Serotonin
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Gravide kvinder med depression bør overveje psykoterapi frem for psykofarmaka som behandling, i følge en rapport fra American Psychiatric Association og American College of Obstetricians and Gynecologists, der er blevet publiceret i tidsskriftet General Hospital Psychiatry.
Rapporten advarer om at ved en ubehandlet depression bør risikoen for fosteret også tages i betragtning, fordi deprimerede gravide kvinder kan have mere stress og være dårlige til at tage vare på sig selv, hvilket kan påvirke fostrets udvikling. I følge anbefalingerne bør gravide kvinder, der har oplevet moderate til svære depressive symptomer, herunder selvmordstanker, eller har haft gentagne episoder af depression, fortsætte med at tage medicin.
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Tags: american college of obstetricians and gynecologists, american psychiatric association, antidepressiva, behandling, børn, depression, fontex, gravide, graviditet, guideline, kvinder, psykiatri, psykofarmaka, psykoterapi, pulmonary hypertension, selvmord, Serotonin, sertralin, sertraline, ssri, stress, yale university, yonkers, zoloft
Forskere ved University of Minnesota Medical School har opdaget, at en anti-oxidant kan hjælpe til at stoppe trangen hos dem med trikotillomani, en lidelse karakteriseret ved kompulsiv (tvangsmæssig) hårudtrækken.
Undersøgelsen er publiceret i juli 2009 udgaven af Archives of General Psychiatry.
Trikotillomani er en invaliderende tilstand, hvor enkeltpersoner gentagne gange trækker hår ud, hvilket fører til et mærkbart hårtab. Trikotillomani er karakteriseret ved følgende diagnostiske kriterier: tilbagevendende at trække sit hår ud, hvilket resulterer i et mærkbart hårtab; en stigende følelse af spænding, umiddelbart før man trækker sit hår ud eller når man forsøger at modstå trangen; og glæde, tilfredsstillelse eller lettelse når man trækker et hår ud. Psykosociale problemer er almindelige hos personer med trikotillomani og omfatter endvidere betydelig nedsat livskvalitet, nedsat arbejdsevne og produktivitet og nedsat social funktion.
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Tags: anti oxidant, archives of general psychiatry, impulse control disorders, jon grant, misbrug, n acetylcysteine, nac, placebo, psykiatri, Serotonin, skade, trang, Trikotillomani, university of minnesota medical
Et nyt studie publiceret i Nature tidskriftet Molecular Psychiatry har påvist at intensiv kognitiv adfærds terapi kan ændre aktiviteten i bestemte områder af hjernen. Den opdagelse kan have vigtig klinisk indflydelse på udviklingen af den fremtidige psykoterapi. Ved daglig terapi over fire uger fandt man signifikante ændringer i regioner af hjerne ved behandling af OCD (obsessive-compulsive disorder).
Tidligere scanningsstudier af OCD har påvist at den øget aktivitet i frontal-subcortical kredsløb i hjernen reduceres som svar på behandling med nyere antidepressiva (SRI) eller kognitiv adfærdsterapi.
Før antog man at kliniske forbedringer ved OCD krævede 12 ugers behandling med enten kognitiv adfærdsterapi eller medicinsk behandling med antidepressiva.
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Tags: antidepressiva, anxiety disorder, behandling, brain researchers, clinical improvements, cognitive behavioral therapy, depression, intensiv, intensive treatment, kognitiv, kognitiv adfærdsterapi, molecular psychiatry, obsessive compulsive disorders, OCD, psykoterapi, scanning, Serotonin
A senior lecturer at Tel Aviv University, Dr. Dannon is known worldwide for work in the area of gambling and addiction, a major research focus for him since 1995. His first article on kleptomania was published in 1996. He will present his new research findings on addiction at the National Gambling Council’s meeting in Las Vegas this November.
Is your first craving in the morning for your computer mouse? Do you obsessively check email in the middle of the night?
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Tags: addictive disorders, anxiety, dannon, depression, faculty of medicine, handwashing, Internet addiction, internet addiction disorder, internet surfers, isolation, mental health condition, national gambling, obsessive compulsive disorder, OCD, pathological condition, sackler faculty, Serotonin, sex addiction, stress, teenager, US
Sekretariatet for Referenceprogrammer under Sundhedsstyrelsen, der er Sundhedsministeriets faglige vejleder, har valgt at iværksætte et referenceprogram for angsttilstande hos voksne. Man har valgt at inddrage OCD-foreningen og Angstforeningen i arbejdet. Når man udarbejder et referenceprogram inddrager man behandlere og brugere med mest viden og erfaring på området, hvorefter man udarbejder et referenceprogram, hvorved “forstås en systematisk beskrivelse af de elementer, som bør indgå i undersøgelse, behandling, pleje, rehabilitering og forebyggelse af en bestemt sygdom eller et kompleks af symptomer på grundlag af dokumenteret viden.” (Sekretariatet for Referenceprogrammer‘ egen definition). Sekretariatet for Referenceprogrammer opslag om referenceprogram for Angsttilstande hos voksne er følgende: Læs resten af dette indlæg »
Tags: ADHD, angst, angsttilstande, anxiety disorder, body dysmorphic disorder, CBT, cognitive behavioral therapy, consensus, depression, dokumentation, evidence, guideline, litteratur, obsessive compulsive disorder, OCD, psykiatri, psykolog, Psykologi, referenceprogram, Serotonin, SRIs, stress, treatment options, vejledninger
Det ser ud til at brug af SSRI (de nye antidepressiva) under sidste del af graviditeten er mere problematisk end først antaget. Lægemiddelstyrelsen refererer en artiklel fra New England Journal of Medicin, hvor det fremgår at der er en mindre forøget dødelighed hos nyfødte, men samtidig at der kræves yderligere forskning på området.
Samtidig skal det bemærkes at det også ser ud til at nyfødte af mødre, der tager SSRI sidst i graviditeten kan have Neonatal Abstinence Syndrome (NAS), når fosteret eksponeres for SSRI sidst i graviditeten. Efterfølgende vil nogle spædbørn udvise abstinenssymptomer.
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Tags: abstinence, abstinenssymptomer, angst, antidepressant drugs, antidepressiva, børn, depression, kvinder, neonatal abstinence syndrome, new england journal of medicin, OCD, reuptake inhibitor, Serotonin, ssri
New research article publised in Archives of Pediatrics and Adolescent Medicine about neonatal abstinence syndrome (NAS). Its when an infant is exposed to selective serotonin reuptake inhibitors (SSRIs) (New Antidepressiva) like Zoloft, Paxil/Seroxat etc. during pregnancy. After birth the infant is at risk for developing neonatal abstinence syndrome (NAS), a withdrawal disorder characterized by high-pitched crying, tremors, and disturbed sleep, new research suggests.
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Tags: antidepressiva, neonatal abstinence syndrome, paroxetine, paxil, prolonged exposure, selective serotonin reuptake inhibitors, Serotonin, seroxat, SRIs, ssri, venlafaxine
OCD suffers not responding to standard drug and CBT treatment might get greater symptom improvement with high-dose drug treatment. 
The Journal of Clinical Psychiatry has published a research article about high-dose treatment:
High-Dose Sertraline Strategy for Nonresponders to Acute Treatment for Obsessive-Compulsive Disorder: A Multicenter Double-Blind Trial Objective: To evaluate the efficacy and safety of high-dose sertraline for patients with obsessive-compulsive disorder (OCD) who failed to respond to standard sertraline acute treatment.
Method: Sixty-six nonresponders to 16 weeks of sertraline treatment who met DSM-III-R criteria for current OCD were randomly assigned, in a double-blind continuation phase of a multicenter trial, either to continue on 200 mg/day of sertraline or to increase their dose to between 250 and 400 mg/day for 12 additional weeks. Efficacy measures included the Yale-Brown Obsessive Compulsive Scale (YBOCS), the National Institute of Mental Health Global Obsessive Compulsive Scale (NIMH Global OC Scale), and the Clinical Global Impressions-Severity of Illness and -Improvement (CGI-I) scales. Data were collected from July 26, 1994, to October 26, 1995.
Results: The high-dose (250-400 mg/day, mean final dose= 357, SD = 60, N = 30) group showed significantly greater symptom improvement than the 200-mg/day group (N = 36) as measured by the YBOCS (p=.033), NIMH Global OC Scale (p = .003), and CGI-I (p = .011). Responder rates (decrease in YBOCS score of > = 25% and a CGI-I rating < = 3) were not significantly different for the 200-mg/day versus the high-dose sertraline group, either on completer analysis, 34% versus 52%, or on endpoint analysis, 33% versus 40%. Both treatments showed similar adverse event rates.
Conclusion: Greater symptom improvement was seen in the high-dose sertraline group compared to the 200-mg/day dose group during continuation treatment. Both dosages yielded similar safety profiles. Administration of higher than labeled doses of selective serotonin reuptake inhibitors may be a treatment option for certain OCD patients who fail to respond to standard acute treatment.
(J Clin Psychiatry 2006;67:15-22) The research is rather old, done back in 1995 and another thing is its sponsored by Pfizer, the maker of the SSRI sertraline (Zoloft). At the other hand high-dose treatment is not a new thing and drugs like clomipramine (Anafrenil) and paroxetine (Paxil/Seroxat) have been tested too and proven effective. Evidence-based pharmacotherapy of obsessive-compulsive disorder. Fineberg NA, Gale TM., Int J Neuropsychopharmacol. 2005 Mar;8(1):107-29. Epub 2004 Sep 28. Read the entire article at the journals homepage A qualitative analysis of nonresponse: management of treatment-refractory obsessive-compulsive disorder, Pallanti S, Hollander E, Goodman WK., J Clin Psychiatry. 2004;65 Suppl 14:6-10.
Tags: acute treatment, CBT, evidence, institute of mental health, journal of clinical psychiatry, multicenter trial, NIMH, obsessive compulsive disorder, OCD, paroxetine, paxil, pharmacotherapy, selective serotonin reuptake inhibitors, Serotonin, serotonin reuptake inhibitors, seroxat, sertraline, ssri
Today The National Institute for Health and Clinical Excellence (NICE) in England published a new guidelines set to improve identification,diagnosis and treatment of obsessive-compulsive disorder in children and adults.
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Tags: andrew dillon, body dysmorphic disorder, CBT, child, clinical psychology, cognitive behaviour therapy, cognitive behavioural, cognitive behavioural therapy, depression, England, guideline, intrusive thoughts, Maudsley, national collaborating centre, OCD, psychological therapies, response prevention, Serotonin, social phobia, SRIs, ssri, tim kendall, treatment of obsessive compulsive disorder
A new very interesting book is being published july 2005.
Handbook of OCD: Concepts and Controversies
Jonathan S. Abramowitz (Editor), Arthur C. Houts (Editor)
Product Details:
Concepts and Controversies in Obsessive-Compulsive Disorder
Series: Series in Anxiety and Related Disorders,
Abramowitz, Jonathan S.; Houts, Arthur C. (Eds.)
2005, XIV, 803 p. 5 illus., Hardcover
Publisher: Springer-Verlag New York Inc.
You can pre-order it at amazon.co.uk
Here is some information about the book:
Synopsis
Few conditions are as fascinating to a psychologist as obsessive-compulsive disorder (OCD), and few generate as much controversy. Experts disagree over topics related to classification, etiology, and treatment, and differing points of view also occur along disciplinary lines between psychology and psychiatry. Because of the insularity of various scientific communities that study OCD, there is rarely a forum for examining these issues from various perspectives, and for trying to provide a more complex and multifaceted picture of the disorder. This volume creates such a forum.
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Tags: abramowitz, anxiety, anxiety disorder, anxiety disorders, body dysmorphic disorder, cognitive therapy, Compulsive, exposure therapy, Neuropsychiatric, obsessive compulsive disorder, OCD, Psychiatry, psychology, Research, researcher, Serotonin, Syndrome, tic disorders, Tourette, treatment
