Posted by Le Grande Fromage on December 17, 2004, at 16:06:00
In reply to Re: antidepressant afterglow » Le Grande Fromage, posted by Tepiaca on December 16, 2004, at 21:03:34
> So it would be like taking an stimulant ???
>Not necessarily, I suppose it depends on the effect the drug has on you. My theory about increased dopamine doesn't work so well with a MAOI like Nardil, because it would have boosted dopamine, so presumably on discontinuation, your dopamine may actually drop. (Interestingly, MAOIs have been less commonly implicated in SSRI-apathy, perhaps because they don't neglect the dopamine while boosting the serotonin.) Keep in mind that when you stop your pills, the level of the drug in your body does not drop immediately. Depending on its half-life, the drug may remain in your system for days or weeks.
A possible explanation for your experience of feeling good for a couple of days, and then crashing, is that the drug level has stayed fairly high for those days, and only thereafter dropped significantly. Since the therapeutic effect of your pills are merely one of their many side-effects, it is arguable that some of their side effects persist for longer than others, upon cessation of the drug. In other words, when you take a pill, it will have effect A for a time, effect B for another length of time and so forth. So it's possible that some of the negative side-effects fade faster than the therapeutic effect. Of course, this is all speculation as no one really knows how antidepressants "work".
> I´m currently on Nardil , I also have vivid nigthmares but only in the second week without it. In the first 7 seven days I feel very good.
>
>
> Can you think in something that could happen to my brain if I continue starting and suspending the medicine ??? Brain damage... Hypertensive Crisis.... Tardive Diskinesia ???
>The main danger is probably that your brain chemistry will be constantly shifting, so you will be less likely to make an intelligent decision about whether to continue your meds. One is tempted to stop after a couple of weeks when all one experiences is the side-effects. But if the medical experts are to be believed, your pills should be given at least 6 weeks to kick in properly. Likewise, if you decide to go without them, you should stay off them for at least 6 weeks. They take a while to reach therapeutic dosage, and likewise to be worked out of your system.
I have experienced the same concerns about repeatedly starting and stopping my meds. Any attempt to answer your question about whether you may cause some kind of permanent damage would be absolute speculation. I'm inclined to think that it is not healthy for your neurochemical levels to be in a constant state of flux. However, ceasing medication which is not working may be akin to giving your brain a break from the stimulation of meds, allowing what goes up to come down.
My main concern with starting and stopping is not permanent damage but rather a delay in finding a tenable situation. You have to wonder whether such a neurochemical rollercoaster delays the attainment of some kind of neurochemical equilibrium, which your brain may have been able to achieve minus all the repeated changes.
I once asked my psychiatrist about whether it was a problem that I kept stopping pills and opting for different brands. He felt it was risky, because whatever benefit accrued the first time may be lost by your system's newfound familiarity with such drugs. Indeed, I found my first few days on my first few drugs much more intense in terms of side effects. As I worked my way through the SSRIs I found their side-effects less bothersome (and impliedly their positive effects less significant), so it does seem that my body was less effected by each subsequent drug. However, it is equally arguable that my body would have adapted as rapidly, if not more so, had I remained on one drug for the entire period. But it's all conjecture and not even my psych really knew what was going on. He just wanted to add more pills to the mix to see what would happen.
Did you take Nardil for SA? Did it work? Did you stop because of side-effects? I have tried Effexor, Lexapro, Celexa, Parnate, beta blockers, Buspar, and Remeron. All of them failed on the side-effect : benefit ratio.
Good luck!
poster:Le Grande Fromage
thread:429199
URL: http://www.dr-bob.org/babble/20041217/msgs/430934.html