Posted by Elizabeth on March 9, 2002, at 15:14:05
In reply to Thanks Alan, Elizabeth???, posted by paulb on March 9, 2002, at 10:33:58
Hi guys.
Interesting that you bring this up. There is actually some evidence that Xanax may act as an antidepressant, at least in mild or moderate depression. (Upjohn seized on this as an excuse to get "anxiety associated with depression" listed as an indication for Xanax.) The dose required may be quite high, though. Xanax and Halcion differ in chemical structure from the other benzos (they have a ring with three nitrogens in it, so they are called triazolobenzodiazepines; trazodone and nefazodone share the triazolo moiety). It's not known for sure what pharmacological properties this chemical characteristic may confer on these drugs, though. Halcion typically causes too much sedation and memory impairment to be suitable for use as an antidepressant, so we don't know if it shares Xanax's antidepressant efficacy. A third triazolobenzodiazepine, adinazolam (brand name Deracyn), is used as an antidepressant in some countries, but not in the U.S. (I've always thought it would be nice if we had adinazolam here.)
These benzos have some endocrine effects which may be significant. Xanax and Valium both decrease cortisol secreation, Xanax quite a bit more than Valium. There have also been findings suggesting that depressed patients who have elevated urinary levels of MHPG (a norepinephrine metabolite) are more likely to respond to alprazolam than are depressed patients without elevated urinary MHPG. There are some other endocrine effects that I can't remember right now. An interpretation of these findings has been that Xanax-responding depressives have hyperactive hypothalamic-pituitary-adrenal (HPA) axis functioning.
As Alan says, there are probably some cases of depression (I'm guessing quite a lot, although I don't know of any statistics regarding this) that are secondary to anxiety disorders; that is, the person was originally anxious and then became depressed as a result of the anxiety. (I like Alan's description of the anxiety "overloading" the person, although it's not known what pharmacological mechanism might be responsible for this.) It's not surprising that in such a case, treating the anxiety might relieve the depression also.
Some people do feel euphoric or high on benzos, and Valium and Xanax are believed to be particularly "good" (or "bad," depending who you talk to). I don't think this is the same as an antidepressant effect, but some depressed people find that a drug that might normally be expected to cause euphoria simply makes them feel normal. So I could see how some people might experience relief of depression (without euphoria) on benzos just as I do on opioids.
> I would have to agree to diagree that the the AD effect is mild. I have often heard reports of euphoria with these two benzodiazepines, making them popular drugs of abuse, as opposed to other benzodiazepines.
This is my impression also. I think that their rapid onset of action might have something to do with it: both Xanax and Valium are relatively fast-acting when taken orally, compared to the other benzos. I've also heard people say that they can feel it when Xanax or Valium kicks in, but they don't notice anything when Klonopin or Librium (for example) starts to work.
> I agree that Lizzy would be helpful, this lady knows her stuff. Elizabeth??
Thanks...but who are you calling a "lady??!!!"
:-)
-e
poster:Elizabeth
thread:97091
URL: http://www.dr-bob.org/babble/20020307/msgs/97221.html