Inositol (Vitamin B8) as Natural Remedy for Clinical Depression





Administration of inositol decreased signs
of depression in two animal studies. Several small human studies suggest that
inositol may be of value in the treatment of depression, particularly for those
who do not respond to antidepressant medications.


(Harry
Croft, MD (Psychiatrist) Medical Director)














What
is Inositol?





Inositol,
or Vitamin B8, is a water soluble fatty lipid that is required by the body for
the formation of healthy cells. Inositol has been shown to be effective in
treating some cases of depression, anxiety, OCD and other psychological
disorders that respond to serotonin uptake inhibitors.





Inositol is a naturally occurring isomer of glucose,
though it is generally considered to be a member of the B vitamin family. It is
a key intermediate in the intracellular phosphatidyl inositol second messenger
pathway activated by numerous serotonergic, cholinergic, and noradrenergic
receptors. In this capacity it serves as an important signal transduction
molecule, but inositol is also a structural component of cellular membrane
phospholipids. Research indicates that inositol is an effective and safe option
in the treatment of panic disorder, obsessive-compulsive disorder (OCD),
bulimia nervosa, binge eating and/or depression. Inositol's efficacy, in the
absence of side effects, makes this nutrient an attractive addition to
treatment plans for specific mood disorders. Following is a scientific review
of inositol for the treatment of mood disorders, including a discussion of its
anecdotal use for the treatment of insomnia and its cautioned use by pregnant
women for the prevention of neural tube defects and embryopathies.





Among
other reported benefits of inositol in clinical settings are:


  • Reduction in the need for pain medication when
    patients are given inositol.

  • Reduction of edema in treatment of scald burns.

  • Relieving the symptoms of diabetic neuropathy.






According
to an abstract published by Lisa Colodny, Pharm D. and Ronald L. Hoffman, M.D.
about the clinical applications of inositol, “Inositol is now established as a significant mediator of calcium
mobilization in the endoplasmic reticulum. Modifying this mobilization of
calcium may be effective in treating some CNS disorders like Alzheimer's
disease, depression, panic disorder, obsessive compulsive disorder, and as an
analgesic for pain control. Likewise, its use to alleviate lithium-induced
adverse reactions is also promising.”






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What
inositol  Does?





Inositol is used in the production of inositol
triphosphate and diacylglycerol, both of which are molecules involved in the
system that allows communication between neurotransmitters and the interior of
cells. It is believed that a decrease in inositol could lead to a shortage of
these two molecules, causing mood-regulating neurotransmitters - such as serotonin,
dopamine and norepinephrine - not to be able to properly communicate with the
interior of brain cells. Supplementation with inositol could help depression by
improving the functioning of this.





So,
Inositol is a ‘second messenger’, triggering the release of calcium in cells.
It also is involved in the transmission of messages between neural cells and
the transport of fats within cells. It’s most important role seems to be in the
central nervous system, where it serves to help transmit messages along neural
pathways. Various studies have shown its efficacy in treating a number of
psychological disorders that seem to have a chemical basis, including bulimia,
OCD, depression and bipolar mood disorder. Inositol seems to be present in
greater concentration in the cells in and around the central nervous system,
including brain cells and retinal cells, and in other specialized cells such as
bone marrow and intestinal cells. It is also found in high concentration in
mother’s milk, leading to the possibility of a link to the immune system.





Because
of its role in cell health and neurotransmission, inositol is considered an
important nutrient, even though it is not technically a ‘vital’ nutrient or a
vitamin.






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Health
Benefits of inositol





Inositol
has been used for some time in the treatment of several neurologically based
disorders. These include:


  • Mild to
    moderate depression
    . Patients treated with supplements of inositol showed a
    definite improvement in several studies of depression.




    Depressive patients generally have decreased levels of inositol in their
    cerebrospinal fluid. Researchers now theorize that inositol produces
    positive clinical results in patients with depression due to intracellular
    phosphatidyl inositol serving as a second messenger for
    5-hydroxytryptamine (5-H[T.sub.2]) receptor signaling mechanisms.
    Serotonin selective reuptake inhibitors (SSRIs), a family of drugs
    commonly used to treat depression, have a similar therapeutic profile to
    inositol in that they inhibit serotonin reuptake in the synaptic cleft.



    Levine et al. performed a double-blind, placebo-controlled trial for 28
    days on 28 depressed patients using a large dose (12 grams per day) of
    inositol. The Hamilton Depression (HAMD) Scale was used to evaluate
    patients after the 28-day trial period, and a significant overall benefit
    was confirmed in the inositol group compared to the placebo group. No
    changes were noted in liver, kidney, or hematological function as a result
    of the high-dose inositol supplementation.






  • Obsessive-compulsive
    disorder (OCD).
    In several studies, patients suffering from OCD and
    related disorders showed relief of their symptoms when given supplements
    of inositol.






Levine completed a review of
research studies using inositol on psychiatric patients. The review highlighted
some interesting findings with OCD patients. Serotonin plays a definitive role
in obsessive-compulsive disorder as confirmed by the effectiveness of SSRIs in
OCD patients and the fact that serotonin agonists exacerbate the syndrome.
Rahman and Neuman effectively reduced serotonin receptor desensitization via
the administration of myo-inositol.



These research findings, coupled with the knowledge that SSRIs have proven
beneficial in the treatment of OCD, influenced Fux et al. to complete a
double-blind, placebo-controlled, random, crossover treatment trial of inositol
on OCD. Thirteen patients, all of whom met DSM-III-R criteria for OCD,
completed the trial. Six patients began the trial on placebo and seven began
the trial on inositol (18 grams per day) for a total of six weeks for the first
phase and six weeks for the crossover phase. The researchers administered 18
grams of inositol rather than 12 grams (typical dose for depressive patients)
because OCD patients generally respond to higher relative doses of SSRIs than
is needed to effect change in most depressives. The OCD patients were free of
drug and alcohol abuse and had no evidence of diabetes or GI disorder. OCD was
assessed using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and
depression and anxiety were assessed using the Hamilton Depression Scale (HDS)
and Hamilton Anxiety Scale (HAS). The mean improvement in OCD symptoms from
baseline to six weeks was 5.9 for inositol versus 3.5 for placebo. This
indicates a measurable positive response of OCD patients to inositol.





  • Panic
    attacks.
    Clinical evidence suggests that large doses of inositol may reduce
    the number and severity of panic attacks.






Panic attacks are recurring
attacks of severe anxiety without an apparent cause. Agoraphobia (irrational
fear and avoidance of crowds, travel, and multiple situations), depression,
alcohol abuse, and suicide are common symptoms and may be exacerbated by
post-traumatic stress. Current treatments usually consist of antidepressant
drugs and cognitive-behavioral therapy.



Antidepressant medications affecting serotonin metabolism are effective about
70% of the time for dramatic, short-term improvement of anxiety symptoms.
However, chronic residual symptoms often persist in the long term. 25-75% of
patients with panic disorder discontinue drug treatment because of side
effects, and these patients quickly relapse.




In one study, twenty-one patients diagnosed with panic disorder with or without
agoraphobia were given 12 grams of inositol per day or placebo. In the
treatment group, the severity and frequency of panic attacks declined
significantly with minimal associated side effects. The average number of panic
attacks per week in patients treated with inositol fell from 10 to 3.5 per
week. The researchers concluded that these results were "clinically
meaningful" in the management of panic attacks.



More recently, inositol was compared with the antidepressant fluvoxamine in the
treatment of panic disorder. This study represents a more stringent test of the
effects of inositol in treating panic disorder because it is the first to
compare inositol with an established antidepressant drug. In this study of 20
patients with panic disorder, inositol was found to be slightly but
significantly more effective than fluvoxamine in reducing the number of panic
attacks. Otherwise, it was comparable to fluvoxamine on all other measures
(HAS, phobia, and Clinical Global Impression (CGI) Scale). Since inositol
appears to be as effective as fluvoxamine, patients may prefer it and continue
to take it for the long term because side effects are extremely rare and mild.






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Inositol in Diet





Fruits and vegetables that are especially rich in inositol
include: cabbage, beans, legumes, seeds, nuts, cantaloupe, bananas, raisins,
oranges and other citrus fruits. It is also found in wheat, cereal, oat flakes,
wheat bran, wheat germ, brown rice, brewer's yeast and unrefined molasses.





Inositol is also found in organ meats, such as
brain, heart and liver.





Dosage





The recommended doses for inositol generally fall in
the range of 6 to 20g per day, with 12g being the more usual dose. It is taken
in divided doses, two to four times a day.





Due to the potential risk of cycling, patients with
bipolar disorder should consult with their physician before supplementing with
inositol.





Side Effects and Limitations





Inositol is well-tolerated and appears to be quite
safe. Side effects may include: mild decreases in plasma glucose, flatulence
(gas), nausea, sleepiness, insomnia, dizziness and headache. There have been
some case reports of inositol-induced mania in bipolar patients. To date, there
have been no reports of toxicity or drug-drug interactions with inositol.





Inositol supplementation is not recommended for
pregnant women due to the fact that there is a risk of inducing uterine
contractions. It is not known if it is safe for breastfeeding women.





Is Inositol an Effective Treatment for
Depression?





Inositol is readily available in most health food
stores without a prescription and recommended for the treatment of a variety of
mental disorders, including depression.





Thus far, inositol has mainly been investigated as
an add-on to mood stabilizers and antidepressants for the treatment of the
depressive symptoms of bipolar disorder. Findings suggest that it may be at
least somewhat helpful for these patients.





It is not known whether inositol could also help
unipolar depression. Although two studies conducted using unipolar patients had
negative results, their sample sizes were too small to draw any definitive
conclusions.
More research is
still needed to consider Inositol as effective solution for depression relief. The
good thing, however, to come of the trials was that the supplement was absolutely
safe and was not associated with any side effects.






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Sources and Additional
Information:







Psychotic Major Depression Symptoms




What is Psychotic Major Depression? -

Its a subset of major depression, where the depression has a co-existing form of psychosis. Its defined as a flawed view of reality.

You may find that some of the symptoms of psychosis include delusions, visual hallucinations or auditory hallucinations.

Psychotic Depression Symptoms -

(1) He/She is concerned that something is terribly wrong with his or her body, will claim that something is wrong with his or her physical health.
(2) Paranoid delusions and delusions of guilt are the most common signs of this illness.
(3) Some of experience delusional guilt believe that they are being punished for past misdeeds.
(4) Word salad or meaningless speech
(5) Schizophrenia are loose associations, flight of ideas and echolalia which is repeating what others say.

Depression with Psychotic Features Treatments -

(1) There are a variety of different medications that are used to treat individuals that suffer from this severe form of depression.
(2) With perfect cures, patients can stabilize the varying moods that the individual experiences.
(3) The medications used for this form of depression include antidepressants, antipsychotic medications, and special neuroleptic medications.

Postpartum Depression Definition Symptoms Quiz


Postpartum Depression Definition -

Post-Partum Depression is a depressive disorder experienced by some women following childbirth.

Post Natal Depression or 'Baby Blues' affects new moms usually within the first few days or weeks after giving birth.

It is a form of clinical depression and can last for a week, months or even a year in some cases.

Postpartum Depression Symptoms -

(1) New mothers might experience feelings of negativity towards their baby and lose interest in their son or daughter
(2) You might find yourself worrying that you are going to hurt your baby all the time
(3) Drastic or sudden weight and appetite changes
(4) Lack of motivation and loss of pleasure
(5) Sleep patterns change, some people might sleep more than usual, some might sleep less than usual
(6) Flirting with suicide, thoughts of suicide and the like
(7) Guilty feelings and feelings of worthlessness

Postpartum Depression Quiz helps us to ascertain whether we are suffering from this disease in the first place or not, and once the fact has been established, and it is found that depression is present, then the depression quiz also helps us ascertain the exact type and symptoms experienced.

How long does Postpartum Depression last -

It could last for many months, might last even up to a whole year. He/She will certainly feel as if this condition will not go away.

Nevertheless, we also need to make an effort to emerge out of our clinical-depression by engaging in healthy behaviors.

Postpartum Depression Exercises Treatments -

Physical exercise, meeting people and keeping yourself busy are a few of the main steps you can take to deal with it.

Control your sleep habits. Retire to bed early during the night and get out of bed early. Try to get up prior to 8 AM in the mornings and go to sleep by 10 or 11 PM during the night.

Make a plan to keep your brain occupied. An empty mind is a devil's workshop and it will continue going over doubts and harmful thoughts. Engage in some beneficial work.

Probiotic Yogurt as Natural Antidepressant




What is Probiotic Yogurt?





Probiotics are a type of “good” bacteria. This particular
bacteria helps strengthening the immune system and improves general digestion
process. The probiotic food can be purchased in any grocery or convenience store.





The cultures in probiotic yogurt work in the intestines and
are symbiotic with your body. These micro-organisms help to fight off the “bad”
bacteria by developing protein that kills it. Note that our bodies do not have
the ability to create these types of bacteria themselves.





Sometimes when we take antibiotics, it is not too selective,
killing both good and bad bacteria in our bodies, probiotic yogurt will help
you to replenish your friendly bacteria.





There are different types of bacteria in these foods such as
Lactobacillus. These are
"friendly" bacteria that normally live in our digestive, urinary, and
genital systems without causing disease and protecting its environment from
enemies.





It is been proven to be the most effective at helping
improve the immune system and promote good health. One thing to note is that
when you buy a probiotic food is to check and see how much cultures it contain.
You can check this by looking at the label for CFU. CFU is colony forming
units. You want anywhere from one billion to five million in your food or
supplement. You can ask your doctor for more information and what brands he/she
recommends.






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Probiotic for
Depression





While the positive effects of probiotic yogurt on your
health and wellbeing have been already properly researched and documented, the
recent Irish study has found the
first evidence that probiotics benefit brain chemistry as well,
helping
in the treatment of anxiety and depression-related disorders.








For the study, a team of Canadian and Irish researchers
regularly fed one group of mice a broth spiked with a strain of bacteria called
lactobacillus rhamnosus JB-1. Other mice were given a bacteria-free broth.





Normally timid creatures, the mice were put through a series
of challenging experiments, such as being placed in a pool of water and forced
to swim. The mice given the bacterial-enhanced diet seemed better able to cope
with the stressful conditions. They showed far less anxiety and depression-like
behavior than the bacteria-deprived rodents.





Blood tests also revealed they had lower levels of the
stress hormone corticosterone flowing through their veins. What’s even more
remarkable is that there was evidence of a change in certain neurochemical
receptors in the brain, according to the findings published in the Proceedings
of the National Academy of Sciences.





The scientists say that bacteria in the gut ‘communicate’
with the brain via a nerve called the vagus. “This is the first-ever
demonstration that harmless bacteria, found naturally in the intestine, can
influence mood and behavior in a normal animal,” said John Bienenstock, a
co-author of the study and director of the McMaster Brain-Body Institute at St.
Joseph’s Healthcare in Hamilton.





Professor John Cryan of University College, Cork, added: “By
affecting gut bacteria, you can have very robust and quite broad-spectrum
effects on brain chemistry and behavior. Without overstating things, this does
open up the concept that we could develop therapies that can treat psychiatric
disorders by targeting the gut”.






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The Canadian researchers, along with their Irish colleagues
at University College Cork, eventually hope to conduct human trials. Much work
needs to be done to prove that what helps mice can also benefit people. And
even if further research establishes that bacteria can provided a lift to those
who are stressed or depressed, it’s unlikely that you would get the same
results from just any brand of yogurt.





Dr. Bienenstock noted the specific strain of lactobacillus
used in the animal experiments is not currently found in commercial yogurts. “Not
all probiotics are the same,” he said. “We tested bacteria that didn’t work. So
these effects are very likely to be strain specific.” That suggests tests would
have to be carried out on individual products to evaluate their mind-altering
potential.





So, this is quite promising but mostly forward-looking
approach, requiring additional research and development. As of today, you still
have to choose more traditional ways dealing with your depression.






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Respiratory Distress Syndrome

Premature babies have most common breathing difficulties found -

Respiratory Distress Syndrome
Idiopathic RDS
Hyaline Membrane Disease

RDS main cause is a lack of surfactant which is a substance that keeps the lungs of the premature baby open so that she is able to continue breathing.

It coats the air sacks inside the lungs allowing the release of carbon dioxide and the absorption of oxygen into the lungs to then be absorbed into the blood.

Surfactant is produced naturally by normal healthy mature lungs and a premature baby's body is too immature to produce this important thick liquid. Lungs mature very late in gestation and the earlier a premature baby is born the greater the problems that may arise.

When severe respiratory distress develops fairly acutely in a previously healthy person as a result of edema in the interstitium and alveoli it is termed ARDS.

This disorder is known by several names such as shock lung, wet lung, etc, since it may accompany different conditions such as shock, septicemia, inhalation of irritant gases etc.

The risk of RDS in the newborn can be assessed antenatally by the estimation of lecithin/sphingomyelin ratio (L/S) in the amniotic fluid. Administration of corticosteroids to the mother before delivery reduces the risk of RDS in the newborn.

Ayurvedic medicines for Respiratory Depression Symptoms can be used to improve treatment outcomes in ARDS and increase the chances for survival and a complete recovery. Since these patients are seriously ill, all medicines have to be fine-powdered and administered through a naso-gastric tube, along with honey and milk.

Whipping therapy – remedy for depression and suicide prevention





This controversial depression treatment approach called whipping therapy may
indeed have some valid effect explanation; however, it is hard to expect that
it will ever be used in our society due to the borderline ethical issues. Even
the research arrangement for the statement validation would be problematic.






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Let’s review the approach description from the Russian developers,
published in once the most famous Soviet newspaper Pravda (Truth):  





Russian scientists from the city of Novosibirsk, Siberia,
made a sensational report at the international conference devoted to new
methods of treatment and rehabilitation in narcology. The report was called
“Methods of painful impact to treat addictive behavior.”





Siberian scientists believe that addiction to alcohol and
narcotics, as well as depression, suicidal thoughts and psychosomatic diseases
occur when an individual loses his or her interest in life. The absence of the
will to live is caused with decreasing production of endorphins - the
substance, which is known as the hormone of happiness. If a depressed
individual receives a physical punishment, whipping that is, it will stir up
endorphin receptors, activate the “production of happiness” and eventually
remove depressive feelings.





Russian scientists recommend the following course of the
whipping therapy: 30 sessions of 60 whips on the buttocks in every procedure. A
group of drug addicts volunteered to test the new method of treatment: the
results can be described as good and excellent.





Doctor of Biological Sciences, Sergei Speransky, is a
very well known figure in Novosibirsk. The doctor became one of the authors of
the shocking whipping therapy. The professor used the self-flagellation method
to cure his own depression; he also recovered from two heart attacks with the
help of physical tortures too.





”The whipping therapy becomes much more efficient when a patient
receives the punishment from a person of the opposite sex. The effect is
astounding: the patient starts seeing only bright colors in the surrounding
world, the heartache disappears, although it will take a certain time for the
buttocks to heal, of course,” Sergei Speransky told the Izvestia newspaper.





The whipping therapy has not become a new discovery in
the history of medicine. Tibetan monks widely used it for medical purposes too.
Soviet specialists used a special method of torturing therapy at mental
hospitals. They made injections of brimstone and peach oil mixture to inspire
mentally unbalanced patience with a will to live. A patient would suffer from
horrible pain in the body after such an injection, but he or she would change
their attitude to life for the better afterwards.





”People might probably think of me as a masochist,” Dr.
Speransky said. “But I can assure you that I am not a classic masochist at
all,” he added.





The revolutionary method may take the Russian healthcare
to a whole new level. The method is cheap and highly efficient, as its authors
assure. Why not using something more efficient, a rack, for example?





This is the only original article on the whipping,
which I was able to find in the English sources. Everything else looks more
like humorous commentaries and reference to Masochism and sexual minorities’
weirdness. So, I checked the source in Russian Internet to see if that is not
April Joke, and the related therapeutic approach has been indeed tested and
approved.





No, there are many Russian posts on the topic, and
that does not seem to be a joke. Sergei Speransky claims that has not invented
the whipping therapy method. About 40 years ago, in the home library of his
older sister, Dr. Speransky found a German medical book, describing the
prosperous medical institution in pre-First World War Germany, where many
diseases, and not just neuro-psychological, were successfully cured by whipping.





The idea has been idle for long, before Dr.
Speransky got affected by severe depression himself, triggered by personal
stressful life events. He applied self-whipping approach, and miracle cure
came, when he got substantial improvement in his health conditions, what all
other scientific traditional approaches failed to achieve.






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Dr. Speransky has not even expected the recovery
will be so drastic and so fast, so he started to look for volunteers wishing to
try this therapeutic approach as well. The next person, who has agreed to participate
in the trial, was 50-years-old T., having difficulties to recover from stroke –
half of his body was paralyzed, and he was unable to speak. The whipping
procedure has been performed on a weekly base under supervision of the several
specialists. After the 8th treatment, the patient returned to work. Его было тогда пятьдесят лет. Now it's
almost a healthy man: he is walking with slight limp, but his speech and memory
has been fully restored. The only reminder on this devastating medical
condition is unstable blood pressure. Вот
только давление не вполне нормализовалось





So, how Dr. Speransky explains the method
effectiveness? The mechanism is simple: the marks of flogging trigger
activation of the body internal immune forces. And there is not much difference
for the white blood cells where to apply the healing effect: on bruises on your
ass, or on scars on the heart. They do both tasks simultaneously. In addition
to the physical disorders, whipping therapy is efficient for treatments of the
following: alcoholism, drug addiction, depression, and other psychosomatic
diseases. Это все уход от жизни, утрата
вкуса к ней.





In a way, depression means going away from the real
life to the internal world of sadness, and losing taste of the real life,
caused by reduction in "happiness hormones" А если такого человека как следует выпороть, у него
активируются эндорфиновые рецепторы, происходит выброс эндорфинов и
возвращается вкус к
production – endorphins. The whipping activates
endorphin receptors; endorphins are released to the blood stream, and the person finds a
new interest in real life. If you never experienced pain, you cannot learn on
how to live without it! К сожалению, у
многих упоминание о порке вызывает скаберзное хихиканье.






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Some guidelines for the whipping therapy:





  • The patient
    should be mentally ready for the procedure and should understand its
    mechanism and background. Do not try to use it for people, who are not
    prepared for it, and who might still consider it humiliating.

  • The effect
    is usually amplified in the event that the procedure does a person of the
    opposite sex. Мужчина — женщине, и
    наоборот.
    The recommendation
    might be routed in the traditional cultural sexism, which is still flourishing
    in the Russian society.

  • The
    recommended course is 30 procedures, 60 strokes each time with one 15
    minutes rest in the middle of the process.

  • Strikes
    should be applied to the buttocks, taking in consideration a personal physical
    build, with constant monitoring of the affect and patent conditions.

  • The method
    is not applicable for children and teenagers’ treatment, as they may not
    be psychologically ready for this approach, and may perceive it as
    preventive punishment.









To my surprise, whipping therapy (called “porko-therapy”)
is gaining popularity among Russian therapists. Some of them have already
officially included it in the treatment plans, and report amazingly good
results of the applied treatment courses.






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The closest you can find to the whipping therapy in
the Western society is so-called spanking therapy. But, do not mix these two.
Spanking therapy is usually related to the sexual games, and does not claim in
most cases to have a clinical therapeutic effect on the patients. There are,
however, the first attempts, to apply the therapy for the wellbeing
improvement. For example, holistic center in Washington, DC, Spanking for Wellness,
is helping its patients to achieve wellness through positive spanking experiences.
Their philosophy of positive spanking encompasses spanking experiences which
are geared toward personal growth, wholeness and healing, emotional, physical,
spiritual and psychological well being, and that which fosters deep connection
and mutual respect in family environment. We claim to have good success record
in using spanking for stress reduction/relaxation and releasing blocked
emotions as well as changing negative behavior patterns that the client wishes
to transform.





You are skeptical? Me too. But, is there a big
difference between whipping or spanking therapy and highly intrusive Korean
massage? Really, not much… But nobody will even think laughing on the statement
that Korean massage is good for your physical and emotional state.


И не только
нервно-психических.








Sources
and Additional Information:









Respiratory Depression Symptoms Definition



The miracle of opioid pain relief is fatally limited by tolerance, addiction and Respiratory System Depression.

Opioids cause respiratory depression in the individual as it affects the specialized respiratory neurons in the brain.

Along with the common adverse effects, opioids have many possible uncommon adverse effects.

Uncommon or infrequent adverse reactions in opioid abusers include dose-related respiratory depression, bad dreams, hallucinations, seizures, urticaria, urinary retention etc.


Smell of alcohol or kerosene, severe respiratory depression, circulatory collapse, convulsions, constricted pupil, Cardiac arrhythmia's etc.

Liver diseases, respiratory depression, and spontaneous abortion are caused by long-term use of Opiates.

Toxic effects of nalorphine include respiratory depression, hypertension, drowsiness and hypothermia.

Signs of increasing magnesium levels are hypotension, nausea, vomiting, depressed reflexes, respiratory depression, and coma.

Any analgesic capable of causing respiratory depression should be avoided if patient already shows any signs of respiratory impairment.

The program undergoes new inclusions and revisions on information on how to treat respiratory depression in infants at the time of birth.

Effects on central nervous system include drowsiness, coma, convulsions, and vomiting.
 
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