The brain has many ways to regulate itself so that this is not possible.
To take any compound at those levels would be not only toxic; but also addictive. Fatally so.
It would tap out at a point, resulting in ‘side effects’ being the ‘primary effects’. And life without the compound is then impossible – with prior symptoms exaggerated, if you survived withdrawal. And bear in mind, symptoms at this point were already at a level where treatment was being sought.
Essentially all drugs are addictive, definition dependant. But the AntiD’s (as a rule) don’t tend to be fatally so.
And yes, antidepressants are addictive; I repeat – essentially all drugs are.
I don’t care what your friend says.
They are all addictive and mood effects are not serotonin mediated either.
Why does everyone say that? The answer is either they don’t, TV- or some mix therein.
Undergrads aren’t taught these mechanisms in any great depth, TV doctors don’t care what they tell you, and practicing physicians are busy. Practicing medicine.
They read the pamphlets on new medications and trust the FDA/TGA and conferences to let them know what not to do.
Of course, FDA/TGA, the drug companies, and conference going researchers have only done limited human trials, by necessity.
They themselves are waiting to see how many people fall down when a drug is prescribed en mass and long term in the community, before changing any recommendations.
I know, it seems like it would be the other way. But think about it for just one
second. See? It just can’t be any other way. That is why this IS the way it is.
Just like reason tells us they must be general in their effect, since they sell to a GENERAL market, but we are all given to individual differences (*that and we don’t really know what we are doing); so too does reason tell us they are addictive.
There would be a rebound headache from paracetamol, if you took it every day and stopped suddenly. And if the headache was bad enough: you would also see seeking behaviour. Caffeine causes withdrawal and seeking. Think.
The trick is to balance the dose level and clearance rates so that a certain “shield” effect can be met, without withdrawal being too powerful, or the long-term effects too toxic.
We were once taught that short half lives were good, get a drug out of your system, quicker the better.
Now we teach the exact opposite. This happens in science. Because they are no wizards. At all.
As for anti-depressant effects and the catecholamine/indolamine pop focus, as mentioned: most effects are probably not directly serotonin et al mediated. But that would take too long to go into.
To suffice it to say – the reason side effects are noticeable at first is likely related; but why these drugs don’t “work” immediately, is because it is downstream effects that are being manipulated. This is also why serotonin uptake ENHANCERS like tianeptine are efficacious. That and the “magic” of multiple receptor subtypes, across multiple transmitters, along side individual differences and environment.
Collectively, this conglomerate is what I refer to as “we don’t know what we are doing…but this sometimes seems to work…sometimes…plus, also…I mean, science…what’s up with that anyway?”.
Again, despite what your cluey friend in the glasses “who knows about this stuff” says: not 5-hydroxytrptamine, not dopamine, not norepiniephrine – but rather a gated, idiosyncratic, downstream shift-regulation of receptors, endogenous chemical production, and enzyme level changes that are poorly understood, largely fictionalized theoreticals, that function within even more poorly mapped systems -this is the truth of how your treatment is actually working.
As far as we know.
Your doctors are not research scientists, they are medical practitioners.
Your pharmacists have long since stopped caring. (*Some hospital pharmacists are an exception).
The truth is, you would not want a drug that made you feel better right away; the biological price would be too high.
And each condition is ultimately specific to you. This is why it is unlikely they will develop the dunk pill: you can’t make a profit like that, because you can not market a drug that is that specific.
Therefore, drugs must always be general in order to form market share of any tangible value. There is no motivation for perfection.
Except for the motivation you find with medication assistance…and a few tricks of the trade.
JJR. (2013). Psychiatric Medications (Top 5 and the Truth), J Chron. Lett. & Sci (1), Sept, Jaded Medicine Collection, Ed 5.
Follows from: Psychiatric Medications
Follows to: Treatment Tricks to Know