Posted by SLS on May 20, 2009, at 5:56:10
In reply to Avoid serotonergics after bad SRI reaction?, posted by sowhysosad on May 19, 2009, at 20:02:11
> Some of the sites of the "paxil progress" variety claim that after a negative serotonin-mediated reaction to an SRI you should avoid all serotonergics for a year. I was a bit sceptical when I read this as there was no indication of where they got this rule of thumb from.
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> However, I'm now starting to think they might be onto something! Back in October I had akathisia after raising my generic Zoloft dose too quickly, and since then even mildly serotonergic meds (escitalopram/mirtazapine/imipramine) have made the resulting depression worse.
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> The last few of weeks I've been med-free but experimenting with 5-HTP supplements. Despite some transient good moods, as I've increased the dose I've mostly had increased anxiety, fear and depression and early awakening. It feels almost identical to the startup anxiety I had when starting Paxil, as if I can't tolerate the sudden boost of serotonin.
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> Is there any evidence - scientific or anecdotal - that the SSRI alarmists might have a point? Does a bad SRI reaction somehow fry the serotonin receptors and make them more sensitive, making other serotonergics intolerable?
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> Surely, if anything, the receptors would downregulate so you'd be less sensitive to the effects of serotonin, not more!
Look into "kindling". Kindling might be operating as the result of the overactivity of certain neural pathways (perhaps glutamatergic) that produce severe side effects. Kindling would account very nicely for subsequent hypersensitivity to these drugs with regard to side effects.I think poop-out is another phenomenon entirely.
- Scott
poster:SLS
thread:896671
URL: http://www.dr-bob.org/babble/20090515/msgs/896767.html