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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by gadchik on December 15, 2013, at 18:13:43
I copied the info from the link below:
http://theconversation.com/some-antidepressants-work-better-than-others-now-we-know-why-17850
SSRIs vs NRIs
Our research suggests that the varying effectiveness of SSRIs and NRIs may be underpinned by their different impacts on brain activity, which can be seen after just one dose.We took brain activity data from nine different international studies. Five studies looked exclusively at SSRIs, two looked exclusively at NRIs, and the other two looked at both SSRIs and NRIs. A total of 152 patients participated in these studies: 103 received SSRIs while the other 81 received NRIs.
When participants were given an SSRI, the amygdala became less active. This indicates that our brains become less emotionally reactive after a single dose of an antidepressant.
SSRI treatment also increased activity in frontal regions of the brain, including a region of the prefrontal cortex involved in regulating emotions, suggesting that SSRIs may increase capacity to regulate our emotions.
In contrast, when participants were given an NRI, only frontal regions increased in activity, while amygdala activity did not change.
So, SSRIs may be more effective than NRIs for treating mood and anxiety disorders because SSRIs impacted the emotionally reactive amygdala, while NRIs did not.
Next stepsThese findings are important because patients only begin to display observable changes in symptoms after six weeks of ongoing treatment. But if the increases in frontal lobe activity and decreases in amygdala activity follow a single dose of an SSRI, this could act as an early indicator of the effectiveness of treatment over the longer term.
The next steps in our research are to further investigate how these changes occur, and whether genetic differences play a role. More research is also needed on both healthy people and patient samples to better understand how antidepressant treatments work and to predict outcomes with different treatments.
Though we dont yet have the answers or tests to predict whether a treatment will work for a particular patient, its important that we increase our understanding about why some antidepressants are more effective than others.
Posted by jono_in_adelaide on December 15, 2013, at 22:21:46
In reply to Info on Why SSRIS are Good for Anxiety/Mood, posted by gadchik on December 15, 2013, at 18:13:43
I found a combo aproach worked best for me, an SSRI + an NARI (welbutrin, nortriptyline, reboxetine)
Posted by Phillipa on December 15, 2013, at 22:23:50
In reply to Info on Why SSRIS are Good for Anxiety/Mood, posted by gadchik on December 15, 2013, at 18:13:43
Gadchik reminds me of years ago when Prozac new and only came in 20mg capsules a pdoc convinced me to take one when only taking .5 of Xanax. The day I took it wallpapered a room that had had the wallpaper for for three years, day two anxiety had had none till then, but day three pure panic at which point flushed them down the toilet. When I finally was back to normal in three days. I told the pdoc who begged me to take one every three days. He felt I'd had a dramatic response to it. But I refused. At the time working felt great. But I have to wonder what would have happened if they had pills to split or lower doses then? P
Posted by gadchik on December 16, 2013, at 7:38:24
In reply to Re: Info on Why SSRIS are Good for Anxiety/Mood » gadchik, posted by Phillipa on December 15, 2013, at 22:23:50
ive always wondered if more people could benefit by starting a much smaller dose of ssri, esp if anxiety is high.
Posted by gadchik on December 16, 2013, at 7:39:16
In reply to Re: Info on Why SSRIS are Good for Anxiety/Mood, posted by jono_in_adelaide on December 15, 2013, at 22:21:46
I did very well on zoloft/klonopin combo, but the article didnt mention gaba. Ive never tried zoloft by itself tho
Posted by Phillipa on December 16, 2013, at 20:24:46
In reply to Re: Info on Why SSRIS are Good for Anxiety/Mood » jono_in_adelaide, posted by gadchik on December 16, 2013, at 7:39:16
Gadchik that is what makes no sense to me. If SSRI's cause anxiety and one needs a benzo to alleviate it and the initial complaint is anxiety why not just the benzo? P
Posted by bleauberry on December 17, 2013, at 4:51:28
In reply to Info on Why SSRIS are Good for Anxiety/Mood, posted by gadchik on December 15, 2013, at 18:13:43
"suggesting"...."may be"....I dunno, these kinds of articles do not impress me. See, they take an assumption, draw conclusions as to what it means, and then state their opinion in such a way that it appears 100% accurate and reliable, when in fact it is no more sure than the words in quotes above.
Carrots may kill people. Since everyone who eats a carrot will die, that suggests a possible link between carrots and death. kidding, but you get the point.
The statement that some antidepressants are more effective than others, I dispute that. It's not whether the antidepressant is somehow "better" or not....it's a matter of how well do the genetic mechanisms of a drug counteract against whatever mysterious hidden thing is actually going on inside the person's unique physiology. Since depression is caused by a range of different things, there is no way to predict which antidepressant will be best for which person.
> I copied the info from the link below:
>
> http://theconversation.com/some-antidepressants-work-better-than-others-now-we-know-why-17850
>
> SSRIs vs NRIs
> Our research suggests that the varying effectiveness of SSRIs and NRIs may be underpinned by their different impacts on brain activity, which can be seen after just one dose.
>
> We took brain activity data from nine different international studies. Five studies looked exclusively at SSRIs, two looked exclusively at NRIs, and the other two looked at both SSRIs and NRIs. A total of 152 patients participated in these studies: 103 received SSRIs while the other 81 received NRIs.
>
> When participants were given an SSRI, the amygdala became less active. This indicates that our brains become less emotionally reactive after a single dose of an antidepressant.
>
> SSRI treatment also increased activity in frontal regions of the brain, including a region of the prefrontal cortex involved in regulating emotions, suggesting that SSRIs may increase capacity to regulate our emotions.
>
> In contrast, when participants were given an NRI, only frontal regions increased in activity, while amygdala activity did not change.
>
> So, SSRIs may be more effective than NRIs for treating mood and anxiety disorders because SSRIs impacted the emotionally reactive amygdala, while NRIs did not.
> Next steps
>
> These findings are important because patients only begin to display observable changes in symptoms after six weeks of ongoing treatment. But if the increases in frontal lobe activity and decreases in amygdala activity follow a single dose of an SSRI, this could act as an early indicator of the effectiveness of treatment over the longer term.
>
> The next steps in our research are to further investigate how these changes occur, and whether genetic differences play a role. More research is also needed on both healthy people and patient samples to better understand how antidepressant treatments work and to predict outcomes with different treatments.
>
> Though we dont yet have the answers or tests to predict whether a treatment will work for a particular patient, its important that we increase our understanding about why some antidepressants are more effective than others.
Posted by bleauberry on December 17, 2013, at 4:58:26
In reply to Info on Why SSRIS are Good for Anxiety/Mood, posted by gadchik on December 15, 2013, at 18:13:43
Oh, one more thing. The title. Why SSRIs are good for anxiety/mood. Well, there again is another assumption that just simply is not true. Ever seen the black box warning on the package? Depression can be made worse, even suicidal, by SSRIs, and this does happen a lot. Happened to me a lot. To say SSRIs were good for my mood is a absolutely wrong. I'm not alone on that. Obviously. Black box warning. Hundreds of more examples in the archives here.
While SSRIs generally might have some anti-anxiety effects to them, given enough time, they also worsen anxiety horribly for some people.
Whether a ssri is good for anxiety/mood or not will vary dramatically from patient to patient.
The best antidepressant is to figure out what is the insult happening to the brain, and do something to counter that. It takes some experimentation and detective work. Nobody does that hardly. Easier just to get a script and hope for the best.
Posted by gadchik on December 17, 2013, at 7:30:38
In reply to Re: Info on Why SSRIS are Good for Anxiety/Mood, posted by bleauberry on December 17, 2013, at 4:58:26
If I were a betting man, I'd bet if u start low and go slow, give it time to work, do other things to help ur mental health(exercise, eat right, sleep), then an ssri can work for alot of people. No, not everyone, but I think drs start out wrong with these meds, too high dose, too quick to escalate...then people quit it before it has time to help.
Posted by gadchik on December 17, 2013, at 7:32:40
In reply to Re: Info on Why SSRIS are Good for Anxiety/Mood » gadchik, posted by Phillipa on December 16, 2013, at 20:24:46
P, I think some people have start up anxiety with ssris because they start at too high a dose. But the benzo alone can work, and has worked for me. Just some people have to keep escalating their dose for relief, so the benzo is not gonna be good long term for them
Posted by Phillipa on December 17, 2013, at 20:44:16
In reply to Re: Info on Why SSRIS are Good for Anxiety/Mood » Phillipa, posted by gadchik on December 17, 2013, at 7:32:40
43 years now of benzos and take less than when first began. So for me they work. Not everyone of course. P
Posted by gadchik on December 18, 2013, at 17:10:33
In reply to Re: Info on Why SSRIS are Good for Anxiety/Mood » gadchik, posted by Phillipa on December 17, 2013, at 20:44:16
Well, Ive gained weight since starting zoloft again for neck pain. I have increased appetite. I cant do this again(gained 30lbs)last time,sooo, Im dumping it...now I get to experience withdrawal. I can always depend on klonopin no matter what. Maybe I will try a higher dose and it will conquer this neck pain? I cant be happy or content when Im fat. Im happiest when Im strong, fit, and moving.
Posted by Phillipa on December 18, 2013, at 21:11:43
In reply to Re: Info on Why SSRIS are Good for Anxiety/Mood » Phillipa, posted by gadchik on December 18, 2013, at 17:10:33
Gachik I totally agree with you on this. Cutting the Lexapro down again and then will discontinue it. Yes the klonopin might help the neck pain. How bout a massage? P
Posted by gadchik on December 19, 2013, at 8:39:29
In reply to Re: Info on Why SSRIS are Good for Anxiety/Mood » gadchik, posted by Phillipa on December 18, 2013, at 21:11:43
I have had swedish massages only. They help for a few hrs, then it comes back. I may try a deep tissue massage. I ended up taking the zoloft last night because I cant deal with withdrawal over xmas. My hubby says its my age and eating causing the weight gain...but when not on zoloft, I eat properly. I did turn 50 though. My husband is a big fan of zoloft and has always thought I should get off the klonopin, everyone thinks benzos are evil. But I do well on it. He asked me what I was gonna do if neck pain comes back...that I didnt consider. I really hate the neck pain. Hate weight gain too.
Posted by Phillipa on December 19, 2013, at 8:51:49
In reply to Re: Info on Why SSRIS are Good for Anxiety/Mood » Phillipa, posted by gadchik on December 19, 2013, at 8:39:29
Gadchik neck pain isn't a good reason to take an SSRI unless one Is depressed. Are you depressed? Turning 50 could have thrown you for a loop mentally. I would see an ortho doc or a chiropractor for at least an x-ray. Who knows if you really didn't hurt something in your neck? P
Posted by gadchik on December 19, 2013, at 8:53:59
In reply to Re: Info on Why SSRIS are Good for Anxiety/Mood » gadchik, posted by Phillipa on December 18, 2013, at 21:11:43
Zoloft has stopped my neck pain. I dont know what to do. I tried increasing my klonopin last night to .75mg from .5mg, and I dont like it. I like my lower dose. I also dont like weight gain, I seem to have bad eating habits on z, and it may be slowing my metabolism. What to do?!
Posted by gadchik on December 19, 2013, at 10:56:19
In reply to Re: Info on Why SSRIS are Good for Anxiety/Mood » gadchik, posted by Phillipa on December 19, 2013, at 8:51:49
Ur right P. I hadn't thought of it that way! I need proper care & diagnosis of my neck pain. My ins kicks in 1/14! Thanks for opening my mind up!
Posted by Phillipa on December 19, 2013, at 19:59:05
In reply to Re: Info on Why SSRIS are Good for Anxiety/Mood » Phillipa, posted by gadchik on December 19, 2013, at 10:56:19
Gadchik I glad as think about if pain is the first med one reaches for an Ad or maybe even first an anti-inflammatory. Did you try motrin. Pretty sure you did. Did you sleep wrong? Twist wrong? P
Posted by baseball55 on December 19, 2013, at 20:06:44
In reply to Re: Info on Why SSRIS are Good for Anxiety/Mood » Phillipa, posted by gadchik on December 19, 2013, at 10:56:19
I think I've posted on this topic before, but, in case you never saw it, I'll post it again. Many years ago, I had horrible neck and shoulder pain. I went to a chiropractor who didn't help at all, though she was quite lovely. One morning, I woke up with my neck muscles in such spasm that my right ear was practically touching my shoulder and I couldn't move my neck.
I went to the chiropractor and she recommended I see a Feldenkreis practitioner. This is a kind of message therapy, but the point is not simply to massage, but to train you to become aware of tension in your muscles, so you can learn to relax them before they go into spasm. It was developed to help athletes avoid injuries and muscle spasms. I went to about nine session, an hour-and-a half each. I spent money I didn't have at the time.
I never spent money so wisely. I learned to control the muscles in my neck and shoulders, learned to recognize tension long before it became a problem, learned exercises and techniques to release the tension before it got worse. I have not had any pain in my neck or back or shoulders since then -- twenty years ago.
If your neck pain is mostly muscle pain (soft tissue) as opposed to disk or cervical spine problems, I strongly suggest looking into Felderkreis.
Posted by gadchik on December 20, 2013, at 8:33:43
In reply to Re: Info on Why SSRIS are Good for Anxiety/Mood, posted by baseball55 on December 19, 2013, at 20:06:44
Thanks, baseball, I will look into that, it feels like a pinched nerve, but I have spasms on and off on one side too. But when I started the zoloft, it all went away.
This is the end of the thread.
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