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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by denise190466 on August 24, 2005, at 10:43:54
If what researchers say about SSRIs is true and that they mainly work by ultimately increasing BDNF, why in the past have SSRI's only taken a few days to work for me when they have worked.
The first time I ever took an antidepressant (Dothiepin) it actually worked within 24 hours I just don't get it. Can anyone shed any light?
Denise
Posted by Jedi on August 24, 2005, at 12:01:43
In reply to BDNF Question, posted by denise190466 on August 24, 2005, at 10:43:54
> If what researchers say about SSRIs is true and that they mainly work by ultimately increasing BDNF, why in the past have SSRI's only taken a few days to work for me when they have worked.
>
> The first time I ever took an antidepressant (Dothiepin) it actually worked within 24 hours I just don't get it. Can anyone shed any light?
>
Hi Denise,
In my opinion, when a true antidepressant medication works in one day it is probably a side effect of the med or the placebo effect you are feeling. I've been on at least 25 different combination trials and just the anticipation of having something work when I feel so bad can make me feel somewhat better. This type of feeling has never lasted. Everybody is different and some get quicker response. I wish I could tell in a few days if a med was going to work. It sure would save a lot of time.
Take care,
Jedi
Posted by linkadge on August 24, 2005, at 16:51:55
In reply to Re: BDNF Question » denise190466, posted by Jedi on August 24, 2005, at 12:01:43
I would hazzard to *slightly* disagree with the above post. The TCA's can provide some degree relief very quickly due to their profile.
First they are potent anticholinergics. Anticholinergics are fast acting antidepressants. Infact single injections of anticholinergics in mice increases dopamine in the neuculeus accumbens. Anticholinergics are rewarding, and that is why some people abuse potent anticholinergic drugs like cogentin.
Second, their 5-ht2a blocking potential can lower cortisol immediately.Third, they have strong effects on the opiate system, that work immediately. Opiates like heroin, relive depresson immediately.
The antihistamine effects can also relieve some anxiety.
The neurotrophic effects of the meds would certainly take longer to kick in, that does not mean they cannot provide some subjective relief quickly.
Linkadge
Posted by 4WD on August 24, 2005, at 21:11:43
In reply to Re: BDNF Question, posted by linkadge on August 24, 2005, at 16:51:55
> I would hazzard to *slightly* disagree with the above post. The TCA's can provide some degree relief very quickly due to their profile.
>
> First they are potent anticholinergics. Anticholinergics are fast acting antidepressants. Infact single injections of anticholinergics in mice increases dopamine in the neuculeus accumbens. Anticholinergics are rewarding, and that is why some people abuse potent anticholinergic drugs like cogentin.
>
>
> Second, their 5-ht2a blocking potential can lower cortisol immediately.
>
> Third, they have strong effects on the opiate system, that work immediately. Opiates like heroin, relive depresson immediately.
>
> The antihistamine effects can also relieve some anxiety.
>
>
> The neurotrophic effects of the meds would certainly take longer to kick in, that does not mean they cannot provide some subjective relief quickly.
>
>
> Linkadge
>
>
>
Do all anticholinergic drugs behave like this? Or just the TCAs? Is Remeron considered an anticholinergic drug?Marsha
Posted by linkadge on August 25, 2005, at 6:30:37
In reply to Re: BDNF Question » linkadge, posted by 4WD on August 24, 2005, at 21:11:43
Remeron has strong antihistamine properties, but I don't think it is significantly anticholinergic.
I know a lot of anticholinergics have significant abuse potential. Some of the activity of rewardings illegal drugs like marajuanna, datura, etc are partially explained by potent anticholinergic effects.
Some authors suggest that remeron relievs depression faster than other AD's. If this is true, I would attribute this to its sleep promoting and anticortisol effects that it does share with the TCA's.
Linkadge
Posted by denise190466 on August 25, 2005, at 13:18:29
In reply to Re: BDNF Question, posted by linkadge on August 25, 2005, at 6:30:37
First Time I took prothiaden (tryciclic), I definately felt better within 24 hours and it was no placebo effect. Perhaps like Linkadge says it was to do with it's antihistamine effects.
However, I also felt better pretty quickly when I first took Seroxat.
It's a shame I don't get the same effects now when I take these drugs.
Denise
Posted by pseudoname on August 25, 2005, at 14:52:24
In reply to BDNF Question, posted by denise190466 on August 24, 2005, at 10:43:54
Denise--
How long did the good effects of those ADs last when you first took them?
In my experience I can get a couple days of truly non-placebo-effect improvement out of various meds, but then nothing.
Posted by iforgotmypassword on August 25, 2005, at 16:09:20
In reply to How long did they last? » denise190466, posted by pseudoname on August 25, 2005, at 14:52:24
i don't know what they mean by 'moderate', but to them it seems associated with low incidence of anticholinergic effects like you are saying. do you think it's anything to worry about? i'm sort of obsessed with acetylcholine right now. :P
Posted by linkadge on August 25, 2005, at 17:03:29
In reply to remeron, moderate muscarinic recepton antagonist?, posted by iforgotmypassword on August 25, 2005, at 16:09:20
I could definately not feel any anticholinergic effects on remeron, no dry mouth, blurred vision, urinary problems, memory problems (except due to morning drowsiness).
Linkadge
Posted by iforgotmypassword on August 25, 2005, at 17:31:08
In reply to Re: remeron, moderate muscarinic recepton antagonist?, posted by linkadge on August 25, 2005, at 17:03:29
yeah... and there's even a study saying that it improves memory. too bad i found it unhelpful, and practically like a brick to the head at times. but this was a few years ago though...
Posted by 4WD on August 25, 2005, at 18:08:10
In reply to Re: remeron, moderate muscarinic recepton antagonist?, posted by linkadge on August 25, 2005, at 17:03:29
> I could definately not feel any anticholinergic effects on remeron, no dry mouth, blurred vision, urinary problems, memory problems (except due to morning drowsiness).
>
>
>
> Linkadge
>
>
Did it just not work for you? Why did you quit taking it?Marsha
Posted by linkadge on August 25, 2005, at 20:33:41
In reply to Re: remeron, moderate muscarinic recepton antagonist? » linkadge, posted by 4WD on August 25, 2005, at 18:08:10
It was not a mood brighener for me. It did not improve my mood at all. It seemed to just alter my attitude. Made me angrier and more bitter at things in general.
I just could not fill my gullet fast enough. And it made me p*ssed off that I was always going around hungry.
Irritable and hungry.
It also did not change the way I felt about wanting to life my life or die.
Linkadge
Posted by denise1966 on August 26, 2005, at 12:56:14
In reply to How long did they last? » denise190466, posted by pseudoname on August 25, 2005, at 14:52:24
Hi,
I guess I must have been very lucky at one time because the effects lasted for five years for the prothiaden and then for the Seroxat until I stopped taking them, which was about 3 years. The seroxat never stopped working for me but I foolishly came off them.
Then almost five years ago I started to get very depressed again and nothing has worked as well since, infact most of the antidepressants have made me feel more suicidal than ever when I first started taking them.
I've been taking Nardil this week and have been feeling suicidal all week. Infact I find the idea that I could jump off a cliff if I wanted to strangely comforting.
Denise
Posted by 4WD on August 26, 2005, at 20:49:38
In reply to Re: How long did they last?, posted by denise1966 on August 26, 2005, at 12:56:14
> Hi,
>
> I guess I must have been very lucky at one time because the effects lasted for five years for the prothiaden and then for the Seroxat until I stopped taking them, which was about 3 years. The seroxat never stopped working for me but I foolishly came off them.
>
> Then almost five years ago I started to get very depressed again and nothing has worked as well since, infact most of the antidepressants have made me feel more suicidal than ever when I first started taking them.
>
> I've been taking Nardil this week and have been feeling suicidal all week. Infact I find the idea that I could jump off a cliff if I wanted to strangely comforting.
>
> Denise
Denise,I'm sorry you feel so bad. I think that feeling is pretty normal (I mean for a depressed person). I know that when I was at my worst, it was comforting to know that if I truly couldn't stand it any more, I could end it. It gave me a feeling of security to know that I didn't HAVE to live in such pain. I did have a way out if it became impossible to go on.
Thankfully, I held on to the hope that it would get better. And it has. I'm glad I didn't do it but I still have in the back of my mind that if it ever gets that bad or worse, I don't have to just stand for it.
I think you will get better. You still have the hope that the Seroxat will work again after you finish the Nardil. And remember you can go back and do the ECT if you need to.
Don't give up hope yet.
Marsha
Posted by denise1966 on August 28, 2005, at 12:19:47
In reply to Re: How long did they last?, posted by 4WD on August 26, 2005, at 20:49:38
Thanks Marsha, it's nice to know that other people understand the way I'm feeling but not nice for them of course :-)
that's what I've been telling myself today "that I'm not always going to feel like this and that things will get better". I'm just sometimes not sure that this Nardil to Seroxat plan is going to work out, I'm just going on the fact that the Seroxat seemed to work better last time after I'd stopped taking Nardil but it could just be pure co-incidence.
What are you taking anyway and is it helping?
Denise
Posted by Pfinstegg on August 28, 2005, at 16:48:29
In reply to Re: How long did they last?, posted by denise1966 on August 28, 2005, at 12:19:47
I know you know this, but ECT plus the best possible AD at the right dose is the most potent treatment for TRD. The first two ECTs went well, from what you say (well in terms of minimal or no side-effects). But you would need about 8 to know if they really helped. I'm puzzled as to why you didn't continue with the ECT. You might be someone who needs an AD plus occasional maintenance ECT. Would it be worthwhile revisiting the ECTpossibility while you are waiting for the Nardil to help?
Posted by denise1966 on August 30, 2005, at 15:08:11
In reply to Re: How long did they last? » denise1966, posted by Pfinstegg on August 28, 2005, at 16:48:29
Hi Pfinstegg,
I think I need to get back on a medication before I'll retry ECT. It may be something I'll try in the future but not whilst I'm not any medication.
Denise
Posted by 4WD on August 30, 2005, at 21:57:24
In reply to Re: How long did they last?, posted by denise1966 on August 28, 2005, at 12:19:47
> Thanks Marsha, it's nice to know that other people understand the way I'm feeling but not nice for them of course :-)
>
> that's what I've been telling myself today "that I'm not always going to feel like this and that things will get better". I'm just sometimes not sure that this Nardil to Seroxat plan is going to work out, I'm just going on the fact that the Seroxat seemed to work better last time after I'd stopped taking Nardil but it could just be pure co-incidence.
>
> What are you taking anyway and is it helping?
>
> Denise
Hi Denise,I think a lot of people are kind of in the same boat - on some med trial with no idea whether it's going to work, knowing that any results (IF any results) will be at least a few weeks in the future and feeling like crap in the meantime. It's an awful place to be.
I'm back on Celexa. I had done a month's trial of Lexapro to see if it would help more with anxiety but it just made it worse. The Celexa isn't perfect, still have some anhedonia and apathy and energy problems, still some unpleasant side effects but I can at least function and can get by with a lot less Klonopin. Actually today I felt pretty good.
My biggest problem the last few months has been waking up scared. Followed by getting out of bed and getting more scared. That's getting better. Thanks for asking.
And remember, if the Nardil/Seroxat thing doesn't work, there's always another option. And if the Zyprexa keeps you going in the meantime, take it. Zyprexa has gotten me through some really rough times. (I don't take it often either - it makes me want to stay up all night drinking coffee, or else take drugs, or else binge on food. Now that I think of it, it makes me want to do all three.) Anyway, if it helps you there's no reason to feel worried about it. I don't think it has a rep for pooping out.
Marsha
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