Listening to Prozac, 20 years later.

gretchen

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20 years ago, a psychiatrist named Peter Kramer wrote a book called Listening to Prozac. In the book he detailed people's personal transformations from using the SSRI drug Prozac. People said using the drug caused them to become happier and more like their idealized selves. In the years after this book was published, Prozac became a household name.

In the news lately we are hearing a lot of reports about gun violence that is likely linked to use of SSRIs. It's clear they make people more aggressive. How does this mesh with what Kramer wrote 20 years ago? There are continued anecdotes all over the Internet of people who can't function off SSRIs. Why is this?

http://www.amazon.com/gp/aw/d/014026671 ... mdp_mobile
 

John Eels

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Re: SSRIs, aggression and American culture

I think it's relevant to distinguish between short term effects and long term effects. Shirt term, I mean a couple of months, there might be a sense of heightened mood and energy. The effects over a couple of years are a different story. I see a lot of people on SSRI's and they often complain about tiredness and increased daytime sleepiness. I had been on Prozac and I felt less sensitive to stimuli. In consequence I was less able to both experience joy and sadness. I was blunted by the drug.

Danny Roddy published a blog post not long ago about Serotonin and SSRI's (http://www.dannyroddy.com/main/things-are-getting-trippy-serotonin-and-lsd). Here's a excerpt from it:
Q: Yeah, but I took (an antidepressant or 5-HTP or tryptophan) once and it made me feel good. Real good!

SSRIs, 5-HTP and tryptophan can all increase levels of serotonin.

Serotonin can act on the pituitary to release adrenocorticotropic hormone (ACTH), which tells the adrenal glands to produce more cortisol.
“Serotonin acts centrally to affect renin release, and it promotes ACTH secretion.”
— Constance R. Martin (Endocrine Physiology 1986)
ACTH and cortisol, possibly due to their anti-inflammatory effects, can make one feel good, at least in the beginning:
“Adaptive hormones can cause mental changes in man. Many patients who take ACTH or cortisol first develop a sense of extraordinary wellbeing and buoyancy, with excitement and insomnia; this is sometimes followed by a depression which may go so far as to create suicidal tendencies.”
— Hans Selye
“Glucocorticoids exert early influences on the brain that tend to elevate mood and increase the sense of ‘well-being.’ Larger amounts can bring on temporary euphoria. However, the secondary effects include psychic depression. Patients with chronically elevated levels tend to have mood swings. They have been known to display bizarre behavior and to suffer hallucinations.”
— Constance R. Martin
The effects of Prozac may be due to its effects on neuroactive steroids like pregnenolone (http://www.sciencedirect.com/science/article/pii/S0091305706002528):
Pregnenolone and its sulfate enhance learning and memory in rodent models, and therefore pregnenolone elevations may be relevant to cognitive changes in psychotic and affective disorders. Since pregnenolone decreases have been linked to depression, it is possible that olanzapine- and fluoxetine-induced pregnenolone elevations may contribute to the antidepressant actions of these agents.
In the book "Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America" (http://tinyurl.com/bhtavc5) Robert Whitaker compiles evidence that suggests that over a five year period people on SSRI's fare worse than those not medicated. For instance, in third world countries the long term outcome of schizophrenia patients is better than those in developed nations b/c they get prescribed an antipsychotic whereas only 16% of the patients in poor countries receive medication (according to a WHO report). The psychotropic substances that are supposed to help you make you seek, Whitaker concludes.
 
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gretchen

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Re: SSRIs, aggression and American culture

On Zoloft I flipped over in to a manic state within a few months & instinctively stopped taking it after the damage was done.

This is unrelated, but I also took estrogen (the bcp) which also increases aggression. I consistently worked and stayed hyped up while on it. Since going off, I feel more mellow and quiet ; some days I don't even want to leave the house. Is this like what people go through on SSRIs- they get all fired up to do something, which is very American (laying around and being peaceful is lazy), then the social approval dynamic kicks in and everyone says good job, I'm so proud you work/shop/are happy/ party woo hoo way to go! Only the fact is, when I wasn't active (on estrogen), I used to just sit on my futon by myself and wonder how I would cope. Everything drove me crazy.
 

Lucy

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I have a similar anecdote. One of my friends had a good job as a programmer, was in a decent relationship, saving some money for an apartment, in short, she lead what you could call a normal life. But she is prone to depression/anxiety and got put on several antidepressants by her psychiatrist. And one of them, the one that worked best according to her, sent her into hypomania (which I saw with my own eyes - it included aggression on top of extreme restlessness and grandiose ideas). She kept taking it for a few years and in the mean time left her job, her boyfriend, sold her car and used up all her savings, just to be able to start a new business of her own - a huge international online portal. Well, a few years later, the portal was functioning, but she didn't earn a dime off it and was completely broke with nowhere to go but her parents' place. Then she stopped ADs and calmed down, and now she's saying she doesn't want to be an enterpreneur at all, but just wants a regular 8-hour job and a family life. She now has a regular job and is building her life again, but I think her grandiose idea cost her a lot.

I'm almost sure this happened because she was put on ADs. And I also think that estrogen drives the crazy western behaviour (workaholism, partying excessively, aggression etc.). Like the mice that run 30 miles per day when given estrogen. When I watch documentaries of hunter-gatherers or other noncivilized people, what strikes me the most is how extremely placid they are in comparison to western people.
 

jyb

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Re: SSRIs, aggression and American culture

John Eels said:
In the book "Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America" (http://tinyurl.com/bhtavc5) Robert Whitaker compiles evidence that suggests that over a five year period people on SSRI's fare worse than those not medicated. For instance, in third world countries the long term outcome of schizophrenia patients is better than those in developed nations b/c they get prescribed an antipsychotic whereas only 16% of the patients in poor countries receive medication (according to a WHO report). The psychotropic substances that are supposed to help you make you seek, Whitaker concludes.

I recall reading that it's similar for those on sleeping pills. Those with insomnia who get drugs for it are worse off in the long run.
 
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Lucy said:
I'm almost sure this happened because she was put on ADs. And I also think that estrogen drives the crazy western behaviour (workaholism, partying excessively, aggression etc.). Like the mice that run 30 miles per day when given estrogen. When I watch documentaries of hunter-gatherers or other noncivilized people, what strikes me the most is how extremely placid they are in comparison to western people.

Sayyid Qutb's observations are relevant here:

This small city of Greeley, in which I am staying, is so beautiful that one may easily imagine that he is in paradise. Each house appears as a flowering plant and the streets are like garden pathways. As one observes, the owners of these houses spend their leisure time in toil, watering their private yards and trimming their gardens. This is all they appear to do ...

I stayed there six months and never did I see a person or a family actually enjoying themselves, even on summer nights when breezes waft over the city as if in a dream. The most important thing for these people is the tending of their gardens, much in the same way a merchant spends time organizing his store or a factory owner his factory. There is nothing behind this activity in the way of beauty or artistic taste. It is the machinery of organization and arrangement, devoid of spirituality and aesthetic enjoyment.
 

Lucy

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This small city of Greeley, in which I am staying, is so beautiful that one may easily imagine that he is in paradise. Each house appears as a flowering plant and the streets are like garden pathways.

There is nothing behind this activity in the way of beauty or artistic taste.

Isn't he contradicting himself a bit here?
 

kiran

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Dorito Loyalist said:
Sayyid Qutb

He was an islamist radical, indeed the granddaddy of all islamist radicals. I'm not sure that we can put any weight upon his words.
 

John Eels

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And I also think that estrogen drives the crazy western behaviour (workaholism, partying excessively, aggression etc.). Like the mice that run 30 miles per day when given estrogen. When I watch documentaries of hunter-gatherers or other noncivilized people, what strikes me the most is how extremely placid they are in comparison to western people.
I like your thinking. Maybe western society's pace is related to people's overall physiology which might be estrogen dominant.
 

kiran

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I'm not sure I believe that. The hunter-gatherers left today are mostly on marginal land and comparatively shy, perhaps not the most typical of H-Gs in general.

I imagine the healthy human would be very curious and experimental.
 

Lucy

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Placid and curious/experimental are not traits that are mutually exclusive, actually all three combined are how I would like my child to be, for example :) (In comparison to the children I sometimes see who can hardly focus enough to learn anything, and are anything but placid.) Perhaps H-G are not the best example, but in general they don't seem to suffer from such afflictions. By the way, this is an interesting example: http://ngm.nationalgeographic.com/2009/ ... inkel-text

Ha, I just noticed the word "placid" is used in the first sentence of this article :)
 

Jenn

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"Old fashion" serotonin inhibitors are different that the "improved" SSRIs. They work differently, though I don't pretend to understand them. The newer ones can do serious damage and can affect how hormone supplements behave in the body....like pregnenelone, progestE etc.
 
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It's surreal of every generation of "remedies" gets more and more dangerous.
 

mandance

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Jenn said:
"Old fashion" serotonin inhibitors are different that the "improved" SSRIs. They work differently, though I don't pretend to understand them. The newer ones can do serious damage and can affect how hormone supplements behave in the body....like pregnenelone, progestE etc.

Where did you hear that?
 

4peatssake

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mandance said:
Jenn said:
"Old fashion" serotonin inhibitors are different that the "improved" SSRIs. They work differently, though I don't pretend to understand them. The newer ones can do serious damage and can affect how hormone supplements behave in the body....like pregnenelone, progestE etc.

Where did you hear that?
She is probably referring to this:

Ray Peat said:
Every doctor in the country seems to know that the old MAO-inhibitors are dangerous because they can raise blood pressure if you eat certain kinds of cheese while taking them. In fact, statistics show that they are safer than the new generation of antidepressants.
Bold is Ray Peat

and

The drug companies like to call some of their new products SSRI, “selective serotonin reuptake inhibitors,” meaning that they don’t indiscriminately increase all the biogenic amines, the way the old MAO inhibitors supposedly did.

Serotonin, depression, and aggression: The problem of brain energy

The article well explains the serious damage done by SSRIs. Just one snippet.

Ray Peat said:
Some research shows that increased serotonin is associated with certain types of increased aggressiveness, and antiserotonin agents decrease aggresiveness (Ieni, et al., 1985; McMillen, et al., 1987) but the clearest research has to do with the crucial role of serotonin in learned helplessness. Learned helplessness is a biological condition that is created by inescapable stress. In this state, animals that would normally swim for hours will stop swimming after a few minutes and allow themselves to drown. They simply don’t have enough mental or physical energy to overcome challenges.
 

mandance

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She is probably referring to this:

Ray Peat said:
Every doctor in the country seems to know that the old MAO-inhibitors are dangerous because they can raise blood pressure if you eat certain kinds of cheese while taking them. In fact, statistics show that they are safer than the new generation of antidepressants.
Bold is Ray Peat



Well ive read that article, but she said that they do serious damage and effect how hormone supplements effect the body...Im wondering where she got that info because I have not come across it before. I def feel the learned helplessness thing...since getting off these pills recently after a long time on them...I dont have much will to do anything, even eating.
 

HDD

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mandance said:
Jenn said:
"Old fashion" serotonin inhibitors are different that the "improved" SSRIs. They work differently, though I don't pretend to understand them. The newer ones can do serious damage and can affect how hormone supplements behave in the body....like pregnenelone, progestE etc.

Where did you hear that?


I asked about this a week or so ago. I was considering letting my son take pregnenolone until I read that.

Jenn, could you explain?
 

mandance

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I think its fine...Peat knows my history of antidepressants and still advised preg and thryoid. I only took it once, it felt good but I will hold off on supps for awhile.
 

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