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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by llurpsienoodle on September 12, 2008, at 12:49:28
I continue to be confused as to whether a CNS depressant -i.e. one that contributes to lower level of neural activity (upsets the inhibitory/excitatory NT balance) can cause symptoms of clinical depression
Posted by Phillipa on September 12, 2008, at 12:59:15
In reply to CNS depressant vs. clinical depression, posted by llurpsienoodle on September 12, 2008, at 12:49:28
Lurpsie don't look for an answer from me as you are so above me intellectually. I have no idea what the difference is are you taking courses realated to that in school. Love Phillipa would like to learn pea brain of mine is turned off it seems.
Posted by JayMac on September 12, 2008, at 13:01:04
In reply to CNS depressant vs. clinical depression, posted by llurpsienoodle on September 12, 2008, at 12:49:28
> I continue to be confused as to whether a CNS depressant -i.e. one that contributes to lower level of neural activity (upsets the inhibitory/excitatory NT balance) can cause symptoms of clinical depression
>I'm sure it can. I haven't had biopsychology in a couple years, but I remember that depression, as well as other mental disorders, has to do with various neurotransmitters (whether it's too much, too little, or none at all).
Is that what you are wondering? Let me know, I may be confused :P
Posted by Sigismund on September 12, 2008, at 17:59:39
In reply to CNS depressant vs. clinical depression, posted by llurpsienoodle on September 12, 2008, at 12:49:28
The short answer would be no or not necessarily, wouldn't it?
Depression, being the rag-bag of psychiatry, must have so many different parts, some of which might be helped by a depressant. Someone suffering from agitated depression might need a depressant like a benzo, even at the risk of aggravating the situation.
Posted by yxibow on September 13, 2008, at 2:31:14
In reply to CNS depressant vs. clinical depression, posted by llurpsienoodle on September 12, 2008, at 12:49:28
Most calming agents are "depressive", akin basically to depressing the CNS (central nervous system). They can increase GABA and target a whole panoply of receptors.
The main risk and danger of all the agents that fall into the class of CNS depressants (e.g. benzodiazepines, Neurontin, pseudobenzodiazepines [Lunesta, etc] alcohol, barbiturates, heroin, kava, OTC antihistamines like Benadryl to an extent)..... is "stacking" (multiple, 2, 3, 4 at at time, i.e. an attempt to promote bad anxiety or insomnia).
Stacking can lead to "CNS depression" which is a serious medical condition of low heart rate, breathing, lung depression, and possible coma and death depending on just how much the central nervous system is slowed down. Immediate medical attention is necessary.
This is a possible theory of what may have happened to Heath Ledger, for example, or it may have been suicide. Many instances of this have happened.
The point is, for your doctor, and for yourself to monitor this polypharmacy and your own additional add-ons to prevent this.
-- Jay
Posted by llurpsienoodle on September 13, 2008, at 5:29:30
In reply to Re: CNS depressants and CNS depression, posted by yxibow on September 13, 2008, at 2:31:14
Good morning Jay,
Thanks for your response. Is there any theory about whether GABA activity can influence depressive symptoms, like sadness, feelings of worthlessness, suicidality?For instance, my T (not the most pharmacological savvy person...!) suggested that daily klonopin might be contributing to my depressed mood and negative self-cognition.
Although... I can see how this would be mediated by psychological factors (learning/conditioning/priming) as well as pharmacological ones.
Well. I think I better go make some coffee.
tidings back to you!
-Ll
Posted by med_empowered on September 13, 2008, at 6:03:31
In reply to Re: CNS depressants and CNS depression » yxibow, posted by llurpsienoodle on September 13, 2008, at 5:29:30
OK, yeah...on the one hand, long-term use of sedatives can lead to feelings that might be called "depressive symptoms"--lethargy, cognitive slowing, low mood, so on and so forth. With the benzos, Klonopin and Tranxene are apparently particularly bad when it comes to causing/worsening this kind of depression; Xanax has some stimulating properties, so its considered a mild anti-depressant.
On the other hand, like another poster said, there's a big segment of the "depressed" patient group that could really use a downer. This is why some "depressed" people respond well to low-dose neuroleptics (or the atypicals), benzos, hydroxyzine, anticonvulsants, etc.
Then there's the Q of whether or not low neurotransmitter levels can cause depression. They used to say that this had been suggested or proven b/c reserpine, an early antipsychotic and antihypertensive, lowered levels of a number of neurotransmitters and some patients apparently developed "depression."
The problem with that is...at high enough doses, reserpine induces Parkinsonism and Neuroleptic Dysphoria just like any other antipsychotic, so the mood problems may have had to do with a) dosing and b) chemically-induced Parkinson's (its worth noting that Parkinson's disease is often marked by apathy, anxiety, and low mood BEFORE the dyskinetic movements pop up.). Also, reserpine actually *helped* some people with depression.
Also, if low neurotransmitter levels=depression, then stimulants would be a sure-fire depression cure. They're not. Even when they were being RX'd like crazy for psychiatric complaints, amphetamines were regarded as best used for "mild depressions" characterized by low mood and ennervation; more severe depressions were treated by other means (ECT, lobotomies, neuroleptics, upper/downer combo pills, etc.)Sooo...your T might be on to something. I mean, as benzos go, Klonopin is one of the more depressing ones. On the other hand, Therapists, in my experience at least, have serious problems with benzos: they tend to view them as addictive band-aids that keep people from dealing with their "underlying issues". Some shrinks share this view, too.
Its also worth noting that Klonopin can actually augment antidepressants, at least in the short term, via some sort of serotonergic action (and, I imagine, by counteracting over-activation and akathisia). Sooo...use your own judgement.
Posted by Phillipa on September 13, 2008, at 19:35:28
In reply to downers and depression, posted by med_empowered on September 13, 2008, at 6:03:31
Klonopin was depressing for me and I felt suicidal and called the doc he said stop the med go back on xanax which I did and all was well as I couldn't figure out why I felt suicidal. It was very strange. Phillipa
Posted by NewQuestions on September 16, 2008, at 10:20:35
In reply to Re: downers and depression, posted by Phillipa on September 13, 2008, at 19:35:28
I found all benzos to actually make me more depressed, in a numbing kind of way. The only one that works for me is lorazapam.
This is the end of the thread.
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