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Re: antidepressant afterglow

Posted by Le Grande Fromage on December 16, 2004, at 6:27:49

In reply to Re: starting,suspending,starting,suspending MEDICINES, posted by francesco on December 14, 2004, at 17:10:16

Same here. I have always felt better once stopping my pills, but only for a few days to maybe a couple of weeks. This was most pronounced when stopping Effexor.

This is clearly because the beneficial effects of SSRIs take at least two weeks to kick in, whereas the negative side-effects are immediate. (The reason why it takes 2 weeks for pills to help is the subject of some controversy, but a convincing argument is that antidepressants trigger a kind of neural regeneration in certain brain structures). As a result, when you stop the pills, the beneficial effects do not stop right away, rather they linger for about two weeks. But (most of) the negative side effects stop right away. So you find yourself in a post-antidepressant glow, with the benefits of medication without its myriad miserable side-effects.

It is trite that long-term serotonin elevation decreases the dopamine levels in the brain. This is theorized to be the cause of "Prozac poop-out", and perhaps that flat zombie-like apathy some of us feel when taking our meds like we're supposed to. Anyway, the corollary would be that when you stop your pills, and your serotonin normalizes, so does your dopamine. In other words, your dopamine levels will increase when you stop your pills. The longer you have been taking the pills, and the higher your dose, the more pronounced the dopamine effect, in part because your brain, in it's dopamine-deprived state, has become more sensitive to its effects.

So, not only do you enjoy the long-term serotonin benefits without the concomitant side-effects, you also get a dopamine boost to boot!

However, this seems to go against the weight of experience of people reporting negative withdrawl effects. Perhaps there is something unique in my own physiology, or a certain subset of patients that causes this apparent contradiction. I have withdrawn from several medications expecting a hellish withdrawl period, only to be greeted by a fortnight's mood-elevation. The only negative effect I've had from discontinuation has been a feeling akin to dizziness, which seems to pass after several weeks.

Interestingly, I found that when on Effexor (150mg), which increased both my serotonin and nor-epinephrine levels, and arguably depressed my dopamine system, I suddenly found nicotine to be very reinforcing. Perhaps this is because of the increase in dopamine associated with nicotine, combined with an increased sensitivity to dopamine as a result of it's decrease by serotonin. On the other hand, when on the MAOI Parnate, smoking made me feel nauseous, perhaps because my dopamine was already high before lighting up. This is presumably how Wellbutrin/Zyban works.

Anyway, sorry for the length of this post, best of Luck


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poster:Le Grande Fromage thread:429199
URL: http://www.dr-bob.org/babble/20041211/msgs/430181.html