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Re: Scott's rebound effect » andys

Posted by SLS on October 1, 2001, at 16:45:31

In reply to Re: Scott's rebound effect, posted by andys on October 1, 2001, at 11:17:51

> Scott,
> To clarify my theory about feeling the benefits of a drug after it is stopped: The theory being that the benefit is actually happening, but because of serious side effects (like severe sedation), I can’t “feel” the benefit. Then when the side effect lifts (yet the brain-level of the drug is still high), I feel the benefits for 5-7 days.
> Can you tell me where I can read further about the “withdrawal rebound” effect? This is really important to me, because I plan on starting a painfully long trial on Mirapex, trying to overcome it’s sedation, thinking that I’ll get this wonderful response, if I ever am able to tolerate the sedation, over time. If your “unspringing” theory is true, then a long term trial isn’t necessarily going to get me the benefit I hope for, so I won’t bother with Mirapex.
> -Andy

Hi Andy.

At this point, I don't think it makes sense to draw any conclusions as to the effectiveness of Mirapex based upon hypotheses. If anything, there might be some predictive power behind the appearance of sedation. I don't know that there is any real evidence to substantiate that there is any, although some of us here were trying to establish an association. There may be none. However, I don't think I've seen anyone for whom sedation appeared early in treatment go on to respond well to Mirapex. Without anything definitive, though, I guess it makes sense to continue with it, especially if you have already failed to respond to many drugs.

A number of different drugs cause a rebound of one sort or another upon their discontinuation. For instance, when someone takes a benzodiazepine like Xanax or Klonopin to treat anxiety, the anxiety that appears upon the discontinuation of these drugs can be much higher than that which existed before treatment. Some sleeping pills can allow for rebound insomnia when they are discontinued. In fact, the shorter acting drugs like Halcion can produce a rebound awakening that same night as it leaves the blood stream.

If you find anything on the Internet regarding withdrawal rebound, I'd be interested to read it. Believe it or not, some people experience such a potent physiological rebound upon the discontinuation of antidepressants, that they actually become manic, even though they are not bipolar.

- Scott




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