Posted by Racer on August 5, 2004, at 14:12:06
In reply to Re: MAOI poop-out?, posted by Ilene on August 4, 2004, at 21:10:08
> > SSRIs work by inhibiting the reuptake of serotonin, right? That means that they're affecting the serotonin receptors, which first spew out some serotonin -- then suck some of it back in, to keep the balance of serotonin in the synapse where they think it should be. The SSRIs depend on the serotonin that's already there, and then on that receptor 'listening' to the drug. What seems to happen with this mechanism -- again, I'm so close to totally ignorant about this stuff, so don't consider this the final answer -- is that the serotonin receptors pay attention for a while, but then get desensitized to the message and go back to what they were doing in the first place.
> >
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> Some people now think that SSRI-induced changes occur elsewhere in the brain.
>Well, yes and no: keeping the Serotonin active in those synapses by keeping the receptors from sucking it back up *does* change other areas in the brain. Serotonin has a lot of effects throughout the body -- 90% of the serotonin in the body is active in the gastrointestinal tract, for example -- but the mechanism for the drugs remains in the receptors. So, those other effects happen as secondary to the reuptake thing.
Serotonin does interact with the whole stress-system, influencing the whole limbic-hypothalamic-pituotaru-adrenal axis which produces glucocoricoids that are involved in stress response. That whole system is only partially understoond. FOr a long time, it was throught to be a very closed loop system, but now it's been found to be influenced by a lot of elements outside that loop. Don't ask me what other things serotonin does, though...
And norepinephrine and dopamine are also involved in that feedback system, since theres' an element that creates dopamine, norepinehprine and epinephrine, but I can't remember anything about that today. If it comes back tomorrow, I'll try to jump in with it.
>
> > MAOIs, on the other hand, inhibit the action of an enzyme that contributes to the breakdown of the Big Three neurotransmitters -- serotonin, norepinephrine, and dopamine. Without that enzyme going about bashing our friendly little one-amino-acid neurotransmitters, the little guys can come out and play to their hearts content. Again, it depends on having enough of the neurotransmitters in the first place, but it's not so dependant on the receptors.
> >
> > I think that the biggest difference is that MAOIs don't depend on the reuptake inhibition, so much on the survival of the neurotransmitter molecule itself. Does that make sense?
> >
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> In theory, I should be happy.
>Actually, stress will counteract anything that happens. In the list of Major Life Stressors, moving is high on the list, along with divorce, loss of a loved one, etc. My guess is that moving alone is more than enough to create the kind of problem you're having now.
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> > Anyway, while I will not say that MAOIs shouldn't poop out the way some other drugs can, I hope this will hold you over until someone who actually *knows* anything about this comes along.
>
> I'm hoping they have a better record, poop-out wise. It could be that when I went from 40 to 50 mg. I got below my effectiveness threshold, but it took a few months for it to happen. Or that the extra stress of moving means I need to boost the dose.
>
> At least the Zyprexa is still working. I don't have nearly the anxiety I did a few months back.
>
> And how are you?Me? Lousy. Right now, since 6PM last night, I'm downing enough Xanax to knock me out until there's a hope I can function at the same level of depression I was functioning at for the last few weeks. Yesterday was so bad, I figured the safest thing for me was to sleep through as much of it as I could. SO, massive doses of Xanax to keep me asleep until I thought i could be awake for a while. THis just happens to be the point where one dose wore off enough to wake me up, before the next dose took effect. Once the next dose kicks in, back to sleep for me.
poster:Racer
thread:374083
URL: http://www.dr-bob.org/babble/20040805/msgs/374405.html