Posted by Cam W. on June 3, 2000, at 17:56:55
In reply to RE: NEED HELP; SOMEONE PLEASE ANSWER, posted by Angela on June 3, 2000, at 11:31:03
Angela - You may still have to give the Zoloft a few more weeks. Why have you been going through so many different antidepressants in such a short time? (side effects?)
The SSRIs are mostly unrelated chemically. They all (even Celexa to a small degree) bind to other receptors than the serotonin reuptake receptor. Some feel that these other receptors contribute to the differences in efficacy seen between the SSRIs. Perhaps it is one of Zoloft's effects at another receptor site that helped your depression before.I am still not convinced (and become less convinced everyday) that the increase in serotonin is the main mechanism of action of antidepressants in all (or most) forms of depression. There are just too many exceptions to the rule (eg Wellbutrin, desipramine). Now, this could be due to different biochemical breakdowns or we could be looking at the wrong site for a mechanism of action. Scientists can deplete the human body of serotonin, but this does not lead to the development of depression; the same can be said for norepinephrine, (something else is going on) but adding a drug that blocks serotonin reuptake (and thus increasing synaptic srotonin levels) relieves depressive symptoms in many people. Is this increased serotonin only an artifact of a closely related system that "is" relieving the depressive symptoms. Just because we see increased serotonin levels with antidepressants doesn't mean that it is the serotonin is "fixing" the depressive symptoms.
Therefore, "your" response to Zoloft in the past may not be due to serotonin, but to another (possibly minor and to date unknown) mechanism of action of Zoloft. If this were the case, then because you have not responded to other SSRIs and even though serotonin levels have been raised, the proper "fix" for you has not kicked in with the Zoloft yet.
Again, why did you not give adequate trials to the other antidepressants (eg 8 weeks)?
Other people can have sequential effect from different SSRIs taken successively in a short period of time, but their depressions could in fact be related to a serotonin breakdown. Perhaps yours isn't. (Is it a chicken/egg thing or is it a chicken/turkey thing?)
Hope this helps - Cam
poster:Cam W.
thread:35842
URL: http://www.dr-bob.org/babble/20000603/msgs/35897.html