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Obesity becomes morbid when it reaches the point of significantly increasing the risk of one or more obesity-related health conditions or serious diseases (also known as co-morbidities) that result either in significant physical disability or even death.

The term morbid obesity, also called “clinically severe obesity” or “class-3” obesity – is a disease of excess body fat (adipose tissue), which can adversely affect general health, mobility and quality of life. Morbid obesity is typically defined as being 100 lbs. or more over ideal body weight or having a Body Mass Index of 40 or higher. According to the National Institutes of Health Consensus Report, morbid obesity is a serious disease and must be treated as such. It is a chronic disease, meaning that its symptoms build slowly over an extended period of time.

Morbid obesity is a significant risk factor for hypertension, cardiovascular disease, some cancers, diabetes, respiratory problems and musculo-skeletal disorders. Generally, the health threats of morbid obesity are: double risk of early death if your weight is more than twice your ideal, 5-7 times greater risk of death from diabetes or heart attack, high risk of “end-stage” (untreatable) obesity, numerous negative social, psychological and economic effects.

The causes of severe clinical obesity remain complex and varied, and typically include factors such as family genetic history, lifestyle and eating habits in childhood and adolescence, medication usage, calorie-intake, mood/depression, degree of physical activity, and cultural, socioeconomic and psychosocial factors. Although there are several clearly identifiable causes and contributory risk factors for morbid obesity, experts have been unable to pinpoint the relative importance of these risk factors in the ongoing obesity epidemic.

Treatment for morbid obesity usually includes a combination of liquid or very-low-calorie diets, weight loss medications and exercise counseling. Patients suffering from significant co-morbid conditions may also qualify for bariatric weight loss surgery such as gastric banding or stomach bypass.

Mildly obese patients can benefit from diet and exercise treatments, sometimes provided in conjunction with weight loss medication. Patients with morbid obesity, especially those with serious co-morbid conditions, may qualify for bariatric surgical treatments such as Lap Band or Roux-en-Y gastric bypass. Lap-band adjustable gastric banding is the latest entrant (approved by the FDA in 2001) in the sphere of surgical treatment of morbid obesity

It has become increasingly clear that those with morbid obesity may not be able to get their weight under significant control on their own without surgery. If you are morbidly obese you run a significant risk of dying prematurely due to your weight. In fact, those with morbid obesity can be expected to die 13-20 years prematurely unless they can lose most of their excess weight.

Erectile dysfunction (ED) is an especially tricky issue for men to be concerned with. Not that the issue cannot be treated, but due to the fact that men suffering from it often feel too humiliated to seek medical attention. There are numerous reasons why one may be suffering from ED. Below we discuss a few questions a doctor may begin with in order to uncover the real cause of the issue.

There are numerous ‘reactions’ happening simultaneously in the human mind and while an erection is being achieved. Every time any of these reactions does not happen or something hinders it from happening completely, ED results. An erection is started off initially by nerve signals within the body. These signals is first triggered off in the human brain, then travels down the spine to the area of male genital. Disruptions to this process may be either physical, psychological or both.

Physical reasons causing erectile dysfunction may include injuries to muscles, arteries and tissues around the penis. There are also symptoms and conditions that might advance to to these physical problems. If one is suffering from kidney trouble, atherosclerosis (a vascular disease), diabetes, alcoholism, and neurological illnesses, he might suffer from erectile dysfunction. These symptoms account for approximately seventy percent of cases of men suffering from erectile dysfunction. Those with physical conditions caused by obesity and excessive smoking may too have an additional effect to this issue.

If one is taking medication for depression, hypertension , or ulcer, there might be a possibility of having a side effect due to medication, occurrences of ED. In this case, the best solution is to see your doctor and let him rule out that these medications are a real cause of erectile dysfunction. A change of medication might just be the remedy to this problem

There are also numerous psychological reasons that cause ED. These may account for approximately twenty percent of erectile dysfunction cases. If a man is feeling constantly stressed, depressed, with a sense of low self-esteem or if he is feeling frustrated over his sexual performance, it is highly likely that he is suffering from this condition. It is required to get hold of the root cause or source of erectile dysfunction for the correct treatment to be given . If the root cause is purely psychological, paying a visit to a trained psychologist on the problems of erectile dysfunction would be the first step to lower the pressure and frustration of this man. A action strategy to tackle these psychological root causes can help go a long way in relieving the frustrations centered on one’s sexual performance.

Nowadays, it has become a normal thing to discuss about erectile dysfunction and the root causes of this issue. It has lead to many state-of-the-art remedy plans to correct the problem. At present, there are medication and devices which work to correct the problems. Doctors, at this point in time, are able to improve blood flow to the penis with the aid of these devices and medication.

With the economy dropping and medicine prices spiking would certain herbs be considered as an alternative for erectile dysfunction treatment?

Erectile dysfunction treatment (ED) is the inability of a man to achieve and maintain erection during sex. And though there are different erectile dysfunction treatments out there, clinics and laboratories still try to come up with herbal remedies to introduce in the market since erectile dysfunction is not usually covered in health cards.

If you’re not into prescribed drugs or injections and if therapists intimidate you then this would be good suggestions for you to think about. Here are some of the herbal remedies still being tested. Since Food and Drug Administrative haven’t given official approval to these herbs yet, it’s better to consult your physician first before trying anything.

· Gingko. A herb that can be found at Zhejiang province in Eastern China. This is the herb used by those who suffers from sexual dysfunction, or those who suddenly lost their libido. It helps the smooth muscles in the penis to relax and increase blood flow.

· Tongkat Ali. You can find this herb in Eurycoma Longifolia Jack or Pasak Bumi Indonesia. It increases the testosterone on your body level. The young plants of this herb is not recommended for medical remedies but the older roots (at least 10 years old) are believe to have real effect. The increase level of testosterone can improve one’s sex drive and have a longer, harder and more natural erection.

· Tribulus Terrestris. This is a flowering plant that’s native in the soils of southern Europe. It can also be found in southern Asia, northern Australia and almost all over Africa. Like the other herbs mentioned above, Tribulus Terrestris, commonly called as Yellow Vine, can help in sexual stimulation. It can enhance and lengthen penile erection.

· Ashwagandha. This is also known as the Winter Cherry and grows productively in India and Pakistan as well as in Sri Lanka and Bangladesh. It is considered as a potent aphrodisiac thus it enhances sexual drives and long lasting endurance. It also helps increase sperm counts and improves its quality.

Keep in mind that these herbal remedies also have serious side-effects. Gingko can cause headache, dizziness, skin reactions and even gastrointestinal upset. Tongkat Ali can also cause skin irritation, redness and soreness. Tribulus Terrestris can cause stomach upset and headaches. And as for ashwagandha it can cause constant drowsiness.

It’s true these herbal remedies can be considered as erectile dysfunction treatment. But you also have to put everything side by side to weigh and perceive the right treatment for you. Sporadic erectile dysfunction is normal. But if erectile dysfunction becomes a recurring problem then visit a doctor before trying self erectile dysfunction treatment. Talk it over with your doctor; ask about herbal medicines and supplements. With his/her expertise and your medical history you can come up with the correct erectile dysfunction treatment that suits your body.

People with allergies are faced with a driving dilemma: whether or not to drive while taking allergy medication. If you do want to wreck your Demio or Chariot Grandis, then it is best to keep them parked when allergy season hits and you are feeling miserable. 44% of the American population hit the road when allergy season starts. If you suffer from allergies, you need to be very careful before getting behind the wheel of your Demio or Chariot Grandis.

There are non-drowsy allergy medications on the market, such as Claritin, but it is still important for you to read the medicine label before taking it. Even though the medication may say it is a non-drowsy formula, it could react with other medications you are taking and make you drowsy. Plus, some people naturally become drowsy when taking this medicine even if it is a non-drowsy formula. Their natural body chemistry causes this. You never want to get behind the wheel of a vehicle if you find out that taking this medicine will make you sleepy.

Drivers need to be aware of what they are doing at all times. You need to be focused in order to react to any possibility on the road. Over the counter medications are not always non-drowsy formulas, which is why you need to be sure that the medicine you purchase is the right one. 38% of American drivers which equals out to about four out of ten drivers have reported becoming drowsy while driving after taking their allergy medicine.

In order to prevent getting drowsy behind the wheel of your Demio or Chariot Grandis, here are a few tips for you to follow:

* Carefully read all medicine labels before you take it and get behind the wheel. Check the labels for any type of drowsiness warning and drug interactions that could cause you to get sleepy.

* If you are already sleepy when you are ready to go drive, stop and wait. You do not want to take the chance of having an accident when you get behind the wheel. If you need to pick up your children or meet someone, make other arrangements.

* Take along a travel companion with you if you are planning a long trip. If you cannot take someone along, plan on taking breaks while you are on the road so that you can shake off any tired feeling you may develop.

* Make sure you get plenty of sleep when taking your allergy medication so that you can avoid getting sleepy on the road.

* Pull over if you feel drowsy while you are behind the wheel.

Almost 40 percent of the human population will suffer from allergies at some point in their lives. Allergies can come from various sources. This being the case, it is not quite easy to come up with a single treatment plan that covers every type of allergy, most allergies are acquired after birth. Allergy relief can be found in many different shapes and forms of medications, both those available over the counter at your local drugstore or pharmacy or those that are prescribed by your physician. The best solution to avoid triggering allergies is to avoid coming in contact with the specific allergen that affects the individual.

Antihistamines

All antihistamines block most of histamines effects by competing at histamine receptor sites thereby preventing them from producing an effect on the tissues. Antihistamine drugs prevent, but can’t reverse, histamine responses. Some of the general uses of antihistamines include relief from nausea and vomiting, relief from motion sickness, and relief from coughs. Usually antihistamines are administered orally since they are well absorbed in the intestinal tract, or topically, although a few can be given intravenously. To maintain a therapeutic dose, these medicines are given two to four times per day because the liver rapidly metabolizes them. Most over the counter antihistamines used in allergy relief prove effective, yet they may make you sleepy. It’s very important not to use allergy relief medications while driving if you find that you’re sensitive to drowsiness.

One of the most popular treatments for seasonal allergies is Claritin allergy medication. It’s usually used to treat an allergy to pollen, which is commonly known as hay fever. Claritin is an antihistamine and works by relieving the symptoms. These symptoms include; Itchy, watery eyes, runny nose, sore throat, coughing and headache.

Vitamin C

Very effective at fighting allergies. Vitamin C helps to reduce the level of antihistamines in the body. When you have an allergic reaction, your body’s immune system reacts by producing an enormous amount of antihistamines to fight the aberrant allergen. It’s the histamines that cause all of the various types of irritation and inflammation that make us uncomfortable or that could kill us. Vitamin C can slow down the reaction giving you time to get medical attention in the event of a serious reaction.

Bioflavonoids such as Quercetin work well with Vitamin C as an anti-histamine to tackle allergens.

Air Purifiers

Air purifiers for allergies may not solve all your allergy problems, however, most will certainly help alleviate some of the congestion and breathing problems often associated with allergies.

Heavy Metal Detox

Most common reason why allergy treatment fails is heavy metal toxicity. Diseases associated with metal toxicity include allergy, autism, Alzheimer’s, Epilepsy, Crone’s Disease, irritable bowel syndrome and others. Detoxifying the body of these pollutants is very important. The great benefits of a detox program are better skin, more energy, bowel movements that are more regular and overall higher levels of performance and concentration.

The nature of emergency medicine inherently presents with multiple challenges – from making diagnosis, treatment and appropriate referral. For this reason, emergency medicine locums are widely sought out by many physicians in all disciplines of medicines and surgery. The work of emergency medicine is abundant in scope, erratic and potentially unlimited in demands.

Emergency medicines locums for all types of physicians are readily available in most hospitals all over the country. Because many patients do not have a primary physician, thousands of patients seek the emergency room as their primary care facility. All over the country, emergency rooms are packed with patients. Almost every emergency room today caters every type of patient – from routine colds, trauma, acute surgical problems, heart attacks, children’s disease and the elderly.

The typical emergency medicine patient is usually unknown to the physician. He or she did not anticipate the illness and the visits are almost never scheduled unless it is for a wound change. In almost all cases, patients arrive to the emergency room because of the chance encounter with an acute illness or trauma. In many cases, patients do not arrive in the emergency room prepared, many do not have the list of their medications or know the exact details about their illness, some are not able to give a history, and others need emergency life support.

Emergency rooms today have become a lifeline for many patients who have no medical insurance and no one wants to care for them. Even insured patients now find solace in emergency rooms when their own physicians cannot schedule them on time or when they have any acute illness. The majority of the people who come to the ER have already reached a point where there needs are urgent in the face of a downward spiraling illness and there is a little margin of errors. The majority of people living in North America will visit the ER at some point in their lives. In almost all cases, the visit will be unplanned, undesired and stressful. The ability of emergency room physician is to anticipate the needs of patients facing an acute illness or injury may determine the success in providing rapid, appropriate and safe treatment.

Even though it may sound like emergency rooms are stressful, congested and demanding, the discipline is one of the most gratifying in all of medicine. It is not often that one gets a chance to save a life of a patient. Emergency medicine locums are also well reimbursed. The opportunities in emergency medicine locums are vast and due to being attached to emergency services, one can get good experience that could benefit their life and career. As a medical aspirant, one can opt for Anesthesiology, Radiology, Emergency Medicine, CRNA, Psychiatry and many more. You can provide a quality services in different medical facilities of the United States.

With this New Year comes many resolutions, the most popular being weight loss. As with all good intentions, resolutions are most successful when a person has a plan to help support the effort. Whether you are trying to lose 20 lbs or 100 lbs it is important to create a plan for success. Part of your plan should include the nutrients your body needs in order to function at its peak. Since so many millions of people today are taking prescription medications for health concerns, it is often confusing when attempting to choose the best support formula for weight loss. Don’t be fooled by the ads that claim that “anyone” can take this formula or that formula. That simply is not true. If you are currently taking medication for High blood pressure, cardiac concerns, diabetes, kidney, thyroid, stress, pain, or any other health issue, it is wise to avoid certain supplements and herbs. It is impossible to list all of the supplements that one should avoid since each body has an individual bio-chemistry and unique needs. Please do not just walk into a drug store, health food store, or your local grocer and choose a formula off the shelf. It would be much wiser for you to know that the supplements you are taking coincide with all medications your doctor has prescribed. If you’d like more information on how you can obtain a custom formula that is made specifically for you and your health concerns, call my office.

For over 23 yrs I have helped people achieve their health goals including weight loss. Weight loss is not just an issue of the body, it is connected closely to your mental and emotional states. Here are some important elements to help you succeed:

· Make movement part of every idle moment. When you are on “hold” waiting for someone to come back to a phone conversation just stand up, or move your feet, your legs, your hands, or your arms until the conversation continues. If you are sitting down to finish your conversation, rotate your wrists and ankles. Squeeze your leg muscles for a few seconds and release. Just think MOVE whenever you have idle time. Park your car a longer distance from the grocery store than your norm. Each extra step you take equates to burned calories…so the more you move, the more calories you burn. Be sure to include weight-bearing exercises as part of your health routine. The dense muscles of your body will actually continue burning calories after your work out has finished, which is contrary to aerobic exercise. It is important that you use weights three times per week. Talk to your doctor to find out what you are allowed to do. If you do not get any guidelines for restriction, speak with an exercise coach, a physical therapist, or even the physical education instructor at a local high school or college if you can. Find out what is allowed for your age and condition.

· Eat foods that are filled with fiber. You will find that raw fruits and vegetables, and slightly steam veggies are generally rich in fibers and packed with nutrients. Limit the amount of animal foods that you consume. Certainly cut out empty calorie junk foods such as pies, cakes, ice creams, donuts, soda, alcohol, sugar, and white flour foods. Whatever you put in your mouth should be as valuable as possible. Eat nutrient dense foods, foods that are closer to nature. If you wish to dip your raw veggies try non-fat or low fat dressings.

· Be sure to eat three main meals and two snacks daily. This will actually help to keep your metabolism active. It will prevent you from having a craving because it will allow more stable blood sugar throughout your day. If a person were to cut back on calories and skip meals it would trick the mind and the metabolism into thinking that it needed to hold onto weight and/or water in order to survive. This is our body’s natural survival instinct.

· Drink purified water throughout the day. Do not drink soda or alcohol.

· Cut down on the amount of salt you take in daily

· Find hobbies that will occupy your time.

· Taking digestive enzymes with your meals may help. Check to see if you are compatible with papaya tablets, bromelain, and probiotics.

· Include more dark leafy greens if your condition allows. Dark leafy green vegetables have more iron which in turn will hold more oxygen in the cells. If you are not allowed to take extra iron you might want to avoid extra dark leafy greens and other iron-rich foods like raisins and liver.

· Use non-salt flavorings such as dried herbs to add pep to your dishes.

· Get used to chewing your food for thirty seconds before swallowing. Carbohydrate metabolism begins in the mouth.

· Find activities that interest you. Often eating too much has its roots in boredom, if it is not due to metabolism issues. Fill your life with new activities to change your focus. Changing your focus is paramount to the success of any weight loss program.


If you need to “chew” something, use sugarless gum in a pinch.

· When you find yourself craving a food that you smell or see start saying the following immediately: “No food tastes as good as thin feels!”

· Wear a small alarm, or use your phone alarm. Set the alarm to go off once each half hour when you first start your lifestyle change. When the alarm goes off, repeat your favorite positive affirmation. Along with the affirmation drink some purified water – add a little lemon juice if you can tolerate it, or slice of orange, or strawberry. Warm green tea may be good if your doctor allows.

· If you are someone who was used to having an alcoholic beverage more than once or twice a week, try the following: Ice water with an olive. Ice Tea with a lemon wedge. Tonic Water with an olive or other fresh fruit slice. Sip slowly and repeat your positive affirmation mentally. A small amount of wine may be permissible. Again, ask your physician.

· Adding some invisible fiber to your foods may also help to curb your appetite. You will find invisible fiber in most all grocery stores and drug stores. Follow the directions on the label. When we eat foods rich in fiber we naturally eat less because we feel fuller faster.

· Practice deep breathing exercises to avoid stress periods during your day. Close your eyes, breathe in deeply and hold it for three seconds. Exhale. Repeat three to five times. As you breathe correctly from the diaphragm you will feel invigorated and get a mental lift as well.

· Get a good pair of walking shoes and USE them. When the weather permits walk out of doors. If not, walk in place while you watch your favorite program. You will surprised how fast the time goes by. If you can’t walk for thirty minutes consecutively, start out with five minutes at a time. Before you know it you will be walking ten then twenty and eventually you should be able to easily walk for thirty minutes. You can try to sing or repeat the alphabet or talk with your family or a friend while you walk. You should be able to hold a conversation as you walk – if not, you might be walking too quickly. Pace yourself and make it fun!

· Get some good work-out music. When we hear energizing music our heart rate increases and our bodies are filled with a sense of power.

Some people do best if they can check in with a coach. Ask for referrals in your area. Do what it takes to stay motivated.
· Remember that each day away from an old habit is one day closer to SUCCESS!

Janet Angel, Ph.D.

847/836-8345

A number of studies conducted in the 1980s and the early 1990s showed that SSRIs (selective serotonin reuptake inhibitors) such as Prozac led to short term reductions in alcohol consumption in both humans and rats. This led to a lot of enthusiasm and intensive research on the effects of SSRIs on alcohol consumption because some researchers hoped that SSRIs might hold the key to the cure for alcoholism.
 
However, the research proved that the effects of SSRIs on alcohol consumption are far less simple than they initially appeared. The short term reductions in drinking in human alcoholics lasted no longer than a week and then the subjects were once again drinking just as much as they ever had. Moreover, the research showed that SSRIs may actually worsen drinking in Early Onset Alcohol Abusers and in women.
 
There is one group, however, which seems definitely to benefit from SSRIs. Patients who have both Alcohol Dependence and severe Major Depressive Disorder show significant improvement both in depression and alcohol consumption when treated with SSRIs. In this article we will take a look at the research which has been done on SSRIs and alcohol consumption in these populations.
 
In 1995 and 1996 Dr Henry Kranzler MD and his colleagues did a study which suggests that the SSRI Prozac may actually worsen the drinking behavior of Early Onset Alcohol Abusers while having no effect at all on Late Onset Alcohol Abusers. Early Onset Alcohol Abusers are defined as those who begin heavy drinking in early life and who have worse alcohol related consequences. Late Onset Alcohol Abusers are defined as those who begin heavy drinking later in life and have fewer alcohol related problems.
 
The Kranzler group studied the effects of Prozac on 95 non-depressed patients who were being treated with talk therapy for Alcohol Dependence. Half of these subjects received Prozac and the other half got a placebo. When Kranzler and his colleagues analyzed the group as a whole they found that there was no significant difference in improvement between the placebo group and the group receiving Prozac.

However, they then divided the patients up into two categories: Late Onset Alcohol Abusers and Early Onset Alcohol Abusers. When they reanalyzed the data using these two categories they obtained a very surprising result which was quite contrary to what they expected. They found that Early Onset Alcohol Abusers receiving the Prozac did significantly WORSE than the group receiving the placebo. There was no significant difference between the Late Onset Alcohol Abusers who received Prozac and those who received the placebo.
 
The Kranzler study strongly suggests that Prozac may actually worsen the drinking of Early Onset Alcohol Abusers who are not receiving any sort of talk therapy for their Alcohol Dependence. All that remains is for someone to do the crucial experiment needed to verify this highly likely conclusion.
 
In 1995 Dr Claudio Naranjo MD and his colleagues did a study of the effect of the SSRI Celexa on 62 non-depressed problem drinkers who were being taught moderate drinking strategies. 56% of the subjects in the study were male and 44% were female. Half of the subjects in the study got Celexa and the other half got a placebo. The Naranjo group found that women receiving the Celexa did significantly WORSE than women receiving the placebo in moderating their drinking. The men did the same whether they received Celexa or the placebo. This suggests that Celexa may actually INCREASE the drinking of female problem drinkers who are not receiving moderation training or some other form for talk therapy. All that is needed to confirm this is an experiment with drinkers who are receiving Celexa but no talk therapy.
 
The patients in the studies we have discussed so far did not suffer from severe Major Depressive Disorder. In 1997 Dr Jack Cornelius MD and his colleagues studied the effect of the SSRI Prozac on 51 patients with both severe Major Depressive Disorder and severe Alcohol Dependence. The subjects were 51% male and 49% female. All patients received talk therapy for their Alcohol Dependence. In addition to the talk therapy, 25 patients received Prozac and 26 received a placebo. In this study the patients who received the Prozac showed significantly greater improvements in both depression and in drinking outcomes than did those receiving the placebo. Taken together with the other studies this leads to the conclusion that SSRIs can lead to a reduction in drinking in people with severe Major Depressive Disorder but not in other groups.
 
In 2007 Dr Kathryn Graham PhD and her colleagues published the results of a massive telephone survey of 14,063 individuals in Canada which asked people about their use of alcohol and antidepressants. This survey showed that depressed men who took antidepressants drank less alcohol on the average than did depressed men who did not take antidepressants. However, depressed women who took antidepressants drank at least as much as did depressed women who did not take antidepressants, if not more.

Like the Naranjo study, this study also suggests that antidepressants affect the drinking behavior of men differently than they do the drinking behavior of women. Since this study did not specifically ask respondents if they were taking an SSRI or another type of antidepressant such as a tricyclic we must be somewhat cautious in what we can conclude from it. It is possible that if the data were limited to SSRIs that the researchers might have seen an increase in the alcohol consumption of women taking the medication. It remains for further research to confirm whether this is actually the case.
 
The studies to date seem to suggest that SSRIs only lead to reduced alcohol consumption in men who have severe Major Depressive Disorder. SSRIs do not seem to affect the alcohol consumption of most other people either one way or the other. However, the studies also suggest that it is possible that SSRIs might tend to increase alcohol consumption in some individuals–particularly in women and in Early Onset Alcohol Abusers.

Therefore, we would like to suggest that people become pro-active health care consumers. If you drink alcohol and take antidepressant and the antidepressants seem to be causing you to increase your drinking or to drink in a dangerous fashion, then you should talk to your doctor. You may need to switch to a different kind of antidepressant or stop taking antidepressants altogether. Or you may find that quitting drinking is your wisest course.
 
REFERENCES:
Cornelius JR, Salloum IM, Ehler JG, Jarrett PJ, Cornelius MD, Perel JM, Thase ME, Black A. (1997). Fluoxetine in depressed alcoholics: a double-blind, placebo-controlled trial. Archives of General Psychiatry, 54, 700-5.
Graham, K, Massak, A. (2007). Alcohol consumption and the use of antidepressants. CMAJ. 176(5), 633-7.
Kranzler HR, Burleson JA, Korner P, Del Boca FK, Bohn MJ, Brown J, Liebowitz
N. (1995). Placebo-controlled trial of fluoxetine as an adjunct to relapse prevention in
alcoholics. American Journal of Psychiatry, 152, 391-397.
Kranzler HR, Burleson JA, Brown J, Babor TF. (1996). Fluoxetine treatment seems to reduce the beneficial effects of cognitive-behavioral therapy in type B alcoholics. Alcoholism: Clinical and Experimental Research, 20, 1534-41.
Naranjo CA, Bremner KE, Lanctot KL. (1995). Effects of Citalopram and a brief psycho-social intervention on alcohol intake, dependence and problems. Addiction, 90, 87-99.

Prescription acne products are usually considered a safe method of acne control. Since you consult with your physician to get these prescription acne products, they should be the right choice for your skin and its problems, as the guesswork sometimes involved with over-the-counter products is eliminated. Physicians know your skin condition very well and they prescribe the combination of medications that will work in the most effective manner on your skin.

The common problem with over-the-counter products is that people don’t tend to know about the severity of their acne and the combination of medications that will work for them. They tend to go for the most popular ones and the branded ones, which usually have minimal effect, when used without proper knowledge. When it comes to prescription acne products, you don’t have to worry about all these things, as the physician would have made the diagnosis and prescription, rather than you simply guessing the correct product for your condition.

There are topical applications and oral antibiotics available as prescription products. Benzoyl Peroxide, Adapalene, Erythromycin, and Azelaic Acid are some of the most used medications.

Azelaic Acid kills the bacteria that cause acne and it renews the skin, thus preventing the buildup of cells and sebum underneath the skin layer. Adapalene cuts down the rate of accumulation of dead cells and effectively prevents the formation of acne. Benzoyl Peroxide fights against acne and produces drying and peeling effect when taken excessively. Erythromycin is a powerful antibiotic and it’s used very commonly in both prescription and over-the-counter medications.

These topical applications are found to be very effective on the right type of skin and they are available in various formulas including lotions, creams, and gel. Azelex, Differin, and Brevoxyl are some of the famous brand names with these medications.

Oral antibiotics are taken internally and they tend to control the bacteria from the inside out. They act effectively on the P. Acne bacteria, which cause acne. Vibramycin and Minocin are the most popular prescription oral antibiotics for acne control.

It is highly recommended to follow the physician’s advice while taking these medications. Most of these medications have a drying and peeling effect when the skin is exposed to sunlight. It may cause redness of the skin, irritation, peeling and other symptoms. It is important to use the proper sunscreen lotion before going out in the sun.

There are many ways that chronic pain can occur. Some of these are due to an injury, or maybe an illness and some are due to age. Chronic pain can affect many parts of the body, but in most cases the back is what is affected. Chronic back pain relief is a must to find, because if it is not corrected, it can effect all parts of your life. You can be affected emotionally and depression can even set in. There is good news, because there are many ways to find chronic pain relief. There is a bit of trial and error to find the correct pain relief. You and your doctor and other health professionals can partner to keep chronic pain from destroying your life.

What You Should Do First

The first thing that you must do is contact your doctor. The doctor can determine where and why the chronic pain is occurring. Finding the cause of the pain is the first step in chronic pain relief.

Chronic Pain Relief – Using Medications

Sometimes the first option for chronic pain relief is treating it with medications. There are many different types of medications that can be used. Over the counter drugs such as acetaminophen and ibuprofen are effective when the pain flares up.The next step after this would be to try using prescription drugs. These medications include antidepressants, corticosteroids and muscle relaxants. These drugs will work sometimes in the short term for bringing chronic back pain relief under control, but there are serious side effects if they are used for long periods of time for chronic pain relief. Due to these side effects, it is a good idea to find other methods of pain relief wile reducing the frequency of the prescription drugs.

Chronic Pain Relief – Other Options

Rest is probably the first thing that you should do for a day or two after an injury. After this, physical activity is thought as a good chronic pain relief. Exercise will increase your flexibility and strength and improve muscle tone. Exercise is an important part of having a healthy life style long term and will bring pain relief. If you decide that you are going to start a physical exercise program to relieve chronic pain, make sure you consult your doctor. He may have you work with a physical therapist or maybe a personal trainer. Many people today are using physical trainers to guide them to the right exercises to relieve chronic pain. This will also prevent you from further injuring yourself.You can also employ some natural methods for chronic pain relief. These could be herbal treatments for relief of pain. Herbal relief from pain can be quite effective. There is also acupuncture for pain relief as well as massage therapy. Acupuncture for pain relief has been used effectively for many years. If you have never tried acupuncture for pain relief, maybe you should. After an injury that has caused chronic pain, your doctor may have you start physical therapy to bring strength and condition the injured area. Another natural pain relief method that you can do at home is hot and cold therapy. These can be an effective chronic pain relief treatment. What you do is switch between cold (ice) and then use hot packs to the affected area. These can be extremely effective method to relieve pain. Some people find that aromatherapy and biofeedback techniques help them to relax there muscle. These techniques also allow you to release tension. Both are effective at chronic pain relief. As you can see there are a variety of methods for chronic pain relief. Try each one to determine which will work best for you.For more information on this type of pain and others visit: Acupuncture for Pain Relief