Psycho-Babble Medication Thread 225001

Shown: posts 1 to 25 of 25. This is the beginning of the thread.

 

kind of freaking out re: AD's

Posted by bookgurl99 on May 7, 2003, at 22:43:02

I am freaking out, because I have had a mind that I did not recognize for a whole year. I was taking Zoloft, and had all this trouble concentrating, memory problems, unhappy, headache, low energy.

Now, after tapering off, and "barely" starting on Serzone again (at 75 mgs), I feel like my old self again. I'm happy, joking, don't feel as out of it. My brain feels faster, more accessible, but also controlled -- not manic.

Is this just a placebo effect? The positive benefit of not being on zoloft? (of which withdrawal made me feel like my brain was being dragged around by a shoe string somewhere).

I'm freaking out because I don't want to be on meds for life, and here I feel my best on this one particular med (which also has the black box liver warning.). Is it that it altered my brain permanently, so that now I _need_ it?

What gives?

 

Re: kind of freaking out re: AD's

Posted by Caleb462 on May 7, 2003, at 23:01:55

In reply to kind of freaking out re: AD's, posted by bookgurl99 on May 7, 2003, at 22:43:02

> I am freaking out, because I have had a mind that I did not recognize for a whole year. I was taking Zoloft, and had all this trouble concentrating, memory problems, unhappy, headache, low energy.
>
> Now, after tapering off, and "barely" starting on Serzone again (at 75 mgs), I feel like my old self again. I'm happy, joking, don't feel as out of it. My brain feels faster, more accessible, but also controlled -- not manic.
>
> Is this just a placebo effect? The positive benefit of not being on zoloft? (of which withdrawal made me feel like my brain was being dragged around by a shoe string somewhere).

My guess is that you're just experiecing how it feels to not have your 5-HT2c receptors over-activated. In lamens terms, that means the Zoloft isn't causing your brain to stop releasing dopamine, and therefore you can experience life like you did previous to Zoloft.

 

Re: kind of freaking out re: AD's » Caleb462

Posted by bookgurl99 on May 7, 2003, at 23:18:56

In reply to Re: kind of freaking out re: AD's, posted by Caleb462 on May 7, 2003, at 23:01:55

Caleb,

thanks for normalizing this for me. :D

> My guess is that you're just experiecing how it feels to not have your 5-HT2c receptors over-activated.


sweetie,

what is a 5-HT2c receptor?

books

 

Re: kind of freaking out re: AD's » bookgurl99

Posted by Snoozy on May 7, 2003, at 23:21:05

In reply to kind of freaking out re: AD's, posted by bookgurl99 on May 7, 2003, at 22:43:02

Hi -

how great that you're feeling better! You haven't been on the Serzone long? Give it some time and you may feel even better. :) I don't think I've ever been on Serzone, but it sounds like you're off to a promising start.

On the more general philosophical question of being on meds for the rest of your life: for me, I've accepted it and it is what it is. I've been taking at least one daily medication since I was a teenager. Some of them are pretty benign, but some of them can have long-term effects. I know I'll be taking pills every day for the rest of my life, which would bug me if I still had to chew my pills (yecchh). A lot of people do. You can even be taking vitamins and supplements every day.

You haven't been on the Serzone long, so I would say just see how it goes for a while - you've got plenty of time to worry down the road ;-)

Please don't feel I'm making light of your feelings - I certainly don't mean anything like that. I'm just trying to say try and relax a bit for right now.

> I am freaking out, because I have had a mind that I did not recognize for a whole year. I was taking Zoloft, and had all this trouble concentrating, memory problems, unhappy, headache, low energy.
>
> Now, after tapering off, and "barely" starting on Serzone again (at 75 mgs), I feel like my old self again. I'm happy, joking, don't feel as out of it. My brain feels faster, more accessible, but also controlled -- not manic.
>
> Is this just a placebo effect? The positive benefit of not being on zoloft? (of which withdrawal made me feel like my brain was being dragged around by a shoe string somewhere).
>
> I'm freaking out because I don't want to be on meds for life, and here I feel my best on this one particular med (which also has the black box liver warning.). Is it that it altered my brain permanently, so that now I _need_ it?
>
> What gives?

 

Re: kind of freaking out re: AD's » bookgurl99

Posted by Ritch on May 8, 2003, at 1:22:08

In reply to kind of freaking out re: AD's, posted by bookgurl99 on May 7, 2003, at 22:43:02

> I am freaking out, because I have had a mind that I did not recognize for a whole year. I was taking Zoloft, and had all this trouble concentrating, memory problems, unhappy, headache, low energy.
>
> Now, after tapering off, and "barely" starting on Serzone again (at 75 mgs), I feel like my old self again. I'm happy, joking, don't feel as out of it. My brain feels faster, more accessible, but also controlled -- not manic.
>
> Is this just a placebo effect? The positive benefit of not being on zoloft? (of which withdrawal made me feel like my brain was being dragged around by a shoe string somewhere).
>
> I'm freaking out because I don't want to be on meds for life, and here I feel my best on this one particular med (which also has the black box liver warning.). Is it that it altered my brain permanently, so that now I _need_ it?
>
> What gives?


I've had these kind of worries in the last few years. Before all of these fancy new meds my moods/anxiety, etc. were only half-assed controlled by the older meds (and not being on them didn't make a whole hell lot of difference a lot of the time), and now there have been a few that seem to have quite dramatically positive results now and then. So, maybe the newer meds effectiveness is the "problem"? I've experienced some mild concerns lately about losing my meds on a trip or whatever and relapsing because of that.

 

Re: kind of freaking out re: AD's

Posted by Caleb462 on May 8, 2003, at 3:50:13

In reply to Re: kind of freaking out re: AD's » Caleb462, posted by bookgurl99 on May 7, 2003, at 23:18:56

> what is a 5-HT2c receptor?


Serotonin has many receptors in the brain that it attaches to and causes a reaction. The 5-HT2c is one of these receptors. When serotonin activates a 5-HT2c receptor, it's basically telling the brain "don't release dopamine here". When you take an SSRI, the 5-HT2c receptors become activated to a much greater degree due to all the excess serotonin, which means a larger inhibition of dopamine.

 

Re: kind of freaking out re: AD's » bookgurl99

Posted by Viridis on May 8, 2003, at 3:51:49

In reply to kind of freaking out re: AD's, posted by bookgurl99 on May 7, 2003, at 22:43:02

I wouldn't worry so much -- take what works, for as long as you need it. Your brain is pretty resilient, and I doubt that many of these changes are "for life". If they are, and they're positive, then great; if not, move on. The last thing you need is some vague dread over medications. People take drugs for various conditions, some short- and some long-term, and mental problems are no different. Just be happy that you've found something that works, and cross the next bridge when you come to it.

 

5-HT2c Receptor » Caleb462

Posted by jack smith on May 8, 2003, at 12:48:57

In reply to Re: kind of freaking out re: AD's, posted by Caleb462 on May 8, 2003, at 3:50:13

> When you take an SSRI, the 5-HT2c receptors become activated to a much greater degree due to all the excess serotonin, which means a larger inhibition of dopamine.

Interesting. But how does serzone avoid hitting this receptor, is it even more selective? Does remeron hit this receptor? Are there any other seratonergic drugs that do not hit this receptor? Perhaps this explains why Celexa pooped out on me?? What do you think?

JACK

 

Re: 5-HT2c Receptor

Posted by Caleb462 on May 8, 2003, at 14:35:33

In reply to 5-HT2c Receptor » Caleb462, posted by jack smith on May 8, 2003, at 12:48:57

> > When you take an SSRI, the 5-HT2c receptors become activated to a much greater degree due to all the excess serotonin, which means a larger inhibition of dopamine.
>
> Interesting. But how does serzone avoid hitting this receptor, is it even more selective? Does remeron hit this receptor? Are there any other seratonergic drugs that do not hit this receptor? Perhaps this explains why Celexa pooped out on me?? What do you think?
>
> JACK
>
>

Serzone avoids this effect by also being a 5-HT2 antagonist. Meaning it blocks this receptor and prevents the widespread dopamine ihhibition that would otherwise occur if all the serotonin was allowed to bind to it. Remeron is also a 5-HT2 antagonist.

As for why Celexa pooped out... who knows? But I do believe that SSRIs can induce a depressive state, that may or may not be different from the previous depressive state, by inhibiting dopamine release.

 

is this dopamine factor the reason for. . » Caleb462

Posted by bookgurl99 on May 8, 2003, at 17:21:34

In reply to Re: 5-HT2c Receptor, posted by Caleb462 on May 8, 2003, at 14:35:33

as soon as i stopped taking zoloft daily, i noticed that sweet foods no longer taste as _good._ is it possible that i was self-medicating for low dopamine with snickers?

 

Re: is this dopamine factor the reason for. .

Posted by Caleb462 on May 8, 2003, at 22:04:43

In reply to is this dopamine factor the reason for. . » Caleb462, posted by bookgurl99 on May 8, 2003, at 17:21:34

> as soon as i stopped taking zoloft daily, i noticed that sweet foods no longer taste as _good._ is it possible that i was self-medicating for low dopamine with snickers?

Seems possible. Dopamine is the brain's "reward" chemical. So the momentary dopamine release you got from a snickers bar may have seemed more pleasurable on the Zoloft, since it was a rarer occurence. This is of course, just a guess, and it could also work the other way around (i.e. snickers being less pleasurable on zoloft since the reward signals are being inhibited). I think most anti-depressants have a possible "taste perversion" side effect, this could also be a factor.

 

Caleb, Re: kind of freaking out re: AD's

Posted by McPac on May 9, 2003, at 0:36:23

In reply to Re: kind of freaking out re: AD's, posted by Caleb462 on May 8, 2003, at 3:50:13

"When you take an SSRI, the 5-HT2c receptors become activated to a much greater degree due to all the excess serotonin, which means a larger inhibition of dopamine".

But isn't this inhibition of dopamine offset by the excess serotonin (isn't it a good thing to get the excess serotonin)? Thanks!

 

Re: Caleb, Re: kind of freaking out re: AD's

Posted by Caleb462 on May 9, 2003, at 13:39:31

In reply to Caleb, Re: kind of freaking out re: AD's, posted by McPac on May 9, 2003, at 0:36:23


> But isn't this inhibition of dopamine offset by the excess serotonin (isn't it a good thing to get the excess serotonin)? Thanks!

Excess serotonin is not neccesarily a good thing, no. It's not the excess serotonin itself that causes the anti-depressant response, it's the changes the brain goes through after being bombarded with serotonin for 4-6 weeks. Anyway... for some folks, this works out fine. For others, the dopamine inhibition can be quite troublesome... causing intolerable sexual dysfunction, apathy, lack of motivation, fatigue, anhedonia, etc. It all just depends on the individual.

 

i feel mournful about my year on zoloft

Posted by bookgurl99 on May 10, 2003, at 0:31:39

In reply to Re: Caleb, Re: kind of freaking out re: AD's, posted by Caleb462 on May 9, 2003, at 13:39:31

Right now I'm not on 'anything,' due to a hard time starting up serzone again. I'm gonna wait a few more days to let zoloft clear.

BUT, I feel so much more 'with it' and present that I feel mournful about my year on Zoloft.

My partner was always upset, taking it personally that I didn't remember things I told her. My THERAPIST, who knew me long before, was starting to doubt me when I told her that I had _never_ had troubles in school or had an ADHD dx.

NOTHING IMPORTANT THAT I'VE WANTED TO GET DONE THIS YEAR HAS GOTTEN DONE!

I can't believe I was on this drug this whole time. It had some terrible side effects for me. And why did I stay on it? Because I went to a general practicioner, not a psychiatrist, and she did not believe me when I said I was having the symptoms of poor concentration and low motivation. She just patted my hand and wanted me to stay on.

I should have taken the bull by the horns and gone to a better doctor. But I didn't. WHY? Because the DAMN DRUG made me so malleable.

Oh, I weep for my lost year. ONE WHOLE YEAR.

 

Re: i feel mournful about my year on zoloft » bookgurl99

Posted by Dinah on May 10, 2003, at 12:39:10

In reply to i feel mournful about my year on zoloft, posted by bookgurl99 on May 10, 2003, at 0:31:39

Don't feel responsible for that. A psychiatrist would have probably said the same.

 

Re: i feel mournful about my year on zoloft » bookgurl99

Posted by Snoozy on May 10, 2003, at 12:45:00

In reply to i feel mournful about my year on zoloft, posted by bookgurl99 on May 10, 2003, at 0:31:39

Hi books -

I can identify with what you're going through. I hope you've found a good pdoc? The depression can make me so meek that I can't be assertive enough to get the best care. And I'm just kicking myself the whole time.

I hope your mind clears up now that you're off the Zoloft. The "brain fog" from these drugs makes me so crazy sometimes. I mean, when your attention wanders off during a 30 minute tv show....and you can't read the "McPaper" that's pretty pathetic.

I know this is way easier said than done, but try not to beat yourself up about the past year. Yesterday I had to drive through one of the college campuses in town, and I saw all the graduates and people moving out of the dorms, all enjoying a nice spring day, lives full of promise. And I started dwelling again on how you know, if I'd been tried on Prozac when I was in high school instead of some lousy TCA and AP that had me explaining to all of my teachers why I was sleeping at my desk, maybe I could have gone away to the college I really had my heart set on, and my life would be totally different today. You can probably tell this is something I've thought about a lot over the years. But it really doesn't get me anywhere - it just makes me even more depressed. I think I had a point in there somewhere, maybe you can dig it out ;)

Anyway, hang in there and if it makes you feel better to share these feelings, keep doing so.

> Right now I'm not on 'anything,' due to a hard time starting up serzone again. I'm gonna wait a few more days to let zoloft clear.
>
> BUT, I feel so much more 'with it' and present that I feel mournful about my year on Zoloft.
>
> My partner was always upset, taking it personally that I didn't remember things I told her. My THERAPIST, who knew me long before, was starting to doubt me when I told her that I had _never_ had troubles in school or had an ADHD dx.
>
> NOTHING IMPORTANT THAT I'VE WANTED TO GET DONE THIS YEAR HAS GOTTEN DONE!
>
> I can't believe I was on this drug this whole time. It had some terrible side effects for me. And why did I stay on it? Because I went to a general practicioner, not a psychiatrist, and she did not believe me when I said I was having the symptoms of poor concentration and low motivation. She just patted my hand and wanted me to stay on.
>
> I should have taken the bull by the horns and gone to a better doctor. But I didn't. WHY? Because the DAMN DRUG made me so malleable.
>
> Oh, I weep for my lost year. ONE WHOLE YEAR.
>
>
>
>

 

Re: 5-HT2c Receptor » Caleb462

Posted by MB on May 11, 2003, at 2:22:54

In reply to Re: 5-HT2c Receptor, posted by Caleb462 on May 8, 2003, at 14:35:33

> > > When you take an SSRI, the 5-HT2c receptors become activated to a much greater degree due to all the excess serotonin, which means a larger inhibition of dopamine.
> >
> > Interesting. But how does serzone avoid hitting this receptor, is it even more selective? Does remeron hit this receptor? Are there any other seratonergic drugs that do not hit this receptor? Perhaps this explains why Celexa pooped out on me?? What do you think?
> >
> > JACK
> >
> >
>
> Serzone avoids this effect by also being a 5-HT2 antagonist. Meaning it blocks this receptor and prevents the widespread dopamine ihhibition that would otherwise occur if all the serotonin was allowed to bind to it. Remeron is also a 5-HT2 antagonist.
>
> As for why Celexa pooped out... who knows? But I do believe that SSRIs can induce a depressive state, that may or may not be different from the previous depressive state, by inhibiting dopamine release.


Serzone blocks 5HT-2a receptors, but one of its active metabolites is mCPP (metachlorophenylpiperazine) which is a 5HT-2c agonist. So you actually are getting some 5HT-2c agonism. Trazodone, Serzone's cousin, is also metabolized into the 5HT-2c agonist mCPP, which is why it has been tried as a treatment for weight gain induced by atypical antipsychotics (which are thought to induce weight gain not only by blocking H-1 receptors, but by blocking 5HT-2c receptors as well).

Treating atypical AP weight gain with trazodone:
http://www.nimh.nih.gov/ncdeu/abstracts2001/ncdeu3080.cfm

It's Serzone's ability to block 5HT-2a receptors that keeps the dopamine levels from dropping, and why there are fewer incidences of akathisia with nefazodone:
http://www.antidepressantsfacts.com/07-2001-SSRI-Induced%20Akathisia.htm

A great paper written on the different serotonin receptor subtypes and their functions can be found here:
http://www.biotrend.com/pdf/serot.pdf

MB


 

Re: 5-HT2c Receptor

Posted by MB on May 11, 2003, at 2:40:34

In reply to Re: 5-HT2c Receptor » Caleb462, posted by MB on May 11, 2003, at 2:22:54

Another interesting thing about 5HT-2c receptors is that they are initially acivated by the rise in extracellular serotonin levels following initiation of SSRI treatment. Anxiety, appetite loss, and weight loss are usually early side efects of SSRI treatment (and are also effects of 5HT-2c receptor agonism). However, after some time on SSRIs, 5HT-2c receptors become desensitized to serotonin, and it is around this time that the tardive (late onset) weight gain is seen in patients "doing" long-term SSRI therapy. This being the case, adding Serzone or another drug effecting 5HT-2c agonism might be an answer to tardive SSRI weight gain.

Just conjecture,
MB

 

Re: 5-HT2c Receptor » MB

Posted by noa on May 11, 2003, at 11:41:35

In reply to Re: 5-HT2c Receptor » Caleb462, posted by MB on May 11, 2003, at 2:22:54

>>A great paper written on the different serotonin receptor subtypes and their functions can be found here:
http://www.biotrend.com/pdf/serot.pdf

Thank you for the link!

 

Re: 5-HT2c Receptor

Posted by jrbecker on May 11, 2003, at 17:09:38

In reply to Re: 5-HT2c Receptor » MB, posted by noa on May 11, 2003, at 11:41:35

http://ernesto.ashley-pub.com/vl=5303534/cl=31/nw=1/rpsv/cw/apl/13543784/v7n10/s1/p1587

 

still kind of freaking out

Posted by bookgurl99 on May 12, 2003, at 21:29:37

In reply to kind of freaking out re: AD's, posted by bookgurl99 on May 7, 2003, at 22:43:02

I'm still kind of freaking out about AD's, despite all the reassurance I'm getting.

Over a year ago, a misinformed general practicioner had me attempt to cross-taper Serzone with Luvox. The result was a week of extreme confusion, where I was very forgetful and had trouble even figuring out how to use the remote control. At the end of that week, my dr. did tests on me and found no elevated liver enzymes, but elevated white blood cells.

Once I stopped taking both meds, my sense of having virtually short-term memory and having forgotten some important long-term memory things persisted. This led to quite a few medical tests to figure out 'what happened.' The best that happened was that I got a dx of severe complicated migraines, and treating them did help my symptoms.

But I wonder if that episode of unfortunate med-mixing could have harmed my liver that week, damaging some part of my brain involved in short-term memory. It has just not been the same since. (Though I'm hoping it's the Zoloft.)

So, I'm freaking out. Am I just being anxious?

 

Re: still kind of freaking out » bookgurl99

Posted by Ritch on May 13, 2003, at 12:07:21

In reply to still kind of freaking out, posted by bookgurl99 on May 12, 2003, at 21:29:37

> I'm still kind of freaking out about AD's, despite all the reassurance I'm getting.
>
> Over a year ago, a misinformed general practicioner had me attempt to cross-taper Serzone with Luvox. The result was a week of extreme confusion, where I was very forgetful and had trouble even figuring out how to use the remote control. At the end of that week, my dr. did tests on me and found no elevated liver enzymes, but elevated white blood cells.
>
> Once I stopped taking both meds, my sense of having virtually short-term memory and having forgotten some important long-term memory things persisted. This led to quite a few medical tests to figure out 'what happened.' The best that happened was that I got a dx of severe complicated migraines, and treating them did help my symptoms.
>
> But I wonder if that episode of unfortunate med-mixing could have harmed my liver that week, damaging some part of my brain involved in short-term memory. It has just not been the same since. (Though I'm hoping it's the Zoloft.)
>
> So, I'm freaking out. Am I just being anxious?
>


It is possible that the Serzone > Luvox switch went awry because the Luvox was making you zombified and the white blood count rise was coincidental. When you dumped both antidepressants you may simply have had a relapse of depressive symptoms (memory and cognition wipe me out first thing when I cycle into depression).

 

Re: still kind of freaking out » Ritch

Posted by bookgurl99 on May 13, 2003, at 14:31:31

In reply to Re: still kind of freaking out » bookgurl99, posted by Ritch on May 13, 2003, at 12:07:21

> It is possible that the Serzone > Luvox switch went awry because the Luvox was making you zombified and the white blood count rise was coincidental. When you dumped both antidepressants you may simply have had a relapse of depressive symptoms (memory and cognition wipe me out first thing when I cycle into depression).
>

Rich,

thanks for bringing up a far less catastrophic and equally reasonable explanation. :D

 

I wish I could take my own advice more often! :) (nm) » bookgurl99

Posted by Ritch on May 13, 2003, at 22:46:27

In reply to Re: still kind of freaking out » Ritch, posted by bookgurl99 on May 13, 2003, at 14:31:31

 

Re: 5-HT2c Receptor » jrbecker

Posted by MB on May 14, 2003, at 17:22:47

In reply to Re: 5-HT2c Receptor, posted by jrbecker on May 11, 2003, at 17:09:38

Interesting article. I wonder if 5HT-2C desensitization after prolonged exposure to SSRIs is what causes SSRI poopout? Maybe not, because people tend to get fat from SSRIs way before the drug poops out...

MB

> http://ernesto.ashley-pub.com/vl=5303534/cl=31/nw=1/rpsv/cw/apl/13543784/v7n10/s1/p1587


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