How Safe is the Latest SSRI Drug on Children and the Elderly in the Treatment of Depression

SSRI drugs – that is, drugs belonging to the Selective Serotonin Reuptake Inhibitor class of drugs – are used in the treatment of depression and generalized anxiety disorders. The latest such drug to enter the US market is Lexapro, whose active principle is escitalopram oxalate. Available in the US since 2002, Lexapro is superior to older SSRI drugs by way of smaller dosage, quicker onset of action, and milder side-effects in most cases. Yet, it is not without side-effects altogether and therefore requires expert medical attention during the treatment. This is particularly true in the cases of child and elderly patients.

Children and adolescents: Though the potential side-effects of Lexapro on children and adolescents is the same as for adults, the younger patients require special attention because they may not thoroughly understand their medical condition and the effects of the anti-depressants, especially an SSRI, with which they are being medicated.The side-effects manifest in pediatric treatment more quickly than in adults. These side-effects include: panic attacks; agitation; aggressive or irrational behavior; increase in worry, anxiety and/or depression; suicidal thoughts; insomnia; unusual excitation; or any abrupt changes in behavior.

These side-effects arise in the first few days to about three weeks of the start of treatment and taper off thereafter, though exceptions have been noted.Parents must make it a point to report to the doctor every sign of abnormal behavior in their child taking Lexapro. The doctor is the only person to decide the course of action – which may be a reduction in dosage, or administration of an additional medicine to cope with specific side-effects, or a change of medication, or simply an advice to live with the side-effects through the first few weeks. In any event, children and adolescents need constant attention from parents or guardians to ensure that they do not end up doing something drastic as the side-effects run their course.

Elderly patients: The pleasant information concerning Lexapro is that its side-effects on elderly patients are much less than that of other SSRI drugs such as Paxil, Prozac, and Zoloft. The specific side-effect on which Lexapro scores above the other SSRIs is: suicidal tendency. Since elderly patients usually have the thought of death in their mind, aggravation of their depressive or anxiety disorder (as an initial side-effect of SSRI treatment) can be understood to fuel suicidal tendencies.

But a research in Canada has shown that elderly patients taking Paxil, Prozac, and Zoloft are nearly five times more likely to commit suicide in the first month of treatment than those talking Lexapro or other classes of anti-depressants. As for side-effects other than the suicidal thought, they are of the same nature but higher intensity in elderly patients than in younger patients. This is because the body system of the elderly is less adaptable to the physiological changes caused by Lexapro and other anti-depressants, even though these changes are temporary. Therefore, as with children and adolescents, elderly patients too need close medical attention and family care to avoid self-harm in the course of their treatment.

Important Reasons Why Your Child Should Visit a Chiropractor

Chiropractic is commonly viewed as a therapeutic treatment for neck and back pain. It has proven to be very effective. So effective that many of its other health benefits are overlooked. Simply stated, chiropractic care is much more than a pain reliever.

The basic tenet of chiropractic is that the central nervous system controls and coordinates every function of your body. This central nervous system includes the brain, spinal cord and the millions of nerves that extend to every cell and tissue in your body. Your delicate nervous system is protected by the spinal column. Your spinal column is comprised of 24 freely moveable bones called vertebrae. These vertebrae may become misaligned causing interference to your nervous system. This minor misalignment of a vertebrae is termed subluxation.

A recent study of over 1200 infants revealed that 95% of those evaluated were found to have from mild to severe spinal issues. Symptoms of these issues included hyperactivity, sleeplessness and vomiting. The authors note that chiropractic adjustments were beneficial. Many of the infants stopped crying, became quieter, showed signs of muscle relaxation and sleepiness. This study also concluded that, if left untreated, these spinal issues called subluxation, can lead to impairment of motor skills and the central nervous system resulting in a lower resistance to many infections and viruses especially those affecting the ears, nose and throat.

You may ask yourself how a child’s vertebrae could become misaligned. The first potential for misalignment is the birth process. Breach presentation, forceps delivery and prolonged labor place a significant amount of stress on a newborn’s spine and nervous system. Other events include falls while learning to walk, sports injuries, etc. The list goes on and on. All of these seemingly mild traumas have a cumulative effect and may result in subluxation.

As an adult you are able to discuss with your chiropractor any symptoms or health issues you notice. Infants and young children don’t as readily express themselves in words. They express themselves in other ways. They cry, become irritable and don’t eat properly. When your child is seen by a pediatric chiropractor they will be expertly evaluated for the presence of subluxation. They want to make sure that your child begins life with the best possible potential. Whether your child presents with symptoms or for a check-up, a thorough history of the birth and labor process is taken. This is followed by a thorough physical examination that includes orthopedic, neurological and movement testing. If subluxations are detected, a proper treatment program will be explained.

To review, we have talked about how the brain and central nervous system control and coordinates all functions of the body. Minor misalignments of the vertebrae are called subluxations. Subluxations are caused from a difficult birth process, falls, sports injuries, etc. These subluxations interfere with the proper functioning of the nervous system resulting in a loss of health. Chiropractors are specially trained to identify and correct subluxations, thereby alleviating symptoms and restoring health.

So why should your child or infant to a chiropractor? So that they reach their full potential. To give them the best start in life. Because they are worth it.

How to Choose The Ideal Pediatric EHR Software?

A pediatrician, generally a primary care physician who specializes in the medical care of infants, adolescents and children, has workflows that are noticeably different from other specialties and primary care physicians.

And while the initial screening process for identifying the ideal Pediatrics Electronic Health Record (EHR) system is similar to that of other specialties, there are a few important distinctions which you must keep a look out for.

Look for a specialty-based system

Use online sources, EHR rating and review websites, and pediatrician referrals to identify a few of the leading pediatrics-EHR providers out there.

Note: Make sure that you identify at least eight vendors providing a solution for your specialty as opposed to a generic EHR.

Make sure it’s a Cloud-based

In the initial screening, get rid of all the server-based options; shortlist only Cloud-based systems.

Why?

There are huge hardware costs (purchase, storage, maintenance and staff) associated with dedicated server rooms in addition to software upgrade costs with server-based systems.

Cloud-based systems cost markedly lesser, and can be accessed from anywhere with an internet connection and a computer.

The cost differs as you do not require a dedicated server room, updates are free (in most Cloud-systems), and expensive hardware does not need to be purchased.

Seek an integrated solution

An EHR integrated with a Practice Management system will enhance coordination between the front desk staff and the billing personnel, resulting in administrative efficiency and higher revenue.

Arrange Demos and ask for pricing details

With such a selection base, your options would have reduced and the next step would be to arrange demos (short for demonstrations) and/or meetings with these potential EHR vendors.

During these demos, you will get a better idea of the product they’re offering and it gives you a chance to see the product’s shortcomings.

Also inquire about their pricing model and how much such a system would cost you. Compare how much each vendor is charging with respect to the services they are offering.

Check how much time they’re taking for implementation, the costs for training, and for services such as customer services (some vendors provide this for free).

Check for features: Family profile, growth charts, questionnaires and clinical encounters

This step can be integrated with the previous step or can also be done after. Irrespective of the timing of the step, you need to ask the vendors if they have provisions for the following:

Feature 1: Family profile

For a pediatrician, the maintenance of a comprehensive family profile with simple functionality whereby you can link charts, demographics, etc is extremely important for analyzing trends and for avoiding duplicate or redundant data.

This can only be achieved if the Pediatric EHR Software has the relevant templates specific to pediatrics.

Feature 2: Growth charts

These use features such as clinical calculators for vitals, BMI, etc, which allow the system to generate charts showing the patient’s growth-progress; making it markedly easier to identify anomalous situations and focus on curative and preventive measures.

Various templates for capturing different data streamline the process, making it a lot more efficient and effective.

Feature 3: Questionnaires

Customizable questionnaires can be integrated with progress notes for early identification of various diseases (particularly behavior-related health issues).

The guardians can be informed and the data can subsequently be shared with relevant professionals; creating provision for mechanisms to deal with the problems early on (which are generally more effective in contrast to late diagnosis).

Feature 4: Clinical encounters

These include a range of templates for both sick-visits and episodic well-visits which work towards making clinical documentation swifter and help avoid potential illnesses in the future.

Once you complete these steps, you will realize that the eight initial vendor options have automatically been reduced to one, or two at maximum. Select the vendor that possesses these features in addition to appealing to you the most (in terms of efficiency, reputation and description) and purchase that solution.

One Hope Saves Many Lives

Have you ever purchased something because you knew that a portion of the proceeds would go to a certain cause? Breast cancer stamps, Paul Newman salad dressing, Yoplait yogurt?

There’s a new for-profit company called OneHope that was created to sell a product and reserve 50% of the profits for a specific charity. The founders decided to create a specific product, designate a cause and find a market and allow the product to sell itself.

The founders decided to take their winemaking talents and produce merlot to benefit AIDS research, sauvignon blanc supports the environment and zin supports the U.S. troops. In 2009 they raised over $1.5 million in sales and donated money and in-kind contributions to over 150 charities.

Although the idea of setting aside profits for a cause is not new, the mission behind this organization is unique. The idea that each product will benefit a certain cause has them looking to produce more products and create a cause-oriented lifestyle brand.

When someone needs to bring wine to a party or give as a gift, which do you think they’ll buy? I know I would buy the one that benefits a charity. In fact, I’d probably buy several.

Cookies for Kid’s Cancer is a website that offers information on how to have a charitable bake sale including recipes, banners, and links to vendors and products to help make the event successful. The site sells cookies and 70% of the proceeds go to fund pediatric cancer research at cancer centers in the U.S.

Other companies can take the lead and create a ‘charity-related’ product with a new look and logo. Nabisco mint oreo cookie sales could announce they plan to promote The Trouble with the Alphabet book to increase awareness of the plight of children across the world. Nestles could create a line of bottled water that benefits water projects across the world. Purina could get creative and establish a line of dog food and give half the proceeds to the humane society or help animals during a crisis (a hurricane, forest fire, heat wave, etc.). Calvin Klein could team up and design a unique line of prescription glasses and send proceeds to a struggling school district or create scholarships with the money they raise.

Consumers are already making the purchase and will tend to purchase the product that benefits a cause. Wine, beer and liquor industry continues to skyrocket. Sales in 2009 reached over $455 million and in many cases wine is chosen on how pretty the label is designed. Adding a note that describes OneHope’s objective will help make the choice and sale easier than ever.

Thinking outside the box is outdated and overrated. Thinking in a circular fashion allows the flow of ideas to touch, connect and grow in a fluid motion. As budgets are reduced, jobs are eliminated and money is in short supply, it makes sense to create a product that the public buys anyhow and share the proceeds.

It looks good for the company, it adds dollars to the charity and it’s a no-brainer for the consumer!