Posted by Alan on November 28, 2002, at 5:59:06
In reply to AD poop out, posted by ItsHowdyDudyTime on November 27, 2002, at 20:52:52
> There is no formal medical term for antidepressant poop out to my knowledge. This just exemplifies the lack of interest within psychiatry to help the chronic TRD patient. They dont even have terms to accurately describe this common occurence known as antidepressant poop out.
>
> However I can tell you that the term "tolerance" as one poster described, is not an accurate description of what is happening here. Tolerance is a term used with drugs of addiction...alcohol, cocaine, heroin, amphetamines, etc. With drugs of physical addiction, you need more and more drug to maintain the effect, this is due to "tolerance" and is well established in medical literature.
>
> However, antidepressants are not controlled substances and are not physically addictive. Therefore "tolerance" is a very poor term to use to describe what you are describing. > Howdy Doody=============================================
Just addressing the dependence/withdrawal phenomen - however technically one has the ability yet to describe it's scientific origins:As long as doctors are pushing an SSRI at every patient who even looks at 'em cross-eyed, there's not going to be any opportunity to observe drug-seeking behavior...or more accurately, the presentation of physical addiction. In fact, what they see right now is SSRI-avoidant behavior.
But let the doctors start withholding SSRIs and doing all they can to get people off of them (a day that may well come and arguably is already here), and then we will see drug-seeking behavior from people who might even prefer to be off but can't possibly quit over the two week period now recommended as a taper.
The complaint rate for dependence is currently much higher for SSRIs (in fact, globally the absolute numbers are unprecedented in recorded medical history), but that's probably the result of overoptimistic expectations created by misleading marketing. The manufacturers' unpublished rates of withdrawal in trials with healthy volunteers were equivalent to those for benzodiazepines. The World Health Organisation's report on worldwide complaints about withdrawal places the top drugs all as AD's with bzds lagging far behind - and the bzds were initially far less overprescribed than the AD's are being commercially pushed now.
Bottom line: dependence/withdrawal - in whatever "technical" terms one wants to describe it - is a wash. Neither type of drug can claim "dependence" doesn't happen. I would say that pragmatically speaking, based on the evidence, there will quickly be seen a sea change in the understanding of physical addiction and reorganisation or special classification of the AD's are soon to come.
If a case is serious enough or sufficiently biological in manifestation to require medication, the medication should be chosen according to individual response.
Alan
poster:Alan
thread:129589
URL: http://www.dr-bob.org/babble/20021127/msgs/129700.html