Posted by AndrewB on November 29, 2000, at 10:53:43
In reply to Anybody know WHY Zoloft poops out?, posted by shar on November 26, 2000, at 10:09:59
Of course Bradley is right, it seems no one really knows with any authority what causes drugs like Zoloft to poop out. And there isn't necessarily just one single process that explains everyone's poop out. I agree with Scott that, considering the (extended) time it takes for poop out to occur, secondary systems within the postsynaptic dopamine (D2/D3) neurons (changes in peptide function, to name one) or through other neurotransmitter systems acting on the these dopamine neurons may explain (at least in many cases) poop out of drugs like Zoloft. The dopaminergic system is perhaps a relatively complex neurotransmitter system with an often frustrating ability to regain homeostasis, that is, it returns to its original functional state, through the various regulating mechanisms it possesses. One can often initially raise the levels of activity in a particular part of this system, only to be disappointed some time later when the system manages to readjust its level of activity downward again.
But theories aside, the knowledge isn't out there to use theory as a means of coming up with pharmacological remedies for poop out. Rather we are left with to rely on a pool of anecdotal evidence, that is, what worked for others with similar conditions. Because we have to rely on this anecdotal evidence, boards like this, and sections like Dr. Bobs tips section are important resources. (I was so glad to hear Dr. Bob is going to update and improve the tips section. It has helped so many as it is.) For the same reason, it is important to have psychiatrist who is knowledgeable of the various potential ways to deal with poop out. He needs to have a large base of case histories gleaned from his own practice and from exchange with other professionals on what has worked in various situations for poop out. Often the psychiatrists who have the most complete knowledge in such matters are termed psychopharmocologists.
There are so many options to deal with poop out; higher dosages, switches between other serotonergic agents, add-ons like stimulants and dopaminergic agonists (bromocriptine, Mirapex).... the list goes on. Presuming one’s doctor is aware of the various options, one hopes he has the experience to know which approaches, given an individual’s situation, are most promising and to be tried first, and when and what is best to try next if the first attempts at dealing with poop out fail. It is my opinion, that when dealing with issues secondary to depression like poop out, one should seek the most experienced and qualified psychiatrists out there.
AndrewB
poster:AndrewB
thread:49441
URL: http://www.dr-bob.org/babble/20001115/msgs/49617.html