Sunday 1 December 2013

Selective serotonin re-uptake inhibitor (SSRI) discontinuation syndrome - Treatments In Herbal medicine perspective

Selective serotonin re-uptake inhibitors or serotonin-specific reuptake inhibitor (SSRIs) are a types of  antidepressant medications to treat depression and certain neurological disorders, including  obsessive-compulsive disorder, panic disorder (PD), generalized anxiety disorder, post traumatic stress disorder (PTSD), and social anxiety disorder (SAD), etc..

SSRI discontinuation syndrome is defined as a condition of a syndrome as a result of interruption, reduced doses or discontinuation of any anti depressant medication, including SSRI (selective serotonin re-uptake inhibitor) and serotonin–norepinephrine reuptake inhibitor (SNRI), researchers  showed that The SSRI discontinuation syndrome is a characteristic selective serotonin reuptake inhibitor (SSRI) discontinuation syndrome appears to exist. It is usually mild, commences within 1 week of stopping treatment, resolves spontaneously within 3 weeks, and consists of diverse physical and psychological symptoms, the commonest being dizziness, nausea, lethargy and headache. SSRI reinstatement leads to resolution within 48 h(1).
Treatments
Herbs to treat symptoms of  Selective serotonin re-uptake inhibitor (SSRI) discontinuation syndrome
1. Lemon Balm
a. Anxiety-like reactivity
In the determination of the effects of chronic (15 consecutive days of treatment) per os administration of Melissa officinalis L. extract (Cyracos, Naturex) on anxiety-like reactivity in mice, found that the Cyracosdose at which it exerted anxiolytic-like effects in the elevated plus maze did not alter exploratory or circadian activities. Therefore, our results demonstrate that Cyracos has anxiolytic-like effects under moderate stress conditions and does not alter activity levels, according to "Effects of chronic administration of Melissa officinalis L. extract on anxiety-like reactivity and on circadian and exploratory activities in mice" by

Ibarra A, Feuillere N, Roller M, Lesburgere E, Beracochea D.(23)

b. Anxiety disorders and insomnia
In the assessment of Cyracos(®), a standardized Melissa officinalis L. extract and it anti-stress and anxiolytic effects found that Cyracos(®) reduced anxiety manifestations by 18% (p < 0.01), ameliorated anxiety-associated symptoms by 15% (p < 0.01) and lowered insomnia by 42% (p < 0.01). As much as 95% of subjects (19/20) responded to treatment, of which 70% (14/20) achieved full remission for anxiety, 85% (17/20) for insomnia, and 70% (14/20) for both, according to "Pilot trial of Melissa officinalis L. leaf extract in the treatment of volunteers suffering from mild-to-moderate anxiety disorders and sleep disturbances" by Cases J, Ibarra A, Feuillère N, Roller M, Sukkar SG.(24)
2 Ginseng Asia
a. Antipsychotic effect
In the investigation of Panax quinquefolium (PQ) and its significant neuroactive properties for its antipsychotic potential found that PQ blocked ketamine induced memory impairment in the passive avoidance paradigm. In the chronic studies, PQ reduced the ketamine induced enhanced immobility in the forced swim test and did not show extra-pyramidal side effects in bar test and wood block test of catalepsy. These behavioural effects were compared with standard drugs haloperidol and clozapine. Further PQ reduced DA and 5-HT content after chronic treatment, but not after acute administration, according to "Evaluation of the Antipsychotic Potential of Panax quinquefolium in Ketamine Induced Experimental Psychosis Model in Mice" by Chatterjee M, Singh S, Kumari R, Verma AK, Palit G.(25)


b. Neuroprotective effect
In the analyzing Panax ginseng C.A. Meyer and its beneficial effects in cerebral ischemia and inhibition of the inflammatory cascade in sepsis found that Ginsenoside Rb1 (GRb1) partially inhibited the activation of nuclear factor-κB (NF-κB) pathway from 6 h to 72 h after ischemia and reperfusion onset, as determined by the expression of total and phosphorylated NF-κB/p65, inhibitor protein of κB (IκB)-α, and IκB-kinase complex (IKK)-α. All these results indicate that suppression of local inflammation after cerebral ischemia might be one mechanism that contributes to the neuroprotection of GRb1, according to "Suppression of local inflammation contributes to the neuroprotective effect of ginsenoside Rb1 in rats with cerebral ischemia" by Zhu J, Jiang Y, Wu L, Lu T, Xu G, Liu X.(26)

3. Ginkgo  
a. Brain-cognition effects
Ginkgo Biloba extract (GBE) have exhibited the function of alleviating symptoms of cognitive impairment in aging populationby increasing the SSVEP(state visually evoked potentia) amplitude at occipital and frontal sites and SSVEP latency at left temporal and left frontal sites, according to the study of "Examining brain-cognition effects of ginkgo biloba extract: brain activation in the left temporal and left prefrontal cortex in an object working memory task" by Silberstein RB, Pipingas A, Song J, Camfield DA, Nathan PJ, Stough C., posted in PubMed(27)

b. Acute cognitive effects
Administration of GBE complexed with phosphatidylserine have exerted the results of improingsecondary memory performance and speed of memory task performance, according to the study of "Acute cognitive effects of standardised Ginkgo biloba extract complexed with phosphatidylserine" by Kennedy DO, Haskell CF, Mauri PL, Scholey AB., posted in PubMed(28) 

4. Etc. 

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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/10958258
(23) http://www.ncbi.nlm.nih.gov/pubmed/20171069
(24) http://www.ncbi.nlm.nih.gov/pubmed/22207903
(25) http://www.ncbi.nlm.nih.gov/pubmed/22189635
(26) http://www.ncbi.nlm.nih.gov/pubmed/22173011
(27) http://www.ncbi.nlm.nih.gov/pubmed/21941584
(28) http://www.ncbi.nlm.nih.gov/pubmed/17457961
 

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