Antidepressants and East-West comparison

[Guest guest]

Unless one has lived in the West and in India and practised in both the

countries, One thing we must absolutely desist from is this holier-than-thou

attitude regarding life style or practise of medicine in either hemispheres.

 

Yes, depression is a recognized disease in the west, and is treated,mostly

timely. In India, it is not even recognized and is usually not treated due to

social non-acceptance. This is a legitimate question, whether the fetus has a

withdrawal and perhaps even convulsions, and manifestes as fetal distress.

regardless of the cause of the distress, that would be an indication for

C-Section, since we do not have any way of monitoring fetal EEG yet.

 

There are hundreds of women in the West who do not take any medications during

pregnancy. And although usually there is protection of the woman by the family

in India, there are lots of women who do not get along with their in-laws, and

are deprived of it.

 

Instead of generalizing all these issues as the West is bad, or India is bad,

depending on the issues, let us look at all the issues impartially, if we have

to learn something from these columns. Not everyone raises their children in the

West to become Footballers or Boxers, and not all Indians raise their kids to be

Yogis. There is a strong movement in the West to become "herbally conscious" and

at the same time, Ayurveda does not have all the answers either.

 

Let us stay away from such comparisons.

 

Durgesh Mankikar,MD

 

 

in ayurveda shirishbhate wrote:

 

 

Infants of women who took antidepressants while pregnant, might

experience symptoms of withdrawal, including convulsions, according

to a study published in the Feb. 4 issue of the journal Lancet. Dr.

Emilio Sanz of La Laguna Medical School in Spain and colleagues

analyzed a World Health Organization database on adverse drug

reactions recorded since 1968, specifically looking for reports on

newborns who had been exposed to antidepressants in utero and

experienced symptoms at birth such as fever, quickened breathing

and "heightened agitation". The researchers found more than 100 such

cases in the WHO database and concluded that 93 could be "linked

strongly" to antidepressants based on original medical reports, as

reported in (Carey, New York Times, 2/4). In 13 of the 93 cases, the

infants also experienced convulsions -- a reaction that has not

been "widely" documented in adults who cease using antidepressants,

according to the Times. The researchers concluded that the recorded

symptoms were "more common than would be expected by chance". Paxil,

known generically as paroxetine, was most commonly associated with

withdrawal symptoms, but Celexa, Prozac and Zoloft also were linked

to withdrawal symptoms.

 

Recommendations, Reaction

 

According to Sanz, Paxil "should not be used in pregnancy, or if

used, should be given at the lowest effective dose" (Peres, Chicago

Tribune, 2/4). Approximately 10% to 15% of women experience some

depression during pregnancy, and about 25% of those women take

antidepressants, according to the Times. If left untreated, women who

experience depression during pregnancy also might be at an increased

risk of postpartum depression -- a potentially "devastating"

condition than can "cloud the relationship between mother and child"

and "interfere with the child's social development," the Times

reports (New York Times, 2/4). Therefore, some doctors "reacted with

caution" to the study, the Tribune reports. In an accompanying Lancet

opinion piece, Dr. Vladislav Ruchkin, a child psychiatrist at Yale

University, writes that a "precipitous shift away from widespread

prescription of [antidepressants] is not called for and would do much

more damage than good." However, he adds that "doctors should be more

careful" in prescribing such medications to pregnant women (Chicago

Tribune, 2/4). Dr. Patrick O'Brien, a consulting obstetrician at

University College London Hospital, said, "My advice is that if you

can avoid medication in pregnancy do, but without a doubt there will

be women who should be taking medication for depression during their

pregnancy" (BBC News, 2/4). Until further research is available, Sanz

and colleagues said that doctors should use alternative therapies to

treat depression in pregnant women and review prescription doses

(Reaney, Reuters, 2/4).

 

This author has discussed various simple remedies to be used in case

of depression in past. A cured case who followed these, is also

reported on the archieves earlier. Indian pregnant women are very

reluctant to take any medicines during pregnancy even herbal, and

they are well cared by joint family system, with daily showering of

love and advise by elderlies. Mother-in-law and daughter-in-law, if

they have sore relationship normally, the sourness and soreness melts

during pregnancy. Due to this, depression during pregnancy or even

Post-partum, is relatively unheard in India. Time has come for rest

of the world to follow either simple herbal regime or contented love-

filled lifestyle of oriental culture.

 

Dr Bhate

[Guest guest]

Dear Dr. Mankikar and all esteemed Vaidyas and group memebers;

 

Living in the US and working with Ayurved for postpartum mothers, also

having students of same, I am following all news and discussion of

this topic with interest, and feeling that you vaidyas all have SO

MUCH to offer the allopathic model of medicine.

 

I have seen depression so easily managed with ayurveda too, with or

without the whole extended family support. I also find as part of my

couseling with these parents that they are in excellent receptivity to

expand their appreciation of extened family, whether by communications

with blood family or more often the creative means of giving them

ideas how to involve their frienship/work/spiritual local community.

We work with all these things in our counseling. But the central

effectiveness information is about resetting diet/lifestyle and some

of the more well known anyrvedic herbs. It is such great results.

 

I personally am very concerned about the antidepressant use and side

effects in theis couhntry, and welcome all posts on the subject; each

one adds. I have been collecting/educating myself and am asking for

more understanding of the chemistry of why the SSRI's are such a

problem (if you look for instance at www.drugawareness.org point of

view adn research/reports) compared to why natural serotonin

increasing herbs and foods are so wonderful! THis needs to be

defined I beleive to make the needed progress easier. Is it about the

ama of excess serotonin with the SSRI's, or is it more about the

situations of weak agni/low and poor lipid intake/high ama/blood sugar

problems and other factors as even I am familiar with just not being

addressed that are bigger factors than the acctual (extremely high)

accumulations of serotonin that result from SSRI use in the brain

tissue (and tend to download in extremely high doses weeks, even 6

months after discontinuing) which create the many bad side effects?

How does the cortisol increasing effect of SSRI's relate to the

apparent cortisol reducing effects of the herbs lilke shankapushpi,

ashwaghanda, arjuna, milk, and other serotonin increasing natural

substances? These are some of my questions I will keep asking until I

find answers.

 

This quoted report: Dr. Patrick O'Brien, ... said, "My advice is that

if you can avoid medication in pregnancy do, but without a doubt there

willbe women who should be taking medication for depression during

theirpregnancy" (BBC News, 2/4). UNTIL FURTHER RESEARCH IS AVAILABLE,

Sanzand colleagues said that doctors should use alternative therapies

totreat depression in pregnant women and review prescription doses

(Reaney, Reuters, 2/4).

 

THis report as well as mine is among many calls for those of you who

have medical credentials, and I would guess also good research in

India on the subject? to please come forward however you may be able.

 

There is much grant moneys in the US on the subject of finding answers

to Postpartum depression, etc. I have interviewed a woman about what

it takes to do a research grant and am realizing for me ... it may not

be my place. Although I would love to be involved in some such

research for my postpartum work with Ayurveda. An easi4er way to

begin getting the word out in my opinion is as offered speakers at

conferences, presenting research papers papers at same, (can also be

submitted at the medical, ayurveda, alternative medicine and wholistic

health conferences in the US) and MORE SIMPLY ALSO, in the many goodof

journals looking for articles of real significant news to us here.

 

Around the world, mothers are understood to be such a central

organizing principle to the helath and happiness of a culture - tho

unfortunately not enough here, still many know, and are asking for

help in these ways. The call is apparent with our statistics on

depression. I hope this may inspire a little more? MAny thanks even

for your attention. I have been told that what we put our attention

on grows - so many thanks for reading, feeling and praying.

 

Namaste;

Martha

[Guest guest]

>

> I personally am very concerned about the antidepressant use and side

> effects in theis couhntry, and welcome all posts on the subject;

 

depression is a multifaceted condition that needs a multifaceted

approach

the failure of SSRIs is the reduction of a complex issue to a simple

argument about neurotransmitters - its not even reflective of the

actual state of the science, but it demonstrates the strangle-hold that

drug companies have on doctor's minds - i remember one advert for an

SSRI in a medical journal that had an image of a woman, clutching her

head in obvious emotional distress, and in the background a doctor

leaning against his brand new SUV!! you draw your own conclusions!

 

in contrast to the single-origin theory of depression, and the potent

and highly specific activity of SSRIs, you cannot reduce 99% of herbs

to a single pharmaceutical effect, such as serotonin release or

cortisol release, because they contain hundreds of active metabolites

that elicit state-specific responses - that's the whole point of having

an energetic understanding of health, such as tridosha, ying-yang,

somatotyping etc. etc., and the specific qualities (dravyguna) of even

one "class" of herbs, e.g. medhya rasayanas

 

some of your questions simply require more research

but if in need of clinically proven alternatives to MD-prescribed

SSRIs, give your depressed patient's St. John's Wort, as per this most

recent study

 

St. John's Wort as Effective as Paroxetine for Major Depression

 

NEW YORK (Reuters Health) Feb 10 - Extract of Hypericum perforatum (St.

John's wort) is at least as effective as paroxetine (Paxil,

GlaxoSmithKline) for the treatment of moderate to severe major

depression, while being better tolerated, Germany investigators report

in the British Medical Journal, published online on February 10.

 

Dr. Meinhard Kieser, at Dr Willmar Schwabe Pharmaceuticals in

Karlsruhe, and his associates enrolled outpatients in 21 clinics. All

scored 22 points or higher on the 17-item Hamilton depression scale. A

total of 125 were randomly assigned to hypericum extract WS 5570 300 mg

t.i.d. and 126 to paroxetine 20 mg q.d. Doses were doubled after 2

weeks if depression score had not improved by at least 20%.

 

After 42 days, Hamilton depression scores declined by 14.4 points in

the hypericum group and 11.4 points in the paroxetine group

(corresponding to decreases of 57% and 45%, respectively), a difference

that the authors call "clinically relevant."

 

Responder rates were 70% and 60%, respectively, and remission rates

were 50% and 35%. The authors observed differences favoring hypericum

in secondary measures, including Montgomery-Asperg depression rating

scale, Beck depression inventory and clinical global impressions.

 

During the trial, there were 172 adverse events reported in 55% of

those in the hypericum group, and 269 reported by 76% in the paroxetine

group.

 

"Our results support the use of hypericum extract WS 5570 as an

alternative to standard antidepressants in moderate to severe

depression, especially as it is well tolerated," Dr. Kieser's group

concludes.

 

BMJ 2005.

 

Caldecott

http://www.toddcaldecott.com

todd