Posted by SLS on April 20, 2011, at 12:45:35
In reply to Re: the only way out » SLS, posted by 49er on April 20, 2011, at 10:51:01
> 49er- " Poop out is not a withdrawal symptom in my opinion."
>
> SL - " I agree. I think you misunderstood me."
>
> Wouldn't be the first time I misunderstood someone:)
>
> "When poop-out occurs, something in the brain has changed. Perhaps it involves a type of overshoot that destabilizes the system. This change usually results in a resistance to responding to that same drug subsequently.""
>
> Sorry for my elementary question but when you say overshoot, are you talking for example about an SSRI drug that is overloading the system with Serotonin?I was just thinking out loud. Silly, I know. I was thinking along the lines of receptor downregulation continuing beyond the point that is necessary to maintain efficient neurotransmission. It would be a gene expression thing. Sorry for my elementary answer to a sophisticated question.
> > Withdrawal Effects vs Residual Effects: Not only are withdrawal effects time-limited, but they differ significantly in presentation.
> >
> > "severe flulike symptoms - headache, diarrhea, nausea, vomiting, chills, dizziness and fatigue. There may be insomnia. Agitation, impaired concentration, vivid dreams, depersonalization, irritability and suicidal thoughts are sometimes occurring. These symptoms last anywhere from one to seven weeks and vary in intensity."> Uh, they can last alot longer than that. And they come and go.
What are the most common symptoms to persist beyond 4 weeks?
If we were talking about Paxil at 40mg or Effexor at 300mg, approximately how long would it take to taper these drugs and reach total discontinuation using a the schema you recommend? A rough guess would be fine. 4 weeks? 12 weeks? 12 months?
> <<I'm not advocating abrupt discontinuation. However, when the situation arises where a doctor and patient elect to change medications, it is prohibitive to spend a year or more to taper the old drug before beginning the new drug.>>
> I see your point. But again, I see too many situations where people were transitioned way too quickly from one drug to another and suffered horribly.
>
> The problem is by doing this too quickly, you can't really access whether the person is on the right drug or not because withdrawal symptoms are confusing the issue.This is true. I guess one would rely on the notion that the period for withdrawal is time limited. I don't think a depressive rebound due to the discontinuation of antidepressants will usually last much beyond four weeks. I'm not absolutely sure, though. I think the answer to this question will depend upon which observations one is using to identify true withdrawal, and which are consistent with a syndrome of persistent post-discontinuation adverse effects. Although I have seen references to a time limit on withdrawal periods as a way of delineating adverse events, I have not seen any kind of scientific investigation to resolve this issue. I haven't looked, though.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.
poster:SLS
thread:983009
URL: http://www.dr-bob.org/babble/20110418/msgs/983340.html