Psycho-Babble Medication | about biological treatments | Framed
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Re: SSRI Theory

Posted by King Vultan on October 15, 2004, at 8:13:45

In reply to SSRI Theory, posted by jboud24 on October 14, 2004, at 18:14:53

> Hi, I'm new to the PB board, even though I've been reading it for quite some time now.
> I have a theory about SSRI meds that I have been struggling with and refining for quite some time now. Basically it's this:
> SSRI's inhibit the reuptake pump for the serotonin transporter, this much we all know. This is the way that they increase synaptic 5-HT. But, after a while, wouldn't this prevent the proper level of 5-HT from getting re-packaged into the vesicles and subsequently released?
> I have thought that this is a flawed mechanism for a long time know, and have always thought that MAOI's were a better way to go, specifically because they don't screw up the amount of monoamines for repackaging and subsequent synaptic release.
> I know this is pretty pharmalogically based, but has anyone else thought about this before? If so, does anyone think this is why MAOI's show such a better success rate?
> Thanks,
> Justin (100 mg Zoloft currently, and very
> disatisfied with SSRI's in general)

The neuron can still synthesize new serotonin, though, so blocking reuptake should not by itself cause the neuron to run out of serotonin (this holds true in an analogous fashion for NE and dopamine reuptake inhibitors). The theory behind SSRIs is that the extra serotonin made available from blocking reuptake winds up having an effect on receptor densities and/or neuron firing rate, and they do seem reasonably effective at getting this done.

The big problem I have with SSRIs is that they only work on one neurotransmitter, serotonin, which is not a good thing in the long term IMO. Increasing serotonin transmission depletes dopamine (due to stimulation of serotonin-2A receptors), and the very important norepinephrine system is also left neglected by SSRIs. The conclusion I've come to is that the big advantage of the MAOIs is that they work on all three of these systems simultaneously. I think this is the reason why they can continue to work so well in the long term, in some cases, for decades.





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