CNS will fail. Political and socio-economic reforms offer at best a lame stopgap. To the scientific naturalist, all routes to happiness must ultimately be biological: "culture" must be neurochemically encoded to exert any effect.
Some of these routes to happiness involve the traditional environmental detours. They are too technical, diverse and futile to tackle here. If the quality of our lives is to be significantly enhanced in the long term, then the genetically predisposed set-point of our emotional thermostats needs to be recalibrated. The malaise-ridden norm typically adaptive in humanity's ancestral environment must be scrapped. So while we wait for germ-line gene-therapy to become standard, it's worth considering instead how ordinary late twentieth-century Homo sapiens can sustainably maximise emotional well-being with only present-day pharmacology to rely on. No less importantly, how is it possible to combine staying continuously high - one's embarrassment at using the frisson-charged term from the vernacular is revealing - with retaining one's sense of social and ethical responsibility to other people and life-forms?
Extracting reliable information on this topic is extraordinarily difficult for laity and professionals alike. The layman is more likely to be given heavily slanted propaganda. Unvarnished fact might confuse his uneducated and functionally diminutive brain. Career-scientists, on the other hand, are bedevilled by a different problem. Access to funds, laboratories, raw materials, journal publication, professional preferment, and licenses to conduct experimental trials is all dependent on researchers delivering results their paymasters want to hear. The disincentives to intellectual integrity could scarcely be greater; and they are cloaked in such reputable disguise.
By way of illustration, it's worth contemplating one far-fetched scenario. How might an everlasting-happiness drug - a drug which (implausibly!) left someone who tried it once living happily-ever-after - find itself described in the literature?
"Substance x induces severe, irreversible structural damage to neurotransmitter sub-system y. Its sequelae include mood-congruent cognitive delusions and several chronic and intractable cases of toxic affective psychosis".
Eeek! Needless to say, no sensible adult would wish to mess around with such a potent neurotoxin under this description.
Several excellent researchers play the game by the rules. They keep their heterodox opinions to themselves. Others find such cognitive dissonance too unpleasant. They gradually internalise the puritanical role and tendency to warped scientific prose expected of them. [Whereas horribly-tortured experimental animals, for instance, blandly get "used" and "sacrificed", certain drugs always get "abused" by "drug-abusers"] On the other hand, some of the most original and productive minds in the field of psychopharmacology - pre-eminently Alexander Shulgin - have already been silenced. Many more careers have been intellectually strangled at birth or consigned to professional oblivion. The danger of poisoning the wells of information, for whatever motives, is straightforward. When young people discover they have been lied to or deceived, over cannabis for instance, they will pardonably assume that they have been lied to or deceived over the dangers of other illegals too. And this, to put it mildly, would be exceedingly rash.
Most recently, the Internet daily delivers up an uncontrollable flood-tide of fresh ideas to counter official misinformation. Unfortunately, a lot of it isn't much more objective in content or style than the professional journals it complements. Devising one's own system of filtering and quality-control to drown out the noise is a challenging task for anybody.
It's all very well being told our descendants will experience every moment of their lives as a breathtakingly magical epiphany. For emotional primitives and our loved ones at present, most of life's moments bring nothing of the sort. In
centuries to come, our base-line of emotional well-being may indeed exceed anything today's legacy wetware can even contemplate. Right now, however, a future Post-Darwinian Era of paradise-engineering can seem an awfully long way off. Mainstream society today has a desperately underdeveloped conception of mental health.
There's clearly a strong causal link between the raw neurobiological capacity to experience happiness and the extent to which one's life is felt to be worthwhile. High-minded philosophy treatises should complicate but not confuse the primacy of the pleasure-pain axis. So one very practical method of life-enrichment consists in chemically engineering happier brains for all in the here-and-now. Yet how can this best be done?
Any strategy which doesn't subvert our in-built hedonic treadmill of inhibitory feedback mechanisms in the CNS will fail. Political and socio-economic reforms offer at best a lame stopgap. To the scientific naturalist, all routes to happiness must ultimately be biological: "culture" must be neurochemically encoded to exert any effect.
Some of these routes to happiness involve the traditional environmental detours. They are too technical, diverse and futile to tackle here. If the quality of our lives is to be significantly enhanced in the long term, then the genetically predisposed set-point of our emotional thermostats needs to be recalibrated. The malaise-ridden norm typically adaptive in humanity's ancestral environment must be scrapped. So while we wait for germ-line gene-therapy to become standard, it's worth considering instead how ordinary late twentieth-century Homo sapiens can sustainably maximise emotional well-being with only present-day pharmacology to rely on. No less importantly, how is it possible to combine staying continuously high - one's embarrassment at using the frisson-charged term from the vernacular is revealing - with retaining one's sense of social and ethical responsibility to other people and life-forms?
Extracting reliable information on this topic is extraordinarily difficult for laity and professionals alike. The layman is more likely to be given heavily slanted propaganda. Unvarnished fact might confuse his uneducated and functionally diminutive brain. Career-scientists, on the other hand, are bedevilled by a different problem. Access to funds, laboratories, raw materials, journal publication, professional preferment, and licenses to conduct experimental trials is all dependent on researchers delivering results their paymasters want to hear. The disincentives to intellectual integrity could scarcely be greater; and they are cloaked in such reputable disguise.
By way of illustration, it's worth contemplating one far-fetched scenario. How might an everlasting-happiness drug - a drug which (implausibly!) left someone who tried it once living happily-ever-after - find itself described in the literature?
"Substance x induces severe, irreversible structural damage to neurotransmitter sub-system y. Its sequelae include mood-congruent cognitive delusions and several chronic and intractable cases of toxic affective psychosis".
Eeek! Needless to say, no sensible adult would wish to mess around with such a potent neurotoxin under this description.
Several excellent researchers play the game by the rules. They keep their heterodox opinions to themselves. Others find such cognitive dissonance too unpleasant. They gradually internalise the puritanical role and tendency to warped scientific prose expected of them. [Whereas horribly-tortured experimental animals, for instance, blandly get "used" and "sacrificed", certain drugs always get "abused" by "drug-abusers"] On the other hand, some of the most original and productive minds in the field of psychopharmacology - pre-eminently Alexander Shulgin - have already been silenced. Many more careers have been intellectually strangled at birth or consigned to professional oblivion. The danger of poisoning the wells of information, for whatever motives, is straightforward. When young people discover they have been lied to or deceived, over cannabis for instance, they will pardonably assume that they have been lied to or deceived over the dangers of other illegals too. And this, to put it mildly, would be exceedingly rash.
Most recently, the Internet daily delivers up an uncontrollable flood-tide of fresh ideas to counter official misinformation. Unfortunately, a lot of it isn't much more objective in content or style than the professional journals it complements. Devising one's own system of filtering and quality-control to drown out the noise is a challenging task for anybody.
Saturday, June 6, 2009
Herbal and dietary products
Herbal and dietary products are chemicals that have druglike effects in people. Unfortunately, their effects are largely unknown and may be dangerous for some people because there is little reliable information about them. For most products, little research has been done to determine either their benefits or their adverse effects.
The safety and effectiveness of these products are not documented or regulated by laws designed to protect consumers, as are pharmaceutical drugs. As a result, the types and amounts of ingredients may not be standardized or even identified on the product label. In fact, most products contain several active ingredients and it is often not known which ingredient has the desired pharmacologic effect. In addition, components and active ingredients of plants can vary considerably, depending on the soil, water, and climate where the plants are grown.
These products can be used more safely if they are manufactured by a reputable company that states the ingredients are standardized (meaning that the dose of medicine in each tablet or capsule is the same).
The product label should also state specific percentages, amounts, and strengths of active ingredients. With herbal medicines especially, different brands of the same herb vary in the amounts of active ingredients per recommended dose. Dosing is also difficult because a particular herb may be available in several different dosage forms (eg, tablet, capsule, tea, extract) with different amounts of active ingredients.
These products are often advertised as "natural". Many people interpret this to mean the products are safe and better than synthetic or man-made products. This is not true; "natural" does not mean safe, especially when taken concurrently with other herbals, dietary supplements, or drugs.
When taking herbal or dietary supplements, follow the instructions on the product label. Inappropriate use or taking excessive amounts may cause dangerous side effects.
Inform health care providers when taking any kind of herbal or dietary supplement, to reduce risks of severe adverse effects or drug-supplement interactions.
Most herbal and dietary supplements should be avoided during pregnancy or lactation and in young children.
The American Society of Anesthesiologists recommends that all herbal products be discontinued 2-3 weeks before any surgical procedure. Some products (eg, echinacea, ephedra, feverfew, garlic, gingko, ginseng, kava, valerian and St. John's wort) can interfere with or increase the effects of some drugs, affect blood pressure or heart rhythm, or increase risks of bleeding; some have unknown effects when combined with anesthetics, other perioperative medications, and surgical procedures.
Store herbal and dietary supplements out of the reach of children.
Read about Hemorrhoids herbal cream
The safety and effectiveness of these products are not documented or regulated by laws designed to protect consumers, as are pharmaceutical drugs. As a result, the types and amounts of ingredients may not be standardized or even identified on the product label. In fact, most products contain several active ingredients and it is often not known which ingredient has the desired pharmacologic effect. In addition, components and active ingredients of plants can vary considerably, depending on the soil, water, and climate where the plants are grown.
These products can be used more safely if they are manufactured by a reputable company that states the ingredients are standardized (meaning that the dose of medicine in each tablet or capsule is the same).
The product label should also state specific percentages, amounts, and strengths of active ingredients. With herbal medicines especially, different brands of the same herb vary in the amounts of active ingredients per recommended dose. Dosing is also difficult because a particular herb may be available in several different dosage forms (eg, tablet, capsule, tea, extract) with different amounts of active ingredients.
These products are often advertised as "natural". Many people interpret this to mean the products are safe and better than synthetic or man-made products. This is not true; "natural" does not mean safe, especially when taken concurrently with other herbals, dietary supplements, or drugs.
When taking herbal or dietary supplements, follow the instructions on the product label. Inappropriate use or taking excessive amounts may cause dangerous side effects.
Inform health care providers when taking any kind of herbal or dietary supplement, to reduce risks of severe adverse effects or drug-supplement interactions.
Most herbal and dietary supplements should be avoided during pregnancy or lactation and in young children.
The American Society of Anesthesiologists recommends that all herbal products be discontinued 2-3 weeks before any surgical procedure. Some products (eg, echinacea, ephedra, feverfew, garlic, gingko, ginseng, kava, valerian and St. John's wort) can interfere with or increase the effects of some drugs, affect blood pressure or heart rhythm, or increase risks of bleeding; some have unknown effects when combined with anesthetics, other perioperative medications, and surgical procedures.
Store herbal and dietary supplements out of the reach of children.
Read about Hemorrhoids herbal cream
Sunday, May 17, 2009
Prescription drugs
Prescription drugs are always prescribed by a physician or a doctor and are very effective on the body.
Some people get confused with prescription drugs and over-the-counter drugs which are available without any prescription. All prescription drugs come in market after getting approved by concerned legitimate body such as FDA.
The reason behind taking approval is that all the prescription drugs contain medicinal values which can prove to be fatal for life if taken without any prescription. Even then some people, other than the patient, get access to these drugs and after consuming heavy doses feel vulnerable.
Perhaps this is the main reason behind all those warnings mentioned on the cover of each prescription drugs. It is also noticed that some patients consume heavy doses of prescription drugs, without consulting their doctors, to get rid of the pain. However, such patients usually end up fighting for their lives against the side effects of prescription drugs.
In order to avoid such complications doctors advice their patients to consume specified amount of drugs for safe and effective results. However, there are some people who knowingly abuse prescription drugs. Generally, these people abuse prescription drugs either to lose weight or to get high on life. While abusing prescription drugs people often forget that they can die because of this.
Undoubtedly, abuse of prescription drugs is increasing day by day. However, it is believed that many prescription drug abusers are ignorant teenagers who consume drugs to get high. Also these kinds of drug abusers are increasing at an alarming rate. Due to lack of proper information teenagers, unknowingly, abuse prescription drugs that adversely affect their body in the long run.
FDA and other concerned bodies are putting all their efforts in order to stop prescription drug abuse. They have issued several guidelines to which every drug manufacturing company needs to abide. For instance, it is mandatory for every drug manufacturing company to obtain a license before selling their prescription drugs in the market. Also drugs sold whether generic or branded must be genuine and as per the guidelines of FDA.
No Prescription Drugs
In some countries, there is a need to obtain what is called a prescription before medicine can be obtained. These prescription drugs can't always be accessible to some, so there is a need for such people to get alternative treatments. But how does one go about getting a dependable drug without the prescription given by a doctor?
Drugs That Don't Need Prescriptions: Several types of drugs are not regulated this included herbs, minerals, vitamins, and food supplements. Since these items are not regulated, there is no prescription required for them.
It should be noted that since these drugs are not, in fact, regulated they may not live up to their claims. It is commonplace to see an herbal remedy make falsified claims, simply because they can get away with it and make extra sales.
The majority of these drugs do work, however. But there is still a need for more powerful and dependable drugs- such as the kind that would have a prescription attached to them. But how do we obtain a prescription drug without a doctor's approval?
How to Get Prescription Drugs without a Prescription: There are several legit reasons why one would need a prescription drug without the prescription. Cost is a large factor- not every family has the money that is needed to see a doctor and then pay for the medicine too. Others can't make it to the doctor's office because of disabilities. Whatever the case, there are truly logical reason why one would need such drug without a prescription.
The beautiful thing about the Internet is that it has become a large marketplace of goods and services. Literally anyone around the world can obtain items and services from locations throughout every country on Earth.
The best part of the scheme is that not every country has prescription laws- meaning that prescription drugs could be shipped to one's household from another country. In many cases, it is even less expensive than what the medicine would cost otherwise. This is due to the fact that there is no regulation- and because drugs can often be produced cheaper outside country borders.
It's very important that one take care when buying drugs without a prescription online. First, there are many scams or tricks that fake Internet companies play on needy consumers. There is also concern in the fact that prescriptions are usually required for a reason. A doctor may be needed to check for family history or problems that one might encounter from the drug.
In most cases, buying online drugs without a prescription is perfectly safe. With a little research and optimism, reliable sources of prescription drugs can be found. And thanks to the global shipping system that only takes days to get an item around the world (given enough money is paid), emergencies can be tended to whereas they might not have been previously.
Final Thoughts on Obtaining Drugs without a Prescription: As with everything, make sure you engage in a sense of caution. Do your research, and make sure that the drug is completely safe to use. If there is any high risk or doubt, be sure to see a doctor. In every other case, you may enjoy the benefits of cheap drugs- both from saving you doctor visits and bloated medicine fees at the pharmacy.
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Some people get confused with prescription drugs and over-the-counter drugs which are available without any prescription. All prescription drugs come in market after getting approved by concerned legitimate body such as FDA.
The reason behind taking approval is that all the prescription drugs contain medicinal values which can prove to be fatal for life if taken without any prescription. Even then some people, other than the patient, get access to these drugs and after consuming heavy doses feel vulnerable.
Perhaps this is the main reason behind all those warnings mentioned on the cover of each prescription drugs. It is also noticed that some patients consume heavy doses of prescription drugs, without consulting their doctors, to get rid of the pain. However, such patients usually end up fighting for their lives against the side effects of prescription drugs.
In order to avoid such complications doctors advice their patients to consume specified amount of drugs for safe and effective results. However, there are some people who knowingly abuse prescription drugs. Generally, these people abuse prescription drugs either to lose weight or to get high on life. While abusing prescription drugs people often forget that they can die because of this.
Undoubtedly, abuse of prescription drugs is increasing day by day. However, it is believed that many prescription drug abusers are ignorant teenagers who consume drugs to get high. Also these kinds of drug abusers are increasing at an alarming rate. Due to lack of proper information teenagers, unknowingly, abuse prescription drugs that adversely affect their body in the long run.
FDA and other concerned bodies are putting all their efforts in order to stop prescription drug abuse. They have issued several guidelines to which every drug manufacturing company needs to abide. For instance, it is mandatory for every drug manufacturing company to obtain a license before selling their prescription drugs in the market. Also drugs sold whether generic or branded must be genuine and as per the guidelines of FDA.
No Prescription Drugs
In some countries, there is a need to obtain what is called a prescription before medicine can be obtained. These prescription drugs can't always be accessible to some, so there is a need for such people to get alternative treatments. But how does one go about getting a dependable drug without the prescription given by a doctor?
Drugs That Don't Need Prescriptions: Several types of drugs are not regulated this included herbs, minerals, vitamins, and food supplements. Since these items are not regulated, there is no prescription required for them.
It should be noted that since these drugs are not, in fact, regulated they may not live up to their claims. It is commonplace to see an herbal remedy make falsified claims, simply because they can get away with it and make extra sales.
The majority of these drugs do work, however. But there is still a need for more powerful and dependable drugs- such as the kind that would have a prescription attached to them. But how do we obtain a prescription drug without a doctor's approval?
How to Get Prescription Drugs without a Prescription: There are several legit reasons why one would need a prescription drug without the prescription. Cost is a large factor- not every family has the money that is needed to see a doctor and then pay for the medicine too. Others can't make it to the doctor's office because of disabilities. Whatever the case, there are truly logical reason why one would need such drug without a prescription.
The beautiful thing about the Internet is that it has become a large marketplace of goods and services. Literally anyone around the world can obtain items and services from locations throughout every country on Earth.
The best part of the scheme is that not every country has prescription laws- meaning that prescription drugs could be shipped to one's household from another country. In many cases, it is even less expensive than what the medicine would cost otherwise. This is due to the fact that there is no regulation- and because drugs can often be produced cheaper outside country borders.
It's very important that one take care when buying drugs without a prescription online. First, there are many scams or tricks that fake Internet companies play on needy consumers. There is also concern in the fact that prescriptions are usually required for a reason. A doctor may be needed to check for family history or problems that one might encounter from the drug.
In most cases, buying online drugs without a prescription is perfectly safe. With a little research and optimism, reliable sources of prescription drugs can be found. And thanks to the global shipping system that only takes days to get an item around the world (given enough money is paid), emergencies can be tended to whereas they might not have been previously.
Final Thoughts on Obtaining Drugs without a Prescription: As with everything, make sure you engage in a sense of caution. Do your research, and make sure that the drug is completely safe to use. If there is any high risk or doubt, be sure to see a doctor. In every other case, you may enjoy the benefits of cheap drugs- both from saving you doctor visits and bloated medicine fees at the pharmacy.
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Monday, May 11, 2009
Medical Terminology
Medical terminology is made up of terms that describe human anatomy and physiology (body organs, systems, and their functions), body locations, diseases, diagnostic imaging and laboratory testing, together with clinical procedures, surgeries, and diagnoses.
Why do we need medical terminology?
A medical term usually describes in one word a disease or condition that, under normal circumstances, would take several words to describe.
Building a medical vocabulary involves breaking down a word by identifying its prefix, suffix, and root word. The root word is the foundation or basic meaning of the word. It can appear with a prefix and suffix or between a prefix and suffix, as prefixes and suffixes never stand alone. They must be attached to a root word.
- Prefix: Appears at the beginning of a word and tells the how, why, where, when, how much, how many, position, direction, time, or status.
- Root word: Specifies the body part to which the term refers.
- Suffix: Appears at the end of a word and indicates a procedure, condition, or disease.
Each prefix, root, and suffix has its own meaning, so it’s your job to remember them and put the three meanings together into one greater word meaning.
Medical language is an entity unto itself and followed a historical development.
Common medical vocabulary used today includes terms built from Greek and Latin word parts, some of which were used by Hippocrates and Aristotle more than 2,000 years ago. That’s quite an extensive pedigree, and one that only continued to build as time flew by, right into the modern age.
One type of medical term is the eponym, a term named after the personal name of someone. An example would be Parkinson’s disease, named after the English physician Dr. James Parkinson.
With the great advancements in medicine throughout the 20th century, medical language changed with the times and continues to do so today. Some words are discarded or considered obsolete, whereas others are changed, and new words are continually added.
Now available in several formats including traditional print, CD-ROM, Web sites, databases, and even wall charts, medical dictionaries grow bigger with each new edition. Check out Chapter 24 for a list of great resources. The rapid increase in medical and scientific knowledge necessitates new medical vocabulary to describe it. Changes in medicine in the 20th century became apparent in the growing size of medical dictionaries. Knowledge about immunology, antibodies, allergies, and viruses was in the infancy stage in early editions of dictionaries.
Greek and Latin
You can thank the two founding fathers of medical terminology for getting the ball rolling: Hippocrates and Aristotle. Hippocrates, considered the father of medicine, was a student, teacher, and great physician. Aristotle was a Greek philosopher and a physical scientist. He stressed observation and induction. His major studies were of comparative anatomy and physiology.
The Hippocratic Oath — an oath of professional behavior sworn by physicians beginning a medical career — is attributed to Hippocrates. The Greeks were the founders of modern medicine, but Latin is the basic source of medical terms. With origins in ancient Rome and thanks to good, old-fashioned conquest, Latin quickly made its way through the world, solidifying its rep as the language of choice for medicine and science.
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Why do we need medical terminology?
A medical term usually describes in one word a disease or condition that, under normal circumstances, would take several words to describe.
Building a medical vocabulary involves breaking down a word by identifying its prefix, suffix, and root word. The root word is the foundation or basic meaning of the word. It can appear with a prefix and suffix or between a prefix and suffix, as prefixes and suffixes never stand alone. They must be attached to a root word.
- Prefix: Appears at the beginning of a word and tells the how, why, where, when, how much, how many, position, direction, time, or status.
- Root word: Specifies the body part to which the term refers.
- Suffix: Appears at the end of a word and indicates a procedure, condition, or disease.
Each prefix, root, and suffix has its own meaning, so it’s your job to remember them and put the three meanings together into one greater word meaning.
Medical language is an entity unto itself and followed a historical development.
Common medical vocabulary used today includes terms built from Greek and Latin word parts, some of which were used by Hippocrates and Aristotle more than 2,000 years ago. That’s quite an extensive pedigree, and one that only continued to build as time flew by, right into the modern age.
One type of medical term is the eponym, a term named after the personal name of someone. An example would be Parkinson’s disease, named after the English physician Dr. James Parkinson.
With the great advancements in medicine throughout the 20th century, medical language changed with the times and continues to do so today. Some words are discarded or considered obsolete, whereas others are changed, and new words are continually added.
Now available in several formats including traditional print, CD-ROM, Web sites, databases, and even wall charts, medical dictionaries grow bigger with each new edition. Check out Chapter 24 for a list of great resources. The rapid increase in medical and scientific knowledge necessitates new medical vocabulary to describe it. Changes in medicine in the 20th century became apparent in the growing size of medical dictionaries. Knowledge about immunology, antibodies, allergies, and viruses was in the infancy stage in early editions of dictionaries.
Greek and Latin
You can thank the two founding fathers of medical terminology for getting the ball rolling: Hippocrates and Aristotle. Hippocrates, considered the father of medicine, was a student, teacher, and great physician. Aristotle was a Greek philosopher and a physical scientist. He stressed observation and induction. His major studies were of comparative anatomy and physiology.
The Hippocratic Oath — an oath of professional behavior sworn by physicians beginning a medical career — is attributed to Hippocrates. The Greeks were the founders of modern medicine, but Latin is the basic source of medical terms. With origins in ancient Rome and thanks to good, old-fashioned conquest, Latin quickly made its way through the world, solidifying its rep as the language of choice for medicine and science.
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Friday, May 8, 2009
Sexual Health
Sexual difficulties may begin early in a person's life or they may develop after an individual has previously experienced enjoyable and satisfying sex. A problem may develop gradually over time, or may occur suddenly as a total or partial inability to participate in one or more stages of the sexual act.
What causes Sexual Problems?
The causes of sexual difficulties can be physical, psychological, or both.
Emotional factors affecting sex include both interpersonal problems and psychological problems within the individual. Interpersonal problems include marital or relationship problems, or lack of trust and open communication between partners. Personal psychological problems include depression, sexual fears or guilt, or past sexual trauma.
Physical factors contributing to sexual problems include:
Drugs, such as alcohol, nicotine, narcotics, stimulants, antihypertensives (medicines that lower blood pressure), antihistamines, and some psychotherapeutic drugs (drugs that treat psychological problems such as depression)
Injuries to the back
An enlarged prostate gland
Problems with blood supply
Nerve damage (as in spinal cord injuries)
Disease (diabetic neuropathy, multiple sclerosis, tumors, and, rarely, tertiary syphilis)
Failure of various organs (such as the heart and lungs)
Endocrine disorders (thyroid, pituitary, or adrenal gland problems)
Hormonal deficiencies (low testosterone, estrogen, or androgens)
Some birth defects
Sexual dysfunctions are more common in the early adult years, with the majority of people seeking care for such conditions during their late 20s through 30s. The incidence increases again in the geriatric population, typically with gradual onset of symptoms that are associated most commonly with medical causes of sexual dysfunction.
Sexual dysfunction is more common in people who abuse alcohol and drugs. It is also more likely in people suffering from diabetes and degenerative neurological disorders. Ongoing psychological problems, difficulty maintaining relationships, or chronic disharmony with the current sexual partner may also interfere with sexual function.
Types of Sexual Problems
Sexual dysfunction disorders are generally classified into 4 categories:
sexual desire disorders
sexual arousal disorders
orgasm disorders, and
sexual pain disorders.
Sexual desire disorders (decreased libido) may be caused by a decrease in the normal production of estrogen (in women) or testosterone (in both men and women). Other causes may be aging, fatigue, pregnancy, and medications -- the SSRI anti-depressants which include fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil) are well known for reducing desire in both men and women. Psychiatric conditions, such as depression and anxiety, can also cause decreased libido.
Sexual arousal disorders were previously known as frigidity in women and impotence in men. These have now been replaced with less judgmental terms. Impotence is now known as erectile dysfunction, and frigidity is now described as female sexual dysfunction, a term that covers a range of several specific problems with desire, arousal, or anxiety.
For both men and women, these conditions may appear as an aversion to, and avoidance of, sexual contact with a partner. In men, there may be partial or complete failure to attain or maintain an erection, or a lack of sexual excitement and pleasure in sexual activity.
There may be medical causes for these disorders, such as decreased blood flow or lack of vaginal lubrication. Chronic disease may also contribute to these difficulties, as well as the nature of the relationship between partners. As the success of Viagra attests, many erectile disorders in men may be primarily physical, not psychological conditions.
Orgasm disorders are a persistent delay or absence of orgasm following a normal sexual excitement phase. The disorder occurs in both women and men. Again, the SSRI antidepressants are frequent culprits -- these may delay the achievement of orgasm or eliminate it entirely.
Sexual pain disorders affect women almost exclusively, and are known as dyspareunia (painful intercourse) and vaginismus (an involuntary spasm of the muscles of the vaginal wall, which interferes with intercourse). Dyspareunia may be caused by insufficient lubrication (vaginal dryness) in women.
Poor lubrication may result from insufficient excitement and stimulation, or from hormonal changes caused by menopause, pregnancy, or breast-feeding. Irritation from contraceptive creams and foams may also cause dryness, as can fear and anxiety about sex.
It is unclear exactly what causes vaginismus, but it is thought that past sexual trauma such as rape or abuse may play a role. Another female sexual pain disorder is called vulvodynia or vulvar vestibulitis. In this condition, women experience burning pain during sex which may be related to problems with the skin in the vulvar and vaginal areas. The cause is unknown.
Symptoms
Men or women:
Lack of interest in sex (loss of libido)
Inability to feel aroused
Pain with intercourse (much less common in men than women)
Men :
Inability to attain an erection
Inability to maintain an erection adequately for intercourse
Delay or absence of ejaculation, despite adequate stimulation
Inability to control timing of ejaculation
Women:
Inability to relax vaginal muscles enough to allow intercourse
Inadequate vaginal lubrication before and during intercourse
Inability to attain orgasm
Burning pain on the vulva or in the vagina with contact to those areas
Diagnosis
Specific physical findings and testing procedures depend on the form of sexual dysfunction being investigated. A complete history is usually taken and a physical examination performed to:
Identify predisposing illnesses or conditions
Highlight possible fears, anxieties, or guilt specific to sexual behaviors or performance
Uncover any history of prior sexual trauma
A physical examination of both the partners should include the whole body and not be limited to the reproductive system.
Call your doctor if:
Call for an appointment with your health care provider if sexual problems persist and are a concern.
Treatment Options
Treatment depends on the cause of the sexual dysfunction. Medical causes that are reversible or treatable are usually managed medically or surgically. Physical therapy and mechanical aides may prove helpful for some people experiencing sexual dysfunction due to physical illnesses, conditions, or disabilities.
For men who have difficulty attaining an erection, the medication sildenafil (Viagra), which increases blood flow to the penis, may be very helpful, though it must be taken 1 to 4 hours prior to intercourse.
Men who take nitrates for coronary heart disease should not take sildenafil. Mechanical aids and penile implants are also an option for men who cannot attain an erection and who find that sildenafil isn't helpful.
Women with vaginal dryness may be helped with lubricating gels, hormone creams, and -- in cases of premenopausal or menopausal women -- with hormone replacement therapy. In some cases, women with androgen deficiency can be helped by taking testosterone.
Vulvodynia can be treated with testosterone cream, with use of biofeedback, and with low doses of some antidepressants, which also treat nerve pain. Surgery has not been successful.
Behavioral treatments involve many different techniques to treat problems associated with orgasm and sexual arousal disorders. Self-stimulation and the Masters and Johnson treatment strategies are among the many behavioral therapies used.
Simple, open, accurate, and supportive education about sex and sexual behaviors or responses may be all that is required in many cases. Some couples may benefit from joint counseling to address interpersonal issues and communication styles. Psychotherapy may be required to address anxieties, fears, inhibitions, or poor body image.
Prevention
Open, informative, and accurate communication regarding sexual issues and body image between parents and their children may prevent children from developing anxiety or guilt about sex and may help them develop healthy sexual relationships.
Review all medications, both prescription and over-the-counter, for possible side effects that relate to sexual dysfunction. Avoiding drug and alcohol abuse will also help prevent sexual dysfunction.
Couples who are open and honest about their sexual preferences and feelings are more likely to avoid some sexual dysfunction. One partner should, ideally, be able to communicate desires and preferences to the other partner.
People who are victims of sexual trauma, such as sexual abuse or rape at any age, are urged to seek psychiatric advice. Individual counseling with an expert in trauma may prove beneficial in allowing sexual abuse victims to overcome sexual difficulties and enjoy voluntary sexual experiences with a chosen partner.
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What causes Sexual Problems?
The causes of sexual difficulties can be physical, psychological, or both.
Emotional factors affecting sex include both interpersonal problems and psychological problems within the individual. Interpersonal problems include marital or relationship problems, or lack of trust and open communication between partners. Personal psychological problems include depression, sexual fears or guilt, or past sexual trauma.
Physical factors contributing to sexual problems include:
Drugs, such as alcohol, nicotine, narcotics, stimulants, antihypertensives (medicines that lower blood pressure), antihistamines, and some psychotherapeutic drugs (drugs that treat psychological problems such as depression)
Injuries to the back
An enlarged prostate gland
Problems with blood supply
Nerve damage (as in spinal cord injuries)
Disease (diabetic neuropathy, multiple sclerosis, tumors, and, rarely, tertiary syphilis)
Failure of various organs (such as the heart and lungs)
Endocrine disorders (thyroid, pituitary, or adrenal gland problems)
Hormonal deficiencies (low testosterone, estrogen, or androgens)
Some birth defects
Sexual dysfunctions are more common in the early adult years, with the majority of people seeking care for such conditions during their late 20s through 30s. The incidence increases again in the geriatric population, typically with gradual onset of symptoms that are associated most commonly with medical causes of sexual dysfunction.
Sexual dysfunction is more common in people who abuse alcohol and drugs. It is also more likely in people suffering from diabetes and degenerative neurological disorders. Ongoing psychological problems, difficulty maintaining relationships, or chronic disharmony with the current sexual partner may also interfere with sexual function.
Types of Sexual Problems
Sexual dysfunction disorders are generally classified into 4 categories:
sexual desire disorders
sexual arousal disorders
orgasm disorders, and
sexual pain disorders.
Sexual desire disorders (decreased libido) may be caused by a decrease in the normal production of estrogen (in women) or testosterone (in both men and women). Other causes may be aging, fatigue, pregnancy, and medications -- the SSRI anti-depressants which include fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil) are well known for reducing desire in both men and women. Psychiatric conditions, such as depression and anxiety, can also cause decreased libido.
Sexual arousal disorders were previously known as frigidity in women and impotence in men. These have now been replaced with less judgmental terms. Impotence is now known as erectile dysfunction, and frigidity is now described as female sexual dysfunction, a term that covers a range of several specific problems with desire, arousal, or anxiety.
For both men and women, these conditions may appear as an aversion to, and avoidance of, sexual contact with a partner. In men, there may be partial or complete failure to attain or maintain an erection, or a lack of sexual excitement and pleasure in sexual activity.
There may be medical causes for these disorders, such as decreased blood flow or lack of vaginal lubrication. Chronic disease may also contribute to these difficulties, as well as the nature of the relationship between partners. As the success of Viagra attests, many erectile disorders in men may be primarily physical, not psychological conditions.
Orgasm disorders are a persistent delay or absence of orgasm following a normal sexual excitement phase. The disorder occurs in both women and men. Again, the SSRI antidepressants are frequent culprits -- these may delay the achievement of orgasm or eliminate it entirely.
Sexual pain disorders affect women almost exclusively, and are known as dyspareunia (painful intercourse) and vaginismus (an involuntary spasm of the muscles of the vaginal wall, which interferes with intercourse). Dyspareunia may be caused by insufficient lubrication (vaginal dryness) in women.
Poor lubrication may result from insufficient excitement and stimulation, or from hormonal changes caused by menopause, pregnancy, or breast-feeding. Irritation from contraceptive creams and foams may also cause dryness, as can fear and anxiety about sex.
It is unclear exactly what causes vaginismus, but it is thought that past sexual trauma such as rape or abuse may play a role. Another female sexual pain disorder is called vulvodynia or vulvar vestibulitis. In this condition, women experience burning pain during sex which may be related to problems with the skin in the vulvar and vaginal areas. The cause is unknown.
Symptoms
Men or women:
Lack of interest in sex (loss of libido)
Inability to feel aroused
Pain with intercourse (much less common in men than women)
Men :
Inability to attain an erection
Inability to maintain an erection adequately for intercourse
Delay or absence of ejaculation, despite adequate stimulation
Inability to control timing of ejaculation
Women:
Inability to relax vaginal muscles enough to allow intercourse
Inadequate vaginal lubrication before and during intercourse
Inability to attain orgasm
Burning pain on the vulva or in the vagina with contact to those areas
Diagnosis
Specific physical findings and testing procedures depend on the form of sexual dysfunction being investigated. A complete history is usually taken and a physical examination performed to:
Identify predisposing illnesses or conditions
Highlight possible fears, anxieties, or guilt specific to sexual behaviors or performance
Uncover any history of prior sexual trauma
A physical examination of both the partners should include the whole body and not be limited to the reproductive system.
Call your doctor if:
Call for an appointment with your health care provider if sexual problems persist and are a concern.
Treatment Options
Treatment depends on the cause of the sexual dysfunction. Medical causes that are reversible or treatable are usually managed medically or surgically. Physical therapy and mechanical aides may prove helpful for some people experiencing sexual dysfunction due to physical illnesses, conditions, or disabilities.
For men who have difficulty attaining an erection, the medication sildenafil (Viagra), which increases blood flow to the penis, may be very helpful, though it must be taken 1 to 4 hours prior to intercourse.
Men who take nitrates for coronary heart disease should not take sildenafil. Mechanical aids and penile implants are also an option for men who cannot attain an erection and who find that sildenafil isn't helpful.
Women with vaginal dryness may be helped with lubricating gels, hormone creams, and -- in cases of premenopausal or menopausal women -- with hormone replacement therapy. In some cases, women with androgen deficiency can be helped by taking testosterone.
Vulvodynia can be treated with testosterone cream, with use of biofeedback, and with low doses of some antidepressants, which also treat nerve pain. Surgery has not been successful.
Behavioral treatments involve many different techniques to treat problems associated with orgasm and sexual arousal disorders. Self-stimulation and the Masters and Johnson treatment strategies are among the many behavioral therapies used.
Simple, open, accurate, and supportive education about sex and sexual behaviors or responses may be all that is required in many cases. Some couples may benefit from joint counseling to address interpersonal issues and communication styles. Psychotherapy may be required to address anxieties, fears, inhibitions, or poor body image.
Prevention
Open, informative, and accurate communication regarding sexual issues and body image between parents and their children may prevent children from developing anxiety or guilt about sex and may help them develop healthy sexual relationships.
Review all medications, both prescription and over-the-counter, for possible side effects that relate to sexual dysfunction. Avoiding drug and alcohol abuse will also help prevent sexual dysfunction.
Couples who are open and honest about their sexual preferences and feelings are more likely to avoid some sexual dysfunction. One partner should, ideally, be able to communicate desires and preferences to the other partner.
People who are victims of sexual trauma, such as sexual abuse or rape at any age, are urged to seek psychiatric advice. Individual counseling with an expert in trauma may prove beneficial in allowing sexual abuse victims to overcome sexual difficulties and enjoy voluntary sexual experiences with a chosen partner.
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Health
Mental health
Mental health refers to an individual's emotional and psychological well-being. "A state of emotional and psychological well-being in which an individual is able to use his or her cognitive and emotional capabilities, function in society, and meet the ordinary demands of everyday life."
One way to think about mental health is by looking at how effectively and successfully a person functions. Feeling capable and competent; being able to handle normal levels of stress, maintain satisfying relationships, and lead an independent life; and being able to "bounce back," or recover from difficult situations, are all signs of mental health.
Physical health
Physical fitness refers to good body health, and is the result of regular exercise, proper diet and nutrition, and proper rest for physical recovery.
A strong indicator of the health of localized population is their height or weight, which generally increases with improved nutrition and health care. This is also influenced by the standard of living and quality of life. Genetics also plays a major role in people's height. The study of human growth, its regulators, and implications is known as Auxology.
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Mental health refers to an individual's emotional and psychological well-being. "A state of emotional and psychological well-being in which an individual is able to use his or her cognitive and emotional capabilities, function in society, and meet the ordinary demands of everyday life."
One way to think about mental health is by looking at how effectively and successfully a person functions. Feeling capable and competent; being able to handle normal levels of stress, maintain satisfying relationships, and lead an independent life; and being able to "bounce back," or recover from difficult situations, are all signs of mental health.
Physical health
Physical fitness refers to good body health, and is the result of regular exercise, proper diet and nutrition, and proper rest for physical recovery.
A strong indicator of the health of localized population is their height or weight, which generally increases with improved nutrition and health care. This is also influenced by the standard of living and quality of life. Genetics also plays a major role in people's height. The study of human growth, its regulators, and implications is known as Auxology.
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