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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 davpet on January 17, 2007, at 12:06:25
I am an anti-depressant non-responder . The consensus amongst the medical community is that depression is caused by a lack of the monamines (serotonin;dopamine;norepinephrine) and thus nearly all anti-depressants work in one way or another by increasing the amount of neurtransmitters circulating in your brain . But has anyone considered that depression may be caused by high levels of neutransmitters not low . Let me explain as i'm sure some of you know neurotransmitter receptors work on a system of down-regulation and up-regulation . The more you expose a receptor to its respective neurotransmitter the more it desensitises (down-regulates) thus more neutransmitter is required to get the same amount of activation out the receptor . For example drugs and and binge eating flood your brain with neutransmitters - you feel good for awhile and then crash . Over time this constant flooding desensitises your receptors and now your normal neutransmitters levels are not enough to activate their receptors . It is this deficit that equals depression . So what do you do , you go to a P/doc and what do they say - you don't have enough serotonin etc. and they give you an SSRI. Which floods your brain once again with serotonin which causes further down-regulation worsening the problem.
Posted by bulldog2 on January 17, 2007, at 13:37:16
In reply to Too MUCH serotonin causes depression(not 2LITTLE), posted by davpet on January 17, 2007, at 12:06:25
A good book to read is "Listening to Prozac" by Peter Kramer. He talks about some of the theories of depression. Chronic stress is one of those theories. When under chronic stress there is probably an overabundance of norepineprhine being produced. After a while the tank gets depleted(to little norepineprhine) and more receptors are created downstream and they become hypersensitive to norepineprhine activity. The old tricyclics tended to elevate norepineprhine and the theory is they caused downregulation of the downstream receptors and thereby created homeostasis. The fact is that the ssris do not work as well as the old tricyclics or maois for major depression. He theorizes that serotonin acts more as a mood modulator and works to reduce perceived stress.
Posted by linkadge on January 17, 2007, at 16:04:40
In reply to Re: Too MUCH serotonin causes depression(not 2LITTLE), posted by bulldog2 on January 17, 2007, at 13:37:16
But inhibiting the reuptake of a neurotransmitter is not really creating more of the neurotransmitter. If the brain really needed to, it could modify the reuptake of its own neurotransmitters to compensate.
Actually it does this. As norepiniephrine becomes depleted, NET drops to try and compensate. So by taking a NET inhibitor, you're not really making the brain any more resemblant of a healthy brain.
Some of the TCA's act upon gene expression on the HPA axis. I remember reading that imipramine alters a gene that codes for cortisol sythesis.
Another thing is that serotonin can be anxiogenic dependant on the brain state. Serotonin released in the amygdala for instance creates fear. Individuals who posess the SS varient of the serotonin tranporter (which codes for a lower uptake of serotonin) show enhanced amygdala activation in response to frigtening images, as well as incease GI response to stress.Serotonin released in the dorsal raphai neucleus is also anxiogenic. So taking an SSRI would enhance the response of serotonin release here.
So the fact that some people find SSRI's very anxiogenic does not suprise me. And the concept that serotonin is the "calming neurotransmitter" is nonsensicle.
Linkadge
Posted by Phillipa on January 17, 2007, at 17:50:44
In reply to Re: Too MUCH serotonin causes depression(not 2LITTLE), posted by linkadge on January 17, 2007, at 16:04:40
They don't calm me they reve me up . Only one I tolerate in low doses is luvox. So I take benzos which somewhat now work for me. Love Phillipa
Posted by flmm on January 17, 2007, at 21:57:37
In reply to Re: Too MUCH serotonin causes depression(not 2LITTLE) » linkadge, posted by Phillipa on January 17, 2007, at 17:50:44
ssri meds always calm me, but do not address depression as well. I am now on Cymbalta, and, once I got used to the added anxiety that comes with this type of med, my depression feels well treated. Any med that works with NE will add some anxiety in me. But, to be free of depression, one must have emotions, not just ssri induced apathy! No more SSRIs for me! I only take 30 mg of Cymbalta and still improve 6 months later! 60 mg of this is way too much.
Posted by Dr. Bob on January 18, 2007, at 21:31:41
In reply to Re: Too MUCH serotonin causes depression(not 2LITTLE), posted by bulldog2 on January 17, 2007, at 13:37:16
> A good book to read is "Listening to Prozac" by Peter Kramer.
I'd just like to plug the double double quotes feature at this site:
http://www.dr-bob.org/babble/faq.html#amazon
The first time anyone refers to a book, movie, or music without using this option, I post this to try to make sure he or she at least knows about it. It's just an option, though, and doesn't *have* to be used. If people *choose* not to use it, I'd be interested why not, but I'd like that redirected to Psycho-Babble Administration:
http://www.dr-bob.org/babble/admin/20020918/msgs/7717.html
Thanks!
Bob
Posted by itsme2003 on January 20, 2007, at 3:05:24
In reply to Too MUCH serotonin causes depression(not 2LITTLE), posted by davpet on January 17, 2007, at 12:06:25
Stablon (tianeptine) works as an SSRA causing serotonin to be taken back up more rapidly, but still provides relief from depression. I believe it is unknown if that results from an up-regulation of receptors, or increased neuroplasticity.
Posted by medievil on January 20, 2007, at 11:04:07
In reply to Re: Too MUCH serotonin causes depression(not 2LITTLE), posted by itsme2003 on January 20, 2007, at 3:05:24
> Stablon (tianeptine) works as an SSRA causing serotonin to be taken back up more rapidly, but still provides relief from depression. I believe it is unknown if that results from an up-regulation of receptors, or increased neuroplasticity.
serotonin has nothing to do with depression lol, otherwise ssri's would work in 3 days buddyi beleive its one final change in one changing regulating something else
not just neurogenis, i doubt that does much for depression, we have poop out occuring, dont think these are the new cells dying
Posted by medievil on January 24, 2007, at 11:59:09
In reply to Re: Too MUCH serotonin causes depression(not 2LIT, posted by medievil on January 20, 2007, at 11:04:07
"or increased neuroplasticity"
i've seen tianeptine pooping out often, i dont think that has any antidepressant action, i do beleive you need neurogenesis to get the antidepressant effect
so basicly the 2 working togheter
Posted by psychobot5000 on January 25, 2007, at 23:20:09
In reply to Re: Too MUCH serotonin causes depression(not 2LITTLE), posted by itsme2003 on January 20, 2007, at 3:05:24
> Stablon (tianeptine) works as an SSRA causing serotonin to be taken back up more rapidly, but still provides relief from depression. I believe it is unknown if that results from an up-regulation of receptors, or increased neuroplasticity.
I think there are some other possible mechanisms of action, too. Tianeptine modestly (by around 15-20% I believe) increases dopamine in the Nucleus Accumbens, for example, and in the frontal cortex at higher doses, but these effects to not seem to be dependent on Tianeptine's serotonergic effects--blocking its serotonergic reuptake acceleration with another drug leaves the dopamine effects unchanged.
In my opinion, it's not clear what Tianeptine's mechanism is, and whether the things we observe about it are effects, causes, or something else. But I'm glad it works!
Posted by Clayton on January 28, 2007, at 20:36:06
In reply to Re: Too MUCH serotonin causes depression(not 2LIT, posted by psychobot5000 on January 25, 2007, at 23:20:09
This is fascinating! Can you tell me the condition for which the tianeptine was prescribed? Any other info you can offer is appreciated. Thanks so much!
Posted by okydoky on January 21, 2008, at 13:33:26
In reply to Re: Too MUCH serotonin causes depression(not 2LITTLE), posted by linkadge on January 17, 2007, at 16:04:40
I just ordered tianeptine. Not sure if I made a good decision. Anyway I only ordered 45 tabs so I need to find a cheaper place as it cost me $55. I don't think I will know by 20 days if it is working? So I guess I need to order more before I even start it.
I really need to know if I can take tianeptine with oxycontin?? I take some valium too but I thought that would not be a problem. Actually I take ritalin also but thought I would stop while trying the tianeptine.
Long winded I am! Does anyone know if I can take tianeptine with oxycontin? I cannot go off the oxycooontin so I really need to know this before I invest more money and of course before I begin to take it. Well the way I feel today I might not care but that is another subject.
Thanks,okydoky
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Dr. Bob is Robert Hsiung, MD,
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