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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 Geezer on December 19, 2001, at 16:00:53
I am ignorant about neurochemistry but would like to ask a question please. It would seem a large number of people suffer "withdrawal" symptoms when discontinuing antidepressant drugs and the worst offenders (based on what I read) seem to be Effexor and Paxil. Is it likely the withdrawal problems are related to norep. rather than seritonin ? I have discontinued Celexa and Zoloft by substituting Prozac for a few days then just stopping Prozac-NO withdrawal. I have never taken Effexor or Paxil (have only done a little reading on the effects of both drugs to Norep.). Also have you received any info. on a "black box" warning from the FDA RE: Paxil-something to do with the liver ? In the 80s I detoxed from prolonged and SEVER Benzo. abuse, then a year later from SEVER Amphetamine abuse. All considered, it's a wonder I can think at all! All these problems were of my own doing NOT the fault of any doctor or any drug. If this question does not appear on the board or fails to receive a response I will understand - do not want to hinder anyone's treatment. Thank you and Happy Holiday.
Posted by Cam W. on December 20, 2001, at 1:05:42
In reply to Question For CAM About SSRI Withdrawal, posted by Geezer on December 19, 2001, at 16:00:53
Geezer - The withdrawl from both Paxil™ (paroxetine) and Effexor (venlafaxine) is caused by taking away the extra serotonin in the gap between nerves cells (synaptic cleft or synaptic gap) that these drugs cause by blocking the reuptake of serotonin back into the nerve cell that it was released from (the presynaptic neuron).
The postsynaptic neuronal membrane (the receiving nerve cell) has serotonin receptors in it to carry on the electrical impulse that is being transferred from the presynaptic neuron. The sudden decrease in the availability of serotonin to bind to these receptors causes the withdrawl symptoms.
If the amount serotonin is slowly decreased, as by a slow decreasing of dose over time (eg. lowering the dose by half every week or so), or using an SSRI with a long half-life (eg. Prozac™ - fluoxetine - which leaves the body much more slowly than Paxil or Effexor), the body has time to adjust to the decrease in serotonin. The body can either start producing more serotonin on it's own (which is what we are trying to do by taking antdepressants in the first place) or increase (or even decrease, depending upon the situation and genetics of the individual) the number of postsynaptic serotonin receptors.
Of course, the reality of this situation is not as simple as described above. One must also take into account what the decrease in serotonin does to other neurotransmitter, hormonal, etc. systems of the body (including those that involve norepinephrine).
The withdrawl symptoms, though, are what one would expect (for the most part) to happen when serotonin levels are lowered,
I hope that this rambling gives you an answer. - Cam
Posted by Geezer on December 20, 2001, at 10:10:58
In reply to Re: Question For CAM About SSRI Withdrawal, posted by Cam W. on December 20, 2001, at 1:05:42
Cam,
Thanks so much for answering my question; a lot of us turn to you in hard times because we have respect for your honesty, we know your information is correct (but not intended to direct treatment) and most important you are one of us. It's a great comfort to have a frofessional on the "consumer' side of the issue , yet I am very sorry you have to suffer this illness.
Happy Holidays
Geezer
This is the end of the thread.
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