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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by ed_uk on February 11, 2006, at 11:57:45
'Antidepressants can elicit a response within two weeks and even within the first three days of treatment, contrary to the currently accepted timeframe of several weeks. This is the conclusion reached by the author of an editorial in the British Journal of Psychiatry, which examines available data (2006;188:105).'
Posted by pseudoname on February 11, 2006, at 13:52:30
In reply to Antidepressant time of onset, posted by ed_uk on February 11, 2006, at 11:57:45
Nice set of news items, Ed. Have you considered starting a psych-med blog? You'd be great!
> "...contrary to the currently accepted timeframe of several weeks..."
My last pdoc but one firmly dismissed my report that Wellbutrin had a huge, remarkable (and brief!) effect on my mood and cognition within 24 hours of starting it. There's no way it was normal fluctuation or placebo effect. But he insisted, poor dear, that early effects from the med were impossible.
I'm serious about that blog.
Posted by ed_uk on February 11, 2006, at 14:02:15
In reply to Ed should blog! » ed_uk, posted by pseudoname on February 11, 2006, at 13:52:30
Hi PN
>Have you considered starting a psych-med blog?
I haven't. What sort of things would I include?
>But he insisted, poor dear, that early effects from the med were impossible.
How ridiculous! Anyone who's taken ADs knows that they can affect you within an hour of taking the first dose, even if the effects are actually side effects - as is usually the case! The beneficial effects often take weeks to develop but not always. Some people seem to respond very quickly. This is usually dismissed by doctors as the placebo effect (seems like an unwise assumption to me). Who's to say that they can't work quickly? The drug permeates your brain and body right from the first dose.
Regards
Ed
Posted by pseudoname on February 11, 2006, at 14:38:58
In reply to Re: Ed should blog! » pseudoname, posted by ed_uk on February 11, 2006, at 14:02:15
> > Have you considered starting a psych-med blog?
>
> I haven't. What sort of things would I include?You could put stuff like these psych-med news items, with some of your excellent background info about the drugs or issues in question and some of your sensible commentary.
I suppose you could also talk about stuff that comes up here at Babble, too. And Ed's idle musings on medication issues.
Of course, it's nice to get that from you right here, but ... maybe you could get ad revenue (LOL! from Big Pharma, of course) with a blog...
I've seen a couple psych-related blogs, but they were from very narrow (anti- or just contrarian) viewpoints. I can't remember where they were.
Well, I'm just thinking out loud. But if you ever do a blog, I will totally hot-link it.
Posted by Phillipa on February 11, 2006, at 17:08:56
In reply to Re: Ed should blog! » ed_uk, posted by pseudoname on February 11, 2006, at 14:38:58
I'll second that!!!!And Ed which AD's work the fastest with the least amt of side effects? Love PJ O
Posted by ed_uk on February 11, 2006, at 17:36:26
In reply to Re: Ed should blog! » ed_uk, posted by pseudoname on February 11, 2006, at 14:38:58
Hi PN :)
>Ed's idle musings on medication issues
Yes, I would have to call it that :)
>I've seen a couple psych-related blogs, but they were from very narrow (anti- or just contrarian) viewpoints. I can't remember where they were.
People with balanced opinions of psych meds appear to be few and far between!
Regards
Ed
Posted by ed_uk on February 11, 2006, at 17:42:21
In reply to Re: Ed should blog!, posted by Phillipa on February 11, 2006, at 17:08:56
That's not an easy question to answer PJ!
Have you managed to get a prescription for diazepam since your tablets ran out?
Ed
Posted by Phillipa on February 11, 2006, at 19:01:32
In reply to Re: Ed should blog! » Phillipa, posted by ed_uk on February 11, 2006, at 17:42:21
Ed Yes I did. Now the question is do I go higher on luvox or switch to something like liquid prozac in low dose? The pdoc will never up the dose of valium. And I've lowered it to l0mg since I think my anxiety has turned more into depression. Sorry I missed you on MSN I was writing an E-mail and you disappeared. Love PJ O
Posted by yxibow on February 11, 2006, at 20:21:19
In reply to Antidepressant time of onset, posted by ed_uk on February 11, 2006, at 11:57:45
> 'Antidepressants can elicit a response within two weeks and even within the first three days of treatment, contrary to the currently accepted timeframe of several weeks. This is the conclusion reached by the author of an editorial in the British Journal of Psychiatry, which examines available data (2006;188:105).'
Editorials are like case reports, they are scientifically valid, but they dont examine thousands of patients.
My experience is that the fastest "antidepressant" is Zyprexa, which is an antipsychotic. I found a lift within several days.
But things like SSRIs don't usually start to show a sign for about two weeks I would say from my experience. These things are so individual. Full onset is usually about 6-12 weeks.
My Cymbalta gradually simmered around for up to two months and suddenly I had an epiphany when it was raised to 80 mgs, it was a one time wonder day but I swore it was the Cymbalta. I now take 90 mgs.
Remeron I think is the fastest acting antidepressant, it unfortunately carries a serious weight gain potential that has to have a restriced calorie diet. I started feeling effects quite early on. Its fairly "clean" in terms of neurotransmitters as well.
Just my 2c
tidings and cheers
Jay
Posted by James K on February 11, 2006, at 21:57:54
In reply to Antidepressant time of onset, posted by ed_uk on February 11, 2006, at 11:57:45
Way back when in 92 or so, when I took my first psych med, Prozac, I felt it within hours - as a high - which to my mind would have worked as an anti-depressant.
Unfortunately by a few months later, reality had overridden anything positive achieved by changing my brain chemistry.
James K
Posted by Sabrina_0805 on February 12, 2006, at 1:41:42
In reply to Re: Antidepressant time of onset » ed_uk, posted by James K on February 11, 2006, at 21:57:54
I never experienced anything other than instant and severe side effects to every drug I was on. My depression seemed to excerbate and distort after a few weeks. Stopping all medication is the only thing that has kept me sane though not taken away my depression.
I hope I am one of few who experience this as I really do believe in the value of AD's
Sabrina
Posted by ed_uk on February 12, 2006, at 5:03:26
In reply to Re: Antidepressant time of onset » ed_uk, posted by yxibow on February 11, 2006, at 20:21:19
>Editorials are like case reports, they are scientifically valid, but they dont examine thousands of patients.
That's true Yxi.
SSRIs have always taken ages to work for me.
Ed x
Posted by blueberry on February 12, 2006, at 6:38:30
In reply to Antidepressant time of onset, posted by ed_uk on February 11, 2006, at 11:57:45
I think in clinical studies there are indeed patients who respond in 1 to 3 days, some within 2 weeks, some not until 6 weeks. But the studies don't break down the results that way, so it is not apparent that these things happened.
Just a theory, but maybe depression can be caused by a variety of factors. In one person it might be hypo-serotonin. In another, hypo-norepinephrine, or another hypo-dopamine. Roughly speaking. Much more complicated I'm sure. The hypo-serotonin patient will probably feel relief very fast on an ssri since it is targeting the problem directly, whereas the hypo-norepinephrine patient may not respond for weeks as the ssri takes time to cause all kinds of cascade effects that in some ways help the problem eventually but never really get to it exactly.
Not sure we'll ever know why it happens, but I know some people do experience rapid relief while others don't.
Posted by crxsi on February 13, 2006, at 9:45:40
In reply to Re: Antidepressant time of onset, posted by blueberry on February 12, 2006, at 6:38:30
I felt better the first day of taking effexor even though I had mild side effects such as nausea. When I look back I think it was probably because it caused a high for the first four days which did not take long to go away. I was taking it for mild depression and severe anxiety. It definetly made me forget about my anxiety for the first couple of days.
My anxiety has re surfaced after two months but I am only on a low dose 75mg which I hear does not have much dopamine effect. Is this true?
Posted by Tony P on February 13, 2006, at 19:52:03
In reply to Re: Antidepressant time of onset, posted by crxsi on February 13, 2006, at 9:45:40
> I felt better the first day of taking effexor ...
I felt Effexor kick in within 4-5 days at 37.5 or 75 mg/day. Unfortunately, for me it caused too much anxiety to tolerate. Due to circumstances I couldn't take the time off to escalate the dose and see if better effects kicked in or the anxiety decreased. I may try it again if I hit another bad depressive episode and don't have time constraints. Happily, I got a really good bounce-back effect when I stopped taking it!
Wellbutrin similarly worked very quickly for me (week to 10 days) but also cause too much anxiety & insomnia - I seem to be hypersensitive to NE boosters.
Serzone also worked quickly - fixed my sleep disorder literally overnight, and a gradually increasing mood improvement over about 10 days. Alas, no longer available in Canada. It was the only med I have ever taken which really helped my sleep long-term and relieved my depression without significant side-effects.
> ... I am only on a low dose 75mg which I hear does not have much dopamine effect....
I am starting to think that dopamine is the unsung hero (or poor sister) of A/D therapy. It's talked about here but has such a bad rep elsewhere that I wonder how Wellbutrin managed to survive FDA attention! I suspect that SSRI's work in the long term for those for whom they DO work by some kind of indirect dopamine upreg, and vice versa for those for whom they don't work or poop out.
I read recently that caffeine boosts dopamine; I've been finding lately that two cups of good coffee does more for my immediate mood and my activity level than any Rx I've been on lately. ;-) And it works in under an hour! Can't ask for faster response than that. But if caffeine were discovered today would the FDA approve it?
Posted by 4WD on February 14, 2006, at 12:35:09
In reply to Re: Ed should blog! » pseudoname, posted by ed_uk on February 11, 2006, at 14:02:15
> Hi PN
>
> >Have you considered starting a psych-med blog?
>
> I haven't. What sort of things would I include?
>
> >But he insisted, poor dear, that early effects from the med were impossible.
>
> How ridiculous! Anyone who's taken ADs knows that they can affect you within an hour of taking the first dose, even if the effects are actually side effects - as is usually the case! The beneficial effects often take weeks to develop but not always. Some people seem to respond very quickly. This is usually dismissed by doctors as the placebo effect (seems like an unwise assumption to me). Who's to say that they can't work quickly? The drug permeates your brain and body right from the first dose.
>
> Regards
>
> Ed
It's funny, then that you'd have a positive placebo effect from one drug and a negative one from another drug. Doctors can be such as****.Marsha
This is the end of the thread.
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