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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by FredPotter on June 23, 2005, at 23:10:30
I'm often told, and I often read here, "Oh that side effect will wear off in a little while". How does the brain know the difference between a side effect and an intended, therapeutic effect? Surely the therapeutic action of some drugs is the result of some chance observation. I don't believe brain drugs are as targeted as some people think.
One might regard the main effect of Prozac as sexual dysfunction and the anti-depressant effect as a side effect (it might be considered a treatment for rapists). Is poop-out a "side-effect" wearing off?
Fred
Posted by Nezirov on June 24, 2005, at 3:08:35
In reply to Side effects and therapeutic effects, posted by FredPotter on June 23, 2005, at 23:10:30
I think that's a very good point. Furthermore, the sexual side effects of SSRIs can sometimes be permanent.
Nezirov
Posted by linkadge on June 24, 2005, at 6:37:40
In reply to Re: Side effects and therapeutic effects, posted by Nezirov on June 24, 2005, at 3:08:35
Yes, I agree, that is a good point.
The doctors would have you believe that this drug is a computer designed magic bullit for depression, but this is so far from the truth it is rediculous. They screen for these drugs by pumping a mouse full of them for a few weeks and see if they swim longer than the sober mice.
I think they achieve the majority of their short term effects by activating the HPA axis, and mimicing the effects of sleep deprivation.
Linkadge
Posted by SLS on June 24, 2005, at 7:10:44
In reply to Side effects and therapeutic effects, posted by FredPotter on June 23, 2005, at 23:10:30
> I'm often told, and I often read here, "Oh that side effect will wear off in a little while". How does the brain know the difference between a side effect and an intended, therapeutic effect? Surely the therapeutic action of some drugs is the result of some chance observation. I don't believe brain drugs are as targeted as some people think.
>
> One might regard the main effect of Prozac as sexual dysfunction and the anti-depressant effect as a side effect (it might be considered a treatment for rapists). Is poop-out a "side-effect" wearing off?
> Fred
Great observation! Interesting change of perspective.Great thought-provoker.
I think some receptors are downregulated while others are not. It might be that those that are coupled with G-proteins change in sensitivity more robustly than non G-protein receptors. It is these same receptors that influence most the genetic machinery of the cell and are most responsible for creating an action potential.
The antidepressant response, the thing that takes weeks to develop, is the result of a CHANGE in receptor sensitivity while the side effects are the result of a continued stimulation of receptors that do not change (or change as much).
- Scott
Posted by xbunny on June 24, 2005, at 9:38:35
In reply to Side effects and therapeutic effects, posted by FredPotter on June 23, 2005, at 23:10:30
> I'm often told, and I often read here, "Oh that side effect will wear off in a little while". How does the brain know the difference between a side effect and an intended, therapeutic effect?
I often wonder this too. I came up with this idea from my experience, it has nothing to do with brain chemistry, though I think the chemical ideas are just as valid and very interesting. Side effects dont wear off you get used to them and they cease to be a bother or something you think about. Two examples; meds and hunger (like say mitrazapine). When you first start it the hunger hits you like an express train, your hungry all the time. After time you get used to that feeling of hungryness and it become your new 'zero level' of hungryness, you no longer feel hungry all the time because you have allowed yourself to be conditioned to that effect and ignore it, its become the norm and gradually you return to a normal eating pattern if it had gotten out of whack. Another example meds and sedation, you first take them and feel really tired, after time the level of tiredness becomes the norm. Eventually you no longer notice the level of tiredness anymore because it whats your used to even though compared to pre the drug you would have found that level of tiredness pretty bothersome. Gradually you return to feeling not so tired because you have shifted your internal level of tiredness scale.
I kinda think of it like a tongue peircing, it would irritate me to high heaven having the bar knocking around in my mouth all the time, but Im sure eventually I wouldnt even notice it.
I would guess this only works if the side effect is not so severe as to be unaccomodatable.
I think one reason I like this theory is that it plays well with the intended effect. The drug hopefully has its therapeutic effect and gradually it becomes your norm, so you still stay happier or whatever.
Buns
Posted by Phillipa on June 24, 2005, at 19:57:34
In reply to Re: Side effects and therapeutic effects, posted by xbunny on June 24, 2005, at 9:38:35
I never stayed on them long enough to find out. Except the benzos that i don't think work anymore. Fondly,Phillipa
Posted by FredPotter on June 25, 2005, at 2:49:06
In reply to Re: Side effects and therapeutic effects, posted by linkadge on June 24, 2005, at 6:37:40
> Yes, I agree, that is a good point.
>
> The doctors would have you believe that this drug is a computer designed magic bullit for depression, but this is so far from the truth it is rediculous. They screen for these drugs by pumping a mouse full of them for a few weeks and see if they swim longer than the sober mice.
>
> I think they achieve the majority of their short term effects by activating the HPA axis, and mimicing the effects of sleep deprivation.
>
>
>
> LinkadgeAh interesting. I've heard one night without sleep cures depression temporarily. Obviously not a long term strategy. I've heard from a therapist that depressed people have more REM sleep and that SSRIs suppress it, and so does ECT. Most of our dreams are anxious ones I think, well mine are
Fred
Posted by linkadge on June 25, 2005, at 19:52:06
In reply to Re: Side effects and therapeutic effects » linkadge, posted by FredPotter on June 25, 2005, at 2:49:06
I had a night of sleep derpviation the other night. I work nights, sleep days, and had to stay up to go to a dr.s apointment.
Yes, It cured my depression in one night. All aspects of it.
Linkadge
Posted by linkadge on June 25, 2005, at 19:52:30
In reply to Re: Side effects and therapeutic effects » linkadge, posted by FredPotter on June 25, 2005, at 2:49:06
Gives you that really strong "I've got somethign to live for" feeling.
Linkadge
Posted by KaraS on June 25, 2005, at 23:19:52
In reply to Re: Side effects and therapeutic effects, posted by linkadge on June 25, 2005, at 19:52:30
> Gives you that really strong "I've got somethign to live for" feeling.
>
>
> Linkadge
I also respond strongly to sleep deprivation. I would do it more often but I always end up sick the following day. Do you have the kind of depression that is much worse in the morning and things get better as the day progresses? I think they call that diurnal variation, no? I wonder why sleep deprivation works so well. The only theory I've heard about this is that it is related somehow to cortisol levels. Anyone know any more about it?
Posted by linkadge on June 26, 2005, at 0:36:18
In reply to Re: Side effects and therapeutic effects, posted by KaraS on June 25, 2005, at 23:19:52
Yeah, my depression is bad in the morning. Sleep deprivation does seem to regulate the HPA axis. It also activates what are called immediate early genes, which are similar to the genes that are affected when you take certain drugs like cocaine.
To much SD can make you psychotic. But it really has a good anti-anhedonia affect. Kind of like the world is a strange and new place that you've never experienced before. Kind of like the real world and the dream world become one.
Cool, but can be scarry.
Linkadge
Posted by linkadge on June 26, 2005, at 0:38:21
In reply to Re: Side effects and therapeutic effects, posted by linkadge on June 26, 2005, at 0:36:18
It kind of puts my brain in that "not allowed to die" mode. Like there is something that is so special about you that you cannot die. But it probably affects people differently. Strange, I had the same experience on Parnate. Maybe some common mechanism. I can definately see going psychotic on too much SD.
Linkadge
Posted by Declan on June 26, 2005, at 3:13:03
In reply to Re: Side effects and therapeutic effects, posted by linkadge on June 26, 2005, at 0:38:21
Hi Link
Do you mind going over your experience with Parnate, how much you took, and why you stopped it. TIA
Declan
Posted by KaraS on June 26, 2005, at 3:28:42
In reply to Re: Side effects and therapeutic effects, posted by linkadge on June 26, 2005, at 0:38:21
Thanks for the info.
I have never experienced that scary side of sleep deprivation. Maybe if I had gone longer without sleep. As I've experienced it, I just enjoyed living and had motivation. I imagine that's how it feels to be well.
K
Posted by SLS on June 26, 2005, at 6:56:45
In reply to Re: Side effects and therapeutic effects, posted by KaraS on June 25, 2005, at 23:19:52
> I also respond strongly to sleep deprivation. I would do it more often but I always end up sick the following day. Do you have the kind of depression that is much worse in the morning and things get better as the day progresses? I think they call that diurnal variation, no? I wonder why sleep deprivation works so well. The only theory I've heard about this is that it is related somehow to cortisol levels. Anyone know any more about it?
The first thing that popped into my head is that their is a temporary upset in the dopaminergic/acetylcholinergic balance.
- Scott
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