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Re: I think Gaba B might be key for TRD and Dysthymia

Posted by cassandracomplex on March 31, 2013, at 13:45:53

In reply to I think Gaba B might be key for TRD and Dysthymia, posted by FrequentFryer on March 30, 2013, at 21:35:17

I don't think it's that simple. I don't think that TRD is a "one-size-fits-all" diagnosis from a neurochemical perspective. Why do amphetamines - which release DA and NE - relieve depression in many (in fact, were some of the first medications on label here in the US to treat depression) and yet lead to depression in others? The same goes for adjunctive antipsychotic medication, which inhibits DA. Why does MDMA have a short-lived response rate in nearly everyone who takes it, even those with major depression, and yet causes a profound "crash" in some afterward - certainly in most who use it on a prolonged basis, and yet its effects are entirely blocked by SSRIs/SNRIs. Why do benzodiazepines worsen depression in some but not all? Why doesn't Ketamine have a 100% response rate? Why doesn't Xyrem/GHB? This is why, I think, so-called "dirty drugs" have proven superior in treating TRD (and there are still those who fail to respond to those/require augmentation): because we're talking about more than one neurobiological process here. There is no one key that opens dozens of different locks. JMHO.

 

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poster:cassandracomplex thread:1041406
URL: http://www.dr-bob.org/babble/20130322/msgs/1041439.html