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Antipsychotics used in depression???

Jug

Jug

Bluelighter
Joined
Aug 7, 2001
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196
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Perth Australia
Allot of shrinks use Antipsychotics to augment Antidepressants even when psychosis isn't present. (I can get plenny of sources if you want)
I Take Seroquel sometimes because its the only thing that puts me to sleep.

But Seroquel antagonizes
5HT1A and 5HT2 (IC50s=717 & 148nM)
dopamine D1 and D2 (IC50s=1268 & 329nM)
adrenergic a1 and a2 receptors (IC50s=94 & 271nM)

Aren't these pleasurable receptors we want elevated?
And dosn't serotonin play an important role in a good nights sleep?
Or dose Antagonize not really mean reduce / lower, more like bring back to baseline.

Thanks...
I know its not really Advanced
 
Antagonise means block, stop, prevent. The receptor is neccesarily inactive.

We don't know how antidepressants work. The clinical evidence (AFAIK) is pretty thin on the ground that antipsychotics supplementation is useful in unipolar depression.

But yeah, don't ask me for a biorational answer, though I would ignore the idea that you're trying to act of "pleasurable receptors".
 
Jug said:
Aren't these pleasurable receptors we want elevated?
And dosn't serotonin play an important role in a good nights sleep?
Or dose Antagonize not really mean reduce / lower, more like bring back to baseline.

Thanks...
I know its not really Advanced
Click to expand...

Well, to be honest I think this is an Advanced question...even more so because it highlights that dealing with depression seems to be such an inexact science.

BilZ0r himself has said that the whole chemical imbalance theory is not proven when it comes to depression...correct me if I am wrong??

So if we accept the argument that medicating depression is about stopping you from feeling like life is worthless, or that you want to kill yourself then something that breaks the cycle would be effective treatment.

Previous threads have argued that something that adds +3 to your mood whether it is through elevating 5HT1A, 5HT2, D1, D2, A1, A2 is not an anti depressant, but a euphoriant. The recent thread about the potential for an opiate based antidepressant has debated this very thing.

Anyway my point is that an antipsychotics effectiveness when it comes to treating depression probably does not lie in boosting a persons mood but shutting them down, to prevent a further downwards spiral.
 
I guess my understanding of an anti depressant is a drug that inhibits the reuptake of 5-HT/NA and to a lesser extent DA, and must be reasonably long acting and devoid of certain sideeffects including anorexia etc.

Whether or not it adds +n to your mood isnt really an issue since the whole point of it is to make the depressed individual feel better. If it's not doing that then it has failed to do its job correctly.

Yeah, I think antipsychotics just knock people out (the lunatic was so out of control he had to be restrained by 4 nurses until IV haloperidol was administered).
 
AlexxRed said:
BilZ0r himself has said that the whole chemical imbalance theory is not proven when it comes to depression...correct me if I am wrong??
Click to expand...

He's right. They can't prove an imbalance occurs before the negative thoughts. In actuality it could be reverse, and negative thoughts trigger an imbalance.


There are numerous drugs out there with superior anti-depressant properties to them than SSRIs, and they don't have paradoxical effects which can trigger more depression and provoke suicidal tendancies like SSRIs/SSNRIs do.

The way I see it, an anti-depressant drug has to be stimulating or pleasurable in some way to promote a positive mood. There's just no way around it and doctors don't want to admit to it.
 
A doctor once explained to me that some depressive persons were prescribed Antipsychotics because it turns them into a zombie-like state, so they don't complain anymore....

I think Antipsychotics shouldn't be prescribed to depression-suffering persons.... If they suffer only from depression, it can only make things worse...

However newer antipsychotics such as Risperidone (Risperdal), Amisulpride (Solian), Quietapine (Seroquel), Olanzapine (Zyprexa) can improve the mood of people with bipolar disorders....

There's a new antipsychotic called Abilify (Aripiprazole), and maybe this one can improve mood in depression-suffering persons, because it doesn't block Dopamine receptors, but regulate them (when the person lacks Dopamine, it releases more Dopamine, and when the person has too much Dopamine, then it blocks the Dopamine receptors...)

I would really like to hear reports of Abilify use in depression or bipolar disorders suffering persons....
 
Amisulpride (Solian) is a newer generation antipsychotic (like Zyprexa or Risperdal).
It comes in 100mg, 200mg or 400mg tablets I think.
At the smallest prescribed dosage, it's an antipsychotic just like Zyprexa, it blocks Dopamine receptors.

But when you take less than the usual dosage (~50mg), it raises Dopamine levels, and brighten your mood....
 
Speaking from personal experience here...

I am currently prescribed Seroquel, but I only take it very haphazardly because of the illicit drugs I take. I suffer from major depression and an unidentified personality disorder, coupled with significant symptoms of dysmythia, anxiety and thought disorder, and of course drug dependancy and addiction on top of that.

Yeah, no really, it's great fun. Anyway. I've been on a few different SSRIs, and I refuse to take them anymore. The medications themselves did not help me (though to be fair, I know many people who have found them extremely effective), and I recieved next to no support from the mental health system in that time. I was actively suicidal when made to start seeing them, and essentially got, "Here's some anti-depressants, we'll see you in four weeks. No, we can't do anything to help you in the meantime."

I started making some progress when I got in with the drug and alcohol services section of the mental health system, and after some discussion with the counselor asked to be put on an anti-psychotic as I believed it would help with the very distressing obsessive thoughts that I was experiencing. She chose Seroquel because it also had sedative properties and I was also suffering from chronic insomnia, and because it doesn't have any bad reactions with heroin.

When I actually take it, I find that the Seroquel is very helpful in fixing up my sleep, and alleviating stress and obsessive thinking. It does also make me quite spaced out though - it took me a couple of weeks to adjust to it, and in that time I was dopey and frequently caught myself on the brink of rocking or drooling.

To get back to the original point, the problem with the Seroquel is it did absolutely nothing to treat the depression. Nothing at all, though at least it also didn't make it any worse. Life did become easier when I wasn't dealing with the insomnia, obsessive thinking or quite so much anxiety, but the depression was still completely crippling in its own right. So in my experience, and also from what I've read about it and heard from other people, it doesn't actually help at all with unipolar depression and I would suspect this would be much the same for most anti-psychotics.

I've just now started taking the pills again. I stopped taking them for a few weeks when the depression got very severe, but I've finally overcome that through carefully regulated heroin use. I'm hoping that these two influences together will make a big difference to my life.
 
Did anybody hear from the treatment of depression with ketamine?
I recently read in an interesting article that its dissociative effects could also help persons that are resistant to other antidepressants.
 
EN21 said:
Did anybody hear from the treatment of depression with ketamine?
I recently read in an interesting article that its dissociative effects could also help persons that are resistant to other antidepressants.
Click to expand...

Ketamine is an NMDA antagonist, recently, they discovered a NMDA antagonist could be helpful against Alzheimer (it's Memantine); but I'm sure that NMDA antagonists such as Memantine could be used for the treatment of many diseases, including depression...
 
I read the article about the effectiveness of using ketamine as an antidepressant - I've been casually casting around for a k source, and if I find one I'll be testing it out. My concern though is that it will work in much the same way as ADs and APs do - namely, by ultimately making you numb and disassociated from yourself, which becomes very unpleasant very fast once the enthusiasm of the lack of depression fades. I seriously doubt that it would only effect depression rather than your emotions and personality as a whole.
 
Ketamine is no antidepressant.

Depression is a spiritual problem. To overcome it, you have to believe in something greater and better than yourself.
 
Wow, easy on the preaching there pal. Not all of us feel the need to rely on imaginary friends to validate our lives, yeah? I fully respect those with spiritual beliefs of various types, but to go out there telling other people they don't really have any problems, they're just wrong because they don't share your beliefs, is a pretty revolting thing to do.

We're on a drug discussion forum - so I am going to presume that you're fully aware that ingesting physical chemicals effects the way our minds work, the way our body works, and our emotions. Extend that to conditions like epilepsy, narcolepsy, and other brain disorders, or observe the effect that brain damage has on people. Ergo, even if you do believe that there is a spiritual element to someone's being, someone's personality, someone's emotions (and I don't say that there isn't, I'm an agnostic fence-sitter on the matter) it's ridiculous to deny there is not ALSO a physical element to it - after all, we're not just spiritual beings - and the physical side can get sick and damaged just like the spiritual side. The brain works on chemicals, and those chemicals can become unbalanced, which is where mental illness can emerge.

A lot of depression is circumstantial, and helping to fix the environment and the person's way of thinking can do great advancements. But there are some people for whom it goes deeper than just the mindset, it is an actual illness, and to simply dismiss that and tell them to their face they're essentially 'making it up' is extremely cruel, and extremely irresponsible.
 
Helios. said:
Ketamine is no antidepressant.

Depression is a spiritual problem. To overcome it, you have to believe in something greater and better than yourself.
Click to expand...

Ketamine and similar dissociatives tend to make people very spiritual at times, with particularly positive long-term effects.
 
Helios. said:
Depression is a spiritual problem. To overcome it, you have to believe in something greater and better than yourself.
Click to expand...

Well that's your belief/opinion... For me, depression is not a "spiritual" problem at all. It's just something going wrong chemically in our brain.
 
Here are some scientific articles, but there is actually more research going on in this field.

Antidepressant effects of ketamine in depressed patients. Berman, R. M.; Cappiello, A.; Anand, A.; Oren, D. A.; Heninger, G. R.; Charney, D. S.; Krystal, J. H. Abraham Ribicoff Center Clinical Neuroscience Research Unit of the Connecticut Mental Health Center, New Haven, CT, USA. Biological Psychiatry (2000), 47(4), 351-354. Publisher: Elsevier Science Inc., CODEN: BIPCBF ISSN: 0006-3223. Journal written in English. CAN 133:68749 AN 2000:126948 CAPLUS

Abstract

Subjects with major depression completed 2 test days that involved i.v. treatment with ketamine-HCl [an N-methyl-D-aspartate (NMDA) receptor antagonist] (0.5 mg/kg) or saline solns. under randomized, double-blind conditions. The subjects evidenced significant improvement in depressive symptoms within 72 h after ketamine but not placebo infusion. These results suggest a potential role for NMDA receptor-modulating drugs in the treatment of depression.



Small-dose ketamine improves the postoperative state of depressed patients. Kudoh, Akira; Takahira, Yoko; Katagai, Hiroshi; Takazawa, Tomoko. Department of Anesthesiology, Hakodate Watanabe Hospital, Hirosaki, Aomori, Japan. Anesthesia & Analgesia (Baltimore, MD, United States) (2002), 95(1), 114-118. Publisher: Lippincott Williams & Wilkins, CODEN: AACRAT ISSN: 0003-2999. Journal written in English. CAN 137:134991 AN 2002:579114 CAPLUS

Abstract

We investigated whether ketamine is suitable for depressed patients who had undergone orthopedic surgery. We studied 70 patients with major depression and 25 patients as the control (Group C). The depressed patients were divided randomly into two groups; patients in Group A (n = 35) were induced with propofol, fentanyl, and ketamine and patients in Group B (n = 35) were induced with propofol and fentanyl, and all patients were maintained with 1.5%-2.0% isoflurane plus nitrous oxide. The mean Hamilton Depression Rating (HDR) score was 12.7 ± 5.4 for Group A and 12.3 ± 6.0 for Group B 2 days before surgery and 9.9 ± 4.1 for Group A and 14.4 ± 3.8 for Group B 1 day after surgery. The HDR score in Group A 1 day after surgery was significantly (P < 0.05) lower than that in Group B. The HDR score in Group C was 4.2 ± 1.7 2 days before surgery and 4.8 ± 1.6 1 day after surgery. Depressed mood, suicidal tendencies, somatic anxiety, and hypochondriasis significantly decreased in Group A as compared with Group B. Postoperative pain scores in Group A at 8 and 16 h after the end of anesthesia were 26.6 ± 8.7 and 24.9 ± 8.2, resp., which were significantly (P < 0.05) lower than 34.3 ± 12.0 and 31.1 ± 8.8 in Group B. In conclusion, small-dose ketamine improved the postoperative depressive state and relieved postoperative pain in depressed patients.
 
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