Psycho-Babble Medication Thread 890517

Shown: posts 1 to 12 of 12. This is the beginning of the thread.

 

Return to baseline after AD discontinuation

Posted by sowhysosad on April 13, 2009, at 22:03:44

Can anyone find any research - or make an intelligent guess - on how long it takes the brain to return to baseline after discontinuing chronic antidepressant treatment? More specifically imipramine or TCA's in general if possible.

Research shows it takes 40 days for D2 receptor sensitivity to return to baseline, but what about the brain's other systems?

Looks like most studies of psychotropic drugs use a two-week wash-out period before measuring "return to baseline" values.

My pdoc wants me to go drug-free for a while before reassessing me, and I'll have been "clean" almost two weeks if I stick to the program. I wonder if two-weeks is a rule-of-thumb for wash-out periods in psychiatry as it seems to be in research?

 

Re: Return to baseline after AD discontinuation » sowhysosad

Posted by jedi on April 14, 2009, at 2:29:41

In reply to Return to baseline after AD discontinuation, posted by sowhysosad on April 13, 2009, at 22:03:44

Hi,
Most psychotropic medications are probably washed out of your system after two weeks, though some (like Prozac) can take five weeks. However, their effects on the neurotransmitters can last much longer. I don't know the numbers, but I'm sure there are some medications that change the brain permanently.
Jedi

> Can anyone find any research - or make an intelligent guess - on how long it takes the brain to return to baseline after discontinuing chronic antidepressant treatment? More specifically imipramine or TCA's in general if possible.
>
> Research shows it takes 40 days for D2 receptor sensitivity to return to baseline, but what about the brain's other systems?
>
> Looks like most studies of psychotropic drugs use a two-week wash-out period before measuring "return to baseline" values.
>
> My pdoc wants me to go drug-free for a while before reassessing me, and I'll have been "clean" almost two weeks if I stick to the program. I wonder if two-weeks is a rule-of-thumb for wash-out periods in psychiatry as it seems to be in research?

 

Re: Return to baseline after AD discontinuation

Posted by bleauberry on April 14, 2009, at 5:11:27

In reply to Return to baseline after AD discontinuation, posted by sowhysosad on April 13, 2009, at 22:03:44

Well, in this sample of one, after 8 years of prozac and zyprexa I settled into a baseline somewhere in the 3 to 4 month range after the last dose following a slow weaning, where my last dose was about 1/8mg zyprexa and 1mg prozac.

I think all kinds of things have to readjust. Genes that convert proteins to neuros. Receptor sensitivity. Receptor density. Crosstalk between receptors. Cortisol and other hormones. And who knows what. Immune system even. It is a whole body thing, not just as simple as making sure the last molecule of the drug is gone. The bodily adjustments I believe take months, not weeks, and that the previous baseline will never be repeated, because some things were changed permanently.

No proof. Just my intuition.

 

Re: Return to baseline after AD discontinuation » bleauberry

Posted by sowhysosad on April 14, 2009, at 9:15:31

In reply to Re: Return to baseline after AD discontinuation, posted by bleauberry on April 14, 2009, at 5:11:27

Yeah, that was my thought too. Two weeks seemed very optimistic!

Perhaps they're allowing a two-week washout to allow the option to use an MAOI, but I sincerely doubt it.

> Well, in this sample of one, after 8 years of prozac and zyprexa I settled into a baseline somewhere in the 3 to 4 month range after the last dose following a slow weaning, where my last dose was about 1/8mg zyprexa and 1mg prozac.
>
> I think all kinds of things have to readjust. Genes that convert proteins to neuros. Receptor sensitivity. Receptor density. Crosstalk between receptors. Cortisol and other hormones. And who knows what. Immune system even. It is a whole body thing, not just as simple as making sure the last molecule of the drug is gone. The bodily adjustments I believe take months, not weeks, and that the previous baseline will never be repeated, because some things were changed permanently.
>
> No proof. Just my intuition.

 

Re: Return to baseline after AD discontinuation » jedi

Posted by Phillipa on April 14, 2009, at 11:22:45

In reply to Re: Return to baseline after AD discontinuation » sowhysosad, posted by jedi on April 14, 2009, at 2:29:41

Jedi what about 75mg of luvox as that happened to me two years ago and the pdoc upped benzos to extremely high doses and didn't sleep. Ended up in ER they said go back on luvox and low valium I did and slept again any idea what happened? Hence afraid to stop luvox. Love Phillipa

 

Re: Return to baseline after AD discontinuation

Posted by Zana on April 14, 2009, at 11:27:38

In reply to Re: Return to baseline after AD discontinuation, posted by bleauberry on April 14, 2009, at 5:11:27

I think bleauberry is right. I think meds have many and complex effects on the brain and that it takes a long time for the brain to re-estabish a pre-drug state. But it all depends on what you're trying to get to "baseline" for. If it's for MAOIs, two weeks. If it's to know what you are like med free-- I would say months.

Zana

 

Re: Return to baseline after AD discontinuation » Phillipa

Posted by jedi on April 14, 2009, at 13:10:17

In reply to Re: Return to baseline after AD discontinuation » jedi, posted by Phillipa on April 14, 2009, at 11:22:45

> Jedi what about 75mg of luvox as that happened to me two years ago and the pdoc upped benzos to extremely high doses and didn't sleep. Ended up in ER they said go back on luvox and low valium I did and slept again any idea what happened? Hence afraid to stop luvox. Love Phillipa

Hi Phillipa,
Of course, I'm not sure what may have happened with your Luvox withdrawal. A known side effect of fast withdrawal from the medication is insomnia. If you want to discontinue the medication, I would suggest a long slow taper. This allows your body to adjust to the decreasing medication and lessens any withdrawal symptoms. I would suggest this with any psychotrophic medication.
http://anxiety.emedtv.com/luvox/luvox-withdrawal.html

A slow withdrawal is especially important with long term benzodiazepine use. I just took three months to taper off 2mg of clonazepam. When I quit completely, I still had two weeks of increased insomnia and anxiety. But I had been on clonazepam for years.

Take care and be well,
Jedi

 

Re: Return to baseline after AD discontinuation

Posted by NewQuestions on April 14, 2009, at 13:50:37

In reply to Return to baseline after AD discontinuation, posted by sowhysosad on April 13, 2009, at 22:03:44

The wash out period is a matter of weeks, but the return to baseline process as the body readjusts takes months or even years. This has been proven in the case of long term benzo use, and there is much anecdotal evidence for SSRI use (see paxilprogress.com).

 

Re: Return to baseline after AD discontinuation

Posted by Zana on April 14, 2009, at 15:45:21

In reply to Re: Return to baseline after AD discontinuation » Phillipa, posted by jedi on April 14, 2009, at 13:10:17

Jedi, I am curious about why you tapered off the clonzaepam since I am taking a total of 3mgs a day and no one, no pdoc, seems concerned about it. Friends and family are very concerned that it is a downer and contributes to my depression. Unfortunately, I have a trememdous amount of anxiety too and difficulty sleeping (2 of the 3 mgs I take at night.) I started to taper myself off and my pdoc said she wouldn't suggest it.
What do you think?

 

Re: Return to baseline after AD discontinuation » Zana

Posted by jedi on April 14, 2009, at 18:43:51

In reply to Re: Return to baseline after AD discontinuation, posted by Zana on April 14, 2009, at 15:45:21

> Jedi, I am curious about why you tapered off the clonzaepam since I am taking a total of 3mgs a day and no one, no pdoc, seems concerned about it. Friends and family are very concerned that it is a downer and contributes to my depression. Unfortunately, I have a trememdous amount of anxiety too and difficulty sleeping (2 of the 3 mgs I take at night.) I started to taper myself off and my pdoc said she wouldn't suggest it.
> What do you think?

Hi Zana,
I had taken clonazepam for many years as an augmenter of Nardil for my social anxiety and atypical depression. It seemed to work really well for that. However, after many years on the medication, my memory was getting much worse. I think most people will agree that long term use of benzodiazepines does affect your memory. This is why I tapered off the drug. My anxiety level had reduced to a point where I thought I could stop the clonazepam, so I did.

3mg of clonazepam is a large dose. It doesn't sound like much, but most equivalence charts show that it is 20 times more potent than diazepam(Vallium). This would make 3mg of clonazepam like 60mg of diazepam.

If you need the med, stay on it. However, there are better medications for sleep. I take 25mg of Seroquel, which just knocks me out. I am super sensitive to the histamine medications, and this is why Seroquel works so well for me.

Even after a 3 month taper, when I finally quit clonazepam, I had some rebound anxiety and insomnia. These withdrawal symptoms went away after a couple of weeks. People that are prone to addiction will probably have a very hard time with clonazepam withdrawal. Especially if they were long term users like me. I'm not addicted to anything, except maybe food, and 3 months was actually pushing it for tapering off 2mg of long term clonazepam usage.

Be Well,
Jedi

 

Re: Return to baseline after AD discontinuation » jedi

Posted by Phillipa on April 14, 2009, at 20:36:38

In reply to Re: Return to baseline after AD discontinuation » Phillipa, posted by jedi on April 14, 2009, at 13:10:17

Jedi thanks that pdoc was wrong to stop the luvox and just give benzos. Thanks. Love Phillipa

 

Re: Return to baseline after AD discontinuation » NewQuestions

Posted by Amelia_in_StPaul on April 19, 2009, at 13:57:45

In reply to Re: Return to baseline after AD discontinuation, posted by NewQuestions on April 14, 2009, at 13:50:37

Absolutely, I agree. It can take months. I went off of fluoxetine and noticed that I finally, completely tanked after 9 months. I recall reading (somewhere!) that that was an accurate amount of time.


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