Psycho-Babble Medication | about biological treatments | Framed
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Re: Thanks for asking

Posted by Racer on November 25, 2007, at 12:06:23

In reply to Re: Thanks for asking Racer, posted by Phillipa on November 25, 2007, at 11:35:37

> I didn't know you had anxiety as they is why my pdoc wouldn't let me go on it . I really would like to try emsam have since it came out. If anxiety still don't understand how concerta or a stimulating med helps. I know you know your neurotransmitters is there a simple way to explain? Thanks Phillipa

The simple way to explain is that the neurotransmitters are not all that well understood, so a lot of what we discuss on this board is supposition, not accepted fact. Excessive serotinergic activity can be associated with anxiety, for example, and yet SSRIs are known to improve anxious symptoms. While it's easy to say, "Oh, I'm anxious, so I need more serotonin," or "I suffer from anhedonia, so I need more dopamine," it's just not that simple. What's more, the drugs don't increase neurotransmitters in a simple, direct manner, either. An SSRI affects the serotonin reuptake transporter, not serotonin itself -- that's indirect. If there's a problem with serotonin synthesis, inhibiting the transporter won't do a lot of good. And that brings up another issue: synthesis of the neurotransmitters. Dopamine is a neurotransmitter in its own right, but it's also a precursor to norepinephrine. That affects the whole metabolic picture in ways that can muddy the waters even more.

So, why do I do better on noradrenergic medications than on serotinergic meds? I don't know why, I only know that it's been true so far.

Depression is most likely related to the actions of the Big Three neurotransmitters we talk about on this board. No one knows, though, exactly what goes on. There is no test to show that this one or that one is the problem -- at least, no practical test. Even if research showed unequivocally that depression was caused by, say, low serotonin activity, that wouldn't necessarily prove that it was true in EVERY case of depression. Our neurochemistry is different, our metabolic chemistry is different -- even diet makes a difference. That's why what works for one person doesn't necessarily work the same way for someone else.

I've read your posts for a long time, and I'm curious about *why* you want to try EMSAM? If it's just because it's a new drug and people are talking about it a lot, or because a lot of people on this board have had good results from MAOIs, that's probably not a good rationale. As far as I recall, you haven't been able to get to a therapeutic dose of an SSRI, which would probably be a better choice for an anxiety-dominant depressive disorder. Frankly, I'd strongly suggest you try to do that, first, rather than moving on to EMSAM or another MAOI. If you really want to try an MAOI, Nardil is said to be very good for anxiety.

Regardless, though -- what works for one person won't necessarily work for another, even with the same general diagnosis. The fact that I do much better on stimulating medications, despite an anxiety disorder, is an example of that. It's all very individual, and the only way to see if a medication will work for you is to try it -- at a therapeutic dose for an adequate length of time -- and see if it works.


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Psycho-Babble Medication | Framed

poster:Racer thread:796919
URL: http://www.dr-bob.org/babble/20071125/msgs/796959.html