According to the National Institutes of Health (NIH) antidepressants may cause mild and, usually, temporary side effects in some people.  The most common side effects according to NIH, are: 

  1. Dry mouth: Drink lots of water, chew sugarless gum, clean  teeth daily. 

  2. Constipation: Eat bran cereals, prunes, fruit, and vegetables. 

  3. Bladder problems: Emptying your bladder may be troublesome, and your urine stream may not be as strong as usual. Call a doctor, however, if pain is experienced. 

  4. Sexual problems: Sexual functioning may change. If worrisome, discuss with your doctor. 

  5. Blurred vision: This will probably pass soon. Do not get new glasses. 

  6. Dizziness: Rise from bed or chair slowly. 

  7. Drowsiness: This will pass soon. Do not drive or operate heavy equipment if feeling drowsy or sedated.

Clozapine - Unfortunately, clozapine can also cause a fatal agranulocytosis. Patients receiving the drug must undergo weekly blood tests to monitor for
agranulocytosis.  When considering the risk (and the price) of clozapine therapy versus the benefits, patients and their families have to decide how important it is to try taking those first steps out of darkness. 
(Recently Alvir et al. evaluated data from 11,555 patients who received clozapine between February 1990 and April 1991. Agranulocytosis developed in 73 patients, with fatal infections in two.  The risk of agranulocytosis increased with age and was higher in women. The investigators suggest that less frequent monitoring is possible after 6 months, because the incidence of agranulocytosis at this point is no greater than with many other drugs. (Alvir J et al. N Engl J Med. 1993; 329: 162-167.) 
 

Treatments for Panic Disorder  
     Antianxiety medication and a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs) often bring dramatic relief to people experiencing panic attacks or severe anxiety. In the past, many people with severe anxiety were treated with Xanax. This medication, however, is very addictive and also causes depression. The SSRI medications such as Taxol or Zoloft have proven to be highly effective. 
 
Antipsych otic Medications
     The first effective drugs for treating schizophrenia were antidopaminergic agents, primarily dopamine2 (D2 ) receptor blockers. For years, researchers concentrated on developing ever stronger D2 receptor blockers, even though these new drugs did not improve the treatment of schizophrenia but simply increased side effects resulting from dopamine blockade (parkinsonian extrapyramidal effects). 
     When researchers found that serotonin is also involved in the pathophysiology of schizophrenia, the way was opened for the development of entirely new classes of drugs. 
     The last major antipsychotic to receive FDA approval for schizophrenia was clozapine (Clozaril/Sandoz), a potent 5HT receptor blocker.  Clozapine is a dibenzodiazepine antipsychotic  which is superior to traditional antipsychotic drugs for the treatment of refractory schizophrenia and causes fewer dopamine related side effects (parkinsonism, dystonia, tardive dyskinesia, and elevated prolactin levels).  About one third of patients treated will show a significant response to clozapine therapy Although highly effective for reducing psychosis and paranoia, clozapine also reduces white blood cell counts, so its administration must be accompanied by costly blood tests to monitor for potentially fatal agranulocytosis. (see side effects) 
     Risperidone is a benzisoxazol that blocks receptors for both serotonin and dopamine. It also blocks central adrenergic receptors. Because risperidone does not cause major side effects that require special monitoring, the drug costs only one third to one half as much as clozapine. In comparative trials, risperidone was as effective as clozapine and possibly more effective than haloperidol. 
     Quetiapine is an antipsychotic drug belonging to the class of dibenzothiazepines. Even though the antagonistic nature of quetiapine is understood, the exact mechanism of action remains unknown. However, it is believed that the antipsychotic action of quetiapine is largely due to antagonism at the dopamine and serotonin receptors.  

• Psychodynamic therapy helps people understand what motivates their behavior and what types of things trigger their feelings.
• Behavioral therapy helps patients confront fearful situations and teaches coping skills.
• Cognitive therapy seeks to restructure self-defeating thought processes. 

The area of marriage and family counseling/therapy has exploded over the past decade. Counselors at all levels are expected to work effectively with couples and families experiencing a wide variety of issues and problems.  (see family information for specifics) 

 This technique attempts to place control in the hands of the individual.  Specific directives are given as to when, where, and with whom, and for what amount of time one should do the undesired behaviors. As the client follows this paradoxical directive, a sense of control over the symptom often develops, resulting in subsequent, change. 

Many people with severe anxiety or panic disorders also benefit from the use of breathing techniques that concentrate on using the diaphragm and increasing oxygen intake.