Psycho-Babble Medication Thread 679424

Shown: posts 1 to 10 of 10. This is the beginning of the thread.

 

Are antipsychotics good for depression???

Posted by Frequent Fryer on August 23, 2006, at 19:31:52

Dont they inhibit SE,NA & DA.
Yow want those

And Sseretonin while REM sleep could be important

 

Re: Are antipsychotics good for depression??? » Frequent Fryer

Posted by Phillipa on August 23, 2006, at 19:54:27

In reply to Are antipsychotics good for depression???, posted by Frequent Fryer on August 23, 2006, at 19:31:52

Ive read here that low dose seroquel helps depression. Love Phillipa

 

Re: Are antipsychotics good for depression??? » Frequent Fryer

Posted by JahL on August 23, 2006, at 20:37:02

In reply to Are antipsychotics good for depression???, posted by Frequent Fryer on August 23, 2006, at 19:31:52

> Dont they inhibit SE,NA & DA.
> Yow want those
>
> And Sseretonin while REM sleep could be important

Hi FF.

I think the jury is out somewhat on this subject, but there is some evidence that some APs can be of some use in depression.

Here in the UK Sulpiride, a D2/D3-specific old-style AP, is often prescribed for depression *at low doses* - where it exerts it effects *pre-synaptically* - by research establishments to patients who have failed on standard ADs (Prozac etc). It's not considered a particularly potent AD, but aside from the possible potentional for TD (considered to be very low in the doses used) it is remarkedly side-effect free. There is little or no risk of serotonin syndrome or hypomania precipitation. I have taken it for eight years and it has been crucial in getting my severe social phobia under control. I can't be certain, but I think it also exerts a mild AD effect also.

As Philipa points out, newer atypical APs such as Seroquel (which has recently been approved for use in Bipolar) have potential benefits, but again, these are not considered to be particularly potent. Of course Lilly markets Symbyax (Prozac/Olanzapine combination treatment) for depression.

When I first trialed Seroquel, there was a discernal AD effect, though it was rather transient in nature.

On the other hand some argue that long-term AP usage can actually *cause* chronic, if usually mild depression.

With regard to sleep, Seroquel is the single most effective agent I have ever tried. The flipside of this is that it is prone to promote grogginess during the day.

Make of that what you will.

Take care,

Jah.

 

Re: Are antipsychotics good for depression???

Posted by med_empowered on August 23, 2006, at 21:40:16

In reply to Re: Are antipsychotics good for depression??? » Frequent Fryer, posted by JahL on August 23, 2006, at 20:37:02

Use of antipsychotics in varying doses for depression goes all the way back to Thorazine in the 50s. The first antidepressant/AP combos were introduced in the 60s; the idea was to "cool off" anxiety, hostility, etc. and allow the AD to get to work.

Today's antipsychotics tend to have pretty strong serotonin antagonsim and some (like zyprexa) are very "dirty" drugs, meaning they hit up receptors all over the place. Combined with reuptake inhibitors, some people find them very useful. I didn't. I kind of thing the risk of AP-induced dysphoria and movement disorders outweights any benefits, but some people like Symyax and other AP/AD combos so...who knows.

Personally, given the long-term risks, I'd try other treatment strategies first.

 

Re: Are antipsychotics good for depression???

Posted by finelinebob on August 23, 2006, at 23:29:12

In reply to Re: Are antipsychotics good for depression???, posted by med_empowered on August 23, 2006, at 21:40:16

Atypical antipsychotics are also being used as mood stablizers which, depending on your PDoc's view on what "depression" is, may be helpful. But med-empowered is right about them being "dirty", particularly when it comes to lipid levels.

When zyprexa was first out, docs started seeing higher incidences of diabetes in people taking the med. For many years, this was written off as people not being able to suppress or manage cravings for food that zyprexa might cause. Eventually it was found that zyprexa was the actual culprit.

Zyprexa worked wonders for me. Well, other than shooting my tryglycerides up to 900. Mind you, the tests for it start loosing accuracy at about 450, so who knows what it really was. Abilify didn't help as much, but it only shot my triglycerides up over 600 or so.

So, if you're thinking of a trial, make sure your PDoc knows the score and has your family doc keep a close eye on your blood chemistry.

 

Re: Are antipsychotics good for depression??? » finelinebob

Posted by laima on August 24, 2006, at 0:39:58

In reply to Re: Are antipsychotics good for depression???, posted by finelinebob on August 23, 2006, at 23:29:12

Zyprexa can pull me out of hell-FAST, though the couple times I tried it were very brief due to not tolerating the bizarre side effects that I got from it-mostly severe fatigue and vaguely hallucinatory senses- oh and shockingly voracious appetite.

 

Re: Are antipsychotics good for depression???

Posted by JahL on August 24, 2006, at 8:11:16

In reply to Re: Are antipsychotics good for depression??? » Frequent Fryer, posted by JahL on August 23, 2006, at 20:37:02

OK, there a couple of good success stories above - and I'm obviously *very* - sincerely - pleased for the beneficiaries. I haven't really been around here much lately so maybe I'm a little behind the times.

Having thought about it some more, I do actually recall my own AP (relative) success story (besides Sulpiride).

Upon initiation of 20mg Abilify (which has powerful 5HT action), I enjoyed a *very* significant early onset improvement. Unfortunately I had to abandon it because of near unbearable akathesia and constipation. The latter sounds trivial, but not when you haven't been for a whole MONTH (seriously). I was later able to obtain some hardcore laxatives but second time round the improvement was much less profound and petered out after a couple of weeks. [sorry if the above is a little graphic!]

As is pointed out above, APs are often accompanied by unpleasant side effects, which are, variously, movement disorders (especially the older APs which should be a treatment of *last resort*), diabetes, weight gain, somnolence, akathesia etc.

As with most things in life, I think it comes down to simple risk:benefit anaysis. I.E. The risks typical to the drug and the severity of your depression (risk = self-harm etc) vs. the degree of benefit you derive from said drug.

Up until two days ago I had been profoundly suicidal my entire life and so I was prepared to take almost anything that worked. An efficacious drug is quite literally a life-saver for me.

Just wanted to acknowledge the experiences described in the above posts. I'll get more sleep (only 1 hour yesterday) before I post next time...

Take care,

Jah.

 

Re: Are antipsychotics good for depression???

Posted by Frequent Fryer on August 24, 2006, at 17:44:18

In reply to Re: Are antipsychotics good for depression??? » Frequent Fryer, posted by JahL on August 23, 2006, at 20:37:02

I fully hear ya Seroquel is the only drug that puts me out to. I dont think it is nescicary to inhibit 5HT though, Seretonin plays an important part in your sleep...

So what you wake up the next day and all your Neuro Chemicals return to their original states?

I had a theory the Anti-D's Reuptake the Neuro Chems (dunno propper word) and they stay in the synapse for to long and then the Antipsychotics kinda flush em out so new Serotonin etc can be re-uptaken, maybe thats why there good.

{but I wouldn't have a clue} Just seems a tad contradictory to me.


> > Dont they inhibit SE,NA & DA.
> > Yow want those
> >
> > And Sseretonin while REM sleep could be important
>
> Hi FF.
>
> I think the jury is out somewhat on this subject, but there is some evidence that some APs can be of some use in depression.
>
> Here in the UK Sulpiride, a D2/D3-specific old-style AP, is often prescribed for depression *at low doses* - where it exerts it effects *pre-synaptically* - by research establishments to patients who have failed on standard ADs (Prozac etc). It's not considered a particularly potent AD, but aside from the possible potentional for TD (considered to be very low in the doses used) it is remarkedly side-effect free. There is little or no risk of serotonin syndrome or hypomania precipitation. I have taken it for eight years and it has been crucial in getting my severe social phobia under control. I can't be certain, but I think it also exerts a mild AD effect also.
>
> As Philipa points out, newer atypical APs such as Seroquel (which has recently been approved for use in Bipolar) have potential benefits, but again, these are not considered to be particularly potent. Of course Lilly markets Symbyax (Prozac/Olanzapine combination treatment) for depression.
>
> When I first trialed Seroquel, there was a discernal AD effect, though it was rather transient in nature.
>
> On the other hand some argue that long-term AP usage can actually *cause* chronic, if usually mild depression.
>
> With regard to sleep, Seroquel is the single most effective agent I have ever tried. The flipside of this is that it is prone to promote grogginess during the day.
>
> Make of that what you will.
>
> Take care,
>
> Jah.

 

Re: Are antipsychotics good for depression???

Posted by Frequent Fryer on August 24, 2006, at 17:56:03

In reply to Re: Are antipsychotics good for depression???, posted by JahL on August 24, 2006, at 8:11:16

I guess it dose depend on the individual.
Like sometimes when I cant slepp I have racing thoughts in my mind I find hard to controll... their my own but yeah major tranquilizers come in handy there.
When I smoke weed its allot worse to. I think Im gonna stop doing that because weed used to and makes allot of people sleep better.
I reckon theres a close connection between those rapid thoughts & schitzophrenia although not very severe in myself, I would love to see a selective Anti psychotic anyways that dosnt inhibit 5HT or DA2.
Because DA2 is pleasurable & I would like to wake up allert & motivated in the mourning ya know.


 

Re: Are antipsychotics good for depression???

Posted by linkadge on August 24, 2006, at 18:48:47

In reply to Re: Are antipsychotics good for depression???, posted by Frequent Fryer on August 24, 2006, at 17:56:03

Depression is more complicated than low serotonin etc. It may be due to low neurotransmitter action at certain serotonin receptors rather than low levels of the chemical overall.

Taking an SSRI increases serotonin activity at all serotonin receptors, but different serotonin receptors have greatly varying effects on mood.

*Reducing* serotonin activity (at certain receptors) also seems to help mood and anxiety.

Taking an atypical antipsychotic is a crude way to reduce serotonin activity at certain receptors, and to perhaps augment the action of the drug.

Agents that block the 5-ht2a receptors like seroquel often promote sleep, and reduce anxiety, that is because blocking 5-ht2a increases melatonin release.

There are other agents that might augment an antidepressant equally as well as an atypical antipsychotic. Those being, Trazodone, periactin, remeron, TCA's, serzone etc.

Linkadge




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