Home | Help | Contact Us

 MALE QUESTIONNAIRE - PAGE 7(d) 

You are on page 7(d) of 9 >  


This section deals with drug use over the past 2 years for psychiatric complaints such as anxiety, depression, mania, panic, hysteria or insomnia. You may enter further information in the notes box below.
804.  Have you used prescription antianxiety medication during the past 2 years?
Don't know
No
In the past only
Current intermittent use or regular low dosage use
Current regular use of a typical or high dose
805.  Have you used prescription antidepressant medication during the past 2 years?
Don't know
No
In the past only
Current intermittent use or regular low dosage use
Current regular use of a typical or high drug dose
806.  Have you used tranquilizers or sedatives during the past 2 years?
No / don't know
Some / occasionally
Significant amounts

Add any additional information here for the questions above:

Please mention the question number(s) if possible.

 


 


GLOSSARY

Antidepressant (Antidepressants)
Literally, substances meant to oppose depressions or sadness, and generally heterocyclic types such as Elavil, MAO inhibitors like phenelzine, or lithium carbonate. This category of substances formerly included stuff like amphetamines and other stimulants. Botanical examples include Hypericum, Peganum and Oplopanax.

Anxiety
Apprehension of danger, or dread, accompanied by nervous restlessness, tension, increased heart rate, and shortness of breath unrelated to a clearly identifiable stimulus.





























 

Home | Help | Contact Us
Design by: RoyalWebHosting.com