Posted by Psychquackery on August 8, 2003, at 22:00:04
In reply to NYTimes:Debate on SSRIs and Suicide risk continues, posted by jrbecker on August 7, 2003, at 9:47:43
> looks like the mass media is going to grab a hold on this one again due to the latest paxil concerns in children
>
> http://www.nytimes.com/2003/08/07/health/07DEPR.html?hpThe SSRI-akathisia connection a definite thing. It doesnt occur in all or even most people, but it does occur. You can read right out of Stephen Stahl that SSRIs can cause akathisia and the mechanism is simple. I will read right out of Stahl's "Essential Psychopharmacology of Depression and Bipolar Disorder" book. Chapter 2 page 99:
"Thus, acute stimulation of serotonin 2A and 2C receptors in the projection from raphe to limbic cortex may cause the acute mental agitation, anxiety, or induction of panic attacks that can be observed with early dosing of an SSRI. Acute stimulation of the 2A receptors in the basal ganglia may lead to changes in motor movements due to serotonin's inhibition of dopamine neurotransmission there. Thus, akathisia (restlessness), psychomotor retardation, or even mild parkinsonism and dystonic movements can result."
So there you go, right from one of the top psychopharmacologists in the country...Stephen Stahl.
And if you do the opposite...if you block or antagonize the serotonin 2A receptor instead of stimulate it, you get an anti-akathisia or anti-EPS effect. Thats why antidepressants like Remeron, Serzone and trazodone dont cause akathisia they block the serotonin 2A receptor rather than stimulate it like the SSRIs do.
Some psychiatrists dont even know the above information and dont warn their patients of possible akathisia from SSRIs. And when it happens, patients get scared and think the problem is them when its just their own particular reaction to the drug and stop the SSRI. Or rarely, go off the deep end cause the akathisia shook them up bad and committ suicide. Its rare but it has happened.
One thing about that article that irked me was how Dr. Charles Nemeroff of Emory University totally denies the SSRI-akathisia connection. That guy is so connected to the drug companies, he has too many conflicts of interest to even ask that question to. Ive read some things about that guy that dont impress me, I think he has a bad temper.
Also, a few years ago I had all my psychiatric records copied to me. One of them mentioned that I had experienced akathisia from SSRIs and that "akathisia treatment would be beneficial." That was coming from a Neuropsychiatrist evaluation. Not one of the other psychiatric records mentioned a thing about akathisia. I think thats typical of psychiatry...they pretty much pay pure attention to the behavioral aspects of the diseases we have and they dont know enough about the drugs they prescribe.
Igor
poster:Psychquackery
thread:248910
URL: http://www.dr-bob.org/babble/20030807/msgs/249436.html