Posted by linkadge on November 26, 2005, at 10:47:51
In reply to Re: Studies on long term use of SSRI's, posted by law663 on November 25, 2005, at 19:56:45
Some doctors consider them "placebo's with a buzz", since the placebo margin can be increasingly reduced when active placebos are used. I don't admit they do something, but as far as saying they effectively treat the condition of depression is hard for some to accept.
Like I said in previous posts, I think they initially help because they cause a profound reduction in rem sleep. This improves depression in its own right. But the brain fights back, desparately wanting rem sleep. The result? You become what so many psychiatric patients complain about being "a zombie". Rem sleep is critical for the brain to create the most insighful ideas into its current state of being. So yes I think they have initial "effects", but I don't think they actually are very effective long term at all.
Neuroimiaging is another thing. It was shown that the people who respond to SSRI's have frontal cortex activation. But that doesn't say anything, because the patients who didn't respond didn't have that activation. Therapy was also shown to activate the frontal cortex. So I don't think it is necesarily the drug, as much as recovery, or placebo effect.
THe BDNF issue too has not been too conclusive. I was reading a nice little page on how prozac increased BDNF in mice. But then the article went on to say that BDNF was increased to a similar extent in any mouse that had been "handled".
Some of the BDNF increases are phasic, showing elevations for a number of hours and then going back to baseline.Not all studies show that SSRI's reliably increase BDNF.
Another thing to consider is this. Scientists have been trying to find a bad serotonin gene. One of the latest studies has found a significant predisposition to depression if you cary a Short-Short varient of the serotonin transporter gene. Ie. The people with this varient showed significantly more lifetime depressive episodes, than people with the long-long or other varients.
But the problem is this. The short-short varient codes for a slower reuptake of serotonin than do other varients.So essentially, researchers have found that the people who are the most depressed already have a slower serotonin uptake than people without the gene. These findings are the exact opposite to what researchers were expecting to find.
This is a case for Tianeptine, a clincally effective antidepressant that is a serotonin reuptake acellerator.
There is a lot of reasearch being done to discover their hazards too. I know that there is research being done into the propensity of antidepressants to induce rapid cycling and manic, and suicidal behaviors. This kind of research does not become accepted overnight. Just like how valium was not declared overnight to be addicting.
Then their is poop out and withdrawl. I talked to a lady who said she had taken prozac for 5 years and it took her five years to fully get over withdrawl. I said to myself, "thats about right".
Untreated depression rarely lasts longer than a year, but we have people on these drugs for many many years.
Meds are like Shawshank prison. At first you can't stand them, then you grow to tollerate them. Soon enough you can't live without them.
Linkadge
poster:linkadge
thread:582087
URL: http://www.dr-bob.org/babble/20051126/msgs/582341.html