Does zoloft cause excessive sweating. How to cope with sweating caused by antidepressants. Oxybutynin may reduce sweating in patients taking sertraline.

Antidepressants and Excessive Sweating

Many antidepressants, including Selective Serotonin Reuptake Inhibitors (SSRIs) like Zoloft (sertraline), can cause excessive sweating, a condition known as hyperhidrosis. While the exact mechanism is not fully understood, it is thought to be related to the effects of serotonin on the body’s temperature regulation system. This can lead to overactivation of the sweating response, resulting in uncomfortable and sometimes embarrassing sweating, especially during hot weather.

Risks of Antidepressant-Induced Sweating

In hot weather, the increased sweating and sensitivity to heat can lead to dehydration, heat stroke, heat rash, and other heat-related issues. It is important for those taking antidepressants to be vigilant about staying hydrated, taking breaks from the heat, and avoiding overexertion. Additionally, the sweating can potentially mask the symptoms of serotonin syndrome, a rare but serious side effect of some antidepressants.

Managing Antidepressant-Induced Sweating

If the sweating is significantly impacting your quality of life, it is important to discuss it with your healthcare provider. They may be able to prescribe a medication like oxybutynin to help counteract the sweating side effect. In the meantime, there are some self-care measures that can help, such as:

• Regularly measuring your body temperature to monitor for any concerning changes
• Staying hydrated by drinking plenty of fluids throughout the day
• Avoiding activities that can trigger or worsen sweating, such as intense exercise or consuming alcohol and spicy foods
• Wearing loose, breathable clothing made of natural fibers like cotton or linen

Oxybutynin for Antidepressant-Induced Sweating

A double-blind, placebo-controlled clinical study found that the medication oxybutynin can effectively reduce sweating in depressed patients being treated with the SSRI antidepressant sertraline (Zoloft). Oxybutynin works by blocking the action of acetylcholine, a neurotransmitter involved in the sweating process. This can provide relief for those struggling with excessive sweating as a side effect of their antidepressant medication.

Prioritizing Medication Adherence

It is important to note that stopping antidepressant medication suddenly due to the sweating side effect is not recommended, as this can lead to withdrawal symptoms and a worsening of the underlying condition. Instead, work closely with your healthcare provider to find ways to manage the sweating, whether through adjunct medications, lifestyle changes, or adjustments to your antidepressant regimen.

Conclusion

Excessive sweating is a common side effect of many antidepressant medications, including Zoloft (sertraline). While the exact cause is not fully understood, it is thought to be related to the effects of serotonin on the body’s temperature regulation system. Managing this side effect is important, as it can lead to dehydration, heat-related illnesses, and even potentially mask the symptoms of serotonin syndrome. By working closely with your healthcare provider and implementing self-care measures, it is possible to find ways to reduce the burden of antidepressant-induced sweating and maintain adherence to your medication regimen.

Key Takeaways

• Many antidepressants, including SSRIs like Zoloft, can cause excessive sweating (hyperhidrosis)
• Antidepressant-induced sweating can increase the risk of dehydration, heat-related illnesses, and potentially mask serotonin syndrome symptoms
• Discussing the sweating with your healthcare provider is important, as they may be able to prescribe medications like oxybutynin to help manage the side effect
• Self-care measures such as staying hydrated, avoiding triggers, and wearing breathable clothing can also provide relief
• It is crucial to continue taking your antidepressant medication as prescribed and work with your healthcare provider to find ways to manage the sweating, rather than stopping the medication suddenly

Antidepressants can cause excess sweating and overheating – how to cope

Feeling the heat? Your medication might be to blame (Picture: Getty/Metro.co.uk)

Yes, it is extremely hot right now.

But if you’ve noticed that you’re sweating more than you ever have before, there might be another reason: your antidepressants.

Many antidepressants increase your likelihood of excessive sweating, known as hyperhidrosis.

It’s not clear why mental health medication can trigger a major case of sweaty upper lip syndrome, but the good news is that if you are experiencing this, you’re certainly not alone – and there are ways to reduce the struggles.

Let’s get into it.

Why do antidepressants make you sweat more?

‘The majority of antidepressants increase the risk of hyperhidrosis,’ explains Dr Kandi Ejiofor. ‘Some American studies cite that excess sweating can affect up to 15% of people take antidepressants.

‘Specifically, Tricyclic Acid and SSRI (selective serotonin reuptake inhibitors) antidepressants are responsible for this.

‘The way in which antidepressants cause excessive sweating is still relatively unknown – it is thought to be linked to the effects of serotonin, the happy hormone, in trying to maintain the internal core temperature of the body.

‘Your body sweats to try and cool down the body but overstimulation of this process can lead to overheating and excess sweating.’

What risks do antidepressants pose in hot weather?

In the current heatwave, some people who are taking antidepressants will notice not only more sweating than usual, but also simply feeling the heat more.

This can then lead to dehydration, heat stroke, heat rash, and other heat related issues, so it’s essential that you’re really on top of all the regular hot-weather-related care, such as drinking plenty of water, taking time out of the sun, and avoiding overexertion.

Dr Stephanie Ooi, GP at MyHealthcare Clinic, notes that the hot weather could also disguise the symptoms of serotonin syndrome, a rare, but potentially serious set of side effects that are linked to SSRIs

‘Serotonin syndrome occurs when the levels of serotonin in your brain are too high,’ says Dr Stephanie. ‘This can occur if you take an SSRI in combination with something else that also raises serotonin levels, such as another antidepressant or St John’s Wort.’

Symptoms of serotonin syndrome can include:

• confusion
• agitation
• muscle twitching
• sweating
• shivering
• diarrhoea

That is unlikely, by the way. The main risks you’ll face in the UK heatwave when taking antidepressants are the minor, but annoying ones: feeling super sweaty, hot, and uncomfortable.

This poses a greater risk though: that you might get so fed up of being covered in sweat that you stop taking your medication in an attempt to lower your temperature.

This is not a good idea.

‘Sweating secondary to antidepressant medication is usually not a cause for concern on its own but the symptoms can be so bothersome that it causes people to stop taking their medication, which of course could be problematic,’ says Dr Kandi.

Your GP might be able to help tackle the sweaty effects of your meds (Picture: Getty Images/iStockphoto)

What should you do if your antidepressants are causing excess sweating?

First things first: keep taking your meds. Don’t do a sudden stop out of desperation to cool down.

Instead, it’s worth talking to your GP if hyperhidrosis is negatively affecting your life.

‘They may consider prescribing you another medication to counteract the effects of the medication you are on,’ suggests Dr Kandi.

Along with this, there are many things you can do on your own to reduce any hot weather induced discomfort.

Measure your temperature

Dr Kandi recommends investing in a thermometer, so you can regularly measure your temperature and thus know when there’s a problem.

‘If your core temperature is consistently raised above the baseline, it is worthwhile discussing with your doctor to review you and manage your symptoms appropriately,’ she notes.

Drink plenty of fluids

Make sure you’re sipping water throughout the day, carrying a bottle with you wherever you go.

This is key to avoid dehydration, especially if you’re losing a lot of fluid from excess sweating.

Take it easy

Now might not be a great time to rush around doing loads of things at once, or to do super intense workouts. Give yourself plenty of rest and prioritise keeping cool.

Wear the right clothes

‘Wear loose clothing in breathable materials such as cotton or linen,’ Dr Stephanie suggests. ‘Avoid tight clothing or synthetic materials.’

More: Health

Avoid other triggers for increased sweating

Drinking alcohol and eating spicy food can make your sweating worse.

Get a good antiperspirant

Speak to your pharmacist about one that will work best for excess sweating.

You can also buy armpit or sweat shields if you’re worried about protecting your clothing.

Prioritise lowering stress and anxiety

You know the drill: you sweat, then you get self-conscious and panic about sweating, then you sweat more, and so the awful cycle continues.

Remind yourself that sweating is perfectly natural, and people will understand – it’s boiling right now, so we doubt anyone is judging you for perspiring.

In moments when your excess stress is bothering you, try to ground yourself and do breathing exercises to slow your heartrate and bring you back to a place of calm.

Do you have a story to share?

Get in touch by emailing [email protected].

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Does Zoloft Cause Night Sweats? (5 Things You Need To Know)

In this blog, we will learn about zoloft induced night sweats. We will also discuss the reason behind it and how to overcome this condition. If you’ve noticed you are sweating more than usual, you need to take a look at your medication list.

Does zoloft cause night sweats?

Yes, zoloft is associated with many side effects, one of which is excessive sweating at night, called ‘night sweats’. In fact, zoloft induced night sweats are one of the most disturbing side effects. 

The thought of sweating profusely, in the might of the night, even during winters, is quite disturbing. Zoloft not only causes excessive sweating at night, but at any part of the day. 

Not only zoloft, a lot of other antidepressants do the same. Zoloft belongs to the class of SSRIs. SSRIs increase serotonin levels in the brain. Serotonin can affect hypothalamus, which is responsible for regulating your homeostasis. 

It can have an impact on your body temperature and your ability to sweat. Abnormal sweating, is in fact, a very common side effect of SSRI antidepressants, occurring in around 10–20% of patients. It usually sticks around, or even worsens. 

Antidepressant-induced sweating is different for everyone. For some people, it is so severe that they need to find a different drug, or quit antidepressants altogether.  

Is zoloft induced excessive sweating that bad?

Excessive sweating is quite problematic. In short, it is disabling. It affects the quality of life as it ends up disturbing people more than they could imagine. It becomes socially embarrassing for them, and in some cases, they are embarrassed in front of their spouses as well. 

Imagine snowing outside, literally it’s that cold. You wake up in the middle of the night just to find out that you’re sweating profusely. It not only ruins your sleep quality, but also your hygiene as well.

Zoloft induced sweating is more prominent in the upper body, face, scalp, neck and chest. Do not wait for it to subside on its own. This does not go away that easy. 

What could be done? 

If the night sweats are disrupting your life that terribly, one of the few things might help:

Dose reduction

Dose reduction can be considered, if possible. If there’s a chance of your condition worsening with a lower dose, then this option is not so helpful. But if there is a chance to minimise side effects by reducing the dose, without affecting the therapeutic response, this might help. 

Consider changing antidepressant

If feasible, you can switch to a different SSRI or any other class of antidepressant (except bupropion, which has a higher rate of night sweats as compared to any other antidepressant). 

For example, if zoloft (Sertraline) is inducing night sweats in you, ask your healthcare provider to prescribe another antidepressant of the same family (SSRIs), which might help you with depression without inducing excessive sweating. 

Give your body time

Your body might need some time to adapt to the presence of zoloft. These meds affect your brain and alter the amounts of excitatory neurotransmitters, to get rid of your anxiety and depression. It can not happen overnight. 

Side effects associated with zoloft start to fade away within a few weeks. Make sure you give your body enough time to adjust. Do not stop your med abruptly.

What if it gets worse?

If your night sweats get worse and even after weeks of treatment, this side effect persists, your healthcare provider may prescribe some medical treatment to overcome your night sweats. Medications used to reduce excessive sweating include:

TERAZOSIN 

Terazosin is an alpha-1 adrenergic antagonist, generally used in the treatment of symptomatic benign prostatic hyperplasia and management of hypertension. 

In a study conducted in 2013, it was observed that in the beginning of the study, 48.5% patients suffered from high grade sweating. After 14 days of treatment with terazosin, the percentage reduced down by half.

This concludes that terazosin is effective in decreasing sweating severity in patients using zoloft (Sertraline).

Side effects of terazosin 

As it’s nothing new to know that every medicine has its own side effects. Let’s take a look at side effects associated with the use of terazosin.  

• Chest tightness and pain
• Dizziness/lightheadedness/vertigo
• Shortness of breath.
• Unconsciousness 
• Arrhythmia or irregular heartbeat.
• Swelling of lower extremities
• Impotence (inability to have an erection)
• Blurred vision
• Nausea
• Stuffy or runny nose

One thing that I always try to tell my readers is, every human body is different, and no I don’t mean physically or the way we look, I mean internally! Just like every human being reacts differently to different situations.

Similarly every human body reacts differently when they are exposed to medications. Every single individual out there has a different physiological composition. A certain medicine might be beneficial for one but ends up producing serious side effects in another. 

GLYCOPYRROLATE AND OXYBUTYNIN

Glycopyrrolate and Oxybutynin are also known as ‘The sweat pills’. Glycopyrrolate (sold under the brand name Robinul) is one of the anticholinergics used most often in the treatment of excessive sweating.  

The effectiveness of glycopyrrolate is often related to the dose a patient is able to handle, and obviously how the patient responds to the drug. Studies suggest that glycopyrrolate reduces sweating efficiently but it is not tolerated by some people because of its side effects.

Side effects of Glycopyrrolate 

Side effects include:

• Dry mouth (the most common side effect) 
• Dry eyes or decreased lacrimation
• Constipation
• Nausea 

Drinking more water, mints, eye-drops and increased fibre consumption might help fight these side effects.

Fear of serotonin syndrome 

Yes, it is very important to rule out serotonin syndrome as sometimes, you think that excessive sweating is a side effect you’re getting from the use of zoloft, but what if it’s something else? 

Serotonin syndrome (SD), also known as serotonin toxicity, is a potentially life threatening condition involving excessive serotonergic activation. It has many symptoms to talk about.  

The basic cause of this condition is the serotonin overload and the antidepressants are considered the main culprit for this condition. The syndrome is pretty rare, so it is unlikely to occur when a patient is sticking to the dose recommended by the healthcare provider.

Sometimes, they combine the use of these types of medications, for the sake of achieving better results, so if you are already on a stable dose but you combine zoloft with other medications. 

Other non psychological medications, which somehow increase the amount of serotonin in the body, it also results in serotonin syndrome. 

For example, if selene, which is a Parkinson’s disease medication, is also added on a patient when a patient is already on zoloft, it increases the risk for serotonin syndrome. 

Now, let’s briefly talk about the path of physiology behind this condition. It all begins with the amino acid tryptophan, which is used to produce serotonin. 

It actually undergoes a couple of enzymatic reactions and ends up producing serotonin, which can act on a variety of different receptors in the brain to modulate mood, appetite, sleep and attention but it also has other regulatory functions in the body.  

One of the main symptoms of serotonin syndrome is profuse sweating, which is why I had to mention this condition, as oftentimes it is not even a side effect of zoloft but an actual syndrome, and the patient has no clue of it. 

Signs and symptoms of serotonin syndrome 

• Excessive sweating 
• Restlessness and fatigue
• Headache, which often feels like your head is pounding
• Changes in blood pressure and/or temperature
• Nausea
• Vomiting
• Diarrhoea
• Bradycardia
• Tremors
• Muscle twitching and muscle pain
• Shivering and goosebumps

Conclusion

Zoloft, an antidepressant, is often seen to be associated with profuse sweating, especially at night. This is indeed a pretty depressing condition, as it decreases the quality of life. 

In this blog, we discussed the options you have if you’re going through this problem. You can either reduce the dose or change the kind of antidepressant you’re on right now. If that doesn’t solve your problem, then terazosin and glycopyrrolate are prescribed to take your excessive sweating down a notch. 

In the end, always look out for serotonin syndrome. Immediately notify your healthcare provider, if you feel excessively increased heartbeat, chills and fever along with sweating. 

FAQs : Zoloft night sweats 

How long do night sweats last with Zoloft?

It depends on the dose you’re prescribed. Antidepressants usually take 4 to 6 weeks to produce their effects, as well as side effects. Most probably, these side effects subside when your body adapts to the presence of the med. 

Some side effects don’t. Make sure you discuss the do’s and don’ts with your healthcare provider. 

Why do antidepressants cause night sweats?

SSRIs induce sweating by blocking muscarinic receptors. Abnormal sweating, is in fact, a very common side effect of SSRI antidepressants, occurring in around 10–20% of patients. 

It usually sticks around, or even worsens. Antidepressant-induced sweating can take various forms, one of which is night sweats.

For some patients, the antidepressant-induced sweating is so severe that they need to find a different drug, or quit antidepressants altogether.

How do I stop night sweats from antidepressants?

As we have discussed in this blog, dose reduction can be considered, if possible. If there’s a chance of your condition worsening with a lower dose, then this option is not so helpful. But if there is a chance of doing so, this might help. 

Consider changing your antidepressant, if feasible. You can switch to a different SSRI or any other class of antidepressant (except bupropion, which has a higher rate of night sweats as compared to any other antidepressant).

In severe cases, terazosin or glycopyrrolate are recommended. 

Can paroxetine cause night sweats?

Yes, it can. Paroxetine is a member of SSRIs family. Its side effect profile is somewhat similar to other members of this class of antidepressants. Make sure you don’t exceed the recommended dose. 

What are the most common side effects of Zoloft?

Most common side effects include nausea, dizziness, drowsiness, dry mouth, loss of appetite, increased sweating, diarrhoea, upset stomach, trouble sleeping, weight gain and decreased libido. 

Nausea and vomiting may be more likely to occur with initial use of zoloft. It improves over time when the body starts to accept it. Within a few weeks, gastrointestinal side effects subside. 

Always remember, the proper use of medicines is the key to their maximum beneficial effect. Avoid deviating from the dose suggested by your healthcare provider, and never stop it abruptly.

References 

• James W. Mold and Barbara J. Holtzclaw – Selective Serotonin Reuptake Inhibitors and Night Sweats in a Primary Care Population https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4883206/
• Pilot Study of Terazosin in Treatment of Antidepressant Induced Excessive Sweating https://clinicaltrials. gov/ct2/show/NCT00237510
• Ali Ghaleiha et al. Int J Psychiatry Clin Pract. 2013 – Effect of terazosin on sweating in patients with major depressive disorder receiving sertraline: a randomized controlled trial https://pubmed.ncbi.nlm.nih.gov/22731399/
• Rajnish Mago et al. Ann Clin Psychiatry. 2013 – Antidepressant-induced excessive sweating: clinical features and treatment with terazosin https://pubmed.ncbi.nlm.nih.gov/23638448/
• Hyun Ho Lee, MD, Do Won Kim, MD. Efficacy of Glycopyrrolate in Primary Hyperhidrosis Patients https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3259134/

Safe treatment of stress disorders in the practice of psychiatrists and psychologists

According to the World Health Organization, about 30% of the world’s population use psychotropic drugs. All over the world, these funds have entered the general somatic network – they are prescribed by therapists, and family doctors, and narrow specialists, and, of course, psychiatrists and psychologists.

In Russia, the attitude to this pharmacotherapy is far from unambiguous. To this day, there are stereotypical ideas that all psychotropic drugs without exception necessarily cause addiction, slow down the speed of thinking and reduce mental abilities, and their side effects inevitably lead to serious disorders of the internal organs.

A bad reputation in the eyes of patients certainly complicates the provision of necessary care and requires a particularly attentive and friendly attitude towards patients.

Psychotropic drugs of the older generation do have a lot of negative effects, and today psychiatrists and psychologists are faced with the task of selecting a drug that meets the following criteria:
• rapid development of a therapeutic effect;
• minimal unwanted side effects;
• selective anxiolytic action in the absence of hypnotic and muscle relaxant effects;
• pronounced vegetative corrective action;
• no addiction or drug dependence;
• Improved concentration.

All of the above requirements are fully satisfied by the daytime tranquilizer Grandaxin (tofisopam), which combines the unique properties of a selective anxiolytic and an effective vegetative corrector.

An important fact is that Grandaxin does not potentiate the effect of alcohol and sedatives. The reaction rate with its regular use also does not decrease, which means that its intake does not impose restrictions on driving vehicles and engaging in hazardous activitiesiii.

Grandaxin (Tofisopam): mechanism of action and spectrum of application

Grandaxin (tofisopam), manufactured by Egis, has been actively used all over the world for more than 20 years and is well known in Russia.

The main feature of the group of drugs to which Grandaxin (tofisopam) belongs is the location of the nitrogenous group. Whereas traditional benzodiazepines have the nitrogen group in position 1-4, Grandaxin and similar drugs have it in position 2-3, which is why they are usually referred to as 2-3-benzodiazepines.

Due to the specifics of its structure, the properties of the drug differ significantly from the “classical” benzodiazepines. Its vegeto-corrective and anxiolytic effects, not accompanied by sedative and muscle relaxant effects, have made it possible to find wide application in clinically pronounced manifestations of anxiety within the framework of well-studied psychogenic mental illnesses, psychopathy, and pathocharacterological personality developments.

Grandaxin (tofisopam) is used for menopausal syndromeiii, PMS, alcoholism, adjustment disorders, PTSD, ADHD and other conditions accompanied by anxiety, emotional stress, mild depression, autonomic dysfunction, apathy, decreased activityiv.

Grandaxin (tofisopam) is now included in a number of standards of primary health care and specialized care, for example, for withdrawal, amnestic conditions and acute intoxication caused by the use of psychoactive substances.

Clinical practice and evidence of effectiveness

The use of Grandaxin (Tofisopam) in anxiety disorders

Permanent anxiety disorders are often accompanied by various types of psychovegetative symptoms. Grandaxin (tofisopam), due to its vegeto-corrective action, quickly relieves anxiety and its vegetative accompaniment, significantly improves the patient’s quality of life and helps restore optimism regarding the prognosis of the disease.

With paroxysmal anxiety, panic attacks, the use of Grandaxin (tofisopam) is advisable for:
• acceleration of the clinical effect, since the own anti-panic effect of antidepressants is delayed;
• for the correction of anxiety and panic disorders, the aggravation of which is provoked by the start of antidepressants;
• Increase the effect of an antidepressant when it is not possible to increase the dose due to the risk of side effects.

The absence of sedative and muscle relaxant effects allows treatment on an outpatient basis, without disturbing the patient’s usual daily routine and without adding to his stress.

In addition, the dopaminergic effect of Grandaxin (tofisopam) determines its activating effect and contributes to a certain behavioral correction. It is no coincidence that 2-3-benzodiazepine preparations are sometimes referred to as atypical antipsychoticsviii. In the case of panic disorders, these properties of Grandaxin (Tofisopam) may be useful for the relief of secondary disorders, in particular, agoraphobic, hysterical and hypochondriacal syndromes.

The use of Grandaxin (Tofisopam) in psychovegetative disorders

Vegetative disorders are one of the urgent problems of modern medicine. In the population, vegetative disorders of varying severity. starting from puberty, occur in 25-80% ixx. Psychovegetative symptoms are encountered by specialists of various profiles, and often patients are referred for an appointment with a psychologist, psychotherapist or psychiatrist.

Psychovegetative syndrome develops in the pathology of the suprasegmental vegetative systems of the brain of any etiology, more often psychogenic than organic.

The main manifestations, as the name implies, unfold in the psychic and vegetative spheres in the form of permanent and paroxysmal disorders.

In the work carried out by Artemenko A.R. et al.xi studied the effectiveness of Grandaxin (tofisopam) in patients with psychovegetative disorders (asthenic manifestations, emotional disturbances, sleep disturbances, headaches, blood pressure lability, hyperhidrosis, cardialgia, hyperventilation disorders, etc.).

After 4 weeks of treatment, patients significantly decreased fatigue; decreased severity of emotional disorders, sleep and appetite disorders; decreased manifestations of Raynaud’s phenomenon and sweating; completely regressed non-infectious subfebrile condition; decreased headaches, hyperventilation manifestations, fluctuations in blood pressure, cardialgia and dysfunction of the gastrointestinal tract.

As a result of the treatment, the indicators of emotional tension significantly decreased, the quality of life improved, and the subjective assessment of health disorders (VAS) decreased.

Thus, the authors have shown that Grandaxin (tofisopam) can be used as monotherapy for mild and moderate manifestations of PVS. Therapeutic doses of Grandaxin (Tofisopam) are well tolerated by patients, practically do not lead to side effects. Grandaxin (tofisopam) deserves wider application in clinical practice, not only as a well-known daytime tranquilizer, but also as a highly effective vegetative correctorxii.

The use of Grandaxin (tofisopam) for psychoemotional and neurovegetative disorders in menopause

Climacteric syndrome is an interdisciplinary problem, and often not only and not so much gynecologists, but endocrinologists, cardiologists, neurologists, psychologists and psychotherapists deal with the treatment of patients undergoing menopause.

In addition to the physiological extinction of the ovarian function, an important medical and social problem is the rehabilitation of a woman after gynecological operations (adnexectomy, hysterectomy). The most common psycho-emotional consequences of hysterectomy are depression and anxiety, which can contribute to a decrease in the quality of life and worse prognosis.

Thus, depression accompanies menopause, both physiological and postoperative, and its therapy is extremely important for a full-fledged comprehensive rehabilitation.

A study of the use of Grandaxin (Tofisopam) in patients with psycho-emotional and neurovegetative disorders during menopause showed a significant improvement in their well-beingxiii. The maximum effect was achieved in relation to psycho-emotional disorders. An excellent correction of both depression and anxiety (not only severity, but also frequency), especially situational anxiety in operated patients, was noted.

The data obtained indicate an undoubted positive effect of therapy with Grandaxin (tofisopam) in order to correct psycho-emotional and neurovegetative disorders, and therefore Grandaxin (tofisopam) can be recommended for use as part of the complex therapy of menopausal disorders.

The use of Grandaxin (Tofisopam) for premenstrual syndrome

The deterioration of the mental and physical condition of a woman before menstruation is described as early as the time of Hippocrates. And today, PMS is often the cause of an exacerbation of the serious condition of women who are regularly observed by psychiatrists and psychologists.

“Premenstrual dysphoric disorder” in a pronounced form occurs in 8-25% of women of reproductive age. Hormone therapy (in particular, GRF agonists) can not always be used due to the high risk of somatic complications, and also because of the psychological resistance of women who prefer to suffer from recurrent PMS symptoms than take hormones.

Therefore, recently, in the treatment of PMS, drugs are actively used that reduce emotionally affective and motivational disorders and secondarily affect the occurrence of autonomic and metabolic endocrine-metabolic disorders.

Solovieva A.D. et al in 2001xiv investigated the efficacy of Grandaxin (Tofisopam) in women with PMS using it for 8 weeks at a dose of 100 mg. After treatment, the patients’ sleep significantly improved, personal anxiety and depression decreased, and the quality of life improved. It should also be noted that Grandaxin (tofisopam) was also effective in relation to specific hormonal symptoms of PMS, such as swelling, engorgement and soreness of the mammary glands and pain in the lower abdomen, which once again confirms the close relationship between brain structures and sex hormones.

The use of Grandaxin (Tofisopam) for stress

Stress is an inevitable companion of an active social life, and in most cases a person has reserves to cope with stress on his own. However, in some cases, the body’s response to stress becomes disproportionately strong compared to the external influence causing it. This violates the adaptive capabilities of the body and sometimes can even provoke the development of psychosomatic diseases.

Therefore, the best help for a patient who is in a state of chronic stress is outpatient treatment with drugs from the group of daytime tranquilizers.

A group of Moscow scientists summarized the experience of using Grandaxin (Tofisopam) to correct pre-exam stress in university studentsxv. The specialists came to the conclusion about the high clinical efficacy of the drug: 94% of the students had a very good or good effect when using it. According to the students themselves, this therapy helped to cope more successfully and much easier with the tasks set during the examination session.

Students who are in a strong psycho-emotional stress caused by chronic stress most often have anxiety disorders of a non-psychotic level with a pronounced PVS of a psychophysiological nature (sweating, lability of temperature, pulse, blood pressure, disorders of the gastrointestinal tract, etc.). The drug Grandaxin (tofisopam) affects the level of anxiety and vegetative manifestations, as a result of which the indicators of stress resistance are significantly improved, and hence adaptation in situations of psycho-emotional stress.

Use of Grandaxin (Tofisopam) for Attention Disorder with Hyperactivity in Adolescents

ADHD is a major social problem as it occurs in 5-30% of children and adolescents in the general populationxvixviixviiiixix. Children who are characterized by restlessness, distractibility, hyperactivity, impulsiveness, poor academic performance, irascibility, and low self-esteemxx xxi are seen by psychiatrists and psychologists. In older children, especially adolescents with ADHD, anxiety and depressive disorders are often noted xxiixxiii.

Psychostimulants recommended for the treatment of ADHD and showing high efficiency in the Western world are not allowed in our country. In the Russian Federation, cerebrolysin, piracetam, instenonxxiv are prescribed in such cases. However, these drugs do not affect impulsivity and anxiety-depressive disorders. Thus, the development of new treatments for ADHD is an important medical and social problem. In clinical psychopharmacology, the drug Grandaxin (tofisopam) has found wide application.

A studyxxv conducted on 36 ADHD adolescents aged 14 to 17 showed a significant improvement of 63.9%. Parents noted an improvement in behavior, attention, memory in their children. In 80% of adolescents who complained of headache, treatment reduced their frequency and intensity.

A psychological study conducted using the TOVA test revealed a statistically significant increase in attention indicators, a decrease in reaction time, a decrease in impulsivity and hyperactivity (70%), and anxiety.

After 30 days of using Grandaxin (Tofisopam) at a dose of 50 mg, 1 tablet 2 times a day, pronounced positive changes in the clinical condition are observed, the behavior and academic performance of children have improved.

The effectiveness of using Grandaxin (Tofisopam) in the treatment of ADHD is approximately equal to the results of the use of psychostimulants in the absence of their typical side effects.

The use of Grandaxin (Tofisopam) in disorders of adaptation

Psychic traumas and mental stress associated, in particular, with a forced change of residence, economic difficulties, unsettledness for a long time in a new place, uncertainty of the future, in the vast majority of cases lead to the development of neurotic disorders of various levels and social maladaptationxxvi.

Despite the fact that adjustment disorders, in principle, relate to conditions with a favorable prognosis and are successfully amenable to psychotherapeutic interventionxxviixxviii, the risk of developing more complex psychopathological disorders (for example, generalized anxiety disorders, pathological personality development, etc.) with long-acting and currently intractable stress situations is quite high. This requires psychopharmacotherapy with the use of tranquilizers that best meet the safety criteria.

The study of Grandaxin (Tofisopam) in adaptation disordersxxix makes it possible to attribute it to a number of basic, so-called “drugs for the population”. Their use minimizes the risk of developing adverse events, so they can be prescribed on an outpatient basis to a wide range of people with unexpressed anxiety disorders who are in a chronic stressful situation to prevent the development of more severe psychopathological disorders in them. The drug can be recommended for use in a comprehensive program of therapy and rehabilitation of refugees and internally displaced persons with adjustment disorders with anxiety symptoms, in medical and psychological rehabilitation centers.

The use of Grandaxin (Tofisopam) in post-traumatic stress disorder

The problem of post-traumatic stress disorder (PTSD) has become more and more urgent in recent years: all over the world and, in particular, in Russia, there are many hotbeds of tension where active hostilities are taking place. The search for a drug for adequate therapy of anxiety, repeated repeated experience of a traumatic situation, constant intense expectation of the return of a traumatic event, is the subject of work of many specialists.

The effectiveness of Grandaxin (Tofisopam) for the treatment of PTSD was tested in a study xxx in which military personnel participated in the hostilities in Chechnya in 1994-1996. and 1999-2000 All patients had borderline psychiatric disorders. Syndromally, these states were regarded as anxious, depressive, hypochondriacal.

After taking Grandaxin (Tofisopam) at a dose of 50 mg 3 times a day for 2-3 weeks, a subjective improvement was noted in almost all patients. Sleep indicators significantly improved: presomnic disorders stopped in 72% of patients, intrasomnic disorders – in 50%, nightmares ceased to bother 78.6% of patients. With the normalization of sleep correlates with a decrease in the manifestations of anxiety. The total score on the anxiety scale changed 7 times, on the depression scale – 2 times, on the asthenia scale – 1.5 times towards improvement. The data of A.M. Wayne (2000) on the positive effect of Grandaxin (Tofisopam) on the cephalgic syndrome.

It can be assumed that the reduction of the anxiety radical will entail a decrease in craving for alcohol; relief of cephalalgia will reduce the dose of analgesics consumed; normalization of sleep will reduce the need for hypnotics. Rehabilitation of patients with PTSD, of course, cannot be reduced at this stage to a single, albeit effective, drug. Of course, it is necessary to use a set of measures, including psychological and social assistance. However, Grandaxin (tofisopam) should take its rightful place in the treatment of patients suffering from post-traumatic stress disorders.

Thus, Grandaxin (tofisopam) is an effective drug used by psychiatrists and psychologists, which is able to effectively protect against stress, fight psycho-emotional and vegetative disorders that accompany both normal physiological processes and somatic, neurological and mental diseases.

Anxiety in children and adolescents with cancer

What is anxiety?

Anxiety is the experience of fear, confusion or anxiety, often experienced in response to a stressful situation. Thoughts and feelings of uneasiness and stress are common to anyone facing a serious illness such as childhood cancer. In most cases, children and adolescents are psychologically resilient and cope well with the difficulties during and after cancer.

But sometimes it happens that anxiety causes constant stress or interferes with daily life. This may be indicative of a particular anxiety disorder. Studies show that anxiety disorders are no more common in children with cancer than in other children. However, advice on coping with anxiety can be helpful to all children with cancer. A variety of resources and services help manage symptoms, improve mental health, and improve quality of life during and after treatment.

Signs and symptoms of anxiety in children and adolescents

Everyone experiences anxiety differently. This is especially true for children and teenagers. Young children may not be aware of their experiences. Older children and teenagers are not always willing to talk about their worries in order not to upset their parents or because they are afraid to make the situation worse.

Possible signs and symptoms of anxiety:

• Feeling tense, anxious or afraid
• Irritability or excessive touchiness
• Difficulty thinking or concentrating
• Restlessness, inability to sit still
• excessive tearfulness
• Unwillingness to be alone, desire to constantly be with loved ones
• Avoidance of activities or situations that cause disturbing thoughts or feelings
• The need for constant encouragement
• Signs of self-mutilation
• Sleep disorders
• Rapid heartbeat or breathing
• Tense muscles
• Headaches
• Loss of appetite or change in eating habits
• Indigestion, abdominal pain, constipation or diarrhea

Many of these symptoms may be a manifestation of physical illness or may occur as a side effect of cancer treatment. A mental health professional can help families recognize the symptoms of anxiety and how to better manage them.

Anxiety disorders in children and adolescents

An anxiety disorder is a persistent fear or worry that interferes with the patient’s daily life or causes great stress. Anxiety is usually within the normal range of a person’s thoughts and emotions. However, anxiety symptoms may also indicate the presence of an anxiety disorder or other mental illness requiring special treatment. If your child’s anxiety symptoms get worse, interfere with daily life, or continue even after the stressful event has ended, talk to your care team.

Each anxiety disorder has a set of symptoms that point to a specific diagnosis. Some anxiety disorders may have similar symptoms and treatments. However, only an assessment by a specialist will allow you to choose the best method of treatment.

Types of anxiety disorders

1. In separation anxiety disorder, a person experiences intense anxiety about being separated from another person. When it comes to children, it is often the fear of separation from one or both parents. The child is worried that if mom or dad leaves, something bad will happen. The thought of separation causes deep stress. Other symptoms of separation anxiety disorder can include extreme attachment, nightmares, and a desire to avoid being alone.

2. A person with a specific phobia has an intense fear of a specific object or situation. This often causes the sufferer to worry about the cause of the phobia and take steps to avoid the object of fear or the event causing the phobia.

3. In social anxiety disorder, a person experiences extreme fear or anxiety about situations of interacting with people or performing in front of others. A person may worry about being embarrassed and avoid certain situations. This often leads to problems at school or at work. A child with social anxiety disorder may appear shy or withdrawn.

   Social anxiety disorder, National Institute of Mental Health

4. In panic disorder, a person experiences recurring, sudden panic attacks. Attacks are very unpleasant, but usually last only a few minutes. They may occur unexpectedly or be triggered by a frightening object or event. During a panic attack, there may be a rapid heartbeat, increased sweating, and trembling. Shortness of breath or a feeling of suffocation may occur. A panic attack is accompanied by feelings of intense fear, helplessness, or bad foreboding.

   Panic disorder, National Institute of Mental Health

5. In generalized anxiety disorder (GAD), anxiety symptoms occur almost daily and last for at least six months. Symptoms include uncontrollable anxiety, irritability, restlessness, trouble concentrating, fatigue, increased muscle tone, and sleep disturbances. The symptoms can be severe enough to interfere with a person’s normal life at home, school, or work.

   National Institute of Mental Health Generalized Anxiety Disorder

6. In obsessive-compulsive disorder, a person is overwhelmed by repetitive, intrusive anxious thoughts or fears. They may be accompanied by an urgent need to perform certain actions (compulsive urges) in order to relieve tension. Examples of compulsions or compulsive behaviors include handwashing, counting, checking, or other repetitive activities. OCD usually develops in teenagers or young adults and can be hereditary. Often the patient knows that his thoughts and behavior are irrational, but he is unable to control them.

   Obsessive Compulsive Disorder, National Institute of Mental Health

7. Post-traumatic stress disorder may develop after a fearful, threatening or emotionally traumatic event. Symptoms of PTSD are re-experiencing the event, avoiding reminders of the trauma, irritability or fearfulness. Details of an event may be forgotten, or negative thoughts and feelings may arise: guilt, sadness, or hopelessness.

   PTSD, National Institute of Mental Health

Coping with anxiety is useful whether or not the patient has a diagnosable anxiety disorder. High levels of anxiety can:

• Cause health problems and physical symptoms such as headaches, abdominal pain, nausea, or diarrhea
• Interfere with cancer treatment and procedures
• Influence personal relationships
• Interfering with study or work
• Influence appetite, sleep, physical activity and other aspects of health
• Increase the risk of other problems such as depression, alcohol or substance use, smoking, self-mutilation or eating disorders

In general, children with cancer are psychologically resilient and no more likely to develop an anxiety disorder than their healthy peers. At the same time, recommendations for overcoming anxiety can be useful to almost all patients with cancer at any stage of life.

Dr. Niki Jurbergs, child psychologist

Treating anxiety in children and adolescents

Managing anxiety symptoms is important for mental health and quality of life during and after cancer. It is best to use several different strategies to deal with anxiety. Specialists such as psychologists, psychiatrists, social workers, counselors, nurse psychologists, child adaptation specialists, music therapists, art therapists and priests will help with this.

Psychological Therapy for Anxiety

• Cognitive Behavioral Therapy (CBT) is a type of psychotherapy or “talk therapy” that teaches you how to change negative thoughts into positive ones and respond more effectively to different situations. Such therapy can help to adapt to specific objects, places, events, or thoughts that usually cause fear or anxiety.
• Distraction Techniques: Distraction is an important tool for coping with anxiety. But this does not mean that you should just not think about what causes stress. Children can be distracted from disturbing thoughts or situations by engaging in enjoyable activities. For children, art therapy, music therapy and play therapy are very useful, which help patients control anxiety.
• Mindfulness and Relaxation Strategies: Patients can learn specific techniques to help manage stress and anxiety and reduce their impact on mental health. The advantage of many of these strategies is that they can be applied almost anywhere and anytime. Examples of relaxation techniques include deep breathing, guided visualization, auto-training, and progressive muscle relaxation.
• Psychosomatic Therapy: Many patients benefit from biofeedback, therapeutic massage, yoga, exercise and other psychosomatic therapies. Studies show that the use of these therapies can activate other nerve and chemical signals in the brain, thereby reducing anxiety levels.

Many of these therapies not only reduce anxiety, but also provide a number of other benefits such as reducing pain, nausea and depression.

Medicines for treating anxiety in children and adolescents

Your doctor may prescribe a separate medicine to treat anxiety symptoms. Sometimes this or that medicine is prescribed to help the patient relax before the procedure. These drugs usually work quickly, but not for long.

Some patients may need long-acting drugs to treat their anxiety disorder. Such drugs do not help immediately. Some patients may be prescribed a combination of several drugs. The following medications may be used to treat anxiety disorders in children.

• Fluoxetine (Prozac®)
• Escitalopram (Lexapro®)
• Sertraline (Zoloft®)
• Venlafaxine (Effexor®)
• Duloxetine (Cymbalta®)
• Fluvoxamine (Luvox CR®)
• Benzodiazepines, including diazepam (Valium®), alprazolam (Xanax®), and clonazepam (Klonopin®)

Patients taking anti-anxiety medications should be monitored by a physician to monitor the effects of the medications and possible side effects. It is important to carefully follow the dosage instructions. Patients should not increase doses or stop taking medications without consulting their doctor. If anxiety does not decrease, be sure to tell your doctor.

Questions to ask your doctor when prescribing medication to reduce anxiety:

• When will anxiety symptoms improve?
• Are there any contraindications for taking this drug with any other drugs or dietary supplements?
• Should any activities be avoided?
• What are the common side effects?
• What side effects should I be particularly concerned about?
• What to do if the time of taking the drug was missed?
• How long do I need to take this drug?

Anxiety medications can be unsafe if taken more often or in higher doses than prescribed, or stopped too soon. Be sure to check with your doctor before changing your dosage. Keep medicines in a safe place out of the reach of children.

Coping with anxiety: advice for parents and caregivers

• Communicate openly. It can be difficult for parents and caregivers to talk to children about fears and concerns.
  • Try to talk regularly about your thoughts and feelings in familiar situations. And when the time comes for a difficult conversation, it will be easier.
  • Use a variety of words to describe feelings to help children understand emotions and discuss their worries.
  • Ask, don’t guess. Use open-ended questions and try to really understand the child’s point of view.
  • Acknowledge and respect the child’s problems, even if you disagree.
  • If this is true and appropriate, admit that you sometimes have similar thoughts and feelings too. This makes it easier for children to believe that they are not “crazy” and not alone.
  • Keep a journal to keep track of your thoughts and feelings.
• Reach out to friends and family. Social support is important for patients and families dealing with childhood cancer. Help kids and teens stay in touch with friends and find ways to focus on “normal” things.
• Try contacting support groups. Patients and their relatives often find that it is easier for them to share their feelings about the disease with someone who has already had a similar experience. By joining a cancer support group, participating in group activities, or simply making new friends at the hospital, patients find a safe environment to talk about their worries and find ways to cope.
• Use a variety of resources to help you manage your anxiety. Fighting cancer is a tough experience. Teach your child to use anxiety reduction skills even when things are going well. Then it will be easier to apply these strategies when they are really needed. It’s good to know a few different ways to deal with anxiety. Sometimes the usual method is not suitable or does not help.
• Try to manage your own anxiety and stress. Remain calm when your child is anxious. Children feel the mood of people close to them. Moreover, they learn coping strategies by observing others. Parents and caregivers should take care of their mental health. Find ways to deal with your own anxiety so your child knows they can do the same.
• Teach your child to face their fears, not avoid them. Children and adolescents with anxiety often avoid fearful situations. Allowing a child to avoid situations that cause discomfort will reduce his anxiety at first, but in the long run it will not go away, if not increase at all. Praise and encourage your child when he makes an effort to cope with anxiety in a frightening situation.
• Stay safe and comfortable without being overprotective. Parents strive to protect their children from trauma, both physical and emotional. With cancer, parents should be especially careful to allow the child to be independent to the best of his age. This helps the child develop confidence in their ability to adapt and solve problems.
• If anxiety symptoms worsen, seek help for your child (or yourself).