BIOMEDICINE – PSYCHIATRIC DRUGS: Antidepressants (Selective Serotonin Reuptake Inhibitors (SSRIs))
ACTION: Inhibits reuptake of the neurotransmitter serotonin by CNS neurons, thereby increasing the amount of serotonin available in nerve synapses. An elevated serotonin level may result in elevated mood and reduced depression.
INDICATIONS: To treat generalized anxiety disorder or major depression
SIDE EFFECTS: Nausea, xerostomia, insomnia, constipation, dizziness, diaphoresis, tiredness, drowsiness.
ADVERSE EFFECTS/ TOXIC REACTIONS:
CNS: Abnormal gait, acute psychosis, aggression, akathisia, delirium, dizziness, dyskinesia, dystonia, extrapyramidal effects, fatigue, headache, hypomania, insomnia, lethargy, mania, myoclonus, neuroleptic malignant syndrome, paresthesia, seizures, serotonin syndrome, somnolence, suicidal ideation
CV: Atrial fibrillation, cardiac failure, deep vein or phlebitis thrombosis, hypotension, MI, prolonged QT interval, thrombosis, torsades de pointes, ventricular arrhythmias
EENT: Diplopia, dry mouth, glaucoma, nystagmus, rhinitis, sinusitis, toothache, visual hallucinations
ENDO: Diabetes mellitus, hyperprolactinemia, syndrome of inappropriate ADH secretion
GI: Abdominal pain, constipation, decreased appetite, diarrhea, flatulence, GI bleeding or hemorrhage, hepatic necrosis, hepatitis, indigestion, nausea, pancreatitis, rectal hemorrhage, vomiting
GU: Acute renal failure, anorgasmia, decreased libido, ejaculation disorders, impotence, priapism
HEME: Bleeding, decreased prothrombin time, hemolytic anemia, leukopenia, thrombocytopenia
MS: Neck or shoulder pain, rhabdomyolysis
RESP: Pulmonary embolism
SKIN: Ecchymosis, erythema multiforme, increased sweating, photosensitivity, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria
OTHER: Anaphylaxis, angioedema, flu-like symptoms, hyponatremia
INTERACTIONS:
DRUGS: aspirin, NSAIDs, warfarin – increased risk of bleeding. Additive CNS effects – lithium. MAO inhibitors: Possibly hyper pyretic episodes, hypertensive crisis, serotonin syndrome, and severe seizures.
HERB: St. John’s wort: Increased risk of serotonin syndrome
(Lexapro)
TCM – Chapter 13b: Nourishing Medicinals that Calm the Shen (Spirit)
Enters: Ht, LV, GB, K
Temperature: warm
Taste: sweet
ACTION: Calm Shen, Tonify Heart Qi.
INDICATIONS: Depression d/t Ht Qi deficiency, Ht and K not harmonized,
Tongue: pink, pale.
Pulse: thin, thready, choppy,
RATIONALE: It anchors the mind, directs Ht Qi downward, and rises K Qi to meet the Ht; its sweet properties tonify Ht Qi.
CAUTION: Overuse may deplete Yin, leading to symptoms such as palpitations, tachycardia, sweating, and dry mouth. It may dry up Liv Blood and Yin, causing Liv Qi stagnation & Liv Wind.
NOTE: Its warm properties may transform preexisting Damp accumulation into Phlegm, which in turn may obstruct the Heart, leading to maniac conditions.
MODIFICATIONS: With Qi stagnation, add Chai Hu