Posted by Elizabeth on May 17, 2001, at 14:37:11
In reply to I'm a little scared of these drugs..., posted by roo on May 15, 2001, at 11:26:50
> I'm scared that my brain has become dependent
> upon antidepressants to create seratonin and can't do it
> without them now.For the record (and I hope this will reassure you), antidepressants like Prozac don't create new serotonin (or act as substitutes for serotonin). Rather, they make your use of existing serotonin more efficient. Prozac does this by preventing serotonin from being reabsorbed ("uptaken") by cells (it binds to the serotonin transporter -- the cellular site where reuptake into the cell occurs (like a door that lets in serotonin) -- and blocks it, preventing serotonin from reentering the cell through it. As a result, more serotonin is available to act on receptor sites.
This is what Prozac does immediately. The reason that Prozac takes a few weeks to work is that the above-described mechanism results in gradual changes that compensate for the serotonin reuptake inhibition. This compensation is felt to be responsible for Prozac's antidepressant effects.
> While I'm grateful that there are drugs out
> there to help my depression, I never counted on having to be
> on them forever--particularly since they effect my sexual life
> so dramatically.Have you tried Wellbutrin? It's a mildly stimulating antidepressant that can be added to SSRIs and usually reverses that pesky sexual problem. It may also be used by itself (but there is no guarantee that it would work for you, since it works differently from Prozac).
> Has anyone else had this fear or talked
> with other people who took an antidepressant not for life long
> clinical depression, but for a situational thing, and then was
> unable to come off the drug without getting depressed?I think the expression "situational depression" can be misleading. It is true that a particular circumstance or event can trigger a depression that seriously interferes with your ability to function and does not go away on its own within a reasonable time. There are two general reasons that I could think of why this would happen (there can be some overlap between the two):
(1) The event or situation is so extreme that almost anybody would have an extreme reaction to it. The trauma of such events can turn your life upside down. (I'm thinking of things like being tortured as a prisoner of war, being a victim of long-lasting or severe domestic violence, etc.)
(2) The person experiencing the event or situation has a "depressive temperament" -- he or she is more likely to become depressed than the average individual. In this case the event acts as a trigger but is not the primary cause. Such depressions are likely to recur the next time such a difficult event or situation comes up. I believe that after such a depression occurs, it becomes increasingly likely that the depression will become chronic or will start to recur without triggers.
The point is, if you have a serious depression, it may be dangerous *not* to get treated for it. At the same time, I would like to see more research into the possible negative effects of long-term use of these drugs. The problem is, when research is done, it's most likely to be done or funded by the company that markets the drug. This can result in biases in the way the experiment is done and in the way the results are interpreted.
> Again, I'm not antidrug, and I will keep taking my prozac rather
> than being depressed...but I am really disappointed that I may never
> be able to go off of it and have a normal sex life again.Please do look into ways to correct the sexual problem. From what I hear, Wellbutrin doesn't need to be taken on a regular basis if you're only using it to reverse the sexual side effects of Prozac. There are also other ways to deal with the problem.
Best wishes.
-elizabeth
poster:Elizabeth
thread:63095
URL: http://www.dr-bob.org/babble/20010515/msgs/63359.html