Posted by linkadge on December 15, 2005, at 19:01:44
In reply to Re: Dr. Tracy on SSRIs.. » linkadge, posted by Larry Hoover on December 15, 2005, at 0:21:20
>I read it. There was no evidence presented that >the pre-synaptic neuron would release identical >amounts of serotonin under both transporter >conditions, nor any evidence presented that COMT >or MAO-A concentrations were the same.
But the point is that the level of the protein is reduced. If our theory of depression is that the *5-ht* reuptake mechanism is too active in depression, then this is information to suggest against it. Of course there could be compensatory changes in MAO-A, but this could also happen in patents treated with SSRI's.
>There is no evidence to reach that conclusion. >It is a conceivable hypothesis, but it has never >been tested.Scientists like to study one gene at a time. It makes sence to see if the 5-ht transporter is associated with depression or not. It's just like if you found low acetylcholinsterase in Alzeimer's disease, then it might make one rethink the model.
>The only easily tested hypothesis which arises >from this heterogeneity of SERT promoter regions >is to determine if SSRI response is different >under the three natural populations. It may well >explain why SSRIs don't work for everybody. Or >part of the why.One researcher found that individuals with the long varients of the transporter responded better to SSRI's than did those with the short varients.
>SSRIs are depressogenic?
Yes, I would argue that they can be for certain individuals. Mood may be maintained by a very delicate ballence between serotonin and dopamine. If you get too much serotonin, I think it can cause depression. I experienced a distinct worsening of all core symptoms of depression on paxil.
>Suicide rates are falling.
>http://www.afsp.org/statistics/USA.htmBut to associate this with SSRI use may not be accurate.
>There is no autopsy evidence for SSRI >potentiation of suicide. But alcohol? Huge. >Widely available, without a prescription.
I don't think that autopsy information is necessary.
>No, it doesn't. It links a homozygous gene to >those events. Not SSRIs.I realize that. It is not a direct link, but it is something that has really baffled a lot of researchers. I emailed Dave on www.biopsychiatry.com and asked him what he thought about the issue of the serotonin transporter, and some of the recent findings. He said to me, that sometimes in psychiartry you will find things that don't fit the mold. Sometimes the findings will seem to indicate the exact opposite.
SSRI's may *work* through a different mechanism alltogether. We have serotonin uptake inhibiting drugs that have no antidepressant potential whatsoever. All of the currently available SSRI's increase the activity of the gabaergic neurosteroid allopregnalone, some 20 fold.
>Or Tianeptine might work on homozygous short->short SERTs?
Well this is it. I was just more surprised by the fact that the study seemed to suggest that the most chronically depressed posessed the double short varient.
>I strongly reiterate. There is no pathological excess serotonin state.I strongly reiterate. Some researchers think that excessive serotonergic function in certain areas of the brain result in anxiety. There are researchers who believe that certain generalized anxiety disorders are due to elevated serotonin activity. Some think high serotonergic neurotransmission may be involved in anorexia.
http://www.mhsource.com/expert/exp1041502a.html
>Getting back to how this phrase came into our >discussion, Tracy claims that this "excess >serotonin" state causes premature aging. You >seem to have just contradicted that, quite >explicitly.I don't see what you mean. There are theories out there as to how SSRI's may advance aging. The melatonin theory sounds convincing. I can see how chronically lowering melatonin might acellerate aging. There are other theories too.
>No, not potentiation. "...all data were >compatible with additivity of effects rather >than true potentiation."The article says that fluoxetine substituted for LSD in certain paradigms.
>The one above was about dogs. I wonder just what >the dogs said to describe their experiences.
This is about findings that may confirm some of the experiences that people have had.
>And, individual idiosyncratic reactions happen >all the time.
It is not an idiosyncracy. Both agents potently stimulate certain sertonin receptors. We have no problem accepting that GI effects may be due to excess 5-ht3 stimulation, but yet cannot believe that people have had perceptual disturbances consistant with excess 5-ht2a agonism ?
There are some documented cases of antidepressant induced perception disorder on www.biopsychiatry.com in addition to expert explainations of the events.
>How? Who the heck knows that?Exactly. We can pop a pill based on unproven theory, yet we start wars in defence of drugs based on unproven theory. She is not the only one who has attacked the theory behind SSRI medications.
>That's what I meant earlier about mechanistic >arguments. They really are pointless.
So what good is it to say that she is devoid of proof, when we have no proof of the opposite. Her proof may be our lack of proof.
>Other people, with different beliefs, discovered >salicylic acid in willow bark, derived a >synthetic form, and made a near-bankrupt German >dye chemist named Bayer very rich.
True, but we later learned how aspirin causes more deaths each year than any other drug (I believe). I am not going to try and dismiss the information that points to the dangers of aspirin.
>That's not hyperbole.
Did I say it was ?
>And we don't know why. But we do know that they >work. Empirical evidence.
It is a truth that the drug company can still market a drug when only 1/8 of the studies show any benefit.
>How about promoting better medical management. >More personal interaction with caregivers. >Providing critical information for true informed >consent. No fear-mongering required.Fair enough.
>Post hoc ergo propter hoc is a fallacious >interpretation, a good part of the time.
>You may have other medical concerns.I'm sorry I brought it up. I didn't know you were going to be one of those people.
>Sometimes, they do. And if appropriate >precautions had been taken, and corrective >action initiated at the first sign of trouble, I >think that many of the most serious outcomes >would simply never have happened.
For certain individuals, the kind of monitoring necessary is not tangable. Monitoring cannot prevent all potential problems. Monitoring cannot prevent T.D. for instance, with neuroleptic use.
>I didn't listen to the whole interview.
I know
>I have read through some of the complete >clinical trial data for some of the SSRIs.
..
>If you want to see that, I'll dig it up and show >it to you.You are one individual. Other individuals have analayed similar data, and have come to different conclusions.
>All else is interpretation.
Thats the problem. The argument in support of these drugs is interpretation. The mechanisms are theoretical. When you don't know why they work, and why they fail, then interpretation becomes more tangable.
>Link, I have very closely followed the research. >I read every study on this subject. The recent >Healy and Martinez studies were rather >compelling. If there is a suicidal signal, it is >brief, early, and small. Medical management can >handle these issues.
Lar, dispite your independant research, you are not the final say. And you have not read every study on the subject. (oh I know I'm going to get banned)
>She's in the ballpark. She's the candy floss.
?
>They can induce psychosis, yes. They can trigger >mania, certainly.
Agreed.
>I was meaning her evidence. Her hypotheses are >not directly connected to evidence. I'm being >generous. Myrrh oil? All mental illness is sugar >related? (or something like that)From my school of thought, if somebody argues something, and another has evidence to support it, then it becomes his evidence.
>It's far from closed. And I am not trying to >shut the door. I'm trying to lay a solid >foundation of empirical evidence, and put to >rest hyperbole and fear-mongering.
Fear mongering wakes people up. Bad things can happen behind closed doors, and sometimes raising appropriate concern is a good thing. Where her arguments are not appropriate, I do not support them.
Linkadge
poster:linkadge
thread:587690
URL: http://www.dr-bob.org/babble/20051211/msgs/589426.html