BIOMEDICINE – Psychiatric Drugs: 06.03 – Selective Serotonin Reuptake Inhibitors (SSRIs)
ACTION: Blocks reuptake of the neurotransmitter serotonin at CNS neuronal presynaptic membranes, increasing availability at postsynaptic receptor sites.
INDICATIONS: Treatment of major depressive disorders, panic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), social anxiety disorder.
OFF-LABEL: Eating disorders, bulimia nervosa, generalized anxiety disorder (GAD).
SIDE EFFECTS:
Frequent: (26%–12%):Headache, nausea, diarrhea, insomnia, drowsiness, dizziness, fatigue, rash, dry mouth.
Occasional: (6%–4%): Anxiety, nervousness, agitation, tremor, dyspepsia, diaphoresis, vomiting, constipation, sexual dysfunction, visual disturbances, altered taste.
Rare: (less than 3%): Flatulence, urinary frequency, paresthesia, hot flashes, chills.
ADVERSE EFFECTS/ TOXIC REACTIONS: Serotonin syndrome (seizures, arrhythmias, high fever), Neuroleptic malignant syndrome (muscle rigidity, cognitive changes), Suicidal ideation have occurred.
INTERACTIONS:
HERBAL: Gotu kola, kava kava, St. John’s Wort, Valerian may increase CNS depression. St. John’s wort may increase risk of serotonin syndrome.
LAB VALUES: May increase total serum cholesterol, triglycerides, ALT, AST. May decrease serum uric acid.
(Zoloft)
TCM – Chapter 14b: Nourish the Heart & Calm the Spirit
Enters: Ht, LV, GB, K
Temperature: warm
Taste: sweet
ACTION: Calm Shen, Tonify Heart Qi.
INDICATION: 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.
CATION: Liver and/or Ht fire, Yin deficiency, deficient heat.
NOTE: Warm temperature with overuse may deplete Yin – causing palpitations, tachycardia, sweating, dry mouth à may dry up Liv Blood and Yin, causing Liv Qi stagnation & Liv Wind. A sweet taste with pre-existing Dampness may cause Phlegm to obstruct the heart, resulting in manic conditions.
MODIFICATIONS: With Qi stagnation – add Chai Hu