Posted by Snoozy on June 6, 2003, at 20:28:29
In reply to Re: ? about med chemistry/biology - need help! » Snoozy, posted by Larry Hoover on June 6, 2003, at 12:43:35
Thank you Lar.
I'm unhappy with my lack of biological knowledge. But I have only met one other person as ridiculously squeamish as me, and I had a really creepy biology teacher. So between those things I think I developed a mental block with this stuff.
> And yet, in 2001, a study was published showing substantially enhanced serotonin activity with bupropion treatment, through down-regulation of NE activity.
>
> What I conclude is, they still don't know how this drug, or other drugs work. I like the black box theory. You put new stuff (drugs) in the black box (brain), and new stuff comes out (possible remission of depression, side-effects, and so on). No mechanism required. Pure observation.
>I like this theory too! That's very interesting about the enhanced serotonin activity finding. All these years it was "Wellbutrin doesn't work on serotonin".
> > Second question: I know there's a theory that a lot of meds the body just adjusts to and they're not as effective.
>
> That's one theory of what we sometimes call "poop out". I think your body will quite naturally try to decrease the effect of any stimulus it receives. It doesn't matter what the stimulus is, your body will try to do things which make "the next time" you experience the stimulus less effective. The first time seems never to be re-experienced. If you extrapolate that process, you get something like poop-out.
>When I first started taking AD's in the early 90's, I would sometimes have positive effects for 2-4 months, and then they would go away. I think I actually did call it poop-out when I told my pdocs, but they reacted like I was some freak of medicine. That just doesn't happen! This might be more of an existential question, but I wonder if they really were aware of this phenomenon, and that it was actually fairly common, but they didn't know what else to do with me?
> Are you thinking of "paradoxical reaction"? Like taking a stimulant to calm hyperactivity? Or taking a sedating antihistamine and getting a buzz?
>
Yes, that is the word I was looking for! I've always been puzzled by the stimulants for hyperactivity thing, but that's probably a whole other can of worms! I have had that paradoxical reaction to antihistamines. I've used Benadryl as an occasional sleep aid over the years. Probably 95% of the time it makes me really drowsy, but there have been times where I've had that "buzz". Very strange feeling!> >For example, a drug that originally caused a side effect of insomnia would eventually cause hypersomnia.
>
> There's another way to look at that altogether, as short-term or acute effects, compared with long-term or chronic effects. I think anything's possible, when we're thinking in terms of individual experience. Only when you look at groups of people do you consider likelihood. For the individual with an unusual side-effect, his/her incidence rate is 100%.
>What started me wondering about these things (stop me if you've heard this one before!) was my experience with Wellbutrin and excessive sleepiness. I've been on it for 3 or 4 years, and when I first started, I had the insomnia and irritability. Eventually those subsided. I started having this problem with excessive sleepiness about a year ago. A member of my family has been asking me recently if it could be the Wellbutrin now causing sleepiness. So I've been looking into it, and it seemed unlikely to me (just based on how I feel), and my pdoc thinks it's unlikely as well.
I've had a theory for a few years which I think would fit with the black box theory. Which is that the AD's sometimes work because of the side effects they cause. A few months ago I was reading an article in the paper about studies done on depressed people and sleep. I can't remember the details, but the gist was that a lot of people with depression would get better if you deprived them of sleep (I'm thinking maybe it was an hour of deprivation). And there were observations that depressed people who were allowed to sleep however long they wanted, got somewhat worse. If there's anything to these studies, it would seem possible that it's the insomnia the drugs cause as a side effect that may be helping lift the depression. Unless they're not really viewed as somewhat separate "side" effects, but as integral to the drug.
Thanks again Lar, I really appreciate it!
> > Any information would be very appreciated. I need relief of my idiocy!
>
> You're not an idiot. Please. You're asking good questions. And those are questions which will help settle things in your mind, which is a very important aspect of self-care.
>
> I've purposely not gotten into major discussions about your questions, not because I don't want to answer, but because there are so many variables to consider, each of which may or may not have any bearing on your experience.
>
> I'm happy to bounce ideas back and forth with you, but I am going off-line for a short period.
>
> Lar
poster:Snoozy
thread:231897
URL: http://www.dr-bob.org/babble/20030604/msgs/232017.html