Stimulant dependents, medical treatment

Nausea is a common early side effect of all SSRIs. Early nausea is probably attributable to the stimulation of serotonin type 3 (5-HT3) receptors in the gastrointestinal tract, which downregulate after several weeks of treatment. Hence this side effect is both dose dependent and transient. Some patients report less nausea if they take the medication with food. Although rarely needed, medication that blocks the 5-HT3 receptor (e.g., ondansetron) can be used to reduce SSRI-induced nausea. 

Modafinil is a stimulant medication used to improve wakefulness in patients with narcolepsy, obstructive sleep apnea/hypopnea syndrome (as adjunct to standard treatments for the underlying disorder), and shift work sleep disorder. Controlled and open trials provided data on the efficacy and safety of modafinil in patients with narcolepsy (Besset et al. 1996 Billiard et al. 1994 Broughton et al. 1997 Mitler et al. 2000 U.S. Modafinil in Narcolepsy Multicenter Study Group 1998, 2000). Modafinil has a long duration of action and low potential for dependence and may be a reasonable first choice in the treatment of mild to moderate narcolepsy (Silber 2001). There is also considerable interest in the potential use of modafinil in the treatment of ADHD, and studies are in progress. 

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Prior to the use of wakefulness-promoting agents, and in some pediatric patients, maintenance of wakefulness is dependent on stimulant medications and antidepressants. The safety of such medications during reproductive years and the risk of driving accidents without medication are typically handled during discussions between the prescribing practitioner and the patient. Irritability, anxiety, and erectile or ejaculatory dysfunction have been reported with these medications (78). The costs of newly approved medications for the treatment of narcolepsy,... 

My interest in the influence of diet on hormone-dependent cancers was first stimulated about 20 years ago by studies carried out in collaboration with colleagues at the Collip Medical Research Laboratory of the University of Western Ontario. They were involved in studies on the role of hormones in mammary cancer and for this purpose were inducing tumors in rats with 7,12-dimethylbenz(oi)-anthracene (DMBA) as described by Huggins et al ( 1). They were concerned to know whether hormonal treatment might affect tumorigenesis by altering the degree and time of exposure of mammary... 

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