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Re: grouch's rebound effect

Posted by SLS on October 1, 2001, at 8:06:43

In reply to Re: grouch's rebound effect, posted by andys on September 30, 2001, at 12:52:36

> I think I understand the phenomenon you referred to as “withdrawal positive rebound” (I figured it out myself, observing my own phenomena, for what it’s worth): When I quit a drug, the blood-level drops to the point where the side-effects go away, and the benefits (that were being masked by the side effects), show through. Because brain-levels are slower to clear out, you get the drug’s benefit for a short period, while the brain-level-concentration coasts down to a non-therapeutic level. (For me, the benefit lasts 4-5 days). Of course, if others have no side effects, my theory doesn’t hold water.
> Also, for others who are very sensitive to side effects: Most pdocs will have you lower the dose, to better tolerate side effects over time, then titrate back up. I find it much more effective to completely quit the drug for 2-4 weeks. This seems to “re-set” my body, to better tolerate the drug for a second trial.
> Regarding my anti-depressant response to Dexedrine, I really couldn’t characterize it as brief or sustained, since it’s just more of a “boost”, that will “nudge” me away from depression, in general. (I can “generally” say that I tend to be less depressed while on Dexedrine).


The withdrawal rebound is most likely being produced by physiological processes in the brain that cause a shift in neural function in the direction of improvement. It might have something to do with the changes in receptor numbers or function that result from chronic exposure to the drug persisting for a few weeks after the drug is withdrawn. I am sure that it is not an illusion or unmasking due to the waning of side effects. It can be thought of as an "unspringing" of a coil spring resulting from the removal (withdrawal) of the physiological "weight" of the drug that had been compressing it. The spring ends up reaching a height greater than its initial ground state (baseline).

- Scott




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