Antidepressants

[HeadDoc]

Fred, I'm looking into this. Pat

American Board of Sleep Medicine

[LowTestosterone38]

Originally Posted by marianco

"
Some practitioners believe in "SSRI Poop-out" - where it is thought that "tolerance" develops to an SSRI (serotonin reuptake inhibitor - such as Prozac), which is why it will stop working. I do not believe this generally happens. I think the patient's illness either changes in characteristics or the diagnosis needs to be reassessed (e.g. bipolar disorder rather than major depressive disorder may be present) or other complicating health factors contribute to worsening of their symptoms.

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SSRIs can and do "poop out." The fact is, no psychiatrist anywhere, knows what causes antidepressant poop out. One of the theories Ive read about pushed by expert psychopharmacologist Ivan Goldberg, MD is that by depleting dopamine, SSRIs create a form of mild EPS that over time, leads to loss of effectiveness.

A recent study by psychiatry itself called STAR*D showed that a popular SSRI, Celexa, "pooped out" two third of the time and did not push the depressive into remission. I dont believe most of those people had bipolar disorder or other psychiatric conditions. What I think is that these medications simply do not work effectively for the majority of patients who really need them.

Shock treatment is the single most effective treatment for major depression as well as for bipolar disorder. Since there isnt much money to be made in shock treatment compared to pharmacology, you dont hear about ECT much anymore. Its still the single most effective treatment for almost all mood disorders and many forms of psychosis.

I bet shock treatment is also good at treating secondary hypogonadism as well. It juices up the old pituitary and hypothalamus glands.

Fred

[bullmastiff]

Some p-docs have found that dopamine agonists prevent ssri poop out and maintain libido.It's a shame that more docs don't use this tool.

[bullmastiff]

Originally Posted by swordfish

I am not on TRT yet. I did a 30 day trial with some cream from the endo. Doubled my t levels, but I still dont feel normal... i'll try to go higher when I experient again.

I'm thinking of trying armour... My body temp at night feels sooo warm but temps are normal...

Depression is very complicated and for some restoring T is of little value. When My T goes high I get agitated and aggressive.

[s0b]

I still dont understand how SSRIs can be used to treat adrenal fatigue.
All i have read till now in all my medical texts is that when someone suffers from neurasthenia (recently named adrenal fatigue) the only serious treatment without sides is rest, rest, rest.
This has been done for 50 or more years and i think will continue to be done till a miraculous treatments evolves.

I ve been followed by leading neuroendocrinologists in the field of HPTA axis dysfunction last six months and they told me to stay away from SSRIs or anything that will alter- increase serotonin or noradrenaline- and in trun my cortisol levels. Despite their sayings i went on trying Prozac and then Celexa, with aknowledged adrenal fatigue as shown by physical, urine and saliva tests and ended up in a very worse state.
Actually all i lasted was around 10 days on celexa max. On the 11th day i almost fainted, my hypoglycemia was so strong i couldnt stop sweating and shivering, my body temperature was lower than ever, but the worst of all was that i couldnt walk out of bed from the fatigue and couldnt sleep at nights without the use of sleep pills.

When i went back to my doc. dr. Chrousos,
George P. Chrousos - Wikipedia, the free encyclopedia

he told me that he has never seen anyone in his 30 yr old practice recover from neurasthenia, chronic fatigue syndrome or adrenal fatigue with such a treatment. I even tried combining armour with celexa it went even worse. He said the only treatment is to take directly cortisol, or other substitutes, and rest for many months to years.

SSRIs have a directly opposing effect causing HPA axis suppression and actually are major causes of adrenal fatigue themselves.. I found out by trying and now i started to believe my doc. Initially i thought that serotonin level rises will not have any effect on cortisol, but this is far from reality. They will raise your cortisol levels to the point of exhausting your adrenals, yet on the same time trying to resensitize GR and MR receptors in certain brain areas (hippocampus, amygdala, parts of frontal cortex etc etc) to allow for better intracellular cerebral cortisol utilisation in these areas. In the end the HPA axis will evidently regain its sensitivity and shut down high serum cortisol levels.

If someone can convince me by blood /urine/ saliva tests that SSRI treatment may pose any benefit to adrenal fatigue recovery i would be quite interested.