PAXIL: Postpartum: Mother Has Worsening Depression with 2nd Baby

PAXIL:   PostpartumMother Has
Worsening Depression with 2nd Baby After Taking Antidepressants:  Had

Postpartum with 1st Baby and Recovered With No Meds:
U.S.A.

Sentences three through seven read:  ” I went through postpartum depression with my first baby eight years ago but at
that time I didn’t have anxiety and I didn’t take any medication.
And I started getting better after 3½ months itself. But now it’s
been three months that I am going through this. I have been
taking medications (Paxil 20 mg, Buspar 10 mg) and getting counseling but
it’s not helping much. I still don’t feel myself and am having unwanted
thoughts.”

http://www.cnn.com/2009/HEALTH/expert.q.a/09/08/postpartum.depression.raison/

Expert Q&A

updated 10:03 a.m. EDT, Tue September 8,
2009

How long will my postpartum depression last?

Asked by Sheeza Ashraf, Fremont, California

I have a
4-month-old baby. I am going through postpartum depression with a lot of anxiety
and panic attacks. I went through postpartum depression with my first baby eight
years ago but at that time I didn’t have anxiety and I didn’t take any
medication. And I started getting better after 3½ months itself. But now it’s
been three months that I am going through this. I have been taking medications
(Paxil 20 mg, Buspar 10 mg) and getting counseling but it’s not helping much. I
still don’t feel myself and am having unwanted thoughts. How long does

postpartum depression last? Is this temporary? Will this anxiety and depression
ever go away? Should I stop the medications and try it on my own? Does exercise
help to get out of the depression? Will I ever be normal like I was
before?

Mental Health Expert Dr.
Charles Raison
Psychiatrist,
Emory University Medical School

Expert answer

Dear Sheeza,

I am sorry to hear of your difficulties —
you are far from alone in your struggles with postpartum depression. Indeed, up
to 20 percent of women become depressed in the six months following delivery,
but company doesn’t help much when it comes to depression — or at least the
company we typically provide in the U.S. Traditional cultures understood the
vulnerability of new mothers and would often surround them with family and
friends to help with the significant emotional and practical burdens of coping

with the newborn.

I am going to make some general recommendations about
what you might want to consider doing, based only on the information you have
provided above. As always, this should not be taken as specific advice for your
actual situation. That kind of advice can come only from a clinician who knows
you and is involved in your care.

First and most important, it is very
important to continue medication when one is still depressed, so given what you
describe, I would counsel against stopping the antidepressant. It is not clear
how long you have been on the Paxil (generic: paroxetine), but let’s assume
you’ve been on it for at least six weeks. You are on a low dose. A reasonable
first step would be to talk with your doctor about raising the dose to 40 mg a
day and trying this dose for at least several weeks.

If you see no
benefit, there are in general two paths your doctor might recommend (and I say
doctor in the generic sense, given that many folks nowadays see physician
assistants or nurse practitioners who often — in my experience — do a better
job diagnosing and treating depression than do MDs). First, your doctor might
add a second antidepressant or an atypical antipsychotic to your Paxil. Although
they are called “antipsychotics,” these agents (for example Seroquel, Abilify,
Zyprexa) are also widely used to help with severe depression and anxiety and are
often quite effective. Second, your doctor might switch you from the Paxil to
another antidepressant. Unfortunately, we have no scientific way of knowing
which agent you should switch to — our best data suggest that they are all
about equal. But one thing is clear: Many people who don’t do well with one
antidepressant will have a great response to a different one.

Anxiety and
panic are quite common when one has a bad depression, and they can be more
miserable to endure than the feeling of depression itself. It is unlikely that
the low dose of Buspar (generic: buspirone) you are taking is of much benefit.
You might want to discuss with your doctor raising the dose to at least 10 mg
three times a day or discontinuing it. The best immediate way to relieve
disabling anxiety is through the use of benzodiazepines (for example lorazepam
or clonazepam). These medications can be lifesavers, but if you take them for
more than three or four weeks your body will become dependent upon them, and
should you want to stop, you will have to reduce them slowly under the
supervision of a doctor.

Let me say a word about exercise. Yes, exercise

has been shown in many studies not only to raise a person’s mood immediately,
but also to work over time as an antidepressant. Therefore, I strongly recommend
adding regular exercise to your treatment regimen. Try to exercise in the
morning, especially when it is sunny. To get the best effect you will need to
work up a sweat. I find that it is even better if you can exercise in a place
with some natural beauty — as being in nature is itself quite comforting for
most of us.

I don’t have an answer to your question about how long the
depression will last and whether it will ever go away. Everyone is different. We
do know, however, that the longer one stays depressed and/or the more episodes
one has had, the harder it is to treat the condition. This is just the
frightening truth of the disease, and it really highlights how important it is
for you to really get aggressive about your treatment. My sincere hope is that
whatever specific treatment route you follow, you will start feeling like
yourself again as quickly as possible.

Finally, whenever I talk about
specific pharmacologic treatments I need to disclose that in addition to my
academic work I have given lectures for two pharmaceutical companies in the last
year: Lilly and Wyeth. I have also served on an advisory board for Lilly in the
last 12 months.
[]

1,085 total views, no views today

PROZAC: Personality Change: Later He Died: England

Paragraph 14 reads:  “In January 2008,
he saw Dr Francis Roberson, of the Ridgeway Medical
Practice in Plympton, Plymouth, complaining of anxiety and panic attacks.
He was prescribed anti-depressant
drugs.”

Later, Mathew saw Dr Stephen Robinson at the same
medical practice, and was prescribed the
anti-depressant fluoextine  [Prozac]  as the original
prescription was causing unpleasant side-effects and had done little to ease his
anxiety.”

Paragraphs 21 through 24 read:  “Mr Swan, of Tern
Gardens, Plympton, Plymouth, said he noticed a change

in Mathew’s behaviour from early in 2008.

He became
more distant, was fidgety and restless and would
fall asleep suddenly. Mr Swan said he also witnessed Mathew suffer a panic
attack in a bank queue.”

He said Mathew also became disillusioned
with his work that he had previously loved,
and had various run-ins with colleagues.”

This, said Mr Swan, was

totally out of character.

http://www.thisisplymouth.co.uk/news/Plymouth-man-died-inhaling-aerosol-gases/article-1320479-detail/article.html

Plymouth man died after inhaling aerosol gases

Tuesday, September 08, 2009, 11:45

5 readers have commented on
this story.
Click
here to read their views.

A TWENTY-TWO-year-old apprentice
electrician who died from inhaling a deodrant aerosol was suffering from
undiagnosed medical condition which meant he was more at risk from the gases in
the can, an inquest heard.

Mathew Burrows was found dead in bed by his
father in Churchdown, Glos, just weeks after he had moved from Plymouth to start
a new life with his dad.

After the tragedy, a pathologist found Mathew
was suffering from Hashimoto’s Thyroiditis, a condition which meant the butane
and propane in the spray were more likely to kill him, the Cheltenham inquest
was told.

Mathew, of Farrant Avenue, Churchdown, Glos, who had a history
of anxiety and panic attacks, was found dead by his father on Sept 14 last
year.

Recording a verdict of accidental death, Gloucestershire coroner
Alan Crickmore said there were a limited number of explanations as to how Mathew
came to inhale the gases.

He said he was sadly drawn to the conclusion
that Mathew inhaled deliberately although he was ‘absolutely satisfied’ this was
not intended to cause harm to himself.

The inquest heard that the day
before he was found dead Mathew had enjoyed a family day out at the Newent Onion
Fayre.

His father, Andrew Burrows, said he found his son’s body under a
duvet when he took him a cup of tea at around 9am.

Later, when a scene of
crime officer and a policeman moved Mathew, an aerosol can of deodorant was
found in the bed.

The inquest heard that Mathew had moved to Gloucester
area from Plymouth to be closer to his girlfriend, Charlotte
Morton.

Described by his mother, Tracy Brown, from Plymouth, as a ‘happy
lad, bright and popular,’ the inquest heard that Mathew had seen his doctor in
November 2007 after suffering palpitations.

Blood tests and an
electro-cardiograph were carried out and found to be normal.

In January
2008, he saw Dr Francis Roberson, of the Ridgeway Medical Practice in Plympton,
Plymouth, complaining of anxiety and panic attacks. He was prescribed
anti-depressant drugs.

Later, Mathew saw Dr Stephen Robinson at the same
medical practice, and was prescribed the anti-depressant fluoextine as the
original prescription was causing unpleasant side-effects and had done little to
ease his anxiety.

Over the next six months, Dr Robinson increased
Mathew’s dosage to 60mg and his condition was improving. Dr Robinson also
referred Mathew to a confidential counselling service for young people, called
The Zone.

After Mathew’s move to the Gloucester area, he was seen by Dr
Tim Macmorland of the Churchdown Surgery on September 4 and they discussed his
anxiety and panic attacks.

Dr Macmorland arranged for Mathew to see the
community psychiatric nurse with a view to future appointments with a
psychiatrist and a psychologist and for a full range of blood tests to be
carried out.

When asked by the coroner whether he had any concerns about
Mathew’s behaviour, Dr Macmorland said: ‘No, I did not. He was looking forward
to his new life in Gloucester. He looked relaxed and talked freely and
openly.’

In a statement read to the inquest, Mrs Brown said her son had
passed the first year of an electrical apprenticeship with distinction. When she
saw him over the August Bank Holiday weekend, he ‘seemed really
settled.’

Witness Michael Swan said he had known Mathew since he was 15
and became very close describing him as his family’s ‘surrogate son.’

Mr
Swan, of Tern Gardens, Plympton, Plymouth, said he noticed a change in Mathew’s
behaviour from early in 2008.

He became more distant, was fidgety and
restless and would fall asleep suddenly. Mr Swan said he also witnessed Mathew
suffer a panic attack in a bank queue.

He said Mathew also became
disillusioned with his work that he had previously loved, and had various
run-ins with colleagues.

This, said Mr Swan, was totally out of
character.

His father, Andrew, told the inquest he left Mathew watching
television at around 10.30pm on Saturday, September 13. They had enjoyed a
family trip to the onion fayre and later they had shared a bottle of wine over
dinner.

The next morning Mr Burrows found his son lying face down on his
bed under the duvet.

He was cold and when he tried to rouse him, there
was no movement or reaction. Mathew was later pronounced dead by
paramedics.

He was such a happy-go-lucky guy. He never demonstrated any
behaviour that would lead him to anything like that,” said Mr
Burrows.

Consultant forensic toxicologist Dr Simon Elliott told the
inquest that analysis of lung, brain and blood tissue revealed the presence of
butane and propane gases used as propellants in aerosol cans and cigarette
lighters.

Dr Elliott said investigation of blood and urine samples
revealed levels of alcohol above the legal drink-drive limit but way below any
fatal concentrations, and the presence of anti-depressant drug fluoextine that
fell within the range that could lead to fatal consequences in some
circumstances.

Dr John McCarthy, a consultant pathologist, said post
mortem examinations revealed that Mr Burrows had been suffering with Hashimoto’s
Thyroiditis, a condition that might simulate the symptoms of a depressive
illness.

Earlier, the inquest had heard from thyroid disease expert Dr
Edward Coombes who said such a condition could make a sufferer at risk of heart
failure.

Dr McCarthy said after studying the toxicology reports it was
more likely than not that the inhalation of butane and propane caused a sudden
cardiac arrest.

The coroner, giving his verdict, said the primary care
Mathew had received in Plymouth and Gloucester was of a high standard and there
had been no diagnostic reason for his thyroid problem to have been
spotted.

Mr Crickmore said the amount of relatively safe anti-depressants
at the lower end of the toxicity scale were not the direct cause of death nor
was the alcohol in his system.

He said that on the balance of
probabilities, it was likely that Mathew inhaled sufficient amounts of butane
and propane to get into his system and he accepted Dr Coombes point that his
heart, sensitised by the thyroiditis, put him at more risk.

Verdict:
Accidental.

1,278 total views, 3 views today

PAXIL: Postpartum Depression Medication Worsens Depression

Sentences three through seven read:  ” I went through
postpartum depression with my first baby eight years ago but at
that time I didn’t have anxiety and I didn’t take any medication.
And I started getting better after 3½ months itself. But now it’s
been three months that I am going through this. I have been
taking medications (Paxil 20 mg, Buspar 10 mg) and getting counseling but
it’s not helping much. I still don’t feel myself and am having unwanted
thoughts.”

http://www.cnn.com/2009/HEALTH/expert.q.a/09/08/postpartum.depression.raison/

Expert Q&A

updated 10:03 a.m. EDT, Tue September
8, 2009

How long will my postpartum depression last?

Asked
by Sheeza Ashraf, Fremont, California

I have a 4-month-old baby. I am
going through postpartum depression with a lot of anxiety and panic attacks. I
went through postpartum depression with my first baby eight years ago but at
that time I didn’t have anxiety and I didn’t take any medication. And I started
getting better after 3½ months itself. But now it’s been three months that I am
going through this. I have been taking medications (Paxil 20 mg, Buspar 10 mg)
and getting counseling but it’s not helping much. I still don’t feel myself and
am having unwanted thoughts. How long does postpartum depression last? Is this
temporary? Will this anxiety and depression ever go away? Should I stop the
medications and try it on my own? Does exercise help to get out of the

depression? Will I ever be normal like I was before?

Mental
Health Expert
Dr.
Charles Raison
Psychiatrist,
Emory University Medical School

Expert answer

Dear Sheeza,

I am sorry to hear
of your difficulties — you are far from alone in your struggles with postpartum
depression. Indeed, up to 20 percent of women become depressed in the six months
following delivery, but company doesn’t help much when it comes to depression
or at least the company we typically provide in the U.S. Traditional cultures
understood the vulnerability of new mothers and would often surround them with
family and friends to help with the significant emotional and practical burdens
of coping with the newborn.

I am going to make some general
recommendations about what you might want to consider doing, based only on the
information you have provided above. As always, this should not be taken as
specific advice for your actual situation. That kind of advice can come only
from a clinician who knows you and is involved in your care.

First and
most important, it is very important to continue medication when one is still
depressed, so given what you describe, I would counsel against stopping the
antidepressant. It is not clear how long you have been on the Paxil (generic:
paroxetine), but let’s assume you’ve been on it for at least six weeks. You are
on a low dose. A reasonable first step would be to talk with your doctor about
raising the dose to 40 mg a day and trying this dose for at least several weeks.

If you see no benefit, there are in general two paths your doctor might
recommend (and I say doctor in the generic sense, given that many folks nowadays
see physician assistants or nurse practitioners who often — in my experience —
do a better job diagnosing and treating depression than do MDs). First, your
doctor might add a second antidepressant or an atypical antipsychotic to your
Paxil. Although they are called “antipsychotics,” these agents (for example
Seroquel, Abilify, Zyprexa) are also widely used to help with severe depression
and anxiety and are often quite effective. Second, your doctor might switch you
from the Paxil to another antidepressant. Unfortunately, we have no scientific
way of knowing which agent you should switch to — our best data suggest that
they are all about equal. But one thing is clear: Many people who don’t do well
with one antidepressant will have a great response to a different
one.

Anxiety and panic are quite common when one has a bad depression,
and they can be more miserable to endure than the feeling of depression itself.
It is unlikely that the low dose of Buspar (generic: buspirone) you are taking
is of much benefit. You might want to discuss with your doctor raising the dose
to at least 10 mg three times a day or discontinuing it. The best immediate way
to relieve disabling anxiety is through the use of benzodiazepines (for example
lorazepam or clonazepam). These medications can be lifesavers, but if you take
them for more than three or four weeks your body will become dependent upon
them, and should you want to stop, you will have to reduce them slowly under the
supervision of a doctor.

Let me say a word about exercise. Yes, exercise
has been shown in many studies not only to raise a person’s mood immediately,
but also to work over time as an antidepressant. Therefore, I strongly recommend
adding regular exercise to your treatment regimen. Try to exercise in the
morning, especially when it is sunny. To get the best effect you will need to
work up a sweat. I find that it is even better if you can exercise in a place
with some natural beauty — as being in nature is itself quite comforting for
most of us.

I don’t have an answer to your question about how long the

depression will last and whether it will ever go away. Everyone is different. We
do know, however, that the longer one stays depressed and/or the more episodes
one has had, the harder it is to treat the condition. This is just the
frightening truth of the disease, and it really highlights how important it is
for you to really get aggressive about your treatment. My sincere hope is that
whatever specific treatment route you follow, you will start feeling like
yourself again as quickly as possible.

Finally, whenever I talk about
specific pharmacologic treatments I need to disclose that in addition to my
academic work I have given lectures for two pharmaceutical companies in the last
year: Lilly and Wyeth. I have also served on an advisory board for Lilly in the
last 12 months.
[]

1,240 total views, no views today

PROZAC: Personality Change: Later He Died: England

Paragraph 14 reads:  “In January 2008,
he saw Dr Francis Roberson, of the Ridgeway Medical
Practice in Plympton, Plymouth, complaining of anxiety and panic attacks.
He was prescribed anti-depressant
drugs.”

Later, Mathew saw Dr Stephen Robinson at the same
medical practice, and was prescribed the
anti-depressant fluoextine  [Prozac]  as the original
prescription was causing unpleasant side-effects and had done little to ease his
anxiety.”

Paragraphs 21 through 24 read:  “Mr Swan, of Tern
Gardens, Plympton, Plymouth, said he noticed a change

in Mathew’s behaviour from early in 2008.

He became
more distant, was fidgety and restless and would
fall asleep suddenly. Mr Swan said he also witnessed Mathew suffer a panic
attack in a bank queue.”

He said Mathew also became disillusioned
with his work that he had previously loved,
and had various run-ins with colleagues.”

This, said Mr Swan, was

totally out of character.

http://www.thisisplymouth.co.uk/news/Plymouth-man-died-inhaling-aerosol-gases/article-1320479-detail/article.html

Plymouth man died after inhaling aerosol gases

Tuesday, September 08, 2009, 11:45

5 readers have commented on
this story.
Click
here to read their views.

A TWENTY-TWO-year-old apprentice
electrician who died from inhaling a deodrant aerosol was suffering from
undiagnosed medical condition which meant he was more at risk from the gases in
the can, an inquest heard.

Mathew Burrows was found dead in bed by his
father in Churchdown, Glos, just weeks after he had moved from Plymouth to start
a new life with his dad.

After the tragedy, a pathologist found Mathew
was suffering from Hashimoto’s Thyroiditis, a condition which meant the butane
and propane in the spray were more likely to kill him, the Cheltenham inquest
was told.

Mathew, of Farrant Avenue, Churchdown, Glos, who had a history
of anxiety and panic attacks, was found dead by his father on Sept 14 last
year.

Recording a verdict of accidental death, Gloucestershire coroner
Alan Crickmore said there were a limited number of explanations as to how Mathew
came to inhale the gases.

He said he was sadly drawn to the conclusion
that Mathew inhaled deliberately although he was ‘absolutely satisfied’ this was
not intended to cause harm to himself.

The inquest heard that the day
before he was found dead Mathew had enjoyed a family day out at the Newent Onion
Fayre.

His father, Andrew Burrows, said he found his son’s body under a
duvet when he took him a cup of tea at around 9am.

Later, when a scene of
crime officer and a policeman moved Mathew, an aerosol can of deodorant was
found in the bed.

The inquest heard that Mathew had moved to Gloucester
area from Plymouth to be closer to his girlfriend, Charlotte
Morton.

Described by his mother, Tracy Brown, from Plymouth, as a ‘happy
lad, bright and popular,’ the inquest heard that Mathew had seen his doctor in
November 2007 after suffering palpitations.

Blood tests and an
electro-cardiograph were carried out and found to be normal.

In January
2008, he saw Dr Francis Roberson, of the Ridgeway Medical Practice in Plympton,
Plymouth, complaining of anxiety and panic attacks. He was prescribed
anti-depressant drugs.

Later, Mathew saw Dr Stephen Robinson at the same
medical practice, and was prescribed the anti-depressant fluoextine as the
original prescription was causing unpleasant side-effects and had done little to
ease his anxiety.

Over the next six months, Dr Robinson increased
Mathew’s dosage to 60mg and his condition was improving. Dr Robinson also
referred Mathew to a confidential counselling service for young people, called
The Zone.

After Mathew’s move to the Gloucester area, he was seen by Dr
Tim Macmorland of the Churchdown Surgery on September 4 and they discussed his
anxiety and panic attacks.

Dr Macmorland arranged for Mathew to see the
community psychiatric nurse with a view to future appointments with a
psychiatrist and a psychologist and for a full range of blood tests to be
carried out.

When asked by the coroner whether he had any concerns about
Mathew’s behaviour, Dr Macmorland said: ‘No, I did not. He was looking forward
to his new life in Gloucester. He looked relaxed and talked freely and
openly.’

In a statement read to the inquest, Mrs Brown said her son had
passed the first year of an electrical apprenticeship with distinction. When she
saw him over the August Bank Holiday weekend, he ‘seemed really
settled.’

Witness Michael Swan said he had known Mathew since he was 15
and became very close describing him as his family’s ‘surrogate son.’

Mr
Swan, of Tern Gardens, Plympton, Plymouth, said he noticed a change in Mathew’s
behaviour from early in 2008.

He became more distant, was fidgety and
restless and would fall asleep suddenly. Mr Swan said he also witnessed Mathew
suffer a panic attack in a bank queue.

He said Mathew also became
disillusioned with his work that he had previously loved, and had various
run-ins with colleagues.

This, said Mr Swan, was totally out of
character.

His father, Andrew, told the inquest he left Mathew watching
television at around 10.30pm on Saturday, September 13. They had enjoyed a
family trip to the onion fayre and later they had shared a bottle of wine over
dinner.

The next morning Mr Burrows found his son lying face down on his
bed under the duvet.

He was cold and when he tried to rouse him, there
was no movement or reaction. Mathew was later pronounced dead by
paramedics.

He was such a happy-go-lucky guy. He never demonstrated any
behaviour that would lead him to anything like that,” said Mr
Burrows.

Consultant forensic toxicologist Dr Simon Elliott told the
inquest that analysis of lung, brain and blood tissue revealed the presence of
butane and propane gases used as propellants in aerosol cans and cigarette
lighters.

Dr Elliott said investigation of blood and urine samples
revealed levels of alcohol above the legal drink-drive limit but way below any
fatal concentrations, and the presence of anti-depressant drug fluoextine that
fell within the range that could lead to fatal consequences in some
circumstances.

Dr John McCarthy, a consultant pathologist, said post
mortem examinations revealed that Mr Burrows had been suffering with Hashimoto’s
Thyroiditis, a condition that might simulate the symptoms of a depressive
illness.

Earlier, the inquest had heard from thyroid disease expert Dr
Edward Coombes who said such a condition could make a sufferer at risk of heart
failure.

Dr McCarthy said after studying the toxicology reports it was
more likely than not that the inhalation of butane and propane caused a sudden
cardiac arrest.

The coroner, giving his verdict, said the primary care
Mathew had received in Plymouth and Gloucester was of a high standard and there
had been no diagnostic reason for his thyroid problem to have been
spotted.

Mr Crickmore said the amount of relatively safe anti-depressants
at the lower end of the toxicity scale were not the direct cause of death nor
was the alcohol in his system.

He said that on the balance of
probabilities, it was likely that Mathew inhaled sufficient amounts of butane
and propane to get into his system and he accepted Dr Coombes point that his
heart, sensitised by the thyroiditis, put him at more risk.

Verdict:
Accidental.

1,196 total views, no views today