Living with depression or anxiety is not easy. Those who live with it would know that the most common medication prescribed are serotonin reuptake inhibitor or SSRI. However, at times when their depression and anxiety cannot be treated with those, it may be the time to switch to serotonin-norepinephrine reuptake inhibitor (SNRI). This is a common strategy that follows the medical treatment of prolonged mental health illness, but under doctor's supervision, of course.

While both takes care of mood management, the kinds may be different, especially in terms of how it approaches. What is more helpful is to be aware of these variation, so it can be a seamless transition.

So, why is there a need to make a switch in the first place?

About two-thirds of people with major depression, according to research, do not react well to their initial antidepressant and frequently need to switch within a few weeks without seeing any noticeable improvement. The doctor you are see may suggest you to switch from SSRI to SNRI.

While SNRIs enhance both serotonin and norepinephrine levels, as the name also suggests, SSRIs, only primarily raise serotonin. What is norepinephrine, if one asks? They regulate energy levels, stress responses and alertness. This dual action can result in additional benefits like increased energy, reduced chronic pain, and many more. There are studies that also suggests that because SNRIs influence dopamine, they could be a faster solution to depression.

The following are the main causes of SSRI to SNRI switching:

Incomplete Symptom Relief: If an SSRI has not been effective in lowering symptoms of anxiety or depression, an SNRI may have a more balanced impact by concentrating on both the serotonin and norepinephrine channels.

Coexisting Symptoms: An SNRI may be more helpful if you're also dealing with chronic pain, fatigue, or low energy because it tackles mood in addition to these other problems.

Side Effects: Weight gain and sexual dysfunction are two adverse effects of SSRIs that some people find difficult to manage. Without these issues, SNRIs may have similar mood-enhancing effects.

Switching Strategies

When switching antidepressants, careful preparation is required to lower the risk of drug interactions and withdrawal symptoms. The main techniques for switching are as follows:

Conservative Approach: Weaning off the SSRI gradually and allowing the medication to leave the body over time—typically five half-lives—is the conservative approach. It may take longer and necessitate a time of no treatment, even though it is the safest approach.

Moderate Approach: By reducing the washout time to about two days, this strategy finds a balance between safety and convenience.

Direct Switch: In some circumstances, the SNRI is started the next day after the SSRI is terminated. This method is quicker, but there is a higher risk of withdrawal symptoms and drug interactions.

Cross-Tapering: This tactic entails introducing the SNRI at a low dose while progressively lowering the SSRI dosage. After the SSRI is reduced, the SNRI dosage is gradually raised. This approach facilitates a more seamless transition and lessens withdrawal symptoms.

Risks and Side Effects

When switching from an SSRI to an SNRI, it's important to take into account the potential risks and side effects:

SSRI Withdrawal: If SSRIs are tapered off too soon, side effects might include flu-like symptoms, nausea, irritability, and disorientation. These side effects may worsen if the medication was taken for an extended period of time.

SNRI Onset: Starting an SNRI too soon may cause headaches, nausea, and dizziness. It is often necessary to raise the dosage gradually to help the body acclimatize.

Serotonin Syndrome: When using SSRIs and SNRIs combined during a medication switch, serotonin syndrome may occur since both medications increase serotonin levels. Symptoms that require immediate medical attention include fever, agitation, a rapid heartbeat, high blood pressure, and confusion.

Mood Shifts: During the shift, some people may experience mood swings, increased anxiety, or worsening depression, however this isn't always the case.

Increased Blood Pressure: When taken in larger doses, SNRIs, notably venlafaxine, have the potential to raise blood pressure. This may worry people who already have high blood pressure or are at risk.

Drug Interactions: SNRIs and SSRIs may interact with one another to increase their negative effects or decrease their effectiveness. It is important to consider any other medications you may be taking, especially ones that affect serotonin or blood pressure. Some SNRIs, such desvenlafaxine, have less interactions due to their simpler metabolic profiles.

In Louisiana, two more people have died after eating oysters contaminated with the flesh-eating bacteria, Vibrio vulnificus. This brings the total number of deaths from the bacteria to six so far this year. With 14 more people infected, the total number of cases in the state has reached 34, marking the highest rate of infection in a decade.

What Is Brain-Eating Bacteria/ Vibrio vulnificus?

Vibrio vulnificus is the most dangerous type of this bacteria. It causes about 200 illnesses each year, and as many as one in five of those infections are fatal—a much higher rate than other types of Vibrio. Vibrio bacteria live naturally in coastal waters, and people can get infected in two main ways:

Eating contaminated seafood

The most common way to get sick is by eating raw or undercooked shellfish, especially oysters. Oysters feed by filtering water, which can cause the Vibrio bacteria to build up inside them.

Wounds in water

The bacteria can enter the body through an open wound, such as a recent cut, scrape, piercing, or tattoo, when a person is in coastal water.

What Has Caused The Increase In Vibrio Bacteria?

Doctors and experts say that Vibrio vulnificus is becoming a yearly threat along the Gulf Coast and is now appearing further north along the Eastern Seaboard. Scientists believe that climate change is helping the bacteria spread as coastal waters get warmer. A recent study found that the northernmost cases are moving about 30 miles farther north each year.

A 2023 review published in the Microbiology Insights journal explained that as our oceans get warmer, a rare but dangerous "flesh-eating" bacterium called Vibrio vulnificus is becoming more common. This bacterium is now moving along the U.S. East Coast. It can cause serious infections that lead to limb amputations or even death within a day or two.

The bacteria can cause a severe infection called necrotizing fasciitis, which is when the flesh around an open wound starts to die. In July 2023, North Carolina reported three deaths from the infection after people with open wounds came into contact with coastal water. The state is now warning residents to be careful, especially during the warmer months.

Vibrio vulnificus thrives in warm, salty water. It can be found in sea animals and is often linked to eating raw or uncooked seafood, particularly oysters. The infection is also easily transmitted through small cuts or scrapes when a person is in seawater.

The symptoms of a Vibrio infection can be severe. In serious cases, a person may need multiple surgeries to remove dead or infected tissue, and sometimes even an amputation. These severe cases are most often seen in elderly people, those with weakened immune systems, or people with liver disease or diabetes.

Are People With Certain Diseases More At Risk?

The infection typically starts with a sudden fever and chills, followed by skin sores, usually on the legs or torso. In severe cases, it can lead to death very quickly. People with certain health conditions are at a much higher risk for serious infections, including those with:

• Diabetes
• Liver problems
• Kidney disease
• Weakened immune systems
• Those 65 and older

How Can You Protect Yourself?

According to the Center of Disease Control and Prevention, treating the infection requires antibiotics and sometimes aggressive surgery to remove dead tissue. In some cases, limb amputation is necessary. The best way to prevent the infection is to take a few simple steps:

• Do not eat raw or undercooked shellfish, like oysters.
• Avoid contact with warm seawater or brackish water if you have any open wounds.
• Wear protective clothing when handling raw shellfish.
• Cook shellfish thoroughly before eating it.

In South Korea, AI companion robots are being given to elderly people who live alone. These robots, called Hyodol, act as a comforting presence and a helpful tool for overworked eldercare staff. For seniors who lives alone in Seoul, the robot becomes like most treasured companion, a "lovely granddaughter" she talks to affectionately.

How Does AI Robots Transform Elderly Care

According to Taylor & Francis Online 2024 study, the Hyodol robot, a plush doll with built-in AI, is designed to keep seniors company in a nation where many older adults are deeply lonely. It Hyodol acts as a companion, offering services like religious chants, quizzes to help with memory, and daily reminders to take medicine. Media reports show that the Guro municipality in Seoul has given out over 400 of these robots, and more than 12,000 are in use across the country.

Eldercare workers say the robots have become their "eyes and ears," helping them monitor clients between visits. While the robots add to their workload with maintenance, workers feel it's worth it because of the comfort they bring. The bots provide a constant presence and someone to talk to, which can help ease feelings of loneliness and depression.

How Do Humans Bond With Bots?

Older adults often form strong connections with their Hyodols. They care for the dolls as if they were real grandchildren, feeding them pretend meals and dressing them in special outfits. Some people have even asked to be buried with their robots. Based on research at welfare centers and in seniors' homes, it shows that the robots create a "robotic multi-care network." This network includes the robots themselves, their monitoring system, elderly users, caregivers, company staff, and family members.

Instead of replacing human caregivers, the robots change how care work is done. They shift and share tasks, creating different kinds of care practices—some are hands-on, some are digital, some are close by, and some are done from a distance.

There are also ethical issues. Some seniors may become more isolated, staying home because they have a companion greeting them at the door. For those with dementia, the robots' words can be taken too literally. For example, after her Hyodol mentioned a stream, one elderly woman with dementia walked to a creek alone with her robot. The company has since removed phrases that could be misinterpreted.

Will AI Become New Age Care For Elderly?

Within this network, elderly users have found different ways to connect with the robot. Some see Hyodol as a "grandchild" and treat it with affection, while others view it as a way to stay in touch with their caregivers. The 2024 study shows that while the robots don't replace human caregivers, they do change and redistribute the work, proving to be a valuable addition to the eldercare system.

South Korea is facing a shortage of care workers, and the Hyodol program is a way to fill this gap. The robots are a much cheaper alternative to hiring more staff. While they can't replace human care, they act as a "central node" that connects people. The robots handle the first layer of oversight, alerting social workers when there's an issue.

The program has led to heartwarming moments, like a fashion show where seniors and their robots wore matching outfits. For many, the robot is not just a device, but a cherished friend. As one elderly woman said, after receiving her Hyodol, she no longer wanted to die.

When the music begins, Lidia Beltran, a Parkinson's disease patient, let's go of her physical struggles. Holding onto her therapist, she moves with grace and precision. This is part of a special program in Buenos Aires that uses tango to help people with Parkinson's. For over 15 years, around 200 patients have participated in these workshops to see how dancing affects their symptoms.

Parkinson’s is an age-related degenerative brain condition that causes parts of your braint to deteriorate. It weakens the nerve cells in some parts of your brain and causes it to become damaged. Which means things like maintaining your posture, cramped or small handwriting etc.

How Tango Can Help Parkinson’s Diseases

Media reports explain a neurologist Nelida Garretto says that a big problem for people with Parkinson's is trouble walking. She explains that since tango is a walking dance, it helps patients practice important movements like starting and stopping.

Other experts note that the results have been very good. Many patients find ways to manage their symptoms, like the sudden "freezing" that makes their feet feel stuck. One patient found that doing a "figure eight" with her feet could help her get out of a freeze. According to Arakaki, dancing creates a "sensory pathway" in the brain that helps with walking

While medication is a necessary part of Parkinson's treatment, tango acts as a form of physical therapy. Arakaki believes that music and dance help people move past difficult physical moments.

Lidia Beltran, 66, was diagnosed with Parkinson's two years ago and had never danced tango before. She joined the program on her doctor's advice, hoping it would slow the disease's progression. Beyond the physical improvements, the dance workshop also helps with the social isolation and sadness that often come with the disease. Beltran says that dancing boosts her stability and her mood. She feels that after dancing, she will have a better day.

How Does Dance Help With Parkinson’s

According to a 2024 study published in the Scientific Reports, while medications for Parkinson's disease (PD) can help with many movement issues, they don't always address other symptoms, like thinking problems or balance issues. Because of this, doctors are looking for other treatments to use alongside medication.

In a new study, researchers looked at two different types of activities to see if they could help with Parkinson's symptoms: Argentine tango and physical therapy.

Specialists say tango is effective because it is more than just a dance; it requires the brain to do many things at once. Dancers must:

• Walk in a specific way.
• Keep up with the music's rhythm.
• Respond to their partner's movements.

The 2024 study followed 24 patients with Parkinson's over four months. Half of them took part in tango classes twice a week, and the other half had group physical therapy twice a week. Both groups were tested before and after to see how their symptoms had changed.

Improved Balance and Motor Skills

Both groups saw similar improvements in their motor skills, especially with balance, both when standing still and when moving. The physical activities helped stabilize their overall abilities and slow down the disease's progression.

Better Thinking Skills

Both groups also improved on a test that measures "action naming," which is a type of cognitive skill.

Tango's Unique Benefit

The most interesting finding was that only the tango group showed a significant improvement in recognizing emotions on people's faces. This suggests that tango might help with certain social and emotional skills in a way that regular physical therapy does not.