SNRI Drugs – Antidepressant

Serotonin and norepinephrine reuptake inhibitors (SNRIs)

Q: What is purpose of this form of drug?

A: Help relieve depression symptoms – irritability, sadness.  Can also be used for anxiety disorders and nerve pain (and long-term chronic pain).  If you have both depression AND chronic pain, then SNRIs by be helpful.  Effective in treating depression.

Q: How do SNRIs work?

A: Block the reabsorption (reuptake) of the neurotransmitter Serontonin and Norepinephrine in the brain.

Q: What drugs approved by FDA for SNRI?  Additional URL info through www.drugs.com:

A: Desvenlafaxine (Pristiq)

A: Duloextine (Cymbalta).  This is also approved to treat anxiety and certain types of chronic pain

A: Levomilnacipran (Fetzima)

A: Venlafaxine (Effexor XR).  This is also approved to treat certain anxiety disorders and panic disorder.

Q: What kinds of side effects and cautions?

A: All SNRIs work same way, but if you can’t tolerate one, try a different one.  Side effects could be non or mild and usually go away after a couple weeks.  To reduce nausea, take with food.

A: Some common side effects are nausea, dry mouth, dizziness, headache, excessive sweating.

A: Other possible side effects are tiredness, constipation, insomnia, changes in sexual function – reduced sexual desire, difficulty reaching orgasm or the inability to maintain an erection (erectile dysfunction), and loss of appetite.

Q: What are some safety issues?

A: Venlafaxine, desvenlafaxine, levomilnacipran may raise blood pressure.

A: Duloxetine may worsen liver problems.

A: Same issues as SSRI’s regarding bleeding and tell MD about herbal drugs.  OTC drugs that increase risk of bleeding – Advil, Motrin IB, Aspirin, Warfarin (Coumadin), and other blook thinners.

A: Same as SSRI re: Serotonin Syndrom.

A: Same as SSRI re: Pregnancy.

A: Same as SSRI for Suicide Risk.

A: Same as SSRI for Stopping treatment – too quickly

A: Same as SSRI for finding the right antidepressant

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SSRI Drugs – antidepressant (anxiety disorders)

Selective Serotonin Reuptake Inhibitor (SSRI)

Q: What is purpose of drug?

A: Type of depressant that treats both major depressive disorders and anxiety disorders.  Can help overcome depression.  Ease symptoms of moderate to severe depression.  Aside from depression, SSRI can also treat anxiety disorders.

Q: What are some benefits of this particular form of drug?

A: Relatively safe and typically causes fewer side effects than other types of antidepressants

Q: What are some examples of FDA approved drug names?  I create URL links to point to sites within drugs.com

A: Citalopram (Celexa)

A: Escitalopram (Lexapro)

A: Fluoxetine (Prozac)

A: Paroextine (Paxil, Pexeva)

A: Sertraline (Zoloft)

Q: Which drug is best to take?

A: Depends on a numbers of issues – symptoms, health conditions.

Q: What is Serotonin?

A: Serotonin is one of the chemical messengers (neurotransmitter) that carry signals between brain nerve cells (neurons).

Q: How do SSRI drugs work?

A: They block/inhibit the absorption (reuptake) of serotonin into neurons.  They increase levels of serotonin in the brain.  By having more serotonin in the brain, it improves transmission of messages between neurons.  The keyword “selective” is used because SSRI’s mainly affect serontonin, and not other neurotransmitters.

A: SSRIs differ in their potencies at blocking serotonin reuptake and in how quickly the body eliminates (metabolizes) the drug.

Q: What are some potential side-effects of SSRI?  If you can’t tolerate one SSRI, you may by able to tolerate a different one.

A: Nausea, vomiting or diarrhea

A: Headache

A: Drowsiness

A: Dry mouth

A: Insomnia

A: Nervousness, agitation or restlessness

A: Dizziness

A: Sexual problems, such as reduced sexual desire, difficult reaching orgasm or inability to maintain an erection (erectile dysfunction).

A: Impact on appetite, leading to weight loss or weight gain.

Q: What are suggestions on usage?

A: Take meds with food – may reduce risk of nausea.  Can take at bedtime, to reduce impact of nausea, if it doesn’t keep you from sleeping.

Q: What are some safety issues or concerns?

A: SSRIs are generally safe for most people.

A: High doses of citalopram (Celexa) may cause dangerous abnormal heart rhythms.  Avoid doses over 40mg a day.  Recommended max dose is 20mg for patients over age 60.

Q: What are some contraindications to be aware of?

A: Inform doctor of any other OTC meds, herbs or other supplements being taken.

A: SSRIs may increase risk of bleeding.  Issue being with other meds that increase risk of bleeding – nonsteroidal antiinflammatory drugs (NSAIDs), aspirin, warfarin (Coumadin) and other blood thinner.

Q: What about having too much Serotonin?  Serotonin Syndrome.

A: This is rare, but the issue is when too much accumulates.  Typically because of combining meds with something like the herbal supplement St. John’s wort.

A: Serotonin Syndrome is signs and symptoms of anxiety, agitation, high fever, sweating, confusion, tremors, restlessness, lack of coordination, major changes in blood pressure and a rapid heart rate.

Q: Any issues with antidepressants and pregnancy?

A: Talk to doctor to review various risks and meds options.

Q: Any concerns with suicide risk with antidepressants?

A: Generally safe, but FDA has strict control over this, and primary area of focus is age 25 and lower.  Antidepressant are more likely to reduce suicide risk in the long run by improving mood.

Q: How do you stop taking antidepressants?

A: Not a good idea to just stop cold, as you could get withdrawal symptoms – discontinuation syndrome.

A: Symptoms of withdrawal include general feeling of uneasiness, nausea, dizziness, lethargy, flu-like symptoms.

Q: Is there a one size fits all drug for everyone?

A: No.  Each person reacts different to each type of antidepressant.  If a drug worked well for a close relative, this should be a primary drug choice to consider, because of inherited trait.  Blood tests can also help fine down the choice.  It can take several weeks or longer for an antidepressant to be fully effective, requires keeping a log and having some patience.

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Overview of Humanity Rising Initiative

NOTE: This document is being edited.

<Insert overview of first meeting and various links

 

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History of System Racism toward African Americans in USA

NOTE: This document currently being edited

-History of African Americans in United States

-Lynching

-Jim Crow

-Research from xx on presenting issues associated with systemic racism – women in childbirth

-Black Lives Matter (BLM)

-Sheryl Hill (Hypno) perspective on communication and Hypno interventions

-Civil Rights Movement — blacks enduring white violence until whites paid attention

-Stats of black-americans vs white-americans – poverty; education; crime; healthcare

 

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Tableau using BSCC data

Tableau is a dynamic Business Intelligence (BI) tool that can take in data and provide myriad options for data analysis – asking questions of the data.

There are various versions (Public – Free), Desktop, Prep, Server.  For the next couple months, I have the full version of Desktop, but will also focus on Public, which is not time-limited.  Only thing of note with Public, is to ensure that no confidential data is included.

In general, the strategy is to take known data (typically in an MS-Excel format) and upload to Tableau.  There may also be online data-sets that you can integrate into a Tableau Vizz.

As there are many moving parts of this system, I’ll place posts within the knowledgebase.

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Community Activism for emergency preparedness

It is rewarding to reflect on consistent efforts where prior community activism reached a tangible desired outcome. These thoughts triggered yesterday at a Commission on Aging meeting where San Luis Obispo County’s Kelly Van Buren and her staff presented on what individuals can do to prepare for a future disaster.

After relocating to Ojai in 2007, I approached Ventura County District 1 Supervisor Steve Bennett with an idea to integrate the “OK Drill” (concept borrowed from Culver City) with his recent adoption of CERT (Community Emergency Response Team) for the Ojai Valley.

Over time, comprehensive collaboration occurred between CERT, Ham Radio and Ojai’s Red Cross chapter.  As each grassroots volunteer group worked together, expanded and matured, the relationship between the community and professional first responders and agencies (Fire, Sheriff, OES, Public Health, Cities, County) deepened.

Here’s an example of a web article I wrote in 2010 which outlines the outcome of the 3rd Annual Ojai Valley OK Drill and highlights all the partners.  Before the proclamation was read I requested the City of Ojai to modify the language to include the OK Drill recurring on the “3rd Wednesday of September at 7PM”.

By 2017, the valley had completed 10 annual Ojai Valley OK Drills.

Then, the Thomas Fire burned 287,000 acres and encircled the entire valley.  While our emergency preparedness had focused on earthquakes, the training material and awareness translated to any emergency.

While any loss of life is tragic, the outcome was two deaths.  A professional firefighter from Moorpark and an automobile driver attempting egress in Santa Paula.

Much credit goes to the last citizens out before 100% evacuation — Ojai Valley Amateur Radio Club; Ojai Chapter of American Red Cross; Ojai Valley CERT.

The community activism was consistently focused on, “neighbor helping neighbor”,  establishing ongoing awareness of personal responsibility, and forming strategic relationships of trust between grassroots volunteer organizations and professional first responders.

Supervisor Steve Bennett’s office have maintained our Drill material on their web-site for several years now.

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Stepping Up Initiative

The Stepping Up Initiative intends to assist counties with developing and implementing a systems-level, data-drive plan that can lead to measurable reductions in the number of people with mental illnesses in local jails.

Web-site Info

KnowledgeBase Articles on Stepping Up

 

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Financials – Student Loans

Grace Period

-After graduation, there is a standard 6-month grace period.

Interest info

-Pay a little now to save a lot later. Although payments aren’t due at this time, interest grows or “accrues” on unsubsidized loans while you’re in school, grace, or deferment. When you enter repayment, this unpaid interest is “capitalized” or added to your loan balance. At that point, interest will then begin to accrue on the new, higher loan balance.

We encourage you to consider making payments while you’re in school, grace, or deferment – no matter how small. Money you are able to apply to your student loan balance now will reduce the amount of accrued interest on your unsubsidized loans. That means less interest to be capitalized and added to your balance later – helping you save money in the long run. You can also make payments on any subsidized loans you have while you’re in school, grace, or deferment, which can reduce your principal balance while receiving a government interest subsidy.

Repayment options

Start learning about repayment plans. The Department of Education website, StudentLoans.gov, will help you evaluate your federal student loan repayment options and determine which plans you may qualify for. While you’re there, log in and try out the Repayment Estimator to see the impact of future borrowing and personalized repayment plan choices, including repayment plans based on income.

 

-Insert Path to Success info

 

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