The term sibling refers to children who are related and living in the same family. Sibling rivalry has existed as long as families. Think back to Biblical times and Joseph's problems with his brothers or of the dreadful time Cinderella had with her stepsisters!

It seems strange that whenever the word sibling comes up, the word rivalry seems sure to follow despite the fact that there are many solid sibling relationships in families (brothers and sisters who like and enjoy one another). However, it is the rivalry that gets attention the proverbial squeaky wheel.

What causes sibling rivalry? Think about it. Siblings don't choose the family they are born into, don't choose each other. They may be of different sex, are probably of different age and temperament, and. worst of all, they have to share the one person or the two people they most want for themselves: their parents. Other factors include:

• Position in the family, for example, the oldest child may be burdened with responsibilities for the younger children or the younger child spends his life trying to catch up with an older sibling;
• Sex, for instance, a son may hate his sister because his father seems more gentle with her. On the other hand, a daughter may wish she could go on the hunting trip with her father and brother;
• Age, a five and an eight year old can play some games together but when they become ten and thirteen, they will probably be poles apart.

The most important factor, however, is parental attitude. Parents have been taught that they must be impartial but this can be extremely difficult. It's inevitable that parents will feel differently about children who have different personalities with differing needs, dispositions. and place in the family. Picture the age-old conflict of the young child whining. "It's not fair. Why can't I stay up until nine-thirty like Johnny?" Fairness has nothing to do with it. Susie is younger and needs more sleep. It's as simple as that, and parents are advised never to give in to the old "it's not fair" strategy. Besides, when Susie is finally allowed to stay up until nine-thirty, it will seem a real privilege to her.

Many parents feel that in order to be fair they must try to treat their children equally. It's simply not possible, and it can be dehumanizing If a mother feels that when she hugs one child. she must stop and hug all of her children, hugs soon become somewhat meaninglessin that family. When Susie has a birthday or is ill, she is the one who merits the special attention and presents. You can be sure that the other youngsters in the family no matter what they may say, recognize the inherent "fairness" of the situation.

Ever since we decided that sibling rivalry is normal, we've had a terrible time figuring out what to do about it. However, here are some do's and don'ts that may be helpful in dampening down sibling rivalry within a family:

1. Don't make comparisons. ("I don't understand it. When Johnny was her age, he could already tie his shoes.") Each child feels he is unique and rightly so-he is unique, and he resents being evaluated only in relation to someone else. Instead of comparison, each child in the family should be given his own goals and levels of expectation that relate only to him.

2. Don't dismiss or suppress your children's resentment or angry feelings. Contrary to what many people think, anger is not something we should try to avoid at all costs. It's an entirely normal part of being human, and it's certainly normal for siblings to get furious with one another. They need the adults in their lives to assure them that mothers and fathers get angry, too, but have learned control and that angry feelings do not give license to behave in cruel and dangerous ways. This is the time to sit down, acknowledge the anger ("I know you hate David right now but you cannot hit him with a stick"). and talk it through.

3. Try to avoid situations that promote guilt in siblings. First we must teach children that feelings and actions are not synonymous. It may be normal to want to hit the baby on the head, but parents must stop a child from doing it. The guilt that follows doing something mean is a lot worse than the guilt of merely feeling mean. So parental intervention must be quick and decisive.

4. When possible, let brothers and sisters settle their own differences. Sounds good but it can be terribly unfair in practice. Parents have to judge when it is time to step in and mediate, especially in a contest of unequals in terms of strength and eloquence (no fair hitting below the belt literally or figuratively). Some long-lasting grudges among grown siblings have resulted when their minority rights were not protected.

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When One Sibling is Handicapped

Quite different considerations must come into play when there is a handicapped child in the family, especially if it is a youngster who requires a lot of extra services both in and out of the home. In this case non-handicapped siblings can be resentful of the time spent on their brother or sister. They sense the parent's preoccupation. They feel that often they are receiving only surface attention, that the parent is not really alert to their needs.

There is one critical point that should be made and emphasized in all such cases. Whatever time and effort is spent with the handicapped child, it is done with the goal of improvement-of making the young- better able to function independently. As he improves. the demands on his parents will decrease commensurately, freeing them to devote more time to other members of the family. It actually boils down to, "Come on, let's everyone help-and everyone will ultimately benefit."

However, there are other measures to be taken to lessen sibling rivalry and tension in families with a handicapped child. Every child deserves a certain amount of quality time with a parent. It needn't be long but it should be undivided. Maybe a short quiet chat before bedtime-or lunch at a special restaurant. And when one of the non-handicapped siblings is involved in a school or community function, the parents should make every effort to be there no matter how much advance planning is required. Should the handicapped child go, too? Take your clue from the youngster who is involved in the function-it's his night. Sometimes yes. Sometimes no.

When One Sibling Is Gifted

Different people, including gifted children, have abilities and talents in different areas. Talk openly about this reality with your children so they can begin to develop appropriate expectations for themselves. You can do this by comparing your own strengths with those of your husband/wife or other family members or friends. There are two important points to be emphasized: (1) Don't expect to be great in everything; (2) recognize and develop those areas of strength you do have, Help your children make similar comparisons among themselves in the hope that they will have greater understanding and respect for each other. ("My brother gets all A's in school but he sure can't hit a baseball.")

It's also okay to mention your weaknesses. This can be especially effective if there is something you don't do as well as your non-gifted youngster. ("I wish I could make brownies as good as yours.")

Above all, honesty and acceptance are the greatest consideration you can give your children when the ways in which they are alike and unlike come under discussion.

Some Useful Behavior Management Strategies

Common Mistakes Parents Make in Managing Sibling Rivalry

• Taking sides such as attempting to punish the child who is at fault, usually the one seen pounding on the other child. (How long has this child put up with the taunting of the other child before taking drastic measures?)
• Ignoring appropriate behavior. Parents often ignore their children when they are playing nicely. They only pay attention when a problem arises. (Behavior Mod 101 teaches that behaviors that are ignored (go unrewarded) decrease while behaviors which receive attention (are rewarded) increase.

Simple Parenting Techniques That Work

1. When the rivalry progresses to excessive physical or verbal violence OR when the number incidents of rivalry seem excessive, take action. (Action does speak louder than words). Talk with your children about what is going on. Provide suggestions on how they can handle the situation when it occurs such as:

• Ignoring the teasing.
• Kidding back in a way that is humorous.
• Simply agreeing (in a kidding way) that whatever the teaser is saying is true.
• Telling the teaser that enough is enough.
• When these measures aren't working ask the person in charge (parent, baby sitter) for help.

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2. When the above does not work, introduce a family plan to help with the situation that provides negative and positive consequences for all concerned such as:

• When there is any fighting or shouting, all involved will have a consequence such as a time out or writing sentences ("I will play nicely with my brother).
• However, when we can go the whole day or afternoon or evening (whatever makes sense for your situation), then everyone will earn a privilege such as (1) you can have a snack, (2) I will read you a story, (3) we will all play a game together, (4) I will play outside with you (catch, etc) or (5) you can stay up later. (Note that several of these provide parental attention for appropriate behavior).

3. Develop a system for evenly distributing coveted privileges. In other words, a system for taking turns for such things as:

• Who gets to ride "shot gun" in the car. (It's amazing how many teenagers and young adult siblings still make this an important issue).
• Who gets to push the button in the elevator;
• Who gets to chose where to go to eat lunch or dinner,
• Who gets to chose the television show,
• Who does the dishes or takes out the trash (rotate on a weekly or monthly basis)

For more parenting techniques visit Parenting 101. For help in improving your ability to cope with the rigors of parenting we suggest Stress Management For Parents.

Yes, siblings ran create certain stresses but if they are overcome successfully, they will give your children resources that will serve them well later in life. Siblings learn how to share, how to come face to face with jealousy, and how to accept their individual strengths and weaknesses.

Best of all. as they watch you handle sibling rivalry with equanimity and fairness, they will be pining knowledge that will be valuable when they, too, become parents.

Useful Books on Sibling Rivalry

Siblings Without Rivalry : How to Help Your Children Live Together So You Can Live Too (an excellent resource for parents)

I'd Rather Have an Iguana (for children 4-6 having to cope with a new baby in the family)

Birth Order Blues : How Parents Can Help Their Children Meet the Challenges of Birth Order (The author raises parents' awareness of the impact of birth order upon children and suggests ways to resolve or circumvent potential problems relating to birth order issues).

Brothers and Sisters : Born to Bicker? (Teen Issues) (An intriguing entry in the Teen Issues series focuses on the interaction between brothers and sisters: ``The sibling relationship has much to do with how we feel about ourselves, as well as how we relate to others throughout our lives.")

Other Helpful Resources

You may also want to consider reading When Anger Hurts Your Kids.

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Find out why Celexa is prescribed, side effects of Celexa, Celexa warnings, effects of Celexa during pregnancy, more - in plain English.

Pronounced: sell-EX-ah

Celexa (citalopram) Full Prescribing Information

Why is Celexa prescribed?

Celexa is used to treat major depression--a stubbornly low mood that persists nearly every day for at least 2 weeks and interferes with everyday living. Symptoms may include loss of interest in your usual activities, insomnia or excessive sleeping, a change in weight or appetite, constant fidgeting or a slowdown in movement, fatigue, feelings of worthlessness or guilt, difficulty thinking or concentrating, and repeated thoughts of suicide.

Like the antidepressant medications Paxil, Prozac, and Zoloft, Celexa is thought to work by boosting serotonin levels in the brain. Serotonin, one of the nervous system's primary chemical messengers, is known to elevate mood.

Most important fact about Celexa

Be careful to avoid taking Celexa for 2 weeks before or after using an antidepressant known as an MAO inhibitor. Drugs in this category include Marplan, Nardil, and Parnate. Combining Celexa with one of these medications could lead to a serious--even fatal--reaction.

How should you take Celexa?

Celexa is available in tablet and liquid forms. Take either formulation once a day, in the morning or evening, with or without food. Although your depression will begin to lift in 1 to 4 weeks, you should continue taking Celexa regularly. It takes several months for the medication to yield its full benefits.

 

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at the same time.

--Storage instructions...

Store at room temperature.

What side effects may occur when taking Celexa?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Celexa.

• • More common side effects of Celexa may include: Abdominal pain, agitation, anxiety, diarrhea, drowsiness, dry mouth, ejaculation disorders, fatigue, impotence, indigestion, insomnia, loss of appetite, nausea, painful menstruation, respiratory tract infection, sinus or nasal inflammation, sweating, tremor, vomiting

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• Less common side effects may include: Amnesia, attempted suicide, confusion, coughing, decreased sexual drive, depression, excessive urination, fever, gas, impaired concentration, increased appetite, increased salivation, itching, joint pain, lack of emotion, loss of menstruation, low blood pressure, migraine, muscle pain, rapid heartbeat, rash, skin tingling, taste disturbances, visual disturbances, weight gain, weight loss, yawning

• Rare side effects may include: Abnormal dreams, acne, aggressive behavior, alcohol intolerance, angina (chest pain), arthritis, belching, bone pain, breast enlargement, breast pain, bronchitis, bruising, chills, conjunctivitis (pinkeye), decreased muscle movements, delusions, dermatitis, difficulty breathing, difficulty swallowing, dizziness, drug dependence, dry eyes, dry skin, eczema, emotional instability, excessive milk flow, excessive muscle tone, eye pain, fainting, feeling of well-being, flu-like symptoms, flushing, frequent urination, gum inflammation, hair loss, hallucinations, heart attack, heart failure, hemorrhoids, high blood pressure, hives, hot flashes, inability to hold urine, inability to urinate completely, increased sex drive, increased urination, involuntary muscle movements, leg cramps, mouth sores, muscle weakness, nosebleeds, numbness, painful erection, painful urination, panic, paranoia, pneumonia, psoriasis, psychosis, ringing in the ears, sensitivity to light, skin discoloration, slow heartbeat, stomach and intestinal inflammation, stroke, swelling, teeth grinding, thirst, uncontrollable muscle movements, unsteady or abnormal walk, vaginal bleeding

Why should this drug not be prescribed?

If Celexa gives you an allergic reaction, you cannot continue using it. Also remember that Celexa must never be combined with an MAO inhibitor (see "Most important fact about this drug," above).

Special warnings about Celexa

Read FDA warning covering all antidepressants and the possibility of suicidal thoughts and behaviors in children, adolescents and adults. More details here.

In recommended doses, Celexa does not seem to impair judgment or motor skills. However, a theoretical possibility of such problems remains, so you should use caution when driving or operating dangerous equipment until you are certain of Celexa's effect.

There is a slight chance that Celexa will trigger a manic episode. Use Celexa with caution if you suffer from manic-depression (bipolar disorder). Use caution, too, if you are over 60 years old, have liver or kidney problems, suffer from heart disease or high blood pressure, or have ever had seizures.

Possible food and drug interactions when taking Celexa

Celexa does not increase the effects of alcohol. Nevertheless, it's considered unwise to combine Celexa with alcohol or any other drug that affects the brain. (Be particularly careful to avoid MAO inhibitors.)

If Celexa is taken with certain other drugs, the effects of either could be increased, decreased, or altered. Tell your doctor about any prescription or over-the-counter drugs you are planning to take, and be especially certain to check with him before combining Celexa with the following:

Carbamazepine (Tegretol) Cimetidine (Tagamet)
Erythromycin (Eryc, Ery-Tab)
Fluconazole (Diflucan)
Itraconazole (Sporanox)
Ketoconazole (Nizoral)
Lithium (Lithobid, Lithonate)
Metoprolol (Lopressor)
Omeprazole (Prilosec)
Other antidepressants such as Elavil, Norpramin, Pamelor, and Tofranil
Sumatriptan (Imitrex)
Warfarin (Coumadin)

Special information if you are pregnant or breastfeeding

The effects of Celexa during pregnancy have not been adequately studied, and the potential for harm has not been ruled out. If you are pregnant or plan to become pregnant while on Celexa therapy, tell your doctor immediately.

Celexa appears in breast milk and will affect the nursing infant. You should consider discontinuing either breastfeeding or Celexa. Talk with your doctor about the pros and cons of each option.

Recommended dosage for Celexa

ADULTS

The recommended starting dose of Celexa tablets or oral solution is 20 milligrams once a day. Dosage is usually increased to 40 milligrams once daily after at least a week has passed. Do not exceed 40 milligrams a day. For older adults and those who have liver problems, the recommended dose is 20 milligrams once a day.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

• Symptoms of Celexa overdose may include: Amnesia, bluish or purplish discoloration of the skin, coma, confusion, convulsions, dizziness, drowsiness, hyperventilation, nausea, rapid heartbeat, sweating, tremor, vomiting

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Celexa (citalopram) Full Prescribing Information
Celexa medication guide

back to: Psychiatric Medication Patient Information Index

Brand name: Serax
Generic name: Oxazepam

Pronounced: SER-aks

Serax Full Prescribing Information

Why is this drug prescribed?

Serax is used in the treatment of anxiety disorders, including anxiety associated with depression.

This drug seems to be particularly effective for anxiety, tension, agitation, and irritability in older people. It is also prescribed to relieve symptoms of acute alcohol withdrawal.

Serax belongs to a class of drugs known as benzodiazepines.

Most important fact about this drug

Serax can be habit-forming or addicting and can lose its effectiveness over time, as you develop a tolerance for it. You may experience withdrawal symptoms if you stop using the drug abruptly. When discontinuing the drug, your doctor will reduce the dose gradually.

How should you take this medication?

Take Serax exactly as prescribed.

--If you miss a dose...

If you remember within an hour or so, take the dose immediately. If you do not remember until later, skip the dose you missed and go back to your regular schedule. Do not take 2 doses at once.

--Storage instructions...

Store at room temperature in a tightly closed container.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Serax. Your doctor should periodically reassess the need for this drug.

More common side effects may include:
Drowsiness
Less common or rare side effects may include:
Blood disorders, change in sex drive, dizziness, excitement, fainting, headache, hives, liver problems, loss or lack of muscle control, nausea, skin rashes or eruptions, sluggishness or unresponsiveness, slurred speech, swelling due to fluid retention, tremors, vertigo, yellowed eyes and skin
Side effects due to rapid decrease or abrupt withdrawal from Serax:
Abdominal and muscle cramps, convulsions, depressed mood, inability to fall or stay asleep, sweating, tremors, vomiting

 

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Why should this drug not be prescribed?

If you are sensitive to or have ever had an allergic reaction to Serax or other tranquilizers such as Valium, you should not take this medication. Make sure your doctor is aware of any drug reactions you have experienced.

Anxiety or tension related to everyday stress usually does not require treatment with Serax. Discuss your symptoms thoroughly with your doctor.

Serax should not be prescribed if you are being treated for mental disorders more serious than anxiety.

Special warnings about this medication

Serax may cause you to become drowsy or less alert; therefore, you should not drive or operate dangerous machinery or participate in any hazardous activity that requires full mental alertness until you know how this drug affects you.

This medication may cause your blood pressure to drop. If you have any heart problems, consult your doctor before taking this medication.

The 15 milligram tablet of this drug contains the coloring agent FD&C Yellow No. 5, which may cause an allergic reaction. If you are sensitive to aspirin or susceptible to allergies, consult your doctor before taking the tablet.

Possible food and drug interactions when taking this medication

Serax may intensify the effects of alcohol. It may be best to avoid alcohol while taking this medication.

If Serax is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Serax with the following:

Antihistamines such as Benadryl
Narcotic painkillers such as Percocet and Demerol
Sedatives such as Seconal and Halcion
Tranquilizers such as Valium and Xanax

Special information if you are pregnant or breastfeeding

Do not take Serax if you are pregnant or planning to become pregnant. There is an increased risk of birth defects. Serax may appear in breast milk and could affect a nursing infant. If this drug is essential to your health, your doctor may advise you to stop breastfeeding until your treatment with this medication is finished.

Recommended dosage

ADULTS

Mild to Moderate Anxiety with Tension, Irritability, Agitation

The usual dose is 10 to 15 milligrams 3 or 4 times per day.

Severe Anxiety, Depression with Anxiety, or Alcohol Withdrawal

The usual dose is 15 to 30 milligrams, 3 or 4 times per day.

CHILDREN

Safety and effectiveness have not been established for children under 6 years of age, nor have dosage guidelines been established for children 6 to 12 years. Your doctor will adjust the dosage to fit the child's needs.

OLDER ADULTS

The usual starting dose is 10 milligrams, 3 times a day. Your doctor may increase the dose to 15 milligrams 3 or 4 times a day, if needed.

Overdosage

An overdose of Serax can be fatal. If you suspect an overdose, seek medical attention immediately.

Symptoms of mild Serax overdose may include:
Confusion, drowsiness, lethargy

Symptoms of more serious overdose may include:

Coma, hypnotic state, lack of coordination, limp muscles, low blood pressure

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Serax Full Prescribing Information

Detailed Info on Signs, Symptoms, Causes, Treatments of Depression

Detailed Info on Signs, Symptoms, Causes, Treatments of Anxiety Disorders

Detailed Info on Signs, Symptoms, Causes, Treatments of Alcoholism and Other Addictions

back to: Psychiatric Medication Patient Information Index

Find out why Tegretol is prescribed, side effects of Tegretol, Tegretol warnings, effects of Tegretol during pregnancy, more - in plain English.

Generic name: Carbamazepine
Other brand names: Carbatrol, Epitol, Tegretol-XR

Pronounced: TEG-re-tawl

Tegretol (carbamazepine) Full Prescribing Information

Carbatrol (carbamazepine) Full Prescribing Information

Why is Tegretol prescribed?

Tegretol is used in the treatment of seizure disorders, including certain types of epilepsy. It is also prescribed for trigeminal neuralgia (severe pain in the jaws) and pain in the tongue and throat.

In addition, some doctors use Tegretol to treat alcohol withdrawal, cocaine addiction, and emotional disorders such as depression and abnormally aggressive behavior. The drug is also used to treat migraine headache and "restless legs."

Most important fact about Tegretol

There are potentially dangerous side effects associated with the use of Tegretol. If you experience symptoms such as fever, sore throat, rash, ulcers in the mouth, easy bruising, or reddish or purplish spots on the skin, you should notify your doctor immediately. These symptoms could be signs of a blood disorder brought on by the drug.

How should you take Tegretol?

This medication should only be taken with meals, never on an empty stomach.

Shake the suspension well before using.

Tegretol-XR (extended-release) tablets must be swallowed whole; do not crush or chew them and do not take tablets that have been damaged.

 

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once. If you miss more than 1 dose in a day, check with your doctor.

--Storage instructions...

Store Tegretol at room temperature. Keep the container tightly closed. Protect the tablets from light and moisture. Keep the liquid suspension away from light.

What side effects may occur with Tegretol?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Tegretol.

• • More common side effects of Tegretol, especially at the start of treatment, may include: Dizziness, drowsiness, nausea, unsteadiness, vomiting

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• Other side effects may include: Abdominal pain, abnormal heartbeat and rhythm, abnormal involuntary movements, abnormal sensitivity to sound, aching joints and muscles, agitation, anemia, blood clots, blurred vision, chills, confusion, congestive heart failure, constipation, depression, diarrhea, double vision, dry mouth and throat, fainting and collapse, fatigue, fever, fluid retention, frequent urination, hair loss, hallucinations, headache, hepatitis, hives, impotence, inability to urinate, inflammation of the mouth and tongue, inflamed eyes, involuntary movements of the eyeball, itching, kidney failure, labored breathing, leg cramps, liver disorders, loss of appetite, loss of coordination, low blood pressure, pancreatitis (inflammation of the pancreas), pneumonia, reddened skin, reddish or purplish spots on the skin, reduced urine volume, ringing in the ears, sensitivity to light, skin inflammation and scaling, skin peeling, skin rashes, skin pigmentation changes, speech difficulties, stomach problems, sweating, talkativeness, tingling sensation, worsening of high blood pressure, yellow eyes and skin

Why should this drug not be prescribed?

You should not use Tegretol if you have a history of bone marrow depression (reduced function), a sensitivity to Tegretol, or a sensitivity to tricyclic antidepressant drugs such as amitriptyline (Elavil). You should also not be taking Tegretol if you are on an MAO inhibitor antidepressant such as Nardil or Parnate, or if you have taken such a drug within the past 14 days.

Tegretol is not a simple pain reliever and should not be used for the relief of minor aches and pains.

Special warnings about Tegretol

If you have a history of heart, liver, or kidney damage, an adverse blood reaction to any drug, glaucoma, or serious reactions to other drugs, you should discuss this history thoroughly with your doctor before taking this medication.

Anticonvulsant drugs such as Tegretol should not be stopped abruptly if you are taking the medication to prevent major seizures. There exists the strong possibility of continuous epileptic attacks without return to consciousness, leading to possible severe brain damage and death. Only your doctor should determine if and when you should stop taking this medication.

Since dizziness and drowsiness may occur while taking Tegretol, you should refrain from operating machinery or driving an automobile or participating in any high-risk activity that requires full mental alertness until you know how this drug affects you.

Older adults, especially, can become confused or agitated when taking Tegretol.

Tegretol has been known to cause serious blood, liver, and skin reactions, both early in treatment and after extended use. Alert your doctor immediately if you develop such warning signs as fever, sore throat, rash, ulcers in the mouth, easy bruising or spots in the skin, swollen lymph glands, loss of appetite, nausea or vomiting, or yellowing of the skin and eyes.

The coating of the Tegretol-XR tablet is not absorbed and passes through your body intact. If you notice it in your stool, it is not a cause for alarm.

Possible food and drug interactions when taking Tegretol

The use of the antiseizure medications phenobarbital, phenytoin (Dilantin), or primidone (Mysoline) may reduce the effectiveness of Tegretol. Take other anticonvulsants along with Tegretol only if your doctor advises it. The use of Tegretol with other anticonvulsants may change thyroid gland function.

The following drugs may also reduce the effectiveness of Tegretol: cisplatin (Platinol), doxorubicin HCl (Adriamycin), felbamate (Felbatol), rifampin (Rifadin), and theophylline (Theo-Dur).

The effectiveness of acetaminophen (Tylenol), alprazolam (Xanax), clonazepam (Klonopin), clozapine (Clozaril), dicumarol, doxycycline (Doryx), ethosuximide (Zarontin), haloperidol (Haldol), lamotrigine (Lamictal), methsuximide (Celontin), oral contraceptives, phensuximide (Milontin), phenytoin (Dilantin), theophylline (Theo-Dur), tiagabine (Gabitril), topiramate (Topamax), valproic acid (Depakene), and warfarin (Coumadin) may be reduced when these drugs are taken with Tegretol.

Tegretol may increase the effectiveness of clomipramine HCl (Anafranil), phenytoin, or primidone if the drugs are taken together.

All of the following drugs may raise the amount of Tegretol in the blood to harmful levels: azithromycin (Zithromax), cimetidine (Tagamet), clarithromycin (Biaxin), danazol (Danocrine), diltiazem (Cardizem), erythromycin (E-Mycin), fluoxetine (Prozac), isoniazid (Nydrazid), itraconazole (Sporanox), ketoconazole (Nizoral), loratadine (Claritin), niacinamide, nicotinamide, propoxyphene (Darvon), troleandomycin (Tao), valproate (Depakene), and calcium channel blockers such as Calan.

Lithium (Eskalith) used with Tegretol may cause harmful nervous system side effects.

If you are taking an oral contraceptive and Tegretol, you may experience blood spotting and your contraceptive may not be completely reliable.

Do not combine Tegretol suspension with other liquid medications such as Thorazine solution or Mellaril liquid. The mixture may congeal internally.

Special information if you are pregnant or breastfeeding

There are no adequate safety studies regarding the use of Tegretol in pregnant women. However, there have been reports of birth defects in infants. Therefore, this medication should be used during pregnancy only if the potential benefits justify the potential risk to the fetus. If you are pregnant or plan on becoming pregnant, you should discuss this with your doctor.

Tegretol appears in breast milk. If you are breastfeeding, your doctor may advise you to discontinue doing so if taking Tegretol is essential to your health.

Recommended dosage for Tegretol

ADULTS

Seizures

The usual dose for adults and children over 12 years of age is 200 milligrams (1 tablet or 2 chewable or extended-release tablets) taken twice daily or 1 teaspoon 4 times a day. Your doctor may increase the dose at weekly intervals by adding 200-milligram doses twice a day for Tegretol-XR or 3 or 4 times per day for the other forms. Dosage should generally not exceed 1,000 milligrams daily in children 12 to 15 years old and 1,200 milligrams daily for adults and children over 15. The usual daily maintenance dosage range is 800 to 1,200 milligrams.

Trigeminal Neuralgia

The usual dose is 100 milligrams (1 chewable or extended-release tablet) twice or one-half teaspoon 4 times on the first day. Your doctor may increase this dose using increments of 100 milligrams every 12 hours or one-half teaspoonful 4 times daily only as needed to achieve freedom from pain. Doses should not exceed 1,200 milligrams daily and are usually in the range of 400 to 800 milligrams a day for maintenance.

CHILDREN

Seizures

The usual dose for children 6 to 12 years old is 100 milligrams twice daily or one-half teaspoon 4 times a day. Your doctor may increase the dose at weekly intervals by adding 100 milligrams twice a day for Tegretol-XR, 3 or 4 times a day for the other forms. Total daily dosage should generally not exceed 1,000 milligrams. The usual daily dosage range for maintenance is 400 to 800 milligrams.

The usual daily starting dose for children under 6 years of age is 10 to 20 milligrams per 2.2 pounds of body weight. The total daily dose is divided into smaller doses taken 2 or 3 times a day for tablets or 4 times a day for suspension. Daily dosage should not exceed 35 milligrams per 2.2 pounds.

OLDER ADULTS

To help determine the ideal dosage, your doctor may decide to periodically check the level of Tegretol in your blood.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately. The first signs and symptoms of an overdose of Tegretol appear after 1 to 3 hours.

• The most prominent signs of a Tegretol overdose include: Coma, convulsions, dizziness, drowsiness, inability to urinate, involuntary rapid eye movements, irregular or reduced breathing, absence or low production of urine, lack of coordination, low or high blood pressure, muscular twitching, nausea, pupil dilation, rapid heartbeat, restlessness, severe muscle spasm, shock, tremors, unconsciousness, vomiting, writhing movements

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Tegretol (carbamazepine) Full Prescribing Information

Carbatrol (carbamazepine) Full Prescribing Information

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Find out why BuSpar is prescribed, side effects of BuSpar, BuSpar warnings, effects of BuSpar during pregnancy, more - in plain English.

Generic name: Buspirone hydrochloride
Brand name: BusPar

Pronounced: BYOO-spar

BuSpar (buspirone) Full Prescribing Information

Why is BuSpar prescribed?

BuSpar is used in the treatment of anxiety disorders and for short-term relief of the symptoms of anxiety.

Most important fact about BuSpar

BuSpar should not be used with antidepressant drugs known as monoamine oxidase (MAO) inhibitors. Brands include Nardil and Parnate.

How should you take BuSpar?

Take BuSpar exactly as prescribed. Do not be discouraged if you feel no immediate effect. The full benefit of this drug may not be seen for 1 to 2 weeks after you start to take it.

--If you miss a dose...

Take the forgotten dose as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time.

--Storage instructions...

Store at room temperature in a tightly closed container, away from light.

What side effects may occur when taking BuSpar?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking BuSpar.

• More common side effects of BuSpar may include: Dizziness, dry mouth, fatigue, headache, light-headedness, nausea, nervousness, unusual excitement

• Less common or rare side effects may include: Anger/hostility, blurred vision, bone aches/pain, confusion, constipation, decreased concentration, depression, diarrhea, fast, fluttery heartbeat, incoordination, muscle pain/aches, numbness, pain or weakness in hands or feet, rapid heartbeat, rash, restlessness, stomach and abdominal upset, sweating/clamminess, tingling or pins and needles, tremor, urinary incontinence, vomiting, weakness

Why should this drug not be prescribed?

 

If you are sensitive to or have ever had an allergic reaction to BuSpar or similar mood-altering drugs, you should not take this medication. Make sure your doctor is aware of any drug reactions you have experienced.

Anxiety or tension related to everyday stress usually does not require treatment with BuSpar. Discuss your symptoms thoroughly with your doctor.

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The use of BuSpar is not recommended if you have severe kidney or liver damage.

Special warnings about BuSpar

The effects of BuSpar on the central nervous system (brain and spinal cord) are unpredictable. Therefore, you should not drive or operate dangerous machinery or participate in any hazardous activity that requires full mental alertness while you are taking BuSpar.

Possible food and drug interactions when taking BuSpar

Although BuSpar does not intensify the effects of alcohol, it is best to avoid alcohol while taking this medication.

If BuSpar is taken with certain other drugs, the effects of either can be increased, decreased, or altered. It is especially important to check with your doctor before combining BuSpar with the following:

The blood-thinning drug Coumadin Haloperidol (Haldol) MAO inhibitors (antidepressant drugs such as Nardil and Parnate) Trazodone (Desyrel)

Special information if you are pregnant or breastfeeding

The effects of BuSpar during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. It is not known whether BuSpar appears in breast milk. If this medication is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment is finished.

Recommended dosage for BuSpar

ADULTS

The recommended starting dose is a total of 15 milligrams per day divided into smaller doses, usually 5 milligrams 3 times a day. Every 2 to 3 days, your doctor may increase the dosage 5 milligrams per day as needed. The daily dose should not exceed 60 milligrams.

CHILDREN

The safety and effectiveness of BuSpar have not been established in children under 18 years of age.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose of BuSpar, seek medical attention immediately.

The symptoms of BuSpar overdose may include: Dizziness, drowsiness, nausea or vomiting, severe stomach upset, unusually small pupils.

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BuSpar (buspirone) Full Prescribing Information

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Find out why Wellbutrin is prescribed, side effects of Wellbutrin, Wellbutrin warnings, effects of Wellbutrin during pregnancy, more - in plain English.

Generic name: Bupropion hydrochloride
Brand names: Wellbutrin SR, Wellbutrin XL

Pronounced: Well-BEW-trin

Wellbutrin XL (buproprion) Full Prescribing Information
Wellbutrin XL Medication Guide

Why is Wellbutrin prescribed?

Wellbutrin, a relatively new antidepressant medication, is given to help relieve certain kinds of major depression.

Major depression involves a severely depressed mood (for 2 weeks or more) and loss of interest or pleasure in usual activities accompanied by sleep and appetite disturbances, agitation or lack of energy, feelings of guilt or worthlessness, decreased sex drive, inability to concentrate, and perhaps thoughts of suicide.

Unlike the more familiar tricyclic antidepressants, such as Elavil, Tofranil, and others, Wellbutrin tends to have a somewhat stimulating effect.

The drug is available in regular and sustained-release formulations (Wellbutrin SR).

Most important fact about Wellbutrin

Although Wellbutrin occasionally causes weight gain, a more common effect is weight loss: Some 28 percent of people who take this medication lose 5 pounds or more. If depression has already caused you to lose weight, and if further weight loss would be detrimental to your health, Wellbutrin may not be the best antidepressant for you.

How should you take Wellbutrin?

Take Wellbutrin exactly as prescribed by your doctor. The usual dosing regimen is 3 equal doses spaced evenly throughout the day. Allow at least 6 hours between doses. Your doctor will probably start you at a low dosage and gradually increase it; this helps minimize side effects.

You should take Wellbutrin SR, the sustained-release form, in 2 doses, at least 8 hours apart. Swallow Wellbutrin SR tablets whole; do not chew, divide, or crush them.

 

If Wellbutrin works for you, your doctor will probably have you continue taking it for at least several months.

--If you miss a dose...

Take it as soon as you remember. If it is within 4 hours of your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time.

--Storage instructions...

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Store at room temperature. Protect from light and moisture.

What side effects may occur when taking Wellbutrin?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Wellbutrin.

Seizures are perhaps the most worrisome side effect.

• More common side effects of Wellbutrin may include: Abdominal pain (Wellbutrin SR), agitation, anxiety (Wellbutrin SR), constipation, dizziness, dry mouth, excessive sweating, headache, loss of appetite (Wellbutrin SR), nausea, palpitations (Wellbutrin SR), vomiting, skin rash, sleep disturbances, sore throat (Wellbutrin SR), tremor

• Other side effects of Wellbutrin may include: Acne, allergic reactions (severe), bed-wetting, blisters in the mouth and eyes (Stevens-Johnson syndrome) blurred vision, breathing difficulty, chest pain, chills, complete or almost complete loss of movement, confusion, dry skin, episodes of over-activity, elation, or irritability, extreme calmness, fatigue, fever, fluid retention, flu-like symptoms, gum irritation and inflammation, hair color changes, hair loss, hives, impotence, incoordination and clumsiness, indigestion, itching, increased libido, menstrual complaints, mood instability, muscle rigidity, painful ejaculation, painful erection, retarded ejaculation, ringing in the ears, sexual dysfunction, suicidal ideation, thirst disturbances, tooth ­ache, urinary disturbances, weight gain or loss

Why should this drug not be prescribed?

Do not take Wellbutrin if you are sensitive to or have ever had an allergic reaction to it.

Since Wellbutrin causes seizures in some people, do not take it if you have any type of seizure disorder or if you are taking another medication containing bupropion, such as Zyban, the quit smoking aid. If you have a seizure while taking Wellbutrin, stop taking the drug and never take it again.

Do not take Wellbutrin while abruptly giving up alcohol or sedatives, including tranquilizers such as Librium, Valium, and Xanax. Rapid withdrawal increases the risk of seizures.

If you have had any kind of heart trouble or liver or kidney disease, be sure your doctor knows about it before you start taking this drug. It must be used with extreme caution if you have severe cirrhosis of the liver. A reduced dosage may be needed if you have any sort of liver or kidney problem.

You should not take Wellbutrin if you currently have, or formerly had, an eating disorder. For some reason, people with a history of anorexia nervosa or bulimia seem to be more likely to experience Wellbutrin-related seizures.

Do not take Wellbutrin if, within the past 14 days, you have taken a monoamine oxidase inhibitor (MAO inhibitor) drug, such as the antidepressants Marplan, Nardil or Parnate. This particular drug combination could cause you to experience a sudden, dangerous rise in blood pressure.

Special warnings about Wellbutrin

All antidepressants carry an FDA warning about the possibility of causing suicidal thoughts or behaviors in children, adolescents and even adults. More info on that here.

If you take Wellbutrin, you may be vulnerable to seizures if your dosage is too high or if you ever suffered brain damage or experienced seizures in the past.

Stop taking Wellbutrin and call your doctor immediately if you have difficulty breathing or swallowing; notice swelling in your face, lips, tongue, or throat; develop swollen arms and legs; or break out with itchy eruptions. These are warning signs of a potential severe allergic reaction.

The danger of seizures is greater in people addicted to narcotics, cocaine, or stimulants, and in those using over-the-counter stimulants or diet pills. Alcohol abuse or withdrawal also increases the risk, as does the use of other antidepressants or major tranquilizers. The risk is higher, too, if you are taking insulin or oral diabetes medication.

Since Wellbutrin may impair your coordination or judgment, do not drive or operate dangerous machinery until you find out how the medication affects you.

Possible food and drug interactions when taking Wellbutrin

Do not drink alcohol while you are taking Wellbutrin; an interaction between alcohol and Wellbutrin could increase the possibility of a seizure.

If Wellbutrin is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Wellbutrin with the following:

Beta blockers (used for high blood pressure and heart conditions) such as Inderal, Lopressor, and Tenormin
Carbamazepine (Tegretol)
Cimetidine (Tagamet)
Cyclophosphamide (Cytoxan)
Heart-stabilizing drugs such as Rythmol and Tambocor
Levodopa (Larodopa)
Major tranquilizers such as Haldol, Risperdal,
Thorazine, and Mellaril
MAO inhibitors (such as the antidepressants Parnate and Nardil)
Nicotine patches such as Habitrol, NicoDerm CQ, and Nicotrol patch
Orphenadrine (Norgesic)
Other antidepressants such as Elavil, Norpramin, Pamelor, Paxil, Prozac, Tofranil, and Zoloft
Phenobarbital
Phenytoin (Dilantin)
Steroid medications such as Prednisone
Theophylline (Theo-Dur)

Special information if you are pregnant or breastfeeding

If you are pregnant or plan to become pregnant, notify your doctor immediately. Wellbutrin should be taken during pregnancy only if clearly needed.

Wellbutrin does pass into breast milk and may cause serious reactions in a nursing baby; therefore, if you are a new mother, you may need to discontinue breastfeeding while you are taking this medication.

Recommended dosage for Wellbutrin

No single dose of Wellbutrin should exceed 150 milligrams.

ADULTS

Wellbutrin

At the beginning, your dose will probably be 200 milligrams per day, taken as 100 milligrams 2 times a day. After at least 3 days at this dose, your doctor may increase the dosage to 300 milligrams per day, taken as 100 milligrams 3 times a day, with at least 6 hours between doses. This is the usual adult dose. The maximum recommended dosage is 450 milligrams per day taken in doses of no more than 150 milligrams each.

Wellbutrin SR

The usual starting dose is 150 milligrams in the morning. After 3 days, if you do well, your doctor will have you take another 150 milligrams at least 8 hours after the first dose. It may be 4 weeks before you feel the benefit and you will take the drug for several months. The maximum recommended dose is 400 milligrams a day, taken in doses of 200 milligrams each.

If you have severe cirrhosis of the liver, your dosage should be no more than 75 milligrams once a day. With less serious liver and kidney problems, the dosage will be somewhat reduced.

CHILDREN

The safety and effectiveness in children under 18 years old have not been established.

OLDER ADULTS

Although they are more sensitive to antidepressant drugs, older people have responded no differently to Wellbutrin than younger people.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose of Wellbutrin, seek medical attention immediately.

• Symptoms of Wellbutrin overdose may include: Hallucinations, heart failure, loss of consciousness, rapid heartbeat, seizures

• Symptoms of Wellbutrin SR overdose may include: Blurred vision, confusion, jitteriness, lethargy, light-headedness, nausea, seizures, vomiting

• An overdose that involves other drugs in combination with Wellbutrin may also cause these symptoms: Breathing difficulties, coma, fever, rigid muscles, stupor

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Wellbutrin XL (buproprion) Full Prescribing Information
Wellbutrin XL Medication Guide

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how to have good sex

1. Good Solid Information
2. Base it on Pleasure
3. Good Sex can Flourish
4. Communication is Key
5. Focus on Your Pleasure
6. Appreciate the Differences

1. Accurate information about your own sexuality, your partner's, and about sex itself.

This means getting away from the myths and unrealistic expectations, and being able to learn about your own sexuality and that of your partner.

2. Having or developing an orientation based on pleasure (arousal, love, lust, and fun) rather than performance.

In other words, holding to some version of the definition of good sex, and being willing to work and focus on arousal, excitement, and passion -- the keys to good erotic feelings.

3. Having the kind of relationship in which good sex can flourish.

Whether your relationship lasts for an afternoon or forty years, its dynamics have a significant influence on the quality and quantity of sex. Relationship issues are typically seen as something more important to women than to men --and they certainly are very important to women -- but, as we shall see, they are also crucial to men. A major aspect of having a good relationship is being able to deal with differences of opinion and conflicts quickly and effectively. Sex usually suffers when there is tension, hostility, or distance.

4. Being able to communicate verbally and nonverbally about sex.

Perhaps the most important component of a good relationship is the ability to communicate. Regarding sex, you need to be able to express your wants and don't wants, your questions and concerns, and your pleasure, and you need to be able to listen to and understand what your partner is expressing. You also need the capacity to discus conflicts and problems with your partner and work toward mutually satisfying solutions.

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One reason you need to be able to communicate is that sex with another person involves physical coordination of a kind that's rare anywhere else. Let's compare masturbation with partner sex to illustrate this point. Our bodies are the most sophisticated feedback systems ever built. When you touch your own body, the process is automatic, self correcting and extremely efficient. Continuous feedback between your penis, your brain, and your hand allows the brain automatically to move your hand to achieve the results you want.

Now let's consider your partner stimulating your penis with her hand. Suddenly, things are much more complex. Your feedback mechanism still works -- you know to what extent you're getting what you want -- but your friend isn't part of it. To include her in the feedback loop, you must bring into awareness and put into words what by yourself was done without words or awareness. "Move your hand up...too far...down a bit more...that's right, and a little harder...a little faster...that's good...oops, harder now...faster...that's great," and so on. You even have to tell your friend when to stop stimulating, because she may stop sooner than you want or not soon enough.

This is complicated business, and the complications increase with other acts. In oral sex, for instance, you may have to inform your partner that her teeth are hurting you, and that she should apply more or less pressure with her mouth and hand (assuming that she is also using her hand), or that you want her to take more of your penis in her mouth. With a partner, you may want-and she most certainly wants -- certain kinds of stimulation that you ordinarily can't or don't do by yourself (hugging, kissing, expressing feelings orally, and so on). With her, you may also want certain feelings to develop aside from sexual arousal, and their development may require the expression of certain attitudes and behaviors. With masturbation, you can do it or not do it, or start and abruptly change your mind, stop, and do something else. With a partner, you have to inform her of what is happening. And since the two of you won't always be in agreement as to what should or should not be done, there has to be a way of expressing and dealing with the discrepant desires. Partner sex also carries baggage that masturbation usually does not. If you decide not to masturbate today or for the next ten weeks, or if you decide to masturbate every single day, it's unlikely that issues of love, desirability, or adequacy come into play. It's no big deal whatever you do. But with a partner, things are a bit different. Being able to talk, listen, understand, and negotiate are absolutely essential.

5. Being assertive about your own desires and able to focus fully on your own pleasure and also being exquisitely sensitive to your partner and able to give her what she wants.

I know, it sounds like a contradiction, but it really isn't.

Being only self-centered or only sensitive does not work. The man who only goes after what he wants and pays little attention to his partner will end up alone or with a very unhappy partner. The man who focuses solely on his partner's desires will not get what he wants and therefore be unhappy. And his partner may also be dissatisfied because she senses that no matter how sensitive he is to her needs, he's not expressing or fulfilling his own.

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In days of old, sex was mainly

an act of male assertiveness. Having an orgasm inside a woman was what he wanted, and it was far from clear what she might want or what he might be able to do for her. Many men didn't think women wanted anything in sex but engaged in it only because they wanted something else that sex could bring -- conception, a steady boyfriend, a happy husband -- or because they had been tricked into it. For men who weren't cads, the main aspect of sensitivity was not harming the woman; in other words, treating her gently and using protection against disease.

The view, of women as nonsexual came under attack in the last century and increasingly in the twentieth century until it was finally accepted that women were indeed sexual creatures. Men should strive not only for their own satisfaction but also for their partners'. Since men were still seen as more sexual than women, and since they had more leeway to gain experience, it was their task to introduce women to the joys of sex.

The research of Kinsey and later Masters and Johnson added influence to this view. Women were capable not only of enjoying sex but also of orgasm, maybe more orgasms than men. Men ought to give them their due. This was an important step forward, but one result is that men felt more pressured to perform because somehow the message was that they had to "give" their partners orgasms. Some men became so focused on ensuring their partners' pleasure that they forgot about their own.

In "The New Male Sexuality," I hope we are constructing, the satisfaction of both partners is paramount. The man has to assert his own wants and preferences, but also be sensitive to his partner's. It is not his job to give her orgasms, but it is in his interests to understand her desires and to fulfill them to the best of his abilities.

Being assertive and self-focused entails knowing your conditions, going after them, and thoroughly involving yourself in your own pleasure. You want sex now, so you try to interest your partner. You like to kiss this way, so that's what you do. You like to touch her breasts that way, so you do it. You like intercourse in such a position, so that's what you go for. And while doing these things, you're immersed in your sensations and experience, fully present and alive to what is happening. A good lover is assertive in these ways. He knows what he wants, or is willing to find out, and he goes after it without apology or guilt.

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But a good lover is also sensitive to his partner's needs. You notice if she doesn't seem interested in exactly what you want or suggests something else, and you're flexible enough to try to combine both of your desires to make for a mutually satisfying experience. And you don't use guilt or other types of coercion to get what you want. A good lover is attentive to his partner's breaths, sounds, and movements and notices what works and doesn't work for her. He also listens carefully when she says what she likes. If she doesn't spontaneously voice her likes and dislikes, he asks. Bad lovers don't ask, don't listen, and don't remember.

A good lover takes the time and energy to use his knowledge to make sure his partner enjoys sex as much as he does. He also knows that sex isn't necessarily over when he's satisfied. Maybe she wants something more. A good lover would not be open to the charge a woman made about her new boyfriend: "He's one of these selfish or unconscious men. When he comes, it's all over. I have to go, 'Knock, knock, can I have a turn, too?'" A good lover is also sensitive enough to not pressure his partner to perform to boost his ego.

It is difficult, perhaps impossible, to be both sensitive and self-absorbed at the same time. The trick is to be able to be both, but at different times. If you want her to go down on you, for instance, ask her to. That's being assertive. But if she says no, accept the no with good grace and find out what else you two can do. If she never wants to stimulate you orally and that kind of stimulation is important to you, talk to her about it and see if something can be worked out. If she wants you to go down on her, listen to her request and do as she wants, say you don't feel like it now, or tell her what your objection is and work something out. If you want her to initiate more, you say so, but you also listen sympathetically if she tells you why this is difficult.

There can be times when sex is mainly for her and others when it's mainly for you. If it's for you, then get into your self-absorbed mode and get exactly what you want. If it's for her, then focus entirely on what she wants.

Of course there are other times when it's mainly for both of you. This requires some shifting back and forth. Perhaps you like to kiss her breasts quite hard but she likes that only, after some softer touching and kissing. So you could do it the way she wants until she's ready for you to do it your way. If she likes slow and gentle intercourse and you prefer it fast and furious, you could do it her way for a while, then your way. Or there can be occasions when intercourse is done her way, other times when it's done your way. Perhaps your favorite intercourse position is from the rear or with you on top. Your partner enjoys these positions but they are not her favorites. Nonetheless, she's happy to use them mainly for your pleasure. She adjusts herself to your pace and tries to give you everything you want. You should accept her gifts and make it as pleasurable as possible for yourself. Perhaps her favorite position is her on top. Now you should accommodate yourself to her rhythm and try to give her everything she wants.

We have already started on the self-centered side by determining your conditions. Now let's deal with how to get them met and how to be assertive in your communications. Sometimes I switch back and forth between the two poles of sexual happiness: assertiveness and sensitivity. I realize it's a bit of a balancing act (both for you as reader and me as writer, as well) for all of us in real life. But it is a balancing act that must be mastered if we are to have truly wonderful sex.

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6. Understanding, accepting, and appreciating sex differences.

Perhaps the main reason that being sensitive to your partner is difficult is that she is not only a separate and unique human being, and therefore in some respects not like you, but also because the two of you belong to different cultures.

Of course, one of the greatest attractions women have for us is that they are different. They are small where we are large, soft where we are hard, curvy where we are flat, and they have an orifice where we have a protrusion. But they differ from us in other ways as well, and these differences often drive us crazy, and does the same to them. Since the beginning of time, men and women have been exasperated and frustrated in trying to understand and deal with each other.

Men complain: Why are women so emotional and such nags? Why do they want to talk so much? Why are they so weird about sex? What in God's name do they want? Is there any way to satisfy them? From women come a different set of grievances: Why are men so withholding? Why are they so focused on sex and so unromantic? Why can't they remember a birthday or anniversary? From both men and women come the cry: "Why can't they be more like us!" The common phrase "the war of the sexes" indicates the strength of our feelings.

One could easily get the impression that men and women are totally different, as this man's statement implies: "If the first space visitor arrived from Mars, and was male, I'd have more in common with him than with any woman on Earth." In fact, because we are all humans, we are more similar than different. We all breathe air, sleep, eat, eliminate, use language, think, and feel. If it were possible to quantity everything, we would probably conclude that women and men are 90 percent similar. But it's that remaining 10 percent that causes all the trouble.

Even in something as fundamental as the use of language, there are differences between the typical man and the typical woman. Sex therapist Victor Barbieri sums it up this way: "Men and women use the same words but speak different languages." As Deborah Tannen demonstrated in her You Just Don't Understand, the definitions of even simple terms like talk and conversation depend heavily on whether you are a she or a he. And clearly men and women don't necessarily have the same things in mind when they use words such as relationship, love, sex, and intimacy.

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Girls and boys specialize in different areas. Boys learn to achieve and perform in the outside world, while girls get more practice dealing with feelings, communicating, and relating. In addition, males and females come to sex from different perspectives -- girls approaching via love and sensuality, boys more from lust and a desire to prove themselves. While men and women both want love and sex, they have separate styles of love and being sexual.

It is these separate styles that justify thinking of men and women as representing different cultures and that result in no end of misunderstandings, confusion, and conflicts. Here is a common example:

HE: "Everything between us was so tense after our spat on Sunday. I thought if we made love, things would get better."

SHE: "How can we make love? We haven't talked in days."

The differences between the sexes affect our perceptions and understandings of ourselves, our partners, and our relationships and can make us feel bad about all three. It helps enormously to understand and accept these differences. The more you understand and accept your male tendencies, the better and less guilty you'll feel. The more you understand that your partner is acting as she is not because she wants to thwart you, not because she's neurotic, and not necessarily because of anything you've done, but simply because this is the way women tend to be, the better you'll feel both about her and about yourself.

I now turn to some of the main differences between men and women that can lead to misunderstandings and conflicts. Please keep in mind that I do not believe and am not saying that one way is better than another. The point is to promote understanding, not to pass judgment. There are, of course, exceptions to every single item. But the existence of an exception, or even many of them, does not necessarily invalidate a rule.

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From "The New Male Sexuality" by Bernie Zilbergeld, PhD. Copyright © 1992 by Bernie Zilbergeld. Used by permission of Bantam Books, a division of Bantam Doubleday Dell Publishing Group, Inc.

next: The Secret to Good Sex in Marriage

Find out why Amitriptyline is prescribed, side effects of Amitriptyline, Amitriptyline warnings, effects of Amitriptyline during pregnancy, more - in plain English.

Amitriptyline (a mee trip' ti leen)hydrochloride

Amitriptyline full prescribing information

Why is Amitriptyline prescribed?

Amitriptyline is prescribed for the relief of symptoms of mental depression . It is a member of the group of drugs called tricyclic antidepressants. Some doctors also prescribe Amitriptyline to treat bulimia (an eating disorder), to control chronic pain, to prevent migraine headaches, and to treat a pathological weeping and laughing syndrome associated with multiple sclerosis.

Most important fact about Amitriptyline

You may need to take Amitriptyline regularly for several weeks before it becomes fully effective. Do not skip doses, even if they seem to make no difference or you feel you don't need them.

How should you take Amitriptyline?

Take Amitriptyline exactly as prescribed. You may experience side effects, such as mild drowsiness, early in therapy. However, they usually disappear after a few days. Beneficial effects may take as long as 30 days to appear.

Amitriptyline may cause dry mouth. Sucking a hard candy, chewing gum, or melting bits of ice in your mouth can provide relief.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time.

If you take a single daily dose at bedtime, do not make up for it in the morning. It may cause side effects during the day.

--Storage instructions...

Keep Amitriptyline in a tightly closed container. Store at room temperature. Protect from light and excessive heat.

What side effects may occur when taking Amitriptyline?

 

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Amitriptyline.

Older adults are especially liable to certain side effects of Amitriptyline, including rapid heartbeat, constipation, dry mouth, blurred vision, sedation, and confusion, and are in greater danger of sustaining a fall.

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• Side effects of Amitriptyline may include: Abnormal movements, anxiety, black tongue, blurred vision, breast development in males, breast enlargement, coma, confusion, constipation, delusions, diarrhea, difficult or frequent urination, difficulty in speech, dilation of pupils, disorientation, disturbed concentration, dizziness on getting up, dizziness or light-headedness, drowsiness, dry mouth, excessive or spontaneous flow of milk, excitement, fatigue, fluid retention, hair loss, hallucinations, headache, heart attack, hepatitis, high blood pressure, high fever, high or low blood sugar, hives, impotence, inability to sleep, increased or decreased sex drive, increased perspiration, increased pressure within the eye, inflammation of the mouth, intestinal obstruction, irregular heartbeat, lack or loss of coordination, loss of appetite, low blood pressure, nausea, nightmares, numbness, rapid and/or fast, fluttery heartbeat, rash, red or purple spots on skin, restlessness, ringing in the ears, seizures, sensitivity to light, stomach upset, strange taste, stroke, swelling due to fluid retention in the face and tongue, swelling of testicles, swollen glands, tingling and pins and needles in the arms and legs, tremors, vomiting, weakness, weight gain or loss, yellowed eyes and skin

• Side effects due to rapid decrease or abrupt withdrawal from Amitriptyline include: Headache, nausea, vague feeling of bodily discomfort

• Side effects due to gradual dosage reduction may include: Dream and sleep disturbances, irritability, restlessness These side effects do not signify an addiction to the drug.

Why should this drug not be prescribed?

If you are sensitive to or have ever had an allergic reaction to Amitriptyline or similar drugs such as Norpramin and Tofranil, you should not take this medication. Make sure your doctor is aware of any drug reactions you have experienced.

Do not take Amitriptyline while taking other drugs known as MAO inhibitors. Drugs in this category include the antidepressants Nardil and Parnate.

Unless you are directed to do so by your doctor, do not take this medication if you are recovering from a heart attack.

Special warnings about Amitriptyline

Do not stop taking Amitriptyline abruptly, especially if you have been taking large doses for a long time. Your doctor probably will want to decrease your dosage gradually. This will help prevent a possible relapse and will reduce the possibility of withdrawal symptoms.

Amitriptyline may make your skin more sensitive to sunlight. Try to stay out of the sun, wear protective clothing, and apply a sun block.

Amitriptyline may cause you to become drowsy or less alert; therefore, you should not drive or operate dangerous machinery or participate in any hazardous activity that requires full mental alertness until you know how this drug affects you.

While taking this medication, you may feel dizzy or light-headed or actually faint when getting up from a lying or sitting position. If getting up slowly doesn't help or if this problem continues, notify your doctor.

Use Amitriptyline with caution if you have ever had seizures, urinary retention, glaucoma or other chronic eye conditions, a heart or circulatory system disorder, or liver problems. Be cautious, too, if you are receiving thyroid medication. You should discuss all of your medical problems with your doctor before starting Amitriptyline therapy.

Before having surgery, dental treatment, or any diagnostic procedure, tell the doctor that you are taking Amitriptyline. Certain drugs used during surgery, such as anesthetics and muscle relaxants, and drugs used in certain diagnostic procedures may react badly with Amitriptyline.

Possible food and drug interactions when taking Amitriptyline

Amitriptyline may intensify the effects of alcohol. Do not drink alcohol while taking this medication.

If Amitriptyline is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important that you consult with your doctor before taking Amitriptyline in combination with the following:

Airway-opening drugs such as Sudafed and Proventil
Antidepressants that raise serotonin levels, such as Paxil, Prozac, and Zoloft
Other antidepressants, such as amoxapine
Antihistamines such as Benadryl and Tavist
Barbiturates such as phenobarbital
Certain blood pressure medicines such as Catapres
Cimetidine (Tagamet)
Disulfiram (Antabuse)
Drugs that control spasms, such as Bentyl and Donnatal
Estrogen drugs such as Premarin and oral contraceptives
Ethchlorvynol (Placidyl)
Major tranquilizers such as Mellaril and Thorazine
MAO inhibitors, such as Nardil and Parnate
Medications for irregular heartbeat, such as Tambocor and Rythmol
Painkillers such as Demerol and Percocet
Parkinsonism drugs such as Cogentin and Larodopa
Quinidine (Quinidex)
Seizure medications such as Tegretol and Dilantin
Sleep medicines such as Halcion and Dalmane
Thyroid hormones (Synthroid)
Tranquilizers such as Librium and Xanax
Warfarin (Coumadin)

Special information if you are pregnant or breastfeeding

The effects of Amitriptyline during pregnancy have not been adequately studied. If you are pregnant or planning to become pregnant, inform your doctor immediately. This medication appears in breast milk. If Amitriptyline is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment is finished.

Recommended dosage for Amitriptyline

ADULTS

The usual starting dosage is 75 milligrams per day divided into 2 or more smaller doses. Your doctor may gradually increase this dose to 150 milligrams per day. The total daily dose is generally never higher than 200 milligrams.

Alternatively, your doctor may want you to start with 50 milligrams to 100 milligrams at bedtime. He or she may increase this bedtime dose by 25 or 50 milligrams up to a total of 150 milligrams a day.

For long-term use, the usual dose ranges from 40 to 100 milligrams taken once daily, usually at bedtime.

CHILDREN

Use of Amitriptyline is not recommended for children under 12 years of age.

The usual dose for adolescents 12 years of age and over is 10 milligrams, 3 times a day, with 20 milligrams taken at bedtime.

OLDER ADULTS

The usual dose is 10 milligrams taken 3 times a day, with 20 milligrams taken at bedtime.

Overdosage

An overdose of Amitriptyline can prove fatal.

• Symptoms of Amitriptyline overdose may include: Abnormally low blood pressure, confusion, convulsions, dilated pupils and other eye problems, disturbed concentration, drowsiness, hallucinations, impaired heart function, rapid or irregular heartbeat, reduced body temperature, stupor, unresponsiveness or coma

• Symptoms contrary to the effect of this medication are: Agitation, extremely high body temperature, overactive reflexes, rigid muscles, vomiting

If you suspect an overdose, seek medical attention immediately.

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Amitriptyline full prescribing information

Detailed Info on Signs, Symptoms, Causes, Treatments of Depression

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Find out why Xanax is prescribed, side effects of Xanax, Xanax warnings, effects of Xanax during pregnancy, more - in plain English.

Generic name: Alprazolam
Other brand name: Xanax XR

Pronounced: ZAN-ax

Xanax (alprazolam) Full Prescribing Information

Why is Xanax prescribed?

Xanax is a tranquilizer used in the short-term relief of symptoms of anxiety or the treatment of anxiety disorders. Anxiety disorder is marked by unrealistic worry or excessive fears and concerns. Anxiety associated with depression is also responsive to Xanax.

Xanax and the extended-release formulation, Xanax XR, are also used in the treatment of panic disorder, which appears as unexpected panic attacks and may be accompanied by a fear of open or public places called agoraphobia. Only your doctor can diagnose panic disorder and best advise you about treatment.

Some doctors prescribe Xanax to treat alcohol withdrawal, fear of open spaces and strangers, depression, irritable bowel syndrome, and premenstrual syndrome.

Most important fact about Xanax

Tolerance and dependence can occur with the use of Xanax. You may experience withdrawal symptoms if you stop using Xanax abruptly. The drug dosage should be gradually reduced and only your doctor should advise you on how to discontinue or change your dose.

How should you take Xanax?

Xanax may be taken with or without food. Take it exactly as prescribed. Do not chew, crush, or break the Xanax XR tablets.

--If you miss a dose...

If you are less than 1 hour late, take it as soon as you remember. Otherwise skip the dose and go back to your regular schedule. Never take 2 doses at the same time.

--Storage instructions...

Store Xanax at room temperature.

What side effects may occur when using Xanax?

 

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Xanax. Your doctor should periodically reassess the need for this drug.

Side effects of Xanax are usually seen at the beginning of treatment and disappear with continued medication. However, if dosage is increased, side effects will be more likely.

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• More common side effects may include: Abdominal discomfort, abnormal involuntary movement, agitation, allergies, anxiety, blurred vision, chest pain, confusion, constipation, decreased or increased sex drive, depression, diarrhea, difficult urination, dream abnormalities, drowsiness, dry mouth, fainting, fatigue, fluid retention, headache, hyperventilation (too frequent or too deep breathing), inability to fall asleep, increase or decrease in appetite, increased or decreased salivation, impaired memory, irritability, lack of or decreased coordination, light-headedness, low blood pressure, menstrual problems, muscular twitching, nausea and vomiting, nervousness, painful menstruation, palpitations, rapid heartbeat, rash, restlessness, ringing in the ears, sedation, sexual dysfunction, skin inflammation, speech difficulties, stiffness, stuffy nose, sweating, tiredness/sleepiness, tremors, upper respiratory infections, weakness, weight gain or loss

• Less common or rare side effects may include: Abnormal muscle tone, arm or leg pain, concentration difficulties, dizziness, double vision, fear, hallucinations, hot flushes, inability to control urination or bowel movements, infection, itching, joint pain, loss of appetite, muscle cramps, muscle spasticity, rage, seizures, shortness of breath, sleep disturbances, slurred speech, stimulation, talkativeness, taste alterations, temporary memory loss, tingling or pins and needles, uninhibited behavior, urine retention, weakness in muscle and bone, yellow eyes and skin

• Side effects due to decrease or withdrawal from Xanax or Xanax XR: Anxiety, blurred vision, decreased concentration, decreased mental clarity, depression, diarrhea, headache, heightened awareness of noise or bright lights, hot flushes, impaired sense of smell, insomnia, loss of appetite, loss of reality, muscle cramps, nervousness, rapid breathing, seizures, tingling sensation, tremor, twitching, weight loss

Why should this drug not be prescribed?

If you are sensitive to or have ever had an allergic reaction to Xanax or other tranquilizers, you should not take this medication. Also avoid Xanax while taking the antifungal drugs Sporanox or Nizoral. Make sure that your doctor is aware of any drug reactions that you have experienced.

Do not take this medication if you have been diagnosed with the eye condition called narrow-angle glaucoma.

Anxiety or tension related to everyday stress usually does not require treatment with Xanax. Discuss your symptoms thoroughly with your doctor.

Special warnings about Xanax

Xanax may cause you to become drowsy or less alert; therefore, driving or operating dangerous machinery or participating in any hazardous activity that requires full mental alertness is not recommended.

If you are being treated for panic disorder, you may need to take a higher dose of Xanax than for anxiety alone. High doses--more than 4 milligrams a day--of this medication taken for long intervals may cause emotional and physical dependence. It is important that your doctor supervise you carefully when you are using this medication.

Remember that withdrawal symptoms can occur when Xanax is stopped suddenly or the doctor lowers your dosage. These include abnormal skin sensations, blurred vision, decreased appetite, diarrhea, distorted sense of smell, heightened senses, muscle cramps or twitching, problems concentrating, weight loss, and rarely, seizures. Withdrawal symptoms can be minimized or even avoided altogether by decreasing the Xanax dose gradually.

As with all antianxiety medication, there is a small chance that Xanax could encourage suicidal thoughts or episodes of euphoria known as mania. If you notice any new or unusual symptoms after starting Xanax, call your doctor immediately.

Xanax should be used with caution in elderly or weak patients, and in those with lung disease, alcoholic liver disease, or any disorder that could hinder the elimination of the drug.

Possible food and drug interactions when taking Xanax

Xanax may intensify the effect of alcohol. Do not drink alcohol while taking this medication.

Never combine Xanax with Sporanox or Nizoral. These drugs cause a buildup of Xanax in the body.

If Xanax is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is important to check with your doctor before combining Xanax with the following:

Amiodarone (Cordarone)
Antihistamines such as Benadryl and Tavist
Carbamazepine (Tegretol)
Certain antibiotics such as Biaxin and erythromycin
Certain antidepressant drugs, including Elavil, Norpramin, and Tofranil
Cimetidine (Tagamet)
Cyclosporine (Neoral, Sandimmune)
Digoxin (Lanoxin)
Diltiazem (Cardizem)
Disulfiram (Antabuse)
Ergotamine
Fluoxetine (Prozac)
Fluvoxamine (Luvox)
Grapefruit juice
Isoniazid (Rifamate)
Major tranquilizers such as Mellaril and Thorazine
Nefazodone (Serzone)
Nicardipine (Cardene)
Nifedipine (Adalat, Procardia)
Oral contraceptives
Other central nervous system depressants such as Valium and Demerol
Paroxetine (Paxil)
Propoxyphene (Darvon)
Sertraline (Zoloft)

Special information if you are pregnant or breastfeeding

Do not take this medication if you are pregnant or planning to become pregnant. There is an increased risk of respiratory problems and muscular weakness in your baby. Infants may also experience withdrawal symptoms. Xanax may appear in breast milk and could affect a nursing infant. If this medication is essential to your health, your doctor may advise you to stop breastfeeding until your treatment with this medication is finished.

Recommended dosage for Xanax

ADULTS

Anxiety disorder

The usual starting dose of Xanax is 0.25 to 0.5 milligram taken 3 times a day. The dose may be increased every 3 to 4 days to a maximum daily dose of 4 milligrams, divided into smaller doses.

Panic disorder

The usual starting dose of regular Xanax is 0.5 milligram 3 times a day. This dose can be increased by 1 milligram a day every 3 or 4 days. You may be given a dose from 1 up to a total of 10 milligrams, according to your needs. The typical dose is 5 to 6 milligrams a day.

If you're taking Xanax XR, the usual starting dose is 0.5 to 1 milligram once a day taken in the morning. Depending on your response, the dose may be gradually increased by no more than 1 milligram every 3 or 4 days. The usual effective dose is 3 to 6 milligrams a day. Some people may need a larger dose to relieve their symptoms. Others, including older adults and those with liver disease or other serious illnesses, may need to use lower doses.

Your doctor will reassess your treatment periodically to be sure you're getting the right amount of medication.

CHILDREN

Safety and effectiveness have not been established in children under 18 years of age.

OLDER ADULTS

The usual starting dose for an anxiety disorder is 0.25 milligram, 2 or 3 times daily. The starting dose of Xanax XR is 0.5 milligrams once a day. This dose may be gradually increased if needed and tolerated.

PATIENTS SWITCHING FROM XANAX TO XANAX XR

If you're taking divided doses of Xanax, the doctor will switch you to a once-daily dose of Xanax XR that equals the current amount you're taking. If your symptoms return after switching, the dose can be increased as needed.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

• Symptoms of Xanax overdose may include: Confusion, coma, impaired coordination, sleepiness, slowed reaction time An overdose of Xanax, alone or after combining it with alcohol, can be fatal.

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Xanax (alprazolam) Full Prescribing Information

Xanax Medication Guide

Detailed Info on Signs, Symptoms, Causes, Treatments of Anxiety Disorders

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Find out why Adderall XR is prescribed, side effects Adderall XR, Adderall XR warnings, effects of Adderall XR during pregnancy, more - in plain English.

Pronounced: ADD-ur-all
Generic ingredients: Amphetamines

Adderall XR (amphetamines) full prescribing information
Adderall Medication Guide

Adderall has a high potential for abuse and may be habit-forming if used for a long period of time. Use Adderall only as prescribed and do not share it with others. Abuse of Adderall may cause serious heart problems, blood vessel problems, or sudden death.

What is Adderall used for?:

Treating attention deficit hyperactivity disorder (ADHD) and narcolepsy (sudden and uncontrollable attacks of drowsiness and sleepiness). It may also be used for other conditions as determined by your doctor.

Adderall is an amphetamine. Exactly how it works is not known. Adderall affects certain chemicals in the brain that may affect attention span and behavior.

Do NOT use Adderall if:

• you are allergic to any ingredient in Adderall or to similar medicines
• you have severe hardening of the arteries; active heart or blood vessel disease; moderate, severe, or uncontrolled high blood pressure; an overactive thyroid; glaucoma; or agitation, anxiety, or tension
• you have serious heart problems (eg, heart defect, irregular heartbeat)
• you have a history of alcohol or other substance abuse
• you have taken furazolidone or a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) within the last 14 days
• you are taking guanethidine or guanadrel

Contact your doctor or health care provider right away if any of these apply to you.

Things to Cconsider before using Adderall:

Some medical conditions may interact with Adderall. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances

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• if you have a history of heart problems (eg, heart failure, fast or irregular heartbeat), heart defects, a recent heart attack, high blood pressure, hardening of the arteries, or blood vessel problems, or if a family member has a history of irregular heartbeat or sudden death
• if you have a history of liver or kidney problems, growth problems, thyroid problems, uncontrolled muscle movements (eg, tics), Tourette syndrome, anorexia, or the blood disease porphyria
• if you have a history of seizures or abnormal electroencephalograms (EEGs)
• if you have a history of mood or mental problems (eg, agitation, anxiety, bipolar disorder, depression, psychosis, tension), abnormal thoughts, hallucinations, suicidal thoughts or attempts, or alcohol or other substance abuse or dependence or if a family member has a history of any of these problems

Some MEDICINES MAY INTERACT with Adderall. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Furazolidone or MAOIs (eg, phenelzine) because side effects, such as increased blood pressure, headache, fever, and irregular heartbeat, may occur
• Alkalinizing agents (eg, antacids, sodium bicarbonate, acetazolamide), decongestants (eg, pseudoephedrine), propoxyphene, proton pump inhibitors (PPIs) (eg, lansoprazole, omeprazole), or sympathomimetic medicines (eg, albuterol) because they may increase the risk of Adderall's side effects
• Glutamic acid, haloperidol, lithium carbonate, phenothiazines (eg, chlorpromazine), PPIs (eg, lansoprazole, omeprazole), reserpine, urinary acidifiers (eg, methenamine, ammonium chloride), or vitamin C (ascorbic acid) because they may decrease Adderall's effectiveness
• Meperidine, norepinephrine, selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine), tramadol, or tricyclic antidepressants (eg, desipramine) because the risk of their side effects may be increased by Adderall
• Alpha-blockers (eg, prazosin), antihistamines (eg, diphenhydramine), beta-blockers (eg, metoprolol), ethosuximide, guanadrel, guanethidine, medicines for high blood pressure, phenobarbital, or phenytoin because their effectiveness may be decreased by Adderall

This may not be a complete list of all interactions that may occur. Ask your health care provider if Adderall may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Adderall:

Use Adderall as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Adderall comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Adderall refilled.
• Take Adderall by mouth with or without food.
• Take your last dose of the day 4 to 6 hours before bedtime unless your doctor tells you differently.
• Do not take antacids (eg, calcium carbonate) or certain alkalinizing agents (eg, sodium bicarbonate) with Adderall without first talking with your doctor. They may increase the risk of Adderall's side effects.
• If you miss a dose of Adderall, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Adderall.

Important Adderall safety information:

• Adderall may cause dizziness, drowsiness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Adderall with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• When used to treat ADHD, Adderall should be used as part of an ADHD treatment program that includes a variety of treatment measures (eg, psychological, educational, social).
• Certain foods and medicines can affect the amount of acid in your stomach and intestine. This can increase or decrease (depending on the medicine) the absorption of Adderall. Tell your doctor if you take any of these products: fruit juice, ascorbic acid (vitamin C), sodium bicarbonate, ammonium chloride, sodium acid phosphate, ulcer medicines (eg, H2 blockers such as famotidine and ranitidine, PPIs such as omeprazole and lansoprazole), antacids, methenamine, or acetazolamide.
• Serious effects, including a heart attack, stroke, and sudden death, have occurred with the use of stimulant medicines in patients with heart defects or other serious heart problems. If you have a heart defect or other serious problem, talk with your doctor about other therapies to treat your condition.
• Avoid large amounts of food or drink that have caffeine (eg, coffee, tea, cocoa, cola, chocolate).
• Before you start any new medicine, check the label to see if it has a decongestant in it. If it does or if you are not sure, check with your doctor or pharmacist.
• Do NOT take more than the recommended dose without checking with your doctor.
• Tell your doctor or dentist that you take Adderall before you receive any medical or dental care, emergency care, or surgery.
• Adderall may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Adderall. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
• Adderall may interfere with certain lab tests. Be sure your doctor and lab personnel know you are taking Adderall.
• Lab tests, including blood pressure, pulse, and heart function, may be performed while you use Adderall. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Adderall should not be used in CHILDREN younger than 3 years old; safety and effectiveness in these children have not been confirmed.
• Adderall may affect growth rate and weight gain in CHILDREN and teenagers in some cases. They may need regular growth and weight checks while they take Adderall.
• PREGNANCY and BREAST-FEEDING: Adderall may cause harm to the fetus. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of taking Adderall while you are pregnant. Adderall is found in breast milk. Do not breast-feed while taking Adderall.

When used for long periods of time or at high doses, Adderall may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as TOLERANCE. Talk with your doctor if Adderall stops working well. Do not take more than prescribed.

When used for longer than a few weeks or at high doses, some people develop a need to continue taking Adderall. This is known as DEPENDENCE or addiction.

Do not suddenly stop taking Adderall. If you do, you may have WITHDRAWAL symptoms. These may include feeling unwell or unhappy, anxious or irritable, dizzy, confused, or sluggish. You may also have nausea, unusual skin sensations, mood swings, headache, trouble sleeping, or sweating. If you need to stop Adderall, your doctor will lower your dose over time.

Possible side effects of Adderall:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; diarrhea; dizziness; dry mouth; headache; loss of appetite; nausea; nervousness; restlessness; stomach pain or upset; trouble sleeping; unpleasant taste; vomiting; weakness; weight loss.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision or other vision problems; change in sexual ability or desire; chest pain; confusion; fainting; fast or irregular heartbeat; fever, chills, or sore throat; new or worsening mental or mood problems (eg, aggression, agitation, anxiety, delusions, depression, hallucination, hostility); numbness or tingling of an arm or leg; one-sided weakness; painful or frequent urination; red, swollen, peeling, or blistered skin; seizures; severe or persistent headache; severe stomach pain; severe weight loss; shortness of breath; sudden, severe dizziness or vomiting; slurred speech; uncontrolled muscle movement; unusual weakness or tiredness.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include confusion; fast breathing; fever; hallucinations; irregular heartbeat; muscle pain or tenderness; seizures; severe mental or mood changes; severe or persistent headache or dizziness; severe restlessness.

Proper storage of Adderall:

Store Adderall at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, light, and moisture. Keep Adderall out of the reach of children and away from pets.

General information about Adderall:

• If you have any questions about Adderall, please talk with your doctor, pharmacist, or other health care provider.
• Adderall is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.
• Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Adderall. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: May 4, 2011

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Adderall XR (amphetamines) full prescribing information
Adderall Medication Guide

Detailed Info on Signs, Symptoms, Causes, Treatments of ADHD

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