Posted by SLS on November 27, 2000, at 18:04:57
In reply to Re: Serzone side effects - just temporary? » stjames, posted by shellie on November 27, 2000, at 9:10:40
> > > (I am committed to not being on medication continuously for the rest of my life, and would like to be able to stop without too much discomfort and then restart only when I need to. My MD supports this.)
> > James here....> > Treating only during relapse has the end result of the meds being less and less effective. A day may come when nothing works. Because you have been "penny wise and pound foolish" you now have treatment resistant depression, which may only respond to lots of meds or not respond at all to any med(s). Anyone who has had multiple depressions to the point of becoming suicidal should be on meds all the time.
> James, the part that I would disagree with here is that going on and off of meds is responsible for treatment resistent depression. So it seems as if you are blaming catsparkle. Treatment resistent depression can also occur through continuous anti-depression treatment for many, with drugs becoming less effective the longer you take them. There are certainly a lot of examples of that on the board, including myself. You cannot predict if catsparkle never went off her medication whether she would become treatment resistent or not. Perhaps she is more likely to become treatment resistent if she goes on and off meds, you say the stats support this and I am not familiar enough with the stats to assume that you are not correct. shellie
I agree with both of you.The jargon used for going on and off medication rapidly is "pulsing". Pulsing antidepressants is discouraged and can indeed foster treatment resistance (obviously, not always) as well as precipitate mania in vulnerable individuals. However, I think pulsing refers more to going on and off an effective medication frequently during a single depressive episode. Treating infrequent recurrent episodes periodically does not qualify as pulsing. The problem is, treatment is often truncated at six months, frequently resulting in relapse. I'm too lazy to verify these numbers, but one of my doctors used a treatment range of 12-14 months to "solidify" things and greatly reduce the risk of relapse. If a case history displays frequent recurrent episodes (I believe DSM IV gives guidelines for the word "recurrent"), indefinite treatment is indicated.
> Treatment resistent depression can also occur through continuous anti-depression treatment for many, with drugs becoming less effective the longer you take them.
Shellie, this is a fascinating notion. Well, actually, it is a notion of critical importance. I'm going to keep it in mind from now on. It is a new idea for me. Thanks. As you come across corroborative observations and information regarding this topic, please don't hesitate to post them.
Bye...
- Scott
poster:SLS
thread:49361
URL: http://www.dr-bob.org/babble/20001115/msgs/49504.html