Posted by SLS on May 22, 2009, at 7:33:22
In reply to Re: Avoid serotonergics after bad SRI reaction? » newquestions, posted by sowhysosad on May 22, 2009, at 6:35:02
> But the prior adaptation would be one of DE-sensitisation of the 5HT receptors, not hypersensitivity.
Perhaps the post-drug return to baseline sensitivity overshoots and produces supersensitivity of both postsynaptic and presynaptic receptors, along with the kindling of certain glutamatergic pathways. When an SSRI is reintroduced, the change in the dynamics of the 5-HT synapse never again reach a normal equilibrium, with an increase in the sensitivity of side effects - even at a lower dosage.
Just a thought. I haven't researched this at all.
There is more to consider relating to neuronal behavior in the presence of a serotonin reuptake inhibitor - accomodation for instance - that might explaing the acute effects of these drugs during the first week that disappear upon chronic use. Anxiety would be one such side effect.
As an aside, I am of the tentative belief that the more acute the discontinuation of an SRI along with subsequent withdrawal symptoms, the worse the withdrawal symptoms become subsequently. This might also be a part of the kindling process. The lesson here is that the gradual withdrawal from an SRI is critical to prevent subsequent sensitivities.
Of course, I am not sure about this stuff as I have never seen it written anywhere. I find these things quite fascinating, but extremely relevant.
- Scott
poster:SLS
thread:896671
URL: http://www.dr-bob.org/babble/20090515/msgs/897093.html