Posted by Racer on October 7, 2007, at 13:51:19
In reply to Ssri anxiety mechanism?, posted by johnj on October 7, 2007, at 12:11:53
Serotonin is one of several neurochemicals involved in anxiety, and the simplistic explanation is that increasing serotonin decreases anxiety -- but that is simplistic, because in other cases, excessive serotonergic activity can be involved in increased anxiety. That seems to be the explanation for increased anxiety during the adjustment phase of SSRI treatment.
Additionally, it's always worth remembering that individual neurotransmitters are most likely not the answer to any psychiatric disorder. It seems that the ratios are what matter -- finding the sweet spot between, say, dopamine and serotonin is probably more important than increasing the levels of either one.
Notice, though, I said "adjustment phase." The initial increase in anxiety from serotinergic medications does pass. If you can get through the first two or three weeks, you should find that SSRIs markedly decrease anxiety. Starting at ultra-low doses may not help with this, by the way. If you can start at the standard starting dose, and titrate up to a therapeutic dose on a standard schedule, you'll often find that the improvement in anxiety happens much faster.
Although it may not seem like it, based on my own experiences and those of people I've known who've also experienced significant anxiety problems on starting new medications, a lot of the anxiety actually seems to be psychological. Yes, it's certainly exacerbated by the medications themselves, since they start mucking about with the ratios between the various neurotransmitters pretty quickly. That will certainly affect anxiety levels, but I know in my own case at least that my own psychological reaction to starting these medications has an awful lot to do with my initial anxiety in response ot them.
The good news is that, if you can get through the adjustment phase and get up to an adequate therapeutic dose, SSRIs really are good at reducing anxiety. In fact, for some people they're *too* good at it, leading to a sort of apathy. In any case, if anxiety is a big problem for you, it's well worth trying to get through that start up phase, so that you can find out whether SSRIs will help you.
poster:Racer
thread:787562
URL: http://www.dr-bob.org/babble/20070929/msgs/787608.html