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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Seige on November 17, 2011, at 3:16:06
Hi guys,
So I've figured out that the closest I get to feeling normal is when I'm withdrawing from medication that had an NE enhancing effect (buproprion, agomelatine, effexor, etc).
These meds all made me feel terrible in a specific way, a really heavy feeling, which I attribute to increased NE transmission. However a sudden stop, and I'll wake up the next day with this feeling I can only say is what being normal feels like. This will last for just under a week after any withdrawal.
I figure that during the period on the medication, the NE receptors have downregulated to compensate for the extra NE, and the sudden withdrawal leaves me with:
downregulated transmitters + no NE enhancing medication = overall reduced NE function
So that is what I am aiming for out of a medication. One strategy I have used in the past is to alternate 4 days on and off of buproprion, which affects me the strongest.
However, this isn't ideal and probably is frying my brain. I really think a medication which does something along the lines of only downregulating NE receptors would help. Do classes of medications exist which can replicate this effect? I'm guessing it would be something along the lines of norepinephrine reuptake enhancement, like tianeptine for NE.
Alpha antagonists might be one, though I'm not entirely sure. Have mentioned them to my psych, he was quite reluctant due to blood pressure issues.
Posted by SLS on November 17, 2011, at 7:12:32
In reply to NE reduction?, posted by Seige on November 17, 2011, at 3:16:06
Downregulation is not occurring in the absence of increased concentrations of NE in the synaptic cleft. Perhaps downregulation is compensating for overstimulation such that the net effect is to arrive at a new equilibrium that supports an increase in postsynaptic activation (personal theory).
You might want to read more on neuron function and how over-stimulation of postsynaptic receptors actually reduces the rate of action potentials. I believe this phenomenon is known as "accommodation". I use this as the basis for the way I conceptualize the way reuptake inhibitors might work.
- Scott
Posted by Seige on November 17, 2011, at 7:56:23
In reply to Re: NE reduction? » Seige, posted by SLS on November 17, 2011, at 7:12:32
Hey Scott,
What I meant to say is that I believed downregulation occurred in response to the reuptake inhibition, would persist for a few days even after discontinuation.
However you believe that reuptake inhibition reduces signalling in the target transmitter? That would explain a lot of things.
Posted by Phillipa on November 17, 2011, at 10:35:03
In reply to Re: NE reduction?, posted by Seige on November 17, 2011, at 7:56:23
Used to happen to me but at the time the side effects were so bad on meds that discontinuing was a relief and felt much better off them all the time. Phillipa
Posted by Bob on November 17, 2011, at 15:32:50
In reply to NE reduction?, posted by Seige on November 17, 2011, at 3:16:06
The thing that confounds me is why it seems like some people (myself included) experience this "accomodation" type phenomenon and then return to a baseline state or worse, while others can take these medicines for years or more and they never experience the accomodation.
Bob
Posted by sigismund on November 17, 2011, at 17:00:20
In reply to NE reduction?, posted by Seige on November 17, 2011, at 3:16:06
Hydergine is an alpha antagonist?
Posted by jono_in_adelaide on November 17, 2011, at 23:40:32
In reply to NE reduction?, posted by Seige on November 17, 2011, at 3:16:06
reserpine?
Posted by Seige on November 26, 2011, at 9:47:56
In reply to Re: NE reduction?, posted by jono_in_adelaide on November 17, 2011, at 23:40:32
Thanks for the feedback guys!
On Clonidine now. Surprisingly seems to be less numbing than any AD I've tried, which automatically makes it my favourite. Still not the same effect as ad discontinuation though :/
Posted by Laney on November 29, 2011, at 10:52:45
In reply to Re: NE reduction?, posted by Seige on November 17, 2011, at 7:56:23
Isn't Clonodine primarily used for high blood pressure? It makes my mom super sleepy but she's had to be on hefty doses of it to bring her blood pressure down.
Posted by Phillipa on November 29, 2011, at 18:53:59
In reply to Re: NE reduction?, posted by Laney on November 29, 2011, at 10:52:45
Laney used for that and was used in psych for addiction withdrawal. I think not sure heroine was one and opiods? Phillipa
Posted by Seige on November 30, 2011, at 2:29:01
In reply to Re: NE reduction? » Laney, posted by Phillipa on November 29, 2011, at 18:53:59
Hey Laney,
Yeah it is. Though it does this by effectively reducing NE release, which is the effect we wanted to test. Definitely made me ridiculously sleepy!
This is the end of the thread.
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