Posted by karaS on September 28, 2004, at 0:34:18
In reply to Re: Cymbalta and REM sleep - dreaming? » VelvetElvis, posted by zeugma on September 27, 2004, at 18:09:28
> For a disturbing look at some of the more ominious long-term side effects of the SSRI's, which I predict will rapidly wane in popularity, take a look at this:
>
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15124729
>
> A crucial fact to keep in mind is that the neuromodulators- serotonin, norepinephrine, dopamine, and acetylcholine- are integrally involved in global state changes of the brain such as the transition from sleep to waking, as well as in the construction of what Dr. Gerald Edelman- in a fascinating, difficult book, "A Universe of Consciousness"- calls 'value systems.' And this is in addition, too, to their well-known role in mood disorders.
>
> As a side note, the sleep disorder narcolepsy is treated with drugs that enhance norepinephrine and serotonin, because it is these drugs that actually block the sudden onset of REM atonia known as cataplexy. it appears that the TCA's, which have more powerful effects on NE than on 5-HT, are also more effective in controlling cataplexy. The incidence of REM without atonia which is ordinarily only found in those in late stages of Parkinson's among SSRI users is disturbing, and suggests that serotonin is involved in the control of body movements. It also could be that the hyperserotonergetic state induced by SSRI's causes a hypodopaminergic state similar to that found in Parkinson's. MAOI's do not cause this loss of atonia, possibly because the boost the levels of dopamine as well as serotonin.
zeugma,How do you see an SNRI like Cymbalta fitting in here? Just as much potential for those "ominous long-term side effects" or could the addition of NE change things? If I'm interpreting what you wrote above correctly, then it can only make things worse, no?
Kara
poster:karaS
thread:395372
URL: http://www.dr-bob.org/babble/20040927/msgs/396121.html