![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 201 to 225 of 297. Go back in thread:
Posted by tizza on March 4, 2006, at 1:34:51
In reply to Re: The Truth Do SSRI's and SSNRI's Work For Anyon » tizza, posted by yxibow on March 4, 2006, at 0:54:25
Thanks for the post Jay, I really appreciated it, I'm just pissed off that I was rx'ed zyprexa and seroquel for depression, GAD, etc when it was totally unnescessary. I just don't understand so much about me and I'm so sick and tired of being prescribed numbing medication to just shut me up. Thanks again Paul. I hope you are doing well. I'm a bit freaky at the moment again which is disturbing me but I've go a bit of sh*t going down at the moment and I'm sure it will resolve itself soon.
Posted by cecilia on March 4, 2006, at 2:36:56
In reply to Re:Is advertising Meds allowed in the US? » wildcard11, posted by Chairman_MAO on March 3, 2006, at 9:25:09
You'll never see an ad for a traditional MAOI because they're old and off patent. Once the patent expires, so do the ads, unless the drug companies can figure out a way to tweak it a little to make it seem like a new drug. I bet we'll see plenty of ads for the Emsam patch! Cecilia
Posted by cecilia on March 4, 2006, at 3:01:21
In reply to The Truth Do SSRI's and SSNRI's Work For Anyone?, posted by Phillipa on February 27, 2006, at 13:12:49
Someday hopefully we'll have genetic research that will tell us what will work for whom. But I'm suspicious that even so a lot of people will still not get properly treated because drug companies aren't going to waste their money on a drug that works on only a tiny fraction of the population with a certain genetic makeup,( even if they can get it approved.) I read a book many years ago about a young woman with schizophrenia who failed trials of all the AP drugs available at the time. She went into a clinical trial on kidney dialysis for schizophenia. Overall, it worked no better than placebo,so the trial was discontinued. But for her it worked dramatically, she went on to become a pdoc, and at least at the time the book was written had had no more symptoms. There are probably lots of drugs potentially out there that would work the same way-dramatic results for a tiny percentage of the population but never approvable because overall they're no better than placebo. There may be hundreds of different types of depression, but researchers see them as all the same. It' ridiculous-nobody thinks all cancers should be treated exactly the same way. Cecilia
Posted by linkadge on March 4, 2006, at 9:27:34
In reply to Re: oh » linkadge, posted by Chairman_MAO on March 3, 2006, at 22:01:43
Mice know the difference between real drug and saline. They will lever administer crack without sleep or food till they die. I don't think they'd do the same with saline.
Linkadge
Posted by linkadge on March 4, 2006, at 9:33:33
In reply to SSRIs et alia, Brain Chemistry and a moving target » linkadge, posted by yxibow on March 4, 2006, at 0:38:25
"They work for what they are intended for -- relief from depression and anxiety with the informed consent and predisposed knowledge that they, just like any other antidepressant or anxiolytic, could eventually not work at some point."
Well for some people they do this. Do opiates work for scurvey ? I suppose they might "work" under a loose definition. Although, I'd really like to do better than opiates. Vitamin C would be nice. But I suppose we havn't discovered that.
Linkadge
Posted by linkadge on March 4, 2006, at 9:37:25
In reply to Re: 150mg » linkadge, posted by tizza on March 4, 2006, at 1:10:49
I'm not saying that I don't believe wildcard, I would just need to be there in the room in the insuing days to monitor behavior for myself untill I was able to believe that dropping the drug cold turkey did nothing at all. Thats just skeptical me.
Linkadge
Posted by ed_uk on March 4, 2006, at 13:06:52
In reply to Re: Yes » ed_uk, posted by zeugma on March 3, 2006, at 18:07:08
Hi Z :)
>When people wothdraw from an SSRI the serotonin system is depleted, and they enter REM prematurely, experiencing those 'zap' sensations from cholinergic hypersensitivity, which results from the sudden aminergic weakness.
Some people take diphenhydramine (Benadryl), an antihistamine and anticholinergic, to reduce the symptoms of SSRI withdrawal. I imagine the anticholinergic effect reduces the withdrawal symptoms and the antihistamine effect reduces any insomnia which may be present.
Warm regards
Ed
Posted by ed_uk on March 4, 2006, at 13:09:38
In reply to Re: 150mg » ed_uk, posted by linkadge on March 3, 2006, at 21:17:04
Hi Link,
>How long was it though, until you went on a new medication ??
I think it was about 2 weeks. The withdrawal symptoms were pretty much over by then though. The next AD I took was moclobemide. I didn't have any withdrawal symptoms when I stopped moclobemide, I don't think it was really doing anything!
Ed
Posted by linkadge on March 4, 2006, at 14:41:24
In reply to Re: 150mg » linkadge, posted by ed_uk on March 4, 2006, at 13:09:38
Never knew you took moclobemide.
Linkadge
Posted by Phillipa on March 4, 2006, at 16:50:52
In reply to NASA's , SSRI, SNRI, etc., posted by musky on March 3, 2006, at 23:59:34
Serotonin can't be messured by a blood test. At least the serotonin in your brain. You can test for some TCA's but no blocd test of SSRI ,SNRI. If there were they would know how much and which drug to give you. Correct me if I'm wrong. Fondly, Phillipa
Posted by Phillipa on March 4, 2006, at 17:04:49
In reply to Re: 150mg » tizza, posted by linkadge on March 4, 2006, at 9:37:25
I personally know wildcard and it is true she stopped the med without withdrawal. Her life circumstances changed dramitically hence her depression disappeared. Hence no more need for the effexor. Right now there is a picture of her on the social board in her pregnant state and I've never seen her look so happy. Fondly, Phillipa
Posted by yxibow on March 4, 2006, at 17:23:02
In reply to Re: NASA's , SSRI, SNRI, etc. » musky, posted by Phillipa on March 4, 2006, at 16:50:52
> Serotonin can't be messured by a blood test. At least the serotonin in your brain. You can test for some TCA's but no blocd test of SSRI ,SNRI. If there were they would know how much and which drug to give you. Correct me if I'm wrong. Fondly, Phillipa
There is a test for serotonin serum levels. You may be right that it doesn't allow for blood-brain level testing, although of course more than 90% of the serotonin receptors are -not- in your brain, they are in your gut.http://www.nlm.nih.gov/medlineplus/ency/article/003562.htm
Posted by yxibow on March 4, 2006, at 17:28:40
In reply to Re: SSRIs et alia, Brain Chemistry and a moving target, posted by linkadge on March 4, 2006, at 9:33:33
> "They work for what they are intended for -- relief from depression and anxiety with the informed consent and predisposed knowledge that they, just like any other antidepressant or anxiolytic, could eventually not work at some point."
>
> Well for some people they do this. Do opiates work for scurvey ? I suppose they might "work" under a loose definition. Although, I'd really like to do better than opiates. Vitamin C would be nice. But I suppose we havn't discovered that.You're correct -- I think with due respect you may have missed the issue or I may have not described the above sentence in the right language -- it is for some people. Not everyone.
Opiates for scurvey? I dont know whether to laugh or stare at the ceiling.
There seems to be a spectrum of arguments about opiates -- one also has to remember for a section of the population, opiates, or certain forms of morphine related drugs, do not work at all. Genetically. In fact, they may make an individual sick. So again, there's no one step tailored drug. And I think most people would or should recognize that on here, with this lively debate.
Cheers
Jay
Posted by ed_uk on March 4, 2006, at 17:54:43
In reply to Re: 150mg, posted by linkadge on March 4, 2006, at 14:41:24
Hi Link
I took moclobemide for a couple of months about 3 years ago. It didn't really do anything.
Ed
Posted by Phillipa on March 4, 2006, at 18:46:13
In reply to Re: NASA's , SSRI, SNRI, etc. » Phillipa, posted by yxibow on March 4, 2006, at 17:23:02
Stupid question from stupid me but if they are in your gut how do they affect you brain and depression remember I can be an imbacile. Love Phillipa
Posted by Larry Hoover on March 4, 2006, at 19:20:21
In reply to Re: NASA's , SSRI, SNRI, etc. » Phillipa, posted by yxibow on March 4, 2006, at 17:23:02
> > Serotonin can't be messured by a blood test. At least the serotonin in your brain. You can test for some TCA's but no blocd test of SSRI ,SNRI. If there were they would know how much and which drug to give you. Correct me if I'm wrong. Fondly, Phillipa
>
>
> There is a test for serotonin serum levels. You may be right that it doesn't allow for blood-brain level testing, although of course more than 90% of the serotonin receptors are -not- in your brain, they are in your gut.
>
> http://www.nlm.nih.gov/medlineplus/ency/article/003562.htmThere has never been any evidence that correlates serum serotonin levels, or urine serotonin metabolite levels for that matter, with affective states or mood disorders. The blood test you linked to is part of the screening panel for carcinoid syndrome, the results of a fairly rare cancer which secretes hormones. In effect, that person would develop the various symptoms of serotonin syndrome, plus some others occurring because of regulatory changes over time.
You can test for anything in blood or urine. But there is no meaning you can attribute between blood/serum neurotransmitter levels, and any psychiatric condition (excluding rare bizarre stuff). If there was any utility to such testing, it would be routine. Doctors love simple blood work, and determining treatment from a graph or chart. _If only_ psych treatment was so simple and robustly founded.
Lar
Posted by tizza on March 4, 2006, at 21:17:19
In reply to Re: 150mg » linkadge, posted by ed_uk on March 4, 2006, at 13:09:38
> Hi Link,
>
> >How long was it though, until you went on a new medication ??
>
> I think it was about 2 weeks. The withdrawal symptoms were pretty much over by then though. The next AD I took was moclobemide. I didn't have any withdrawal symptoms when I stopped moclobemide, I don't think it was really doing anything!
>
> Edmoclobemide was the first AD I ever took about 12 years ago and it did sweet f*ck all so they gave me xanax to agument it and next thing I knew I had a serious xanax addiction. Short acting benzo's are terrilbe for me so now it's Valium
Posted by yxibow on March 5, 2006, at 4:14:33
In reply to Re: NASA's , SSRI, SNRI, etc. » yxibow, posted by Larry Hoover on March 4, 2006, at 19:20:21
> > > Serotonin can't be messured by a blood test. At least the serotonin in your brain. You can test for some TCA's but no blocd test of SSRI ,SNRI. If there were they would know how much and which drug to give you. Correct me if I'm wrong. Fondly, Phillipa
> >
> >
> > There is a test for serotonin serum levels. You may be right that it doesn't allow for blood-brain level testing, although of course more than 90% of the serotonin receptors are -not- in your brain, they are in your gut.
> >
> > http://www.nlm.nih.gov/medlineplus/ency/article/003562.htm
>
> There has never been any evidence that correlates serum serotonin levels, or urine serotonin metabolite levels for that matter, with affective states or mood disorders. The blood test you linked to is part of the screening panel for carcinoid syndrome, the results of a fairly rare cancer which secretes hormones. In effect, that person would develop the various symptoms of serotonin syndrome, plus some others occurring because of regulatory changes over time.
>
> You can test for anything in blood or urine. But there is no meaning you can attribute between blood/serum neurotransmitter levels, and any psychiatric condition (excluding rare bizarre stuff). If there was any utility to such testing, it would be routine. Doctors love simple blood work, and determining treatment from a graph or chart. _If only_ psych treatment was so simple and robustly founded.
>
> Lar
Oh -- I thought I made it clear that the test was not for corellation with neurotransmitter levels -- at least not those in the brain. Its used for testing carcinoid syndrome. You're right -- if only we could. But the 21st century holds promise if we avoid the reality distortion field of this current presidential administration, of genetic tailoring of a lot of things. We could go so far by 2050 considering the progress we have made just in the past 2 decades. But it may be countries like China and India, and possibly Great Britain that will overtake us unless we allow stem cell research and other such things. But that's just my political spin.
Posted by yxibow on March 5, 2006, at 4:25:01
In reply to Re: NASA's , SSRI, SNRI, etc. » yxibow, posted by Phillipa on March 4, 2006, at 18:46:13
> Stupid question from stupid me but if they are in your gut how do they affect you brain and depression remember I can be an imbacile. Love Phillipa
Remember the old phrase "gut instinct" ? For whatever reason, and I can only place this if one believes in evolution, genetics somehow could not fit much of the serotonin receptors in an average sized brain. So they ended up in the gut, a great percentage of them. Especially 5HT3, responsible for nausea and vomiting and the like. Ginger is a weak 5HT3 inhibitor, the older Tigan and the new 5HT3 blockers ondansetron and granisetron (and tropisetron outside of the US) are heavy 5HT3 blockers. Its the reason why earlier "unclean" SSRIs initially affect people in the stomach largely until they become accustomed to the nausea. Perhaps it was an early defense system -- your gut is a pretty powerful feeling. Serotonin itself cannot pass the blood brain barrier and largely circulates in your blood stream. Its precursor components such as 5HTP can though.
Posted by SLS on March 5, 2006, at 6:44:59
In reply to Re: NASA's , SSRI, SNRI, etc. » Larry Hoover, posted by yxibow on March 5, 2006, at 4:14:33
> > > > Serotonin can't be messured by a blood test. At least the serotonin in your brain.
> > There has never been any evidence that correlates serum serotonin levels, or urine serotonin metabolite levels for that matter, with affective states or mood disorders.
CSF might be a better source of chemical markers.
If it is found that the etiologies of some mental illnesses are to be found in abnormal gene expression, perhaps microarrays will be helpful in diagnosing and determining treatment. We really aren't all that far from that now. (I guess it's all relative. It is still too far away to suit me).
- Scott
Posted by Larry Hoover on March 5, 2006, at 9:42:50
In reply to Re: NASA's , SSRI, SNRI, etc. » Larry Hoover, posted by yxibow on March 5, 2006, at 4:14:33
> > You can test for anything in blood or urine. But there is no meaning you can attribute between blood/serum neurotransmitter levels, and any psychiatric condition (excluding rare bizarre stuff).
> Oh -- I thought I made it clear that the test was not for corellation with neurotransmitter levels -- at least not those in the brain.
Actually, I'm the one who should apologize. I'm sorry, I didn't mean to centre you out. I just really wanted to emphasize that the only benefit from blood serotonin testing accrues to the laboratory doing the test (and maybe the doctor who ordered it). The patient simply wastes money.
Lar
Posted by Larry Hoover on March 5, 2006, at 9:47:01
In reply to Re: NASA's , SSRI, SNRI, etc., posted by SLS on March 5, 2006, at 6:44:59
> CSF might be a better source of chemical markers.
Keyword "might". I only wish cerebro-spinal fluid was more accessible. The risks attaching to lumbar puncture are far too great to be adopted as part of routine practise. Unless some real evidence is available that way.
> If it is found that the etiologies of some mental illnesses are to be found in abnormal gene expression, perhaps microarrays will be helpful in diagnosing and determining treatment. We really aren't all that far from that now. (I guess it's all relative. It is still too far away to suit me).
>
>
> - ScottIf it's genetic, though, blood suits as a test medium. Saliva, even. Those genes, they be everywhere.
Lar
Posted by SLS on March 5, 2006, at 10:23:47
In reply to Re: NASA's , SSRI, SNRI, etc. » SLS, posted by Larry Hoover on March 5, 2006, at 9:47:01
Hi Larry.
Nice to see your smiling face.
:-)
> > CSF might be a better source of chemical markers.
> Keyword "might". I only wish cerebro-spinal fluid was more accessible. The risks attaching to lumbar puncture are far too great to be adopted as part of routine practise. Unless some real evidence is available that way.
LPs ain't much fun (unless they're made of vinyl). I had a handful performed on me when I was a research patient at the NIMH. You are right. I don't see any putative markers yet identified in CSF to act as a practicable test for anything relating to the diagnosis and treatment of affective disorders. There are some associations between low MHPG and the effectiveness of NE reuptake inhibitors (TCAs), but not much else when last I looked, and I don't know what the coefficient of correlation was. Actually, I think low urine MHPG might be just as reliable (or unreliable) a marker.
> > If it is found that the etiologies of some mental illnesses are to be found in abnormal gene expression, perhaps microarrays will be helpful in diagnosing and determining treatment. We really aren't all that far from that now. (I guess it's all relative. It is still too far away to suit me).
> If it's genetic, though, blood suits as a test medium. Saliva, even. Those genes, they be everywhere.Yes. However, it might be necessary to assay gene activity in a site-specific manner, which would mean taking samples of brain tissue. A gene can be turned on in one cell but not in another. In addition, the proteins expressed by changes in gene activity might never appear extracellularly. I really don't know enough about this stuff to speculate any further regarding the need to sample specific tissues to assay gene activity.
Maybe I'm way off...
- Scott
Posted by sdb on March 5, 2006, at 12:15:01
In reply to Re: NASA's , SSRI, SNRI, etc. » SLS, posted by Larry Hoover on March 5, 2006, at 9:47:01
>>had a 55 percent higher risk of dying than >>those not taking antidepressants
quite a lot
>>There was also no indication whether the >>depressed patients had benefited at all from >>taking antidepressants, Goldberg said.
are the ssris effective?
http://www.memorialhermann.org/healthnews/healthday/060304HD531382.htm
Posted by SLS on March 5, 2006, at 12:29:09
In reply to Re: NASA's , SSRI, SNRI, etc., posted by sdb on March 5, 2006, at 12:15:01
Hi.
I don't understand what you posted here.
What was the opinion or purported fact that you wished to convey?
- Scott
-------------------------------------------
> >>had a 55 percent higher risk of dying than >>those not taking antidepressants
>
> quite a lot
>
> >>There was also no indication whether the >>depressed patients had benefited at all from >>taking antidepressants, Goldberg said.
>
> are the ssris effective?
>
> http://www.memorialhermann.org/healthnews/healthday/060304HD531382.htm
Go forward in 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.