Posted by KarenRB53 on January 20, 2010, at 18:47:01
In reply to Re: No Motivation or Energy on Celexa, posted by bleauberry on January 20, 2010, at 18:22:38
> I saw a metastudy yesterday on the web that looked at this very topic. We've seen it here for years. It has several names, one of which is "SSRI induced apathy syndrome". In that study, 30% of patients complained of it as being their primary side effect, and it was the major side effect that caused them to eventually stop the medication. This was regardless of whether it actually helped their depression or not. A common complaint was that patients could not even cry at a funeral.
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> Maybe it has something to do with longterm serotonin potentiation, which is inhibitory, squashing out the function of the excitatory neurotransmitters dopamine and norepinephrine. I don't think enough research has been done on this. Much more is needed.
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> We do know that enhancement of norepinephrine and/or dopamine can reverse or minimize the apathy syndrome. That includes trials of additional agents such as Ritalin, Adderall, Wellbutrin, Desipramine, Savella, and sometimes one of the atypical antipsychotics can work, despite that they can also pose a risk of worsening it if doses are too high. Natural agents can work very well, including Tyrosine and/or DLPA. The addition of Rhodiola Rosea can work well too, as a few psychiatrists routinely add this herb to pharmaceutical antidepressants for that very reason.
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> I'm glad it wasn't so bad for you on Prozac. For me, Prozac was the friendliest in that regard, but it still left me quite motivationless. Not as bad as the others, but still bad. I had to take both Zyprexa and Adrafinil (or Ritalin) to overcome it, and even those weren't a perfect cure.
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> It's a tough issue. No easy answers. No real explanations from pharm companies or researchers. I think the basic message here is that serotonin function is now too strong, while NE/DA are too weak. The drug has caused a new chemical imbalance that helped depession but created apathy.
Thanks for such great information!!
poster:KarenRB53
thread:934462
URL: http://www.dr-bob.org/babble/20100113/msgs/934484.html