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  • #1038
    chaos
    Member

    I did very well with this in the past. Any reason not to take it?

    #1835
    DrMariano2
    Participant

    @chaos 47 wrote:

    I did very well with this in the past. Any reason not to take it?

    One of the rule of thumbs in psychiatry is that if it worked well in the past, it makes a good choice in the present.

    Even within the serotonin-reuptake inhibitor class of medications, there is high individual variation in the response to the individual medications. Thus, one SSRI will not work as well as another.

    The primary rationale for using an SSRI is that a person has impaired serotonin signaling as one of the many causes of the target illness.

    There are many interactions. These have to be accounted for and adjusted for in treatment.

    #1837
    chaos
    Member

    @DrMariano 48 wrote:

    One of the rule of thumbs in psychiatry is that if it worked well in the past, it makes a good choice in the present.

    Even within the serotonin-reuptake inhibitor class of medications, there is high individual variation in the response to the individual medications. Thus, one SSRI will not work as well as another.

    The primary rationale for using an SSRI is that a person has impaired serotonin signaling as one of the many causes of the target illness.

    There are many interactions. These have to be accounted for and adjusted for in treatment.

    Is it true a drug like Prozac can be used to help treat adrenal fatigue? how?

    #1836
    DrMariano2
    Participant

    @chaos 52 wrote:

    Is it true a drug like Prozac can be used to help treat adrenal fatigue? how?

    You have to first define the term “Adrenal Fatigue”. When you look at James Wilson ND’s book “Adrenal Fatigue – the 21st Century Stress Syndrome”, you will find that Adrenal Fatigue is his term for any Non-Addison’s Disease form of low adrenal function which is primarily caused by stress.

    This term is actually descriptive. It doesn’t define the actual physiologic changes that lead to lower adrenal function. It includes a very broad array of conditions and illnesses that includes most mental illlnesses such as depression, anxiety, posttraumatic stress disorder. If anything, posstraumatic stress disorder is the best example of adrenal fatigue. However, stresses can also include infections, surgeries, and other non-psychological stresses.

    Note that the primary contributing factor to the development of adrenal fatigue is “stress”.

    Prozac and the Serotonin Reuptake Inhibitors (SSRIs) work by increasing the signal duration of serotonin. Serotonin reduces the perception of stress and reduces norepinephrine, the primary signal for stress, in the nervous system. There are other secondary events once these primary actions of serotonin are accomplished, such as reducing pro-inflammatory cytokine signaling. Thus, Prozac and the other SSRIs, can help reduce adrenal fatigue.

    In depression, there are hypothalamic-pituitary-adrenal axis (HPA Axis) changes. In the early development of depression, adrenal function as measured by cortisol can be high. But under chronic stress, this ends up being low. This is referred to by Hans Selye (the father of stress research) as the adrenal exhaustion phase of the stress response. When one includes trauma such as child abuse to the mix in the development of depression, the development of low adrenal function is common.

    Prozac and the other SSRIs have a 4-6 week delayed effect in reducing depressive symptoms. I believe one important reason is that it takes time to recover HPA axis function as a component of depression. The effect on stress signaling is nearly immediate – since increased serotonin signaling occcurs within 20 minutes of ingestion. But the recovery of HPA axis function takes a longer time.

    Dosing is important. If serotonin signaling is increased excessively, dopamine signaling is inhibited excessively. Since dopamine is another control signal on norepinephrine, norepinephrine can increase despite the increase in serotonin. This condition of lower dopamine, higher norepinephrine can be expressed as akathisia (motor agitation), increased anxiety, insomnia. It can lead to worsening rather than improvement of one’s mental function. At worse, it leads to suicides associated with the SSRIs.

    Note that depression is a highly complex, multisystemic illness – affecting nervous system, endocrine system, immune system function and metabolism. The reason that Prozac and other antidepressants often only partially work or not at all is that they address only part of the pathophysiology of depression.

    Additionally, when it comes to stress, serotonin is only one control signal. Addressing other signal abnormalities that lead to excessive stress is important to help a person improve if the initial treatment of increasing serotonin signaling does not work well or completely. This may include addressing norepinephrine directly via other medications, or addressing it indirectly via other routes such as GABA, dopamine, CRH, cortisol, etc.

    #1838
    chaos
    Member

    I have been diagnosed with PTSD.

    #1840
    jill890
    Member

    I had success with Prozac in the past. My employer no longer offers health insurance, so I had to get an Individual Health Insurance plan. Unfortunately, I selected a plan that doesn’t cover name brand pharmaceuticals. Has anyone ever tried the generic? Does it work as well?

    #1839

    Hi Jill, I have never used Prozac but since it is not measured in micro amounts such as Thyroid meds Generic should be fine. Some meds that are measured in very small amounts can be felt if they are only slightly different like the Thyroid meds. I hope it helps you the same as before. All the best.

    #1841
    jill890
    Member

    Thank you for your help, DownTheLaneTheyCame. 🙂

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