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Re: Anybody know WHY Zoloft poops out?

Posted by SLS on November 26, 2000, at 11:37:48

In reply to Anybody know WHY Zoloft poops out?, posted by shar on November 26, 2000, at 10:09:59

> I've seen a lot of posters here talk about Zoloft pooping out after a few months. I also experienced that and my p-doc said it was pretty common. I know that NOT everybody experiences poop out.
>
> The sad part is I felt GREAT on Zoloft. Never have felt so good before or after Zoloft. I've heard that attempts to go back to it can go either way if you've been off it for awhile.
>
> I'm wondering why it poops out, and what is it about Zoloft that makes it work so well for some people.


Good question.


Regarding poop-out...

Complex answer:

SSRI (Zoloft) poop-out may involve a "burn-out" of downstream serotonergic-regulated dopaminergic pathways in the mesolimbic and prefrontal cortex - areas of the brain known to be involved in mood and cognition. Either there is a depletion of DA stores in this area or there is a latent adaptive change in the sensitivity of dopamine (DA) receptors there. I think the latter is more likely. There might be an upregulation of presynaptic receptors or a "reset" of postsynaptic receptors via second messenger systems and nuclear events. After so much time spent in the SSRI-induced change in functional dynamics, the postsynaptic neuron becomes convinced that this new status-quo represents the nominal biological condition and mobilizes the genetic machinery of the cell to act as if nothing had ever changed. The neuron thus reverts to its "default" settings and downregulates its postsynaptic receptors to the level they were before the SSRI was introduced.


Not as complex answer:

Zoloft works by using serotonin to force dopamine function to change. After a while, the dopamine area either spends too much DA and becomes depleted (goes broke), or the neurons get "smart" and go back to the way they were before taking Zoloft.


Least complex answer:

I don't know.


- Scott

 

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