b'Medicine & ResearchRX UpdateTreatinD Emotional Issues Associated with MSBy Ellen Whipple, Pharm.D.It is no surprise that emotional problems, for all of these products to reach their fullsuch as depression and anxiety, which are therapeutic potential. commonlyreportedinpatientswithMS, Patients should expect to have regularnegatively aect quality of life. According to appointmentswiththephysicianwhoDr. Ben Thrower, medical director of the MS prescribedtheantidepressantmedication,Institute at the Shepherd Center, in Atlanta, especially whenstartinganewtreatment.more than 50 percent of people with MS This allows the physician to assess whetherexperience one of these mood changes at some the medication is working and to identifypoint during their illness. Many patients who adverse events. In some cases, antidepressantsuer from emotional problems do not disclose doses may be increased or decreased. It istheir struggles to their physicians. This is importanttounderstandthattheperfectunfortunate, because many good products medication in the perfect dosage is rarelyexist to help patients suering from depression prescribed the rst time. The successful treatmentand anxiety, Thrower said. This article discusses of depression requires patience and cooperationthe medications commonly used to treat these from both the prescribing physician and patient.two conditions and the common adverseeects associated with these medications. The tricyclic antidepressantssuch asDepression is a term commonly used to Elavil (amitriptyline), Tofranil (imipramine),describe a variety of emotional issuesfrom and Pamelor (nortriptyline)have beenfeeling down for a few hours per day on a available the longest. These products are notgiven day to severe clinical depression that may commonly used as first-line agents forlast for many months. Studies have shown depression because they can cause somethat, compared with the general population, annoying adverse eects that can make otherpatients who have chronic conditions (such as MS symptoms feel worse, such as dry mouth,MS) are more likely to suer from depression. constipation, bladder problems, sexualLuckily, various classes of medications exist dysfunction,blurred vision,dizziness,to treat depression. Selective serotonin reuptake drowsiness,andincreasedheartrate.Forinhibiters(SSRIs),selectiveserotoninand treatment-resistant depression, these productsnorepinephrine reuptake inhibitors (SSNRIs), aresometimesusedincombinationwithand tricyclic antidepressants are the most other medications. commonlyprescribedantidepressantsfor The SSRIs include Prozac (fluoxetine),MS-related depression. It is important to Zoloft (sertraline), Celexa (citalopram), Paxilunderstand that it can take up to eight weeks (paroxetine),andLexapro(escitalopram),msfocusmagazine.org 60'