![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by pellmell on July 30, 2001, at 11:44:08
You've said more than a few times recently that Prozac's way different from the other drugs in its class, and maybe shouldn't even be grouped with the rest of the SSRIs. I was wondering if you (or anyone else) could explain, in as much detail as you can (I think I've got a pretty good understanding of the current thinking in psychopharm for a layperson) why you think that. I'm curious, although I don't mean to imply that I disagree.
Thanks, and I look forward to the discussion.
-pm
Posted by SalArmy4me on July 30, 2001, at 21:43:10
In reply to Q for JohnL: So...why's Prozac so different?, posted by pellmell on July 30, 2001, at 11:44:08
Posted by JohnL on July 31, 2001, at 4:57:03
In reply to Q for JohnL: So...why's Prozac so different?, posted by pellmell on July 30, 2001, at 11:44:08
> You've said more than a few times recently that Prozac's way different from the other drugs in its class, and maybe shouldn't even be grouped with the rest of the SSRIs. I was wondering if you (or anyone else) could explain, in as much detail as you can (I think I've got a pretty good understanding of the current thinking in psychopharm for a layperson) why you think that. I'm curious, although I don't mean to imply that I disagree.
>
> Thanks, and I look forward to the discussion.
>
> -pmI have read about the intricate details of how the different SSRIs affect different receptors in the brain. I mean, they all raise serotonin levels, but there is other stuff going on. It's that other stuff that makes the difference. In that other stuff category, I have to admit to you I do not understand it. But I do know that it is quite different than what the other SSRIs do. In layman terms for example, while other SSRIs might dull or shut down certain receptors, Prozac stimulates them and opens them up. Technically speaking, this is far from accurate. But in layman terms, it goes something like that.
Usually when someone considers how Prozac is different than other SSRIs, they refer to its long half life. But that's not what I'm talking about, and may or may not be relevent to anything. At a molecular level, Prozac just does stuff that the others don't.
Hopefully someone else here with more technical expertise can jump in and explain it better.
John
Posted by Else on July 31, 2001, at 7:19:49
In reply to Re: Q for JohnL: So...why's Prozac so different?, posted by JohnL on July 31, 2001, at 4:57:03
>It's that other stuff that makes the difference. In that other stuff category, I have to admit to you I do not understand it. But I do know that it is quite different than what the other SSRIs do. In layman terms for example, while other SSRIs might dull or shut down certain receptors, Prozac stimulates them and opens them up. Technically speaking, this is far from accurate. But in layman terms, it goes something like that.
Well that DOES sound very convincing. All this stuff about STUFF. Research please...
> > You've said more than a few times recently that Prozac's way different from the other drugs in its class, and maybe shouldn't even be grouped with the rest of the SSRIs. I was wondering if you (or anyone else) could explain, in as much detail as you can (I think I've got a pretty good understanding of the current thinking in psychopharm for a layperson) why you think that. I'm curious, although I don't mean to imply that I disagree.
> >
> > Thanks, and I look forward to the discussion.
> >
> > -pm
>
> I have read about the intricate details of how the different SSRIs affect different receptors in the brain. I mean, they all raise serotonin levels, but there is other stuff going on. It's that other stuff that makes the difference. In that other stuff category, I have to admit to you I do not understand it. But I do know that it is quite different than what the other SSRIs do. In layman terms for example, while other SSRIs might dull or shut down certain receptors, Prozac stimulates them and opens them up. Technically speaking, this is far from accurate. But in layman terms, it goes something like that.
>
> Usually when someone considers how Prozac is different than other SSRIs, they refer to its long half life. But that's not what I'm talking about, and may or may not be relevent to anything. At a molecular level, Prozac just does stuff that the others don't.
>
> Hopefully someone else here with more technical expertise can jump in and explain it better.
> John
Posted by Kingfish on July 31, 2001, at 14:12:34
In reply to Re: Q for JohnL: So...why's Prozac so different?, posted by Else on July 31, 2001, at 7:19:49
> Well that DOES sound very convincing. All this stuff about STUFF. Research please...
>
>I usually hold my tongue, but I feel the sarcasm here is unwarranted. JohnL explained his lack of technical knowledge and requested it from others. Sometimes it is best to read all of the posts before adding your own. He is sharing his experience with Prozac, which Is personal research. Just my opinion.
- K.
Posted by Else on August 1, 2001, at 7:05:45
In reply to Re: Q for JohnL: So...why's Prozac so different? » Else, posted by Kingfish on July 31, 2001, at 14:12:34
Sorry about the sarcasm John. But I have read the other posts. When you post information about research several times and then never give references well then, I believe that is not very credible. Pellmell asked a question about why Prozac was so different, a claim you have made several times and you have not only failed to answer to give a proper answer but have also proposed a very non-scientific explanation about neurotransmitters doing a bunch of things or something like that. You should not make claims that certain drugs are scientifically proven to work better in the REAL world if you cannot provide us with the studies refs the or at least the abstracts. Studies may be difficult to read but pretty much anyone can handle an abstract.
>
> > Well that DOES sound very convincing. All this stuff about STUFF. Research please...
> >
> >
>
> I usually hold my tongue, but I feel the sarcasm here is unwarranted. JohnL explained his lack of technical knowledge and requested it from others. Sometimes it is best to read all of the posts before adding your own. He is sharing his experience with Prozac, which Is personal research. Just my opinion.
>
> - K.
Posted by JohnL on August 1, 2001, at 7:16:50
In reply to Q for JohnL: So..why's Prozac so different?JohnL, posted by Else on August 1, 2001, at 7:05:45
Hi Else,
All the research in the world is available at www.metalhealth.com. That's where I study about most things. It would be too cumbersome and time consuming for me to pick and choose research reports in my own biased manner. And besides, I am not technically trained enough to understand what a lot of them explain. Other people can probably understand the stuff better than I can. I go with what works in the real world frequently, but admittedly do not have the technical ability to explain the phenomenon of why certain things work better or more frequently than others. I think it is better that each person go to the website and see all there is to see with their own eyes, and pick and choose what they personally want to study, rather than me spoon feeding. Everything I ever claim and believe is backed up by enormous amounts of research at www.mentalhealth.com.The cool thing about the site is that searches can be customized by erasing whatever is in the search box and typing in whatever is desired to research, using the word AND capitalized to further refine searches.
John
Posted by dove on August 1, 2001, at 16:12:58
In reply to Q for JohnL: So..why's Prozac so different?JohnL, posted by Else on August 1, 2001, at 7:05:45
> Sorry about the sarcasm John. But I have read the other posts. When you post information about research several times and then never give references well then, I believe that is not very credible. You should not make claims that certain drugs are scientifically proven to work better in the REAL world if you cannot provide us with the studies refs the or at least the abstracts. Studies may be difficult to read but pretty much anyone can handle an abstract.
>
>
>First, I'd like to say that the sarcasm in the previous post and the one before it, is indeed uncalled for. I do not know how long Else has been on this board, but I do know how long JohnL has, and I know how much he has gone thru before coming to a place where he feels well and is able to share his experiences. His knowledge may be in layman terms, and based on personal experience--as well as other's personal experiences--but it is also based on eons of research and endless discussions on this board and elsewhere.
I respect him greatly, and am honored to be able to read his knowledge and personal experiences thru hell and back. I may not completely agree with everything he believes; yet I am able to listen and read without finding it absolutely necessary to pile sarcastic response after response upon his empathetic and humble head.
I know he is strong enough to handle the biting sarcastic remarks, but I am not and I wish you would give him the respect he deserves for seeking, searching, and finding the answers he needed to make him well. We all know that there are a multitude of drugs that are psychoactive; be they antidepressants, atypical anti-psychotics, ACE inhibitors, or herbal remedies. The research is endless, and if you looked back into the archives maybe you would find the answers you so urgently seek. All of us have posted abstracts, full papers, preliminary reports, and our *own* experiences with that multitude of drugs.
We are the old-timers, the newbies, the lurkers, the voiceless; who still seek help, still wonder whether our meds are making things better or worse, still hand out support even when we're in the thick of it, and still give time and knowledge to a support board even when we have found the right fix-it plan. JohnL has been enthusiastic with the response he has had to meds normally not used to treat depression or dysthymia, and he wants to share and help others who are stuck with meds that haven't worked and don't work!
His knowledge is precious to me and many others! I would prefer, but that's only my own wish of course, that should someone find the need to strongly disagree or question a person's statement and ask for research (abstracts and whatnot) to verify a personal opinion, that they also should candidly but civilly state their exact disagreement and perhaps back-up their own opinion with the applicable research.
There just isn't enough time to squirrel around with citations and abstracts after you've been writing on the board for years, it becomes a burden rather than a support. Every individual is responsible for their own research, opinions, and the manner in which they give out support or ask for help. JohnL, I love you for your humbleness and dignity, and we are still here listening and reading!
dove
Posted by Sherry on August 1, 2001, at 16:54:00
In reply to Re: Q for JohnL: So..why's Prozac so different? » Else, posted by dove on August 1, 2001, at 16:12:58
You go girl. I wholeheartedly agree with everything Dove said. I too, respect JohnL's opinion and knowledge. Else, please give im a break.
Sherry
> > Sorry about the sarcasm John. But I have read the other posts. When you post information about research several times and then never give references well then, I believe that is not very credible. You should not make claims that certain drugs are scientifically proven to work better in the REAL world if you cannot provide us with the studies refs the or at least the abstracts. Studies may be difficult to read but pretty much anyone can handle an abstract.
> >
> >
> >
>
> First, I'd like to say that the sarcasm in the previous post and the one before it, is indeed uncalled for. I do not know how long Else has been on this board, but I do know how long JohnL has, and I know how much he has gone thru before coming to a place where he feels well and is able to share his experiences. His knowledge may be in layman terms, and based on personal experience--as well as other's personal experiences--but it is also based on eons of research and endless discussions on this board and elsewhere.
>
> I respect him greatly, and am honored to be able to read his knowledge and personal experiences thru hell and back. I may not completely agree with everything he believes; yet I am able to listen and read without finding it absolutely necessary to pile sarcastic response after response upon his empathetic and humble head.
>
> I know he is strong enough to handle the biting sarcastic remarks, but I am not and I wish you would give him the respect he deserves for seeking, searching, and finding the answers he needed to make him well. We all know that there are a multitude of drugs that are psychoactive; be they antidepressants, atypical anti-psychotics, ACE inhibitors, or herbal remedies. The research is endless, and if you looked back into the archives maybe you would find the answers you so urgently seek. All of us have posted abstracts, full papers, preliminary reports, and our *own* experiences with that multitude of drugs.
>
> We are the old-timers, the newbies, the lurkers, the voiceless; who still seek help, still wonder whether our meds are making things better or worse, still hand out support even when we're in the thick of it, and still give time and knowledge to a support board even when we have found the right fix-it plan. JohnL has been enthusiastic with the response he has had to meds normally not used to treat depression or dysthymia, and he wants to share and help others who are stuck with meds that haven't worked and don't work!
>
> His knowledge is precious to me and many others! I would prefer, but that's only my own wish of course, that should someone find the need to strongly disagree or question a person's statement and ask for research (abstracts and whatnot) to verify a personal opinion, that they also should candidly but civilly state their exact disagreement and perhaps back-up their own opinion with the applicable research.
>
> There just isn't enough time to squirrel around with citations and abstracts after you've been writing on the board for years, it becomes a burden rather than a support. Every individual is responsible for their own research, opinions, and the manner in which they give out support or ask for help. JohnL, I love you for your humbleness and dignity, and we are still here listening and reading!
>
> dove
Posted by Kingfish on August 1, 2001, at 17:49:59
In reply to Re: Q for JohnL: So..why's Prozac so different?, posted by Sherry on August 1, 2001, at 16:54:00
Just my two cents - my personal experience.
I am having a little trouble with side effects, but Prozac has by far been the best AD I have tried. I have not tried as many as most, perhaps, but I have great anticipation for being able to continue this medication at a slightly lower dose.
When it "kicked in", I swear my brain breathed a sigh of relief.
- K.
P.S. Very nice post, Dove.
Posted by Else on August 1, 2001, at 18:23:16
In reply to Re: Q for JohnL: So..why's Prozac Else, posted by JohnL on August 1, 2001, at 7:16:50
Ok, but I am not aware of any studies having been made that suggested Prozac was better then other SSRIs in any way. I would have no trouble believing it. I certainly felt less bad on Prozac than I did on Zoloft but that sort of thing is very subjective. I just need to see a study that says "Fluoxetine has shown superior to Drug X in treating X problem" Nothing very complicated. I
have not seen that. I know you can find every study under the sun at www.mentalhealth.com but which one is it? I am not asking questions about neurochemestry here.
> Hi Else,
> All the research in the world is available at www.metalhealth.com. That's where I study about most things. It would be too cumbersome and time consuming for me to pick and choose research reports in my own biased manner. And besides, I am not technically trained enough to understand what a lot of them explain. Other people can probably understand the stuff better than I can. I go with what works in the real world frequently, but admittedly do not have the technical ability to explain the phenomenon of why certain things work better or more frequently than others. I think it is better that each person go to the website and see all there is to see with their own eyes, and pick and choose what they personally want to study, rather than me spoon feeding. Everything I ever claim and believe is backed up by enormous amounts of research at www.mentalhealth.com.
>
> The cool thing about the site is that searches can be customized by erasing whatever is in the search box and typing in whatever is desired to research, using the word AND capitalized to further refine searches.
> John
Posted by Else on August 1, 2001, at 18:36:56
In reply to Re: Q for JohnL: So..why's Prozac so different? » Else, posted by dove on August 1, 2001, at 16:12:58
I don't personnally think I have been this bitchy. I may have been sarcastic (calling my sarcasm biting BTW, is a compliment, I personnally don't find it that good). I admit I am biased against anti-psychotics, even Zyprexa because most of the people I have known who have tried them have done terribly on them. John may have had a great response, I don't doubt that, but I am suggesting that this is probably an atypical response and that other treatments should be tried before.
I was in a pretty bad mood this morning and I am sorry if my posts came off as hostile. I can understand that someone would be very enthusiastic about finally finding something that works but does that make it the solution for everyone?
Also, as far as I know, this is not a support group, at least not in the classical sense. I expect some debating to go on and people not to be destroyed by opposition. John did not strike me as the kind of person who could not handle it. In any event, he can tell me what he thinks himself.
> > Sorry about the sarcasm John. But I have read the other posts. When you post information about research several times and then never give references well then, I believe that is not very credible. You should not make claims that certain drugs are scientifically proven to work better in the REAL world if you cannot provide us with the studies refs the or at least the abstracts. Studies may be difficult to read but pretty much anyone can handle an abstract.
> >
> >
> >
>
> First, I'd like to say that the sarcasm in the previous post and the one before it, is indeed uncalled for. I do not know how long Else has been on this board, but I do know how long JohnL has, and I know how much he has gone thru before coming to a place where he feels well and is able to share his experiences. His knowledge may be in layman terms, and based on personal experience--as well as other's personal experiences--but it is also based on eons of research and endless discussions on this board and elsewhere.
>
> I respect him greatly, and am honored to be able to read his knowledge and personal experiences thru hell and back. I may not completely agree with everything he believes; yet I am able to listen and read without finding it absolutely necessary to pile sarcastic response after response upon his empathetic and humble head.
>
> I know he is strong enough to handle the biting sarcastic remarks, but I am not and I wish you would give him the respect he deserves for seeking, searching, and finding the answers he needed to make him well. We all know that there are a multitude of drugs that are psychoactive; be they antidepressants, atypical anti-psychotics, ACE inhibitors, or herbal remedies. The research is endless, and if you looked back into the archives maybe you would find the answers you so urgently seek. All of us have posted abstracts, full papers, preliminary reports, and our *own* experiences with that multitude of drugs.
>
> We are the old-timers, the newbies, the lurkers, the voiceless; who still seek help, still wonder whether our meds are making things better or worse, still hand out support even when we're in the thick of it, and still give time and knowledge to a support board even when we have found the right fix-it plan. JohnL has been enthusiastic with the response he has had to meds normally not used to treat depression or dysthymia, and he wants to share and help others who are stuck with meds that haven't worked and don't work!
>
> His knowledge is precious to me and many others! I would prefer, but that's only my own wish of course, that should someone find the need to strongly disagree or question a person's statement and ask for research (abstracts and whatnot) to verify a personal opinion, that they also should candidly but civilly state their exact disagreement and perhaps back-up their own opinion with the applicable research.
>
> There just isn't enough time to squirrel around with citations and abstracts after you've been writing on the board for years, it becomes a burden rather than a support. Every individual is responsible for their own research, opinions, and the manner in which they give out support or ask for help. JohnL, I love you for your humbleness and dignity, and we are still here listening and reading!
>
> dove
Posted by Else on August 1, 2001, at 18:40:53
In reply to Re: Q for JohnL: So..why's Prozac so different?, posted by Sherry on August 1, 2001, at 16:54:00
Can't I just disagree on something? I replied to JohnL's posts mostly because they were the only ones there this morning. Now John, please, if you find I am being overly aggressive, please say so. I find I am merely debating an issue about drug therapy which I thought was the point of this board, at least in part. I'll just agree with everyone from now on OK. Sorry.
> You go girl. I wholeheartedly agree with everything Dove said. I too, respect JohnL's opinion and knowledge. Else, please give im a break.
>
> Sherry
>
> > > Sorry about the sarcasm John. But I have read the other posts. When you post information about research several times and then never give references well then, I believe that is not very credible. You should not make claims that certain drugs are scientifically proven to work better in the REAL world if you cannot provide us with the studies refs the or at least the abstracts. Studies may be difficult to read but pretty much anyone can handle an abstract.
> > >
> > >
> > >
> >
> > First, I'd like to say that the sarcasm in the previous post and the one before it, is indeed uncalled for. I do not know how long Else has been on this board, but I do know how long JohnL has, and I know how much he has gone thru before coming to a place where he feels well and is able to share his experiences. His knowledge may be in layman terms, and based on personal experience--as well as other's personal experiences--but it is also based on eons of research and endless discussions on this board and elsewhere.
> >
> > I respect him greatly, and am honored to be able to read his knowledge and personal experiences thru hell and back. I may not completely agree with everything he believes; yet I am able to listen and read without finding it absolutely necessary to pile sarcastic response after response upon his empathetic and humble head.
> >
> > I know he is strong enough to handle the biting sarcastic remarks, but I am not and I wish you would give him the respect he deserves for seeking, searching, and finding the answers he needed to make him well. We all know that there are a multitude of drugs that are psychoactive; be they antidepressants, atypical anti-psychotics, ACE inhibitors, or herbal remedies. The research is endless, and if you looked back into the archives maybe you would find the answers you so urgently seek. All of us have posted abstracts, full papers, preliminary reports, and our *own* experiences with that multitude of drugs.
> >
> > We are the old-timers, the newbies, the lurkers, the voiceless; who still seek help, still wonder whether our meds are making things better or worse, still hand out support even when we're in the thick of it, and still give time and knowledge to a support board even when we have found the right fix-it plan. JohnL has been enthusiastic with the response he has had to meds normally not used to treat depression or dysthymia, and he wants to share and help others who are stuck with meds that haven't worked and don't work!
> >
> > His knowledge is precious to me and many others! I would prefer, but that's only my own wish of course, that should someone find the need to strongly disagree or question a person's statement and ask for research (abstracts and whatnot) to verify a personal opinion, that they also should candidly but civilly state their exact disagreement and perhaps back-up their own opinion with the applicable research.
> >
> > There just isn't enough time to squirrel around with citations and abstracts after you've been writing on the board for years, it becomes a burden rather than a support. Every individual is responsible for their own research, opinions, and the manner in which they give out support or ask for help. JohnL, I love you for your humbleness and dignity, and we are still here listening and reading!
> >
> > dove
Posted by Kingfish on August 1, 2001, at 19:13:54
In reply to Re: Q for JohnL: So...why's Prozac so different? » Else, posted by Kingfish on July 31, 2001, at 14:12:34
For heaven's sake...
Posted by dove on August 1, 2001, at 20:09:47
In reply to Re: Q for JohnL: So..why's Prozac so different? » dove, posted by Else on August 1, 2001, at 18:36:56
>
> I don't personnally think I have been this bitchy.
>I am sorry if you felt I was insinuating that! In no way am I trying to give you a rash or make insidious attacks against you personally (i.e. the "biting sarcasm" remark). In fact, I agree with your point of view regarding anti-psychotics, they scare me to death. I've seen them up-close and personal. I watched one of my closest friends go into a zombie coma due to his not taking the meds and suddenly deciding to go back on, at the previous full dosage of course!
>
>John did not strike me as the kind of person who could not handle it. In any event, he can tell me what he thinks himself.
>I did state exactly that, for John has fought his battles diligently and with empathy. It was I, who was irritated by the undercurrent of the response.
And I will personally try to locate a few informational tidbits that may validate or negate the concept John has presented (we should probably search P-Babble's archives first). I will not use the information against what John has experienced though.
I sincerely apologize if you felt like you were being attacked, that is not what this board is intended for, and I do not want to ostracize you or your opinions, nor your own search for good-health. Thank you for clarifying your intent. And yes, some of us are quite protective of John :o)
dove
Posted by Dr. Bob on August 2, 2001, at 0:41:50
In reply to Re: Q for JohnL: So..why's Prozac so different? » dove, posted by Else on August 1, 2001, at 18:36:56
> as far as I know, this is not a support group, at least not in the classical sense. I expect some debating to go on and people not to be destroyed by opposition.
Which sense is the classical one? This is a group for support and education. Debating goes on, but needs to be civil. Particular members may or may not be able to withstand "opposition". And each post contributes to the overall atmosphere. Thanks,
Bob
PS: Any follow-ups regarding civility should be redirected to Psycho-Babble Administration; otherwise, they may be deleted.
Posted by Elizabeth on August 2, 2001, at 8:01:48
In reply to Q for JohnL: So...why's Prozac so different?, posted by pellmell on July 30, 2001, at 11:44:08
Here's my $0.02 (I hope you don't mind):
The main advantages of Prozac, IMO, involve its pharmacokinetic profile. The active metabolite norfluoxetine is both more selective for the serotonin transporter and more potent than is fluoxetine. At steady state, the plasma concentration of norfluoxetine exceeds that of fluoxetine in normal metabolisers (if I'm remembering correctly: it's been a while since I studied this stuff). Fluoxetine has a long elimination half-life (about 2-4 days), and norfluoxetine is extremely long-lived (its elimination half-life can be as long as two weeks), so Prozac tends to be smoother and missing a dose is less problematic compared with other SSRIs (Paxil in particular seems to cause problems for a lot of people).
That Prozac and its metabolite are so long-lived is a mixed blessing. In particular, there is a high potential for pharmacodynamic and pharmacokinetic interactions, and this persists for several weeks after discontinuing Prozac. As a result, adding or switching to tricyclic antidepressants should be done cautiously, and MAOIs should not be taken for at least five weeks after discontinuing Prozac.
At present, little is known about possible pharmacodynamic effects of fluoxetine or norfluoxetine other than monoamine reuptake inhibition.
Hope this helps.
-elizabeth
P.S. John, I do think that you've been going beyond describing your personal experience: you tell people that they "should" (your word) try certain drugs before considering other options, presumably because those drugs work for you and perhaps you have a general impressionistic sense that they work best for other people. Obviously, readers have the choice of ignoring you, but that doesn't mean that it's reasonable or honest of you to make the suggestion that a particular group of drugs should always be tried first, apparently without even any regard to what condition is being treated.
Posted by JohnL on August 3, 2001, at 3:58:46
In reply to Re: why's Prozac so different? » pellmell, posted by Elizabeth on August 2, 2001, at 8:01:48
> -elizabeth
>
> P.S. John, I do think that you've been going beyond describing your personal experience: you tell people that they "should" (your word) try certain drugs before considering other options, presumably because those drugs work for you and perhaps you have a general impressionistic sense that they work best for other people. Obviously, readers have the choice of ignoring you, but that doesn't mean that it's reasonable or honest of you to make the suggestion that a particular group of drugs should always be tried first, apparently without even any regard to what condition is being treated.Hi Elizabeth,
I go with what works for a lot of people, not with just what works for me. And I especially focus on meds that are especially effective for particular symptom clusters. Please don't misunderstand me. You are correct about the word "should" however. I should change that to "could". Thanks for the tip.John
Posted by CLAIREZ on August 3, 2001, at 6:23:34
In reply to Re: Q for JohnL: So...why's Prozac so different?, posted by JohnL on July 31, 2001, at 4:57:03
> > You've said more than a few times recently that Prozac's way different from the other drugs in its class, and maybe shouldn't even be grouped with the rest of the SSRIs. I was wondering if you (or anyone else) could explain, in as much detail as you can (I think I've got a pretty good understanding of the current thinking in psychopharm for a layperson) why you think that. I'm curious, although I don't mean to imply that I disagree.
> >
> > Thanks, and I look forward to the discussion.
> >
> > -pm
>
> I have read about the intricate details of how the different SSRIs affect different receptors in the brain. I mean, they all raise serotonin levels, but there is other stuff going on. It's that other stuff that makes the difference. In that other stuff category, I have to admit to you I do not understand it. But I do know that it is quite different than what the other SSRIs do. In layman terms for example, while other SSRIs might dull or shut down certain receptors, Prozac stimulates them and opens them up. Technically speaking, this is far from accurate. But in layman terms, it goes something like that.
>
> Usually when someone considers how Prozac is different than other SSRIs, they refer to its long half life. But that's not what I'm talking about, and may or may not be relevent to anything. At a molecular level, Prozac just does stuff that the others don't.
>
> Hopefully someone else here with more technical expertise can jump in and explain it better.
> JohnJohn: I have a question as you seem familiar with Prozac - though a question re:PMS maybe you've read something informative. I take Wellbutrin and have tried multiple other meds (serzone, prozac, buspar) at other times but have found them not quite what I needed or with odd side effects relative usually to "control". However, I do suffer as many do from awful moods periodically; can I combine prozac as its prescribed as Serafem along with Wellbutrin? Isn't the concept of prescribing serafem for 2 weeks a month for PMS as sort of odd?
Curious as to your opinions.
Thanks.
CLAIREZ
Posted by pellmell on August 3, 2001, at 11:07:31
In reply to Re: why's Prozac so different? » pellmell, posted by Elizabeth on August 2, 2001, at 8:01:48
Thanks Elizabeth. I'd read all of that in different places before, but your explanation was more coherent and succinct than the one I had in my head. :)
Still, I wish there were more info on the pharmacodynamic nature of fluoxetine besides 5HT/NE reuptake inhibition. Some seem to think it also agonizes the 5HT-2C receptor. Can you hypothesize about the consequences of that? My understanding is that it might be the cause of Prozac's energizing and (acute, anyway) appetite supressant effects.
-pm
Posted by JohnL on August 3, 2001, at 18:05:13
In reply to Re: Q for JohnL: So...why's Prozac so different?, posted by CLAIREZ on August 3, 2001, at 6:23:34
> John: I have a question as you seem familiar with Prozac - though a question re:PMS maybe you've read something informative. I take Wellbutrin and have tried multiple other meds (serzone, prozac, buspar) at other times but have found them not quite what I needed or with odd side effects relative usually to "control". However, I do suffer as many do from awful moods periodically; can I combine prozac as its prescribed as Serafem along with Wellbutrin? Isn't the concept of prescribing serafem for 2 weeks a month for PMS as sort of odd?
> Curious as to your opinions.
> Thanks.
> CLAIREZHi Clairez,
You ask some good questions. Tough questions.
But yes, you can take Prozac along with Wellbutrin. Some people might find that combination too stimulating, but for others it could be just what they need.Prescribing 2 weeks out of a month for PMS is in a way kind of odd, and in another way not. Here's why. First of all, it is odd because the entire medical community seems completely sold on the idea that these medications take at least 6 weeks to work. So how can those same authorities expect it to do anything in 2 weeks? Hmm? On the other hand, I have personally witnessed countless people experience positive responses to new meds in anywhere from 4 hours to 2 weeks, so it does happen. And furthermore, every clinical study has a certain percentage of patients that respond quickly. That to me is indicitive of the fact that whatever med they are on is a good molecular match for them--a better match than for others who didn't respond until 6 weeks. Or the med just happens by luck to be right on target for that person's brain chemistry. Clinical studies do not set out to check for these early responders, so the data is buried in fine print. It's not what they were looking for. But nevertheless, it happens.
Some will try to explain away rapid responses as side effects or whatever. But anyway, back on subject, Prozac has a very long half life. It takes one week for it to be half gone from your system after the last dose. It takes about 5 weeks to be completely gone. So with that in mind, if you only took it for two weeks out of a month, it is actually still in your system working during the two weeks that you aren't taking it.
Like I said, you ask some good and tough questions. Much easier to explain in person than in writing like this. I hope I did alright.
John
Posted by JohnL on August 3, 2001, at 18:07:30
In reply to Re: why's Prozac so different? » Elizabeth, posted by pellmell on August 3, 2001, at 11:07:31
This entire thread deserves some research to answer why in fact Prozac is different. When I speak of it being different, I am not referring to its pharmacological profile of having a long half life.
I am about to embark on a one week out of town trip for my company's annual convention. When I get back, I will dig up some research to help solidify this thread.
John
Posted by Elizabeth on August 3, 2001, at 18:56:08
In reply to Re: why's Prozac so different? Elizabeth, posted by JohnL on August 3, 2001, at 3:58:46
Hi John.
> I go with what works for a lot of people, not with just what works for me. And I especially focus on meds that are especially effective for particular symptom clusters.
That's cool. I'd like to hear your thoughts as to what drugs are most effective for particular symptoms; I don't think I've read any of your posts in which you've discussed this, and I think it's very important.
> I am about to embark on a one week out of town trip for my company's annual convention. When I get back, I will dig up some research to help solidify this thread.
Unfortunately, I'm not sure that the information you're looking for is out there. The drug companies have a vested interest in perpetuating the monoaminergic "chemical imbalance" (whatever that might mean) hypothesis of depression -- they're not interested in looking for other possible pharmacologic effects that their drugs might have.
-elizabeth
This is the end of the thread.
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