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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Martinchen978 on December 10, 2018, at 19:35:19
A fellow from one of my support groups once told me that both Zoloft and, later on, Lexapro were intolerable because they made him feel like a zombie.
It sounds like he described apathy or indifference. Can SSRI medications cause an apathy / indifference syndrome? Most prescribers seem not to be aware of this side effect of these drugs. This probably because apathy / indifference sounds a lot like lack of interest in formerly pleasurable activities or lack of energy or lack of motivation. All of these quoted symptoms are also part of major depression. So, it can be hard to know the difference between medication-induced apathy versus inadequately-treated depression. Also, the prescribing information for SSRI medications (which includes the official, FDA-reviewed statement of side effects) does not list apathy or indifference. On the other hand, the prescribing information does include fatigue and decreased libido. These could possibly be manifestations of apathy...
Despite the general lack of awareness of this side effect, the medical literature nonetheless contains several case reports and reviews of SSRI-induced apathy. Notably, these reports often mention that the apathy worsens with increased dose of the drug. The presence of such a dose-response relationship supports the notion that the drug actually causes the apathy.
Posted by Martinchen978 on December 10, 2018, at 19:42:18
In reply to Can SSRIs dampen drive / ambition?, posted by Martinchen978 on December 10, 2018, at 19:35:19
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2989833/
https://www.ncbi.nlm.nih.gov/pubmed/22353235
https://www.ncbi.nlm.nih.gov/pubmed/15330228
https://neuro.psychiatryonline.org/doi/pdf/10.1176/jnp.23.1.jnpe19
https://www.health.harvard.edu/depression/is-your-antidepressant-making-life-a-little-too-blah
Posted by rjlockhart37 on December 10, 2018, at 23:23:04
In reply to Can SSRIs dampen drive / ambition?, posted by Martinchen978 on December 10, 2018, at 19:35:19
this was a early article on how effective Prozac used to be in 1993
https://www.psychologytoday.com/us/articles/199307/the-transformation-personalityand during that time i don't think apathy side effect was that known. yes SSRI's can induce that, this is just a quick read article about discontinuation from SSRI
https://www.researchgate.net/publication/221850147_Reversal_of_SSRI-Associated_Apathy_Syndrome_by_Discontinuation_of_Therapy
Posted by bleauberry on December 17, 2018, at 14:20:50
In reply to Can SSRIs dampen drive / ambition?, posted by Martinchen978 on December 10, 2018, at 19:35:19
Apathy is maybe the greatest side effect of antidepressants, along with sexual difficulties. That's because the flood of serotonin or norepinephrine is un-natural and the body's genetic commands try to deal with it however they can - which ends up being serotonin and norepinephrine being sucked up into dopamine reuptake pumps instead of their own pumps, which are blocked. Dopamine is excitatory and stimulating, serotonin is calming. So you don't want serotonin going into the dopamine system but that is what happens.
Often times doctors mistake the apathy as a component of the ongoing depression.
Me, for example, after being on Paxil for a year, I took the multiple choice depression questionnaire. I scored well on almost all of the categories except for the "interest in hobbies" and similar questions - I was emotionally numb, anesthetized in the brain. Flooded with serotonin.
In my case the doctor blew that off and nothing. He was happy I scored well overall. What he failed to realize is that apathy by itself is a psychiatric condition that is not acceptable. It is treatable. So any doctor willing to accept apathy as a fair trade-off for depression is wrong.
There are 3 ways I know of to deal with it. 1.Try a different one - my experience is that Prozac is the least offensive in terms of apathy and sex. 2.Add a dopamine agent to it, either Ritalin, Adderall or Modafinil. 3.Engage in other strategies besides prescription antidepressants. There are other strategies that work as well or better. The Western world will try to sell you on the idea that only your doctor's prescription can help depression and that his a myth.
I totally cured my 20 years of treatment resistant depression/bipolar/schizo with antibiotics, as just one real life example. This, after trying every psych drug on the market for years and years.
Apathy is part of the game. You either have to accept it as a cost of doing business, or manage it as best you can, or refuse to go down that road.
Honestly I thought my long-standing apathy from meds was more crippling to quality of life than the original disease was. Life is extremely difficult when you have no interest in anything.
Posted by Martinchen978 on December 17, 2018, at 18:50:49
In reply to Re: Can SSRIs dampen drive / ambition?, posted by bleauberry on December 17, 2018, at 14:20:50
> I totally cured my 20 years of treatment resistant depression/bipolar/schizo with antibiotics, as just one real life example. This, after trying every psych drug on the market for years and years.
With antibiotics?
Posted by bleauberry on December 19, 2018, at 14:08:26
In reply to Re: Can SSRIs dampen drive / ambition?, posted by Martinchen978 on December 17, 2018, at 18:50:49
> > I totally cured my 20 years of treatment resistant depression/bipolar/schizo with antibiotics, as just one real life example. This, after trying every psych drug on the market for years and years.
>
> With antibiotics?Yes. For 20 years the doctors told me I had major depression with bipolar features and schizo features and it was apparently treatment resistant. Most meds made it all worse. None made it much better. I was a regular here for most of those 20 years and deeply into the whole medication and research thing. I tried them all.
At some point a nurse said, "Gee I wonder if you have Lyme disease - it can be mostly psychiatric with a lot of people." And that began a whole new journey for me that made a ton of progress.
My journey has taught me that psychiatric symptoms are not the mysterious brain things we think they are. They are the body's response to ongoing insults from toxins, infections, inflammation, or inappropriate foods. Lyme happens to be all of those in one bundle. I suspect most everybody here has these issues as the cause of their symptoms. Science estimates 3 out of 10 are undiagnosed Lymies. My own doctors estimate 9 out 10 based on their own office traffic and clinical practice. It's all they do.
Something to learn more about, for sure.
This is the end of the thread.
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