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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by zonked on July 19, 2011, at 8:40:52
Was thinking about this. I wonder if the reason we haven't seen meds which we can tell whether they'll work or not in days, instead of weeks or months, isn't because the science isn't there (opiods have been around forever) but because pharma doesn't pursue developing them because society would have a fit. Depression lifting the same or next day in the same way Xanax stops a panic attack, or Tylenol stops minor aches and pains? Can you imagine the press? However, because of all the suffering depression has caused in my life, the waiting game I see us all have to play, for many of us over and over again, I would like such compounds to be developed.
Posted by Phillipa on July 19, 2011, at 10:52:34
In reply to Antidepressants without latency - will we ever see them?, posted by zonked on July 19, 2011, at 8:40:52
Zonked that makes so much sense and is so true if pain or anxiety meds can work right away and provide relief why no depression ones. Maybe there is no such thing as depression? Not my thinking but that of big pharmacy. Or how come some take an ad and feel good for a few days and then gone? Best thread in such a long time. Thanks for posting it. Phillipa
Posted by sigismund on July 19, 2011, at 15:07:10
In reply to Antidepressants without latency - will we ever see them?, posted by zonked on July 19, 2011, at 8:40:52
Those Servier drugs worked on me straight away...agomelatine, tianeptine and Trivastal, though my depression is only mild.
Posted by jono_in_adelaide on July 19, 2011, at 19:49:57
In reply to Re: Antidepressants without latency - will we ever see them? » zonked, posted by Phillipa on July 19, 2011, at 10:52:34
"Or how come some take an ad and feel good for a few days and then gone?"
Power of suggestion/placebo response.
Posted by morgan miller on July 19, 2011, at 23:36:11
In reply to Antidepressants without latency - will we ever see them?, posted by zonked on July 19, 2011, at 8:40:52
Ketamine
Lithium-especially in the case of suidicals
Vilazodone-has been shown to have a powerful antidepressant response after just one week.
Posted by Christ_empowered on July 19, 2011, at 23:51:02
In reply to Re: Antidepressants without latency - will we ever see them?, posted by morgan miller on July 19, 2011, at 23:36:11
amphetamines, neuroleptics, and benzos.
Posted by SLS on July 20, 2011, at 20:26:29
In reply to Re: Antidepressants without latency - will we ever see them?, posted by Christ_empowered on July 19, 2011, at 23:51:02
Ketamine analogs?
http://www.sciencedaily.com/releases/2008/02/080221090953.htm
http://www.psypost.org/2010/09/ketamine-antidepressant-effect-brain-1889
- Scott
Posted by SLS on July 20, 2011, at 20:41:03
In reply to Re: Antidepressants without latency - will we ever see them?, posted by jono_in_adelaide on July 19, 2011, at 19:49:57
> "Or how come some take an ad and feel good for a few days and then gone?"
My guess is that there is a brief shift in brain function as the brain is first exposed to an antidepressant substance while on the way to establishing a new equilibrium.
> Power of suggestion/placebo response.
As opposed to the power of suggestion that a placebo response must be the explanation for all cases of tachyphylaxis?
Ketamine produces an antidepressant response within hours of its administration. The response lasts but for a few days. I would be hesitant to cite a placebo response for these TRD cases whom experience their first real treatment-effected improvement.
- Scott
Posted by jono_in_adelaide on July 21, 2011, at 6:42:49
In reply to Re: Antidepressants without latency - will we ever see them? » jono_in_adelaide, posted by SLS on July 20, 2011, at 20:41:03
Sure Scott, i understand that, but i wasnt refering to quick acting drugs like amphetamines, ketamine, morphine or Dexamyl, I was refering to traditional antidepressants which generaly take weeks to work, and where tacaphalaxis isd more anacdotal than anything
Posted by SLS on July 21, 2011, at 7:32:10
In reply to Re: Antidepressants without latency - will we ever see them? » jono_in_adelaide, posted by SLS on July 20, 2011, at 20:41:03
The drugs that will act like ketamine, but targeted more directly at BDNF production, should be here at some point. It is thought that these drugs will "jump start" the recovery process when given in conjunction with a standard antidepressant. This should bring relief to patients more quickly, and mitigate suicidal ideations. So, the administration of these drugs in combination produces a virtually instantaneous response that will seemingly last long enough to cover the latency period of antidepressants, and could possibly be recommended for long-term treatment.
- Scott
Posted by linkadge on July 21, 2011, at 21:40:27
In reply to Re: Antidepressants without latency - will we ever see them? » SLS, posted by SLS on July 21, 2011, at 7:32:10
I think that there would really be nothing abnormal about an antidepressant that works immediately.
However, people often confuse depression with normal negative moods and experiences. In theory, depression is maladaptive, whereas negative moods (in response to negative stimulii) are not maladaptive.
A fast acting antidepressant doesn't equate to a pill that can be popped to negate the adverse experience of a bad hair day. All of the "fast acting" substances that we have now are abusable. They do act fast, but they also dose dependantly push the mood upwards.
As a result, the press would likely try and sensationalize the actual benefit of such an antidepresant, to helping every and all negative life experiences.
You have to start with the belief that there is actually something *wrong* with the brain in depression. This basic premise gets muddled since appropriate emotional reactions often get mislabled as depression.
A true, fast acting antidepressant, would not be a euphoriant. It would simply have the ability to neutralize depressed moods more quickly than conventional drugs.
I think that certain forms of depression would lend themselves well to a fast acting antidepressant wherease others would not. Stress induced depression, IMHO would not be a good candidate for a fast acting antidepressant. Stress induced depression does not develop overnight, and is associated with many biochemical alterations. It is infeasable (IMHO) to believe that these alterations could all be immediately ammended with a drug.
OTOH, there are other forms of depression which can be classified a primary emotional dysfunction. This is where there is some problem with the brain (not caused by stress), which is generating the depressed mood. For instance, a woman with bad PMS, ie PMDD is experiencing an internal dysregulation which comes on relatively suddenly. PMDD is probably not associated with any of the significant biochemical alterations which as associated with depression brought on by extended stress. Another example would be ultradian cycling bipolar disorder. The patient can feel completely normal one moment, and then be suicial a few hours later. This tells me that there is some dysfunction in the brain's ability to regulate itself. As such, it would be quite concievable that a drug could restore a neutral mood very quickly. After all, the patient was literally fine a few hours earlier.
So, I guess it really boils down to what the problem is, and is the cause of the depression one that requires time for the brain to heal, or is it one where the brain is fine except for....
All cases of depression can appear like an unsolved rubics cube. Depending on the position of the colors, it may be solved in one move, or may take many moves.
Linkadge
Posted by SLS on July 22, 2011, at 6:31:01
In reply to Re: Antidepressants without latency - will we ever see them?, posted by linkadge on July 21, 2011, at 21:40:27
Great post, Linkadge! Spot on.
Thanks.
- Scott
> I think that there would really be nothing abnormal about an antidepressant that works immediately.
>
> However, people often confuse depression with normal negative moods and experiences. In theory, depression is maladaptive, whereas negative moods (in response to negative stimulii) are not maladaptive.
>
> A fast acting antidepressant doesn't equate to a pill that can be popped to negate the adverse experience of a bad hair day. All of the "fast acting" substances that we have now are abusable. They do act fast, but they also dose dependantly push the mood upwards.
>
> As a result, the press would likely try and sensationalize the actual benefit of such an antidepresant, to helping every and all negative life experiences.
>
> You have to start with the belief that there is actually something *wrong* with the brain in depression. This basic premise gets muddled since appropriate emotional reactions often get mislabled as depression.
>
> A true, fast acting antidepressant, would not be a euphoriant. It would simply have the ability to neutralize depressed moods more quickly than conventional drugs.
>
> I think that certain forms of depression would lend themselves well to a fast acting antidepressant wherease others would not. Stress induced depression, IMHO would not be a good candidate for a fast acting antidepressant. Stress induced depression does not develop overnight, and is associated with many biochemical alterations. It is infeasable (IMHO) to believe that these alterations could all be immediately ammended with a drug.
>
> OTOH, there are other forms of depression which can be classified a primary emotional dysfunction. This is where there is some problem with the brain (not caused by stress), which is generating the depressed mood. For instance, a woman with bad PMS, ie PMDD is experiencing an internal dysregulation which comes on relatively suddenly. PMDD is probably not associated with any of the significant biochemical alterations which as associated with depression brought on by extended stress. Another example would be ultradian cycling bipolar disorder. The patient can feel completely normal one moment, and then be suicial a few hours later. This tells me that there is some dysfunction in the brain's ability to regulate itself. As such, it would be quite concievable that a drug could restore a neutral mood very quickly. After all, the patient was literally fine a few hours earlier.
>
> So, I guess it really boils down to what the problem is, and is the cause of the depression one that requires time for the brain to heal, or is it one where the brain is fine except for....
>
> All cases of depression can appear like an unsolved rubics cube. Depending on the position of the colors, it may be solved in one move, or may take many moves.
>
> Linkadge
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Posted by jono_in_adelaide on July 24, 2011, at 19:20:20
In reply to Re: Antidepressants without latency - will we ever see them? » SLS, posted by SLS on July 21, 2011, at 7:32:10
I remember reading that hyocine/scopolamine was quickly effective in mitigating depression, and it was suggested for use during the initial waiting period.
I've often been tempted to try, its avaliable OTC here as a travel sickness pill containing 0.3mg (Kwells, Travalcalm)
Posted by Zonked on July 24, 2011, at 20:03:40
In reply to Re: Antidepressants without latency - will we ever see them?, posted by jono_in_adelaide on July 24, 2011, at 19:20:20
> I remember reading that hyocine/scopolamine was quickly effective in mitigating depression, and it was suggested for use during the initial waiting period.
>
> I've often been tempted to try, its avaliable OTC here as a travel sickness pill containing 0.3mg (Kwells, Travalcalm)Fascinating... wikipedia indicates it's in Phase II trials for unipolar and bipolar depression. We'll see what happens several years from now, I guess. Thanks for the interesting post.
Posted by Phillipa on July 24, 2011, at 21:50:07
In reply to Re: Antidepressants without latency - will we ever see them? » jono_in_adelaide, posted by Zonked on July 24, 2011, at 20:03:40
Scopalamine? I thought it could cause psychosis? Looked it up a long time ago could be wrong and probably am. Phillipa
This is the end of the thread.
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