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Re: CRF Antagonists

Posted by OldSchool on March 16, 2002, at 12:52:50

In reply to Re: CRF Antagonists » OldSchool, posted by JohnX2 on March 16, 2002, at 4:11:26

>
> > There is some info on this site regarding "SSRI poopout." Its in the tips and tricks section. Basically, the most common hypothesis as to why ADs poop out over the long haul is dopamine depletion. Many ADs, particularly the serotonergic ones, dampen the dopamine system when taken long term.
> >
> > Im building a website myself and will have information on this subject at my site.
> >
> > Old School
>
> In 100 words or less ;)
> What is your insight regarding the degenerative mechanism by which SSRI's poop out?
>
> Also do you think this phenomina can be baggaged into the same mechanisms responsible for the development of tolerance to simulants, and if so why?
>
> How is this dopamine depletion "maintained"?
>
> As an anology, if your car is consistently running low on oil (dopamine) would throwing more oil at it directly be the right fix for the problem? (playing devils advocate)
>
> Thanks for your insight.
> John

John, Im just an average guy with severe refractory depression. Im not up on all the super duper technical stuff behind these drugs. Ive taken a lot of them and read a lot about them but many of the questions above I simply dont have the knowledge to answer.

As far as "SSRI poopout" goes Ive already posted one leading theory behind it...gradual dopamine depletion. Another theory behing AD poop out is subclinical hypothyroidism. Still another is missing mild, not so noticeable bipolar traits which can be fixed by lithium augmentation or lamictal. Still another is too much alcohol usage...some people drink a lot of booze on meds and your meds wont work as good if you drink alcohol regularly.

Another idea could be that you really have psychotic depression but its been missed and you need to have ECT or add anti-psychotics to your antidepressant. Another idea is that depression doesnt involve just the monoamine system but also the opiate system. Opium was used for treatment of melancholia as far back as the 19th century. There are some who believe the opiate system needs to be targeted in some cases of depression. There is that opiate drug buprenorphine which is used for refractory depression rarely, most Pdocs wont prescribe it no matter how bad off you are though.

All I can tell you is that after youve had your thyroid tested by your psychiatrist and it checked out OK, and youve maybe tried lithium augmentation there are basically two major treatments for refractory depression. One is ECT. The second is MAOIs. Basically thats it. Thats all there is. ECT has very broad, across the board effects on your brain and nervous system. MAOIs are also very broad and increase a wide range of brain neurotransmitters, unlike SSRIs.

SSRIs increase specific brain chemicals, mainly serotonin. While ECT and MAOIs do a whole bunch of stuff at the same time.

To be brutally honest, nobody really knows why SSRIs poop out in some people.

Old School


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URL: http://www.dr-bob.org/babble/20020313/msgs/98307.html