![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 4 to 28 of 28. Go back in thread:
Posted by linkadge on September 3, 2010, at 18:58:49
In reply to Trk-b sigma-1r, posted by linkadge on August 29, 2010, at 21:01:59
they don't! I wasn't talking about taking the combo myself, just wondering in terms of neurotrophic activity.
Linkadge
Posted by morgan miller on September 3, 2010, at 18:58:49
In reply to Re: Trk-b sigma-1r, posted by linkadge on August 30, 2010, at 21:23:24
What if you take this combo and it relieves your depression by 70 percent, would you say AD's don't work then?
There is no debate, look around, talk to people, antidepressants work and the work often. There is a subset of people in which they don't work and if you base your beliefs of antidepressants merely on the subset that you read about on the internet, then you're beliefs are not based on reliable data.
Posted by ed_uk2010 on September 3, 2010, at 18:58:49
In reply to Re: Trk-b sigma-1r, posted by linkadge on August 30, 2010, at 21:23:24
> they don't!
Lol. But they sometimes work, and they sometimes don't. If someone gets better on an AD, sometimes it's due to the pharmacological effects of the med, sometimes they would have got better without it, and sometimes it's placebo effect. Don't you think?
Posted by SLS on September 3, 2010, at 18:58:49
In reply to Re: Trk-b sigma-1r, posted by ed_uk2010 on August 31, 2010, at 5:30:52
> > they don't!
>
> Lol. But they sometimes work, and they sometimes don't. If someone gets better on an AD, sometimes it's due to the pharmacological effects of the med, sometimes they would have got better without it, and sometimes it's placebo effect. Don't you think?It would be instructive to learn why practicing psychiatrists continue to use antidepressants. Do they base their decisions upon what they read or what they see? Ask.
- Scott
Posted by ed_uk2010 on September 3, 2010, at 18:58:49
In reply to Re: Trk-b sigma-1r, posted by SLS on August 31, 2010, at 6:01:30
>Do they base their decisions upon what they read or what they see?
Both, I guess. If better treatments were available they would use them - but there are only limited options available.
Posted by SLS on September 3, 2010, at 18:58:50
In reply to Re: Trk-b sigma-1r » SLS, posted by ed_uk2010 on August 31, 2010, at 6:56:23
> >Do they base their decisions upon what they read or what they see?
> Both, I guess. If better treatments were available they would use them - but there are only limited options available.
We were born too early.
- Scott
Posted by Brainbeard on September 3, 2010, at 18:58:50
In reply to Trk-b sigma-1r, posted by linkadge on August 29, 2010, at 21:01:59
>
> what about combining fluvoxamine and amitriptyline? This would theoretically be potently neurotrophic.
>What do you mean by 'neurotrophic'? Literally it means 'cell-changing'.
Posted by Brainbeard on September 3, 2010, at 18:58:50
In reply to Trk-b sigma-1r, posted by linkadge on August 29, 2010, at 21:01:59
BTW, thanks for pointing to this synergy. Very interesting indeed. I actually have been on both meds recently. I have stopped the amitriptyline though because I wanted to see if I could do without it.
Posted by Phillipa on September 3, 2010, at 18:58:50
In reply to Re: Trk-b sigma-1r, posted by Brainbeard on August 31, 2010, at 8:26:48
Brainbeard how did you find the fluvoximine and you've discontinued it? Once it worked for me doesn't seem to any more but my body seems to like it. Phillipa
Posted by Brainbeard on September 3, 2010, at 18:58:50
In reply to Re: Trk-b sigma-1r, posted by Brainbeard on August 31, 2010, at 7:50:48
>
> >
> > what about combining fluvoxamine and amitriptyline? This would theoretically be potently neurotrophic.
> >
>
> What do you mean by 'neurotrophic'? Literally it means 'cell-changing'.
>
>Erm, sorry, 'nerve changing'. Changing for the better, OK, got it.
Posted by Brainbeard on September 3, 2010, at 18:58:50
In reply to Re: Trk-b sigma-1r » Brainbeard, posted by Phillipa on August 31, 2010, at 10:33:17
> Brainbeard how did you find the fluvoximine and you've discontinued it? Once it worked for me doesn't seem to any more but my body seems to like it. Phillipa
Yeah, I know you're hooked on that stuff. ;)
Well, I didn't DISLIKE fluvoxamine.. It made me feel rather well. But it did make me apathetic; when I came home after work, I would only care for watching TV, while normally I'm a little bit more active and ambitious.
For anxiety, it didn't do terribly much.Fluvoxamine inhibits the breakdown of melatonin, the sleep hormone, which means that on it you will build up high levels of melatonin. I slept like a rose on it. But it also made me groggy and drowsy sometimes.
Did you know the kids of the Columbine shooting were on Luvox? I suspect this has given the drug a bad name for some time. Oh, and did you know that Luvox was created by a Dutch chemist? And that Luvox is the first SSRI, apart from zimelidine, which was discontinued because of a rare but serious side-effect?
Did you know that the brand name 'Luvox' is simply part of the chemical name, fLUVOXamine? Neat, eh?
I take the Luvox for the way it alters clomipramine's metabolism, boosting the OCD-busting mother drug and decreasing the side-effect ridden noradrenergic metabolite.
Posted by ed_uk2010 on September 3, 2010, at 18:58:51
In reply to Re: Trk-b sigma-1r, posted by Brainbeard on August 31, 2010, at 13:36:01
>Did you know that the brand name 'Luvox' is simply part of the chemical name, fLUVOXamine? Neat, eh?
Funny, I never thought of that. The brand name here is Faverin, but hardly anyone takes it. Compared with the other SSRIs, it seems to be falling into disuse.
Posted by Brainbeard on September 3, 2010, at 18:58:51
In reply to Re: Trk-b sigma-1r » Brainbeard, posted by ed_uk2010 on August 31, 2010, at 14:13:58
> >Did you know that the brand name 'Luvox' is simply part of the chemical name, fLUVOXamine? Neat, eh?
>
> Funny, I never thought of that. The brand name here is Faverin, but hardly anyone takes it. Compared with the other SSRIs, it seems to be falling into disuse.
>Brand name used to be 'Fevarin' here. It's odd that the drug is falling into disuse, since it's a good SSRI, sharing with Lexapro a faster onset of action than the other SSRI's, but being the most libido and sex-friendly of all the SSRI's too.
Posted by linkadge on September 3, 2010, at 18:58:51
In reply to Re: Trk-b sigma-1r » linkadge, posted by morgan miller on August 30, 2010, at 23:44:44
>There is no debate, look around, talk to people, >antidepressants work and the work often.
This...this is a debate.
Linkadge
Posted by linkadge on September 3, 2010, at 18:58:51
In reply to Re: Trk-b sigma-1r, posted by ed_uk2010 on August 31, 2010, at 5:30:52
>Lol. But they sometimes work, and they sometimes >don't. If someone gets better on an AD, >sometimes it's due to the pharmacological >effects of the med, sometimes they would have >got better without it, and sometimes it's >placebo effect. Don't you think?
How can we say it is due to pharmacological effects when we don't really know what causes depression or how medications may or may not help it?
Linkadge
Posted by linkadge on September 3, 2010, at 18:58:51
In reply to Re: Trk-b sigma-1r, posted by Brainbeard on August 31, 2010, at 13:36:01
Yeah, the columbine shooters were on fluvoxamine. I wonder, fluvoxamine's high binding to the sigma receptors would possibly mimic the psychological effects of DHEA, ie increasing agressivness?
Linkadge
Posted by Phillipa on September 3, 2010, at 18:58:52
In reply to Re: Trk-b sigma-1r, posted by linkadge on August 31, 2010, at 15:36:24
I'm not aggressive but had high energy and early rising when on 250mg second ad for me with ativan at the time. Yes knew of Columbine shootings. Also I Knew first SSRI and was first in Europe. When I now take it feel nothing as sometimes back on computer after it. I do think my OCD counting rituals have decreased on it. And my inner self says stay on it if that makes sense something in that pill my body or mind likes. Phillipa
Posted by Phillipa on September 3, 2010, at 18:58:52
In reply to Re: Trk-b sigma-1r, posted by Brainbeard on August 31, 2010, at 13:36:01
Figures Dutch as I'm part Dutch and at one time was married to a prosperous Dutch older man. Guess that's why my body likes it so much. Phillipa
Posted by morgan miller on September 3, 2010, at 18:58:52
In reply to Re: Trk-b sigma-1r, posted by linkadge on August 31, 2010, at 15:32:32
> >There is no debate, look around, talk to people, >antidepressants work and the work often.
>
> This...this is a debate.
>
> Linkadge
I bet your opinion would be different if you had had a profound lasting positive experience with an antidepressant.
Posted by ed_uk2010 on September 3, 2010, at 18:58:52
In reply to Re: Trk-b sigma-1r, posted by morgan miller on August 31, 2010, at 21:56:39
>I bet your opinion would be different if you had had a profound lasting positive experience with an antidepressant.
Ah well, I think Linkadge's opinions are different on different days :) I'm sure he does a lot of reading, so new ideas develop and old ones get dropped.
Posted by ed_uk2010 on September 3, 2010, at 18:58:52
In reply to Re: Trk-b sigma-1r, posted by linkadge on August 31, 2010, at 15:33:37
>How can we say it is due to pharmacological effects when we don't really know what causes depression or how medications may or may not help it?
In any particular individual, it's very difficult to know. On the other hand, we can see from placebo controlled trials that the overall response rate is usually higher with antidepressants.........so someone must be responding, even if others obtain no benefit.
Posted by linkadge on September 3, 2010, at 18:58:53
In reply to Re: Trk-b sigma-1r » linkadge, posted by ed_uk2010 on September 1, 2010, at 6:56:40
I resent the notion that my opinions change with the wind. I have always contended that effects from antidepressants are slim to nonexistent. Don't get me wrong, I will still try them, and I like reading about their purported mechanisms, but ultimately I think they are much overreated.
>In any particular individual, it's very >difficult to know. On the other hand, we can see >from placebo controlled trials that the overall >response rate is usually higher with >antidepressants.........so someone must be >responding, even if others obtain no benefit.
I would argue with the choice of wording i.e. "usually" higher with antidepressants. The problem is publication bias. Sure, many of the *published* trials show that antidepressants are marginally more effective than placebo, but when the unpublished data is included via mata-analysis, the drug effect becomes more similar to that of placebo.
Some of the largest meta-analysis done to date by Kirsh, have taken into account drug data that up to this date, was not available for inclusion. When looking at all the data, antidepressants don't really differentiate from placebo.
Linkadge
Posted by linkadge on September 3, 2010, at 18:58:53
In reply to Re: Trk-b sigma-1r, posted by morgan miller on August 31, 2010, at 21:56:39
>I bet your opinion would be different if you had >had a profound lasting positive experience with >an antidepressant.
Yes, and I'm sure that my opinions on the existance of God would change if I just had one of those "moments of connection" that religous people always talk about.
Linkadge
Posted by ed_uk2010 on September 3, 2010, at 18:58:53
In reply to Re: Trk-b sigma-1r » ed_uk2010, posted by linkadge on September 1, 2010, at 13:34:07
>I resent the notion that my opinions change with the wind.
Aww I'm sorry Link, I didn't mean to offend. I do like you and I enjoy reading your posts.
>I have always contended that effects from antidepressants are slim to nonexistent.
Well yes, I know you've often said that. On the other hand, I'm sure you've said that certain antidepressants seemed 'potent' eg. clomipramine, even if they didn't suit you personally.
>I think they are much overrated.
A lot of medications are overrated, and not just psych meds. These things change like fashion. Not so long ago, benzos could do no wrong. These days, people are treated like addicts if they dare to ask their doctor for a few tablets. It's basically a case of whatever is the latest and greatest med.
>The problem is publication bias.
You're right, it's a major problem. IMO, another major problem is that depression is a very heterogeneous condition. Depression is not a single disease entity, it's a broad syndrome which encompasses many different types of illness. I do think that some patients respond well to antidepressants (but many don't). The problem is that there is no accurate way of predicting in advance which drug would be best for any given patient. For example, you seem to respond best to Ritalin but who could have predicted that? Lexapro (or whatever) could have been the best drug for you but it wasn't. The trial and error that we have to go through is unfortunate!
In conclusion, I don't think we should be asking 'Do antidepressants work?' Instead, we should be asking 'Who do they work for, and who do they not work for? How can we predict who will benefit, and who will not?'
I think this would be more productive but a lot of research would be needed to get any useful answers. Drug companies would prefer you to believe that their meds work for most people with 'depression' - as if it was a single problem with a single solution. So.... who is going to fund this research?
Posted by violette on September 23, 2010, at 16:36:25
In reply to Re: Trk-b sigma-1r » linkadge, posted by ed_uk2010 on September 3, 2010, at 18:58:53
I think the effects of ADs are analagous to alcohol...
in that alcohol blocks the mind's inhibition of existing emotions and impusles....Emotions and impulses that ALREADY EXIST IN THE MIND.
I think the same thing with Prozac and suicidal thoughts/impulses... No science here, just haunches..so laugh if you will; i will not be offended.
This is the end of the thread.
Psycho-Babble Neurotransmitters | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.