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Harvey, 2003 Neurobiology of antidepressant withdrawal

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Henosis   
Henosis

these journal articles both show that AD withdrawal partially caused by overexpression of NMDA receptors. Sure, it is light, and animal models, but would certainly explain if some people are getting help from NMDA antagonists like ketamine infusion, which I've been considering despite the expense.

 

 

https://www.ncbi.nlm.nih.gov/m/pubmed/12020747/?i=2&from=/14625154/related

 

https://www.ncbi.nlm.nih.gov/m/pubmed/14625154/

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Bobo32   
Bobo32
On 2011-12-22 at 8:19 PM, Altostrata said:

Dr. Harvey sent me this in correspondence:

 

 

Quote

I am very glad to see you are recovering from your own nasty experience. I find it especially interesting that you are showing this recovery using lamotrigine, which is a very effective inhibitor of glutamate release. Our studies have strongly implicated altered glutamatergic activity following antidepressant discontinuation/withdrawal, with especially overt activity at NMDA receptors acting to perpetuate the illness via a kindling-like action. One could even consider this to be a useful case report in support of the argument.

Hey alto,

I read what Dr. harvey said about glutamate dysregulation and how it could be the factor in withdrawal syndrome.

I am now 3 months into withdrawal and I improved in many ways except for tinnitus and pssd. What do you think I should do? Is iamotrigine the answer ?

Thank you in advance for your help

Edited by scallywag
remove graphic description of PSSD symptom

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Jennifer78   
Jennifer78

This paper describes the neurological activity that leads to withdrawal syndrome. The authors conclude:

 

 

The distress that potentially accompanies antidepressant withdrawal has not always been sufficiently appreciated. As alluded to earlier, missed doses, abrupt dose reduction, or abrupt discontinuation of some antidepressants may be associated with an antidepressant discontinuation syndrome. Although the severity of withdrawal symptoms may vary with the type of antidepressant and between patients, all too often not enough emphasis is placed on the possible neurobiological effects and possible longer-term risks associated with inappropriate withdrawal or discontinuation.

 

As emphasized here, antidepressant discontinuation may involve a stress response accompanied by a set of specific biochemical responses that cause further neuronal dysfunction and that may compromise long-term outcome. This is not to say that clinicians should continue antidepressants indefinitely; it is, however, to emphasize that the decision to discontinue antidepressants should be made judiciously and on an individualized basis.

Biol Psychiatry. 2003 Nov 15;54(10):1105-17.

Neurobiology of antidepressant withdrawal: implications for the longitudinal outcome of depression.

Harvey BH, McEwen BS, Stein DJ.

 

Source

 

Division of Pharmacology, School of Pharmacy, Potchefstroom University for Christian Higher Education, Potchefstroom, South Africa.

 

Abstract at http://www.ncbi.nlm.nih.gov/pubmed?term=neurobiology%20withdrawal%20harvey Full text here.

 

Inappropriate discontinuation of drug treatment and noncompliance are a leading cause of long-term morbidity during treatment of depression. Increasing evidence supports an association between depressive illness and disturbances in brain glutamate activity, nitric oxide synthesis, and gamma-amino butyric acid. Animal models also confirm that suppression of glutamate N-methyl-D-aspartate receptor activity or inhibition of the nitric oxide-cyclic guanosine monophosphate pathway, as well as increasing brain levels of gamma-amino butyric acid, may be key elements in antidepressant action. Imaging studies demonstrate, for the most part, decreased hippocampal volume in patients with depression, which may worsen with recurrent depressive episodes. Preclinical models link this potentially neurodegenerative pathology to continued stress-evoked synaptic remodeling, driven primarily by the release of glucocorticoids, glutamate, and nitric oxide. These stress-induced structural changes can be reversed by antidepressant treatment. In patients with depression, antidepressant withdrawal after chronic administration is associated with a stress response as well as functional and neurochemical changes. Preclinical data also show that antidepressant withdrawal evokes a behavioral stress response that is associated with increased hippocampal N-methyl-D-aspartate receptor density, with both responses dependent on N-methyl-D-aspartate receptor activation. Drawing from both clinical and preclinical studies, this article proposes a preliminary molecular perspective and hypothesis on the neuronal implications of adherence to and discontinuation of antidepressant medication.

 

I'm confused about this article. So do we heal from cold turkey or not? What's the point in going off meds if it's only going to make us worse in the long run?

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Altostrata   
Altostrata
On 2017-05-05 at 6:29 AM, Bobo32 said:

 

On 2011-12-22 at 8:19 PM, Altostrata said:

Dr. Harvey sent me this in correspondence:

 

Quote

I am very glad to see you are recovering from your own nasty experience. I find it especially interesting that you are showing this recovery using lamotrigine, which is a very effective inhibitor of glutamate release. Our studies have strongly implicated altered glutamatergic activity following antidepressant discontinuation/withdrawal, with especially overt activity at NMDA receptors acting to perpetuate the illness via a kindling-like action. One could even consider this to be a useful case report in support of the argument.

Hey alto,

I read what Dr. harvey said about glutamate dysregulation and how it could be the factor in withdrawal syndrome.

I am now 3 months into withdrawal and I improved in many ways except for tinnitus and pssd. What do you think I should do? Is iamotrigine the answer ?

Thank you in advance for your help

 

 

Bobo, you've improved after 3 months, that's a very promising rate of healing. It may take somewhat longer for all the symptoms to go away. We don't know of any definite way to cure those symptoms. Please let us know how you're doing in your Intro topic.

 

Jennifer -- This paper describes what might happen after inappropriate discontinuation

 

We know it's not good for your nervous system to go off psychiatric drugs suddenly. This paper describes why the potential neurological results might be. The research did not investigate the process of healing from this.

Edited by scallywag
remove graphic description of PSSD symptom in quoted post

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Bobo32   
Bobo32

alto still having the 

On 2017-05-25 at 2:16 AM, Altostrata said:

 

On 2017-05-05 at 6:29 AM, Bobo32 said:

 

On 2011-12-22 at 8:19 PM, Altostrata said:

Dr. Harvey sent me this in correspondence:
 

Quote

I am very glad to see you are recovering from your own nasty experience. I find it especially interesting that you are showing this recovery using lamotrigine, which is a very effective inhibitor of glutamate release. Our studies have strongly implicated altered glutamatergic activity following antidepressant discontinuation/withdrawal, with especially overt activity at NMDA receptors acting to perpetuate the illness via a kindling-like action. One could even consider this to be a useful case report in support of the argument.


Hey alto,
I read what Dr. harvey said about glutamate dysregulation and how it could be the factor in withdrawal syndrome.
I am now 3 months into withdrawal and I improved in many ways except for tinnitus and pssd. What do you think I should do? Is iamotrigine the answer ?
Thank you in advance for your help

 

 

Bobo, you've improved after 3 months, that's a very promising rate of healing. It may take somewhat longer for all the symptoms to go away. We don't know of any definite way to cure those symptoms. Please let us know how you're doing in your Intro topic.

Alto, is it possible that neuronal damage due to SSRIs is the reason for PSSD? I dont know what to do for this symptom. Should I reinitiate and withdraw differently? I cut the lexapro pill in bits when I quit. Is it the reason I have this? 

 

Edited by scallywag
remove graphic description of PSSD symptom

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Jennifer78   
Jennifer78

 

 

Jennifer -- This paper describes what might happen after inappropriate discontinuation[/color

 

I did a cold turkey. So am I not going to recover mentally?

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btdt   
btdt
On 2017-5-25 at 2:16 AM, Altostrata said:

 

Bobo, you've improved after 3 months, that's a very promising rate of healing. It may take somewhat longer for all the symptoms to go away. We don't know of any definite way to cure those symptoms. Please let us know how you're doing in your Intro topic.

 

Jennifer -- This paper describes what might happen after inappropriate discontinuation

 

We know it's not good for your nervous system to go off psychiatric drugs suddenly. This paper describes why the potential neurological results might be. The research did not investigate the process of healing from this.

when I took amoxacillin recently my movement disorder stopped completely... I found a source that said that ab lowers glutamate and also another source that said high glutamate causes huntingtons which is what my doc thought I had when it first started by the neurologoist she sent me to just said movement disorder...

 

if it was lowering glutamate that stopped it ... what are other potential treatments?  

i am looking for ideas

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Altostrata   
Altostrata

Please stay on topic in the Journals forum.

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