M. Nefarius. University of Texas at Tyler.

These are meetings for people who have a family member with a drinking problem cheap 250mg naprosyn with mastercard. DSM IV - American Psychiatric AssociationNational Institute on Alcohol Abuse and AlcoholismFor more in-depth information on signs-symptoms buy naprosyn 500 mg amex, causes and treatment of alcoholism buy discount naprosyn 250 mg line, click the "next" article below. For information on: Alcoholics: What is an alcoholic? Alcohol Abuse: Determining if you have a drinking problem and what do to about it. Effects of Alcohol: short and long-term, physical and psychological. Because drinking alcohol is woven into so many aspects of society in the United States, alcoholism symptoms can sometimes be overlooked. This first of the warning signs of alcoholism that should be carefully noted is: Does drinking cause problems in your life? If the answer to this is yes, then you have a problem with alcohol and it may be an alcoholism symptom. Tolerance is one of the defining symptoms of alcoholism. Tolerance to alcohol is when more and more alcohol is needed to achieve the same effect. For example, if a person finds that alcohol relaxes them, one of the warning signs of alcoholism is that the person needs more and more alcohol to feel relaxed. The second of the defining symptoms of alcoholism is the experience of alcohol withdrawal when not drinking. Withdrawal is negative physical symptoms that appear when not drinking alcohol. For example, one of the warning signs of alcoholism is when a person needs a drink first thing in the morning just to "get going". Alcoholism symptoms around withdrawl: may make a person extremely irritable, angry or depressed. Other alcoholism signs and symptoms related to withdrawal include:Symptoms of alcoholism include behaviors around the compulsive need to drink. The alcoholism signs and symptoms can generally be seen at home, at work and in daily life. Common warning signs of alcoholism include:Gulping drinks or ordering doubles to become intoxicated more quickly, to feel good or just to feel normalGiving up other activities such as sports or hobbies due to drinkingAlcohol becoming the main focus of daily life and taking up a lot of time and attentionAlcoholism screening test to help determine if you have a drinking problem, alcoholism or alcohol addiction. Answering these alcoholism test questions will take only a few minutes, and will generate personalized results based on your age, gender and drinking patterns. Your responses are completely confidential and anonymous. How many drinks containing alcohol do you have on a typical day when you are drinking? How often do you have six or more drinks on one occasion? How often during the last year have you found it difficult to get the thought of alcohol out of your mind? How often during the last year have you found that you were not able to stop drinking once you had started? How often during the last year have you been unable to remember what happened the night before because you had been drinking? How often during the last year have you needed a first drink in the morning to get yourself going after a heavy drinking session? How often during the last year have you had a feeling of guilt or remorse after drinking? Have you or someone else been injured as a result of your drinking? The AUDIT questionnaire was developed by the World Health Organization (1993) to screen for harmful or hazardous drinking patterns. A score of 8 or more is suggestive of problem drinking. Add up the points associated with your answers above. If your AUDIT score is 8 or above, take the results of this test and share them with your doctor. The following guidelines, questions, and scoring instructions are excerpted from Babor, T. AUDIT: The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Health Care. Geneva, Switzerland: World Health Organization, 1992. Screening with AUDIT can be conducted in a variety of primary care settings by persons who have different kinds of training and professional backgrounds.

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Another kind of antidepressant generic 250 mg naprosyn free shipping, a serotonin norepinephrine reuptake inhibitor (SNRI) like duloxetine (Cymbalta) is also common buy naprosyn 500mg amex. Benzodiazepines ??? these tranquilizers are often prescribed for short-term treatment of acute anxiety symptoms buy naprosyn 500mg low price. Long-term use is often a concern due to increasing tolerance and dependence on the drug. Common benzodiazepines include alprazolam (Xanax) and lorazepam (Ativan). Anticonvulsants ??? this antiseizure medication, like pregabalin (Lyrica), may be given long-term for anxiety disorder treatment. Antipsychotics ??? antipsychotics are often used in conjunction when other medications alone are not sufficient. Examples include risperidone (Risperdal) and aripiprazole (Abilify). Antihypertensives ??? this medication can lower blood pressure and reduce the physical symptoms of an anxiety disorder. This may be particularly useful in post-traumatic stress disorder (PTSD). Antianxiety agents ??? one medication, buspirone (BuSpar) is considered, specifically, an antianxiety medication. Therapy treatments are not cures for anxiety disorders either, but they can be very useful in eliminating anxiety disorder symptoms and changing anxiety-related thought patterns. Several types of therapy are used including:Cognitive behavioral therapy (CBT) can be delivered in-person of even via a computer program (known as FearFighter). CBT is particularly useful in panic and phobia disorders. Behavioral therapy has also been shown useful in clinical studies in treating anxiety disorder. Psychodynamic (talk or insight) therapy is rarely used as a standalone therapy for anxiety disorders unless there are complicating factors such as a history of abuse. Lifestyle changes may not cure an anxiety disorder but they can go a long way to relieving some of the anxiety disorder symptoms. Lifestyle changes are best used in conjunction with other treatments to attain their full benefit. Lifestyle changes that help rid someone of anxiety disorder symptoms include:Dietary changes such as avoiding caffeineGetting more exercise and proper restLearning to meditate, practice mindfulness or do relaxation exercisesLearning skills with which to better handle stressA list of anxiety medications includes several types of medication including antidepressants, antipsychotics, beta blockers and benzodiazepines. The antianxiety medication list below includes all drugs approved by the FDA for the treatment of anxiety disorders as well as those commonly prescribed off-label. Only one drug is of the antianxiety medication class: Buspirone (BuSpar). This drug is approved for anxiety disorders (in general). Antidepressants are typically the first choice treatment for anxiety. A list of common, modern antidepressant anxiety medication that works on the brain chemicals serotonin and norepinephrine includes: Citalopram (Celexa) ???off label for panic disorder, social phobia and trichotillomaniaDuloxetine (Cymbalta) ??? approved for generalized anxiety disorder (GAD)Escitalopram (Lexapro) ??? approved for GADFluoxetine (Prozac) ??? approved for OCD and panic disorderFluvoxamine (Luvox) - approved for OCD in children (8-17 y) and adultsParoxetine (Paxil) ??? approved for obsessive-compulsive disorder (OCD), panic disorder, social phobia, GAL and posttraumatic stress disorder (PTSD)Sertraline (Zoloft) ??? approved for panic disorder, PTSD, social phobia and OCDTrazodone (Desyrel) ??? off label for panic disordersVenlafaxine (Effexor XR) - approved for GAD, panic disorder and social anxiety disorder in adultsAn older type of antidepressant called a tricyclic antidepressant is also sometimes used to treat depression. Tricyclics act on more chemicals in the brain and are more likely to cause side effects so they are not typically a first choice treatment. A list of tricyclic antidepressants used to treat anxiety includes: Clomipramine (Anafranil) ??? approved for OCDDesipramine (Norpramin) ??? off label for panic disorderDoxepin (Sinequan) ??? off label for GADImipramine (Tofranil)- off label for panic disorderList of Monoamine Oxidase Inhibitor Drugs for AnxietyAnother powerful, older class of antidepressants is also used to treat anxiety. These monoamine oxidase inhibitors (moai) are not first choice treatments but may be useful where other treatments have failed. A list of monoamine oxidase inhibitors used to treat anxiety includes: Isocarboxazid (Marplan) ??? off label for social phobiaPhenelzine (Nardil) ??? off label for panic disorders and social phobiaSelegiline (Emsam) ??? off label for social phobiaTranylcypromine (Parnate) ??? off label for social phobiaBenzodiazepines are commonly used to treat short-term anxiety or for acute anxiety episodes. They are not typically used long-term due to concerns about benzodiazepine tolerance, dependence and abuse. A list of benzodiazepines includes: Alprazolam (Xanax) ??? approved for GAD, panic disorder; used off-label for agoraphobia with social phobiaChlordiazepoxide (Librium) ??? approved for anxiety (in general)Clonazepam (Klonopin) ??? approved for panic disorder; used off label for anxiety (in general)Diazepam (Valium) ??? approved for anxiety (in general)Lorazepam (Ativan) ??? approved for anxiety disorders (in general)Oxazepam (Serax) ??? approved for anxiety (in general)While considered investigational, some anticonvulsants (antiseizure medication) are being used to treat anxiety. A list of anticonvulsants used to treat anxiety off label include: Divalproex (Depakote, Depakote ER)These drugs are known as antihypertensive medication because they lower blood pressure. Beta-blockers and others reduce the physical symptoms of anxiety. A list of beta-blockers includes:Atenolol (Tenormin) off label for situational/performance anxietyNadolol (Corgard) ??? off label for situational/performance anxietyPropranolol (Inderal, Betachron E-R, InnoPran XL) ??? off label for panic disorder, situational/performance anxiety, posttraumatic stress disorder and anxiety in generalAntipsychotic drugs are often used in combination with other anxiety medication. They are a second-line option due to the possibility of severe side effects. A list of antipsychotic drugs used to treat anxiety includes:1Molindone (Moban) ??? research suggests antianxiety propertiesOlanzapine (Zyprexa)???off label use for anxiety (in general)Quetiapine (Seroquel) ??? pending FDA-approval for GADRisperidone (Risperdal) ??? off label use for anxiety (in general)HTTP/1. Family members of those with PTSD may also benefit from these PTSD recovery resources.

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Deep brain stimulation is currently FDA approved for the treatment of:Essential tremor (a degenerative neurological disorder)Dystonia (a neurological movement disorder)Deep brain stimulation for depression and other disorders is currently in clinical trials order naprosyn 500 mg fast delivery. For depression order 250mg naprosyn, deep brain stimulation uses electricity to stimulate the part of the brain that controls mood buy naprosyn 250mg with visa. Deep brain simulation requires the implantation of electrodes in the brain as well as the implantation of an electrical generator in the chest. In the first part of the deep brain stimulation implantation procedure, the electrodes are placed in the brain. This is done through two small holes that are drilled into the skull. The patient is awake during the surgery but feels no pain due to the administration of a local anesthetic and because the brain itself has no pain receptors. In the second part of the surgery, the patient is under general anesthesia; the deep brain stimulator is implanted and the electrodes are connected to it by wires known as deep brain stimulator is known as a pulse generator and is implanted into the chest. The pulse generator must be surgically replaced when the battery runs out, about every 6-18 months. Once the deep brain stimulation surgery is complete, the pulse generator is turned on about one week later. Stimulation of the brain is generally constant once the device is turned on. As implanting a deep brain stimulation device involves two surgeries ??? including one in the brain ??? deep brain stimulation can be risky. There are known complications both from the surgery, as well as from the deep brain stimulation itself. Side effects of deep brain stimulation implantation include:Bleeding in the brain (hemorrhage)After surgery, deep brain stimulation side effects include:Unwanted mood changes, such as mania and depressionAllergic reaction to the implantJolting or shocking sensationTemporary pain and swelling at the implantation siteAs deep brain stimulation for treatment of depression is not approved, at this time it is only available through clinical trials. When deep brain stimulation is used for other disorders, it can cost up to $150,000 or more. You may be surprised to learn electroconvulsive therapy (ECT) is still being practiced in most, if not all, psychiatric units in general hospitals and mental institutions. ECT is the procedure of stimulating the brain through the use of an electrical current applied directly to the skull. The original use of electricity as a cure for "insanity" dates back to the beginning of the 16th century when electric fish were used to treat headaches. In 1938, two Italian researchers, Ugo Cerletti and Lucio Bini, were the first to use an electric current to induce a seizure in a delusional, hallucinating, schizophrenic man. The man fully recovered after 11 treatments which led to a rapid spread of the use of ECT as a way to induce therapeutic convulsions in the mentally ill. Many years ago when psychiatry was less advanced, ECT was used for a much wider range of mental illnesses and sometimes, unfortunately, it was used to control troublesome patients. Patients who went through ECT might also have suffered broken bones before the advent of modern anesthesia and muscle paralytics. Today, the American Psychiatric Association has very specific guidelines for the administration of ECT. Electroconvulsive therapy is to be used only to treat severe, debilitating mental disorders and not to control behavior. In most states, written and informed consent is required. The doctor must explain in detail to the patient, and / or family, the reasons why ECT is being considered along with the potential electroconvulsive therapy side effects. Electroconvulsive therapy is generally used in severely depressed patients for whom psychotherapy and depression medication have proven ineffective. As ECT has much quicker antidepressant effects than medication, it may also be considered when there is an imminent risk of suicide. Electroconvulsive therapy is often performed on an inpatient basis, although maintenance ECT may be performed once a week or so as an outpatient. You can watch these ECT videos for a better perspective on modern day ECT. The patient is required to fast for 8-12 hours prior to a treatment of ECT. Involved in the administration of ECT are usually a psychiatrist, anesthesiologist and other supportive medical personnel. The patient is anesthetized with an intravenous injection and then injected with a drug that causes paralysis, to prevent the jerking motions of a seizure. The heart rate and other vital signs are monitored throughout the ECT treatment.

Endocrine System -- Infrequent: diabetes mellitus cheap naprosyn 500 mg line; Rare: diabetic acidosis and goiter purchase 250 mg naprosyn with amex. Hemic and Lymphatic System -- Inrequent: anemia 500mg naprosyn with visa, cyanosis, leukocytosis, leukopenia, lymphadenopathy, and thrombocytopenia; Rare: normocytic anemia and thrombocythemia. Metabolic and Nutritional Disorders -- Inrequent: acidosis, alkaline phosphatase increased, bilirubinemia, dehydration, hypercholesteremia, hyperglycemia, hyperlipemia, hyperuricemia, hypoglycemia, hypokalemia, hyponatremia, lower extremity edema, and upper extremity edema; Rare: gout, hyperkalemia, hypernatremia, hypoproteinemia, ketosis, and water intoxication. Musculoskeletal System -- Frequent: joint stiffness and twitching; Inrequent: arthritis, arthrosis, leg cramps, and myasthenia; Rare: bone pain, bursitis, myopathy, osteoporosis, and rheumatoid arthritis. Nervous System -- Frequent: abnormal dreams, amnesia, delusions, emotional lability, euphoria, manic reaction, paresthesia, and schizophrenic reaction; Inrequent: akinesia, alcohol misuse, antisocial reaction, ataxia, CNS stimulation, cogwheel rigidity, delirium, dementia, depersonalization, dysarthria, facial paralysis, hypesthesia, hypokinesia, hypotonia, incoordination, libido decreased, libido increased, obsessive compulsive symptoms, phobias, somatization, stimulant misuse, stupor, stuttering, tardive dyskinesia, vertigo, and withdrawal syndrome; Rare: circumoral paresthesia, coma, encephalopathy, neuralgia, neuropathy, nystagmus, paralysis, subarachnoid hemorrhage, and tobacco misuse. Respiratory System -- Frequent: dyspnea; Inrequent: apnea, asthma, epistaxis, hemoptysis, hyperventilation, hypoxia, laryngitis, and voice alteration; Rare: atelectasis, hiccup, hypoventilation, lung edema, and stridor. Skin and Appendages -- Frequent: sweating; Inrequent: alopecia, contact dermatitis, dry skin, eczema, maculopapular rash, pruritus, seborrhea, skin discoloration, skin ulcer, urticaria, and vesiculobullous rash; Rare: hirsutism and pustular rash. Special Senses -- Frequent: conjunctivitis; Inrequent: abnormality of accommodation, blepharitis, cataract, deafness, diplopia, dry eyes, ear pain, eye hemorrhage, eye inflammation, eye pain, ocular muscle abnormality, taste perversion, and tinnitus; Rare: corneal lesion, glaucoma, keratoconjunctivitis, macular hypopigmentation, miosis, mydriasis, and pigment deposits lens. Urogenital System -- Frequent: vaginitis * ; Inrequent: abnormal ejaculation *, amenorrhea *, breast pain, cystitis, decreased menstruation *, dysuria, female lactation *, glycosuria, gynecomastia, hematuria, impotence *, increased menstruation *, menorrhagia *, metrorrhagia *, polyuria, premenstrual syndrome *, pyuria, urinary frequency, urinary retention, urinary urgency, urination impaired, uterine fibroids enlarged *, and vaginal hemorrhage * ; Rare: albuminuria, breast enlargement, mastitis, and oliguria. Following is a list of terms that reflect treatment-emergent adverse events reported by patients treated with intramuscular olanzapine for injection (at one or more doses >/=2. This listing may not include those events already listed in previous tables or elsewhere in labeling, those events for which a drug cause was remote, those event terms which were so general as to be uninformative, and those events reported only once which did not have a substantial probability of being acutely life-threatening. Events are further categorized by body system and listed in order of decreasing frequency according to the following definitions: frequent adverse events are those occurring in at least 1/100 patients (only those not already listed in the tabulated results from placebo-controlled trials appear in this listing); infrequent adverse events are those occurring in 1/100 to 1/1000 patients. Body as a Whole -- Frequent: injection site pain; Infrequent: abdominal pain and fever. Cardiovascular System -- Infrequent: AV block, heart block, and syncope. Digestive System -- Infrequent: diarrhea and nausea. Metabolic and Nutritional Disorders -- Infrequent: creatine phosphokinase increased, dehydration, and hyperkalemia. Nervous System -- Infrequent: abnormal gait, akathisia, articulation impairment, confusion, and emotional lability. Adverse events reported since market introduction that were temporally (but not necessarily causally) related to ZYPREXA therapy include the following: allergic reaction (e. Random cholesterol levels of >/=240 mg/dL and random triglyceride levels of >/=1000 mg/dL have been rarely reported. In studies prospectively designed to assess abuse and dependence potential, olanzapine was shown to have acute depressive CNS effects but little or no potential of abuse or physical dependence in rats administered oral doses up to 15 times the maximum recommended human daily oral dose (20 mg) and rhesus monkeys administered oral doses up to 8 times the maximum recommended human daily oral dose on a mg/m 2 basis. Olanzapine has not been systematically studied in humans for its potential for abuse, tolerance, or physical dependence. While the clinical trials did not reveal any tendency for any drug-seeking behavior, these observations were not systematic, and it is not possible to predict on the basis of this limited experience the extent to which a CNS-active drug will be misused, diverted, and/or abused once marketed. Consequently, patients should be evaluated carefully for a history of drug abuse, and such patients should be observed closely for signs of misuse or abuse of olanzapine (e. In premarketing trials involving more than 3100 patients and/or normal subjects, accidental or intentional acute overdosage of olanzapine was identified in 67 patients. In the patient taking the largest identified amount, 300 mg, the only symptoms reported were drowsiness and slurred speech. In the limited number of patients who were evaluated in hospitals, including the patient taking 300 mg, there were no observations indicating an adverse change in laboratory analytes or ECG. Vital signs were usually within normal limits following overdoses. In postmarketing reports of overdose with olanzapine alone, symptoms have been reported in the majority of cases. In symptomatic patients, symptoms with >/=10% incidence included agitation/aggressiveness, dysarthria, tachycardia, various extrapyramidal symptoms, and reduced level of consciousness ranging from sedation to coma. Among less commonly reported symptoms were the following potentially medically serious events: aspiration, cardiopulmonary arrest, cardiac arrhythmias (such as supraventricular tachycardia and one patient experiencing sinus pause with spontaneous resumption of normal rhythm), delirium, possible neuroleptic malignant syndrome, respiratory depression/arrest, convulsion, hypertension, and hypotension. Eli Lilly and Company has received reports of fatality in association with overdose of olanzapine alone. In one case of death, the amount of acutely ingested olanzapine was reported to be possibly as low as 450 mg; however, in another case, a patient was reported to survive an acute olanzapine ingestion of 1500 mg. The possibility of multiple drug involvement should be considered. In case of acute overdosage, establish and maintain an airway and ensure adequate oxygenation and ventilation, which may include intubation. Gastric lavage (after intubation, if patient is unconscious) and administration of activated charcoal together with a laxative should be considered.