Brain And Nervous System

Disorders of the brain and nervous system can manifest themselves as illnesses with predominant physical impairments (for example: epilepsy, strokes) or as illnesses with predominant mental and emotional impairments (for example: schizophrenia or depression).

These illnesses can result from different types of disorders of the brain and nervous system. Death of neurons resulting from poor circulation can be the cause of paralysis; electrical disturbances of certain brain neurons produce the seizures or epilepsy. Temporary changes to blood circulation within and around the brain are thought to be the principal cause of migraine headaches. The exact brain disorder causing mental and emotional impairments such as schizophrenia or depression is not known. Nevertheless, scientific evidence indicates that a malfunction of neurons and neurotransmitters might be implicated. For example, there might be too much or too little neurotransmitter in a brain region or the neurons might be underactive, overactive, or poorly coordinated.

Analgesics

Analgesics are medicaments that relieve pain. For many disorders, the relief of pain is one of the most important aspects of treatment. Since pain is not a disease but a symptom, long-term relief depends on treatment of the underlying cause. For example, the pain of toothache can be relieved by medicaments but can only be cured by appropriate dental treatment.

Damage to body tissue as a result of disease or injury is detected by nerve endings that transmit signals to the brain, where they are interpreted. The interpretation of these sensations can be affected by the psychological state of the individual, so that pain is worsened by anxiety and fear, for example. Often a reassuring explanation of the cause of discomfort can make pain easier to bear. Because of these psychological factors, sleeping medicaments, anti-anxiety medicaments, or antidepressants are sometimes prescribed in addition to, or instead of, analgesics, particularly in pain requiring many months of treatment.

Narcotics and non-narcotics are the two principal types of analgesics. Also, local anesthetics are commonly used to relieve pain. Narcotics such as morphine are the most powerful analgesics but cause drowsiness. Non-narcotic medicaments include ASA, acetaminophen, and non-steroidal anti-inflammatory medicaments (NSAIDs) and may provide adequate pain relief without drowsiness.

Narcotics act directly on the brain and spinal cord to alter the perception of pain. They thus act like the endorphins, hormones naturally produced in the brain that stop the cell-to-cell transmission of pain sensation. Non-narcotics prevent stimulation of the nerve endings at the site of the pain.

When pain is treated under medical supervision, it is common to start with a non-narcotic, and if this provides inadequate relief, to change to a combination medicament (a mixture of a mild narcotic and a non-narcotic). A strong narcotic may be used if the less powerful medicaments are ineffective. More severe (e.g., postoperative) or long-lasting continuous pain may be treated by injections of narcotics. When treating pain with an over-the-counter preparation, for example, taking ASA for a headache, you should seek medical advice if pain persists for longer than 48 hours, recurs, or is worse or different from previous pain.

Sleeping medicaments

Difficulty in getting to sleep or staying asleep (insomnia) has many causes. Most people suffer from sleepless nights from time to time, usually as a result of a temporary worry or discomfort from a minor illness. Persistent sleeplessness can be caused by psychological problems including anxiety or depression, or by pain and discomfort arising from a physical disorder.

Most sleeping medicaments promote sleep by depressing brain function. They interfere with chemical activity in the brain and nervous system by reducing communication between nerve cells. This leads to a reduction in brain activity, allowing you to fall asleep more easily.

A sleeping medicament rapidly produces drowsiness and slowed reactions. Some people find that the medicament makes them appear to be drunk and slurs their speech, especially if they delay going to bed after taking their dose. Most people find they usually fall asleep within one hour of taking the medicament.

Because the sleep induced by medicaments is not the same as normal sleep, many people find they do not feel as well rested by it as by a night of natural sleep. This is the result of suppressed brain activity. Sleeping medicaments also suppress the sleep during which dreams occur, and both dream sleep and non-dream sleep are essential components for a good night's sleep.

Some people experience a variety of "hangover" effects the following day. The benzodiazepines may produce minor side effects, such as daytime drowsiness, dizziness, and unsteadiness, that can impair the ability to drive or operate dangerous machinery. Elderly people are especially likely to become confused; for them, selection of an appropriate medicament is particularly important.

Most sleeping medicaments can produce psychological and physical dependence when taken regularly for more than a few weeks, especially if taken in larger-than-normal doses. If they are withdrawn abruptly, sleeplessness, anxiety, seizures, and hallucinations can arise. Nightmares and vivid dreams may occur because the amount of time spent in dream sleep increases. Anyone who has been using sleeping medicaments regularly for a long time and wishes to stop taking them should seek his or her physician's advice on how to reduce dosage gradually so as to avoid withdrawal symptoms.

One of the risks of taking sleeping medicaments for a prolonged period is that there may be a temptation to exceed the prescribed dose, especially if the person has been taking them for some weeks and their effect has diminished. While it is inadvisable to take more than the prescribed dose of any medicament, overdose can be a particular risk with the barbiturates.

Anti-anxiety medicaments

Anxiety can be a normal reaction to real dangers or to stressful periods of everyday life. It can be beneficial, providing a stimulus to cope with challenges. However, some individuals can chronically experience moderate to severe anxiety when there is no real danger or stressful situation. Their excessive anxiety is often accompanied by an overactivity of the sympathetic nervous system manifested by physical symptoms: shaking, palpitations, breathlessness, sweating, and digestive distress. Some individuals may also experience sudden attacks of anxiety, fear, or panic, accompanied by these physical symptoms. These attacks are called panic attacks.

It is thought that the benzodiazepines depress activity in the part of the brain that controls emotion, by promoting the action of a chemical called gammaaminobutyric acid (GABA). GABA attaches itself to brain cells, blocking transmission of electrical impulses. This reduces communication between brain cells. Benzodiazepines are thought to increase the inhibitory effect of GABA on brain cells, thus preventing excessive brain activity, which causes anxiety.

Benzodiazepines reduce feelings of agitation and restlessness, slow mental activity, and often produce drowsiness. They are said to reduce motivation and, if taken in large doses, may lead to apathy. They also have a relaxing effect on the muscles, and some benzodiazepines are used specifically for that purpose. Minor adverse effects of these medicaments include dizziness and forgetfulness. People who need to drive or operate dangerous machinery should be aware that their reactions may be slowed. Because the brain soon becomes tolerant to their effects, benzodiazepines may become less effective after a few weeks.

The benzodiazepines are considered safe for most people. The main risk is that people who take them regularly may become psychologically and physically dependent, particularly when large doses have been used. For this reason they are usually given for courses of two weeks or less. However, benzodiazepines are sometimes used on a long-term basis for cases of chronic, severe anxiety or panic attacks. The therapeutic benefit in such cases has to be weighed against a potential dependency. If a person has been taking them for a long period, they are normally withdrawn gradually under medical supervision. If they are stopped suddenly, withdrawal symptoms, including excessive anxiety, nightmares, and restlessness, may occur. Benzodiazepines have been abused for their sedative effect, and they are therefore prescribed with particular caution for people with a history of drug or alcohol abuse.

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