Acetylcholine (ACH) is both a peripheral and central agonist affecting muscarinic receptors, including the vestibular nucleus as well as efferent synapses (Soto et al, 2013).Receptors found in the pons and medulla, presumably those involved with dizziness, are almost exclusively of the M2 subtype (Barton et al, 1994).There are at least four major neurotransmitters of the vestibular system involved in the "three neuron arc" between the vestibular hair cells and oculomotor nuclei that drives the vestibulocular reflex.There are also a host of other neurotransmitters which modulate function.Your mental health professional chooses which antidepressant medicine to give you based on your symptoms, the presence of other medical conditions, what other medicines you are taking, cost of the prescribed treatments, and potential side effects.
Ineffective, unsafe, or diverted opioid therapy should be promptly tapered or stopped. However, studies showed that all types of pain were undertreated; as a result, pain education, advocacy, and policy initiatives led to an increase in opioid prescribing for patients with chronic nonterminal pain.
Psychiatrically, it is amazing how Job's resulting symptoms were identical to those of a modern person having Major Depressive Disorder.
This is how Job described his severe depression 2,500 years ago: Self-diagnosis of this disorder is often inaccurate.
Opioids should be prescribed on a trial basis, to be continued only if progress toward functional goals is demonstrated.
Long-acting morphine is the preferred initial drug, although several alternatives are available.
If you have a family history of depression, medicines that have been effective in treating your family member(s) might be one factor to consider in choosing an appropriate medication for you.