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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Cam W. on May 16, 2001, at 10:46:37
Scott - The latest issue of Neuropsychopharmacology has and article by Y.Levkovitz on TMS ("Transcranial Magnetic Stimulation and Antidepressant Drugs Share Simular Cellular Effects in Rat Hippocampus"). It seems that TMS, desipramine and miaserin all increase serotonergic neurotransmission and reverse hippocampal atrophy:
"The present sudy demonstrated a similarity of effects of chronic TMS and two typical antidepressants, miaserin and desipramine, on the reactivity of the hippocampus to stimulation of the perforant path [to the dentate gyrus], its main excitatory afferent pathway arriving from the entorhinal cortex."
"Although these treatments did not affect basal EPSP slopes and population spike size, their effects on paired-pulse and frequency-dependent inhibition indicate that TMS, as do desipramine and mianserin, share a primary action on local inhibitory interneurons activated in these stimulation protocols ."
"Our results on the reduction in efficacy of FFA [test drug fenfluramine] can be reconciled with the suggested increase in serotonergic neurotransmission following chronic antidepressant treatment (Blier and deMontigny 1994). If, indeed, the chronic treatment causes a continuous release of serotonin and/or increase in receptor sensitivity, we can expect that added release, evoked by FFA, will not be effective. Moreover, the chronic increase in serotonin release can have an indirect, downregulating action on the receptor for FFA. Finally, the effects of the antidepressants to increase excitability of the hippocampus are consistent with this possibility."
Alas, Neuropsychopharmacology is no longer free, but if you haven't signed up to the free trial of Neuroscion ( http://www.neuroscion.com ) I would recommend doing so. The allow you to print 25 articles from the Elsevier Science Journals (eg. Cognition, Brain Research Reviews, European Neuropsychopharmaology, Schizophrenia Research, Journal of Psychiatric Research, Psychoneuroendocrinology, etc). I also recommend browsing the journals list rather than setting up a library of journal articles. This is very much a "geek site" but I have printed of some facinating studies (it is where I got Phil Seeman's (guy who came up with receptor site theory) paper on the mechanism of action of atypical antipsychotics (ie 5-HT2A receptors do not have any antipsychotic action and the low D2 binding of these agents is due to the drugs tweaking, rather than irreversibly binding to, D2 receptors).
Anyway Scott, check out Neuroscion because I know that you are as big a geek as me. A word of warning, read the titles and abstracts carefully or you may miss some ground breaking and facinating papers.
;^)
Take care - Cam
Posted by medlib on May 20, 2001, at 1:29:53
In reply to Scott - Transcranial Maganetic Stimulation, posted by Cam W. on May 16, 2001, at 10:46:37
Cam--
As a "semi-geek," I was very interested in your info to Scott on the Neuroscion site. Since I no longer have free access to all the med journals online, it was great to find out about this offer--I signed up immediately (seems that they have extended their trial). Thanks!
I followed your nature/nurture dialog with Scott with great interest; sustained exchanges here that provide more light than heat seem so rare--and so precious. When is Round 2?
The other night, I found myself telling my daughter about your daughter. I was expressing my frustration with losing so much of my life to depression (a.k.a. b*tching). I think I said something like, "You know, some rare souls manage to make an impact on people, on life, in less than a full lifetime. How can some get it right the first time around, while others of us get stuck in some sort of emotional kindergarden for a lifetime that's too long?" (Yeah, I speak as ponderously as I write.) Then I told her who I was referring to. She said, "Wow! She must have been really special." Considering my question, she replied, "I dunno--maybe you're supposed to stick around until you "get it." She added, "Mom, you know, when you stop expecting life to be fair, it's not quite so hard." (She's big on long-suffering patience.) If she's right, I must be a *really* slow learner. Forgive me if this sounds presumptious, but I thought you might like to "see the ripples of her life spread."
I was sorry to learn that you're going through med tribulations, too. Is it Effexor that you take now? At the risk of sending "coals to Newcastle," have you considered "adding back" Wellbutrin to Effexor? I ask, because I had some success recently in "adding back" Prozac (20mg.) to my Effexor (375mg.). It was Prozac poop-out (after only 17 years) that started my latest psychomed saga.
It's my considered opinion that life should give you a break--it's only fair. Well wishes---medlib
Posted by Cam W. on May 20, 2001, at 3:53:31
In reply to Re: Neuroscion, et al » Cam W., posted by medlib on May 20, 2001, at 1:29:53
Medlib - Hi there. Long time no talk to. I hope that you are doing better; you deserve it. It sounds like you have one wonderful daughter.
This is the first time I have gone on short term disability for this silly depression thing. I am currently taking 262.5mg of Effexor XR daily and have been taking the drug for 10 weeks now. I may ask to have it increased to 300mg daily at my next pdoc appointment, as the last 37.5mg increase a week ago has given me much more energy (but I'd like a little more).
I really doubt that I will add back the Wellbutrin and hope that the norepinephrine-reuptake blocking action of the Effexor XR will be enough. It is still a wait and see thing, though. The only thing that hasn't responded to the Effexor is my energy level, but I am hoping that the energy will return with time.
I think that I am going to return to work a week or two after the anniversary date of Suz's death (June 5). My wife and I are planning to take our younger daughter to the mountains for a few days, just to get away from the phone, computer, etc. We just want to walk in the mountains and relax in the hot springs.
Scott and I can get into these meds and mechanisms quite deeply, can't we. Although, I won't be satisfied until I win our nature/nuture argument, which has been running over a year now. ;^) Actually, we learn more from having this disagreement, so maybe I don't want it to end.
Take care and I look forward to reading more of your posts - Cam
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