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@DrMariano 936 wrote:
Congratulations. I am happy it helps you.
SSRIs increase serotonin signal duration. Increasing serotonin signaling (so long as thereis sufficient serotonin being reduced) can lead to decreased norepinephrine signaling (if dopamine isn’t reduced excessively by the increase in serotonin), which can lead to decreased pro-inflammatory cytokine signaling, which can help resolve hypothalamic-pituitary-adrenal axis dysregulation – if one doesn’t have other complicating factors. The main reason depression is generally better after several weeks – if one is lucky – with an antidepressant is this improvement in hypothalamic-pituitary-adrenal axis regulation. With improvement in HPA axis regulation, cortisol signaling improves, then thyroid signaling improves, and so on, until a person is hopefully in remission.
Notice that it is a long chain of events that has to occur, starting with the availability of serotonin production so that the SSRI can work in the first place via its primary mechanism. Since there are a lot of complicating factors that prevent this chain of events from being successful, there are many reasons antidepressants may only partially work or not work at all. Addressing these other factors – which are themselves often causes of depression – helps improve treatment outcome.
SSRIs are very useful medications in the psychiatric toolkit when one knows how to use them as part of an overall scheme of treatment.
That really is amazing.
And I have to tell you, I truly appreciate your approach of considering these illnesses as all part of the same system.
I also use a small amount of isocort and transdermal pregnenolone, which helps greatly. The pregnenolone started relieving the anxiety all by itself, the SSRI capped it off.
As an aside, when one is on a few different meds, do you think it makes sense to use a supplement like milk thistle or liv-52 to keep the liver up to par?
I don’t know how much load I’m putting on my liver with these meds as I don’t understand liver metabolism well, so I don’t even know if it’s much of a concern.
@chaos 946 wrote:
That really is amazing.
And I have to tell you, I truly appreciate your approach of considering these illnesses as all part of the same system.
I also use a small amount of isocort and transdermal pregnenolone, which helps greatly. The pregnenolone started relieving the anxiety all by itself, the SSRI capped it off.
As an aside, when one is on a few different meds, do you think it makes sense to use a supplement like milk thistle or liv-52 to keep the liver up to par?
I don’t know how much load I’m putting on my liver with these meds as I don’t understand liver metabolism well, so I don’t even know if it’s much of a concern.
Unless there is a clear liver damage as a problem with treatment, I would not consider adding Milk Thistle or another putative liver treatment.
Adverse effects associated with oral ingestion of milk thistle may include:
- Gastrointestinal problems (e.g., nausea, diarrhea, dyspepsia, flatulence, abdominal bloating, abdominal fullness or pain, anorexia, and changes in bowel habits).
- Headache.
- Skin reactions (pruritus, rash, urticaria, and eczema).
- Neuropsychological events (e.g., asthenia, malaise, and insomnia).
- Arthralgia.
- Rhinoconjunctivitis.
- Impotence.
Thus, why would one want to complicate treatment – particularly of a condition causing fatigue, with a treatment that may add to fatigue, unless it is clearly indicated?
Sooner or later i will be coming to seeing you Dr. M and i will be very curious to see how you can restore someones downregulated HPA with SSRIs.
I think and seen on myself, that those drugs work only during the initial active high stress/high noradrenaline output periods, but i guess that when the HPA is downregulated and “locks” to a lower level i think an SSRI would be rather harmful than assisting in any way, but i only have some years of experience and only experiment on myself whilst you have seen thousands of patients, plus we are all different patients…Anyways i suppose that you use them in conjuction with other medication or in differing doses, because each and every time i took an SSRI i only got worse, and i mean way worse like hypoglycemic, sleepless, agitated, and nervous. Maybe i didnt use them long enough, but how can i withstand the SSRI extra fatigue superimposed on my own debilitating fatigue and weakness from CFS??Plus i dont understand how you dont worry about atrophying someones adrenal glands with an SSRI, since thats whats supposed to be happening after some months of use with them as i have read over and over again, and that would coincide with lowering of the HPA axis activity wouldnt it ???
Who knows..
I have been taking an SSRI for at least 16 years and I have done my own extensive research on the effects of their use, both pro and con, I was wondering if you could reveal the source(s) of reference which you say you have “read over and over” regarding SSRI’s cause “ATROPHY OF THE ADRENAL GLANDS” I would like to read it for myself if you would reveal where you read that. Thanks
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