Holistic Health Articles and Research Related to Herbal Medicines, Foods and Phytochemicals

Sunday, 1 December 2013

Selective serotonin re-uptake inhibitor (SSRI) discontinuation syndrome - The Phytochemicals and antioxidants

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).
Phytochemicals and antioxidants to reduce the symptoms of Selective serotonin re-uptake inhibitor (SSRI) discontinuation syndrome
1. Tangeretin
Tangeretin, a citrus flavonoid in the oral administration resulted in significant levels of tangeretin in the brain (hypothalamus, striatum and hippocampus). Treatment of the rats with the dopaminergic neurotoxin 6-hydroxydopamine resulted in reduced levels of dopamine, an effect which was reversed by the administration of tangeretin. This study concluded that tangeretin can cross the blood-brain barrier and has a potential use as a neuroprotective agent(16).

2. Epigallocatechin-3-gallate and Polyphenols
Green tea polyphenols (GTPs and epigallocatechin-3-gallate (EGCG) modulation could improve the cognitive impairments induced by psychological stress. The related mechanisms may be involved with the changes of catecholamines, 5-hydroxytryptamine, cytokines and expressions of metallothioneins(17).

3. Furanocoumarins
furanocoumarins found abundantly in grapefruit with CYP2D6 inhibition achieved in the range of 190-900 nM and Anthocyanins and anthocyanidins were shown to be about 1,000-fold less potent, they are unlikely to interfere with drug metabolism by CYP2D6(18).

4. N-acetyl-cysteine and curcumin
N-acetyl-cysteine has been shown to have a significant benefit on depressive symptoms in a randomized placebo-controlled trial. Additionally, curcumin, the yellow pigment of curry, has been shown to strongly interfere with neuronal redox homeostasis in the CNS and to possess antidepressant activity in various animal models of depression, also thanks to its ability to inhibit monoamine oxidases(19)

5. Etc.
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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/10958258
(16) http://www.ncbi.nlm.nih.gov/pubmed/11726811
(17) http://www.ncbi.nlm.nih.gov/pubmed/20463297
(18) http://www.ncbi.nlm.nih.gov/pubmed/19357792
(19) http://www.ncbi.nlm.nih.gov/pubmed/22668245

Selective serotonin re-uptake inhibitor (SSRI) discontinuation syndrome - Diagnosis and the Diet

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).
Diagnosis
There are no specific diagnosis criteria, but researchers in the study of "Selective serotonin reuptake inhibitor discontinuation syndrome: proposed diagnostic criteria", suggested that the criteria are 2 or more of the following symptoms developing within 1 to 7 days of discontinuation or reduction in dosage of an SSRI after at least 1 month's use, when these symptoms cause clinically significant distress or impairment and are not due to a general medical condition or recurrence of a mental disorder: dizziness, light-headedness, vertigo or feeling faint; shock-like sensations or paresthesia; anxiety; diarrhea; fatigue; gait instability; headache; insomnia; irritability; nausea or emesis; tremor; and visual disturbances(11).
Diet to reduce the symptoms of Selective serotonin re-uptake inhibitor (SSRI) discontinuation syndrome
B.1. Foods to Increase Serotonin
Various fruits boost serotonin and other mood-improving chemicals in the brain, including
The following fruits had a high serotonin concentration (mean +/- SEM) expressed in micrograms/g weight: plantain 30.3 +/- 7.5; pineapple 17.0 +/- 5.1; banana 15.0 +/- 2.4; Kiwi fruit 5.8 +/- 0.9; plums 4.7 +/- 0.8; and tomatoes 3.2 +/- 0.6. Only nuts in the walnut or hickory family had a high serotonin concentration expressed in micrograms/g weight; butternuts 398 +/- 90; black walnuts 304 +/- 46; English walnuts 87 +/- 20; shagbark hickory nuts 143 +/- 23; mockernut hickory nuts 67 +/- 13; pecans 29 +/- 4; and sweet pignuts 25 +/- 8. Ingestion of these fruits and nuts resulted in an increase in urinary 5-hydroxyindoleacetic acid excretion with no change in platelet serotonin concentration(13).
B.2. Serotonin Boost from Protein Sources
Food contain high levels of tryptophan such asTurkey, Lean beef, Salmon, etc. can enhance the production of the levels of serotonin, as trytophan ia a precursor of the sorotonin. Some researchers showed that tryptophan is an antidepressant in mild to moderate depression and a small body of data suggests that it can also decrease aggression. Preliminary data indicate that tryptophan also increases dominant behavior during social interactions. Overall, studies manipulating tryptophan levels support the idea that low serotonin can predispose subjects to mood and impulse control disorders. Higher levels of serotonin may help to promote more constructive social interactions by decreasing aggression and increasing dominance(14).

B.3. Carbohydrate-based Foods and carbohydrate snacking that Increase Serotonin
Carbohydrate-based Foods and carbohydrate snacking found abundantly in foods consists of glucose that can boost serotonin production. Evidence is presented that carbohydrate snacking seems to be related to a "need" to increase the level of brain serotonin; treatment with a drug, d-1 fenfluramine, that increases serotoninergic neurotransmission significantly decreases carbohydrate snack consumption(15).

B.4. Etc.

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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/10958258
(11) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1407715/
(12) http://www.circlemedhealthcare.com/ssri.pdf
(13) http://www.ncbi.nlm.nih.gov/pubmed/2413754
(14) http://www.ncbi.nlm.nih.gov/pubmed/11888576
(15) http://www.ncbi.nlm.nih.gov/pubmed/6381575

Selective serotonin re-uptake inhibitor (SSRI) discontinuation syndrome - Causes and risk factors

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).

Causes and risk factors
A. Causes
Dr. Blier P and Dr. Tremblay P. at the University of Ottawa suggested that in the development of animal models to explain the mechanisms of this clinical problem has proved challenging, because less than half of all patients experience any discontinuation symptoms, many of which are subjective in nature. One explanation is that SRI discontinuation symptoms may arise from the rapid decrease in serotonin (5-HT) availability when treatment ends abruptly. Yet, it would appear that discontinuation discomforts may not be mediated exclusively through 5-HT receptors, given the major regulatory role 5-HT exerts on a number of specific chemical receptor systems in the brain(8).
Others showed that one explanation is that antidepressant discontinuation symptoms may arise from the rapid decrease in serotonin availability when treatment ends abruptly. It would appear that discontinuation discomfort may not be mediated exclusively through serotonin receptors, given the major regulatory role serotonin exerts on a number of specific chemical receptor systems in the brain. As a result, attempts to explain the determinants of this phenomenon rely on a certain level of speculation. The article discusses the three systems most likely to account in the symptomatology--the serotonin, the norepinephrine, and the cholinergic systems--and the possible interactions among them(9).

B. Risk factors
Risks of Selective serotonin re-uptake inhibitor (SSRI) discontinuation syndrome are depending to the medication taken. there appears to be less risk with the abrupt interruption of fluoxetine. Paroxetine is the SSRI most often mentioned in the case reports and the reason for this may be as simple as the fact that it is most frequently prescribed. An alternative explanation may involve paroxetine s affinity for cholinergic (muscarinic) receptors, causing cholinergic rebound on discontinuation(10).

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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/10958258
(8) http://www.ncbi.nlm.nih.gov/pubmed/16683857
(9) http://www.ncbi.nlm.nih.gov/pubmed/20214096
(10) http://www.circlemedhealthcare.com/ssri.pdf

Selective serotonin re-uptake inhibitor (SSRI) discontinuation syndrome - Symptoms and signs

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).

I. Symptoms and signs
The use of medication duration is usually 1 month with symptoms developing within a few days after SSRI interruption, cessation, or reduction of dosage.
1. Dizziness
The abrupt withdrawal from an SSRI is likely to cause a sudden decrease in serotonin in the VNC, which will disrupt the function of VNC neurons bilaterally, causing dizziness without vertigo(2).

2. Sleep disturbance
The abrupt discontinuation of paroxetine seemed associated with sudden and impairing effects, some patients may experience sleep disturbances and dizziness(3)

3. AQgitation, irritability, vertigo, lightheadedness and fever
There are a report that a 30-year-old man with depression who was treated with paroxetine (Seroxat) developed severe withdrawal symptoms when the medication was gradually diminished and stopped: agitation, irritability, vertigo, lightheadedness and fever up to 40 degrees C. The symptoms disappeared after the medication was reintroduced but recurred after rediscontinuation(4).

4. Visual and auditory hallucinations, headache, insomnia, and nausea
Other report that Discontinuation symptoms can follow the stoppage of almost all classes of antidepressants can experience visual and auditory hallucinations in addition to dizziness, headache, insomnia, and nausea a couple of days after paroxetine discontinuation(5).

5. Balance, sensory abnormalities, and possibly aggressive and impulsive behavior
Other researchers found that the discontinuation of Selective serotonin re-uptake inhibitor (SSRI) also cause the symptoms of Selective serotonin re-uptake inhibitor (SSRI) such as nausea, lethargy, insomnia, and headache, are similar to those reported with tricyclic discontinuation. However, SSRI discontinuation is also associated with novel symptom clusters, including problems with balance, sensory abnormalities, and possibly aggressive and impulsive behavior(6).

6. Sexual dysfunction
Some patients may also experience Post-SSRI sexual dysfunction (PSSD) caused by the previous use of selective serotonin reuptake inhibitor (SSRI) antidepressants. While apparently uncommon, it can last for months, years, or sometimes indefinitely after the discontinuation of SSRIs(7).

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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/10958258
(2) http://www.ncbi.nlm.nih.gov/pubmed/20144124
(3) http://www.ncbi.nlm.nih.gov/pubmed/8602387
(4) http://www.ncbi.nlm.nih.gov/pubmed/10422558
(5) http://www.ncbi.nlm.nih.gov/pubmed/21489048
(6) http://www.ncbi.nlm.nih.gov/pubmed/9219489
(7) http://en.wikipedia.org/wiki/Post-SSRI_sexual_dysfunction

Muscae Volitantes (Floater) - Treatments In Traditional Chinese medicine perspective

Muscae volitantes or Floater is defined as a condition of pathol moving black specks or threads seen before the eyes, as results of opaque fragments floating in the vitreous humour or a lens defect due to degeneration of the vitreous humour. Floater as it suspends in the vitreous humour, it tends to drift and follows the rapid motions of the eye as a result of damage of the eye that causes material to enter the vitreous humour.
Treatments

C. In traditional Chinese medicine perspective(35)

According tothe article of FLOATERS AND THEIR TREATMENT WITH CHINESE HERBS

by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon wrote that

in theEnglish-Chinese Encyclopedia of Practical Traditional Chinese Medicine (2), there is a short section on diseases of the vitreous. The clinical manifestations are said to range from mild cases with black shadows floating up and down like flying flies (but no other change in vision) to severe cases, where the eyes seem to be covered by a membrane. There are three categories of causation listed:

1. Accumulation and steaming up of damp-heat and attack of turbid qi a. This corresponds to the disorder of the gallbladder described above. b. A recommended formula is modified San ren Tang (Three Seed Decoction), which have a function to clear damp-heat. Ingredients includes b.1. Xing Ren (Apricot Seed or Kernel) b.2. Bai Dou Kou (Round Cardamom Fruit) b.3. Hou Po (Magnolia Bark) b.4. Ban Xia (Pinellia Rhizome) b.5. Yi Yi Ren (Seeds of Job's Tears) b.6. Tong Cao (Rice Paper Pith, Tetrapanax) b.7. Dan Zhu Ye (Lophatherum Stem and Leaves) b.8.Hua Shi (Talcum)
2. Stagnation of liver qi, resulting in blood stasis and extravasation of blood.

a. This corresponds to the leakage of blood into the vitreous cavity, perhaps as a result of retinitis. b. A recommended formula is modified Jiawei Xiaoyao San (Bupleurum and Peony Formula. b.1.Radix Bupleuri Chinensis (Chai hu) b.2. Radix Angelicae Sinensis (Dang gui) b.3. Radix Paeoniae Lactiflorae (Bai shao) b.4. Rhizoma Atractylodis Macrocephalae (Bai zhu) b.5. Sclerotium Poriae Cocos (Fu ling) b.6. Radix Glycyrrhizae Uralensis (Gan cao) b.7. Cortex Moutan Radicis (Paeonia Suffruticosa) (Mu dan pi) b.8. Fructus Gardeniae Jasminoidis (Zhi zi) b.9. Herba Menthae Haplocalycis (Bo he)

3. Deficiency of kidney and liver, resulting in flaring up of deficiency fire.

a. This corresponds to the weakness of the kidney water, and associated heat that causes drying of the vitreous. b. The recommended formula is a modified Zhibai Dihuang Tang (Anemarrhena, Phellodendron, and Rehmannia Formula),. Ingredients include b.1. Radix Rehmanniae Preparata (Shu Di Huang) b.2. Fructus Corni Officinalis (Shan Zhu Yu) b.3. Cortex Moutan Radicis (Paeonia Suffruticosa) (Mu Dan Pi) b.4. Rhizoma Dioscoreae Oppositae (Shan Yao) b.5. Sclerotium Poriae Cocos (Fu Ling) b.6. Rhizoma Alismatis Orientalis (Ze Xie) b.7. Rhizoma Anemarrhenae Asphodeloidis (Zhi Mu) b.8. Cortex Phellodendri Chinensis (Huang Bo)

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Sources

(35) http://www.itmonline.org/arts/floaters.htm

(36) http://www.itmonline.org/arts/floaters.htm

Muscae Volitantes (Floater) - Treatments In Herbal medicine perspective

The aim of the treatment is to enhance the repaired connective tissues, diabetic complication cause of floater and improve circulation and protect the capillaries from broken off. 1. Repaired connective tissues Loss of skin elasticity is one of the main problems of ageing. This is a mechanical property influenced by elastin, a protein in the dermis which, together with collagen and glycosaminoglycans, makes up the connective tissue. In the study to investigate the effects of lady's thistle (Silybum marianum GAERTN), alchemilla or yarrow (Alchemilla vulgaris L.), horsetail (Equisetum arvense L.) as well as germinated seeds (Glycine soja Siebold and Zucc., Triticum vulgare Vilars, Medicago sativa L., Raphanus sativus L.), found that t the plant complex presents non-competitive inhibition in the order of 41.0% against PPE and 50.0% against HLE. An in vivo test was made alongside the in vitro test using an SEM 474 Cutometer (Courage & Khazaka) to study the elasticity of the skin, and positive effects were obtained when applying a cosmetic formulation containing 5% of the plant complex. Image analysis of duplicates of the cutaneous surface, before and after treatment began with a product containing 5% of plant complex and showed that wrinkles were decreased by 36.7%(30).
2. Diabetic complicationsa. Dandelion water extract (DWE), an herbal medication, may exert an effect on the activity and mRNA expression of hepatic antioxidant enzymes and lipid profile in streptozotocin (STZ)-induced diabetic rats. Dr. Cho SY and research team at Yeungnam University suggested that a DWE supplement can improve the lipid metabolism and is beneficial in preventing diabetic complications from lipid peroxidation and free radicals in diabetic rats(31).
3. Circulation enhancers a. GINGER for EYE disorders: Taking Ginger will increase blood circulation so that more nutrition can reach your eye(32). b. Garlic for VARICOSE VEINS. Garlic helps to keep your blood from clumping or becoming too sticky, helping your blood move through your blood vessels and reduces the risk of blood clots. One clove a day should do the trick. You can also take garlic capsules. CAUTION: Medication and Garlic could lead to uncontrolled bleeding and spell HEMORRHAGIC STROKES if it occurs in your brain. To avoid this, take caution against taking standardized garlic extract. Experts suggest eating no more than one clove of garlic a day(33).
4. Prevent Eye diseases
Bilberry has been best known for its function in enhancing vision health, according to the study of "Natural therapies for ocular disorders, part two: cataracts and glaucoma" by Head KA., posted in PubMed(4), researcher indicated that B vitamin riboflavin appears to play an essential role as a precursor to flavin adenine dinucleotide (FAD), a co-factor for glutathione reductase activity. Other nutrients and botanicals, which may benefit cataract patients or help prevent cataracts, include pantethine, folic acid, melatonin, and bilberry(34)
5. Other suggested dandelion, milk thistle, Ginkgo Biloba, etc.

(30) http://www.ncbi.nlm.nih.gov/pubmed/18505506

(31) http://www.ncbi.nlm.nih.gov/pubmed/11814465

(32) http://medicaladvisorjournals.blogspot.ca/2011/12/world-most-healthy-foods-vegetables_1048.html

(33) http://medicaladvisorjournals.blogspot.ca/2011/12/world-most-healthy-foods-vegetables_860.html

(34) http://www.ncbi.nlm.nih.gov/pubmed/11302779

Muscae Volitantes (Floater) - Treatments In conventional medicine perspective

VI. Treatments

A. In conventional medicine perspective

Treatment is not necessary, if the diagnosis indicated that the floater is harmless and will do causes nay damage to the eye vision, but in severe case, the following may be recommended

1. Vitrectomy

In the study to to evaluate the role of pars plana vitrectomy (PPV) in patients with persistent vitreous floaters (VF) in phakic (56.7 %) or pseudophakic (43.3 %) eyes, Dr. Roth M, and the research team at the Universitätsspital Bern, showed that PPV to be a safe and effective primary treatment for visually disturbing VF. In spite of the small number of cases with a lower PVA (5 eyes/16.7 %), which in the most severe case corresponded to a reduction of VA from 1.0 to 0.6 due to a nuclear sclerosis of the lens, all patients were satisfied. As vitreoretinal complications may occur, a critical patient selection and a careful preoperative assessment of specific risks of vitrectomy are mandatory(28).

2. Laser vitreolysis

Dr. Y M Delaney and the research team at The Department of Ophthalmology Stoke Mandeville Hospital Aylesbury Buckinghamshire, in the study of Nd:YAG vitreolysis and pars plana vitrectomy: surgical treatment for vitreous floaters, indicated that Patients’ symptoms from vitreous floaters are often underestimated resulting in no intervention. This paper shows Nd:YAG vitreolysis to be a safe but only moderately effective primary treatment conferring clinical benefit in one third of patients. Pars plana vitrectomy, while offering superior results, should be reserved for patients who remain markedly symptomatic following vitreolysis, until future studies further clarify its role in the treatment of patients with floaters and posterior vitreous detachment(29).

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Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca Sources

(28) http://www.ncbi.nlm.nih.gov/pubmed/16175483

(29) http://www.nature.com/eye/journal/v16/n1/full/6700026a.html