Sunday, October 21, 2007

Baked Eggplant Parmesean


1 Eggplant- sliced into 1/2 inch slices
Seasoned Breadcrumbs
1 cup Low Moisture, Part-Skim Mozzarella- shredded
1/2 cup Parmesean- shredded
1 jar Marinara Sauce
Olive Oil
Black Pepper
Italian Seasoning

Lightly salt sliced eggplant on both sides and let stand on a paper towel for 30 minutes. Dip moistened eggplant into breadcrumbs and cover both sides. Drizzle with olive oil and baked on a non-stick cookie sheet at 350F for 20 minutes or until brown (no need to flip). In baking dish, starting with sauce, layer eggplant, cheese and seasoning. Repeat until all eggplant is used. Finsh with sauce and cheese on top layer. Baked at 350F for 50 minutes.

White Chicken Chili

8 Boneless, Skinless Chicken Breast- cut into 1 inch pieces
2 cans Garbanzo Beans- drained
2 cans Navy Beans- drained
2 cans Low Sodium Chicken Broth
1 cup Water
2 cans White Corn
3 (4 oz) cans Diced Green Chilis
1 White Onion- thinly sliced
2 Cloves Garlic- minced
1 tsp Louisiana Hot Sauce
1 tsp White Pepper
1 tsp Cumin
1 tbsp Olive Oil
Parmesean Cheese

Preheat oven to 350F. Saute onion, garlic and cumin in olive oil until onions are translucent. Combine chicken, beans, corn, chilis, pepper, Louisiana hot sauce, water and chicken broth in Dutch oven. Add onion mixture to it. Stir well. Cover and cook for 50 minutes. Top with fresh grated parmesean.


3 Zucchini- quartered and sliced
6 small Yellow Squash- halved and sliced
1 lb Whole Mushrooms- cleaned and halved
1 Red Onion- thinly sliced
2 cans Tomato Sauce
2 cans Whole Peeled Tomatoes
1/2 tsp Garlic- minced
1 tsp Marjoram
1 tsp Oregano
Thin Sliced Low-Moisture, Part-Skim Mozzarella Cheese

Brown or White Rice- Cook as directed and serve with Ratatouille

Combine all ingredients in a large soup pot and cook on med-high for about 25 minutes or until vegetables are soft, stirring occasionally. Take off heat and layer the top with cheese slices. Allow cheese to melt and serve over brown or white rice.

Corn Shrimp Soup

2 lbs Small or Medium Shrimp- uncooked, peeled, deveined
2 (14 oz) cans Diced Tomatoes
1 Red Onion- chopped
4 Stalks Celery- chopped
1 Green Bell Pepper- chopped
2 Cloves Garlic- minced
1 can Sweet Yellow Corn
1 can Cream Corn
1 can Green Chilis- diced
1 bunch Scallions- chopped
2 cans Low Sodium Chicken Broth
1/4 tsp Ground Red Pepper
1 tbsp Worcestershire
1 cup Water
1/4 tsp Black Pepper

Combine all ingredients in a crock pot and cook 4-6 hours.

Spinach Dip

1 box Frozen Chopped Spinach
1 carton Fat-Free Sour Cream
1 can Waterchestnuts- peeled and sliced
1 envelope Good Seasons Ranch Mix

Thaw spinach and squeeze out excess moisture. Add to sour cream and mix. Stir in ranch dip mix. Chop waterchestnuts and add to sour cream mixture. Refrigerate for at least 1 hour.

Friday, October 19, 2007

Homemade Soft Pretzels

2 tbsp Warm Water
1 1/3 cups Warm Water
1 package Dry Yeast
1/3 cup Brown Sugar
5 cups Flour (3c Wheat/2c White)
1/2 cup Baking Soda
Kosher Salt

Preheat oven to 475F. Mix 2 tbsp water with dry yeast to dissolve. Stir in the rest of the warm water and brown sugar. Mix in flour until it forms a ball. Knead until smooth. Use cooking spray to coat 2 cookie sheets. Bring large pot of water and baking soda to a boil. Using about a golf ball size of dough, roll and form into the shape you choose. Carefully drop the shaped dough into the water for 30 seconds or until they rise to the top. Put on the cookie sheets and sprinkle with salt. Bake 8-10 minutes until golden brown.

Pumpkin Spice Bread

2 cups Unbleached Flour
1 cup Brown Sugar- packed
1 tbsp Baking Powder
2 tsp Cinnamon
1/2 tsp Nutmeg
1/4 tsp Baking Soda
1/4 tsp Ginger
1/4 tsp Cloves
1 (15oz) canned Pumpkin
1/2 cup Skim Milk
2 Eggs Whites- whipped
1/3 cup Fat-Free Sour Cream

Preheat oven to 350F. Prepare bundt pan or loaf pan with cooking spray and set aside. Combine flour, brown sugar, baking powder, baking soda, cinnamon, nutmeg, ginger and cloves in large mixing bowl. In medium mixing bowl, combine pumpkin, skim milk, egg whites and sour cream. Spoon the pumpkin mixture into the flour mixture and mix just until moistened. Pour batter into prepared pan. Bake 60 minutes.

Thursday, October 18, 2007

ADD and ADHD: Do Foods Make a Difference?

Do you know a teenager who has an inability to stay focused on a given task? Were you a child who found it impossible to sit still in your seat during school? Are you being told your child has a discipline problem? These are common complaints heard by physicians all over the world. After thorough testing and evaluation, the physician may give a diagnosis of ADD (Attention Deficit Disorder) or ADHD (Attention Deficit/Hyperactivity Disorder).

While these children often see an improvement with the addition of medications, little emphasis is ever put on the value of a sound diet. There is some evidence that there could nutrients missings from one's diet that could help with some of the side effects of ADD/ADHD. Some research has even shown that certain foods may even be triggers for some symptoms.

The following article written by Susan Kundrat discusses some of the research being done that draws a link between the cause and effect of nutrition on this disorder.

From the website:
"Susan Kundrat, MS, RD, LDN , CSSD, is the President and founder of Nutrition on the Move, Inc. A Licensed, Registered Dietitian, Susan has a passion for helping clients learn to eat to enhance overall health and wellness. Susan is a member of the Gatorade Sports Nutrition Board."


"Medication can control many symptoms, but doesn’t address the underlying causes and may result in side effects. Therefore, many parents and health practitioners are looking for diet-based alternatives..."

To continue reading this article, click on the website below:

Properly Fuel Your Body

There are so many variables that play a roll in a team's overall performance and success. Coaches often focus their attention on the technical aspects of the game, who is the best player for a given scheme and perhaps even motivate them through inspiring speeches.

An area that is sometimes overlooked by coaches is the importance of fueling their athletes. What if they have not eaten a sound pre-game meal? What happens if the athlete has not prepared for the event by increasing their fluid intake? Evidence that shows what an athlete eats and drinks before and after an athletic event can have a major impact on their performance.

This article by Susan Kundrat outlines the importance of the following topics:

  1. Hydration
  2. Foods for High Energy
  3. Quick Snack Ideas
  4. Foods to Have On-Hand

From the website: "Susan Kundrat, MS, RD, LDN , CSSD, is the President and founder of Nutrition on the Move, Inc. A Licensed, Registered Dietitian, Susan has a passion for helping clients learn to eat to enhance overall health and wellness. Susan is a member of the Gatorade Sports Nutrition Board."


"People who are involved in an exercise program for fitness and health can learn to maximize their training efforts and get more out of a workout by learning to fuel their bodies with the right foods and fluids...."

To continue reading this article, click on the website below:

Wednesday, October 17, 2007

Tomato Salsa

1 lb Tomatoes- peeled if desired, seeded and chopped
1 small Onion- minced
1 Jalapeno Chili- seeded and minced
1 tbsp Lime Juice
2 tbsp chopped coriander (if desired)

In a bowl, toss the tomatoes, onion, chili pepper, lime juice, coriander and salt (to taste) and let salsa stand for at least 30 minutes. Serve.

Tortellini with Spinach and Cherry Tomatoes

1 (9 oz) pack Three-Cheese Tortellini
2 tsp Olive Oil
2 tsp Minced Garlic
1/2 to 3/4 tsp Crushed Red Pepper
2 cups Cherry Tomatoes- halved
1/4 cup Fat-Free, Low-Sodium Chicken Broth
1 tbsp Fresh Basil- chopped
1/4 tsp Salt
1 (6 oz) package Fresh Baby Spinach

Cook tortellini according to package directions. While tortellini cooks, heat oil in large non-stick skillet over medium-high heat. Add garlic and red pepper; saute 30 seconds. Add tomatoes, broth, basil, salt, and baby spinach to pan. Cook 2 minutes or until baby spinach wilts. Stir in tortellini and cook 1 additional minute.



1 (15 oz) can Chickpeas (about 2 cups)
1 Lemon
2 tbsp Tahini
2 tbsp Olive Oil
1 small Garlic Clove
Small Handful of Fresh Parsley Leaves
1/4 tsp Salt
Black Pepper
1/4 tsp Ground Cumin
Paprika (optional)

Drain chickpeas in colander and rinse. Drain again, then remove 1 tbsp of chickpeas and set aside. Place the remaining chickpeas in food processor. Cut lemon in half and squeeze out juice into food processor being careful to remove seeds. Add tahini, olive oil, garlic clove, parsley, salt, pepper and cumin to chickpea mix. Process mix for 20 seconds. Remove lid and scrap down sides with rubber spatula and puree for an additional 20 seconds. Add remaining chickpeas and pulse for 3 seconds. Spoon hummus into serving dish. Sprinkle with paprika (optional).



1-2 Ripe Avocados
1 Medium Tomato
1/2 Medium Red Onion
2 tsp Lime Juice (can use fresh lime)
1 Small Garlic Clove
1 Green Chili Pepper- seeded and chopped
Black Pepper
Cut the avocado in half lengthwise, all around the pit. Twist gently and pull apart. Remove the pit. Using a spoon, scoop around the inside of the skin and remove flesh and put into a bowl. Gently mash with a fork into a lumpy puree. Add chopped onion and chopped green chili to puree. Cut the tomato into quarters. Trim off the core then cut each quarter into 8 to 10 chunks. Add to avocado. Add 2 tsp of lime juice to the avocado mixture. Peel garlic and chop it finely; add to avocado. Add salt and pepper to taste.

Tuesday, October 16, 2007

Creamy Basil and Tomato Pasta


2 lbs Tomatoes- chopped (about 3 cups)
1 (8 oz) pkg Philadelphia Light Cream Cheese- cubed
1/4 cup Kraft Sun Dried Tomato Vinaigrette Dressing
1/2 cup Fresh Basil- chopped
1 (16 oz) pkg Whole Wheat or Barilla Plus Linguine or Fettucini
1/2 cup Pine Nuts- toasted (optional)

Toss tomatoes with cream cheese and dressing; cover. refrigerate at least 2 hours. Cook pasta as directed on package; drain. Place in large bowl. Add tomato mixture and pine nuts; toss lightly.

Creamy Spinach and Tortellini

1 (16 oz) package Fresh or Frozen Uncooked Cheese Tortellini
2 tbsp Olive Oil
1/2 cup Onion- chopped
3 Garlic Cloves- chopped
1 (9 oz) package Frozen Chopped Spinach- thawed
1 Large Tomato- cubed
1/4 cup Fresh Basil
1/2 tsp Salt
1/2 tsp Pepper
1 cup Reduced Fat Whipping Cream
1/4 cup Freshly Grated Parmesean Cheese

Cook tortellini according to package directions; drain and return to pan to keep warm. In large pan over medium heat, heat olive oil. Add onion and garlic; saute 4 minutes or until light brown. Stir in spinach, tomato, basil, salt and pepper; cook another 5 minutes, stirring occasionally. Stir in whipping bream and parmesean cheese. Cook until mixture comes to a boil. Reduce heat to low and mix in tortellini and cook another 4 minutes until thoroughly heated. Remove from heat and transfer to individual serving plates and top with additional parmesean cheese.

Red Beans and Sausage


2 lbs Hickory Smoked Sausage- sliced
1 Red Bell Pepper- chopped
1 Green Bell Pepper- chopped
3 Celery Ribs- chopped
1 cup Onion- chopped
4 Garlic Cloves- minced
3 (15 oz) can Red Beans- drained
1 (15 oz) can Tomato Sauce
1 2/3 cups Water
3 tbsp Sweet Pepper Sauce
1 tbsp Worchestershire Sauce
2 tsp Hot Sauce
1 1/2 cups Uncooked Long Grain Rice

Cook sausage in a dutch oven over medium-high heat about 5 minutes, stirring until sausage is brown. Remove sausage, and drain on paper towels, reserving 1 tbsp drippings in Dutch oven. Saute bell peppers and next three ingredients in hot drippings 5 minutes until tender. Stir in red beans and next five ingredients. Bring to a boil, reduced heat, and simmer 15 minutes. Stir in sausage. Simmer and cover 1 1/2 hours. Prepare rice according to package directions. Serve red beans over hot cooked rice.

Baked Pita Chips


1 (8 oz) package Pita Bread
Olive Oil Cooking Spray
Coarsely Ground Kosher Salt

Seperate each pita into 2 rounds. Cut each round into 4 wedges. Arrange in a single layer on an ungreased baking sheet. Coat with olive oil cooking spray and sprinkle evenly with kosher salt. Bake at 350F for 12 to 15 minutes or until golden and crisp.

Whole Grain Marshmallow Crispy Bars

3 tbsp butter (can use Smart Balance)
1 (10.5 oz) bag Miniature Marshmallows
1 (15 oz) box Multi-Grain Cluster Cereal (can use Kashi GoLean Crunch)
1 1/4 cups Dried Cranberries- divided
Vegetable Cooking Spray

Melt butter in large saucepan over low heat. Add marshmallows, and cook, stirring constantly, 4 to 5 minutes or until melted and smooth. Remove from heat. Stir in cereal and 1 cup of cranberries until well coated. Press mixture into a 13 x 9 inch baking dish coated with cooking spray. Chop remaining 1/4 cup cranberries, and sprinkle on top. Let stand 10 to 15 minutes or until firm.

Corn, Mango and Edamame Salad

2 cups Frozen Shelled Edamame
1 1/2 cup Fresh Corn Kernels
1 1/2 cup Mango Cubes (1 med)
1 cup Chopped Tomato (1 lg)
1/2 cup Red Onion- chopped
2 tbsp Fresh Cilantro- chopped
1 tbsp Extra Virgin Olive Oil
1 tbsp Lime Juice
3/4 tsp Salt
1/4 tsp Ground Black Pepper

Prepare edamame per package directions. Drain and rinse under cold water. Trandfer to large bowl. Stir in corn, mango, tomato, onion, cilantro, oil, lime juice, salt and pepper. Toss well.

Green Beans with Bacon


3 Reduced Fat Bacon Slices
1 cup Sweet Onion- chopped
2 (12oz) packages Frozen Green Beans- thawed
1 cup Low-Sodium Fat-Free Chicken Broth
2 tbsp Dijon Mustard
Salt and Pepper to taste

Cook bacon in large nonstick skillet over med-high heat 6-8 minutes or until crisp; remove bacon, and drain on paper towels, reserving 2 tsp drippings in skillet. Crumble bacon. Saute onion in hot drippings in skillet over med0high heat 2-3 minutes or until golden. Add green beans, broth and mustard, tosdsing to coat. Reduce heat to medium; cover and cook 5 miutes. Uncover and cook, stirring occasionally, 3 to 5 more minutes or until liquid thickens and is reduced by half. Add salt and papper to taste. Top with crumbled bacon. Serve immediatley,

Photograph: William Dickey

Spice Rubbed Flank Steak


3 tbsp Brown Sugar
2 tsp Ground Cumin
2 tsp Ground Oregeno
2 tsp Garlic Powder
1/2 tsp Salt
1/4 tsp Ground Allspice
1 1/2 tbsp Extra Virgin Olive Oil
1 (2lb) Flank Steak- trimmed
Vegetable Cooking Spray

Combine first 6 ingredients in a shallow bowl. Stir in olive oil until combined. Gently rub olive oil mixture evenly on steak. Let stand 20 minutes. Coat cold cooking grate on grill over medium-high heat (350F to 400F). Place steak on cooking grate, and grill, covered with grill lid, 8 minutes on each side of until desired degree of doneness. Let stand 5 minutes; cut steak diagnoally accross the grain into thin slices.

Thursday, October 11, 2007

Barbeque Quesadillas

8 (10-inch) Flour or Wheat Tortillas
1/2 cup Barbecue Sauce
8 ounces (2 cups) Monterey Jack Cheese- shredded
1 1/2 cups Diced Cooked Chicken (can use Rotisseire Chicken)

For each quesadilla, spread 1 tortilla with 2 tablespoons barbecue sauce. Layer with 1/4 cup cheese, 1/4 chicken and 1/4 cup cheese. Place layered tortilla in 12-inch skillet. Top with second tortilla. Cook over medium heat, turning once, until cheese is melted (2 to 3 minutes). Repeat with remaining ingredients. To serve, cut into wedges.

Marucci Pumpkin Pie


1 (9 inch) Unbaked Pie Shell
1 (16 oz) Canned Pumpkin
1 (14 oz) Fat Free Condensed Milk
2 Eggs or 4 Egg Whites
1 tsp Ground Cinnamon
1/2 tsp Ground Ginger
1/2 tsp Nutmeg
1/2 tsp Salt
1/4-1/2 tsp Ground Cloves

In large bowl, combine ingredients, mix well and turn into pie shell. Bake 15 minutes at 425 degrees. Reduce heat to 350 degrees and bake an additional 35 to 40 minutes or until knife inserted 1 inch from edge comes out clean. Cool in refrigerator before serving.

Wednesday, October 10, 2007

Vitamins and Minerals, Sources and Functions


Best Sources



Retinol Carotene


Eggs, dark green and yellow vegetables and fruits, lowfat dairy products, liver

Growth and repair of body tissue, immune functions, night vision




Wheat germ, pork, whole and enriched grains, dried beans, seafood

Carbohydrate metabolism, appetite maintenance, nerve function, growth and muscle tone




Lowfat milk products, green leafy vegetables, whole and enriched grains, beef, lamb, eggs

Carbohydrate, protein and fat metabolism, needed for cell respiration, mucous membranes




Fish, poultry, lean meat, whole grain, potatoes

Carbohydrate and protein metabolism, formation of antibodies, red blood cells, nerve function




Lean beef, fish, poultry, eggs, lowfat and nonfat milk

Carbohydrate, fat and protein metabolism, maintains nervous system, blood cell formation


(No RDA)

Egg yolk, meat, lowfat and nonfat milk, dark green vegetables; also made by microorganisms in intestinal tract

Carbohydrate, protein and fat metabolism, formation of fatty acids, utilization of B vitamins

Folic Acid


Green leafy vegetables, dried beans, poultry, fortified cereals, oranges, nuts

Red blood cell formation, protein metabolism, growth and cell division



Poultry, fish, whole and enriched grains, dried beans and peas

Carbohydrate, protein and fat metabolism, health and digestive system, blood circulation, nerve function, appetite

Pantothenic Acid

(No RDA)

Most plant and animal foods, especially leans meats, whole grains, legumes

Converts nutrients into energy, vitamin utilization, nerve function


Ascorbic Acid


Citrus fruits, tomatoes, melons, berries, green and red peppers, broccoli

Wound healing, strengthens blood vessels, collagen maintenance, resistance to infection, healthy gums




200-400 IU

Egg yolk, fatty fish, fortified milk, also made in skin exposed to light

Calcium and phosphorus metabolism (bone and teeth formation)




Vegetable oil, wheat germ, nuts, dark green vegetables, whole grains, beans

Protects cell membranes and red blood cells from oxidation, may be active in immune function



Green leafy vegetables, cereal, egg yolk

Formation of blood clotting agents and bone


Best Sources




Lowfat or nonfat milk products, calcium fortified orange juice and bread, salmon with bones

Support of bone, teeth, muscle tissue, regulates heart beat, muscle action, nerve functions, blood clotting


(No RDA)

Cheese, whole grains, meats, peas, beans

Needed glucose for metabolism (energy), increases effectiveness of insulin, muscle function


(No RDA)

Nuts, dried beans, oysters, cocoa powder

Formation of red blood cells, pigment, needed for bone health



Seafood, iodized salt

Function of thyroid gland, which controls metabolism



Meat, fish, poultry, organ meats, beans, whole and enriched grains, green leafy vegetables

Formation of hemoglobin in blood and myoglobin in muscle, which supply oxygen to cells



Nuts, green vegetables, whole grains, beans

Enzyme activation, nerve and muscle function, bone growth



Meat, poultry, fish, eggs, lowfat milk products, beans, whole grains

Bone development, carbohydrate, protein and fat utilization


(No RDA)

Vegetables, fruits, beans, bran cereal, lowfat milk products

Fluid balance, controls activity of heart muscle, nervous system



Seafood, lean meat, grains, eggs, chicken, garlic

Fights cell damage from oxidation



Lean meat, eggs, seafood, whole grains, lowfat milk products

Taste and smell sensitivity, regulation of metabolism, aids in healing

Antidepression Medications: Are There Side Effects?

Antidepressants may cause mild and, usually, temporary side effects (sometimes referred to as adverse effects) in some people. Typically these are annoying, but not serious. However, any unusual reactions or side effects or those that interfere with functioning should be reported to the doctor immediately.

The most common side effects of tricyclic antidepressants, and ways to deal with them, are:

  • Dry mouth- It is helpful to drink sips of water; chew sugarless gum; clean teeth daily.

  • Constipation- Bran cereals, prunes, fruit, and vegetables should be in the diet.

  • Bladder problems- Emptying the bladder may be troublesome, and the urine stream may not be as strong as usual; the doctor should be notified if there is marked difficulty or pain.

  • Sexual problems- Sexual functioning may change; if worrisome, it should be discussed with the doctor. There is a solution.

  • Blurred Vision- This will pass soon and will not usually necessitate new glasses.

  • Dizziness- Rising from the bed or chair slowly is helpful.

  • Drowsiness- As a daytime problem this usually passes soon. A person feeling drowsy or sedated should not drive or operate heavy equipment. The more sedating antidepressants are generally taken at bedtime to help sleep and minimize daytime drowsiness.

The newer antidepressants have different types of side effects:

  • Headache- This will usually go away.

  • Nausea- This is also temporary, but even when it occurs, it is transient after each dose.

  • Nervousness and insomnia (trouble falling asleep or waking often during the night)- These may occur during the first few weeks; dosage reductions or time will usually resolve them.

  • Agitation (feeling jittery)- If this happens for the first time after the drug is taken and is more than transient, the doctor should be notified.

  • Sexual problems- The doctor should be consulted if the problem is persistent or worrisome.

Depression: Do Medications Work?

There are several types of antidepressant medications used to treat depressive disorders. These include newer medications chiefly the selective serotonin reuptake inhibitors (SSRIs) the tricyclics, and the monoamine oxidase inhibitors (MAOIs). The SSRIs and other newer medications that affect neurotransmitters such as dopamine or norepinephrine generally have fewer side effects than tricyclics. Sometimes the doctor will try a variety of antidepressants before finding the most effective medication or combination of medications. Sometimes the dosage must be increased to be effective. Although some improvements may be seen in the first few weeks, antidepressant medications must be taken regularly for 3 to 4 weeks (in some cases, as many as 8 weeks) before the full therapeutic effect occurs.

Patients often are tempted to stop medication too soon. They may feel better and think they no longer need the medication. Or they may think the medication isn’t helping at all. It is important to keep taking medication until it has a chance to work, though side effects may appear before antidepressant activity does. Once the individual is feeling better, it is important to continue the medication for at least 4 to 9 months to prevent a recurrence of the depression. Some medications must be stopped gradually to give the body time to adjust. Never stop taking an antidepressant without consulting the doctor for instructions on how to safely discontinue the medication. For individuals with bipolar disorder or chronic major depression, medication may have to be maintained indefinitely.

Antidepressant drugs are not habit-forming. However, as is the case with any type of medication prescribed for more than a few days, antidepressants have to be carefully monitored to see if the correct dosage is being given. The doctor will check the dosage and its effectiveness regularly.

Depression: Is There a Treatment?

The first step to getting appropriate treatment for depression is a physical examination by a physician. Certain medications as well as some medical conditions such as a viral infection can cause the same symptoms as depression, and the physician should rule out these possibilities through examination, interview, and lab tests. If a physical cause for the depression is ruled out, a psychological evaluation should be done, by the physician or by referral to a psychiatrist or psychologist.

A good diagnostic evaluation will include a complete history of symptoms, i.e., when they started, how long they have lasted, how severe they are, whether the patient had them before and, if so, whether the symptoms were treated and what treatment was given. The doctor should ask about alcohol and drug use, and if the patient has thoughts about death or suicide. Further, a history should include questions about whether other family members have had a depressive illness and, if treated, what treatments they may have received and which were effective.

Last, a diagnostic evaluation should include a mental status examination to determine if speech or thought patterns or memory have been affected, as sometimes happens in the case of a depressive or manic-depressive illness.

Treatment choice will depend on the outcome of the evaluation. There are a variety of antidepressant medications and psychotherapies that can be used to treat depressive disorders. Some people with milder forms may do well with psychotherapy alone. People with moderate to severe depression most often benefit from antidepressants. Most do best with combined treatment: medication to gain relatively quick symptom relief and psychotherapy to learn more effective ways to deal with life’s problems, including depression. Depending on the patient’s diagnosis and severity of symptoms, the therapist may prescribe medication and/or one of the several forms of psychotherapy that have proven effective for depression.

Males & Depression: Are The Signs & Symptoms Different?

Although men are less likely to suffer from depression than women, 6 million men in the United States are affected by the illness. Men are less likely to admit to depression, and doctors are less likely to suspect it. The rate of suicide in men is four times that of women, though more women attempt it. In fact, after age 70, the rate of men’s suicide rises, reaching a peak after age 85.

Depression can also affect the physical health in men differently from women. A new study shows that, although depression is associated with an increased risk of coronary heart disease in both men and women, only men suffer a high death rate.

Men’s depression is often masked by alcohol or drugs, or by the socially acceptable habit of working excessively long hours. Depression typically shows up in men not as feeling hopeless and helpless, but as being irritable, angry, and discouraged; hence, depression may be difficult to recognize as such in men. Even if a man realizes that he is depressed, he may be less willing than a woman to seek help. Encouragement and support from concerned family members can make a difference. In the workplace, employee assistance professionals or worksite mental health programs can be of assistance in helping men understand and accept depression as a real illness that needs treatment.

Females and Depression: Are They More Vulnerable?

Women experience depression about twice as often as men. Many hormonal factors may contribute to the increased rate of depression in women particularly such factors as menstrual cycle changes, pregnancy, miscarriage, postpartum period, pre-menopause, and menopause. Many women also face additional stresses such as responsibilities both at work and home, single parenthood, and caring for children and for aging parents.

A recent NIMH study showed that in the case of severe premenstrual syndrome (PMS), women with a preexisting vulnerability to PMS experienced relief from mood and physical symptoms when their sex hormones were suppressed. Shortly after the hormones were re-introduced, they again developed symptoms of PMS. Women without a history of PMS reported no effects of the hormonal manipulation.

Many women are also particularly vulnerable after the birth of a baby. The hormonal and physical changes, as well as the added responsibility of a new life, can be factors that lead to postpartum depression in some women. While transient “blues” are common in new mothers, a full-blown depressive episode is not a normal occurrence and requires active intervention.

Treatment by a sympathetic physician and the family’s emotional support for the new mother are prime considerations in aiding her to recover her physical and mental well-being and her ability to care for and enjoy the infant.

Depression: Why am I Feeling So Bad?

Causes of Depression

Some types of depression run in families, suggesting that a biological vulnerability can be inherited. This seems to be the case with bipolar disorder. Studies of families in which members of each generation develop bipolar disorder found that those with the illness have a somewhat different genetic makeup than those who do not get ill. However, the reverse is not true: Not everybody with the genetic makeup that causes vulnerability to bipolar disorder will have the illness. Apparently additional factors, possibly stresses at home, work, or school, are involved in its onset.

In some families, major depression also seems to occur generation after generation. However, it can also occur in people who have no family history of depression. Whether inherited or not, major depressive disorder is often associated with changes in brain structures or brain function.

People who have low self-esteem, who consistently view themselves and the world with pessimism or who are readily overwhelmed by stress, are prone to depression. Whether this represents a psychological predisposition or an early form of the illness is not clear.

In recent years, researchers have shown that physical changes in the body can be accompanied by mental changes as well. Medical illnesses such as stroke, a heart attack, cancer, Parkinson’s disease, and hormonal disorders can cause depressive illness, making the sick person apathetic and unwilling to care for his or her physical needs, thus prolonging the recovery period. Also, a serious loss, difficult relationship, financial problem, or any stressful (unwelcome or even desired) change in life patterns can trigger a depressive episode. Very often, a combination of genetic, psychological, and environmental factors is involved in the onset of a depressive disorder. Later episodes of illness typically are precipitated by only mild stresses, or none at all.

Depression: Signs & Symptoms

Not everyone who is depressed or manic experiences every symptom. Some people experience a few symptoms, some many. Severity of symptoms varies with individuals and also varies over time.

Signs & Symptoms may include:

  • Persistent sad, anxious, or “empty” mood
  • Feelings of hopelessness, pessimism
  • Feelings of guilt, worthlessness, helplessness
  • Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
  • Decreased energy, fatigue, being “slowed down”
  • Difficulty concentrating, remembering, making decisions
  • Insomnia, early-morning awakening, or oversleeping
  • Appetite and/or weight loss or overeating and weight gain
  • Thoughts of death or suicide; suicide attempts
  • Restlessness, irritability
  • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain

Are There Different Types of Depression?

Depressive disorders come in different forms, just as is the case with other illnesses such as heart disease. The three of the most common types of depressive disorders are described below. However, within these types there are variations in the number of symptoms, their severity, and persistence.

  1. Major depression is manifested by a combination of symptoms that interfere with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. Such a disabling episode of depression may occur only once but more commonly occurs several times in a lifetime.
  2. A less severe type of depression, dysthymia, involves long-term, chronic symptoms that do not disable, but keep one from functioning well or from feeling good. Many people with dysthymia also experience major depressive episodes at some time in their lives.
  3. Another type of depression is bipolar disorder, also called manic-depressive illness. Not nearly as prevalent as other forms of depressive disorders, bipolar disorder is characterized by cycling mood changes: severe highs (mania) and lows (depression). Sometimes the mood switches are dramatic and rapid, but most often they are gradual. When in the depressed cycle, an individual can have any or all of the symptoms of a depressive disorder. When in the manic cycle, the individual may be overactive, overtalkative, and have a great deal of energy. Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. For example, the individual in a manic phase may feel elated, full of grand schemes that might range from unwise business decisions to romantic sprees. Mania, left untreated, may worsen to a psychotic state.

Depression: What Is It?

In any given 1-year period, 9.5 percent of the population, or about 20.9 million American adults, suffer from a depressive illness. The economic cost for this disorder is high, but the cost in human suffering cannot be estimated. Depressive illnesses often interfere with normal functioning and cause pain and suffering not only to those who have a disorder, but also to those who care about them. Serious depression can destroy family life as well as the life of the ill person. But much of this suffering is unnecessary.

Most people with a depressive illness do not seek treatment, although the great majority even those whose depression is extremely severe can be helped. Thanks to years of fruitful research, there are now medications and psychosocial therapies such as cognitive/behavioral, “talk” or interpersonal that ease the pain of depression.

A depressive disorder is an illness that involves the body, mood, and thoughts. It affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely “pull themselves together” and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from depression.

Unfortunately, many people do not recognize that depression is a treatable illness. If you feel that you or someone you care about is one of the many undiagnosed depressed people in this country, the information presented here may help you take the steps that may save your own or someone else’s life.

Panic Disorder: Q & A

Q: When does panic disorder start and how long does it last?
A: It usually starts when people are young adults, around 18 to 24 years old. Sometimes it starts when a person is under a lot of stress, for example after the death of a loved one or after having a baby. Anyone can have panic disorder, but more women than men have the illness. It sometimes runs in families. Panic disorder can last for a few months or for many years.

Q: How many people suffer from apnic disorder?
A: An estimate of 6 million Americans suffer from panic disorder.

Q: What can you do about your panic disorder?
A: Talk to your doctor about your fear and panic attacks.Tell your doctor if the panic attacks keep you from doing everyday things and living your life. Ask your doctor for a checkup to make sure you don’t have some other illness. Ask your doctor if he or she has helped other people with panic disorder. Special training is needed to help doctors treat people with panic disorder. If your doctor doesn’t have special training, ask for the name of a doctor or counselor who does.

Q: How can you get more information?
A: Call 1-866-615-6464 to have free information mailed to you.

Q: What can a doctor or counselor do to help you?
A: The doctor may give you medicine. Medicine usually helps people with panic disorder feel better after a few weeks. Talking to a specially trained doctor or counselor who can teach you ways to cope with your panic attacks helps many people with panic disorder. This is called “therapy.” Therapy will help you feel less afraid and anxious.

Panic Disorders: What Are They?

Panic disorder is a real illness. It can be treated with medicine or therapy.

If you have panic disorder, you feel suddenly terrified for no reason. These frequent bursts of terror are called panic attacks. During a panic attack, you also have scary physical feelings like a fast heartbeat, trouble breathing, or dizziness.

Panic attacks can happen at any time and any place without warning. They often happen in grocery stores, malls, crowds, or while traveling.

You may live in constant fear of another attack and may stay away from places where you have had an attack. For some people, fear takes over their lives and they are unable to leave their homes.

Panic attacks don’t last long, but they are so scary they feel like they go on forever.

Anorexia Nervosa: Is There a Treatment?

Eating disorders can be treated and a healthy weight restored. The sooner these disorders are diagnosed and treated, the better the outcomes are likely to be. Because of their complexity, eating disorders require a comprehensive treatment plan involving medical care and monitoring, psychosocial interventions, nutritional counseling and, when appropriate, medication management. At the time of diagnosis, the clinician must determine whether the person is in immediate danger and requires hospitalization.

Treatment of anorexia calls for a specific program that involves three main phases: (1) restoring weight lost to severe dieting and purging; (2) treating psychological disturbances such as distortion of body image, low self-esteem, and interpersonal conflicts; and (3) achieving long-term remission and rehabilitation, or full recovery. Early diagnosis and treatment increases the treatment success rate. Use of psychotropic medication in people with anorexia should be considered only after weight gain has been established. Certain selective serotonin reuptake inhibitors (SSRIs) have been shown to be helpful for weight maintenance and for resolving mood and anxiety symptoms associated with anorexia.

The acute management of severe weight loss is usually provided in an inpatient hospital setting, where feeding plans address the person's medical and nutritional needs. In some cases, intravenous feeding is recommended. Once malnutrition has been corrected and weight gain has begun, psychotherapy (often cognitive-behavioral or interpersonal psychotherapy) can help people with anorexia overcome low self-esteem and address distorted thought and behavior patterns. Families are sometimes included in the therapeutic process.

Bulimia Nervosa: Is There a Treatment?

The primary goal of treatment for bulimia is to reduce or eliminate binge eating and purging behavior. To this end, nutritional rehabilitation, psychosocial intervention, and medication management strategies are often employed. Establishment of a pattern of regular, non-binge meals, improvement of attitudes related to the eating disorder, encouragement of healthy but not excessive exercise, and resolution of co-occurring conditions such as mood or anxiety disorders are among the specific aims of these strategies. Individual psychotherapy (especially cognitive-behavioral or interpersonal psychotherapy), group psychotherapy that uses a cognitive-behavioral approach, and family or marital therapy have been reported to be effective. Psychotropic medications, primarily antidepressants such as the selective serotonin reuptake inhibitors (SSRIs), have been found helpful for people with bulimia, particularly those with significant symptoms of depression or anxiety, or those who have not responded adequately to psychosocial treatment alone. These medications also may help prevent relapse. The treatment goals and strategies for binge-eating disorder are similar to those for bulimia, and studies are currently evaluating the effectiveness of various interventions.

People with eating disorders often do not recognize or admit that they are ill. As a result, they may strongly resist getting and staying in treatment. Family members or other trusted individuals can be helpful in ensuring that the person with an eating disorder receives needed care and rehabilitation. For some people, treatment may be long term.

Binge-Eating Disorder: What Is It?

Community surveys have estimated that between 2 percent and 5 percent of Americans experience binge-eating disorder in a 6-month period.

Symptoms of binge-eating disorder include:

  • Recurrent episodes of binge eating, characterized by eating an excessive amount of food within a discrete period of time and by a sense of lack of control over eating during the episode
  • The binge-eating episodes are associated with at least 3 of the following: eating much more rapidly than normal; eating until feeling uncomfortably full; eating large amounts of food when not feeling physically hungry; eating alone because of being embarrassed by how much one is eating; feeling disgusted with oneself, depressed, or very guilty after overeating
  • Marked distress about the binge-eating behavior
  • The binge eating occurs, on average, at least 2 days a week for 6 months
  • The binge eating is not associated with the regular use of inappropriate compensatory behaviors (e.g., purging, fasting, excessive exercise)

People with binge-eating disorder experience frequent episodes of out-of-control eating, with the same binge-eating symptoms as those with bulimia. The main difference is that individuals with binge-eating disorder do not purge their bodies of excess calories. Therefore, many with the disorder are overweight for their age and height. Feelings of self-disgust and shame associated with this illness can lead to bingeing again, creating a cycle of binge eating.

Bulimia Nervosa: What Is It?

An estimated 1.1 percent to 4.2 percent of females have bulimia nervosa in their lifetime.

Symptoms of bulimia nervosa include:

  • Recurrent episodes of binge eating, characterized by eating an excessive amount of food within a discrete period of time and by a sense of lack of control over eating during the episode
  • Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting or misuse of laxatives, diuretics, enemas, or other medications (purging); fasting; or excessive exercise
  • The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months
  • Self-evaluation is unduly influenced by body shape and weight

Because purging or other compensatory behavior follows the binge-eating episodes, people with bulimia usually weigh within the normal range for their age and height. However, like individuals with anorexia, they may fear gaining weight, desire to lose weight, and feel intensely dissatisfied with their bodies. People with bulimia often perform the behaviors in secrecy, feeling disgusted and ashamed when they binge, yet relieved once they purge.

Anorexia Nervosa: What Is It?

An estimated 0.5 to 3.7 percent of females suffer from anorexia nervosa in their lifetime.

Symptoms of anorexia nervosa include:

  • Resistance to maintaining body weight at or above a minimally normal weight for age and height

  • Intense fear of gaining weight or becoming fat, even though underweight

  • Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight

  • Infrequent or absent menstrual periods (in females who have reached puberty)

People with this disorder see themselves as overweight even though they are dangerously thin. The process of eating becomes an obsession. Unusual eating habits develop, such as avoiding food and meals, picking out a few foods and eating these in small quantities, or carefully weighing and portioning food. People with anorexia may repeatedly check their body weight, and many engage in other techniques to control their weight, such as intense and compulsive exercise, or purging by means of vomiting and abuse of laxatives, enemas, and diuretics. Girls with anorexia often experience a delayed onset of their first menstrual period.

The course and outcome of anorexia nervosa vary across individuals: some fully recover after a single episode; some have a fluctuating pattern of weight gain and relapse; and others experience a chronically deteriorating course of illness over many years. The mortality rate among people with anorexia has been estimated at 0.56 percent per year, or approximately 5.6 percent per decade, which is about 12 times higher than the annual death rate due to all causes of death among females ages 15-24 in the general population. The most common causes of death are complications of the disorder, such as cardiac arrest or electrolyte imbalance, and suicide.

Eating Disorders: What's The Cause?

Eating is controlled by many factors, including appetite, food availability, family, peer, and cultural practices, and attempts at voluntary control. Dieting to a body weight leaner than needed for health is highly promoted by current fashion trends, sales campaigns for special foods, and in some activities and professions. Eating disorders involve serious disturbances in eating behavior, such as extreme and unhealthy reduction of food intake or severe overeating, as well as feelings of distress or extreme concern about body shape or weight. Researchers are investigating how and why initially voluntary behaviors, such as eating smaller or larger amounts of food than usual, at some point move beyond control in some people and develop into an eating disorder. Studies on the basic biology of appetite control and its alteration by prolonged overeating or starvation have uncovered enormous complexity, but in the long run have the potential to lead to new pharmacologic treatments for eating disorders.

Eating disorders are not due to a failure of will or behavior; rather, they are real, treatable medical illnesses in which certain maladaptive patterns of eating take on a life of their own. The main types of eating disorders are anorexia nervosa and bulimia nervosa. A third type, binge-eating disorder, has been suggested but has not yet been approved as a formal psychiatric diagnosis. Eating disorders frequently develop during adolescence or early adulthood, but some reports indicate their onset can occur during childhood or later in adulthood.

Eating disorders frequently co-occur with other psychiatric disorders such as depression, substance abuse, and anxiety disorders. In addition, people who suffer from eating disorders can experience a wide range of physical health complications, including serious heart conditions and kidney failure which may lead to death. Recognition of eating disorders as real and treatable diseases, therefore, is critically important.

Females are much more likely than males to develop an eating disorder. Only an estimated 5 to 15 percent of people with anorexia or bulimia and an estimated 35 percent of those with binge-eating disorder are male.

Melatonin: Is This NCAA Banned?

While melatonin is not banned by the NCAA, it is impermissible for Athletic Departments to provide student athletes with melatonin.

... Nonpermissible Amino acids Chrysin Condroitin Creatine/creatine-containing compounds Ginseng Glucosamine Glycerol HMB I-carnitin Melatonin Pos-2 Protein powders Tribulus Supplements Containing Protein Also during the July 26 telephone conference, the subcommittee ...

Melatonin: What Is It?

This hormone is made by the pineal gland, a structure in the brain. Contrary to the claims of some, secretion of melatonin does not necessarily decrease with age. Instead, a number of factors, including light and many common medications, can affect melatonin secretion in people of any age.

Melatonin supplements can be bought without a prescription. Some people claim that melatonin is an anti-aging remedy, a sleep remedy, and an antioxidant (antioxidants protect against free radicals, which are naturally occurring oxygen-related molecules that cause damage to the body). Early test-tube studies suggested that, in large doses, melatonin might be effective against free radicals. However, cells produce antioxidants naturally, and in test-tube experiments, cells reduce the amount they make when they are exposed to additional antioxidants.

Claims that melatonin can slow or reverse aging are very far from proven. Studies of melatonin have been much too limited to support these claims and have focused on animals, not people.
Research on sleep shows that melatonin plays a role in our daily sleep/wake cycle, and that supplements, in amounts ranging from 0.1 to 0.5 milligrams, can improve sleep in some cases. If melatonin is taken at the wrong time, though, it can disrupt the sleep/wake cycle. Other side effects may include confusion, drowsiness, and headache the next morning. Animal studies suggest that melatonin may cause some blood vessels to constrict, a condition that could be dangerous for people with high blood pressure or other cardiovascular problems.

These side effects are important to keep in mind since the dose of melatonin usually sold in stores—3 milligrams—can result in amounts in the blood from 10 to 40 times higher than normal. What long-term effects such high concentrations of melatonin may have on the body are still unknown. Until researchers find out more, caution is advised.

Human Growth Hormone: Is This NCAA Banned?

YES! It is considered anabolic agent and is banned by the NCAA.

... related compounds . .(e) Street Drugs: . heroin tetrahydrocannabinol . marijuana.3. (THC).3 . .(f) Peptide Hormones and Analogues : . corticotrophin (ACTH) . growth hormone (hGH, somatotrophin) . human chorionic gonadotrophin (hCG) . insulin like growth factor (IGF-1) .luteinizing hormone (LH) .(all the respective releasing factors of the above- .mentioned ...

DHEA: Is This NCAA Banned?

YES! It is considered an anabolic agent and is banned by the NCAA.

... b) Anabolic Agents: . anabolic steroids . androstenediol methyltestosterone . androstenedione nandrolone . boldenone norandrostenediol . clostebol norandrostenedione . dehydrochlormethyl- norethandrolone . testosterone oxandrolone . dehydroepiandro- oxymesterone . sterone (DHEA) oxymetholone . dihydrotestosterone stanozolol . (DHT) testosterone.2. . dromostanolone tetrahydrogestrinone (THG) . epitrenbolone trenbolone . fluoxymesterone and related compounds . gestrinone . mesterolone other ...

Human Growth Hormone: What Is It?

Human growth hormone (hGH) is made by the pituitary gland, a pea-sized structure located at the base of the brain. It is important for normal development and maintenance of tissues and organs and is especially important for normal growth in children.

Studies have shown that injections of supplemental hGH are helpful to certain people. Sometimes children are unusually short because their bodies do not make enough hGH. When they receive injections of this hormone, their growth improves. Young adults who have no pituitary gland (because of surgery for a pituitary tumor, for example) cannot make the hormone and they become obese. When they are given hGH, they lose weight. Like some other hormones, blood levels of hGH often decrease as people age, but this may not necessarily be bad. At least one epidemiological study, for instance, suggests that people who have high levels of hGH are more apt to die at younger ages than those with lower levels of the hormone. Studies of animals with genetic disorders that suppress growth hormone production and secretion also suggest that reduced growth hormone secretion may prolong survival in some species.

Although there is no conclusive evidence that hGH can prevent aging, some people spend a great deal of money on supplements. These supplements are claimed by some to increase muscle, decrease fat, and to boost an individual’s stamina and sense of well being. Shots—the only proven way of getting the body to make use of supplemental hGH—can cost more than $15,000 a year. They are available only by prescription and should be given by a doctor. In any case, people in search of the fountain of youth may have a hard time finding a doctor who will give them shots of hGH because so little is known about the long-term risks and benefits of this controversial treatment. Some dietary supplements, known as human growth hormone releasers, are marketed as a low-cost alternative to hGH shots. But claims that these over-the-counter products retard the aging process are unsubstantiated.

While some studies have shown that supplemental hGH does increase muscle mass, it seems to have little impact on muscle strength or function. Scientists are continuing to study hGH, but they are watching their study participants very carefully because side effects can be serious in older adults. These include diabetes and pooling of fluid in the skin and other tissues, which may lead to high blood pressure and heart failure. Joint pain and carpal tunnel syndrome also may occur. A recent report that treatment of children with human pituitary growth hormone increases the risk of subsequent cancer is a cause for concern. Further studies on this issue are needed. Whether older people treated with hGH for extended periods have an increased risk of cancer is unknown.

In addition, all studies on hGH as an anti-aging therapy for older people have been small and have not investigated the long-term effects of hGH supplementation on the possible development of diseases and on risk of death. Before advocating the use of hGH as an anti-aging therapy, the potential benefits and risks should be assessed by additional research. Until then, there is no convincing evidence hGH supplements will improve the health of those who do not suffer a profound deficiency of this hormone.

DHEA: What Is It?

Dehydroepiandrosterone or DHEA is made from cholesterol by the adrenal glands, which sit on top of each kidney. Production of this substance peaks in the mid-20s, and gradually declines with age in most people. What this drop means or how it affects the aging process, if at all, is unclear. In fact, scientists are somewhat mystified by DHEA and have not fully sorted out what it does in the body. However, researchers do know that the body converts DHEA into two hormones that are known to affect us in many ways: estrogen and testosterone.

Supplements of DHEA can be bought without a prescription and are sold as anti-aging remedies. Some proponents of these products claim that DHEA supplements improve energy, strength, and immunity. DHEA is also said to increase muscle and decrease fat. Right now there is no conclusive evidence that DHEA supplements do any of these things in people, and there is little scientific evidence to support the use of DHEA as a “rejuvenating” hormone. Although the long-term (over 1 year) effects of DHEA supplements have not been studied, there are early signs that these supplements, even when taken briefly, may have several detrimental effects on the body, including liver damage.

In addition, some people’s bodies make more estrogen and testosterone from DHEA than others. There is no way to predict who will make more and who will make less. Researchers are concerned that DHEA supplements may cause high levels of estrogen or testosterone in some people. This is important because testosterone may play a role in prostate cancer, and higher levels of estrogen are associated with an increased risk of breast cancer. It is not yet known for certain if supplements of estrogen and testosterone, or supplements of DHEA, also increase the risk of developing these types of cancer. In women, high testosterone levels can cause acne and growth of facial hair.

Overall, research on DHEA to date does not provide a clear picture of the risks and benefits. Two short-term studies showed no harmful effects of DHEA supplementation on blood, prostate, or liver function. However, the studies were small in size, and no conclusions about the safety or efficacy of DHEA supplementation could be made based on their results.

Researchers are working to find more definite answers about DHEA’s effects on aging, muscles, and the immune system. In the meantime, people who are thinking about taking supplements of this hormone should understand that its effects are not fully known. Some of these unknown effects might turn out to be harmful.

Buyer Beware: Can a Nutritional Supplement Reverse Aging?

Some hormone-like products are available over the counter and can be used without consulting a physician. The Institute discourages people from self-medicating with these products for a number of reasons.

  • First, these products are marketed as dietary supplements, and therefore are not regulated by the FDA in the same way as drugs. This is an important distinction because the requirements for marketing a dietary supplement are very different from those that apply to hormones marketed as drugs. Unlike drug manufacturers, a firm selling dietary supplements doesn’t need FDA approval of its products and doesn’t need to prove that its products are safe and effective before marketing.
  • Also, there is no specific guarantee that the substance in the container is authentic or that the indicated dosage is accurate. Because of these differing standards, hormone-like substances that are sold as dietary supplements may not be as thoroughly studied as drug products, and, therefore, the potential consequences of their use are not well understood or defined.
  • In addition, these over-the-counter products may interfere with other medications you are taking.

Therefore, the NIA (National Institute on Aging) does not recommend taking any supplement, including DHEA and melatonin, that is touted as an “anti-aging” remedy because no supplement has been proven to serve this purpose. The influence of these supplements on a person’s health is unknown, particularly when taken over a long period of time.

Tuesday, October 9, 2007

CNS Depressants: Are They Addictive?

Discontinuing prolonged use of high doses of CNS depressants can lead to withdrawal. Because they work by slowing the brain’s activity, a potential consequence of abuse is that when one stops taking a CNS depressant, the brain’s activity can rebound to the point that seizures can occur. Someone thinking about ending their use of a CNS depressant, or who has stopped and is suffering withdrawal, should speak with a physician and seek medical treatment.

In addition to medical supervision, counseling in an in-patient or out-patient setting can help people who are overcoming addiction to CNS depressants. For example, cognitive-behavioral therapy has been used successfully to help individuals in treatment for abuse of benzodiazepines. This type of therapy focuses on modifying a patient’s thinking, expectations, and behaviors while simultaneously increasing their skills for coping with various life stressors.

Often the abuse of CNS depressants occurs in conjunction with the abuse of another substance or drug, such as alcohol or cocaine. In these cases of polydrug abuse, the treatment approach should address the multiple addictions.

CNS Depressants: What Are They?

CNS depressants slow normal brain function. In higher doses, some CNS depressants can become general anesthetics. Tranquilizers and sedatives are examples of CNS depressants. CNS depressants can be divided into two groups, based on their chemistry and pharmacology:
Barbiturates, such as mephobarbital (Mebaral) and pentobarbitalsodium (Nembutal), which are used to treat anxiety, tension, and sleep disorders.

  • Benzodiazepines, such as diazepam (Valium), chlordiazepoxide HCl (Librium), and alprazolam (Xanax), which can be prescribed to treat anxiety, acute stress reactions, and panic attacks.
  • Benzodiazepines that have a more sedating effect, such as estazolam (ProSom), can be prescribed for short-term treatment of sleep disorders.

There are many CNS depressants, and most act on the brain similarly—they affect the neurotransmitter gamma-aminobutyric acid (GABA). Neurotransmitters are brain chemicals that facilitate communication between brain cells. GABA works by decreasing brain activity. Although different classes of CNS depressants work in unique ways, ultimately it is their ability to increase GABA activity that produces a drowsy or calming effect. Despite these beneficial effects for people suffering from anxiety or sleep disorders, barbiturates and benzodiazepines can be addictive and should be used only as prescribed.

CNS depressants should not be combined with any medication or substance that causes drowsiness, including prescription pain medicines, certain OTC cold and allergy medications, or alcohol. If combined, they can slow breathing, or slow both the heart and respiration, which can be fatal.

Are Opiates Addictive?

Long-term use also can lead to physical dependence—the body adapts to the presence of the substance and withdrawal symptoms occur if use is reduced abruptly. This can also include tolerance, which means that higher doses of a medication must be taken to obtain the same initial effects. Note that physical dependence is not the same as addiction—physical dependence can occur even with appropriate long-term use of opioid and other medications. Addiction, as noted earlier, is defined as compulsive, often uncontrollable drug use in spite of negative consequences.

Individuals taking prescribed opioid medications should not only be given these medications under appropriate medical supervision, but also should be medically supervised when stopping use in order to reduce or avoid withdrawal symptoms. Symptoms of withdrawal can include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps ("cold turkey"), and involuntary leg movements.

Individuals who become addicted to prescription medications can be treated. Options for effectively treating addiction to prescription opioids are drawn from research on treating heroin addiction. Some pharmacological examples of available treatments follow:

  • Methadone, a synthetic opioid that blocks the effects of heroin and other opioids, eliminates withdrawal symptoms and relieves craving. It has been used for over 30 years to successfully treat people addicted to opioids.
  • Buprenorphine, another synthetic opioid, is a recent addition to the arsenal of medications for treating addiction to heroin and other opiates.
  • Naltrexone is a long-acting opioid blocker often used with highly motivated individuals in treatment programs promoting complete abstinence. Naltrexone also is used to prevent relapse. Naloxone counteracts the effects of opioids and is used to treat overdoses.

Opiates: What Are They?

Opioids are commonly prescribed because of their effective analgesic, or pain relieving, properties. Studies have shown that properly managed medical use of opioid analgesic compounds is safe and rarely causes addiction. Taken exactly as prescribed, opioids can be used to manage pain effectively.

Among the compounds that fall within this class—sometimes referred to as narcotics—are morphine, codeine, and related medications. Morphine is often used before or after surgery to alleviate severe pain. Codeine is used for milder pain. Other examples of opioids that can be prescribed to alleviate pain include oxycodone (OxyContin—an oral, controlled release form of the drug); propoxyphene (Darvon); hydrocodone (Vicodin); hydromorphone (Dilaudid); and meperidine (Demerol), which is used less often because of its side effects. In addition to their effective pain relieving properties, some of these medications can be used to relieve severe diarrhea (Lomotil, for example, which is diphenoxylate) or severe coughs (codeine).

Opioids act by attaching to specific proteins called opioid receptors, which are found in the brain, spinal cord, and gastrointestinal tract. When these compounds attach to certain opioid receptors in the brain and spinal cord, they can effectively change the way a person experiences pain. In addition, opioid medications can affect regions of the brain that mediate what we perceive as pleasure, resulting in the initial euphoria that many opioids produce. They can also produce drowsiness, cause constipation, and, depending upon the amount taken, depress breathing. Taking a large single dose could cause severe respiratory depression or death.

Opioids may interact with other medications and are only safe to use with other medications under a physician's supervision. Typically, they should not be used with substances such as alcohol, antihistamines, barbiturates, or benzodiazepines. Since these substances slow breathing, their combined effects could lead to life-threatening respiratory depression.

Stimulants: Q & A

Q: What are stimulants?
A: As the name suggests, stimulants increase alertness, attention, and energy, as well as elevate blood pressure and increase heart rate and respiration. Stimulants historically were used to treat asthma and other respiratory problems, obesity, neurological disorders, and a variety of other ailments. But as their potential for abuse and addiction became apparent, the medical use of stimulants began to wane. Now, stimulants are prescribed for the treatment of only a few health conditions, including narcolepsy, ADHD, and depression that has not responded to other treatments.

Q: How do stimulants effect the brain and body?
A: Stimulants, such as dextroamphetamine (Dexedrine and Adderall) and methylphenidate (Ritalin and Concerta), have chemical structures similar to a family of key brain neurotransmitters called monoamines, which include norepinephrine and dopamine. Stimulants enhance the effects of these chemicals in the brain. Stimulants also increase blood pressure and heart rate, constrict blood vessels, increase blood glucose, and open up the pathways of the respiratory system. The increase in dopamine is associated with a sense of euphoria that can accompany the use of these drugs.

Q: What are the possible consequences of stimulant use and abuse?
A: As with other drugs of abuse, it is possible for individuals to become dependent upon or addicted to many stimulants. Withdrawal symptoms associated with discontinuing stimulant use include fatigue, depression, and disturbance of sleep patterns. Repeated use of some stimulants over a short period can lead to feelings of hostility or paranoia. Further, taking high doses of a stimulant may result in dangerously high body temperature and an irregular heartbeat. There is also the potential for cardiovascular failure or lethal seizures.

Q: Is it safe to use stimulants with other medications?
A: Stimulants should be used in combination with other medications only under a physician's supervision. Patients also should be aware of the dangers associated with mixing stimulants and OTC cold medicines that contain decongestants; combining these substances may cause blood pressure to become dangerously high or lead to irregular heart rhythms.

Marijuana: The Genetic Component

Scientists have found that whether an individual has positive or negative sensations after smoking marijuana can be influenced by heredity. A 1997 study demonstrated that identical male twins were more likely than nonidentical male twins to report similar responses to marijuana abuse, indicating a genetic basis for their response to the drug. (Identical twins share all of their genes.)

It also was discovered that the twins' shared or family environment before age 18 had no detectable influence on their response to marijuana. Certain environmental factors, however, such as the availability of marijuana, expectations about how the drug would affect them, the influence of friends and social contacts, and other factors that differentiate experiences of identical twins were found to have an important effect.

Can Marijuana Be Addicting?

Long-term marijuana abuse can lead to addiction for some people; that is, they abuse the drug compulsively even though it interferes with family, school, work, and recreational activities. Drug craving and withdrawal symptoms can make it hard for long-term marijuana smokers to stop abusing the drug. People trying to quit report irritability, sleeplessness, and anxiety. They also display increased aggression on psychological tests, peaking approximately one week after the last use of the drug.

Marijuana Exposure During Pregnancy: Is There a Risk?

Research has shown that some babies born to women who abused marijuana during their pregnancies display altered responses to visual stimuli, increased tremulousness, and a high-pitched cry, which may indicate neurological problems in development. During the preschool years, marijuana-exposed children have been observed to perform tasks involving sustained attention and memory more poorly than nonexposed children do. In the school years, these children are more likely to exhibit deficits in problem-solving skills, memory, and the ability to remain attentive.

Learning, Social Behavior and Marijuana Use: Is There a Correlation?

Research clearly demonstrates that marijuana has the potential to cause problems in daily life or make a person's existing problems worse. Depression, anxiety, and personality disturbances have been associated with chronic marijuana use. Because marijuana compromises the ability to learn and remember information, the more a person uses marijuana the more he or she is likely to fall behind in accumulating intellectual, job, or social skills. Moreover, research has shown that marijuana’s adverse impact on memory and learning can last for days or weeks after the acute effects of the drug wear off.

Students who smoke marijuana get lower grades and are less likely to graduate from high school, compared with their nonsmoking peers. A study of 129 college students found that, among those who smoked the drug at least 27 of the 30 days prior to being surveyed, critical skills related to attention, memory, and learning were significantly impaired, even after the students had not taken the drug for at least 24 hours. These "heavy" marijuana abusers had more trouble sustaining and shifting their attention and in registering, organizing, and using information than did the study participants who had abused marijuana no more than 3 of the previous 30 days. As a result, someone who smokes marijuana every day may be functioning at a reduced intellectual level all of the time.

More recently, the same researchers showed that the ability of a group of long-term heavy marijuana abusers to recall words from a list remained impaired for a week after quitting, but returned to normal within 4 weeks. Thus, some cognitive abilities may be restored in individuals who quit smoking marijuana, even after long-term heavy use.

Workers who smoke marijuana are more likely than their coworkers to have problems on the job. Several studies associate workers' marijuana smoking with increased absences, tardiness, accidents, workers' compensation claims, and job turnover. A study among postal workers found that employees who tested positive for marijuana on a pre-employment urine drug test had 55 percent more industrial accidents, 85 percent more injuries, and a 75-percent increase in absenteeism compared with those who tested negative for marijuana use. In another study, heavy marijuana abusers reported that the drug impaired several important measures of life achievement including cognitive abilities, career status, social life, and physical and mental health.

Marijuana: The Physiological Effects

Effects on the Brain

Scientists have learned a great deal about how THC acts in the brain to produce its many effects. When someone smokes marijuana, THC rapidly passes from the lungs into the bloodstream, which carries the chemical to organs throughout the body, including the brain.In the brain, THC connects to specific sites called cannabinoid receptors on nerve cells and influences the activity of those cells. Some brain areas have many cannabinoid receptors; others have few or none. Many cannabinoid receptors are found in the parts of the brain that influence pleasure, memory, thought, concentration, sensory and time perception, and coordinated movement.

The short-term effects of marijuana can include problems with memory and learning; distorted perception; difficulty in thinking and problem solving; loss of coordination; and increased heart rate. Research findings for long-term marijuana abuse indicate some changes in the brain similar to those seen after long-term abuse of other major drugs. For example, cannabinoid (THC or synthetic forms of THC) withdrawal in chronically exposed animals leads to an increase in the activation of the stress-response system and changes in the activity of nerve cells containing dopamine6. Dopamine neurons are involved in the regulation of motivation and reward, and are directly or indirectly affected by all drugs of abuse.

Effects on the Heart

One study has indicated that an abuser's risk of heart attack more than quadruples in the first hour after smoking marijuana. The researchers suggest that such an effect might occur from marijuana's effects on blood pressure and heart rate and reduced oxygen-carrying capacity of blood.

Effects on the Lungs

A study of 450 individuals found that people who smoke marijuana frequently but do not smoke tobacco have more health problems and miss more days of work than nonsmokers. Many of the extra sick days among the marijuana smokers in the study were for respiratory illnesses.Even infrequent abuse can cause burning and stinging of the mouth and throat, often accompanied by a heavy cough. Someone who smokes marijuana regularly may have many of the same respiratory problems that tobacco smokers do, such as daily cough and phlegm production, more frequent acute chest illness, a heightened risk of lung infections, and a greater tendency to obstructed airways. Smoking marijuana possibly increases the likelihood of developing cancer of the head or neck. A study comparing 173 cancer patients and 176 healthy individuals produced evidence that marijuana smoking doubled or tripled the risk of these cancers.

Marijuana abuse also has the potential to promote cancer of the lungs and other parts of the respiratory tract because it contains irritants and carcinogens. In fact, marijuana smoke contains 50 to 70 percent more carcinogenic hydrocarbons than does tobacco smoke. It also induces high levels of an enzyme that converts certain hydrocarbons into their carcinogenic form—levels that may accelerate the changes that ultimately produce malignant cells. Marijuana users usually inhale more deeply and hold their breath longer than tobacco smokers do, which increases the lungs' exposure to carcinogenic smoke. These facts suggest that, puff for puff, smoking marijuana may be more harmful to the lungs than smoking tobacco.

Other Health Effects

Some of marijuana's adverse health effects may occur because THC impairs the immune system's ability to fight disease. In laboratory experiments that exposed animal and human cells to THC or other marijuana ingredients, the normal disease-preventing reactions of many of the key types of immune cells were inhibited. In other studies, mice exposed to THC or related substances were more likely than unexposed mice to develop bacterial infections and tumors.