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Aswad -> RE: May be of interest...... (2/28/2008 5:06:47 AM)
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ORIGINAL: Hippiekinkster
All I have to say is, if Citalopram is no more effective than placebo, then that is one hell of a placebo effect I'm feelin'. [:D]
Clinically significant antidepressant action from serotonergic drugs requires a level of reuptake inhibition that citalopram cannot achieve, even with direct injection into the brain, at any dose. However, some people may still experience improvement, though losing words gets tiresome after a while.
How long have you been on it? And, more to the point, is it improvement, or remission? If it is merely improvement, then low doses of Anafranil (clomipramine) and/or Solian (amisulpride) are more likely to lead to actual remission. I have noted that some people whose depression is secondary to another problem (e.g. OCD, anxiety, etc.) respond far better to Celexa (citalopram) than those who have depression as a primary problem.
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New research indicates that SSRIs promote new neuron growth in the brain, which is a slow process.
A lot of drugs increase neurogenesis in the brain.
So will a lot of highly untherapeutic events, like traumatic brain injury, strokes and starvation.
Conversely, depleting serotonin stores will not suppress neurogenesis in the brain, unless you also deplete norepinephrine stores. Neither will inhibiting serotonin synthesis do so by itself. At least, that seems to be the case in rats. Their brains are sufficiently similar to suggest that humans will also need dual suppression for neurogenesis to be downregulated. Which lends some credibility to the notion that serotonergic-noradrenergic therapy is a better choice. The SSRIs don't give that, and the SNRIs aren't significantly better at it.
Compare this to the MAOIs, which will additionally cut the risk of Alzheimers in half with long-term use.
They also nearly eliminate the risk of Parkinsons, and ameliorate its symptoms.
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It appears that there is a gene mutation which may influence efficacy.
Which, in turn, suggests that it's not a very good choice for first line therapy without a gene assay.
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Here's a great site about these meds: http://crazymeds.us/
Crazymeds, a.k.a. Poppin' Zits, isn't exactly the best place to learn about such meds.
Dr. Bob's is somewhat better, but doesn't beat doing the research, of course.
Someone here mentioned Psychotropicals, which turned out to be good.
Personally, I've found PubMed and Cochrane to be fairly useful. [:D]
Health,
al-Aswad.
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