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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 215 to 239 of 297. Go back in thread:
Posted by Phillipa on March 4, 2006, at 18:46:13
In reply to Re: NASA's , SSRI, SNRI, etc. » Phillipa, posted by yxibow on March 4, 2006, at 17:23:02
Stupid question from stupid me but if they are in your gut how do they affect you brain and depression remember I can be an imbacile. Love Phillipa
Posted by Larry Hoover on March 4, 2006, at 19:20:21
In reply to Re: NASA's , SSRI, SNRI, etc. » Phillipa, posted by yxibow on March 4, 2006, at 17:23:02
> > Serotonin can't be messured by a blood test. At least the serotonin in your brain. You can test for some TCA's but no blocd test of SSRI ,SNRI. If there were they would know how much and which drug to give you. Correct me if I'm wrong. Fondly, Phillipa
>
>
> There is a test for serotonin serum levels. You may be right that it doesn't allow for blood-brain level testing, although of course more than 90% of the serotonin receptors are -not- in your brain, they are in your gut.
>
> http://www.nlm.nih.gov/medlineplus/ency/article/003562.htmThere has never been any evidence that correlates serum serotonin levels, or urine serotonin metabolite levels for that matter, with affective states or mood disorders. The blood test you linked to is part of the screening panel for carcinoid syndrome, the results of a fairly rare cancer which secretes hormones. In effect, that person would develop the various symptoms of serotonin syndrome, plus some others occurring because of regulatory changes over time.
You can test for anything in blood or urine. But there is no meaning you can attribute between blood/serum neurotransmitter levels, and any psychiatric condition (excluding rare bizarre stuff). If there was any utility to such testing, it would be routine. Doctors love simple blood work, and determining treatment from a graph or chart. _If only_ psych treatment was so simple and robustly founded.
Lar
Posted by tizza on March 4, 2006, at 21:17:19
In reply to Re: 150mg » linkadge, posted by ed_uk on March 4, 2006, at 13:09:38
> Hi Link,
>
> >How long was it though, until you went on a new medication ??
>
> I think it was about 2 weeks. The withdrawal symptoms were pretty much over by then though. The next AD I took was moclobemide. I didn't have any withdrawal symptoms when I stopped moclobemide, I don't think it was really doing anything!
>
> Edmoclobemide was the first AD I ever took about 12 years ago and it did sweet f*ck all so they gave me xanax to agument it and next thing I knew I had a serious xanax addiction. Short acting benzo's are terrilbe for me so now it's Valium
Posted by yxibow on March 5, 2006, at 4:14:33
In reply to Re: NASA's , SSRI, SNRI, etc. » yxibow, posted by Larry Hoover on March 4, 2006, at 19:20:21
> > > Serotonin can't be messured by a blood test. At least the serotonin in your brain. You can test for some TCA's but no blocd test of SSRI ,SNRI. If there were they would know how much and which drug to give you. Correct me if I'm wrong. Fondly, Phillipa
> >
> >
> > There is a test for serotonin serum levels. You may be right that it doesn't allow for blood-brain level testing, although of course more than 90% of the serotonin receptors are -not- in your brain, they are in your gut.
> >
> > http://www.nlm.nih.gov/medlineplus/ency/article/003562.htm
>
> There has never been any evidence that correlates serum serotonin levels, or urine serotonin metabolite levels for that matter, with affective states or mood disorders. The blood test you linked to is part of the screening panel for carcinoid syndrome, the results of a fairly rare cancer which secretes hormones. In effect, that person would develop the various symptoms of serotonin syndrome, plus some others occurring because of regulatory changes over time.
>
> You can test for anything in blood or urine. But there is no meaning you can attribute between blood/serum neurotransmitter levels, and any psychiatric condition (excluding rare bizarre stuff). If there was any utility to such testing, it would be routine. Doctors love simple blood work, and determining treatment from a graph or chart. _If only_ psych treatment was so simple and robustly founded.
>
> Lar
Oh -- I thought I made it clear that the test was not for corellation with neurotransmitter levels -- at least not those in the brain. Its used for testing carcinoid syndrome. You're right -- if only we could. But the 21st century holds promise if we avoid the reality distortion field of this current presidential administration, of genetic tailoring of a lot of things. We could go so far by 2050 considering the progress we have made just in the past 2 decades. But it may be countries like China and India, and possibly Great Britain that will overtake us unless we allow stem cell research and other such things. But that's just my political spin.
Posted by yxibow on March 5, 2006, at 4:25:01
In reply to Re: NASA's , SSRI, SNRI, etc. » yxibow, posted by Phillipa on March 4, 2006, at 18:46:13
> Stupid question from stupid me but if they are in your gut how do they affect you brain and depression remember I can be an imbacile. Love Phillipa
Remember the old phrase "gut instinct" ? For whatever reason, and I can only place this if one believes in evolution, genetics somehow could not fit much of the serotonin receptors in an average sized brain. So they ended up in the gut, a great percentage of them. Especially 5HT3, responsible for nausea and vomiting and the like. Ginger is a weak 5HT3 inhibitor, the older Tigan and the new 5HT3 blockers ondansetron and granisetron (and tropisetron outside of the US) are heavy 5HT3 blockers. Its the reason why earlier "unclean" SSRIs initially affect people in the stomach largely until they become accustomed to the nausea. Perhaps it was an early defense system -- your gut is a pretty powerful feeling. Serotonin itself cannot pass the blood brain barrier and largely circulates in your blood stream. Its precursor components such as 5HTP can though.
Posted by SLS on March 5, 2006, at 6:44:59
In reply to Re: NASA's , SSRI, SNRI, etc. » Larry Hoover, posted by yxibow on March 5, 2006, at 4:14:33
> > > > Serotonin can't be messured by a blood test. At least the serotonin in your brain.
> > There has never been any evidence that correlates serum serotonin levels, or urine serotonin metabolite levels for that matter, with affective states or mood disorders.
CSF might be a better source of chemical markers.
If it is found that the etiologies of some mental illnesses are to be found in abnormal gene expression, perhaps microarrays will be helpful in diagnosing and determining treatment. We really aren't all that far from that now. (I guess it's all relative. It is still too far away to suit me).
- Scott
Posted by Larry Hoover on March 5, 2006, at 9:42:50
In reply to Re: NASA's , SSRI, SNRI, etc. » Larry Hoover, posted by yxibow on March 5, 2006, at 4:14:33
> > You can test for anything in blood or urine. But there is no meaning you can attribute between blood/serum neurotransmitter levels, and any psychiatric condition (excluding rare bizarre stuff).
> Oh -- I thought I made it clear that the test was not for corellation with neurotransmitter levels -- at least not those in the brain.
Actually, I'm the one who should apologize. I'm sorry, I didn't mean to centre you out. I just really wanted to emphasize that the only benefit from blood serotonin testing accrues to the laboratory doing the test (and maybe the doctor who ordered it). The patient simply wastes money.
Lar
Posted by Larry Hoover on March 5, 2006, at 9:47:01
In reply to Re: NASA's , SSRI, SNRI, etc., posted by SLS on March 5, 2006, at 6:44:59
> CSF might be a better source of chemical markers.
Keyword "might". I only wish cerebro-spinal fluid was more accessible. The risks attaching to lumbar puncture are far too great to be adopted as part of routine practise. Unless some real evidence is available that way.
> If it is found that the etiologies of some mental illnesses are to be found in abnormal gene expression, perhaps microarrays will be helpful in diagnosing and determining treatment. We really aren't all that far from that now. (I guess it's all relative. It is still too far away to suit me).
>
>
> - ScottIf it's genetic, though, blood suits as a test medium. Saliva, even. Those genes, they be everywhere.
Lar
Posted by SLS on March 5, 2006, at 10:23:47
In reply to Re: NASA's , SSRI, SNRI, etc. » SLS, posted by Larry Hoover on March 5, 2006, at 9:47:01
Hi Larry.
Nice to see your smiling face.
:-)
> > CSF might be a better source of chemical markers.
> Keyword "might". I only wish cerebro-spinal fluid was more accessible. The risks attaching to lumbar puncture are far too great to be adopted as part of routine practise. Unless some real evidence is available that way.
LPs ain't much fun (unless they're made of vinyl). I had a handful performed on me when I was a research patient at the NIMH. You are right. I don't see any putative markers yet identified in CSF to act as a practicable test for anything relating to the diagnosis and treatment of affective disorders. There are some associations between low MHPG and the effectiveness of NE reuptake inhibitors (TCAs), but not much else when last I looked, and I don't know what the coefficient of correlation was. Actually, I think low urine MHPG might be just as reliable (or unreliable) a marker.
> > If it is found that the etiologies of some mental illnesses are to be found in abnormal gene expression, perhaps microarrays will be helpful in diagnosing and determining treatment. We really aren't all that far from that now. (I guess it's all relative. It is still too far away to suit me).
> If it's genetic, though, blood suits as a test medium. Saliva, even. Those genes, they be everywhere.Yes. However, it might be necessary to assay gene activity in a site-specific manner, which would mean taking samples of brain tissue. A gene can be turned on in one cell but not in another. In addition, the proteins expressed by changes in gene activity might never appear extracellularly. I really don't know enough about this stuff to speculate any further regarding the need to sample specific tissues to assay gene activity.
Maybe I'm way off...
- Scott
Posted by sdb on March 5, 2006, at 12:15:01
In reply to Re: NASA's , SSRI, SNRI, etc. » SLS, posted by Larry Hoover on March 5, 2006, at 9:47:01
>>had a 55 percent higher risk of dying than >>those not taking antidepressants
quite a lot
>>There was also no indication whether the >>depressed patients had benefited at all from >>taking antidepressants, Goldberg said.
are the ssris effective?
http://www.memorialhermann.org/healthnews/healthday/060304HD531382.htm
Posted by SLS on March 5, 2006, at 12:29:09
In reply to Re: NASA's , SSRI, SNRI, etc., posted by sdb on March 5, 2006, at 12:15:01
Hi.
I don't understand what you posted here.
What was the opinion or purported fact that you wished to convey?
- Scott
-------------------------------------------
> >>had a 55 percent higher risk of dying than >>those not taking antidepressants
>
> quite a lot
>
> >>There was also no indication whether the >>depressed patients had benefited at all from >>taking antidepressants, Goldberg said.
>
> are the ssris effective?
>
> http://www.memorialhermann.org/healthnews/healthday/060304HD531382.htm
Posted by TylerJ on March 5, 2006, at 14:26:40
In reply to Re: NASA's , SSRI, SNRI, etc., posted by SLS on March 5, 2006, at 12:29:09
> Hi.
>
> I don't understand what you posted here.
>
> What was the opinion or purported fact that you wished to convey?
>
>
> - Scott
>
>
> -------------------------------------------
>
>
> > >>had a 55 percent higher risk of dying than >>those not taking antidepressants
> >
> > quite a lot
> >
> > >>There was also no indication whether the >>depressed patients had benefited at all from >>taking antidepressants, Goldberg said.
> >
> > are the ssris effective?
> >
> > http://www.memorialhermann.org/healthnews/healthday/060304HD531382.htm
>
>
-----------------------
Scott,
What the Heck is an NASA?Thanks, Tyler
Posted by SLS on March 5, 2006, at 14:37:58
In reply to Re: NASA's , SSRI, SNRI, etc. » SLS, posted by TylerJ on March 5, 2006, at 14:26:40
> Scott,
> What the Heck is an NASA?
>lol
I haven't a clue! I was hoping you might tell me!
lol
Occasionally, you will see the acronym "NARI". It stands for noradrenaline reuptake inhibitor. Noradrenaline is another term for norepinephrine.
I guess I'll have to go another sleepless night wondering about "NASA". :-)
I'm sure it has a very legitimate meaning that I will come to know with some measure of embarassment.
- Scott
Posted by zeugma on March 5, 2006, at 14:46:58
In reply to Re: NASA's , SSRI, SNRI, etc. » TylerJ, posted by SLS on March 5, 2006, at 14:37:58
> > Scott,
> > What the Heck is an NASA?
> >
>
> lol
>
> I haven't a clue! I was hoping you might tell me!
>
> lol
>
> Occasionally, you will see the acronym "NARI". It stands for noradrenaline reuptake inhibitor. Noradrenaline is another term for norepinephrine.
>
> I guess I'll have to go another sleepless night wondering about "NASA". :-)
>
> I'm sure it has a very legitimate meaning that I will come to know with some measure of embarassment.
>
>
> - ScottNASA= National Aeronautics and Space Administration. Very legitimate meaning, but not here!
NaSSA= Noradrenergic and Specific Serotonergic Antagonist (i.e. mirtazapine). that's what the poster meant.
-z
Posted by sdb on March 5, 2006, at 16:03:43
In reply to Re: NASA's , SSRI, SNRI, etc., posted by SLS on March 5, 2006, at 12:29:09
consciousness is somehow connected to the body. Bad mood means an eventually higher risk for cardiovascular disease eg. blood platelets sticking together. If ssris elevate mood it should diminish the risk for a cv disease. On the other hand srris probably influence metabolism of the body eg. more fatty streaks of coronary arterias and following atherosclerosis maybe by elevating LDL-c, oxiative stress ... whatever. If heart patients have a 55% higher risk of dying I suppose that there are metabolic mechanisms involved. I previously thougt that srris are more or less safe related to cvd in contrast to other ad's or medication.
~sdb
Posted by yxibow on March 5, 2006, at 17:04:04
In reply to Re: NASA's , SSRI, SNRI, etc. » yxibow, posted by Larry Hoover on March 5, 2006, at 9:42:50
> > Oh -- I thought I made it clear that the test was not for corellation with neurotransmitter levels -- at least not those in the brain.
>
> Actually, I'm the one who should apologize. I'm sorry, I didn't mean to centre you out. I just really wanted to emphasize that the only benefit from blood serotonin testing accrues to the laboratory doing the test (and maybe the doctor who ordered it). The patient simply wastes money.
>
> LarYes -- tests are expensive. No worries. Lively discussion. :)
Posted by linkadge on March 5, 2006, at 17:06:08
In reply to Re: 150mg » linkadge, posted by Phillipa on March 4, 2006, at 17:04:49
I guess the point I was trying to make, is that there are many many factors. I still contend that the drugs can be classified as addictive, for many people who take them.
If somebody had a different experience, then I would need to take into account many factors that I don't have access to.
Linkadge
Posted by linkadge on March 5, 2006, at 17:10:32
In reply to Re: SSRIs et alia, Brain Chemistry and a moving ta » linkadge, posted by yxibow on March 4, 2006, at 17:28:40
I guess to put what I am trying to say in laymanns terms is that they may work in that they help your symptoms, but they are not working to fix the root of the problem.
Ie. There has not been established any *clear* link between depressive illness and overactivity of the serotonin transporter. So, if they work, it is probably by supressing symptoms in some yet, unidentified way.
Linkadge
Posted by Dr. Bob on March 5, 2006, at 17:25:23
In reply to Re: Yes » zeugma, posted by ed_uk on March 4, 2006, at 13:06:52
> Some people take diphenhydramine (Benadryl), an antihistamine and anticholinergic, to reduce the symptoms of SSRI withdrawal...
Sorry to interrupt, but I'd like to redirect follow-ups regarding SSRI withdrawal to Psycho-Babble Withdrawal. Here's a link:
http://www.dr-bob.org/babble/wdrawl/20060228/msgs/616287.html
Thanks,
Bob
Posted by ed_uk on March 5, 2006, at 17:25:47
In reply to Re: Yes. diphenhydramine » yxibow, posted by ed_uk on March 5, 2006, at 17:22:08
Your post just vanished. I'm confused.
Ed
Posted by linkadge on March 5, 2006, at 17:26:45
In reply to Re: NASA's , SSRI, SNRI, etc.}} SLS, posted by sdb on March 5, 2006, at 16:03:43
Then there is the alternate possability that SSRI's are dammaging the heart in a manner similar to certain serotonergic weight loss drugs, but I won't go there.
Linkadge
Posted by Dr. Bob on March 5, 2006, at 17:29:44
In reply to Re:New Idea: phillipa » cecilia, posted by Chairman_MAO on March 3, 2006, at 9:16:48
> All advertisements are lies
Please don't exaggerate or overgeneralize.
But please also don't take this personally, this doesn't mean I don't like you or think you're a bad person.
If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
Follow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above post, should of course themselves be civil.
And follow-ups regarding advertisements should be redirected to Psycho-Babble Social.
Thanks,
Bob
Posted by linkadge on March 5, 2006, at 17:36:32
In reply to Re: please be civil » Chairman_MAO, posted by Dr. Bob on March 5, 2006, at 17:29:44
With regards to the SSRI, heart study, I think this is another example of the difference between what doctors want antidepressants to be and what they are.
I guess they would want that when the depression has been treated that everything else will just fall into place, but it doesn't always happen that way.
Linkadge
Posted by Phillipa on March 5, 2006, at 18:48:38
In reply to Re: 150mg » Phillipa, posted by linkadge on March 5, 2006, at 17:06:08
Link you're right. And when someone's life changes for the better in their mind that is a potent reason to stop taking a med. I know myself when paxil at l0mg was working for me and I really felt well the fact that my Son was coming to live with us and he didn't like meds so I quit but I did have some brainzaps so did it slowly. And for the other poster Jay that is very intersting about the serotonin in the gut. That explains to me why I had diarrhea when I did first start to paxil. Love Phillipa
Posted by sdb on March 5, 2006, at 19:01:02
In reply to Re: NASA's , SSRI, SNRI, etc.}} SLS » sdb, posted by linkadge on March 5, 2006, at 17:26:45
I am not sure about cardiovascular risks and ssris involved. According to the new study there is definately a risk but in literature is even written the contrary exempli gratia:
----------------------------------------
Am J Cardiovasc Drugs. 2003;3(3):149-62.
Effect of selective serotonin reuptake inhibitors on platelet activation : can they prevent acute myocardial infarction?Schlienger RG, Meier CR.
Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacology, University Hospital, Basel, SwitzerlandDepartment of Pharmacy, Institute of Clinical Pharmacy, University of Basel, Basel, Switzerland.
In recent years a large body of evidence from several longitudinal studies has emerged suggesting that depression is an independent risk factor for cardiovascular disease (CVD) and that the association between depression and increased CVD risk is not merely due to negative mood-driven behavior related with depression. Even though the underlying mechanisms are not well understood, several hypotheses and explanations have been proposed such as increased activation of the hypothalamic-pituitary-adrenal axis, abnormalities in the sympathoadrenal system, or abnormalities in platelet function. Platelet function abnormalities, including increased platelet reactivity, may predispose patients with depressive disorders to clotting diatheses and may explain their vulnerability to CVD.Serotonin secreted by platelets induces both platelet aggregation and coronary vasoconstriction. Even though serotonin itself is only a weak platelet agonist, it markedly enhances platelet reactions to a variety of other agonists. Several studies have shown that selective serotonin reuptake inhibitors (SSRIs) reduce platelet and whole blood serotonin concentrations after repeated doses, and could therefore exert an inhibitory effect on platelet activation. For that reason, it was hypothesized that SSRIs could have a protective effect against myocardial infarction (MI).Results from three currently available epidemiological studies assessing the risk of MI in patients treated with antidepressants, including SSRIs, are controversial with respect to a potential beneficial effect of SSRIs on CVD risk in depressed patients. However, there is evidence that exposure to SSRIs does not substantially increase the risk of CVD in patients. A recent randomized, double-blind, placebo-controlled, multicenter trial that evaluated the safety and efficacy of the SSRI sertraline in patients with major depression and acute MI or unstable angina suggested that sertraline is well tolerated and effective. Further epidemiological studies or longer-term clinical trials may shed more light on this issue, and answer the question conclusively, whether the effect of SSRIs on platelets or another mechanism translates into a decreased risk of CVD in depressed patients.
PMID: 14727927 [PubMed - in process]
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