Posted by Prefect on December 1, 2012, at 9:34:27
My understanding of SSRI mode of effect is this:
1. They inhibit reuptake of serotonin, making it abundant in the brain
2. Your receptors first compensate by dropping serotonin levels (which is why anxiety/depression gets worse in first few days of administration)
3. At some point, your receptors "give in" to this serotonin abundance and stop trying to regulate it. Serotonin levels get back up.
4. In reaction, the number of the receptors themselves are downregulated. This is aparently where the bulk of mood improvement is observed (which sounds counter intuitive to me).My question is this: Is the eventual amount of receptor downregulation dosage dependent, ie, is there a linear relationship, or is there a dosage before which there is hardly any downregualtion, past which, say, 90% of your receptors downregulate?
I ask because I'm dosing up (just relapsed) and trying to hit that sweet spot where my anxiety is no longer catastrophic, and yet I can still feel enough anxiety so that the bulk of my improvement comes from desensitization during exposure therapy. I seem to have done this 7 years ago on 50 mg/day Luvox and the result was exactly that. My panic during exposure was manageable, but still present enough that I developed real coping skills. I believe this is why I was panic free for 7 years on 50 mg /day Luvox alone. And I felt real emotions too.
I dropped the dose 3 months ago and relapsed, and now the 50 mg/day doesn't seem to work anymore. I want to raise the dose and find that exact point again. Will it be possible for me to find a higher dosage that will be as calming as my original dose and still allow some feeling, by experimenting, or will the receptor downregulation be exponential past a certain point and zombify me useless?
Thanks for attempting to answer this awkwardly presented question from a layman.
poster:Prefect
thread:1032268
URL: http://www.dr-bob.org/babble/20121130/msgs/1032268.html