Posted by Barbara Cat on June 20, 2003, at 0:28:45
In reply to emotional effects of NE reuptake inhibitors » turalizz, posted by zeugma on June 19, 2003, at 21:45:33
NE is excitatory, but as I understand it, any nerve/ligand that is stimulated will eventually reach its threshhold and then settle into a 'discharged' state, not quite inhibitory, but more in the middle of the stimulation spectrum (hmmm, this is sounding obscene). So perhaps there is an initial wired phase before the evening out, antidepressant phase is reached.
I am Bipolar II, at least so it seems, and I have that same effect with SSRIs, totally wired at first and then apathetic. Of course, I now take a couple of mood stabilisers and no more SSRI's for me. I take the TCA nortriptyline and did not have any of the NE stimulating effects at all that I was expecting. I hate to push NE any further on myself because of a dread of anxiety or hypomania. I'm hear you re the frustrating quest for the magic bullet. Why doesn't some of our military spending get funnelled into decent diagnostic/brain imaging equipment? After all, we'd have far less need of weapons and such if we were all a tad better well-adjusted.
> I wish there was more written on the differential aspects of these drugs instead of searching wildly for the "magic bullet" that will cure depression. Reboxetine and the noradrenergic TCA's have a different 'feel' to them which fits some personality types and disorders better than the SSRI's. The emotional intensification these drugs can induce is probably what makes them less suitable for OCD types, as OCD'ers already have enough emotional investment in their surroundings and don't need that level boosted even further. Similarly people undergoing a profound transient depression could probably use some of the apathy SSRI's can deliver.
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> This reasoning was behind the introduction of the concept of 'endogeneous depression' to explain what the TCA's reversed. Someone who is endogeneously depressed is not reacting to external circumstances in a functional way: the TCA's intensify emotional response in these people to bring them back to the normal variation in mood that people generally feel. It's clear that not all, or even most, depression can be 'endogeneous' or the SSRI's could never have displaced the TCA's in popularity. But the supposition that there is a type of depressed individual who responds best to NE reuptake inhibitors remains a tenable one.
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poster:Barbara Cat
thread:235009
URL: http://www.dr-bob.org/babble/20030619/msgs/235311.html