Psycho-Babble Medication Thread 1109302

Shown: posts 1 to 17 of 17. This is the beginning of the thread.

 

Why antipsychotics for Depression, Panic, OCD...?

Posted by Skeletor on March 30, 2020, at 16:54:08

What is the rationale behind prescribing antipsychotics for Depression, Panic, Anxiety and OCD?

There is a growing trend for antidepressant + antipsychotic combos. One does regularly read that patients get prescribed an SSRI and in addition they get some atypical antipsychotic. What is the goal of prescribing an antipsychotic to a person with Depression, Panic, Anxiety or OCD? Shouldn't it be last resort?

It's just that I am unsure about the anti-dopamine effects. It seems to me that one does not want that when having run-of-the-mill-depression.

https://psychotropical.com/psychotic-depression-and-tranylcypromine/

 

Re: Why antipsychotics for Depression, Panic, OCD...? » Skeletor

Posted by Skeletor on March 30, 2020, at 17:26:47

In reply to Why antipsychotics for Depression, Panic, OCD...?, posted by Skeletor on March 30, 2020, at 16:54:08

Here some articles I've been reading:

https://psychotropical.com/dopamine-and-depression-part-1/

https://psychotropical.com/anti-psychotics/

https://psychotropical.com/quetiapine-the-miracle-of-seroquel/

https://psychotropical.com/risperdal-chicanery/

 

Re: Why antipsychotics for Depression, Panic, OCD...?

Posted by rjlockhart37 on March 31, 2020, at 22:26:02

In reply to Re: Why antipsychotics for Depression, Panic, OCD...? » Skeletor, posted by Skeletor on March 30, 2020, at 17:26:47

relief anti-psychosis meds do, they put out the fire going on. But your not in high mindstate, your more in a leveled state, but....thorazine, olanzapine, stelazine, many of them i read in older articles, improvement in depression symptoms. Maybe they remove neurotransmitters that too much in the brain, in certain section and cause a relief and mood improvement. Haldol i heard can be good for anxiety, but haloperidol is definitely not a mood improver.

But that's why you see Rexulti, and Abilify on commercials on tv, they both are anti-psychosis meds, but they have major improvement in depression symptoms. Rexulti i heard will pull you out of slump, or depression mood. But the older and stronger ones, not sure. Thorazine is known to be helpful for mood, even though despite its harsh name. It can give people their lives back. Not all of them are good for mood, there's some that just knock you out and make you lifeless.

anyways, yes they are known for depression treatment, and advertised too.

 

Re: Why antipsychotics for Depression, Panic, OCD...?

Posted by Skeletor on April 1, 2020, at 6:10:46

In reply to Re: Why antipsychotics for Depression, Panic, OCD...?, posted by rjlockhart37 on March 31, 2020, at 22:26:02

> relief anti-psychosis meds do, they put out the fire going on. But your not in high mindstate, your more in a leveled state, but....thorazine, olanzapine, stelazine, many of them i read in older articles, improvement in depression symptoms. Maybe they remove neurotransmitters that too much in the brain, in certain section and cause a relief and mood improvement. Haldol i heard can be good for anxiety, but haloperidol is definitely not a mood improver.
>
> But that's why you see Rexulti, and Abilify on commercials on tv, they both are anti-psychosis meds, but they have major improvement in depression symptoms. Rexulti i heard will pull you out of slump, or depression mood. But the older and stronger ones, not sure. Thorazine is known to be helpful for mood, even though despite its harsh name. It can give people their lives back. Not all of them are good for mood, there's some that just knock you out and make you lifeless.
>
> anyways, yes they are known for depression treatment, and advertised too.

Do you have personal experience with antipsychotics?

And via which mechanism do they work?

 

Re: Why antipsychotics for Depression, Panic, OCD...?

Posted by rjlockhart37 on April 1, 2020, at 23:17:43

In reply to Re: Why antipsychotics for Depression, Panic, OCD...?, posted by Skeletor on April 1, 2020, at 6:10:46

yes, i've been on zyprexa for years and combined with fluoxetine it's antidepressant effect is slightly enhanced, somethign with olanzipine inhibiting 5HT2A, which improves dopamine transmisssion certain sections of brain. I'm not a pharmaologist, but their inhibtation of certain sites, can produce mood improving effects. The only one that i know is not good for mood, is haldol.

I'm saying this, yes, but there's not sources to back it up, i could pull all the links i've read in the past, it would be needle haystack. But certain ones inhinit certain sites, and make better mood. Saying all this is just general info with no sources, but ... im saying yes they do. But's certain ones, like abilify enhances d2, but typical ADs i don't have any sources to back that up. The only way i heard, was a lady in the outpatient therapy, she her depression was resistant, so they just tried thorazine, she said it works, felt relieved from agitated depression

ill go, definitely pull resources i've read but tonight im really tired, and in a bad mood.

ill post some later for evidence

 

Re: Why antipsychotics for Depression, Panic, OCD...?

Posted by Lamdage22 on April 2, 2020, at 2:03:26

In reply to Re: Why antipsychotics for Depression, Panic, OCD...?, posted by rjlockhart37 on April 1, 2020, at 23:17:43

I have nerver noticed mood improvement. But everyone is different of course. Just indirectly to be honest. Delusions and Psychosis are not good for mood. There is such a thing as post psychotic depression. I think I had that and the Neuroleptics prevented that. It faded a bit.

 

Re: Why antipsychotics for Depression, Panic, OCD...? » Skeletor

Posted by Jadde on April 2, 2020, at 10:49:35

In reply to Why antipsychotics for Depression, Panic, OCD...?, posted by Skeletor on March 30, 2020, at 16:54:08

> What is the rationale behind prescribing antipsychotics for Depression, Panic, Anxiety and OCD?
>
> There is a growing trend for antidepressant + antipsychotic combos. One does regularly read that patients get prescribed an SSRI and in addition they get some atypical antipsychotic. What is the goal of prescribing an antipsychotic to a person with Depression, Panic, Anxiety or OCD? Shouldn't it be last resort
> It's just that I am unsure about the anti-dopamine effects. It seems to me that one does not want that when having run-of-the-mill-depression.
>
> https://psychotropical.com/psychotic-depression-and-tranylcypromine/


> What is the rationale behind prescribing antipsychotics for Depression, Panic, Anxiety and OCD?
>
> There is a growing trend for antidepressant + antipsychotic combos. One does regularly read that patients get prescribed an SSRI and in addition they get some atypical antipsychotic. What is the goal of prescribing an antipsychotic to a person with Depression, Panic, Anxiety or OCD? Shouldn't it be last resort?
>

I, too, am unsure about how/why APs work on mood. Years ago I was prescribed Olanzapine and it knocked out a painful depression. So they do work for some people. I stopped taking it because of weight gain. I now take it again, 5mg for sleep (sometimes works, sometimes not).

Jade

 

Re: Why antipsychotics for Depression, Panic, OCD...? » Jadde

Posted by Skeletor on April 3, 2020, at 19:39:55

In reply to Re: Why antipsychotics for Depression, Panic, OCD...? » Skeletor, posted by Jadde on April 2, 2020, at 10:49:35

> > What is the rationale behind prescribing antipsychotics for Depression, Panic, Anxiety and OCD?
> >
> > There is a growing trend for antidepressant + antipsychotic combos. One does regularly read that patients get prescribed an SSRI and in addition they get some atypical antipsychotic. What is the goal of prescribing an antipsychotic to a person with Depression, Panic, Anxiety or OCD? Shouldn't it be last resort
> > It's just that I am unsure about the anti-dopamine effects. It seems to me that one does not want that when having run-of-the-mill-depression.
> >
> > https://psychotropical.com/psychotic-depression-and-tranylcypromine/
>
>
> > What is the rationale behind prescribing antipsychotics for Depression, Panic, Anxiety and OCD?
> >
> > There is a growing trend for antidepressant + antipsychotic combos. One does regularly read that patients get prescribed an SSRI and in addition they get some atypical antipsychotic. What is the goal of prescribing an antipsychotic to a person with Depression, Panic, Anxiety or OCD? Shouldn't it be last resort?
> >
>
> I, too, am unsure about how/why APs work on mood. Years ago I was prescribed Olanzapine and it knocked out a painful depression. So they do work for some people. I stopped taking it because of weight gain. I now take it again, 5mg for sleep (sometimes works, sometimes not).
>
> Jade


Interesting. How did Olanzapine compare to "conventional" antidepressants? In your case...

 

Re: Why antipsychotics for Depression, Panic, OCD...? » rjlockhart37

Posted by Skeletor on April 3, 2020, at 19:40:49

In reply to Re: Why antipsychotics for Depression, Panic, OCD...?, posted by rjlockhart37 on April 1, 2020, at 23:17:43

> yes, i've been on zyprexa for years and combined with fluoxetine it's antidepressant effect is slightly enhanced, somethign with olanzipine inhibiting 5HT2A, which improves dopamine transmisssion certain sections of brain. I'm not a pharmaologist, but their inhibtation of certain sites, can produce mood improving effects. The only one that i know is not good for mood, is haldol.
>
> I'm saying this, yes, but there's not sources to back it up, i could pull all the links i've read in the past, it would be needle haystack. But certain ones inhinit certain sites, and make better mood. Saying all this is just general info with no sources, but ... im saying yes they do. But's certain ones, like abilify enhances d2, but typical ADs i don't have any sources to back that up. The only way i heard, was a lady in the outpatient therapy, she her depression was resistant, so they just tried thorazine, she said it works, felt relieved from agitated depression
>
> ill go, definitely pull resources i've read but tonight im really tired, and in a bad mood.
>
> ill post some later for evidence

Thanks. That's quite interesting. Happy to hear and read more :=))

 

Re: Why antipsychotics for Depression, Panic, OCD...? » Lamdage22

Posted by Skeletor on April 3, 2020, at 19:41:32

In reply to Re: Why antipsychotics for Depression, Panic, OCD...?, posted by Lamdage22 on April 2, 2020, at 2:03:26

> I have nerver noticed mood improvement. But everyone is different of course. Just indirectly to be honest. Delusions and Psychosis are not good for mood. There is such a thing as post psychotic depression. I think I had that and the Neuroleptics prevented that. It faded a bit.

Which did you take?

 

Re: Why antipsychotics for Depression, Panic, OCD...?

Posted by Lamdage22 on April 3, 2020, at 21:32:30

In reply to Re: Why antipsychotics for Depression, Panic, OCD...? » Lamdage22, posted by Skeletor on April 3, 2020, at 19:41:32

Seroquel and Zyprexa

 

Re: Why antipsychotics for Depression, Panic, OCD...?

Posted by SLS on April 10, 2020, at 19:18:21

In reply to Why antipsychotics for Depression, Panic, OCD...?, posted by Skeletor on March 30, 2020, at 16:54:08

> What is the rationale behind prescribing antipsychotics for Depression, Panic, Anxiety and OCD?

Abilify is a chemical compound. It doesn't know that it's an antipsychotic. It is a drug that has been labeled an antipsychotic, but it might also have other effects.

That's a pretty good way to look at any drug. Many chemical compounds have more than one biological effect and multiple sites of activity. With the brain, things become very complicated because a single mechanism can have opposite effects in two different people.

Anyway, whether or not any of the compounds categorized as antipsychotics can help with depression is a question whose answer will depend upon the clinician answering it. My depression improved upon the addition of Abilify to my treatment. It was a mild, but unmistakable improvement. I decided to come off of it because my triglycerides were extremely high and I gained a lot of weight. For unipolar depression, my doctor uses 5 mg/day on his patients. He wouldn't continue to use it if he didn't think he was observing positive results. He could be wrong, of course. I guess the question to be asked is how long does such an improvement last? I'm not sure, but I think one needs to consider that Abilify does more than just antagonize D2 receptors. In fact, it is actually a partial agonist at that receptor. Unlike the older antipsychotics, it has a higher affinity at the D3 receptor as an antagonist. It is also a partial agonist at NE alpha-1 receptors, and an antagonist at 5-HT2a receptors.

I think a double bind clinical trial is more valuable than any attempt to predict the effects of a drug based upon what receptors it affects. Perhaps the drug does more biologically than what is currently known about it.

I think there is a place for anecdotal reports in the absence of clinical trials.


- Scott

 

Re: Why antipsychotics for Depression, Panic, OCD...?

Posted by undopaminergic on April 11, 2020, at 11:13:56

In reply to Re: Why antipsychotics for Depression, Panic, OCD...?, posted by SLS on April 10, 2020, at 19:18:21

>
> I think a double bind clinical trial is more valuable than any attempt to predict the effects of a drug based upon what receptors it affects.
>

Yeah, I suppose, but I recommend reading what Ken Gillman has to say about this topic. Eg. he says a purely antihistaminergic drug could easily produce a statistically significant improvement on some of the rating scales, such as the Montgomery-Asberg.

See https://psychotropical.com/ for Gillman's writings.

-undopaminergic

 

Re: Why antipsychotics for Depression, Panic, OCD...? » undopaminergic

Posted by SLS on April 11, 2020, at 22:28:15

In reply to Re: Why antipsychotics for Depression, Panic, OCD...?, posted by undopaminergic on April 11, 2020, at 11:13:56

> See https://psychotropical.com/ for Gillman's writings.

Funny you should say that.

I spent the morning saving all of his articles on MAOIs.

:-)


- Scott

 

Re: Why antipsychotics for Depression, Panic, OCD...? » SLS

Posted by Skeletor on May 13, 2020, at 14:51:17

In reply to Re: Why antipsychotics for Depression, Panic, OCD...?, posted by SLS on April 10, 2020, at 19:18:21

> > What is the rationale behind prescribing antipsychotics for Depression, Panic, Anxiety and OCD?
>
> Abilify is a chemical compound. It doesn't know that it's an antipsychotic. It is a drug that has been labeled an antipsychotic, but it might also have other effects.
>
> That's a pretty good way to look at any drug. Many chemical compounds have more than one biological effect and multiple sites of activity. With the brain, things become very complicated because a single mechanism can have opposite effects in two different people.
>
> Anyway, whether or not any of the compounds categorized as antipsychotics can help with depression is a question whose answer will depend upon the clinician answering it. My depression improved upon the addition of Abilify to my treatment. It was a mild, but unmistakable improvement. I decided to come off of it because my triglycerides were extremely high and I gained a lot of weight. For unipolar depression, my doctor uses 5 mg/day on his patients. He wouldn't continue to use it if he didn't think he was observing positive results. He could be wrong, of course. I guess the question to be asked is how long does such an improvement last? I'm not sure, but I think one needs to consider that Abilify does more than just antagonize D2 receptors. In fact, it is actually a partial agonist at that receptor. Unlike the older antipsychotics, it has a higher affinity at the D3 receptor as an antagonist. It is also a partial agonist at NE alpha-1 receptors, and an antagonist at 5-HT2a receptors.
>
> I think a double bind clinical trial is more valuable than any attempt to predict the effects of a drug based upon what receptors it affects. Perhaps the drug does more biologically than what is currently known about it.
>
> I think there is a place for anecdotal reports in the absence of clinical trials.
>
>
> - Scott

Indeed. Good comment!

Is Aripiprazole (and Rexulti) the only one with partial agonism at D2?

 

Re: Why antipsychotics for Depression, Panic, OCD...? » Skeletor

Posted by SLS on May 13, 2020, at 18:37:01

In reply to Re: Why antipsychotics for Depression, Panic, OCD...? » SLS, posted by Skeletor on May 13, 2020, at 14:51:17

Hi, Skeletor.

Great name.

> Is Aripiprazole (and Rexulti) the only one with partial agonism at D2?

Great question. I really don't know. Nothing else comes to mind, though.

Asenapine (Saphris) is an interesting drug. I have seen it act very much like an antidepressant with someone being treated for schizoaffective disorder, bipolar type. I was impressed with how much it improved my depression during the first few weeks. Like many other drugs I've tried, it just stopped working. I'm feeing better now than I have in quite awhile since starting Nardil. I am taking 60 mg/day. I would say that I'm 30% improved versus my untreated baseline. Feels good.


- Scott

 

Re: Why antipsychotics for Depression, Panic, OCD...? » Skeletor

Posted by undopaminergic on May 14, 2020, at 3:05:44

In reply to Re: Why antipsychotics for Depression, Panic, OCD...? » SLS, posted by Skeletor on May 13, 2020, at 14:51:17

>
> Is Aripiprazole (and Rexulti) the only one with partial agonism at D2?

No. Cariprazine (Reagila) is similar, but is special in that it has a preference for dopamine D3 receptors.

-undopaminergic


This is the end of the thread.


Show another thread

URL of post in thread:


Psycho-Babble Medication | Extras | FAQ


[dr. bob] 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.