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Potential Anti-Psychotic Action of SSRIs

A

AlphaMethylPhenyl

Moderator: TDS
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This is hypothetical and I may be far off. I know that being on an SSRI would usually disable a psychedelic trip, which is similar to the state of psychosis, pointing to a possible anti-pyschotic mechanism; I know that there is a preparation of zyprexa and prozac in one pill currently used in psychiatry, and that SSRIs are frequently otherwise used to "augment" anti-psychotics, leading me to believe that SSRIs do both not promote psychotic behavior and perhaps counter-act it. And of course counter to the numbed feeling that SSRIs typically give, psychosis is one of intimate feeling, though this is certainly generalization.

http://www.springerlink.com/content/p140t62n72796752/

Yes? No?
 
No.

SSRI’s typically do cause psychotic or agitated behavior. The augmentation of serotonin uptake also causes too much serotonin to build up. This can in fact lead to agitation, and anxiousness. Last time I checked those two things are the last thing you need hallucinating people to be...
 
FullText for those interested


P-Jay, as far as I can tell, SSRIs actually are synergistic with e.g. haloperidol. to some extent. The review discusses a variety of ways that they could interact - SSRI increasing blood levels via enzyme inhibition, downregulation of cortical DA/5-HT via receptor desensitization, etc.

And studies have indeed shown that at proper dosages agitation and anxiousness should not be an issue. I mean, the high power antidopaminergic drugs should do a good job at zombifying you enough.
 
I have HPPD/PTSD and possibly Gray's Disease (yes I know that a thyroid syndrome is irrelevant, but those are the first three things I tell people) and am treated with long term Benzodiazepene therapy unfortunately (for HPPD/PTSD). It cancels my hallucinations. I was given an SSRI run first...and it made my hallucinations/flashbacks 10x worse. (Prozac/Zofram/Cilexa, then Imipramine/Clomipramine [TCA's, just as bad if not way worse.])
 
I think from above evidence its pretty clear that they're powerful anti-psychotic agents when working in conjunction with anti-psychotics. I don't know about by themselves, though. Most drugs can produce paradoxical reactions.
 
Ho-Chi-Minh said:
Most drugs can produce paradoxical reactions.
Click to expand...

That's basically what I've received on every AP/AD treatment drug. Seroquel even at 300mg won't knock me out. When I was given 400mg XR though, it turned me into a walking zombie that had narcolepsy, basically. Did nothing for my hallucinations, in fact made them worse; I can't explain it. But a simple Alprazolam 2mg will knock any hallucination out.

Seroquel hands down was the most dysphoric drug I've ever had the displeasure of experiencing.

@Ho Chi Minh, would you classify or consider benzos to be AP? I don't, but they certainly work for my purposes...
 
They are classified as anxiolytics though have indirect anti-psychotic action via inhibitory GABA. Its not uncommon for people to experience psychosis when withdrawing from them.
 
Actually OP is right. SSRIs cause a long-term downregulation of 5HT2A receptors when taken regularly which would indeed have a anti-psychotic effect. Obviously they would exacerbate symptoms initially so are not used for this purpose.
 
Ho-Chi-Minh said:
I think from above evidence its pretty clear that they're powerful anti-psychotic agents when working in conjunction with anti-psychotics.
Click to expand...

That evidence seems pretty shaky to me. Speculating on why SSRI's seem to be helpful would be fine, but all of the references with clinical data on people with schizophrenia are to fluvoxamine augmentation, most mention massively increased plasma AP concentrations, and none do anything to control for it. As far as I can see references to other SSRI's are all animal studies, mentioning things like increased PFC monoamine concentrations. While that might be helpful, it's hardly a given.

cannibalsnail said:
downregulation of 5HT2A receptors... would indeed have a anti-psychotic effect.
Click to expand...

Reference for that?
 
It says it's about SSRI's, all it's really about is fluvoxamine (not fluoxetine) though.

Also:

cannibalsnail said:
Obviously they would exacerbate symptoms initially so are not used for this purpose.
Click to expand...

I get the impression SSRI's are very commonly used with AP's for schizophrenia. It seems hard to find actual numbers, but I did find this saying

Ehret reviewed the case histories of 1,519 patients diagnosed with schizophrenia at the IOL between February 2000 and July 2009. The patients ranged in age from 18 to 64 with 40 being the average age. Of that total, 425 or 28 % were discharged on antidepressants, mainly selective serotonin reuptake inhibitors (SSRIs).
Click to expand...

I wouldn't be suprised if the number of patients that eventually end up on SSRI's is even higher, since many of those patients would have been only recently diagnosed.
 
^^that logic doesn't follow

^you need a source for that, and that school shootings are precipitated by psychotic states

akathisia is an agitated state but its almost entirely physical, unlike the "heady" state of psychosis
 
I wouldn't say ssri's have any antipsychotic effect but I base that on my personal experience. I think the main reason they mix them with antipsychotics like zyprexa (zyprexa + fluoxetine = symbyax or something like that) is because antipsychotics tend to be massive dysphoria in a pill and adding a bit of ssri counteracts that by making you more mellow due to serotonin reuptake inhibition. Anyhow... I'm not an expert, just have bipolar disorder and I've met quite a few people with schizophrenia over the years.
Shizos tend to have lots of depression (negative side of the symptoms), hence they're often on SSRIs as well. I'd argue that in a lot of the cases APs trigger or make depression worse. It's a known fact that older APs worsen depression. The atypicals aren't supposed to do that and they're quite popular for "augmenting" antidepressants lately and are even prescribed off-label for anxiety & insomnia. Personally I think that's got a lot to do with pharma trying to increase market shares and is disgusting. I read quite a few articles on drug trials and clearly a lot of them are designed to minimise focus on the "negative" effects. I get pretty upset every time psychiatrists try to convince me I should take antipsychotics long term. Bollocks, tried that and it clearly made me miserable. Sure, I won't go manic as long as I take antipsychotics but I'll also end up living in constant anhedonic & dysphoric state... as long as you're also heavily sedated on top of that you won't cause too many problems but I wouldn't call that proper treatment.
 
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