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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Sandra62 on March 24, 2007, at 17:51:24
After years of being on AD's, benzos, and AP's I'm finally deciding that it is high time for me to understand what exactly these meds are doing, or at best, trying to do. I am not in a happy place so I'm searching for ways to improve this, along with my doctor's help. Some of this will require an explanation of neurotransmitters too I guess. TIA for helping to explain!
For instance, the Lexapro I'm taking, what effect does an SSRI supposedly have on the neurotransmitters? What does serotonin "reuptake" inhibitor mean? That you are soaking in more serotonin or less? And what is this effect supposed to do for you?
With something like EffexorXR which my PDOC is considering instead since I'm still depressed, what does a "serotonin-norepinephrine reuptake inhibitor" supposed to do for you exactly?
In addition, why do these meds often cause sexual dysfunction? What is going on in the brain because of these meds that causes that? This is one of my primary concerns as I've found that with the SSRI's only Lexapro has been able to give me the ability to still achieve orgasm, but my libido is definately low.
Interestingly enough, when I tried Wellbutrin it had the opposite effect. It was like an aphrodisiac. Any ideas why? Is it the effect on dopamine? What effect? I subsequently experienced rage on Wellbutrin so had to stop it, sadly.
Another concern I have is weight gain that I've experienced taking Zyprexa. What area of the brain is this med attacking that causes this?
I've also now got 'blunting' going on. I'm suspecting the Zyprexa so my PDOC is taking me off of this. But WHY the blunting?
I guess I'm searching, like many of us, for the perfect med cocktail that will help me balance out. I'm Bipolar and I miss my highs. Now I just have a steady low state. No motivation. No zest for life. I also take Lamictal and Rivotril. I can't even begin to guess what those meds are doing and why. Any ideas would be deeply appreciated.
Posted by Racer on March 24, 2007, at 20:19:41
In reply to Please explain what these meds are actually doing?, posted by Sandra62 on March 24, 2007, at 17:51:24
I can't answer all of it, but here's what I do know:
Neurotransmitters are stored in vesicles inside the neurons. When an action potential triggers them, the neurotransmitters are released into the synaptic gap between neuronal cells. Once there, they communicate a message to another cell, either directly, through what are called ligand-gated ion channels, or indirectly, via G-protein coupled receptors. Serotonin, for example, has both sorts of receptors. After conveying their message, the neurotransmitter molecule is mopped up from the synapse, and transported back to the originating cell, where it's either saved for reuse, or recycled for its component proteins. The "mopper upper," if you will, is usually another molecule specifically designed to transport that particular molecule. Thus, serotonin has its transporter, and dopamine has another. The reuptake inhibitors act to stop the transporter molecules from returning the "used" neurotransmitter to the originating cell.
This leaves the neurotransmitter in the synaptic gap, where it continues to stimulate the receptor on the second cell. Eventually, that receptor says, "Enough already! I'm just going to ignore you now." That's obviously simplistic, but it's called downregulation, and it generally means that there are fewer receptors working on those cells. There are some theories that it's the downregulation of certain receptors that causes the benefits of the reuptake inhibitors. They say that SSRIs, for instance, work because the serotonin receptors get so much less sensitive that it allows more sensitivity to dopamine. No one really knows why they work, though, so it's basically educated guesses.
The reason that SSRIs have sexual side effects is beyond me. I just know they do. What worked for me, though, was taking cyproheptidine about half an hour before I wanted to -- you know. It blocks the action of the SSRIs temporarily. It's not something you'd take constantly, because that would block any action of the SSRI, and you don't want that. But for a couple of times a week, it's a good solution. It doesn't work for everyone, but it's cheap and safe, so it's probably worth a try.
As for some of the other mechanisms, like the weight gain some people get with SSRIs, no one really knows what happens, but it's likely that it involves the serotonin receptors in your digestive tract. Several receptors there regulate both bowel motility and satiety. If those receptors become less sensitive, your digestion will slow down, and the messages that you're not hungry probably won't be as clear. So they probably act both ways -- affecting your metabolism, and increasing your appetite.
I hope that's helpful.
Posted by Sandra62 on March 24, 2007, at 20:23:38
In reply to Re: Please explain what these meds are actually do » Sandra62, posted by Racer on March 24, 2007, at 20:19:41
Posted by Sebastian on March 24, 2007, at 20:59:45
In reply to Re: Please explain what these meds are actually do » Sandra62, posted by Racer on March 24, 2007, at 20:19:41
I think zyprexa slows your metablisim, along with your energy. Abilify seems to speed it up, along with your energy. This is my current combo, and seems to work better than with wellbutrin.
Posted by Sandra62 on March 24, 2007, at 21:11:45
In reply to Re: Please explain what these meds are actually do, posted by Sebastian on March 24, 2007, at 20:59:45
Sebastian thanks but unfortunately Abilify is not available in the country I live in, Costa Rica.
Posted by Phillipa on March 24, 2007, at 21:58:09
In reply to Re: Please explain what these meds are actually do, posted by Sandra62 on March 24, 2007, at 21:11:45
I think I'm about to start a controversial thread. Love Phillipa
This is the end of the thread.
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