• 1) Don’t take chances— there are numerous medical skin treatments used by Americans every day. Some of the treatments are relatively effective, but none is without a certain amount of risk. Even so, some reports indicate that about 100,000 people in North America had collagen injected into their skin to eliminate acne scars and wrinkles on the cheeks and around the eyes. No one can say for certain how long the results of these injections will last— some say six months to a year, and others say not nearly that long. And just recently, many people have begun reporting side effects, ranging from temporary allergic reaction to disease and permanent disfigurement. As of now, the debate continues whether or not collagen injections present a serious risk, But it is a treatment you should investigate as thoroughly as possible before trying.

    Liquid silicone injections are also causing quite a stir. Even though the FDA has not yet given its approval of liquid silicone for dermatological use, some doctors are still injecting it into patients’ skin to smooth out wrinkles and scars. Experts say that since silicone lasts forever, complications such as autoimmune disorders are difficult to correct. Silicone can also swell and harden tissues inside the body, causing permanent disfigurement and damage to internal structures.

    2) Stop smoking— besides all the other health problems attributed to smoking, a study at the University of Utah Health Sciences Center in Salt Lake City suggests that cigarette smoking causes premature facial wrinkles.

    Researchers studied 132 men and women with an average age of 47 and found that those people who had smoked an average of two packs a day for 25 years were 5 times more likely to get facial wrinkles than were non-smokers.

    3) Drink plenty of water— some medical experts recommend that you pay attention to how much water you drink because it can make a difference in the overall appearance of your skin. You should try to drink at least 6 to 8 glasses of water or other noncaffeinated fluids every day to help flush out toxins and to help keep your skin moist and young looking.

    4) Exercise— studies show that physical exercise, if sufficiently vigorous, can have a beneficial effect on your skin. Through exercise, your skin receives a better flow of blood, making you look healthier, younger and more attractive. According to researchers, their findings from a study of several age-matched pairs of sedentary and active people show that there is a pronounced difference in skin tone and texture between the two. The skin of those who exercised looked smoother, more supple, and had fewer wrinkles and better color than the skin of those people who did not get regular exercise.

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  • A potent drug found in most medicine cabinets, aspirin seems to provide more and more health benefits as medical research studies continue. Here are some of the latest promising developments concerning aspirin:

    1) Heart attack and strokes— studies have shown that aspirin, taken every other day by men and women who have had heart attacks, chest pain and strokes caused by clogged blood vessels, can reduce the risk of a second heart attack and lower overall death rates. However, it should be noted that the study also suggests that aspirin may promote those strokes caused by bleeding in the brain.

    The major study, conducted by researchers in Boston, concludes that aspirin is as good as clot-dissolving drugs and high-tech procedures for controlling angina, the dangerous chest pain which afflicts 750,000 Americans every year. The study involved almost 1,400 patients and is, to date, the largest ever conducted in order to determine the best treatment for unstable angina— the leading cause of admissions to hospital coronary-care units.

    2) Pregnancy— researchers at Case Western Reserve University School of Medicine in Cleveland report that daily low doses—1/5 to 1/2 of a tablet—of aspirin can help prevent pregnant women from developing high blood pressure or from giving birth to low-weight babies.

    Studies by French researchers suggest that aspirin may help women who have had previous miscarriages deliver a healthy baby. However, since aspirin can cause bleeding in the late stages of pregnancy, it is not likely to be used except in high-risk cases.

    Caution: Although these studies suggest that aspirin may provide some benefits to pregnant women, you should not take the drug without first getting your doctor’s permission.

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  • Before beginning any weight-loss, diet or exercise program you should consider the following:

    1) You should consult your doctor before you begin any weight-loss, diet or exercise program. This is especially true if you are overweight, or suffer from a medical problem such as diabetes or heart disease.

    2) Avoid crash diets and other rapid-weight-loss programs that drastically cut the number of calories you consume.

    3) Extremely low-calorie, liquid-formula diets should not be used without the recommendation of your doctor and then only under his or her supervision.

    4) The only drugs you should use to lose weight should be prescription drugs, which are recommended by your doctor and used only for a short time.

    5) Avoid diets that call for restricting fluid intake. This can lead to dehydration.

    6) Using dieting aids that contain laxatives or diuretics will not lead to a significant weight loss, and may harm your body.

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  • Fever, headache, muscle ache and weakness are commonly experienced symptoms of influenza or the “flu”. This nasty viral infection comes in a variety pack of three main types: A, B and C.

    Whichever letter of the alphabet you get can make you miserable. There are some precautions you can take to reduce your vulnerability to the flu, but once you get it there’s nothing to do to get rid of it until it’s ready to leave. Antibiotics don’t work because it is a virus. There are, however, certain things you can do to make a bout with the flu a little less miserable. Here are a few suggestions:

    1) Stay in bed— in all but the mildest of cases, a victim of the flu is usually better off in bed, resting in a well-ventilated room.

    2) Get lots of liquids into your system— this is especially important when you have a fever because of the possibility of dehydration. Liquids can also provide essential nutrients when you feel too sick to eat solid food. Try thin soups and fruit and vegetable juices. Warm fluids can also soothe a sore throat.

    3) Make use of a painkiller— an analgesic such as ibuprofen, aspirin or acetaminophen can help reduce the fever and the body aches and pains caused by the flu.

    4) Get steamed— steam heat has a soothing effect on the lungs, helping to reduce the discomfort caused by a cough, sore throat, or dry nasal passages.

    5) Soak your feet— if you have a headache or nasal congestion, soaking your feet in hot water may help.

    6) Get vaccinated— protect yourself against the flu by getting a flu shot in the fall or very early winter. Because the vaccine takes about two weeks to get into action, you shouldn’t wait until the flu is all around you before getting your shot.

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  • Many people are opting for a home gym over health clubs as a method of staying in shape. Having your own home-fitness equipment is both convenient and private, making it much more attractive than waiting in line to use equipment and then being on “display” at most health clubs. However, before you make an investment in home-fitness equipment there are several things you should consider.

    1) What kind of exercise will be best for you? You should know what type of exercise you will enjoy doing and will continue doing on a long-term basis. If you are easily bored, it’s probably a good idea to stay away from such equipment as stationary bicycles. If your time for exercising is limited, you may be better off choosing equipment such as ski machines, rowers, or stairclimbers. A treadmill would be a good choice for anyone who enjoys walking or running.

    2) How many pieces of equipment should you have? Obviously the more pieces of equipment you have in your home gym, the more varied and comprehensive your exercise program will be. Alternating between different equipment provides a variety of benefits as well as helping to prevent boredom.

    3) Is the equipment both comfortable and enjoyable? The best way to determine the appropriate equipment for your needs is to make a personal test at the store. Wear your sweats when you go to look at the exercise equipment and try a 5 to 10 minute workout on several different models. If a particular store won’t let you test the equipment, take your business somewhere else.

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  • A trivial remark or a minor slight, however unintended, can feel like a major blow to people who are temporarily suffering from depression. For others, sensitivity to rejection (real or imagined) can seem to be a lifelong personality trait, virtually inborn, although it does not have to be categorized as an inevitable part of personality.

    Sensitivity to rejection, as proposed by Donald F. Klein, can also be one of the symptoms that characterize atypical depression, along with overeating, oversleeping, and reactivity to the environment. By alleviating the overall atypical depressive syndrome, Prozac can reduce the exquisite sensitivity that causes patients to feel so easily hurt, rejected or snubbed. MAOI antidepressants have this same property, but because their side effects are more intrusive, Prozac may be the better solution for a patient who is easily hurt and becomes depressed each time.

    Would taking Prozac make me more sensitive to the sun? No. Major tranquilizers such as Thorazine and Mellaril do have this side effect but patients who take Prozac do not show any increase in photosensitivity to light or sun. Major tranquilizers are mostly used for schizophrenia, schizoaffective disorder, and during the first ten days of manic psychosis until lithium takes over.

    Will Prozac affect my cholesterol count? Cholesterol count does not seem to be related to Prozac intake.

    Is the central nervous system in any way affected adversely by Prozac? Prozac is remarkably benign, all in all. But as with any drug, there are the rare exceptions. For instance, twelve patients out of six thousand studied had seizures—a rate similar to that of most other antidepressants. Infrequently, there have been reports of abnormal gait, apathy, central nervous system stimulation, delusions, depersonalization, along with dysphoria, hallucinations, hostility, incoordination, paranoia, and other reactions. In very rare cases, an abnormal electroencephalogram has been reported.

    As with all the antidepressants, there are other highly unusual side effects as well. But it is reassuring to note that the worst of these reactions occurs in fewer than one patient out of a hundred (and often fewer than one patient in a thousand). The most common adverse effects on the central nervous system, reported in more than 1% of the patients, are abnormal dreams and agitation.

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  • We live in a violent society. Over 4 million individuals in the United States are victims of violence each year. Data from the National Center for Health Statistics report 8.7 premature deaths due to homicide per 100,000 people in the United States in 1985, making homicide, the second leading cause of injury or death among children. Furthermore, homicide is the leading cause of death among black males ages 15 through 24, and the third leading cause, after motor vehicle injury and suicide, among white males 15 to 24 years of age. Nonfatal violence is even more widespread. In 1985, some 113 violent interactions occurred for every 1000 married couples, and 620 violent interactions occurred for every 1000 children and their parents.

    Despite the fact that violence is so common in the population as a whole, violent events have rarely been reported in association with Prozac. Once in a while, a patient on Prozac has been hauled into court for some harmful act. Nonetheless, in every one of those instances, Prozac has been exonerated of responsibility. Not a single one of the criminals who have come to court armed with the so-called Prozac defense has succeeded in convincing a judge or jury that the crime was committed because the defendant was on Prozac. In all of the cases, the criminal has been convicted and the medication acquitted: a 100% victory for the pharmaceutical company.

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  • Tricyclic antidepressants (TCAs), so-called because they have three rings in their chemical structure, work in the brain by making certain that the neurotransmitter norepinephrine (NE) and, to a lesser extent, serotonin (SE), remain in the synapse between nerve fibers rather than being taken back up into the nerve cell itself. The end result of this is that the amount of neurotransmitter in the synapse increases, thereby allowing the flow of nerve impulses to return to normal. This is associated with an antidepressant response in the patient.

    First-generation tricyclics include:

    * the first TCA, imipramine (Tofranil), which was introduced in 1958

    * amitriptyline (Elavil)

    * desipramine (Norpramin)

    * nortriptyline (Pamelor)

    * protriptyline (Vivactjl)

    * clomipramine (Anafranil)

    * trimipramine (Surmontil)

    * the European medication amineptine (Survector).

    Although side effects vary from drug to drug and person to person, the side effects generally associated with TCAs include dry mouth, constipation, blurred vision, weight gain, an increased heart rate, drowsiness, urinary retention, memory problems, impotence, decreased blood pressure and dizziness when standing up. It generally takes between 7 and IS days before the drug begins to have an antidepressant effect.

    Related medications called tetracyclics include maprotiline (Ludiomil), amoxapine (Asendin), and the European drug mianserin (Bolvidon).

    Monoamine oxidase inhibitors (MAOIs) work by preventing the breakdown of the neurotransmitter hormones norepinephrine and serotonin, which in turn has the effect of increasing the amount of those substances in the synapses.

    MAOIs include:

    o isocarboxazid (Marplan)

    o phenelzine (Nardil)

    o tranylcypromine (Parnate).

    Besides such side effects as restlessness, dizziness, and weight gain, MAOIs have one unique problem. You have to be very careful what you eat while taking an MAOI. Ordinary foods that contain tyramine including—but not limited to—cheese, Chianti wine, yogurt, lima beans, pickled herring, smoked meats, liver, and large amounts of caffeine or chocolate can trigger a sudden rise in blood pressure that has been known to cause blood vessels in the brain to burst, the so-called cheese effect A stroke or even death can be the outcome. A related MAOl is the European drug Deprenyl, which is marketed in the United States as an anti-Parkinson drug, not an antidepressant It requires less attention to dietary restriction.

    Selective serotonin reuptake inhibitors (SSRIs) block the uptake only of serotonin, thereby causing it to increase in the nerve synapse. SSRIs include:

    * fluoxetine (Prozac)

    * sertraline (Zoloft)

    * paroxetine (Paxil)

    * fluvoxamine (Luvox)

    * nefazadone (Serzone)

    * citalopram (under development in U.S., available in Europe as Lipramil or Seropram).

    These drugs relieve depression as effectively as the TCAs and MAOIs, but their side effect profile is considerably milder.

    Lithium, although primarily used as a mood stabilizer with manic-depressive disorders, can also play an important prophylactic role in recurrent unipolar depression and even a therapeutic role in major depression when it is added to an antidepressant as a step-up treatment. It comes in these generic forms under various trade names:

    o lithium carbonate; slow-release lithium carbonate

    o lithium citrate syrup (liquid).

    Structurally unrelated compounds used for the treatment of depression include a number of other medications, such as:

    * trazodone (Deseryl)

    * buproprion (Wellbutrin)

    * venlafaxine (Effexor).

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  • Since its introduction, over 11 million patients worldwide and 6 million in the United States have taken Prozac. These people cover the gamut from children to adolescents to the elderly, from lifelong depressives who, with the help of Prozac, are beginning for the first time to structure their lives in responsible ways, to many highly successful, productive people who have had from one to numerous bouts of depression in their lifetime. Name any randomly chosen group of successful people in society, business, politics, or the arts, and it is likely that 20% to 30% of them are either taking Prozac or have been given Prozac at some point over the last several years. Actors, politicians, housewives, business people, and artists have flooded

    i talk shows, newspapers, magazines, and books with stones of how Prozac has helped them. People of all classes, races, and religions have benefited from and talked about the miraculous effects of Prozac in reversing their despair, chronic lack of pleasure, poor functioning, and persistent low-level depression and in raising them to a level of functioning so much better than their previous state that patients have sometimes used the term “new self.”

    In the past, lithium and other antidepressants have also unleashed a torrent of dramatic claims and testimony in books, articles, and talk shows. But after media reports about the possibility of transforming the self and developing a new personality, Prozac has caused a deluge like no other.

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  • As with every drug in existence, the list of less common side effects is long and extends into virtually every system in the body. At least 1% of the patients on Prozac have complained on at least one occasion of chills, disturbed dreams, bronchitis, agitation, or excessive yawning.

    Other side effects experienced by at least one patient in a thousand include, among many other reactions, feeling hung over, jaw pain, neck pain, excessive belching, gingivitis, thirst, hypothyroidism, anemia, weight gain (a larger number of patients lose weight), arthritis, bursitis, acne, loss of hair, conjunctivitis, ear pain, eye pain, and various urinary disturbances.

    Infrequent cardiovascular side effects include angina pectoris, arrhythmia, hypertension, hypotension, and migraine headaches.

    Infrequent nervous system reactions include abnormal gait, amnesia, apathy, convulsions, hallucinations, hostility, and paranoia.

    Then there are the “rare” side effects, which occur in fewer than one person in a thousand. These extremely unusual events include enlarged abdomen, thrombophlebitis, colitis, duodenal ulcer, increased salivation, hepatitis, jaundice, stomach ulcer, goiter, hyperthyroidism, dehydration, gout, osteoporosis, rheumatoid arthritis, antisocial reaction, eczema, unwanted hair growth, psoriasis, and many other side effects too numerous (and uncommon) to name here.

    The important point is that compared to the older classically used antidepressants, the side effects of Prozac are infrequent and mild—even in overdose.

    Most of the older antidepressants have similarly long lists of side effects, most of which are rare, although they are listed in the Physicians Desk Reference and the package inserts, often to protect the manufacturer as well as the patient.

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