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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by psychobot5000 on April 23, 2007, at 11:07:17
This brief article focuses on research into psychedelics and their possible uses for anxiety disorders and OCD. While much of the emphasis of the article is on the sociological aspect of studying these things, there is content of interest for this community too.
One of the two small studies they refer to is the widely talked about Ketamine study, which apparently showed antidepressant effect. The other is one that seems less known or talked about, where apparently psilocybin was shown to be acutely effective for OCD (assumedly because of it's agonism on 5HT-2a and 2c effects, I believe)
http://www.time.com/time/magazine/article/0,9171,1612717,00.html
Posted by Phillipa on April 23, 2007, at 11:31:38
In reply to Article: mood/ocd research with abused drugs, posted by psychobot5000 on April 23, 2007, at 11:07:17
Being of that ERA and married with kids I did not take part but always found alchohol superior to meds. Just my take. Love Phillipa
Posted by Sebastian on April 23, 2007, at 11:40:49
In reply to Article: mood/ocd research with abused drugs, posted by psychobot5000 on April 23, 2007, at 11:07:17
All these drugs that could help people, but instead making them criminals?
Posted by Sebastian on April 23, 2007, at 11:45:13
In reply to Re: Article: mood/ocd research with abused drugs, posted by Sebastian on April 23, 2007, at 11:40:49
alcohol is realy making me sick and I could realy use a joint. But wouldn't get a job if I did that. Or get arrested. Answer the question, why do people use illegal drugs, is it because they want to be criminals or what?
Posted by nellie7 on April 23, 2007, at 13:12:50
In reply to Article: mood/ocd research with abused drugs, posted by psychobot5000 on April 23, 2007, at 11:07:17
Simple explanation perhaps- these substances can cure people of ocd by making them psychotic instead :)
Posted by linkadge on April 23, 2007, at 14:09:50
In reply to Re: Article: mood/ocd research with abused drugs, posted by nellie7 on April 23, 2007, at 13:12:50
Not necessarily. The anti-OCD effects of these drugs would likely take place at much lower doses than are used to have psychedeic effect.
Many of the psychedellics are potent 5-ht2a/c receptor agonists.
It is believed that the anti-OCD effects of SSRI's are mediated (in part) by agonism of 5-ht2a/c receptors.
Certain psychedellics could theoretically target these receptors with less effect on other receptor subtypes.
THe 5-ht2a/c receptors mediate gabergic responces in the frontal cortex. By activating these receptors one may help ameliorate the pathological frontal cortex activity that one sees in OCD.
So no, there may actually be some theraputic utility to these drugs, beyond their recreactional effects.
Linkadge
Posted by psychobot5000 on April 23, 2007, at 14:37:17
In reply to Re: Article: mood/ocd research with abused drugs » nellie7, posted by linkadge on April 23, 2007, at 14:09:50
> THe 5-ht2a/c receptors mediate gabergic responces in the frontal cortex. By activating these receptors one may help ameliorate the pathological frontal cortex activity that one sees in OCD.
>
> So no, there may actually be some theraputic utility to these drugs, beyond their recreactional effects.
>I would hope this research would lead to the development of drugs with less offensive side-effects (the hallucinations or whatever). I used to know someone who seemed OCD to me (no diagnosis as far as I know), and who used psilocybin frequently in his off hours--it seemed strangely like self-medication to me.
I believe we must also distinguish between 'psychedelic' effects and 'making them psychotic.' If I understand the issues right, I believe they are distinct phenomena, after all, and I'm not aware of psilocybin being associated with psychosis. ...When I was in college it had the reputation of being more of a relaxing, anxiolytic drug.
By the way, I believe it also is a 5-HT2b agonist--which would seem to mean a high risk of heart-valve damage.
Posted by linkadge on April 23, 2007, at 15:58:36
In reply to Re: Article: mood/ocd research with abused drugs, posted by psychobot5000 on April 23, 2007, at 14:37:17
>By the way, I believe it also is a 5-HT2b >agonist--which would seem to mean a high risk of >heart-valve damage.
This is true. BTW. I am absolutely terrified that this sort of dammage could extend to those who use SSRI medications. Afterall, SSRI's are potent 5-ht receptor agonists at all 5-ht receptors.
I hope we don't find out in a few years that SSRI's were/are inducing the same sorts of problems as other 5-ht2b agonists. Afterall, the dopamine agonists that were recetly taken off the market were assumed perfectly safe untill the moment they were shown to cause irreversable cardiac dammage.
Apparently I am the only one who is concerned.
Oh well.
Linkadge
Posted by johnnyj on April 23, 2007, at 16:58:13
In reply to Re: Article: mood/ocd research with abused drugs » nellie7, posted by linkadge on April 23, 2007, at 14:09:50
I thought it was antagonism of those receptor sites that helped with OCD? I am really confused
Posted by Sebastian on April 23, 2007, at 18:43:09
In reply to Re: Article: mood/ocd research with abused drugs, posted by Sebastian on April 23, 2007, at 11:40:49
I just lost a job due to these things.
Posted by Kathii on April 24, 2007, at 0:20:39
In reply to Re: Article: mood/ocd research with abused drugs, posted by linkadge on April 23, 2007, at 15:58:36
> >By the way, I believe it also is a 5-HT2b >agonist--which would seem to mean a high risk of >heart-valve damage.
>
> This is true. BTW. I am absolutely terrified that this sort of dammage could extend to those who use SSRI medications. Afterall, SSRI's are potent 5-ht receptor agonists at all 5-ht receptors.
>
> I hope we don't find out in a few years that SSRI's were/are inducing the same sorts of problems as other 5-ht2b agonists. Afterall, the dopamine agonists that were recetly taken off the market were assumed perfectly safe untill the moment they were shown to cause irreversable cardiac dammage.
>
> Apparently I am the only one who is concerned.
>
> Oh well.
>
> Linkadge
>
>
>No, you can add me to the list of who's concerned. I was recently diagnosed with Mitral Valve Prolapse and Second Degree AV Heart Block - had surgery to implant a pacemaker last month. Neither condition exists in my family (just blocked arteries - mine are just fine).
Have been wondering if there is any connection with my meds. I've been on some AD or other for about 12 years, I'm only in my mid-thirties.If anyone has ideas/comments, I'd like to see them.
Thanks.
Posted by linkadge on April 24, 2007, at 6:29:01
In reply to Re: Article: mood/ocd research with abused drugs » linkadge, posted by johnnyj on April 23, 2007, at 16:58:13
Most of the effective medications for OCD are the SSRI's, which act as agonists at all serotonin receptors including 5-ht2a/c.
Many people have noticed that combining SSRI's with cyproheptadine, a 5-ht2a/c antagonist, abolishes the anti OCD effect.
Linkadge
Posted by linkadge on April 24, 2007, at 14:00:45
In reply to Re: Article: mood/ocd research with abused drugs » johnnyj, posted by linkadge on April 24, 2007, at 6:29:01
Posted by linkadge on April 24, 2007, at 14:11:04
In reply to SSRI's and possible heart damage?! » linkadge, posted by Kathii on April 24, 2007, at 0:20:39
Difficult to say. I'm sure lots of people would like to be able to rule things out but I don't know.
Think of it this way. The two parkinsons meds recently withdrawn for similar cardiac effects were assumed to be perfectly safe up till a few months ago. A large percentage of the individuals taking the two agonsts show some degree of cardiac dammage. Many of these individuals showed no symtpoms untill viewed with medical equiptment.
Some people use the logic that unless a link has been proven there is no link. I think there is the potential that any powerfull serotonergic medication could produce similar effects, only that SSRI's have not been systematically studied for these types of effects.
I'd like to think we are in an age where the most significan side effects could be prescreened. However, I find it scarry that medications like permax and dosinex could slip the radar for so long.
Linkadge
Posted by nellie7 on April 24, 2007, at 14:34:21
In reply to Re: SSRI's and possible heart damage?! » Kathii, posted by linkadge on April 24, 2007, at 14:11:04
Linkadge, this sounds frightening. Though such effects have not been studied, do you know of any related anecdotal information?Nellie.
Posted by Declan on April 24, 2007, at 14:41:54
In reply to Re: Article: mood/ocd research with abused drugs » nellie7, posted by linkadge on April 23, 2007, at 14:09:50
Very few people under the influnce of any dose of a psychedelic are going to remember or care what their particular thing was that was worrying them.
New things will come to worry them, but people have positive experiences on psychedelics too, especially if they don't overdo it.
Posted by Declan on April 24, 2007, at 14:46:34
In reply to Re: Article: mood/ocd research with abused drugs, posted by psychobot5000 on April 23, 2007, at 14:37:17
Hello Psychobot
>When I was in college it had the reputation of being more of a relaxing, anxiolytic drug.That might depend on the source and strength of psiloscybin. Where the psiloscybin is available in high doses it has the repuation of being more dangerous. Some young people seemed not to come back from psiloscybin trips, but if the LSD had been comparably strong the same result might have applied there.
Posted by linkadge on April 24, 2007, at 16:14:40
In reply to Re: SSRI's and possible heart damage?! » linkadge, posted by nellie7 on April 24, 2007, at 14:34:21
The first thing that concerned me is that the SSRI's are going to be potent agonists of all 5-ht receptors including 5-ht2b. We already know that serotonin reuptake inhibitors can activate peripherial 5-ht receptors since GI upset is supposedly due to effects on GI serotonin transporters.
Another piece of information is that mice lacking the serotonin transporter, show similar cardiac damamge as that induced by the currently implicated medications.
http://circ.ahajournals.org/cgi/content/full/113/1/81
It is true that SSRI's do not completely wipe out the ability of the serotonin tranporter to clear serotonin, they can, in clincial doses reduce the activity of the serotonin transporter by some 60-80%.
My speculation is that the net activation of 5-ht2b is less than with direct 5-ht2b agonists, but the potential is still there to induce such problems given a larger time frame.
I am hoping more recearch is initiated promptly on the issue.
Certain SSRI's (like fluoxetine) have mild antagonistic effects on 5-ht2b which may (or may not) overcome the net increase in 5-ht2b transmission created by uptake inhibition, but I don't know if this would extend to other SSRI's.
Linkadge
Posted by psychobot5000 on April 25, 2007, at 0:06:55
In reply to Re: SSRI's and possible heart damage?!, posted by linkadge on April 24, 2007, at 16:14:40
I believe there has been study of cardiac patients taking SSRIs--the hope being that they'd be good for heart patients. If I remember right, the results from these studies showed neither a benefit, nor evidence of additional damage.
Hopefully, the potential damage from an excess serotonin supply simply is much weaker than having direct agonism at the receptors (as already suggested). But perhaps there are other--for example, anxiolytic--benefits that might counterbalance whatever heart damage occurs from serotonergic meds.
Or perhaps taking tianeptine (to counterbalance the increased serotonin) might reduce the serotonin supply, without blocking antidepressant benefits.
Posted by nellie7 on April 25, 2007, at 12:33:24
In reply to Re: SSRI's and possible heart damage?!, posted by linkadge on April 24, 2007, at 16:14:40
Posted by linkadge on April 25, 2007, at 14:04:55
In reply to Re: SSRI's and possible heart damage?!, posted by psychobot5000 on April 25, 2007, at 0:06:55
There have been positive studies and there have been negative studies, ie studies indicating excess cardiac mortality from SSRI use.
It is important to note that many of the studies were used in patients with preexisting cardiac diseases, and generally for short periods of time.
They were also not directly asessing cardiac valve function.
Linkadge
Posted by psychobot5000 on April 26, 2007, at 10:46:23
In reply to Re: SSRI's and possible heart damage?! » psychobot5000, posted by linkadge on April 25, 2007, at 14:04:55
> There have been positive studies and there have been negative studies, ie studies indicating excess cardiac mortality from SSRI use.
>
> It is important to note that many of the studies were used in patients with preexisting cardiac diseases, and generally for short periods of time.
>
> They were also not directly asessing cardiac valve function.
>
> Linkadge
>
>Then I suppose I'm glad I'm not taking an SSRI.
Psychbot
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