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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Janelle on June 24, 2001, at 15:40:58
I'm so confused now, having read in two sources that the SSRI's "trick" your brain into thinking it has more serotonin and/or norepinephrine, so the brain may "stop" producing it, leading to depletion. Does anyone know if this is PERMANENT? I don't want to be on the med(s) for the rest of my life if I can get well, but I fear that by having been on them so long, my brain has been "permanently" altered or damaged with the serotonin stuff - anyone with info, please respond. Thanks!
Posted by Zo on June 24, 2001, at 16:30:42
In reply to Do the SSRI's PERMANANTLY alter your brain?, posted by Janelle on June 24, 2001, at 15:40:58
After a few go rounds and relapses, and seeing one's quality of life really shine and then disappear. .. the concern about "being on meds for the rest of life" kinda disappears.
Good luck!
Zo
Posted by Dale on June 24, 2001, at 18:36:31
In reply to Do the SSRI's PERMANANTLY alter your brain?, posted by Janelle on June 24, 2001, at 15:40:58
Janelle,
I have been wondering the same thing and it is really starting to scare me. I have been on zoloft for 2 1/2 years, going off of it now and starting paxil (which I am wondering about ...). Doctors have told me that the SSRIs just alter things and when you go off the medication everything will be normal. I have always wondered though.
Please read my posting above on Tardive dyskinesia, which I have been recently looking into a bit. Do you have any types of tics or other muscle things going on? Please tell mw you story - what you are taking, etc.
Hope to talk to you soon, and maybe we will both find some answers.
Dale
> I'm so confused now, having read in two sources that the SSRI's "trick" your brain into thinking it has more serotonin and/or norepinephrine, so the brain may "stop" producing it, leading to depletion. Does anyone know if this is PERMANENT? I don't want to be on the med(s) for the rest of my life if I can get well, but I fear that by having been on them so long, my brain has been "permanently" altered or damaged with the serotonin stuff - anyone with info, please respond. Thanks!
Posted by Janelle on June 24, 2001, at 21:19:36
In reply to Re: Do the SSRI's PERMANANTLY alter your brain?, posted by Dale on June 24, 2001, at 18:36:31
Dale,
Thanks for responding, it's always a "relief" to find that I'm NOT the ONLY one wondering about something, and this particular thing is really starting to scare me too!
I was on Paxil (it worked GREAT for what's that's worth) for SEVEN years (eeeeeeek!), am now trying Effexor (after Celexa did NOTHING), and just recently started reading in more than one source about SSRI's making one's brain "think" it has more serotonin and/or norepinephrine than it really does, so the brain "stops" firing it off and goes into depletion. I'm scared that if I am able to go off meds (which would be my goal), my brain will no longer make Serotonin or Norepinephrine on its own, and I'll be "forced" to remain on med(s) forever.
I'm relieved that you said that doctors have told you that the SSRIs just alter things and when you go off the medication everything will be normal. After reading what I did, I'm now wondering too.
To answer your question - no (knock on wood), I've never had any any types of tics or other muscle things going on, like tardive dyskinesia, but saw it happen to someone, but from one of the "older" meds. Also, I was on an older med which had tardive dyskinesia as a possible side effect, which thankfully I never got, but also got off that stuff in reasonable time.
Doctors told me that if a person does get those muscle symptoms and tardive dyskinesia, that it is TEMPORARY and goes away when you stop the medication - and it DID go away when the person I know stopped taking the med that had caused it.
Hope this helps.
Posted by Dale on June 24, 2001, at 21:26:44
In reply to TO DALE - about side effects, brain changes, etc:, posted by Janelle on June 24, 2001, at 21:19:36
Janelle,
Nice to hear from you. Yes, things can be scary and it seems hard to get a correct straight answer today on something so important! I just did a google search using the terms Tardive dyskinesia SSRI and got a lot of hits. Interesting though, as it showed that there may be more to SSRIs inducing various movement disorders. Please do thsi search and look at some of the pages - let me know your thoughts.
Talk to you soon.
Dale
Posted by Janelle on June 24, 2001, at 21:32:58
In reply to Re: TO DALE - about side effects, brain changes, etc:, posted by Dale on June 24, 2001, at 21:26:44
Dale - we must be online at the same time! I will do the search you suggested when I can (my computer time is limited).
ALSO - read my longish response above to your TD posting!
Janelle
Posted by stjames on June 24, 2001, at 23:06:23
In reply to Do the SSRI's PERMANANTLY alter your brain?, posted by Janelle on June 24, 2001, at 15:40:58
> I'm so confused now, having read in two sources that the SSRI's "trick" your brain into thinking it has more serotonin and/or norepinephrine, so the brain may "stop" producing it, leading to depletion.
James here....
There is no suce thing as "tricking " the brain
into thinking it has more NT's. Nor do AD's stop or start more production. If you stopped makeing serotonin or others you would die. Also none of these ideas has anything to do with how AD really work, they are based on a false and symplistic understanding of how AD's work.James
Posted by gilbert on June 24, 2001, at 23:21:32
In reply to Re: Do the SSRI's PERMANANTLY alter your brain?, posted by stjames on June 24, 2001, at 23:06:23
>
> James here....
>
> There is no suce thing as "tricking " the brain
> into thinking it has more NT's. Nor do AD's stop or start more production. If you stopped makeing serotonin or others you would die. Also none of these ideas has anything to do with how AD really work, they are based on a false and symplistic understanding of how AD's work.
>
> JamesThey keep more of the already made serotonin around thus reuptake inhibitning. I don't think they know for sure if somehow the body detects more serotonin in the system if at some point it down regulates by making less....seems like you would of heard more about this sooner.....prozac has been here 20 years already. Shouldn't there be a bunch of serotonin lacking idiots stumbling around out there....I don't see it.
Gil
Posted by AMenz on June 25, 2001, at 0:56:37
In reply to Re: Do the SSRI's PERMANANTLY alter your brain?, posted by stjames on June 24, 2001, at 23:06:23
> > I'm so confused now, having read in two sources that the SSRI's "trick" your brain into thinking it has more serotonin and/or norepinephrine, so the brain may "stop" producing it, leading to depletion.
>
> James here....
>
> There is no suce thing as "tricking " the brain
> into thinking it has more NT's. Nor do AD's stop or start more production. If you stopped makeing serotonin or others you would die. Also none of these ideas has anything to do with how AD really work, they are based on a false and symplistic understanding of how AD's work.
>
> JamesDo you have a more complete explanation you could share?
Posted by Cam W. on June 25, 2001, at 10:30:18
In reply to Re: stjames, posted by AMenz on June 25, 2001, at 0:56:37
AM - Here is a good, basic article on the HPA axis role in depression. Keep in mind that several other of the body's systems also interact wiith the HPA axis in modfying mood. As you read the following article, keep in mind this is only one set of chemical reactions and it is linked to several other systems. If you change one component of one system, all of the other systems all respond to this change. We haven't figured out all of the systems that come into play, let alone the ways that these systems can impact on the body's stress system.
http://www.sciam.com/1998/0698issue/0698nemeroff.htmlThe body doesn't stop producing the serotonin and norepinephrine on a global, bodily scale, but may decrease amounts locally in the body (ie blocking the axon terminal reuptake receptor, may slow down serotonin release from that particular axon - through the 5-HT1B receptor - but other receptors for serotonin are only altered indirectly or not at all).
I used to say (and still do in some presentations) that the lack of reuptake of a neurotransmitter would fool the body into making more of the neurotransmitter. This may happen, but I am not sure if it has been proven, especially when taken in the context of all of the other physiological systems involved in such a change.
Also, type "HPA axis" into the serach function and you can read some of the developments on our understanding of depression over the last few years.
- Cam
Posted by AMenz on June 27, 2001, at 10:36:55
In reply to Re: stjames » AMenz, posted by Cam W. on June 25, 2001, at 10:30:18
Wouldn't the additional production of serotonin because of the lack of reuptake account for hypomanic or mixed state episodes of BPII's on SSRI's and other AD's?
Thanx for reply.
> AM - Here is a good, basic article on the HPA axis role in depression. Keep in mind that several other of the body's systems also interact wiith the HPA axis in modfying mood. As you read the following article, keep in mind this is only one set of chemical reactions and it is linked to several other systems. If you change one component of one system, all of the other systems all respond to this change. We haven't figured out all of the systems that come into play, let alone the ways that these systems can impact on the body's stress system.
>
>
> http://www.sciam.com/1998/0698issue/0698nemeroff.html
>
> The body doesn't stop producing the serotonin and norepinephrine on a global, bodily scale, but may decrease amounts locally in the body (ie blocking the axon terminal reuptake receptor, may slow down serotonin release from that particular axon - through the 5-HT1B receptor - but other receptors for serotonin are only altered indirectly or not at all).
>
> I used to say (and still do in some presentations) that the lack of reuptake of a neurotransmitter would fool the body into making more of the neurotransmitter. This may happen, but I am not sure if it has been proven, especially when taken in the context of all of the other physiological systems involved in such a change.
>
> Also, type "HPA axis" into the serach function and you can read some of the developments on our understanding of depression over the last few years.
>
> - Cam
Posted by Cam W. on June 27, 2001, at 11:37:10
In reply to Re: stjames, posted by AMenz on June 27, 2001, at 10:36:55
AMenz - The extra serotonin being produced by SSRIs and TCAs may cause hypomania some people with BiPD. I guess it depends on the nature of the original chemical breakdown, as to what will happen.
The addition of serotonin to a body who's system is depressed seems to lift the depression. Many of these people with depression have a lack of serotonin in the body. Adding back that serotonin (to regular levels) would probably cause more of a change in the levels of other neurotransmitters (ie. those that changed in response to the lower levels of serotonin), more so than causing problems with serotonin.
I think that adding a serotonergic antidepressant to a person with BiPDII is not the whole story of manic switch. The TCAs cause significantly more manic switch than the SSRIs. There must be some binding to some secondary receptor(s) in the TCAs that cause or augment the development of the hypomania.
All chemical processes in the brain (and body) seem to be highly linked to one another. Any change in one system is felt throughout all the body systems and these systems adjust their chemical reactions (ie. change the concentration of neurotransmitters &/or receptors) to try to compensate for the decrease (in this case) in serotonin. So, the combined changes in these other systems would probably be seen more readily than a an increase in the concentration of serotonin, to more "normal" levels.
This is one reason that looking at individual systems of the brain (eg. HPA axis in depression) can be misleading. One must add in the actions of all of the other systems to truly see what is going on. Many of the systems have not been fully elucidated, yet. Therefore, one has to look at the more overall picture, rather than looking at one system in isolation. We must not take a reductionist view of a system in the body; the HPA axis relies on the input of many other systems to function, as other bodily systems rely on it.
Hope that this is clear. - Cam
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