Posted by med_empowered on September 13, 2008, at 6:03:31
In reply to Re: CNS depressants and CNS depression » yxibow, posted by llurpsienoodle on September 13, 2008, at 5:29:30
OK, yeah...on the one hand, long-term use of sedatives can lead to feelings that might be called "depressive symptoms"--lethargy, cognitive slowing, low mood, so on and so forth. With the benzos, Klonopin and Tranxene are apparently particularly bad when it comes to causing/worsening this kind of depression; Xanax has some stimulating properties, so its considered a mild anti-depressant.
On the other hand, like another poster said, there's a big segment of the "depressed" patient group that could really use a downer. This is why some "depressed" people respond well to low-dose neuroleptics (or the atypicals), benzos, hydroxyzine, anticonvulsants, etc.
Then there's the Q of whether or not low neurotransmitter levels can cause depression. They used to say that this had been suggested or proven b/c reserpine, an early antipsychotic and antihypertensive, lowered levels of a number of neurotransmitters and some patients apparently developed "depression."
The problem with that is...at high enough doses, reserpine induces Parkinsonism and Neuroleptic Dysphoria just like any other antipsychotic, so the mood problems may have had to do with a) dosing and b) chemically-induced Parkinson's (its worth noting that Parkinson's disease is often marked by apathy, anxiety, and low mood BEFORE the dyskinetic movements pop up.). Also, reserpine actually *helped* some people with depression.
Also, if low neurotransmitter levels=depression, then stimulants would be a sure-fire depression cure. They're not. Even when they were being RX'd like crazy for psychiatric complaints, amphetamines were regarded as best used for "mild depressions" characterized by low mood and ennervation; more severe depressions were treated by other means (ECT, lobotomies, neuroleptics, upper/downer combo pills, etc.)Sooo...your T might be on to something. I mean, as benzos go, Klonopin is one of the more depressing ones. On the other hand, Therapists, in my experience at least, have serious problems with benzos: they tend to view them as addictive band-aids that keep people from dealing with their "underlying issues". Some shrinks share this view, too.
Its also worth noting that Klonopin can actually augment antidepressants, at least in the short term, via some sort of serotonergic action (and, I imagine, by counteracting over-activation and akathisia). Sooo...use your own judgement.
poster:med_empowered
thread:851665
URL: http://www.dr-bob.org/babble/20080903/msgs/851756.html