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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by daizy on June 15, 2003, at 5:26:01
What exactly is this side effect? Could it explain why Im getting headaches in the sun? Is it safe to be in the sun when on TCA's? Any info would be much appreciated! Thanx
Posted by zeugma on June 15, 2003, at 9:08:49
In reply to TCA's Photosensitization?, posted by daizy on June 15, 2003, at 5:26:01
> What exactly is this side effect? Could it explain why Im getting headaches in the sun? Is it safe to be in the sun when on TCA's? Any info would be much appreciated! Thanx
I think it has to do with TCA-induced dryness of the skin and dehydration. If you put on sunscreen (PDF 15) and drink plenty of water, and spend only a reasonable amount of time in the sun you should be OK.
Posted by SLS on June 15, 2003, at 13:04:23
In reply to TCA's Photosensitization?, posted by daizy on June 15, 2003, at 5:26:01
> What exactly is this side effect? Could it explain why Im getting headaches in the sun? Is it safe to be in the sun when on TCA's? Any info would be much appreciated! Thanx
Hi.Photosensitization occurs when a substance (drug) contained within the body reacts to sunlight (ultraviolet) to produce a chemical reaction. It often takes the form of an exaggerated sunburn, but can also produce other types of skin eruptions and allergic responses. Photophobia, on the other hand, is an increased visual sensitivity to bright light. Headaches can accompany either of these conditions.
I've been out in the sun often while taking TCAs without any problems. I'm just more careful to limit my exposure to the sun.
- Scott
Posted by daizy on June 15, 2003, at 13:13:36
In reply to TCA's Photosensitization?, posted by daizy on June 15, 2003, at 5:26:01
Thanks for clearing that up for me! ;-)
Posted by Sunnely on June 15, 2003, at 14:21:06
In reply to TCA's Photosensitization?, posted by daizy on June 15, 2003, at 5:26:01
I think you also meant photosensitivity. Patients who are on psychotropic medications especially antipsychotics and antidepressants are at risk for photosensitivity reactions. These are lesions usually confined to light-exposed areas and are most often sunburn-like with redness. Patients who are on psychotropoic meds should be aware of this side effect. Protective clothing, as well as use of sunscreen with a maximum sunblock rating, is recommended. Patients who have increased sensitivity to light should limit their exposure, regardless of which antipsychotic or antidepressant they are receiving. BTW, the herbal preparation commonly taken for depression, St. John's wort also increases risk to photosensitivity reactions.
In addition to photosensivity reactions, people on psychotropic medications (and certain nonpsychotropic meds) are also at risk for other heat-related illnesses during very hot and humid weather. These conditions include 1) Heat cramps, 2) Heat fainting, 3) Heat exhaustion, and 4) the most serious and potentially deadly Heatstroke. The summer fast approaching, here are some tips to Beat The Heat.
WAYS TO BEAT THE HEAT:DID YOU KNOW...
1) During the 1995 heat wave, at least 465 heat-related deaths were reported in the Chicago area, an increase of 85% over the incidence recorded in 1994. There were at least 91 people died of heat-related illnesses in Wisconsin, the highest annual number attributed to this cause since 1936.
2) Between 1936 and 1975, nearly 20,000 people succumbed to the effects of heat and solar radiation.
3) In a normal year, 175 Americans die from extreme heat.
4) U.S. heat-related deaths: 1995 - 1,021; 1996 - 36; 1997 - 81; 1980 - 1,700.
5) Because men sweat more than women, men are more susceptible to heat illness because they become more quickly dehydrated.
6) People living in urban areas may be at a greater risk from the effects of a prolonged heat wave than people living in rural regions. An increased in health problem can occur when stagnant atmospheric conditions trap pollutants in urban areas, thus adding contaminated air to excessively hot temperatures.
7) A heat wave is defined by the National Weather Service (NSW) as 3 or more consecutive days of temperatures at or above 90 F.
8) All heat related illnesses can be prevented. Being in an air-conditioned area is the best way to prevent health-related deaths.
COMMON HEAT-RELATED ILLNESSES:
1) Heat CRAMPS: Caused by dehydration and loss of salt during strenuous activities due to profuse sweating. Symptoms include: a) Muscle pain, b) Heavy sweating, c) Lightheadedness, d) Weakness, e) Normal body temperature in most cases. Treatment: a) Rest in a cool, shaded area, b) Drink fluids, c) Adequate stretching and intake of water before exercise and intake of a drink containing sodium and glucose during workouts often prevent the problem.
2) HEAT FAINTING (Syncope): Dizziness or fainting after exposure to high temperatures is caused by pooling of blood in the heat-dilated vessels of the lower extremities leading to decreased blood flow to the brain. This is usually seen in persons unaccustomed to extreme heat and is less likely to occur once the person is acclimatized. It usually happens when standing for a long time in a hot environment (e.g., soldier on the parade groun). It is considered the mild form of heat exhaustion. Symptoms: a) Dizziness, b) Sudden weakness, c) Fainting. Treatment: a) Lie down, b) Drink fluids, c) Rest a few hours.
3) HEAT EXHAUSTION: This condition results from excessive loss of body water or electrolytes or both. The blood vessels dilate to try to cool the body and compensate for lost of fluids. The body enters a condition like shock when the blood supply to the brain and vital organs is decreased. This condition requires immediate attention. It can potentially lead to heatstroke. Symptoms: a) Weakness, b) Los blood pressure, c) Enlarged pupils, d) Headaches, e) Profuse sweating, f) Cold, clammy pale skin, g) Nausea and vomiting, h) Muscle cramps, h) Irrational behavior, i) Fainting, j) Normal body temperature. Treatment: a) Lie down in a cool, shaded area with feet elevated, b) Drink fluids containing salt (if conscious), c) Call an ambulance (risk of heatstroke).
4) HEATSTROKE: This condition is caused when the body's temperature-regulating system breaks down - the victim CAN'T SWEAT. Internal body temperature often rises as high as 108 F, which can cause irreversible brain damage or death. This condition is also known as "sunstroke." It is the least common, but most dangerous, heat-related illness. It can happen within 10-15 minutes of the first symptoms. The mortality rate ranges from 10% to 75%, but averages 25%. It is a MEDICAL EMERGENCY. Types of heatstroke: a) Exertional - an acute onset in healthy, young adults involved in intense physical activity in environment with high ambient temperatures and high humidity. b) Classic - seen in the elderly and very young and occurs during heat waves. Symptoms: a) Body temperature usually over 104 F, b) DRY or HOT, red skin, c) Small pupils, d) Rapid, weak pulse, e) Rapid, shallow breathing, f) Extreme confusion, f) Weakness, g) Dark urine, h) Seizures, i) Unconsciousness. Treatment: a) Call paramedics, b) Move the person into the shade, a cool room or an air-conditioned area, c) Remove clothing and immerse the person in cold water, or pour cold water over the person's body, d) Place ice wrapped in a cloth on neck, groin and armpits. If a fan is available, use it to blow air across the person.
PEOPLE AT RISK FOR HEAT-RELATED ILLNESSES:
1) Older people
2) Infants and young children
3) People with disabilities
4) Users of some medications for the following conditions: a) Mental disorders (antipsychotic drugs), b) Movement disorders (antiparkinsonian and anticholinergic drugs), c) Depression (antidepressants), d) Allergies (antihistamines), e) Heart or circulatory problems (e.g., digitalis, blood-pressure lowering drugs, diuretics), f) Diabetes, g) Thyroid condition, h) Sleeping aids, alcohol and illicit drugs interfere with the body's natural cooling mechanisms, i) People who use cocaine, amphetamines, and "Ecstacy" (MDMA), j) People with chronic heart or lung problems, diabetes mellitus, hyperthyroidism, parkinsonism, burn scarring, scleroderma, and malignancy, k) People who are overweight, l) People who work outdoors or in hot settings, m) Isolated people who won't know when or how to cool off or call for help.
KNOW THE "HEAT INDEX" IN YOUR AREA:
"Heat Index" (HI) is a value resulting from the combined effects of the actual air temperature and relative humidity to give the "apparent temperature" and to predict health effects. It is similar to the "Wind Chill Factor" in winter. The HI is an accurate measure of how hot it really feels. As the temperature and humidity increase, the more summer "apparently" seems to sizzle!
Possible heat disorders for people in higher Heat Index (HI) risk groups: 1) A HI between 80-90 F - VERY WARM: Fatigue possible with prolonged exposure and/or physical activity. 2) A HI between 90-105 F - HOT: Heatstroke, heat cramps and heat exhaustion are possible with prolonged exposure and/or physical activity. 3) A HI between 105-130 F - VERY HOT: Heatstroke, heat cramps and heat exhaustion are likely. Heatstroke possible with prolonged exposure and/or physical acitivity. 4) A HI between 130 F and higher - EXTREMELY HOT: Heatstroke highly likely with continued exposure.
WHAT TO DO BEFORE A HEAT WAVE OCCURS:
1) Hook up with help. Isolated elderly or disabled persons can enroll in their local Severe Weather Registry.
2) Follow weather reports. Keep cool whenever temperatures reach the 90s. Watch for the "Heat Index".
3) Plan in advance to keep cool. a) Do your windows open if needed? b) Do you have drapes or blinds to keep direct sun out of your home? c) Is there a room with an air-conditioner, or a nearby place you can cool off? d) Who can you call for help or health questions, and who will check in on you if you need it?
TOP TEN WAYS TO BEAT THE HEAT:
1) Keep YOUR LIVING SPACE COOL! a) Cover windows to keep direct sun out, b) Keep curtains, shades, or blinds drawn during the hottest part of the day, c) If you don't have an air-conditioner, open windows to let air circulate, d) Spend a few hours at a mall, cinema, restaurant or neighbor's house with air-conditioner, e) When it is hotter than 95 F, use fans to blow hot air out of the window, rather than to blow hot air on your body, f) Basements or ground floors are often cooler than upper floors.
2) NEVER LEAVE CHILDREN, DISABLED PERSONS OR PETS IN A CAR - EVEN BRIEFLY! Temperature in a car can become life-threatening within minutes. Cracking the windows to let air in does not protect kids from hyperthermia. In summer 1999, one child every 4 days died after being trapped in a parked car in the parching heat. AND PETS, TOO! Watch for signs of heatstroke such as rapid panting, hot skin, twitching muscles, a dazed look. Wrap them in a towel soaked with cool, not cold, water. In severe cases, place them in the bathtub. Heatstroke can be fatal so see your veterinarian as soon as possible.
3) SLOW DOWN! Limit physical activity. It causes the body to produce more heat than it can give off. Plan outings or exertion for the coolest parts of the day (early morning or after dark). If your heat is pounding, you are breathing hard or you feel nauseated, STOP all activity and get to a cool place.
4) DRINK PLENTY! EAT LIGHTLY! Your body needs plenty of water or juice. Drink 10 glasses of water or decaffeniated beverages a day, or 16-32 ounces every hour if working outdoors. Avoid caffeine and alcohol. They cause the body to lose water more quickly. Don't wait until you begin to feel thirsty. By that time, you already might have lost up to 3% of your body's reserves, an amount that is hard to make up. Avoid hot or heavy meals. Foods (like proteins) that increase metabolic heat production also increases water loss.
5) INFANTS... Should drink breast milk or formula to get the right balance of water, salts and energy. Don't dilute formula beyond what the instructions say unless instructed by your doctor.
6) WEAR... Lightweight, loose-fitting, light-colored clothes. Add a hat or umbrella to keep your head cool. Don't forget sunscreen.
7) EASY WAYS TO COOL OFF. a) A cool (not cold) bath or shower works faster than an air conditioner, b) A trip to an air-conditioned lobby or the basement, c) A cold wet rag applied to neck, head and limbs.
8) DON'T STOP MEDICINES... Unless your doctor says so. Ask your doctor or pharmacist for any special heat advice.
9) SCHEDULE OUTDOOR ACTIVITIES CAREFULLY. Plan outdoor activities for either before noon or in the evening. While outdoors, rest frequently in a shady area.
10) CHECK ON EACH OTHER. When working in the heat, monitor the condition of your co-workers and have someone do the same for you. Heat-induced illness can cause a person to become confused or lose consciousness. If you are 65 years of age or older or have a chronic health problem, ask a friend, relative or neighbor to check on you at least twice a day during a heat wave.
GET COOL OR GET HELP NOW IF YOU FEEL... 1) Dizziness, 2) Nausea or vomiting, 3) Headache, 4) Weakness, 5) Muscle cramps.
GET HELP BY CALLING:
Emergency 9-1-1 for these symptoms: a) Hot, dry skin, b) Chest pain, c) Confusion, d) Shortness of breath, e) Unconsciousness.
HAVE A SAFE AND ENJOYABLE SUMMER!
Posted by avid abulia on June 15, 2003, at 16:04:44
In reply to TCA's Photosensitization? Ways to Beat The Heat!, posted by Sunnely on June 15, 2003, at 14:21:06
just a few days ago, i had extreme heat exhaustion, and, like you said, irrational behavior... after drinking a litre of gatorade mixed with a litre of water, i walked a quarter mile to the ER and by the time i got there i had progressed to heat stroke and could no longer remember my name and was so out of it the doctor thought i was on speed and ordered an injection of haldol and ativan. lucky for me, a nurse knew what was going on even if the doctor didn`t and said he was going to put in a TKO line, shot the ativan into me and the haldol into the air when the doc wasn`t looking, and proceeded to let my body draw up 2 litres of physiological saline before i was pronounced okay again. it pays to have friends who are nurses, sometimes.
~AA
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Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
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