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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by jboud24 on October 14, 2004, at 18:14:53
Hi, I'm new to the PB board, even though I've been reading it for quite some time now.
I have a theory about SSRI meds that I have been struggling with and refining for quite some time now. Basically it's this:
SSRI's inhibit the reuptake pump for the serotonin transporter, this much we all know. This is the way that they increase synaptic 5-HT. But, after a while, wouldn't this prevent the proper level of 5-HT from getting re-packaged into the vesicles and subsequently released?
I have thought that this is a flawed mechanism for a long time know, and have always thought that MAOI's were a better way to go, specifically because they don't screw up the amount of monoamines for repackaging and subsequent synaptic release.
I know this is pretty pharmalogically based, but has anyone else thought about this before? If so, does anyone think this is why MAOI's show such a better success rate?Thanks,
Justin (100 mg Zoloft currently, and very
disatisfied with SSRI's in general)
Posted by Shawn. T. on October 15, 2004, at 0:53:00
In reply to SSRI Theory, posted by jboud24 on October 14, 2004, at 18:14:53
SRIs may actually increase neurotransmitter release in some parts of the brain; this seems to involve Ca2+/calmodulin-dependent protein kinase II (CaMKII).
http://molpharm.aspetjournals.org/cgi/content/full/51/1/19
Shawn
Posted by King Vultan on October 15, 2004, at 8:13:45
In reply to SSRI Theory, posted by jboud24 on October 14, 2004, at 18:14:53
> Hi, I'm new to the PB board, even though I've been reading it for quite some time now.
>
> I have a theory about SSRI meds that I have been struggling with and refining for quite some time now. Basically it's this:
> SSRI's inhibit the reuptake pump for the serotonin transporter, this much we all know. This is the way that they increase synaptic 5-HT. But, after a while, wouldn't this prevent the proper level of 5-HT from getting re-packaged into the vesicles and subsequently released?
> I have thought that this is a flawed mechanism for a long time know, and have always thought that MAOI's were a better way to go, specifically because they don't screw up the amount of monoamines for repackaging and subsequent synaptic release.
> I know this is pretty pharmalogically based, but has anyone else thought about this before? If so, does anyone think this is why MAOI's show such a better success rate?
>
> Thanks,
> Justin (100 mg Zoloft currently, and very
> disatisfied with SSRI's in general)
The neuron can still synthesize new serotonin, though, so blocking reuptake should not by itself cause the neuron to run out of serotonin (this holds true in an analogous fashion for NE and dopamine reuptake inhibitors). The theory behind SSRIs is that the extra serotonin made available from blocking reuptake winds up having an effect on receptor densities and/or neuron firing rate, and they do seem reasonably effective at getting this done.The big problem I have with SSRIs is that they only work on one neurotransmitter, serotonin, which is not a good thing in the long term IMO. Increasing serotonin transmission depletes dopamine (due to stimulation of serotonin-2A receptors), and the very important norepinephrine system is also left neglected by SSRIs. The conclusion I've come to is that the big advantage of the MAOIs is that they work on all three of these systems simultaneously. I think this is the reason why they can continue to work so well in the long term, in some cases, for decades.
Todd
Posted by AJsmommy on October 15, 2004, at 8:38:06
In reply to SSRI Theory, posted by jboud24 on October 14, 2004, at 18:14:53
Here is a paper I wrote In college. Read it!
Pseudo Smiles
Today there is a cure for life’s problems. It is the miracle drug none other than Prozac. It seems too good to be true, a pill that can cure depression with no strings attached. Doctors and psychiatrists swear by it so it must be what we’ve been looking for all these years right? Prozac is prescribed for everything from depression to anxiety, ADD to obesity and weight problems. People are even taking Prozac fro headaches and back pain. It is prescribed to anyone from ages one to one hundred. And most of these prescriptions are not even prescribed by psychiatrist but instead the family doctor. In all honesty though it doesn’t matter who is prescribing this drug because no one really knows anything about it. And as the ears go by more and more of the truth is leaking out about the dangers and consequences of Prozac. It should be taken off the market immediately.
Prozac is intended to treat depression by stimulating the brain to make serotonin, the neurotransmitter responsible for making people happy. Unfortunately though this is far from what it actually does. Prozac works on the same receptors in the brain as LSD and cocaine. Instead what happens is that Prozac binds serotonin in the brain. Serotonin is made and is supposed to travel through receptors and pre synaptic cell membranes to the blood where it is deactivated. Prozac traps it in its traveling stage so it never reaches its true destination. This would be ok if it was that simple, but there’s more. When certain parts of the brain aren’t used they die because the brain doesn’t think they need them any more. In any other case this is considered brain damage. Depression is not just caused by a low level of serotonin either, it can be caused from a high level. A person could be making themselves even worse if they take Prozac if that is the case. Prozac does not have the power to regulate serotonin levels and this can be very dangerous because no one is monitoring the people’s levels that are on Prozac.
Prozac does not only bind serotonin in the brain but other things as well such as proteins and toxins. These proteins and toxins become to big to break down and are not easily expelled b the body which causes extreme stress to the liver and other organs involved in metabolizing and elimination. Someone with liver disease or problems could die from this. And drinking with Prozac can send the body into overload to the point where the organs won’t even be able to function right.
Like I said before Prozac is prescribed to all age groups. One in ten people have taken or take Prozac or other anti depressants. In 1998 more than 60 million prescriptions were written for Prozac. Even children are frequently prescribed Prozac as an anti depressant. Good parenting is no longer necessary, now there’s a pill to take it’s place. This is a shame considering all that I mentioned before and the fact that we don’t even know what it’s effects are on adults let alone a child’s developing mind. And what baby could possibly need an anti depressant. I think there’s a bigger problem there then one that can be solved by a pill. More than 75% of primary care physicians have prescribed Prozac and other anti depressants to children even though these drugs have never even been approved for use in children. Many of these problems that kids are having with depression can be cured by a change in diet and more exercise.
Now that you know how Prozac works and who is taking it I will tell you the “wonder pill’s” effects. Prozac has been known to cause neurological disorders such as disfiguring facial and body tics. It can lead to psychosis like paranoia, suicidal behavior, manic behavior, and mild to severe depression. Other side effects include obsessive compulsive behaviors and sexual dysfunction. The later affecting over half of its users. It can cause headaches, nervousness, dizziness, insomnia, agitation, tremors, weight loss, nausea, diarrhea, dry mouth, anorexia, and excessive sweating. Sounds like a miracle pill to me… These dangerous effects are known as “Prozac backlash” the brain’s reaction to artificial levels of serotonin. In twenty years Valium has had less adverse reaction reports then Prozac has in only two years.
If someone experiences these side effects they should just stop taking the drug right? It is not quite that easy. Prozac is addictive and the body will quickly become dependant on it. Not so long ago cocaine was prescribed for everything from a sore throat to depression. Ecstasy was used in marriage counseling. Now they are illegal narcotics. Sounds like history is repeating itself. The withdrawal symptoms include visual hallucinations, shock like sensations in the brain, drowsiness, nausea, dizziness, and anxiety to name a few.
Prozac is obviously a danger to society so why is it so common and readily prescribed? Prozac was first put on the market in the late 1980’s. Its abrupt popularity was due to It’s manufacturers extremely good marketing techniques. Many books of praise were written on the miracle pill by people and newspapers with many credentials. Celebrities were even endorsing Prozac. But the truth is that many of its users have brought lawsuits to its manufacturer Eli Lilly claiming it has completely destroyed their lives. The Citizens Commission on Human Rights have even stated “The wide use of Prozac has been largely generated by Lilly’s false claim that Prozac has fewer side effects than other anti depressant drugs. This is a serious misrepresentation to the public which is destroying lives.” They have even stated that Prozac should be recalled because it is a serious health hazard.
Still we ask ourselves how this drug ever even became approved by the FDA. This is because Eli Lilly’s trials for Prozac were set up and flawed. During these trials patients experiencing any adverse reactions were dismissed after the first two weeks. Those that did remain and showed side effects later were treated with other drugs. People who became agitated or violent were given sedatives. This completely invalidates their results. Also Lilly said that they tested Prozac on a total of 11,000 people, but in the end only 286 completed the trails. The rest probably dropped out or got dismissed because they showed negative effects.
Another part of the trails that was inaccurate is the fact that the manufacturer did not test the drug on people with mental or emotional health problems or with manic behaviors. Indecently those are the exact people Prozac is intended for and prescribed to. So therefore Prozac was inaccurately tested and the results were rigged. It should be taken off the market immediately. By the way no one bothers to mention that there were 18 Prozac related deaths during the trials.
Prozac is a threat to our society. It is handed out like candy on Halloween by people who know no more about it then you or me. It is a dangerous drug that can prove fatal if not monitored closely. It is intended to accompany therapy, not to just be taken as a simple cure. Many people suffer from anxiety merely because they drink too much caffeine. If sleep and work habits were improved people’s health and moods would become better as well. But in a time when there isn’t any time no one wants to stop and sit down for an hour and tell someone their problems or look into . Instead they are hooked on the idea of a quick fix. It is too bad that this miracle is in fact a demon in disguise. It causes severe side effects and has even been known to push people to murder or suicide. It is extremely addictive and even the Citizens Commission on Human Rights says it should be taken off the market. There are many other solutions to life’s problems that don’t end in a pill. People need to wake up and stop being so naive. Prozac is not the answer.
Posted by jboud24 on October 15, 2004, at 11:36:29
In reply to Re: SSRI Theory, posted by AJsmommy on October 15, 2004, at 8:38:06
Thanks for all the responses.
I am aware of the involvement of second messenger systems as well in the brain. But I didn't realize that the pre-synaptic neurons could still synth 5-HT. Duh. I should of thought of that.
I also think that the dual SRI/NRI's are going to show more success than the SSRI's will due to the involvement of the norepinephrine in anhedonia, lack of drive/interest, and so on. Now if they would just make a version of Cymbalta with a longer half-life I might jump at that, but 12 hours seems like asking for trouble in regard to missing a dose and experiencing discontinuation.
I see my pdoc on the 28th of this month, where I am going to bring up the possibility of Nardil or Parnate. My therapist, who is also a psychopharmacologist agrees that this would probably be a good route to explore.
Decisions, decisions.
Justin
This is the end of the thread.
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