ATUALIZAÇÃO Genética e Meio Ambiente na Etiologia do Parto PrematuroGene-environment Interaction in the Etiology of Preterm Birth Tenilson Amaral Oliveira* Márcia Maria Auxiliadora de Aquino*/** *Hospital Maternidade Leonor Mendes de Barros**Universidade Cidade de São Paulo pal causa de morbidade e mortalidade perinatal (Creasy & Merkat, 1990). Em nosso meio, segundo estatística
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Why have Selective Serotonin Re-uptake Inhibitors (SSRIs) such as Prozac, Paxil and Zoloft become the Western Medical standard treatment for clinical depression and related dis-eases of the spirit? Do SSRIs cure these ailments, and if so, how? Are these drugs safe? What alternatives exist? Are the alternatives effective and safe? Reader get ready because this subject is a medical “can of worms” which needs opening here and now. Serotonin, melatonin, tryptophan, dopamines and endorphins are all naturally occuring “feel good” neurotransmitters which are produced, experienced and eventually dismantled by the body. These compounds flush the body and psyche when we’re happy, in love, during orgasm, through meditation, when falling asleep, from athletic envelope pushing (runners’ high), or as a protective mechanism when we’re in extreme pain. They tend towards adequate levels when our lives are balanced in terms of work and play, stress and release, sleep and activity, healthy environment and rhythmic lifestyle. Unfortunately our modern society is marked by severe imbalances in those elements. The stressors inherent in our society challenge our ability to lead balanced and fulfilling lives complete with enough serotonin like compounds in our brains. The Western medical community has more or less diagnosed the root cause of chemical depression as a lack of sufficient levels of these compounds in a patient‘s system. SSRIs such as Prozac impede the dismantling of these neurotransmitters thereby maintaining adequate levels in the brain to essentially keep the patient happy regardless of his/her stress filled and unbalanced existence. The therapy addresses serotonin levels, but is this treatment for the root, or is it a band-aid over the branch of the problem? Systemic societal change and individual healthful lifestyle balancing treat the root causes of depression. Drug (SSRI) therapy arguably treats only the branch pathology. SSRIs can conversely be a lifesaver however, if the patient is in acute depression , unable to see a way out, despondent, despairing and potentially suicidal. In this case prozac can stabilize the individual allowing the time and space for deeper therapies to be employed. SSRIs as a stop gap, short term therapy can be a Godsend for patient and society. Over the long term though we each of us to our individual capacity posses opportunity and bear responsibility to heal selves and society. To this end SSRIs have a place, but as primary therapy they do not necessarily serve the highest good. In terms of safety Prozac (fluoxetine hydrochloride), Paxil (paroxetine hydrochloride) and Zoloft (sertraline hydrochloride) all have contraindications, precautions, side effects and drug interactions too extensive to fully list here. Potentially fatal reactions when combined with monoamine oxidase inhibitors (MAOIs) are common to all three drugs. Specific to each drug range side effects from loss of libido, interference of cognitive abilities and motor functions to effects on respiratory, cardiovascular, nervous, digestive and musculoskeletal systems (1). The safety issues surrounding these drugs are both extensive and serious. Many packed pages of very small print in the Physicians’ Desk Reference (PDR) are devoted to these issues (2). Suffice it to say that these synthetic pharmaceuticals are to be used with caution, respect and full knowledge of their potential dangers.
Fortunately, harmless and effective natural herbal, dietary and supplement alternatives to SSRIs do exist. Most of these substances work on the front end of the previously described neurotransmitter chemical chain. That is to say that the alternative therapies provide building blocks for dopamine, serotonin, endorphins, melatonin and tryptophan. They supply that which is required to make “feel good” compounds rather than bottlenecking the eventual natural dismantling of said compounds. This approach respects the bodies’ innate ability to harmonize and balance chemical constitution versus the SSRI approach of manipulating homeostasis by forcing neurotransmitter balance in a particular man-made direction. Implicit in the alternative therapies is also the acknowledgement that deeper psycho-physical and psycho-emotional work needs to be accomplished to treat the root causes of depression and other spirit disorders.
A typical protocol includes the following: * The amino acids L-Tyrosine and DL-Phenylalanine taken in the morning. * Saint John’s Wort and 5-Hydroxytryptophan (5-HTP) with Vitamin B-6 (Pyridoxine HCL)* An appropriate Chinese Herbal Formula as per the patient’s presentation and diagnosis.
The two amino acids are necessary for synthesis of serotonin type neurotransmitters. These are taken in the morning to nourish the brain proactively in preparation for a day of optimum mental-emotional function. The Saint John’s Wort (SJW) is a safe (despite recent attacks in the press), inexpensive, medically proven single herb available without prescription for treating mild to moderate depression (3). SJW does cause increased photosensitivity for both skin and eyes, and is thus taken in the evening to minimize this risk factor. 5-HTP is a basic building block for the serotonin type neurotransmitters, but as a form of Tryptophan, 5-HTP by definition induces somnolence. It is preferable then to take 5-HTP ninety minutes before bedtime versus during the day. Chinese herbs are often chosen from the “Nourish Heart, Calm Spirit” category (4), but whatever formula the patients’ diagnosis and presentation indicate is utilized to tailor therapy to the individual. This is a standard alternative replacement package for the SSRIs. Many variations on the theme exist with additions, subtractions and progressions of herbs and supplements all tailored to individual patient needs. Ample proof of clinical efficacy from such programs exists (5). The decision to quit the SSRIs must come from the patient, and s/he should not attempt this alone. Guidance by a qualified alternative practitioner, and full disclosure to the MD or other Western allopathic practitioner who originally prescribed the SSRIs is essential. A tapering method is usually employed as well versus going off SSRIs in a “cold turkey” fashion.
These protocols are intended as support within a greater plan for healing of psycho-emotional issues. Such programs essentially put the proverbial ball in the patients’ court as opposed to handing the pharmaceutical companies money in expectations of a pill-popping fix. By taking responsibility for our own healing and simultaneously employing the talents of various healthcare practitioners to support us in our process, we can achieve profound and lasting results. In this way we benefit ourselves which in turn contributes to the healing of all sentient beings.
References:1) Medical Economics Company, Inc. P 3) Bloomfield, Harold H. MD et al Hypericum & Depression Cover page Prelude Press, Los Angeles, CA 19964) Bensky, Dan and Barolet, Randall Chinese Herbal Medicine Formulas & Strategies pg.377 Eastland Press Seattle, WA 19905) Dharmananda, Subhuti, Ph.D. et al START GROUP ITM Journal Various articles Institute For Traditional Medicine, Portland OR. 2004
Members Present: Jim Gilbert, Ethan Ebenstein, Mike Brown, Harold Schneider, Janet Moore, Julie Ebenstein and Jim Gilbert called the meeting to order at 8 am. Harold presented the new CPEF page which is currently under construction on the www.cppschools.com website. He also demonstrated the CPEF Facebook account which is now up and operational. • Jim Gilbert will forward a complete list of c