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Re: What you think of research on long term SSRI use

Posted by linkadge on December 28, 2016, at 18:22:10

In reply to Re: What you think of research on long term SSRI use » linkadge, posted by SLS on December 28, 2016, at 17:28:10

To me, the use of high doses is a sign that either:

a) the individual metabolizes the drug too quickly
b) depression is severe and biochemical alternations are significant requiring a higher dose
c) the individual is responding to an active metabolite (or secondary neurotransmitter target) which requires a higher dose
d) the drug isn't working and so higher doses are tried
e) the individual is developing tolerance

It is possible that higher doses lead to (or are associated with) increased resistance. I don't know the exact reasons for this but they could include:

a) the drug is toxic in higher doses and is damaging the brain in some way as to lead to further worsening
b) the individual is over a therapeutic window and hence responds less to higher doses (i.e. excessive levels of adverse metabolites or the suppression of other neurotransmitter function)
c) side effects of higher doses are interfering with clinical effects)
d) the drug (despite maximal doses) is not able to correct the particular biochemical alterations caused by genetic or situational factors

Or just, as the old saying goes...

"You can never gen enough of the things that you don't need" (i.e the drug just ain't fixing the right problem)


Sorry,

Rambling here.

Linakdge


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URL: http://www.dr-bob.org/babble/20161215/msgs/1093718.html