Posted by Racer on September 8, 2008, at 10:49:08
In reply to Brief immediate responses to meds?? - Advice Pls, posted by Four Feathers on September 8, 2008, at 9:04:00
This probably isn't something you want to hear, but I wonder if this might be -- at least in part -- a placebo response? They're very real, even if they are created in our brains rather than in our chemistry. And, as has been pointed out here before, they're rarely sustained for more than a few days.
In my case, I know I have a very robust and predictable placebo response -- both good and bad. If I am feeling a high degree of trust in my psychopharmacologist AND trying either a new drug or a drug that's been OK in the past, I'll feel some distinct improvement -- often in days. That's usually based on relief that I've found an opening in the wall of my cage, and have a doctor "taking care of" me. Once I've been on the drug for a bit, that goes away, and either I respond or don't respond, which usually takes several weeks.
On the other hand, if I am feeling distrustful or insecure with my doctor, and/or am taking a drug which has caused problems in the past, I'll often get worse. Sometimes, instead, I'll have an initial improvement -- which I think is an effort to please the doctor, to gain his approval. That sort of initial improvement, though, usually ends with a precipitous drop in mood once the placebo effect ends.
What makes all that so crazy-making is that I know it's a pattern I've experienced over and over again, and sometimes I even know I'm doing it -- and it's still "real" to me. Talk about feeling crazy!
The other possible answer, of course, is "no one really knows." Some medications used for multiple disorders have different courses with each of them. SSRIs for depression require weeks to work. SSRIs for premenstrual dysphoric disorder work within a couple of days, and only have to be taken for a few days a month. They may even be less effective if taken throughout the month. Same drug, different clinical pictures. And do you know why that is? No one else does, so I guess we write that up as another neurochemical mystery for now.
I guess what I'm saying is that there are a lot of possibilities, and no firm answers, but maybe a combination of mystery and psychological reaction.
Not so helpful, I'd bet, but I hope you do find a good answer for you.
poster:Racer
thread:850938
URL: http://www.dr-bob.org/babble/20080903/msgs/850955.html