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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by matthhhh on August 19, 2003, at 16:03:57
Ive heard that ssri's and med drugs may cause toxicity and damage the serotonin system. Following is some info i found. Does anyone agree with this?
Dr. Cheney recently came across some information regarding the dangers of Selective Serotonin Reuptake Inhibitors (SSRIÌs), such as Prozac, Zoloft and Paxil, and stimulants like Ritalin and Provigil. During office visits, Dr. Cheney shows patients the book Prozac Backlash: Overcoming the Dangers of Prozac, Zoloft, Paxil and Other Antidepressants by Joseph Glenmullen, M.D., a psychiatrist at Harvard Medical School. It includes endorsements from other Ivy League psychiatrists. Cheney calls the implications of this book "staggering".When talking with patients, Cheney usually opens the book to a picture of a monkey's brain before and after it received a very potent SSRI. The "before" photo shows a dark background filled with fine white lines and white blobs, healthy neurons. The "after" photo is very dark, only a few white lines and blobs remain. Most of the brain cells had been "fried".
SSRIs and stimulants work by increasing the firing of neurons. While this often has great benefits in the short term, doctors are now realizing that long term use "fries" brain cells. The body views any neuron that fires excessively over time as damaged, and destroys it.
SSRIs and stimulants, taken over a period of 10 years or so, can lead to a loss of brain cells, causing neurodegenerative disorders. Many doctors have recently seen a sudden increase in patients with neurological symptoms, and most have been on Prozac, or a similar drug, for about 10 years. Cheney is seeing this in his own practice.
During office visits, Cheney also shows patients a copy of the May 22, 2000 issue of Newsweek with Michael J. Fox on the cover. It has an excellent article on Parkinson's Disease, a condition that involves a loss of neurons in the area associated with motor control. Parkinson's drugs stimulate the remaining neurons to "perform heroically", firing excessively. However, the article notes that while benefits are seen initially, neurological symptoms get much worse at the three to five-year point. Patients experience wild involuntary movements, etc. These drugs, though helpful in the short term, actually speed up the degenerative process.
What mechanisms are at work causing neurons to be "fried"? SSRIs are often prescribed for depression, which involves a lack of serotonin. Serotonin is a neurotransmitter, a chemical messenger. One neuron releases a burst of it into the intersynaptic cleft, (the gap between neurons). The serotonin is then taken up by special receptors in the adjacent neuron. Thus a message is sent from one neuron to another, with serotonin carrying the message across the gap. Excess serotonin is cleared away before a new message is sent. A "reuptake channel" in one neuron vacuums up the left over serotonin.
SSRIs are designed to address a lack of serotonin by blocking the reuptake channel from vacuuming up excess serotonin. While this allows more serotonin to connect with the receptors, often too much is left floating in the intersynaptic cleft. The only way the body can get rid of this excess serotonin is to oxidize it. Unfortunately, this turns it into a toxic compound that, over time, kills both the sending and receiving neurons. Cheney stated, "What starts out as an attempt to increase serotonin and reduce symptoms ends up with the destruction of the serotonergic system itself. It takes about a decade, more in some, less in others.
Now when the serotonergic nerves are dead, you start getting these motor neuron problems, which is what we're seeing." Cheney commented, "You know what a lot of doctors (who do not understand CFIDS) are doing? They're saying 'Well, let's just give them an antidepressant'. And they are frying their (patients') brains and they don't even know it. In fact, a CFIDS patient on one of these drugs fries their brain even faster than a non-CFIDS person." (See the article on Klonopin for an explanation.)
Cheney went on to say, "The other way some people with CFIDS are going is stimulating the brain, using drugs like Ritalin or Provigil. They do the same thing - they fry the brain. They cause neurons to fire at lower stimulus by lowering the firing threshold. All stimulants are dangerous, especially over the long haul. I'm not saying that you might not find them useful in the short-term. But over the long term, the physiology demands that neurons that fire excessively be killed."
Cheney strongly urges anyone taking antidepressants or stimulants to read Glenmullen's book. It lists safe alternatives to SSRIs.
Posted by Bill L on August 19, 2003, at 16:28:15
In reply to SSRI TOXICITY- please read!, posted by matthhhh on August 19, 2003, at 16:03:57
I have not heard of any evidence of those problems. There have been images of brains displayed in recent publications such as Newsweek magazine. But those images show a more healthy looking brain in depressed people who have been on SSRI's than in depressed people who have not taken SSRI's. So that seems to contradict what Dr. Cheney is saying.
Right now, it seems that the evidence is that SSRI's help the brain. But if that ever changes, the docs and lawyers will let us know. Lawyers will make money on lawsuits against drug companies. And docs can make a lot more on psychotherapy than on people who take antidepressants.
For the present time, I am not worried about it. Depression is an awful disease. And there are always people who will scare us so that they can make money on publishing a book.
Posted by Larry Hoover on August 19, 2003, at 20:29:34
In reply to SSRI TOXICITY- please read!, posted by matthhhh on August 19, 2003, at 16:03:57
> When talking with patients, Cheney usually opens the book to a picture of a monkey's brain before and after it received a very potent SSRI. The "before" photo shows a dark background filled with fine white lines and white blobs, healthy neurons. The "after" photo is very dark, only a few white lines and blobs remain. Most of the brain cells had been "fried".
What Cheney and Glenmullen fail to include along with this hyperbole is the information that the monkeys had received simply staggering overdoses of SSRI medication. This is nothing more than fear-mongering, and frankly, takes away from any arguments these doctors may more reasonably have made about the risks of this class of meds.
You cannot infer that normal therapeutic doses of a med will have effects similar to, or even related to, the effects of toxic overdoses. Drink six to eight glasses of water a day, and you're fine. Drink six to eight gallons of water, and your brain will swell until all its cells rupture, and you die. You cannot interpolate the effects of six to eight glasses of water from the observed effect of the overdose. They are totally unrelated.
Lar
Posted by cubbybear on August 19, 2003, at 22:11:26
In reply to Re: SSRI TOXICITY- major deception!!!!! » matthhhh, posted by Larry Hoover on August 19, 2003, at 20:29:34
I read Glenmullen's book after I quit taking Zoloft. I found much of it particularly alarming (whether intended or not)--paticularly the anecdotes or stories about patients who experienced withdrawal symptoms while trying to STOP taking some of these meds (particularly Paxil and Effexor). Yet, I couldn't help but be skeptical about Glenmullen's insistence on conquering depression through psychoanalysis; when you're suffering from this horrible disease, relief must be obtained as fast as possible, and that could never happen with psychoanalysis alone. Not only that, Glenmullen makes no mention of MAOI type anti-depressants whatsoever, which have been around for decades. These can work wonders for many depressed people and I've yet to hear about adverse effects in people who have taken them for long periods. When I sent a comment to Glenmullen's website about his omission of MAOIs from the book, I received no reply. Not very nice.
Posted by Shawn. T. on August 19, 2003, at 22:38:01
In reply to SSRI TOXICITY- please read!, posted by matthhhh on August 19, 2003, at 16:03:57
I once believed that SSRI neurotoxicity might be possible, but after thoroughly researching the matter, there is no evidence to support the claim. If there was any available, I would certainly be aware of it.
Shawn
Posted by pianolady on August 20, 2003, at 18:48:25
In reply to Re: SSRI TOXICITY- please read!, posted by Shawn. T. on August 19, 2003, at 22:38:01
I cannot answer all of your questions on the subject, but I do know a little about the subject you are questioning. I just finished taking a graduate class in psychopharmacology and we discussed neurotoxicity. The truth is that in theory neurotoxicity COULD occur with any psychotropic (psychiatric) drug. But the reality is that the likelihood on antidepressants is extremely slim. The early antipsychotics and drugs of that nature might have a slightly higher likelihood, but all of the therapeutic drugs must have extensive testing to show that the drugs are safe.
Now, don't get me wrong, taking prescribed drugs is always at least a little risky because all drugs have side effects, etc. But I don't think neurotoxicity should be a factor in a decision of whether to use the typical antidepressant drugs or not.
Rather, you might want to look at the neurotoxicity of alcohol, nicotine, or street drugs. Many of these drugs do have a considerably lower threshold for neurotoxicity than most prescribed drugs. In fact, alcohol is a reasonably strong neurotoxin. I say all of this to put things in perspective. Yes, there is some negligible risk in neverland of neurotoxicity with an antidepressant, but it would be of far greater importance to look at drugs that are known to be neurotoxic, rather than a highly unlikely med like antidepressants.
I hope you find that this sorts out some of the subject matter for you. Also, I would encourage you to do some research for yourself beyond the single article that you found. Find articles on both sides of the issue and then make an informed decision about what makes the most sense and seems to be most scientifically sound. (But don't let lots of scientific words equal a scientifically sound proof unless you understand the scientific background).
Good luck in your quest.
Posted by McPac on August 21, 2003, at 0:11:59
In reply to SSRI TOXICITY- please read!, posted by matthhhh on August 19, 2003, at 16:03:57
"Cheney usually opens the book to a picture of a monkey's brain before and after it received a very potent SSRI".
>>>>>>>>>>>>> Actually I think Cheney's been showing pictures of Glenmullen's brain
This is the end of the thread.
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