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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by River1924 on April 3, 2006, at 1:11:18
Any comments?
Use of selective serotonin reuptake inhibitors continues to increase, as does concern about previously unrecognized, subtle side effects and questions about whether these drugs produce effects on healthy subjects. The authors report novel emotional effects identified by an experienced, psychologically healthy meditator who is a psychiatrist and researcher. On a meditation retreat, the subject identified a specific profile of emotional changes related to sertraline use. In particular, cognitive abilities and the emotions of fear and anger seemed unaffected. However, the emotions of sadness, happiness, rapture, and love were dramatically reduced in intensity and duration.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16569138&query_hl=14&itool=pubmed_docsum
Posted by med_empowered on April 3, 2006, at 1:52:44
In reply to zoloft sadness, happiness, rapture, and love, posted by River1924 on April 3, 2006, at 1:11:18
definitely accurate. As for why its taken this long to notice what was going on..I don't know. I guess now that a psychiatrist has noticed these effects, they will be considered "real," finally.
Posted by Declan on April 3, 2006, at 2:58:58
In reply to zoloft sadness, happiness, rapture, and love, posted by River1924 on April 3, 2006, at 1:11:18
So fear and anger are unaffected? This med is clearly no use to me. It sounds like a really bad deal. What's so bad about sadness, not to speak of rapture, love, and happiness.
Declan
Posted by linkadge on April 3, 2006, at 9:30:47
In reply to Re: zoloft sadness, happiness, rapture, and love, posted by Declan on April 3, 2006, at 2:58:58
>So fear and anger are unaffected? This med is >clearly no use to me. It sounds like a really >bad deal. What's so bad about sadness, not to >speak of rapture, love, and happiness.
Exactly, I'd like a med that does the opposite. Ie decrease fear and anger, and intensified sadness rapture love and happiness. (well maybe not so much sadness)Linkadge
Posted by Cairo on April 3, 2006, at 13:58:31
In reply to zoloft sadness, happiness, rapture, and love, posted by River1924 on April 3, 2006, at 1:11:18
This was in a normal investigator. I don't think it means that all who use it will get those side effects. It's like giving insulin to someone with normal blood sugar. They might get hypoglycemic.
Don't throw the baby out with the bathwater.Cairo
Posted by ed_uk on April 3, 2006, at 14:22:34
In reply to Re: zoloft sadness, happiness, rapture, and love, posted by Cairo on April 3, 2006, at 13:58:31
I can't feel love on an SSRI. Not really.
Ed
Posted by SLS on April 3, 2006, at 15:17:01
In reply to Re: zoloft sadness, happiness, rapture, and love, posted by linkadge on April 3, 2006, at 9:30:47
> >So fear and anger are unaffected? This med is >clearly no use to me. It sounds like a really >bad deal. What's so bad about sadness, not to >speak of rapture, love, and happiness.
>
>
> Exactly, I'd like a med that does the opposite. Ie decrease fear and anger, and intensified sadness rapture love and happiness. (well maybe not so much sadness)Nardil.
:-)
- Scott
Posted by john berk on April 3, 2006, at 16:20:28
In reply to Re: zoloft sadness, happiness, rapture, and love, posted by SLS on April 3, 2006, at 15:17:01
I Have just weaned off prozac on to St. Johns Wort, and I am gradually feeling emotions i haven't felt in the last 4 years, I filled up, [actually shed a tear] while reading a favorite passage of a book, I was emotinal at the end of "walk the line", the movie, on saturday, and have returned to church. i honestly am beginning to feel like myself again, i feel more need to be out and around people, and i'm sure i don't have to mention the renewed sexual responsiveness. [ although i just did].
with ocd on my plate, ssri's were very helpful, but i survived without them for my first 31 years of life, and i am now resolved to deal with my ocd with CBT, st. johns wort, and plenty of exercise.i don't find that study suprising in the least, i know for a fact my basic emotions were blunted, if i ever do need a return to anti-depressant meds, i will try a class outside the ssri's for certain. 4 years withouit a tear of happiness or sadness is quite enough, even for a guy, lol. and i never went over 30 mgs. of prozac. [i tryed zoloft 50 mgs., luvox 100 mgs., and celexa also]
for those that need and tolerate ssri's, i know they are a godsend, but i pray i can move on without them...john
Posted by Declan on April 3, 2006, at 17:58:04
In reply to Re: zoloft sadness, happiness, rapture, and love, posted by SLS on April 3, 2006, at 15:17:01
If you want to reduce fear and anger and leave sadness, rapture, happiness and love alone, it seems Nardil, oxytocin or opiates then? And something for irresponsibility perhaps.
Declan
Posted by Phillipa on April 3, 2006, at 18:40:33
In reply to Re: zoloft sadness, happiness, rapture, and love, posted by Declan on April 3, 2006, at 17:58:04
Hey Decie I got a prescription for percocet at the ER for chestpain. My hearts okay by the way but I think that one pill at bedtime for the last two days is making me feel better is that possible? And I've cut down on the luvox to 50mg. Love Phillipa
Posted by CEK on April 4, 2006, at 10:34:08
In reply to Re: zoloft sadness, happiness, rapture, and love » Declan, posted by Phillipa on April 3, 2006, at 18:40:33
On Effexor I felt no anger(even when needed) and felt no love for no one. I cared for my children, but didn't feel the insane love for them that I use to feel. I never even cried. It wasn't until I was off of the AD that I felt guilt for not feeling the love which has now increased my depression because there is nothing that I can do to fix the past. The anger and imense irritation is back along with the love and tears.
Posted by Declan on April 4, 2006, at 13:54:06
In reply to Re: zoloft sadness, happiness, rapture, and love » Declan, posted by Phillipa on April 3, 2006, at 18:40:33
Hi PJ
Percocet. Oxycodone with nasty paracetamol? Hmmm. There was a product here called Percodan, which was maybe a little similar. As soon as they add anything to a narcotic (or make it slow release), the reassuring plain, simple appearance is abandoned in favour of gaudy colours and shapes. Be that as it may, I'm very pleased for you.
Declan
Posted by linkadge on April 4, 2006, at 14:07:53
In reply to Re: zoloft sadness, happiness, rapture, and love, posted by CEK on April 4, 2006, at 10:34:08
I blew off a number of good relationships simply because I couldn't feel the need to form intimate friendships.
We all need people. We all need to be loved and cared about and cared for.
SSRI's often nullified that dimention to life and at first it seemed liberating, but it slowly just evolved into an increasingly robotic personality.
Even the lack of crying was a hard thing to take. Its like the drugs physically blocked the ability to cry. Crying can release emotions that often get bottled up inside. It can be a very good feeling afterwards. Like an orgasm (no grossness intented) which SSRI's can blunt too.
On SSRI's it was much easier to think about suicide because at times the only reason for staying alive is for other people's sake. If you can't feel that dimention of connection, then, in some ways, there really isn't much reason to live.
A robot doesn't care if its alive or dead.
Linkadge
Posted by john berk on April 4, 2006, at 14:47:13
In reply to Re: zoloft sadness, happiness, rapture, and love » CEK, posted by linkadge on April 4, 2006, at 14:07:53
That is exactly what i was feeling Link,
like i was existing to get well for others, my p-doc, my mom who is ill, my family in general, but not myself. I stayed on SSRI'S out of fear, fear of letting others down, since there was supposedly a [cure?], "prozac", everyone and their mother knew prozac was the key, i felt obligated at times to take it, i swear.i actually am excited about the upcoming summer, being off prozac, i even connected with a woman who lives on my cul de sac, before this i was not in need of people, just meds!!
i still hope i can keep my ocd in check with cbt and st. johns wort, but it is worth the struggle to feel like myself again..john
Posted by River1924 on April 4, 2006, at 19:20:11
In reply to Re: zoloft sadness, happiness, rapture, and love » CEK, posted by linkadge on April 4, 2006, at 14:07:53
Link, I agree. When my Dad died, I didn't feel much of anything. We weren't close but I did live with him. My entire family was in tears when they disconnected the ventilator but I was just like an alien (or robot) there to observe the procedure.
I glad someone posted about the amotivational syndrome or SSRI induced apathy a week or two ago on psychobabble. I've been on SSRI's or effexor (most of the time) since the 1990's and I really haven't had a close friend for years. Or much aspiration.
I wonder if Parnate or Wellbutrin would be less deadening. Seroquel and Geodon made me laugh at everything on tv and I could get angry very easily and I cried. (But I can't take them because it affects histamine and any drug that does makes me sleep 80% of the time.)
I'm babbling but I'm usually pretty clever but I never connected my so called "social phobia" with my zoloft induced indifference.
It is weird sometimes how the mind ignores information. I had heard of emotional blunting but I never thought to apply it to my self.
PeaceLoveMysteryGrace. River.
Posted by River1924 on April 4, 2006, at 19:56:01
In reply to Re: zoloft sadness, happiness, rapture, and love » linkadge, posted by River1924 on April 4, 2006, at 19:20:11
This link lists tons or reasons friendship and oxytocin are life enhancing: (It is rather odd site but it seems serious)
http://www.reuniting.info/science/research/benefits_of_sex_without_orgasmBut then I noted: Sustained desensitization of hypothalamic 5-Hydroxytryptamine1A receptors after discontinuation of fluoxetine (serotonin and oxytocin: 60 days after discontinuation of prozac oxytocin response was still low compared to controls)
Does this meanSSRI's induce a permanent alienation? Is that why I feel so awful when I discontinue them. I don't have withdrawal like some but I feel empty/lonely.
Any comments? River.
PS :
(This post also is related to another: http://www.dr-bob.org/babble/20060403/msgs/628875.html)
Posted by linkadge on April 4, 2006, at 20:19:41
In reply to Re: zoloft sadness, happiness, rapture, and love » linkadge, posted by john berk on April 4, 2006, at 14:47:13
No I can believe that. I took my meds faithfully for a long time just so I wouldn't scare my mother. If I told her that I'm coming off my meds she would get all worried about me.
To be honest, I think they're still under the impression I am taking meds.
Linkadge
Posted by linkadge on April 4, 2006, at 20:24:49
In reply to Re: zoloft sadness, happiness, rapture, and love » linkadge, posted by River1924 on April 4, 2006, at 19:20:11
Thats the thing. SSRI's are prescribed for social phobia, and thats great they worked to reduce my fear of people. But OTOH, I also stopped caring about actually talking to or meeting people.
There are different dimentions of poor social relationships. You need both the desire to initiate a relationship and the nerves to be around people. So if I have the nerves to talk to people but no desire then I really no better off!
Yes, I did find that parnate was better in this regard. I think that PEA might be altered in social phobia.
Linkadge
Posted by linkadge on April 4, 2006, at 20:35:31
In reply to Re: zoloft sadness, happiness, rapture, oxytocin, posted by River1924 on April 4, 2006, at 19:56:01
Yeah, I think most SSRI's decrease oxycontin, though I'm not sure.
I think this was the study.
http://jpet.aspetjournals.org/cgi/content/full/288/1/98
I would think that functionality would return eventually.
In America we don't touch people enough. Oxytocin is increased with contact, doesn't necessarily need to be sexual. Human contact can be very healing.
Those mice were cute.
Linkadge
Posted by Laurie Beth on April 5, 2006, at 14:15:15
In reply to Re: zoloft sadness, happiness, rapture, oxytocin, posted by River1924 on April 4, 2006, at 19:56:01
I'm a nursing mom with post-partum depression. I felt great during this pregnancy. True, I was on ~50 mg. of Zoloft throughout (I had continued on Zoloft after a prior PPD episode). But it seemed to me that the pregnancy hormones themselves were a big factor in my feeling very good. (After several years of secondary infertility treatment, I was thrilled to beat the odds and get pregnant at age 41, so that might have something to do with it too, but I also felt better in the second and third trimesters than in the first, so I tend to think that the high levels of estrogen and progesterone, perhaps in combination with the Zoloft, were making me feel good and think clearly.) At birth, we raised my Zoloft dose to 100 mg. prophylactically, in one day. Possibly that had something to do with what happened next, but note that I had been on 200 - 300 mg. of Zoloft between pregnancies, with some blunting of affect and some decrease in motivation, but not so much that I chose to go off at the time (even after I finally figured out that Zoloft was implicated in thesse reactions; no one told me that; like many here, I had to figure it out on my own before I saw it confirmed here). I nursed this baby, as I did my first baby, and continued to feel good for the first 2 months after she was born, and thought that Zoloft and many other precautions had saved me from a second episode of PPD. Then, when she started sleeping through the night at 2 months, I started to feel more anxious, perfectionistic, irritable, and apathetic, started having some insomnia, started having trouble making decisions, and started having problems with cognitive slowing, memory, and even clumsiness. We raised the dose to 200 mg., and the anxiety went away, replaced by increased cognitive slowing, incredible sleepiness and, when I wasn't so sleepy, incredible apathy and anhedonia. I was still nursing.
So why did I now feel SOOOO bad on 100 - 200 mg. of Zoloft, when I had felt only some apathy and emotional blunting on 200 mg. - 300 mg. before? Maybe it was just Zoloft poop-out, but I wonder about the role of of the hormones involved, or of the sudden change in hormones - from estrogen and progesterone in pregnancy, to prolactin and oxytocin after birth, and then, at 2 months, presumably to less, but still significant levels prolactin and oxytocin, as I continued to nurse the baby, but no longer during the night.
I often try to puzzle out these connections. But I can't figure it out in any satisfying way.
I have since gone off Zoloft completely (very slow taper), and started being able to cry again (thank goodness), but I still had significant apathy, anhedonia, and irritability. Two months after taking my last Zoloft pill, I started on Wellbutrin, and am now at 600 mg. and doing better on all fronts - not great, but better. I am still nursing, but my baby is now 15 months, and the birth is 15 months past, so I'm not sure how much of the change is attributable to the Wellbutrin, and how much is attributable to just time, or to being the mother of a toddler instead of a baby now.
My pdoc said that I'd probably be fine again if we could induce a "false pregnancy" hormone state in me. I speculated to him that my brain just doesn't seem to like prolactin (because I had PPD both times, while nursing my daughters), but he said if that, if anything, the emotional and mental difficulties probably had more to do with oxytocin (but he didn't elaborate).
So, for me, it doesn't seem as simple as oxytocin good / serotonin bad. Though I do think that rapid CHANGES in hormones (due to nursing, and due to probable perimenopause) might be a big part of the problems.
Speculation welcome....
-Laurie
Posted by Declan on April 5, 2006, at 14:52:56
In reply to Re: zoloft , apathy/anhedonia, pregnancy, nursing, posted by Laurie Beth on April 5, 2006, at 14:15:15
My wife always said that she was so contented when pregnant, and put it down to hormones. Domestic contentment. Progesterone?
Declan
Posted by linkadge on April 5, 2006, at 15:11:31
In reply to Re: zoloft , apathy/anhedonia, pregnancy, nursing, posted by Declan on April 5, 2006, at 14:52:56
You're right that it is probably more complicated than we understand. In my own case, it is easier to discriminate the effects of the medications since I am niether female nor pregnant.
In addition I don't exactly know where my resting levels of oxytocin are and how they are affected by SSRI treatment. We do know that for some people SSRI's can cause apathy and emotional blunting, but the exact reasoning is yet to be elucidated.
It may sound really weird, but different medications are able to alter my sexual preference. I am male and tend towads males, but high doses of noradrenergic drugs have been able to make me more attracted to females.
Different neurotransmitters interact with different hormonal systems.
Although, I personally hate all this tinkering around it makes me feel like a freak.
Linkadge
Posted by River1924 on April 5, 2006, at 23:31:56
In reply to Re: zoloft , apathy/anhedonia, pregnancy, nursing, posted by linkadge on April 5, 2006, at 15:11:31
This blog is all about oxytocin--- really---
a very specialized blog. It is interesting and fun.http://kuchinskas.typepad.com/hug_the_monkey/
Peace you all, River.
Posted by Tarasaur on June 25, 2010, at 3:18:47
In reply to Re: zoloft , apathy/anhedonia, pregnancy, nursing, posted by Laurie Beth on April 5, 2006, at 14:15:15
"> I'm a nursing mom with post-partum depression. I felt great during this pregnancy. True, I was on ~50 mg. of Zoloft throughout (I had continued on Zoloft after a prior PPD episode). But it seemed to me that the pregnancy hormones themselves were a big factor in my feeling very good. (After several years of secondary infertility treatment, I was thrilled to beat the odds and get pregnant at age 41, so that might have something to do with it too, but I also felt better in the second and third trimesters than in the first, so I tend to think that the high levels of estrogen and progesterone, perhaps in combination with the Zoloft, were making me feel good and think clearly.) At birth, we raised my Zoloft dose to 100 mg. prophylactically, in one day. Possibly that had something to do with what happened next, but note that I had been on 200 - 300 mg. of Zoloft between pregnancies, with some blunting of affect and some decrease in motivation, but not so much that I chose to go off at the time (even after I finally figured out that Zoloft was implicated in thesse reactions; no one told me that; like many here, I had to figure it out on my own before I saw it confirmed here). I nursed this baby, as I did my first baby, and continued to feel good for the first 2 months after she was born, and thought that Zoloft and many other precautions had saved me from a second episode of PPD. Then, when she started sleeping through the night at 2 months, I started to feel more anxious, perfectionistic, irritable, and apathetic, started having some insomnia, started having trouble making decisions, and started having problems with cognitive slowing, memory, and even clumsiness. We raised the dose to 200 mg., and the anxiety went away, replaced by increased cognitive slowing, incredible sleepiness and, when I wasn't so sleepy, incredible apathy and anhedonia. I was still nursing.
>
> So why did I now feel SOOOO bad on 100 - 200 mg. of Zoloft, when I had felt only some apathy and emotional blunting on 200 mg. - 300 mg. before? Maybe it was just Zoloft poop-out, but I wonder about the role of of the hormones involved, or of the sudden change in hormones - from estrogen and progesterone in pregnancy, to prolactin and oxytocin after birth, and then, at 2 months, presumably to less, but still significant levels prolactin and oxytocin, as I continued to nurse the baby, but no longer during the night.
>
> I often try to puzzle out these connections. But I can't figure it out in any satisfying way.
>
> I have since gone off Zoloft completely (very slow taper), and started being able to cry again (thank goodness), but I still had significant apathy, anhedonia, and irritability. Two months after taking my last Zoloft pill, I started on Wellbutrin, and am now at 600 mg. and doing better on all fronts - not great, but better. I am still nursing, but my baby is now 15 months, and the birth is 15 months past, so I'm not sure how much of the change is attributable to the Wellbutrin, and how much is attributable to just time, or to being the mother of a toddler instead of a baby now.
>
> My pdoc said that I'd probably be fine again if we could induce a "false pregnancy" hormone state in me. I speculated to him that my brain just doesn't seem to like prolactin (because I had PPD both times, while nursing my daughters), but he said if that, if anything, the emotional and mental difficulties probably had more to do with oxytocin (but he didn't elaborate).
>
> So, for me, it doesn't seem as simple as oxytocin good / serotonin bad. Though I do think that rapid CHANGES in hormones (due to nursing, and due to probable perimenopause) might be a big part of the problems.
>
> Speculation welcome....
>
> -Laurie"Hi, Laurie. I wonder if you have looked into acetalcholine. I have only recently been made aware of it when I read somewhere that introverts burn through way more acetalcholine than most people, and then they start to get childish and wonky (I know I do). The main source I have been looking at is from an article called "A Heads-Up Look at Brain Health," which can be found at
http://spwb.com/articles/brainarticle.html
Here is some of what it says about acetalcholine"
"AcetylcholineReview: A normal brain takes about 300 msec (milliseconds) plus a persons age in years to think. This is the measurement of the time delay, or latency, between a stimulus given and the recognition of that stimulus in the brain. As the latency increases (speed decreases), a person moves from mild cognition deficits to severe dementia.
Acetylcholine-associated disease states
A diagnostic evaluation of a persons brain speed can give objective evidence of disturbances in cognition, memory, attention, and behavior. After subtracting the patients age, the baseline latency measurement indicates the following: 300 msec is normal; 350 msec indicates mild to moderate disturbances in cognitive function (muddled thinking); 360 to 370 msec indicates ADD or variability of attention, errors of omission or commission, and delayed reaction time; 380 msec is typically found in Parkinson patients; 420 msec is the threshold for Alzheimer disease, with increasing latency as the dementia progresses. Early detection of deficiencies in the speed at which the brain operates can allow early intervention to slow or reverse the decline, possibly delaying or preventing the onset of Alzheimer and other dementias.
Beyond detecting a frank disease state associated with severe acetylcholine deficiency, physicians can analyze the balance of the four neurotransmitters to determine a patients personality type.
The acetylcholine-dominant personality
Acetylcholine is produced in the parietal lobes, which are responsible for thinking functions such as language processing, intelligence, and attention. People with an excess of acetylcholine (about 17% of the worlds population) are adept at working with their senses and view the world in sensory terms. They are quick thinkers, highly creative, and open to new ideas. Flexibility, creativity, and impulsivity open them up to trying almost anything, as long as it offers the promise of excitement and something new; they are not afraid of failure. They love to travel and have a quest for lifelong learning. These people also tend to be extremely sociable, even charismatic. They love making new friends and put a lot of energy into all of their relationships, whether at work, at home, or in the community. They are eternally optimistic, romantic with their significant other, and attentive to the needs of their children. They are quite popular with a broad range of people. People with extremely high levels of acetylcholine, however, risk giving too much of themselves to others, even to the point of being masochistic. They may feel that the world is taking advantage of them, or they may become paranoid. Too much acetylcholine can drive a person into isolation.
The acetylcholine-deficient personality
Low levels of acetylcholine result when either the brain burns too much or produces too little. Shifts in personality occur at a much milder deficiency than the dementia- producing deficiencies mentioned earlier. These personality traits can, in fact, manifest when the acetylcholine level is only slightly lower than the levels of the other three neurotransmitters. And remember, were looking at the relative balance of neurotransmitters. A deficiency in one neurotransmitter is usually offset by an excess of another, which typically produces the personality traits associated with a dominance of that other neurotransmitter.
The eccentric. The absence of thought connections to other people and the world makes this persons behavior seem odd. The eccentric usually steers away from human interaction and keeps himself isolated. Outwardly, he appears bland and inexpressive. When even mildly stressed, however, he can become a danger to himself and others.
The perfectionist. This person is usually hard working, detail oriented, devoted, and exacting. Self-discipline is a hallmark of this personality type, which can be either a plus or a minus, depending on the severity of the imbalance and which other neurotransmitter is dominant. This person can be an excellent worker, or he can be rigid and obsessive to the point that nothing is actually accomplished. The perfectionists life is usually lacking in enjoyment, relaxation, and warmth, which can make that person unapproachable."
Just throwing it out there. Good luck to all of us.
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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