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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Questionmark on June 6, 2003, at 23:00:26
Does anyone feel that s/he has had, or might have had, ANY lasting/permanent effects/damage/changes from Paxil or any SSRI, or any serotonergic med-- or any med other than an AP for that matter (cuz APs can obviously cause tardive dyskinesia and what not) ?
If so, what are they, what dose were you on & for how long, when did the effect start, and why do you think this was caused by the medication?
Thank you.
Posted by bookgurl99 on June 7, 2003, at 0:53:43
In reply to Important Question-- SSRIs, etc., posted by Questionmark on June 6, 2003, at 23:00:26
You know questionmark, part of the issue is that once you have brain damage, it's harder to remember what your brain used to be like. It would be hard to evaluate.
At this point, having not taken anything for a month after having taken about 5 year's worth of SSRI's and one atypical AD, I feel that my brain is normal as it always was. Howevever, I have gone through periods after withdrawals where I seemed manic (even though I don't have a BP dx), or where I had problems with memory, involuntary muscle twitches, headache, and learning. These all returned to normal with time.
Is there any med in particular you're looking at? Are you looking to treat anything in particular.?
Posted by Questionmark on June 7, 2003, at 3:33:11
In reply to Re: Important Question-- SSRIs, etc., posted by bookgurl99 on June 7, 2003, at 0:53:43
> You know questionmark, part of the issue is that once you have brain damage, it's harder to remember what your brain used to be like. It would be hard to evaluate.
That's a good point.
> At this point, having not taken anything for a month after having taken about 5 year's worth of SSRI's and one atypical AD, I feel that my brain is normal as it always was. Howevever, I have gone through periods after withdrawals where I seemed manic (even though I don't have a BP dx), or where I had problems with memory, involuntary muscle twitches, headache, and learning. These all returned to normal with time.
Wow, only one month off after 5 years of being on SSRIs and you feel fine? That's great. Weird though.
> Is there any med in particular you're looking at? Are you looking to treat anything in particular.?Well i'm curious in regard to meds in general, but particularly Paxil (or any SSRI) and Nardil. i was on Paxil for about 2 years and, i can't really tell, but i feel as though i've never been the same since stopping it-- like it's more than just "relapse", like i'm more messed up than i would be. There are so many factors (esp. psychological) involved though, that it's hard to tell. But what IF, you know?! i mean it certainly seems POSsible. But i duno. i hope not. ... But i really WANT to know, and there seems to be so little information on this sort of thing (long-term effects/changes/damage from an SSRI or what have you).
Oh and i am highly considering going on Nardil, and maybe for awhile (months/couple years?). And since Nardil dramatically increases the levels of serotonin in the synapse, as SSRIs do, i am even more concerned about whether it may have long-term consequences (not to mention it virtually obliterates REM sleep-- who knows if thats somehow harmful at all).
"Are you looking to treat anything in particular?"
Yes: stupidity, slowness, incompetence, ADD, depression, social anxiety, indecisiveness, scrawniness, the myriad of problems that come w/ OC-Personality disorder, procrastination, lost youth, regret, inferiority, self-hatred...
Posted by linkadge on June 7, 2003, at 4:20:57
In reply to Re: Important Question-- SSRIs, etc. » bookgurl99, posted by Questionmark on June 7, 2003, at 3:33:11
The sleep related decrease in REM, is mostly dose dependant, and can reduce over time.
We are not sure that SSRI's cause brain dammage, but we do know for sure that they cause brain growth, in the hippocampus areas of the brain. Antidepressants and aerobic excercise are some of the only things known to do this.
My theory is that when a person takes an antidepressant, new connections are made, and new brain wiring is implemented, but without the drug it is hard for the brain to continue to use those new areas, resulting in a feeling of relative deprivation.
I would personally recomend a months worth of vigerous excercise (1 hr day), before you asses your need for an AD.
I don't say this in a stingy way at all. What I mean is that if you are suffering some imparement, it is highly likely that excercise will help reset (or not reset) the brain's wiring.
Excercise, dramatically increases the level of BDNF which is a substance known for its antidepressant and adaptogenic function.
**Excercise is very likely to take your chemistry back to where it was prior Paxil**Whenever I have come off AD's excercise helps the withdrawl, and helps me to more clearly reasses my need and dose of an Antidepressant.
I came off 20 mg of Celexa which only 'sort of worked' started jogging for an hour each day, and then started back on 10 mg with *much better sucess*
Think of it this way - you started paxil for real probems, it may be that those real problems are reemerging. You may just need it again.
But excercise can help you get back to your genetic setpoint for mood - whatever that may be, good or not so good, and may help you make a decision.
Best of Luck
Linkadge
Posted by Questionmark on June 8, 2003, at 23:38:09
In reply to Re: Important Question-- SSRIs, etc., posted by linkadge on June 7, 2003, at 4:20:57
(Sorry, i didn't mean to make the word "relapse" appear as a book title in the above post).
Linkadge, thanks for the info and opinions. They were helpful and are things to think about.
> The sleep related decrease in REM, is mostly dose dependant, and can reduce over time.
Good point. But there is still such a dramatic overall reduction in REM, especially with Nardil, that it causes me some concern. One thing i really wonder is if this could affect memory to some significant extent.
> We are not sure that SSRI's cause brain dammage, but we do know for sure that they cause brain growth, in the hippocampus areas of the brain. Antidepressants and aerobic excercise are some of the only things known to do this.
Also really good points. i am concerned though, since fenfluramine and MDMA supposedly appear to cause damage to 5-HT neurons, and though these are agonists and not SRIs, the effect is still similar enough to make me worried. But i guess you're right-- if antidepressants increase BDNF levels and neuronal growth in the hippocampus, they ARE probably better overall for someone who needs them.. hopefully.
> My theory is that when a person takes an antidepressant, new connections are made, and new brain wiring is implemented, but without the drug it is hard for the brain to continue to use those new areas, resulting in a feeling of relative deprivation.
i agree with that theory-- insofar as the drug is helping, of course. But i am scared about how long this effect will last (until receptor downregulation, increased tolerance, and "poop-out" occur)-- and to what extent the reverse becomes true (reduction in neural connections, loss of brain cells, or etc.) once one discontinues the drug or even if/once "poop-out" occurs.
> I would personally recomend a months worth of vigerous excercise (1 hr day), before you asses your need for an AD.
> I don't say this in a stingy way at all. What I mean is that if you are suffering some imparement, it is highly likely that excercise will help reset (or not reset) the brain's wiring.Very good advice. i wish i would stop putting it off so much.
> Excercise, dramatically increases the level of BDNF which is a substance known for its antidepressant and adaptogenic function.Excellent point.
> **Excercise is very likely to take your chemistry back to where it was prior Paxil**
> Whenever I have come off AD's excercise helps the withdrawl, and helps me to more clearly reasses my need and dose of an Antidepressant.
> I came off 20 mg of Celexa which only 'sort of worked' started jogging for an hour each day, and then started back on 10 mg with *much better sucess* ...
> But excercise can help you get back to your genetic setpoint for mood - whatever that may be, good or not so good, and may help you make a decision.
That is all quite encouraging. Thanks.> Think of it this way - you started paxil for real probems, it may be that those real problems are reemerging. You may just need it again.
i dunno, it seemed like more than just that. But maybe you're right.
>
> Best of Luck
>
> LinkadgeAgain, thank you. Best of luck to you too.
Posted by bookgurl99 on June 9, 2003, at 3:25:18
In reply to Re: Important Question-- SSRIs, etc. » bookgurl99, posted by Questionmark on June 7, 2003, at 3:33:11
> Wow, only one month off after 5 years of being on SSRIs and you feel fine? That's great. Weird though.
Actually, I'm feeling quite hyper. I'm getting a little hypomanic and talking a lot. I kind of think that my brain is still balancing things out. Like, before the dopamine/noripenephrine may have been trying really hard to come out because the med suppressed it, and now there's just too much 'activation.' Meanwhile, the calming serotonin is like, 'you don't need much of us, right? we're blocked in,' even though they're _not_ anymore and need to build up.
> Well i'm curious in regard to meds in general, but particularly Paxil (or any SSRI) and Nardil. i was on Paxil for about 2 years and, i can't really tell, but i feel as though i've never been the same since stopping it--How long have you been off of it?
>like it's more than just "relapse", like i'm more messed up than i would be.
What do you mean by messed up?
I'm noticing that my attention span is still quite short, but improving. (It was short on zoloft this past year.) I don't recall being this way before. I'm anxious that it could be the meds having rubbed away at my little brain connections all these years. Or, this is a transient effect of getting off the meds.
>There are so many factors (esp. psychological) involved though, that it's hard to tell. But what IF, you know?! i mean it certainly seems POSsible. But i duno. i hope not. ... But i really WANT to know, and there seems to be so little information on this sort of thing (long-term effects/changes/damage from an SSRI or what have you).
I think the only way to know would be to get a SPECT scan to examine your brain activiity. And even then you'd have to judge based on what you knew of yourself pre-meds.
> Yes: stupidity, slowness, incompetence, ADD, depression, social anxiety, indecisiveness, scrawniness, the myriad of problems that come w/ OC-Personality disorder, procrastination, lost youth, regret, inferiority, self-hatred...hey, i'm dealing with a lot of the same issues! I was diganosed OCD-PD once myself, though I don't believe it. Maybe we're just highly motivated, mildy perfectionistic, anxious folks with a tendency to worry on the 'what ifs.' Wouldn't we be called 'neurasthenics' in the past and given 6 weeks of bed rest, no responsibilities? Bed rest at once!
books
Posted by Questionmark on June 9, 2003, at 23:53:12
In reply to Re: Important Question-- SSRIs, etc., posted by bookgurl99 on June 9, 2003, at 3:25:18
> > Wow, only one month off after 5 years of being on SSRIs and you feel fine? That's great. Weird though.
>
> Actually, I'm feeling quite hyper. I'm getting a little hypomanic and talking a lot. I kind of think that my brain is still balancing things out. Like, before the dopamine/noripenephrine may have been trying really hard to come out because the med suppressed it, and now there's just too much 'activation.' Meanwhile, the calming serotonin is like, 'you don't need much of us, right? we're blocked in,' even though they're _not_ anymore and need to build up.Ah, yeah-- okay. Yeah i think you're right. i had the same experience for about the first month of being off Paxil (went off this past Dec.). It's like an emotional rebound from all that time of severe apathy. i would get really ticked and sad as heck at the drop of a dime. Even seeing a fairly benign commercial could make me tear up. Crazy. But it was actually kinda nice for the most part.
> > Well i'm curious in regard to meds in general, but particularly Paxil (or any SSRI) and Nardil. i was on Paxil for about 2 years and, i can't really tell, but i feel as though i've never been the same since stopping it--
> How long have you been off of it?About 6 months.
> >like it's more than just "relapse", like i'm more messed up than i would be.
>
> What do you mean by messed up?The depression is BAD. i can't think-- can't think straight. Terribly obsessive-compulsive (which means a lot of different things for me)-- worse than ever i think. Extreme feelings of inferiority that *i'm* not even used to, that i don't even completely understand. States of mind and moods that are much more unpredictable than what i'm accostumed to-- which makes for an extremely vague self-identity. And the list goes on.
> I'm noticing that my attention span is still quite short, but improving. (It was short on zoloft this past year.) I don't recall being this way before. I'm anxious that it could be the meds having rubbed away at my little brain connections all these years. Or, this is a transient effect of getting off the meds.
Yeah, i feel that-- like i just can't think; like i'm not in control of my mind enough at all. i dunno. But yeah i'm anxious about the same freaking thing. Hopefully it Is just a transient effect of getting the meds (and/or maybe a worsening of depression from relapse for me).
>
>
> >There are so many factors (esp. psychological) involved though, that it's hard to tell. But what IF, you know?! i mean it certainly seems POSsible. But i duno. i hope not. ... But i really WANT to know, and there seems to be so little information on this sort of thing (long-term effects/changes/damage from an SSRI or what have you).
>
> I think the only way to know would be to get a SPECT scan to examine your brain activiity. And even then you'd have to judge based on what you knew of yourself pre-meds.Yeah. That'd be neat, but probably inadequate.
> > Yes: stupidity, slowness, incompetence, ADD, depression, social anxiety, indecisiveness, scrawniness, the myriad of problems that come w/ OC-Personality disorder, procrastination, lost youth, regret, inferiority, self-hatred...
>
> hey, i'm dealing with a lot of the same issues! I was diganosed OCD-PD once myself, though I don't believe it. Maybe we're just highly motivated, mildy perfectionistic, anxious folks with a tendency to worry on the 'what ifs.' Wouldn't we be called 'neurasthenics' in the past and given 6 weeks of bed rest, no responsibilities? Bed rest at once!If *you* don't believe it, you're probably right (as long as you were given an adequate description of OCPD). From what i've read, however, i definitely think OCP is an accurate description of many of my quirks and problems. Also, i'm extremely UNmotivated, sickeningly perfectionistic, and, yeah. Ooh, what are 'neurasthenics'? i like their treatment. Six weeks of bed rest-- that's what i need-- well, no. Now an etERnity of bed rest... that would be nice. ok i'm done
Posted by bookgurl99 on June 10, 2003, at 1:07:14
In reply to Re: Important Question-- SSRIs, etc. » bookgurl99, posted by Questionmark on June 9, 2003, at 23:53:12
>Ooh, what are 'neurasthenics'? i like their treatment. Six weeks of bed rest-- that's what i need-- well, no. Now an etERnity of bed rest... that would be nice. ok i'm done
Uh -- i'm not into you seeking out an _eternity_ of bed rest. Are testing out the feeling of suicide?
>But when it comes to neurasthenia, a month or 6 weeks of bed rest was advised.
Here's a short description of neurasthenia done by an academic analyzing a Willa Cather story at http://www.media-culture.org.au/0106/cather.html.
. . . "Discovered" by the neurologist George M. Beard in 1880, neurasthenia was a nervous disorder characterized by a "lack of nerve force" and comprised of a host of neuroses clustered around an overall paralysis of the will.Cultural historian T.J. Jackson Lears, long a student of neurasthenia, defines it as an "immobilizing, self-punishing depression" stemming from "endless self-analysis" and "morbid introspection" (47, 49).
* There is another neat description at http://www.edgarcayce.org/th/tharchiv/research/neurasth.html
I particularly like this part: "In addition to the psychic symptoms here described, the patient also suffers from insomnia. Mostly he has but little difficulty in falling asleep, but the sleep is broken, especially toward the morning hours, and the patient finds difficulty in falling asleep again. If be does, the second sleep is likely to be heavy and the awakening to be accompanied by a feeling of more or less marked prostration. Occasionally the sleep is interrupted a number of times, and often is accompanied by a desire to empty the bladder. Less frequently the patient has difficulty in falling asleep, the oncoming of the first sleep being delayed for an hour or more. The sleep of neurasthenics is rarely refreshing. The patient usually awakens with a feeling of lethargy and depression, and feels but little inclined to activity, especially in the early part of the day. "
hmm. . it all sounds a bit familiar. It sounds like the Questiomark problem!
I like this dx because it addresses simple problems with simple solutions;if a person is tired out, let him rest. it seems much healthier than our pill-popping ways.
unfortunately, it fell out of disuse due to being a little too inclusive. before MRI's and other measuring devices, one couldn't know whether this malaise was due to M.S. or CFS or industrial pollutants, or if the sufferers truly had tired out their consitutions.
Posted by Questionmark on June 16, 2003, at 6:22:12
In reply to neurasthenia, posted by bookgurl99 on June 10, 2003, at 1:07:14
> >Ooh, what are 'neurasthenics'? i like their treatment. Six weeks of bed rest-- that's what i need-- well, no. Now an etERnity of bed rest... that would be nice. ok i'm done
>
> Uh -- i'm not into you seeking out an _eternity_ of bed rest. Are testing out the feeling of suicide?Nooooooooooo. Suicide is bad.
...(That's what all the live people tell me anyway.) Oohwahh!> But when it comes to neurasthenia, a month or 6 weeks of bed rest was advised.
>
> Here's a short description of neurasthenia done by an academic analyzing a Willa Cather story at http://www.media-culture.org.au/0106/cather.html.
> . . . "Discovered" by the neurologist George M. Beard in 1880, neurasthenia was a nervous disorder characterized by a "lack of nerve force" and comprised of a host of neuroses clustered around an overall paralysis of the will.
>
> Cultural historian T.J. Jackson Lears, long a student of neurasthenia, defines it as an "immobilizing, self-punishing depression" stemming from "endless self-analysis" and "morbid introspection" (47, 49).Fascinating. Those are some beautifully descriptive freaking terms there. "Paralysis of the will;" "immobilizing, self-punishing depression;" "endless self-analysis;" "morbid introspection". Man, if that doesn't describe depressions with intense self-hatred wonderfully.. i love it.
> * There is another neat description at http://www.edgarcayce.org/th/tharchiv/research/neurasth.html
>
> I particularly like this part: "In addition to the psychic symptoms here described, the patient also suffers from insomnia. Mostly he has but little difficulty in falling asleep, but the sleep is broken, especially toward the morning hours, and the patient finds difficulty in falling asleep again. If be does, the second sleep is likely to be heavy and the awakening to be accompanied by a feeling of more or less marked prostration. Occasionally the sleep is interrupted a number of times, and often is accompanied by a desire to empty the bladder. Less frequently the patient has difficulty in falling asleep, the oncoming of the first sleep being delayed for an hour or more. The sleep of neurasthenics is rarely refreshing. The patient usually awakens with a feeling of lethargy and depression, and feels but little inclined to activity, especially in the early part of the day. "
>
>
>
> hmm. . it all sounds a bit familiar. It sounds like the Questiomark problem!Hahhah, yes, one of many. But i mostly just have the falling-asleep insomnia (fortunately i can remain asleep once asleep, usu.)
> I like this dx because it addresses simple problems with simple solutions;if a person is tired out, let him rest. it seems much healthier than our pill-popping ways.
Yeah. i think we might all be sickened by how ultimately inadequate our "pill-popping ways" are if it weren't for the pharm companies pumping boatloads of money to keep the fantasy going-- and i'm still falling for the dang fantasies (MAOI this go-around). Oh, but, i don't know if that bed rest for people like this would actually help. i think after the six weeks were up they'd feel even more lethargic and what not from not doing anything for 6 weeks but lying around getting their muscles atrophied. Would be nice for 6 weeks though.
> unfortunately, it fell out of disuse due to being a little too inclusive. before MRI's and other measuring devices, one couldn't know whether this malaise was due to M.S. or CFS or industrial pollutants, or if the sufferers truly had tired out their consitutions.
That's understandable. Hey that'd be nice to get a prescription for 6 wks bed rest, huh? Hah.
Thanks alot for the info. Interesting stuff.
This is the end of the thread.
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