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Re: Nicotine and Depression MrBrice

Posted by Questionmark on October 6, 2006, at 1:35:31

In reply to Re: Nicotine and Depression SLS, posted by MrBrice on October 5, 2006, at 5:39:13

I have to say what a few others have in that I have never heard of a doctor advocating one year on a psychiatric drug in order for it to be effective or even fully effective. And it really makes very little practical sense to me-- much less pharmacological sense (though of which of course i am no expert). Even with complex receptor changes and adaptations, it seems like *any* drug would begin to show benefit after several months or so.
That said, however, the confidence that your doctor has in this treatment route makes me wonder if he actually has some substantiated basis for it-- as in, maybe previous patients have, for whatever reason, derived benefit from this medication after such a length of time. ... Either that or he is displaying another extreme example of psychiatric hubris.
I really think you should ask him, though, why he thinks that it will or should begin to work after 3 or 4 more months-- is it anecdotal experience with past patients, a convincing body of literature, or something else?. It might be helpful to know if he has any good reasons for this recommendation.

Oh and just so you know, I must tell you that nicotine is relatively nothing like an MAOI, especially Nardil.

And in regard to nicotine's actions: one of its most well-known and probably significant (and definitely addictive) properties is its stimulation of dopamine release in the reward areas of the brain (e.g., nucleus accumbens). This is almost definitely the primary reason behind its euphoric properties as well. Also, the (cholinergic) nicotine receptors are involved in cognition, and their stimulation/agonism promotes enhanced cognitive capabilities (enhanced focus, etc.).
I don't know of any direct involvement with norepinephrine (but there very well may be)-- or any other specific actions, although I'm sure there are. But the two mentioned above are I think two of the most significant if not the most.

By the way, yes, at least in the U.S. here nicotine pathes are readily available over-the-counter and in many stores & pharmacies. They are quite expensive however.

(I have something else to say on nicotine tolerance but i'll save that for the next post).

In any case, good luck!

> He told me that nicotine is for the moment probably the best i can take for now.
> He is sure that his dosulepin-plan will work and thus will keep me on it for at least another 4 months. During those 4 months he wants to stretch time and keep me happy with the nicotine.
> I myself am in doubt of wether or not an maoi would be good for me. I've heard they have some terrible side-effects (insomnia for example, man i would hate that) so i don't really know what is the best for me.
> After some research i did find out why it probably is the nicotine is helping me. There are 2 reasons:
> First the nicotine stimulates a whole series of receptors in the brain, including ofcourse the nicotine receptor itself. This causes a release of noradrenaline i believe. This gives me a small boost and keeps me focused, it's nice when you need to 'be cool' and stay focused.
> Secondly, after +- 30 minutes, the noradrenaline is broken off into dopamine. This injection i feel very well, and it makes me relaxed and more enjoyable.
> I wouldn't know what would be best for me right now, but for the moment, i will follow my doc and just go on with my current treatment.
> If it fails, after 4 months we will know, we will switch to nardil and take away the sulpiride and dosulepin.
> grtz,
> Brice




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