![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by rovers95 on July 15, 2019, at 9:38:43
I started taking amitriptyline 25mg on Thursday. Saturday evening I felt better (warmer and calmer), and that feeling come back last night and today? Is this a placebo? I felt awful before and both Saturday & Sunday day tbh.
Posted by rovers95 on July 15, 2019, at 14:39:37
In reply to Can antidepressants work quickly?, posted by rovers95 on July 15, 2019, at 9:38:43
> I started taking amitriptyline 25mg on Thursday. Saturday evening I felt better (warmer and calmer), and that feeling come back last night and today? Is this a placebo? I felt awful before and both Saturday & Sunday day tbh.
Having looked at this it could be because I'm taking lithium orotate alongside and it potentiates the effect of tricyclics.
Posted by linkadge on July 15, 2019, at 17:28:18
In reply to Re: Can antidepressants work quickly?, posted by rovers95 on July 15, 2019, at 14:39:37
TCAs have a few mechanisms associated with more rapid antidepressant effect. For example, amitriptyline has anticholinergic properties as well as 5-ht2c antagonism. The antihistamine and calcium channel antagonism can help anxiety pretty quickly as well.
A fast response can be a good sign.
Linkadge
Posted by SLS on July 15, 2019, at 18:20:08
In reply to Re: Can antidepressants work quickly?, posted by linkadge on July 15, 2019, at 17:28:18
> TCAs have a few mechanisms associated with more rapid antidepressant effect. For example, amitriptyline has anticholinergic properties as well as 5-ht2c antagonism. The antihistamine and calcium channel antagonism can help anxiety pretty quickly as well.
>
> A fast response can be a good sign.Years ago on Psycho-Babble, people often reported feeling noticeably improved for a few days during the first week of antidepressant treatment. The response disappeared but reemerged 2-4 weeks later. That initial blip response seemed to be an indicator of eventual success. No guarantees, of course.
- Scott
Posted by Lamdage22 on July 16, 2019, at 7:54:30
In reply to Can antidepressants work quickly?, posted by rovers95 on July 15, 2019, at 9:38:43
When antidepressants worked for me they always did so almost immediately (sometimes immediately) and maximum was 7-10 days.
Posted by rovers95 on July 16, 2019, at 8:52:04
In reply to Re: Can antidepressants work quickly?, posted by Lamdage22 on July 16, 2019, at 7:54:30
> When antidepressants worked for me they always did so almost immediately (sometimes immediately) and maximum was 7-10 days.
Thanks, do they/did they stop working?
Posted by linkadge on July 16, 2019, at 19:49:25
In reply to Re: Can antidepressants work quickly?, posted by rovers95 on July 16, 2019, at 8:52:04
>Thanks, do they/did they stop working?
Hard to know. I'm not sure if there are any studies on whether or not early response predicts a durable response.
Linkadge
Posted by Lamdage22 on July 16, 2019, at 23:59:06
In reply to Re: Can antidepressants work quickly?, posted by rovers95 on July 16, 2019, at 8:52:04
No, they did not. Sertraline which worked immediately gave me akathisia so badly I had to stop
Posted by rovers95 on July 17, 2019, at 14:26:46
In reply to Re: Can antidepressants work quickly?, posted by Lamdage22 on July 16, 2019, at 23:59:06
> No, they did not. Sertraline which worked immediately gave me akathisia so badly I had to stop
Ah shame, fingers crossed I don't have problems with this.
Posted by linkadge on July 17, 2019, at 16:06:40
In reply to Re: Can antidepressants work quickly?, posted by Lamdage22 on July 16, 2019, at 23:59:06
>No, they did not. Sertraline which worked immediately gave me akathisia so badly I had to stop
Right, but I'm talking about 'in general'.
Linkadge
Posted by porkpiehat on July 22, 2019, at 14:15:24
In reply to Re: Can antidepressants work quickly? » Lamdage22, posted by linkadge on July 17, 2019, at 16:06:40
If I understand correctly, a lot of AD's can spike a neurotransmitter or block/agonize a receptor immediately...then the brain down or upregulates something else in the follow couple of weeks where the "true" AD effect supposedly lies.
I would think there would be some diagnostic value in responding better to the initial action vs the later state. I know this happens to me a lot.
Posted by SLS on July 23, 2019, at 7:26:38
In reply to Re: Can antidepressants work quickly?, posted by porkpiehat on July 22, 2019, at 14:15:24
> If I understand correctly, a lot of AD's can spike a neurotransmitter or block/agonize a receptor immediately...then the brain down or upregulates something else in the follow couple of weeks where the "true" AD effect supposedly lies.
>
> I would think there would be some diagnostic value in responding better to the initial action vs the later state. I know this happens to me a lot.All of your thoughts make sense, and I have tended to embrace them in the past. Now, I also look at the immediate effect of ketamine and the role that BDNF and inflammation might play in the latency of response to antidepressants. Somewhere, there must be a balance between the adages, "the more we learn, the more we realize how little we understand" and "keep it simple, stupid".
I don't know nearly as much now as I did 20 years ago.
- Scott
Posted by rovers95 on August 2, 2019, at 4:43:24
In reply to Re: Can antidepressants work quickly? » porkpiehat, posted by SLS on July 23, 2019, at 7:26:38
> > If I understand correctly, a lot of AD's can spike a neurotransmitter or block/agonize a receptor immediately...then the brain down or upregulates something else in the follow couple of weeks where the "true" AD effect supposedly lies.
> >
> > I would think there would be some diagnostic value in responding better to the initial action vs the later state. I know this happens to me a lot.
>
> All of your thoughts make sense, and I have tended to embrace them in the past. Now, I also look at the immediate effect of ketamine and the role that BDNF and inflammation might play in the latency of response to antidepressants. Somewhere, there must be a balance between the adages, "the more we learn, the more we realize how little we understand" and "keep it simple, stupid".
>
> I don't know nearly as much now as I did 20 years ago.
>
>
> - ScottNow I've gone from 75mg to 100mg and my mood has improved almost immediately, but (and it's a big but) these improvements don't seem to last beyond a few days. I guess I've only been on it at a therapeutic dose (at least 75mg) for 11 days so will give it time and hope that the feeling lasts this time out.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.