Posted by SLS on March 8, 2013, at 3:36:33
In reply to Re: Eric » poser938, posted by phidippus on March 7, 2013, at 23:40:16
> I don't know a single person besides yourself(you must be very unique indeed) who has taken antideppresants and suffered long time effects.
>
> If you keep on blaming the antidepressants, you're never going to figure out what's really going on.
>
> Eric
I agree with Poser938.That antidepressants leave behind persistent changes in brain and CNS function is self-evident. Paxil is a good example of this. How else would non-response to a previously effective drug occur? This phenomenon is sometimes referred to as "drug-discontinuation-induced refractoriness". The term was developed at the NIH by Robert Post to describe his observation that some patients who had been stable on lithium for many years became resistant to its therapeutic effect once it was discontinued and restarted.
- Scott
--------------------------------------------Am J Psychiatry. 1992 Dec;149(12):1727-9.
Lithium-discontinuation-induced refractoriness: preliminary observations.
Post RM, Leverich GS, Altshuler L, Mikalauskas K.
SourceBiological Psychiatry Branch, National Institute of Mental Health, Bethesda, MD 20892.
AbstractThe authors used a systematic life-chart methodology to observe four patients with bipolar disorder in whom long periods (6-15 years) of effective lithium prophylaxis were followed by relapses on lithium discontinuation. Once the drug was reinstituted, it was no longer effective. The incidence, predictors, and mechanisms underlying this phenomenon all require further systematic study. The current preliminary observations suggest an additional reason for caution when lithium discontinuation in the well-maintained patient is considered.
---------------------------------------------
J Affect Disord. 2012 Sep;140(1):6-13. doi: 10.1016/j.jad.2011.09.021. Epub 2011 Dec 7.
Acquired lithium resistance revisited: discontinuation-induced refractoriness versus tolerance.
Post RM.
SourceBipolar Collaborative Network, 5415 W. Cedar Lane, Suite 201B, Bethesda, MD 20814, United States. [email protected]
Abstract
BACKGROUND:While some patients fail to respond to lithium from the outset, others are initially responsive and then develop treatment resistance. These acquired forms of lithium resistance have received relatively little clinical attention.
METHODS:We review the literature on the two different forms of acquired treatment resistance lithium that occur following an initial good response to lithium-discontinuation-induced refractoriness and tolerance- and discuss the possible neurobiological mechanisms involved.
RESULTS:Multiple investigators have reported cases of discontinuation-induced refractoriness, where following a good long-term response, patients discontinue lithium, suffer a major recurrence, and then do not again respond as well or at all to lithium once it is reinstituted at previously effective doses. The development of tolerance has similarly been multiply documented where lithium doses are consistently maintained, but after an extended period of excellent responsiveness, affective episodes of increasing severity, frequency, or duration begin to break through. These two forms of acquired treatment resistance appear to have different underlying neurobiological mechanisms and require differential treatment strategies.
LIMITATIONS:Recognition of acquired forms of lithium resistance depends on careful case descriptions and longitudinal monitoring of patients who are usually treated naturalistically and not in controlled clinical trials.
CONCLUSION:To the extent that these forms of acquired lithium resistance can be better recognized and their development slowed, prevented, or ameliorated, it could yield substantial clinical and public health benefits in avoiding the morbidity and mortality that can accompany lithium non-responsive bipolar disorder.
Copyright © 2011 Elsevier B.V. All rights reserved.
PMID:
22154708
[PubMed - in process]------------------------------------------------
Some see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1038989
URL: http://www.dr-bob.org/babble/20130222/msgs/1039835.html