![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 50 to 74 of 95. Go back in thread:
Posted by SLS on April 19, 2011, at 8:29:50
In reply to Re: the only way out, posted by poser938 on April 19, 2011, at 8:10:08
> so i guess there are no thoughts on what could fix what the mirapex did to me? i guess what it did was kind of like a tolerance thing. that it stimulated my receptors to where they're not tolerant of dopamine anymore. i know they're not because i tried ritalin and tianeptine in the past hoping they would help, they only made me worse.. ritalin made me worse after just one dose. i've been trying DXM (dextromethorphan) at 60mgs a day lately to see if it would help, but hasnt at all so far. its been a week since i started.
Perhaps Abilify would stabilize your DA synapses. It is part DA agonist and part DA antagonist. It also may increase DA activity in PFC via 5-HT2a receptor antagonism.http://www.ncbi.nlm.nih.gov/pubmed/11775041
http://altcancerweb.com/bipolar/abilify/abilify-illustrating-their-mechanism-of-action-stahl.pdf
http://www.ncbi.nlm.nih.gov/pubmed/17205315
- Scott
Posted by morgan miller on April 19, 2011, at 12:46:02
In reply to Re: the only way out » sigismund, posted by SLS on April 19, 2011, at 5:19:43
> > Traditional Chinese Medicine.
> >
> > When I was a kid I was quite frightened, but not badly so, just kind of obviously so. It would have been better for me to be offered TCM formulations than Valium in the 70s. It does the same thing in a more gentle way (at receptor sites), but it didn't really exist here then.
> >
> > If parents can be persuaded to do what is necessary to stop tormenting their children, that might be effective too.
>
> Unfortunately, this is true. Most people don't appreciate the unhealthy changes that can occur in a maturing brain when it is subject to unhealthy surroundings. This is especially true when chronic psychosocial stress is present. Of course, some people are wired to be less resilient than others. It is true that depression runs in families. However, so are pathological behaviors. They are often learned and passed on from generation to generation. If the rate of biological predisposition to depression is 10%, perhaps only 1% would develop the illness if everyone were raised in a low-stress, nurturing environment. 1% is probably an exaggeration, but it serves to make the point. The 10% is probably accurate.
>
>
> - ScottWow Scott we are totally on the same page. I got the impression that when I first joined this site we differed in our beliefs when it came to some topics like nurture versus nature. Maybe I just did not interpret what you were saying accurately. You did direct me to your blog, but I was too impaired at the time to really read it and break it down.
Are you still doing better on the current regimen?
Morgan
Posted by morgan miller on April 19, 2011, at 13:02:57
In reply to Re: the only way out, posted by poser938 on April 19, 2011, at 8:10:08
How about optimal nutrition and proper exercise?
As far as supplements go, I would try high DHA to EPA fish oil omega 3 supplements(maybe a good Cod liver oil, or even better Calamari oil Carlson has one) a good ginger extract(New Chapter's Ginger Force) and Luteolin(Lutimax). If you can afford these, they may be quite helpful.
http://www.ncbi.nlm.nih.gov/pubmed/20971650
http://www.ncbi.nlm.nih.gov/pubmed/19815045
http://www.ncbi.nlm.nih.gov/pubmed/18952146
http://www.livestrong.com/article/400030-can-fish-oil-boost-dopamine/
http://www.ncbi.nlm.nih.gov/pubmed/21109417
Posted by sigismund on April 19, 2011, at 14:07:57
In reply to Re: the only way out, posted by floatingbridge on April 18, 2011, at 23:37:05
>'m still trying to figure this one out. :-/
You are the picture of reasonableness. So you are not well? I don't think children are damaged so much by their parents depression as by confusion and denial around it.
I remember once my son told me that in year 12 he had, at one of those interactive things they have, told the class I guess, certainly the facilitator/teacher that I was depressed. And he told me he said that. He is in good shape. I think most of the problems arise when there is lots of mystification and confusion.
Posted by SLS on April 19, 2011, at 19:41:32
In reply to Re: the only way out, posted by morgan miller on April 19, 2011, at 12:46:02
> > > Traditional Chinese Medicine.
> > >
> > > When I was a kid I was quite frightened, but not badly so, just kind of obviously so. It would have been better for me to be offered TCM formulations than Valium in the 70s. It does the same thing in a more gentle way (at receptor sites), but it didn't really exist here then.
> > >
> > > If parents can be persuaded to do what is necessary to stop tormenting their children, that might be effective too.
> >
> > Unfortunately, this is true. Most people don't appreciate the unhealthy changes that can occur in a maturing brain when it is subject to unhealthy surroundings. This is especially true when chronic psychosocial stress is present. Of course, some people are wired to be less resilient than others. It is true that depression runs in families. However, so are pathological behaviors. They are often learned and passed on from generation to generation. If the rate of biological predisposition to depression is 10%, perhaps only 1% would develop the illness if everyone were raised in a low-stress, nurturing environment. 1% is probably an exaggeration, but it serves to make the point. The 10% is probably accurate.
> >
> >
> > - Scott
>
> Wow Scott we are totally on the same page. I got the impression that when I first joined this site we differed in our beliefs when it came to some topics like nurture versus nature. Maybe I just did not interpret what you were saying accurately. You did direct me to your blog, but I was too impaired at the time to really read it and break it down.
>
> Are you still doing better on the current regimen?
Yes I am. Thanks. I would say that I am about 35% improved. Since adding lithium, my mood is less variable. I am hoping that I will be 50% by the end of summer. I should be able to go back to work with such an improvement. I remain encouraged by the progress I have made since last August. It took about four months for the addition of Nardil to kick in. I am still looking into using vitamins and supplements to provide the building blocks and enzymes to encourage brain tissue growth and functional remodulation.Fish oil and phosphatidylserine are the first two substances I might add. Later, I might try adding N-acetylcysteine, Co-Q10, and other mitochondrial-sparing antioxidants. A bit of magnesium might not be a bad idea.
- Scott
Posted by huxley on April 19, 2011, at 20:08:02
In reply to Re: the only way out » poser938, posted by SLS on April 19, 2011, at 8:29:50
> > so i guess there are no thoughts on what could fix what the mirapex did to me? i guess what it did was kind of like a tolerance thing. that it stimulated my receptors to where they're not tolerant of dopamine anymore. i know they're not because i tried ritalin and tianeptine in the past hoping they would help, they only made me worse.. ritalin made me worse after just one dose. i've been trying DXM (dextromethorphan) at 60mgs a day lately to see if it would help, but hasnt at all so far. its been a week since i started.
>
>
> Perhaps Abilify would stabilize your DA synapses. It is part DA agonist and part DA antagonist. It also may increase DA activity in PFC via 5-HT2a receptor antagonism.
>
> http://www.ncbi.nlm.nih.gov/pubmed/11775041
>
> http://altcancerweb.com/bipolar/abilify/abilify-illustrating-their-mechanism-of-action-stahl.pdf
>
> http://www.ncbi.nlm.nih.gov/pubmed/17205315
>
>
> - ScottScott perhaps you should also point out some of the side effects and unwanted effects of anti
psychotics.
Posted by SLS on April 19, 2011, at 20:34:48
In reply to Re: the only way out, posted by huxley on April 19, 2011, at 20:08:02
> > > so i guess there are no thoughts on what could fix what the mirapex did to me? i guess what it did was kind of like a tolerance thing. that it stimulated my receptors to where they're not tolerant of dopamine anymore. i know they're not because i tried ritalin and tianeptine in the past hoping they would help, they only made me worse.. ritalin made me worse after just one dose. i've been trying DXM (dextromethorphan) at 60mgs a day lately to see if it would help, but hasnt at all so far. its been a week since i started.
> >
> >
> > Perhaps Abilify would stabilize your DA synapses. It is part DA agonist and part DA antagonist. It also may increase DA activity in PFC via 5-HT2a receptor antagonism.
> >
> > http://www.ncbi.nlm.nih.gov/pubmed/11775041
> >
> > http://altcancerweb.com/bipolar/abilify/abilify-illustrating-their-mechanism-of-action-stahl.pdf
> >
> > http://www.ncbi.nlm.nih.gov/pubmed/17205315
> >
> >
> > - Scott
>
> Scott perhaps you should also point out some of the side effects and unwanted effects of anti
> psychotics.Since you brought up this issue, I think it would be appropriate for you to attend to it yourself. I look forward to your contributions. Your list of unwanted effects should be specific for Abilify, since it is this drug that I chose to speak about. Citations are welcome.
- Scott
Posted by morgan miller on April 19, 2011, at 21:34:05
In reply to Re: the only way out » morgan miller, posted by SLS on April 19, 2011, at 19:41:32
Hey Scott,
Great to hear you continue to do better. I've read some good things about milk thistle and the brain lately, like neuroprotection and increase BDNF. I'm sure you are getting plenty of BDNF with your medication regimen, but a little extra neuroprotection and liver and kidney protection would not hurt.
http://www.stopagingnow.com/liveinthenow/article/this-super-herb-protects-both-liver-and-brain
Hope your journey towards wellness continues in the right direction.
Morgan
Posted by floatingbridge on April 20, 2011, at 0:21:49
In reply to Re: the only way out » floatingbridge, posted by sigismund on April 19, 2011, at 14:07:57
> >'m still trying to figure this one out. :-/
>
> You are the picture of reasonableness.Ask my husband :-) The internet can do wonders for one's personality. (Thanks, though sigi.)
>So you are not well? I don't think children are damaged so much by their parents depression as by confusion and denial around it.
I guess that is probably more accurate. Sigh. It's that depression, well, mine, just takes away so much focus. I can be very self-absorbed. Getting better. Still. Not what I had in mind.
>
> I remember once my son told me that in year 12 he had, at one of those interactive things they have, told the class I guess, certainly the facilitator/teacher that I was depressed. And he
told me he said that. He is in good shape. I think most of the problems arise when there is lots of mystification and confusion.This made me laugh. It really is funny; not in an lol way. But funny beautiful or funny poignant. Are you better now than you were? You strike me as someone with a certain amount of self-acceptance.
My son certainly understands that my
pain level affects my mood and ability to participate or tolerate things like jumping on my back. He calls it my arthritis (even though it's only a little OA). I wonder how I would explain depression in an o.k. way. He's just past seven.He seems like he understands alot--verbal and precocious that way, but his world is still very magical. It's like intermittent rationality.
I suppose the most we've ever touched upon it was when my father died, and
sometimes I would be hit by a wave of saddness. Like clouds over the sun, I would say. I was missing my dad. It's o.k. to be sad.Now I'm making the effort to work on anger. I find that as difficult as
saddness. And my son has a temper. I suppose everyone does, but my son is not mild. The best approach is to
understand and manage my own--or else I'll won't be much help to him with
his.He understands in his way his grandfather's Parkinson's--papa's illness, he calls it. And doesn't take his grandfather bouts of discomfort and intolerance (sensitivity to stimulation--
anvawful disease) personally. It's very moving, actually.But a parent with a MI? I just don't know. For me, that is. Still guilty. Scared. When did you start talking to your son? (About depression.) How did you make it be o.k. for your family?
Posted by sigismund on April 20, 2011, at 1:06:12
In reply to Re: the only way out, posted by floatingbridge on April 20, 2011, at 0:21:49
If I were you I would try not to react to your son's temper with anger of your own. My daughter could be terribly provocative. When she was 2 she upended the ice cream on her tray and ground it round with the palm of her hand and looked at us challenging us. My sister was visiting and remembers it. I don't. I am bad with that sort of thing. It is always best to avoid a conflict of wills. Our society is already way too willful.
My depression is not nearly so serious as yours. I never had to call it MI. I just bitched about everything, and we talked and talked, and those who didn't want to talk were free not to.
Sadness is lovely in its way. Anger and depression are not.
The way you manage your depression with your son can either be done well or be done badly.
You can find a way to do it as well as possible.
Posted by 49er on April 20, 2011, at 3:45:38
In reply to the only way out, posted by poser938 on April 16, 2011, at 11:16:30
> so i think i've finally realized the only way out of the situation i'm is to off myself. i've been suffering from stimulant induced anhedonia for a year and a half.(and SSRI induced anhedonia for 3 years before that, i have both now) im completely numb to any feelings of pleasure. im wasting my life just laying in my bed all day everyday. i have zero drive.. and it hurts. i've been to two different psychiatrists and both told me they cant help me. so i guess i'm stuck like this, which is just unnacceptable. i need some help somebody...
Hi Poser,
First of all, I am so sorry that you feel so distressed that you feel the need to commit suicide. As one who has dealt with withdrawal symptoms from psych meds, your feelings are totally understandable.
With all due respect to the other comments, if someone came off of drugs too fast such as cold turkeying them, it is definitely possible to still be suffering from the effects of the drugs.
Have you tried supplements and if so, what you have tried to deal with the symptoms?
Please don't do anything rash ok?
49er
PS - Sadly, psychiatrists aren't much help in this area. But physicians in general aren't helpful with drug side effects.
Posted by 49er on April 20, 2011, at 3:48:54
In reply to Re: the only way out » poser938, posted by SLS on April 18, 2011, at 5:52:41
Sorry, I didn't see your previous post in which you indicated you were going to try drugs again.
Good luck with that.
49er
Posted by SLS on April 20, 2011, at 5:24:00
In reply to Re: the only way out » SLS, posted by morgan miller on April 19, 2011, at 21:34:05
Hi Morgan.
Thanks for the milk thistle links. Very interesting.
I have a saint of a benefactor whom has taken an interest in helping to heal me. He sent me a whole bunch of vitamins and supplements that includes milk thistle. He also invested hours in composing letters with citations to help educate me. I am very grateful for this individual's help.
I have become shy to ingesting "natural" substances simply because some have made me feel MUCH worse. P-5-P induced a suicidal state within a few hours of taking it early in the day. By evening, this state disappeared. Calcium and magnesium make me feel moderately worse. So does Deplin. I tried NAC a few years back, and I recall it made me feel worse as well. I am willing to try it again, perhaps at a reduced dosage. Vitamins and supplements contain a plethora of chemical substances. I have come to treat them with as much respect as I treat pharmaceuticals.
> Hope your journey towards wellness continues in the right direction.
Thanks Morgan, that means a lot to me.
- Scott
Posted by SLS on April 20, 2011, at 6:44:00
In reply to Re: the only way out » poser938, posted by 49er on April 20, 2011, at 3:45:38
Hi 49er.
> First of all, I am so sorry that you feel so distressed that you feel the need to commit suicide. As one who has dealt with withdrawal symptoms from psych meds, your feelings are totally understandable.
I think many people are confusing withdrawal with persistent changes in structure and function. In my experience and observation, drugs can often go in, make changes, and go out, leaving the system in a different state than when it went in. This is evidenced by several phenomena, including drug poop-out, post SSRI sexual and motivational deficits, and the loss of responsiveness to a drug following its discontinuation. These are not acute withdrawal symptoms. They are residual and persist long after drug discontinuation.
I agree with many of your recommendations for drug discontinuation, although I am still of the opinion that the rate of taper you suggest is too slow for most of the drugs being used in psychiatry.
- Scott
Posted by 49er on April 20, 2011, at 7:50:17
In reply to Re: the only way out » 49er, posted by SLS on April 20, 2011, at 6:44:00
Hi Scott
"I think many people are confusing withdrawal with persistent changes in structure and function. In my experience and observation, drugs can often go in, make changes, and go out, leaving the system in a different state than when it went in."So far, we're in agreement.
" This is evidenced by several phenomena, including drug poop-out, post SSRI sexual and motivational deficits, and the loss of responsiveness to a drug following its discontinuation. These are not acute withdrawal symptoms. They are residual and persist long after drug discontinuation. "
Poop out is not a withdrawal symptom in my opinion. That refers to the feeling that the drug has lost its effectiveness when you are taking it.
But regarding motivational and sexual dysfunction, they can either be withdrawal symptoms or residual depending on if they resolve or not which they do for some people. The problem is if they are residual, many psychiatrists will erroneously blame it on the person's label.
> I agree with many of your recommendations for drug discontinuation, although I am still of the opinion that the rate of taper you suggest is too slow for most of the drugs being used in psychiatry.
>
I vehemently disagree. I wish I had a nickle for how many times I have seen posts on boards like this one and others where it was clear to me the person had problems from tapering way too fast.What is the rush? The only issue I see where tapering slowly may not be a good thing is if the doctor feels the side effects are so life threatening that the person has to get off the drug immediately.
But even in cases like that, I have seen people have withdrawal symptoms that were so horrendous that i wonder if simply lowering the dose slowly would have lessened the problems.
After all, Jay Cohen, a psychiatrist who is not anti meds has said alot of side effects are from increasing meds too quickly and starting patients on too large of a dose.
I guess my question to you is what specific objections do you have regarding my plan being too slow?
49er
Posted by SLS on April 20, 2011, at 9:09:12
In reply to Re: the only way out » SLS, posted by 49er on April 20, 2011, at 7:50:17
> Hi Scott
>
> "I think many people are confusing withdrawal with persistent changes in structure and function. In my experience and observation, drugs can often go in, make changes, and go out, leaving the system in a different state than when it went in."
>
> So far, we're in agreement.
>
> " This is evidenced by several phenomena, including drug poop-out, post SSRI sexual and motivational deficits, and the loss of responsiveness to a drug following its discontinuation. These are not acute withdrawal symptoms. They are residual and persist long after drug discontinuation. "
>
> Poop out is not a withdrawal symptom in my opinion.I agree. I think you misunderstood me.
> That refers to the feeling that the drug has lost its effectiveness when you are taking it.
When poop-out occurs, something in the brain has changed. Perhaps it involves a type of overshoot that destabilizes the system. This change usually results in a resistence to responding to that same drug subsequently.
Withdrawal Effects vs Residual Effects: Not only are withdrawal effects time-limited, but they differ significantly in presentation.
"severe flulike symptoms - headache, diarrhea, nausea, vomiting, chills, dizziness and fatigue. There may be insomnia. Agitation, impaired concentration, vivid dreams, depersonalization, irritability and suicidal thoughts are sometimes occurring. These symptoms last anywhere from one to seven weeks and vary in intensity."
Not to mention the brain zaps.
> > I agree with many of your recommendations for drug discontinuation, although I am still of the opinion that the rate of taper you suggest is too slow for most of the drugs being used in psychiatry.
> >
> I vehemently disagree. I wish I had a nickle for how many times I have seen posts on boards like this one and others where it was clear to me the person had problems from tapering way too fast.I'm not advoacating abrupt discontinuation. However, when the situation arises where a doctor and patient elect to change medications, it is prohibitive to spend a year or more to taper the old drug before beginning the new drug.
> What is the rush?
Please see above.
Respectfully.- Scott
Posted by floatingbridge on April 20, 2011, at 10:43:01
In reply to Re: the only way out, posted by sigismund on April 20, 2011, at 1:06:12
sigi, yes, it's very true to my experience that meeting anger of that sort (hmmm, or any...?) with mine is a lose lose situation.
Yesterday, just by coincidence, I was able to meet my son's absolute rage with some equanimity. (That's the upside of being ill w/ stress-responsive ailmemts; I can't afford to get too upset:-/ )
I did need to use my 'voice of god'. Different than yelling. We really worked on the trigger event when he calmed down (a classmate interaction). Which was pretty rapid. Amazing. The rapidity w/which it subsided. He's a pretty sensitive boy. Quick to take umbrage.
Provocative is a very useful word. Here too, in my son's case; therefore I can picture your young daughter and the ice cream quite vividly.
Girls can be quite willful. Amazingly so. All the more surprising because, at least in the US it is schooled out of them regularly. Boys, well, they get, imho, too
much slack line early, (boys will be boys), only to have the heat turned up if they fail to perform in the early grades. Very confusing and harmful.E. B. White, writing as Templeton the Rat, while observing Avery in Charlotte's Web: what fantastic creatures boys are!
Having never been one, I'm inclined to agree.
Sigi, thanks so much. I am very glad to hear that your experience of depression was not so invasive. And that anxiety, well, that you seem to have a very workable relationship with it. I think I'm going to return the thread to poser. I feel like an absolute chatterbox. I'll visit social.
Posted by 49er on April 20, 2011, at 10:51:01
In reply to Re: the only way out » 49er, posted by SLS on April 20, 2011, at 9:09:12
49er- " Poop out is not a withdrawal symptom in my opinion."
SL - " I agree. I think you misunderstood me."
Wouldn't be the first time I misunderstood someone:)
"When poop-out occurs, something in the brain has changed. Perhaps it involves a type of overshoot that destabilizes the system. This change usually results in a resistence to responding to that same drug subsequently.""
Sorry for my elementary question but when you say overshoot, are you talking for example about an SSRI drug that is overloading the system with Serotonin?
> Withdrawal Effects vs Residual Effects: Not only are withdrawal effects time-limited, but they differ significantly in presentation.
>
> "severe flulike symptoms - headache, diarrhea, nausea, vomiting, chills, dizziness and fatigue. There may be insomnia. Agitation, impaired concentration, vivid dreams, depersonalization, irritability and suicidal thoughts are sometimes occurring. These symptoms last anywhere from one to seven weeks and vary in intensity."Uh, they can last alot longer than that. And they come and go.
<<I'm not advoacating abrupt discontinuation. However, when the situation arises where a doctor and patient elect to change medications, it is prohibitive to spend a year or more to taper the old drug before beginning the new drug.>>
I see your point. But again, I see too many situations where people were transitioned way too quickly from one drug to another and suffered horribly.
The problem is by doing this too quickly, you can't really access whether the person is on the right drug or not because withdrawal symptoms are confusing the issue.
49er
Posted by floatingbridge on April 20, 2011, at 11:03:08
In reply to Re: the only way out, posted by poser938 on April 19, 2011, at 8:10:08
> so i guess there are no thoughts on what could fix what the mirapex did to me? i guess what it did was kind of like a tolerance thing. that it stimulated my receptors to where they're not tolerant of dopamine anymore. i know they're not because i tried ritalin and tianeptine in the past hoping they would help, they only made me worse.. ritalin made me worse after just one dose. i've been
trying DXM (dextromethorphan) at 60mgs a day lately to see if it would help, but hasnt at all so far. its been a week since i started.poser,
Seems your post has sparked quite a discussion. How are you hanging in there?
I can second the need for supplemental support. In my case, krill oil (just another type of good quality fish oil) and a few other things (gaba and gaba promoting agents) are helpful. I recently added a melatonin mix, but only after a month or so of being stable on other supplements.
Not that I'm at all saying go out and get some vitamins. Actually, I also second some comments to add supplements very slowly. To my mind, you are pre-
disposed to being sensitive or perhaps drug and/or depressive state have heightened sensitivity.Some people report negative responses to fish oil. Besides, you are considering further medical intervention. You are in
a tough spot, it's very true, but not impossible. Do you take notes about your med trials responses and duration of usage? I find that helpful for getting perspective.Take good care. Please post how you are doing. I feel others would like to know, too.
Posted by SLS on April 20, 2011, at 12:45:35
In reply to Re: the only way out » SLS, posted by 49er on April 20, 2011, at 10:51:01
> 49er- " Poop out is not a withdrawal symptom in my opinion."
>
> SL - " I agree. I think you misunderstood me."
>
> Wouldn't be the first time I misunderstood someone:)
>
> "When poop-out occurs, something in the brain has changed. Perhaps it involves a type of overshoot that destabilizes the system. This change usually results in a resistance to responding to that same drug subsequently.""
>
> Sorry for my elementary question but when you say overshoot, are you talking for example about an SSRI drug that is overloading the system with Serotonin?I was just thinking out loud. Silly, I know. I was thinking along the lines of receptor downregulation continuing beyond the point that is necessary to maintain efficient neurotransmission. It would be a gene expression thing. Sorry for my elementary answer to a sophisticated question.
> > Withdrawal Effects vs Residual Effects: Not only are withdrawal effects time-limited, but they differ significantly in presentation.
> >
> > "severe flulike symptoms - headache, diarrhea, nausea, vomiting, chills, dizziness and fatigue. There may be insomnia. Agitation, impaired concentration, vivid dreams, depersonalization, irritability and suicidal thoughts are sometimes occurring. These symptoms last anywhere from one to seven weeks and vary in intensity."> Uh, they can last alot longer than that. And they come and go.
What are the most common symptoms to persist beyond 4 weeks?
If we were talking about Paxil at 40mg or Effexor at 300mg, approximately how long would it take to taper these drugs and reach total discontinuation using a the schema you recommend? A rough guess would be fine. 4 weeks? 12 weeks? 12 months?
> <<I'm not advocating abrupt discontinuation. However, when the situation arises where a doctor and patient elect to change medications, it is prohibitive to spend a year or more to taper the old drug before beginning the new drug.>>
> I see your point. But again, I see too many situations where people were transitioned way too quickly from one drug to another and suffered horribly.
>
> The problem is by doing this too quickly, you can't really access whether the person is on the right drug or not because withdrawal symptoms are confusing the issue.This is true. I guess one would rely on the notion that the period for withdrawal is time limited. I don't think a depressive rebound due to the discontinuation of antidepressants will usually last much beyond four weeks. I'm not absolutely sure, though. I think the answer to this question will depend upon which observations one is using to identify true withdrawal, and which are consistent with a syndrome of persistent post-discontinuation adverse effects. Although I have seen references to a time limit on withdrawal periods as a way of delineating adverse events, I have not seen any kind of scientific investigation to resolve this issue. I haven't looked, though.
- Scott
Posted by linkadge on April 20, 2011, at 17:18:33
In reply to Re: the only way out, posted by morgan miller on April 19, 2011, at 1:42:06
I've had no problem with benzodiazapines. I use about 2-3 a week, during stressfull times and when the stress subsides I just stop.
I'm not saying people don't have problems with benzos, just like people have problems with alcohol, but that doesn't mean that everybody who drinks will become an alcoholic.
I would advise people against projecting their own negative experiences on everybody.
I'd much prefer a benzo to an SSRI. I wish my doctor had just prescribed a benzodiazapine when I was anxious at 16. I have found them far less mind altering than SSRI's.
Linkadge
Posted by linkadge on April 20, 2011, at 17:43:08
In reply to Re: the only way out, posted by poser938 on April 19, 2011, at 8:10:08
>that it stimulated my receptors to where they're >not tolerant of dopamine anymore. i know they're >not because i tried ritalin and tianeptine in >the past hoping they would help, they only made >me worse.. ritalin made me worse after just one >dose.
Is this before or after the mirapex? Also your investigation is by far not diagnostic of anything. Ritalin has effects on norepinephrine too. Depression can depleat norepinephrine and dopamine rendering it less sensitive to monoamine reuptake. Ever consider that your catecholamine levels are just low (due to depression)?
Also, the sensitivity towards ritalin euphoria is not universal. People with ADHD oftentimes notice the side effect of *depression* from stimulants, yet they still work for ADHD. In mice, the sentivity to stimulants is dramatically influenced by levels of p11 (which is decreased in animal models of depression). When people are depressed, they get less reward from most things, including food, drugs, sex, whatever. Its also got to do with dynorphin and prodynorphin which are natural kappa agonists which are increased in animal models of depression.
When you take a stimulant, it increases the levels of dynorphin to try and reduce the dopamine's pleasurable effect. Interestingly, even though dynorphin has prodysphoric effects, it has potent anti-ADHD effects. Some theorize that its actually the natural dynorphin response that produces the antihyperkinetic effect of ritalin.
Dynorphin doesn't decrease dopamine responsivity it just decreases dopamine release. Dynorphin levels are increased in depression and also dramatically influence the behavioral responses to stimualants.
Also prolonged exposure to dopamine can actually produce depression. Read the following article. Dopamine is *not* the magic pleasure chemical. When mice are exposed to too much mesolimbic dopamine they get depressed! (And this is not due to a simple loss of dopamine responsiveness). The brain is wired to produce a depressive response to too much pleasure! Yes, this is because too much activation of mesolimbic dopamine actually turns on CREB and BDNF in these regions which produce behavioral depression! This is why dopamine blocking (or serotonin raising antidepressants, are generally effective), because, by boosting serotonin, they lower dopamine and hence CREB in this region, and reballance serotonin / dopamine (or so the theory goes).Stress can also increase dopamine release, and increase risk of psychosis and/or depression in susceptable individuals.
People here don't seem to get that! They just read some stupic oversimiplistic websites that say dopamine makes you feel good.
http://www.webmd.com/depression/news/20050728/dopamine-may-play-new-role-in-depression
In certain instances, dopamine mediates feelings of pleasure, but its not a simple dopamine = pleasure effect. Dopamine works in conjunction with many many other brain chemicals to mediate feelings of well being and reward.
For instance, SLS has noted that ritalin often makes his depression worse. Is this because his dopamine receptors are not sensitive??? Of course not necssarily, its because his particular biochemical problem is probably different.
Also, what one drug does one day, does not predict what it will do the next.
>i've been trying DXM (dextromethorphan) at 60mgs >a day lately to see if it would help, but hasnt >at all so far. its been a week since i started.Get your mind off this stupid oversimplistic dopaminergic theory.
Linkadge
Posted by floatingbridge on April 20, 2011, at 18:06:22
In reply to Re: the only way out, posted by linkadge on April 20, 2011, at 17:43:08
Linkage,
I'll be rereading this post. Thanks.
Not all of us have the mental gift to tear through this material. It's not always obstinacy. (Then, of course, there are informed debates between folks who disagree on the results of studies. And the way studies are designed.) I can write a poem, but can't remember the receptors. (I didn't say a good poem. Those, though, I can read.)
That's why I read other people's posts. They help me--like this one.
Thanks again.
:-)
And lifting a cup of coffee to you. Cheers!
Posted by linkadge on April 20, 2011, at 21:04:40
In reply to Re: the only way out » linkadge, posted by floatingbridge on April 20, 2011, at 18:06:22
Hey, I'm no neuroscientist.
I guess the point I'm trying to make is that its complex, and it makes no sense to me when somebody becomes so hard pressed on the notion that they are deficiant in this is that brain chemical.
Depression is so incredably complex. Why one drug works or doesn't, or works then doesn't is not fully understood by the most advanced individuals in the field. So I just don't know how on earth somebody could come on a site like this convinced (literally to the point of death) that their dopamine recepors are permanantly fried. I just don't get it.
Linkadge
Posted by linkadge on April 20, 2011, at 21:30:17
In reply to Re: the only way out, posted by linkadge on April 20, 2011, at 17:43:08
Depression (more than Just Dopamine!!)
There have been a kazillion different proposed targets for depression based on many of the kazzillion findings of abherant brain function in depressed patients. Studies of which include:
-Neurotransmitters (Serotin, Dopamine Etc)
-Neuromodulators (Gaba, Glutamate)
-Trace Amines (PEA, tryptamine, etc.)
-Neuropeptides (Neuropeptide Y, ghrelin)
-Opiate function (kappa, mu, delta, etc)
-Nerve Growth Factors (NGF, FGF, BDNF, GDNF)
-Signal Transduction (Protein Kinases)
-Ion Chanels (Calcium, Sodium, Potassium)
-Cellular Metabolism (ATP)
-Regulation of Apoptosis (BCL-2, Bax)
-Kinases (MAP kinases, stress induced kinases)
-HPA axis (and genes that regulate it)
-Immune function (TNF alpha)
-Cellular Adhesion Molecules
-Supporting Brain Cells (Glia)
-Structural (ie. grey matter changes)
-Cellular Morphology
-Antioxidant Defense Systems
-Genetics
-EnvironmentWhen you are depressed, there can be so much out of wack. What would make somebody conclude that they know the one (and only) possible problem (i.e. my dopamine receptors are not working properly)? Anhedonia is a core feature of depression. Depression is associated *many* *many* possible brain changes.
You can't change one of these systems without affecting the others. That mirapex induced some sort of shift in a bad direction doesn't mean that the problem lies with the inital target of the drug.
Thats like saying that the real problem (now) with the earthquake in Japan is at the subduction zone in the middle of the ocean.
Linkadge
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