Posted by Bob on April 24, 2010, at 12:05:33
In reply to Multiple drug exposures and treatment resistence, posted by SLS on April 24, 2010, at 11:53:56
> Yeah. No kidding...
>
> If you are severely ill, what choice do you have?
>
> I had a doctor tell me that I should remain as clean as possible between trials of newly available medications. He was right. The brain must surely change in response to drug exposure. If it didn't, there would be no such thing as an antidepressant response or the phenomenon of poop-out. Why am I no longer responsive to the same treatment I had success with previously? Something must be different.
>
>
> - Scott
>
>
> -------------------------------------------------
>
>
> Neuropsychobiology. 2009;59(4):227-33. Epub 2009 Jul 2.
>
> Tachyphylaxis after repeated antidepressant drug exposure in patients with recurrent major depressive disorder.
>
> Amsterdam JD, Williams D, Michelson D, Adler LA, Dunner DL, Nierenberg AA, Reimherr FW, Schatzberg AF.
>
> Depression Research Unit, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104-3309, USA. jamsterd@mail.med.upenn.edu
> Abstract
>
> OBJECTIVE: The aim of this post hoc analysis was to examine whether tachyphylaxis occurs after repeated courses of antidepressant drug therapy. METHOD: 276 patients with major depressive disorder (MDD) were treated with sertraline (150-200 mg daily) for 8 weeks. Patients with persistent MDD after sertraline therapy were randomized to continuation therapy with either sertraline plus atomoxetine (n = 72) or sertraline plus placebo (n = 74) for 8 additional weeks. Logistic regression was used to test the hypothesis that an increase in prior antidepressant drug exposure is associated with a reduced responsiveness to sertraline therapy. RESULTS: The number of prior antidepressant drug exposures was negatively associated with response to initial sertraline therapy (odds ratio = 0.81, p = 0.0035). The odds ratio indicates a 19.9% reduced likelihood of response with each prior antidepressant treatment trial. In contrast, the number of prior antidepressant treatment trials was not associated with response to continuation sertraline plus atomoxetine or sertraline plus placebo therapy. CONCLUSION: This observation supports the hypothesis that tachyphylaxis may develop after repeated antidepressant drug trials. Copyright 2009 S. Karger AG, Basel.
>
> PMID: 19571597 [PubMed - indexed for MEDLINE]
If this is true, which it definitely seems to be for me, we need to find a way to re-start the response somehow. Like you said, Scott, sick people simply do not have a choice.
poster:Bob
thread:944856
URL: http://www.dr-bob.org/babble/20100416/msgs/944858.html