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Could somebody explain this?

4K views 21 replies 7 participants last post by  [rula] 
#1 ·
I was wondering if somebody with some knowledge of the brain, could explain to me in simple terms the following lines dealing with the ssri discontinuation syndrome? Why do they feel that the brain is short of serotonin during ssri withdrawal?

"The biological mechanisms underlying this syndrome are not well understood, although an acute decrease in synaptic serotonin in the face of down-regulated or desensitized serotonin receptors has been postulated."
 
#2 ·
Dear DakotaJoe,
Its thought that when the neurons of the brain, or any other chemical receptor of the body, is inundated with too much of its receptor chemical, the body compensates by down-regulating. This either entails reducing the body's own production of serotonin, or the shutting down of serotonin receptor sites. In this way, the body can try its best to keep its original homeostasis. This is why SSRIs may "poop out" on a patient. The body eventually compensates to the point that it is as if the person is not even supplementing any longer. If the substance is withdrawn, the body will fall below acceptable levels of the chemical, and it may take months or even years for the natural supply to increase or the dendrites and receptors to grow back. This is true with practically any withdrawal or addiction- and can also happen with things as common as sugar and amino acids, or as uncommon as benzos. Our bodies very much dislike being tampered with, even if they need to be.

Peace
Homeskooled
 
#3 ·
Dear Dakota,
I'm not sure if you know these things already, but some of the best ways to recover from this de-sensitization and even worse, down regulation, are exercise, dietary supplements, and proper diet. If you are sitting in front of a computer screen for most of the day, this wont help. You want to do things which will encourage the body to ramp up production, or create new cells. Rats who ran on a wheel for 30 minutes a day had 50 percent more brain cell growth in their hippocampus than rats who were forced to remain sedentary. As for supplements, it was found at Harvard that large doses of Omega 3 fatty acids can also ramp up production of cells. Lastly, if you havent lost any receptor sites, but need to ramp up production of the chemicals, the above two are necessary, but a balanced diet and a multi-vitamin rich in B vitamins is a way to give your body the raw materials it needs. Personally, I've been thinking of getting a construction job lately, just because I know the raw physical activity will get my physical and mental self healing quicker. Lastly, you've been so stressed out for so long Joe, that I think your cortisol levels might actually be affecting your blood sugar, causing you to feel suddenly worse when you eat at various times. You may want to do what hypoglycemics do, and eat 6-8 small meals a day. It keeps your cortisol and blood sugar steadier, as eating tends to lower cortisol levels (at least I think- you may want to double-check that) and smaller meals put less stress on the pancreas.

Peace
Homeskooled
 
#4 ·
Hi homeskooled,

Thank you for that explanation. As usual, I think you are right on the money.

It seems my brain fights back every time I would try to modify it with drugs. It seems there is always a price to pay sooner or later. when you try to take a shortcut. They only thing thats ever helped me since my benzo nightmare was the passage of time, staying away from ALL drugs, excercise, and a close watch on my diet. Basically what you recommend. Thanks again.

Joe
 
#5 ·
hey joe,
just wanted to add one more thing. it does sound like you've been stressed out for a while and you cold turkied a huge amount of klonopin that's not easy on the body either (glad the worst is over for you.) you have to look at and treat the body as a whole; here's a very good article on the adrenal system you might want to read cuz it's very likely that your cortisol levels at this point are low, like mine.

http://www.drlam.com/A3R_brief_in_doc_f ... atigue.cfm

peace,
rula
 
G
#6 ·
Homeskooled,

Does this apply to benzo withdrawal too? I know that my gaba receptor sites have been downregulated to the point where they dont respond to my gaba anymore. Would excercise, diet and other activities perhaps speed up the healing and allow these sites to up regulate sooner?
 
G
#7 ·
Thanks to Homeskooled and Rula,there is a lot to digest (no pun)about adrenal exhaustion.

It's not all completely alien to me as I have chronic fatigue syndrome.
There seems to have been no stone left unturned by doctors trying to understand this condition from the fatigue perspective.
I noticed there was mention of a possible underlying cause of adrenal fatigue being bacterial.
With chronic fatigue syndrome,it's considered that it could be a combination of bacteria and viruses.The viruses are considered to be mostly recurring viruses that reside in the body to reappear during times of physical and perhaps emotional stress.

With adrenal fatigue,it's obviously not clear cut.As my 24hr urine test showed normal levels of cortisol whilst my blood tests show high levels.
My doctor said that even being anxious whilst having your blood taken
could raise cortisol levels.
My dhea levels are normal.

One thing I'm uncertain about is that if raised levels of cortisol or as homeskooled mentioned the down regulation of serotonin are often the result of emotional stress,why would it not be possible to restore correct functioning by reducing emotional stress using methods such as meditation,relaxation techiques,CBT etc?
From personal experience only CBT has been helpful in reducing stressful thought patterns.

I feel that certain people are pre wired to have in my terms a fragile nervous system.
Often times this disadvantage can have insult added to the original injury when a person is brougth up in a hostile,or non nurturing environement.
It seems that vitamin supplements and diet,although wise for all people to consider are not really addressing the root of where it all began.

This is simply my opinion and does not apply to all people with dp.
From observations of my family.It appears that some "bodies" are not well equiped to handle stress.Perhaps they might be called sensitive or fragile?
If we look around ,everybody knows several people who have endured all sorts of dramas and yet with time they function at a healthy level.

Cheers Shelly
 
#8 ·
Dear Pure Narcotic,
Yes, following those steps can help when your body downregulates any of your neurotransmitters or the synapses themselves. Including GABA, serotonin, dopamine, etc... And like I put in another post, a high carb diet will increase your levels of serotonin naturally, while a high protein diet will increase your levels of dopamine, and other "alertness" catecholamines. In regards to what you were saying Shelly, I'm familiar with the idea of adrenal fatigue and chronic fatigue syndrome. Were you saying that you think yours was brought on through worry? My advice was directed mainly towards people that suffered chemical downregulation. While worry can change the levels, it doesnt affect the body's homeostasis in the same way that ingesting drugs will. I am, by the way, not anti-prescription drug by any stretch of the imagination, I just understand that our bodies have limits in dealing with them. Do you see a wholistic doctor for your CFS? They seem to have the most success in treating it.

Peace
Homskooled
 
G
#9 ·
Ok sorry Homeskooled re drug down regulation.
I'm not anti medication either,in fact most times I can see that medication is helpful to people with dp.

I've seen many holistic doctors,many different kinds of doctors.
From my experience,they seem to follow a certain concept and like to run with it......I call then "one trick ponies"which is ok if you happen to respond to their one trick as some people do.

The way it seems to be is that if you have CFS mildly or moderately,many treatments may help.If you have it severely and long term,past five years then almost nothing will help,except pacing oneself.
At this stage,perhaps due to lack of funding for research,the best a doctor can do is to try and treat the symptoms.

Cheers Shelly
 
#10 ·
Shelly said:
I noticed there was mention of a possible underlying cause of adrenal fatigue being bacterial.
With chronic fatigue syndrome,it's considered that it could be a combination of bacteria and viruses.
interesting...i have an appointment at Mt. Sinai Monday to speak with Dr. Simeon. the drugs they're currently experimenting with for DP are an antibiotic and an antihistamine. wonder if there's a new theory on a relationship between bacteria and DP.

Shelly said:
It appears that some "bodies" are not well equiped to handle stress.Perhaps they might be called sensitive or fragile? If we look around ,everybody knows several people who have endured all sorts of dramas and yet with time they function at a healthy level.
I think the question is, what makes the body more fragile? I've been wondering about that regarding my own body. I grew up in Lebanon during the civil war, needless to say no amount of stress/fear that i'm going through now can possibly compare to those 16 years. yet, i break down now?? makes no sense...my theory is that diet/organically grown foods play a major role in our body's ability to heal itself. we are what we eat, no? :) -rula
 
#11 ·
Homeskooled-

Your points on downregulating really resonated with me. I have tried to come off effexor three times, after it has cured my dp/dr/obsessive thoughts, and wanted to get my emotion (and ability to play music) back. Unfortunately, I couldnt wait for the serotonin to reach its natural level because all the bad stuff came back worse each time, but I am still dead set on getting off it

Back on the effexor (75mg, xr), but have lived a VERY healthy and active lifestyle for the past 6 months. I feel great, but am somehow worried that if I try to come off the drugs again, I will have no chance of ramping up the serotonin, no matter how healthy I am because my body is already used to the SSRI level of serotonin AND the high level of physical activity.

Do my concerns have any merit in your or anyone elses opinion?

Thanks in advance.

j
 
#12 ·
jw1234 said:
Homeskooled-

Your points on downregulating really resonated with me. I have tried to come off effexor three times, after it has cured my dp/dr/obsessive thoughts, and wanted to get my emotion (and ability to play music) back. Unfortunately, I couldnt wait for the serotonin to reach its natural level because all the bad stuff came back worse each time, but I am still dead set on getting off it

Do my concerns have any merit in your or anyone elses opinion?

Thanks in advance.

j
your serotonin should reach its natural levels if you taper slow enough, how fast did you go the first 3 times? it's suggested that you cut down your dose by 20% each 1-2 weeks. if you start to feel unstable after a cut, go back up to the dose before and stay there for another 1-2 weeks and make the next cut smaller, 10%.

your brain will ramp up serotonin just fine. IMHO staying on an SSRI indefinitely is more concerning than coming off and having temporary withdrawal symptoms. the brain needs resting (reuptake) serotonin to make melotonin and 5-HIAA, and that's not possible when taking SSRI's. -rula
 
#13 ·
One more question. What time of the day is serotonin the highest for most people. I realize nobody can answer this for sure, but Im wondering what most "experts" speculate on this matter. It seems our body is on some sort of a clock with everything and Im wondering if this applies to serotonin also. My doctor told me once that evenings are usually best for most people with anxiety and depression. This was always the case for me over the past 3 years. Tho I feel pretty damn good these days, I want to try and answer some questions about what Ive been thru.
 
G
#14 ·
Rula it is most interesting that Mt Sinai is using or considering using antibiotics and antihistamines.I would like to learn more about this.
Is it possible to find out why they are using them and which ones?

As for my fragile body theory.I think it's mostly genetic.Each day they seem to be discovering a new gene for this or that.Gene therapy is only in it's infancy.
I also believe it's posibble that environmental factors can come into play for eg exposure to chemicals,pesticides etc.
What the mother injested whilst pregnant would have also have an influence.
I think it's possible that the central nervous system might be weakened or under developed in some people due to environemental factors.
Here such things as over head power lines have been under scrutiny,lead,asbestos,femeldahide and even cows milk and the list goes on.
Then there are the childhood diseases as well as more obscure viruses,bacterias and rickettsias etc........many many people have ended up at a psychiatrist's office who are really suffering from lyme disease.

Oh, did I mention vaccines,theres a can of worms for ya.
There is strong speculation that a batch of early polio vaccines
were contaminated with a simian virus (monkey).Scientists believe it's likely that these contaminated vaccines are the cause of an aggressive form of chest cancer.
The same cancer that exposure to asbestos causes.

I could well be incorrect but I thought I read that Freud once said that one day they will discover a physical cause for mental illness.

Cheers Shelly
 
#15 ·
I'm on Effexor 75 mg a day too. I'm kind of at a crossroads and would like to know more. I don't know as much about the physiological aspects of mental health as the pyshological aspects but since I'm taking chemicals then I should know a bit more.

This is how the doctors have put it to me - that for the SSRI to be therapeutic, you need to take it for a substantial amount of time ie 6 months. It was implied that it would it gets the neurotransmitters working properly again. I realise that this is very basic knowledge, please forgive me. Basically, short terms (3 months) of Cirpamil in the past have helped me out of a rut of dp/anxiety, until last summer when I tried it again and as I upped the dosage, I got severe dp, worse than ever. I cold turkied, but started Effexor a few days later and there was immediate change, but gradual after that and now feel so much better. I have also addressed some personal issues and learnt a lot about dp that I did not know before.

I know this is not the end of the journey. But, at this crossroads, my question is, do I continue with SSRI or not? I kind of know what I have to do mentally, to help myself, but it's going to be tough. The Effexor definitely helps. I would take the side effects any day over the dp. (I was desperate) I am quite resilient to physical symptoms. So, with this in mind, it makes sense, since I was able to drop from 150mg to 75mg relatively easily, and 75 is a relatively low dose, to keep taking the Effexor. It helps obsessive thoughts and defintely lifts the mood, although depression has never been a problem for me as such. I still have my moments of dp and other mental symptoms, and worry that these would worsen if I came off Effexor.

I'm concerned about what you say above. Given the evidence that Effexor has worked for me, yes with side effects that are horrible but worth it, (the only one now being lack of sex drive and weight gain), perhaps I should continue to take it. Or, should I quit while I'm ahead and get off it, and get myself onto omega oils and all that crap?

Just to add, I don't take anything else, never touched Benzos, though have an opened bottle of valium that the doc gave me that I have so far resisted :D

Some advice from you chemically minded dudes would be very appreciated!
 
#19 ·
Shelly said:
Rula it is most interesting that Mt Sinai is using or considering using antibiotics and antihistamines.I would like to learn more about this.
Is it possible to find out why they are using them and which ones?
Seromycin (250mg, not the TB dose) and Periactin. they seem to think that the lamictal/SSRI combo hasn't proven too effective or at least not in most cases, i suppose this is their next guess. I have to admit I didn't walk out of Mt. Sinai impressed with their theory, or feeling hopeful, just bored out of my mind for having to repeat the story of how it all began and how it all feels.
 
#20 ·
Dear Rula,
I've inluded a link to an article I read last year. I think that the Periactin is a pretty lame idea - however, the seromycin may be able to do some pretty amazing stuff. Scientists think that it may hold the key to changing a protein which helps us conquer fears. It has shortened therapy sessons for people trying to overcome phobias from 8 to 2 sessions. Here's the link:

http://www.cognitiveliberty.org/dll/fear_pill.html

I also read last year that Dr. Simeon was trying a drug used for opiate addiction. Did they mention this at the meeting? And what were their views regarding Lamictal? Good luck, and I would try the combo, at least for the Seromycin's sake.

Peace
Homeskooled
 
#21 ·
Rula-

Thats the thing, the third time I came off, I spent literally months tapering off. Like 8 months all up. Just coming off 75mg. The last two months I was on 1/4 of ONE 37.5 pill, and doing fine. But three weeks after tapering down to zero, the DP and panic started up with a vengeance. I just dont understand. Do you have anything to add to this homeskooled?

Thanks again,
j

rula said:
jw1234 said:
Homeskooled-

Your points on downregulating really resonated with me. I have tried to come off effexor three times, after it has cured my dp/dr/obsessive thoughts, and wanted to get my emotion (and ability to play music) back. Unfortunately, I couldnt wait for the serotonin to reach its natural level because all the bad stuff came back worse each time, but I am still dead set on getting off it

Do my concerns have any merit in your or anyone elses opinion?

Thanks in advance.

j
your serotonin should reach its natural levels if you taper slow enough, how fast did you go the first 3 times? it's suggested that you cut down your dose by 20% each 1-2 weeks. if you start to feel unstable after a cut, go back up to the dose before and stay there for another 1-2 weeks and make the next cut smaller, 10%.

your brain will ramp up serotonin just fine. IMHO staying on an SSRI indefinitely is more concerning than coming off and having temporary withdrawal symptoms. the brain needs resting (reuptake) serotonin to make melotonin and 5-HIAA, and that's not possible when taking SSRI's. -rula
 
#22 ·
Homeskooled said:
funny. i read that same article early this morning. a lot of cured DP ppl say it goes away when you stop being scared of it/accept it. i know for me it's been fading since i stopped obsessing over it, so maybe the seromycin thing is not so bad. the antihistamine stuff, she asked a lot of questions about the time that DP started, hinting around allergy season. but they're not really testing the 2 drugs as a combo, you take one for 8-weeks, 2 weeks break, then the other for another 8-weeks.

I also read last year that Dr. Simeon was trying a drug used for opiate addiction. Did they mention this at the meeting? And what were their views regarding Lamictal?
she brought up B12 vitamins, which i beleive are usually used in opiate withdrawal, but didn't really get into more specifics. she said the London group is working more with lamictal, but success rates are only around 40%, i guess they're looking for a higher number.

Good luck, and I would try the combo, at least for the Seromycin's sake.
i haven't decided against it yet. but i have to be 'stable' on my meds before they get started. i have to take 12 pills a day of vitamins/minerals, 2 aminos, and 1 klonopin...some days i get pissed and decide to skip this pill or that one, and they want me to stop playing with my meds for 2 weeks first...then they'll add MORE pills! LOL! maybe after the seromycin i'll be DP free AND finally go sky diving! :shock:
 
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