Posted by linkadge on August 14, 2007, at 21:43:58
In reply to Re: Vicodin and Percocet for Depression » linkadge, posted by Quintal on August 14, 2007, at 10:24:51
>The point I raised was the likelihood of >tolerance to the mood elevating effect of
>opiates.But who says I am required to stay within the confines of how you think the thread should behave? I am allowed to just make general comments. They needn't always have a specific point.
>Here we're talking about the antidepressant, >or 'mood elevating' effect, is that right? I'd >like to expand on this, because an interesting >idea occurred to me; is there a difference >between 'euphoriant', 'mood-elevating' >and 'antidepressant' effect? If you think these >are separate effects I'd be interested to hear >why you think that, and how you think they >differ.Yes, this is what I am getting at. Most antidepressants are capable of alleviating depression without producing euphoria. Their antidepressant effect is not dependant on direct stimulation of the neucleus accumbens. SSRI's, for example, have little street value. Euphoria is not a prerequisite for an antidepressant effect.
The term "mood elevating" is abiguous as it applies to the effects of antidepressants and euphoriants.
It is not necessarily a continuoum of effects as most would agree that the antidepressant effects of SSRI's cannot be furthered to euphoria by taking a higher dose, unless of course one is bipolar in which case this may be a separate phenomina.
The reason I think that the terms "antidepressant" and "euphoriant" are destinct is because we have classes of drugs that can fairly selectivly achieve either one or the other effect. Confounding the issue, we also have classes of drugs which may produce both euphoria and an antidepressant effect, ie Parnate, Nardil, Amineptine, ketamine, certain cannabanoids, and possably the opiates etc.>We're not talking about analgesia. We're talking >about the psychoactive effects.
I realize that. I was just making a point that opiates are criticized as painkillers on account of their euphoriant effect, so perhaps likewise, opiates are criticized as antidepressants on account of their euphoriant effects.
I agree, at this point the notion that there is an antidepressant effect of the opiates that is destinct from the euphoriant effect is only speculative. But my whole point here is that there are researchers who believe this to be the case and are therefore studying the substances in this respect.
>It's statements like that which I find >provocative. It would be helpful if you said >something like "For example, euphoria is not a >prerequisite for analgesia".I doin't understand (?) that is what I said. "Euphoria is not a prerequisite for analgesia." How is that not a true statement (??)
(ie we have painkillers that are not euphoriants)>If that was what you were thinking. I would >disagree on that particular point though because >tolerance to the analgesic effect of opiates >often develops quickly too, and in that example >you're trying to compare the rate of tolerance >to a somatic effect to the rate of tolerance to >a psychoactive effect.
Well, there's a study for you. Compare the rate of tollerances. If you were to find statistically significant differences in the rates of euphoria, analgesia, and depressive relaspse, then perhaps this would add to the possability that separate mechanisms are at play.
Lets keep in mind here that for some people the SSRI's poop out in a month, and for some people they last for years. If we assume these accounts are correct, then we have issues of both tollerance, and varying rates of tollerance. This doesn't prevent the SSRI's from being used clinically as antidepressants.
>I think it would be fairer to distinguish >between tolerance to two psychoactive effects; >the euphoriant effects and the antidepressant >effects. But we have yet to establish a definite >difference between the two, and I think we need >to concentrate on doing that before we move on >to the next stage.Analgesia is reduction in physical pain. Euphoria is the production of abnormally elevated well being, and an antidepressant effect is a reduction in the symptoms of clinical depression. There is some overlap, obviously, but neither is a subset of the other. For instance, euphoriants need not necessarily reduce core symptoms of depression. For instance, amphetamine is a euphoriant, but many not help symptoms such as lack of appetite, insomnia, anxiety, guilt, disrupted HPA axis.
>Okay, I'm very interested in this research. Do >you have access to any studies?
Well, I do know that there is a bit research along the lines of "substance P". Opiates apparently reduce substance P neurotransmission in limbic regions. If I am not mistaken, some of the antidepressant effect of the opiates has been attributed to such effects. The substance P inhibitors have antidepressant effect without abuse liability. So, just the fact that the opiates reduce substance P, which, as we now know, can be modulated without producing euphoria, is a bit of a testament to how the opiates may be affecting some aspects of the effective processing *in addition* to producing euphoria.
>Yes, that flood of raw data without a consistent >thread of logic, or narrative tying them all >together was daunting and confusing.Allright, we need not add insult to injury.
>It would be helpful if you talked us through >your thoughts as you go along so readers can >follow your line of reasoning.
Speak for yourself. Let other posters let me know if they were as baffled as yourself.
>You're obviously
>very knowledgeable on esoteric mechanisms link, >but you need to say why a certain piece of >information is important and talk us through how >it fits in the wider picture.Ideally yes. I will try to do better. But this is "psycho-babble". You wil need to excuse me if I do indeed babble. Not everything I am saying needs to have a point. I never knew there was a rule about being required to make sence. Some of what I say can just be taken for what it is.
Linkadge
poster:linkadge
thread:775567
URL: http://www.dr-bob.org/babble/20070808/msgs/776307.html