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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Skeletor on April 1, 2020, at 13:37:30
Why do strong SRIs (serotonin reuptake inhibitors) often cause / induce apathy, indifference and laziness? Maybe not in everyone, but it's one of the most common complaints. I regularly read about it on the internet. I myself was affected by it.
My questions would be:
1.) What causes it?
2.) Were you affected?
3.) Did you successfully get rid of these specific side effects? If so, how so?
4.) Furher comments regarding that "phenomenon"?
Posted by linkadge on April 1, 2020, at 17:37:23
In reply to Why do strong SRIs induce apathy, indifference?, posted by Skeletor on April 1, 2020, at 13:37:30
In theory, it's because elevating serotonin can reduce the release of other neurotransmitters (like norepinephrine and dopamine).
Some strategies to combat this include adding / switching to an agent with a different or complementary mechanism (such as mirtazapine, bupropion etc), stimulant, antipsychotic etc. or reducing the dose
Posted by undopaminergic on April 2, 2020, at 3:08:27
In reply to Why do strong SRIs induce apathy, indifference?, posted by Skeletor on April 1, 2020, at 13:37:30
> Why do strong SRIs (serotonin reuptake inhibitors) often cause / induce apathy, indifference and laziness? Maybe not in everyone, but it's one of the most common complaints. I regularly read about it on the internet. I myself was affected by it.
>
> My questions would be:
> 1.) What causes it?My best guess is (indirect) agonism at the serotonin 5-HT2C receptor, which dampens down dopamine release.
> 2.) Were you affected?
Yes.
> 3.) Did you successfully get rid of these specific side effects? If so, how so?
>No, except if you count quitting the drug.
> 4.) Furher comments regarding that "phenomenon"?
I've read about it too. In certain cases SRIs can even cause symptoms of parkinsonism, such as cogwheel rigidity.
-undopaminergic
Posted by beckett2 on April 3, 2020, at 0:24:21
In reply to Why do strong SRIs induce apathy, indifference?, posted by Skeletor on April 1, 2020, at 13:37:30
Stimulants are the only thing that temporarily cuts the apathy. That is for me.
Posted by undopaminergic on April 3, 2020, at 3:21:06
In reply to Re: Why do strong SRIs induce apathy, indifference?, posted by beckett2 on April 3, 2020, at 0:24:21
> Stimulants are the only thing that temporarily cuts the apathy. That is for me.
>Stimulants for me too, but actually memantine helped even more -- however, it should be used with care as it can induce a manic-like state, which can get you in trouble.
-undopaminergic
Posted by beckett2 on April 3, 2020, at 11:13:06
In reply to Re: Why do strong SRIs induce apathy, indifference?, posted by undopaminergic on April 3, 2020, at 3:21:06
> > Stimulants are the only thing that temporarily cuts the apathy. That is for me.
> >
>
> Stimulants for me too, but actually memantine helped even more -- however, it should be used with care as it can induce a manic-like state, which can get you in trouble.
>
> -undopaminergicMemantine, is that an Alzheimer's medication?
Posted by undopaminergic on April 3, 2020, at 11:19:55
In reply to Re: Why do strong SRIs induce apathy, indifference?, posted by beckett2 on April 3, 2020, at 11:13:06
> > > Stimulants are the only thing that temporarily cuts the apathy. That is for me.
> > >
> >
> > Stimulants for me too, but actually memantine helped even more -- however, it should be used with care as it can induce a manic-like state, which can get you in trouble.
> >
> > -undopaminergic
>
> Memantine, is that an Alzheimer's medication?That is the official indication, yes.
-undopaminergic
Posted by sigismund on April 3, 2020, at 22:02:15
In reply to Re: Why do strong SRIs induce apathy, indifference?, posted by undopaminergic on April 3, 2020, at 11:19:55
Can you say *anything* more about memantine and your experiences? The good and the bad, dosages and stuff?
I recall you mentioning it.
I have some here.
Posted by undopaminergic on April 4, 2020, at 2:09:47
In reply to Re: Why do strong SRIs induce apathy, indifference? » undopaminergic, posted by sigismund on April 3, 2020, at 22:02:15
> Can you say *anything* more about memantine and your experiences? The good and the bad, dosages and stuff?
>
> I recall you mentioning it.
>
> I have some here.You feel weird at first, which led me to try only one dose the first time. Then later, when I *wanted* to feel weird, I took more, maybe 20 mg, and then a pleasant hypomania set in, which was entirely unexpected. I bought 100 grams of pure menantine but I dared only take 20-30 mg because I was afraid of "Olney's lesions". Later I was more adventurous and I took maybe 60. The mania made me impulsively take at least more than a gram of the drug, hoping to produce Olney's lesions, and I got catatonia among other things; I was in intensive care and then they moved me to the psychiatric branch. Later, a friend informed me that memantine does not cause Olney's lesions.
I don't think you need to worry about anything beyond the mania it can induce.
-undopaminergic
Posted by sigismund on April 5, 2020, at 1:26:38
In reply to Re: Why do strong SRIs induce apathy, indifference? » sigismund, posted by undopaminergic on April 4, 2020, at 2:09:47
Oh thank you.
That was very amusing.
Posted by sigismund on April 5, 2020, at 1:31:45
In reply to Re: Why do strong SRIs induce apathy, indifference? » sigismund, posted by undopaminergic on April 4, 2020, at 2:09:47
I could do with a bit of hypomania, having none at all.
This is the end of the thread.
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