Benzos are very safe for short term use, meaning days not weeks/months.
Anything that acts upon the GABA system is pretty safe, but only for limited as needed use.
Long-term use will increase anxiety to toxic levels when the medication is withdrawn.
SSRIs are extremely effective in most people, although the onset takes weeks...normally about five.
The prolactin release grows in the first several weeks and is associated with the therapuetic effects of the drug.
Prolactin is released by the pituitary due to 5HT1a agonism and the release of dopamine from the hypothalamus.
This combination of dopamine and prolactin is the key to SSRIs as well as MDMA.
The difference is speed of onset, with MDMA (a neurotoxin) causing this within 2 hours of the dose.
Both of these drugs target the PFC, your highest emotional center.
High levels of prolactin inhibit sexual function, although SSRIs can temporarily boost sexual performance for this reason.
Anyone that is capable of sex on MDMA knows how incredible it can be.
But extended periods of high prolactin is BAD for dopamine receptors in the central reward circuitry.
It causes down-regulation.
Along with this, high serotonin causes down-regulation in the higher brain.
The PFC is the most vulnerable to such axonal/receptor loss because the serotonin nerves are thin extensions in this area.
So now you have lower serotonin density in the higher brain, along with lower dopamine sensitivity in the limbic reward circuit.
Hmm...
Of course while you are on the medication things are GREAT.
For quite a while, too.
Some patients stay on this stuff for YEARS....often succeeding in areas of life that they didn't before.
Especially social interaction and work.
But eventually the consequences catch up, as with MDMA use.
And discontinuation from SSRIs is known to be very devastating, even dangerous for some people.
And when the network is sufficiently damaged, serotonin transmission is WAY off.
This causes a continued hyperprolactinemia for months or YEARS.
And you can only imagine what this does to dopamine receptors.
A minority of SSRI users will experience long-term sexual dysfunction that includes an inability to feel sensation during orgasm - no pleasure at all.
And libido may also be entirely absent regardless of the stimuli. Some men can never achieve erections again without injections straight into the penis, and women may go on to experience painless childbirth!
At the same time these people often describe a loss of humanity that goes beyond their sexuality.
They have difficulty interacting with people, such as looking them in the face. Eye contact can be a particular struggle.
They cannot enjoy normal activities, such as walking in the sun or smelling good food.
Sleep is sub-standard at best, and head-pressure and 'brain zaps' have been reported as well.
The overlap between SSRI and MDMA recovery is pretty shocking, including the time required to stabilize.
There is a trend I have seen among former SSRI users that suggests the one year mark is when desire begins to return, and two years is when it becomes stable.
Again, such examples are the exception not the rule.
But at least a few months of trouble is VERY common.
I must repeat - SSRIs are VERY effective at treating depression while the medication is used.
In about 15% of users there is a bad reaction, such as akathesia (which is tormenting).
But for the rest of people it can be a damned miracle.
But the emotional and cognitive benefits STOP when treatment stops.
This is a pretty big indicator that it does not CURE depression.
Targeting serotonin into the PFC does produce powerful anti-depressant effects but they are TEMPORARY.
Since serotonin is not directly responsible for the effects, rather dopamine and prolactin release from the HPA...
Boosting dopamine levels is a much safer alternative to SSRIs.
It is not nearly as effective as an anti-depressant and it fails to work in the severely depressed.
And it will also cause dopamine down-regulation especially if doses are taken above prescribed limits.
But a few weaker amphetamines exist that are quite safe even for long-term use.
It has been suggested that my long-winded posts are a result of such a medication...
They are not, although I have strongly considered selegeline - a weak amphetamine that protects the SERT and striatal dopamine.
Boosting serotonin and dopamine is the primary result of ALL anti-depressants.
This restores the function of the hypothalamus-pituitary-adrenal axis.
The hypothalamus literally connects your thoughts to your emotions.
Yes, there are people that used to take SSRIs that cannot experience the magic of MDMA even after years of healthy living.
They still may describe sex as 'interesting' while on the drug, but they do not experience a substantial improvement in orgasm quality.
I have spoken with several people like this, and some have said that the comedown is horrible and makes their sexual dysfunction WORSE afterwards.
There are NO medications that produce permanent improvements in depression, anxiety, or OCD behavior.
Even research on cognitive behavioral therapy has shown that only continued practice produces permanent change.
In other words, you have to keep TRYING to change yourself.
After many years, perhaps it will remain with you for the rest of your life.
But seeking out a medication to take the place of positive thinking is foolish, especially when positive thinking must be maintained for the benefits to remain!
There is only one exception...
Exercise.
I have said it many times before, and I will continue to say it.
We are gifted with an extraordinary ability to reshape our brains using our bodies.
Physical exercise improves mental function in a wide variety of tests, and continued exercise is recommended in ALL forms of brain injury.
Elderly people experience significant improvements in memory after just a few months of exercise.
And in depressed patients the practice is underused, in part because people lack the motivation to do it.
I work out daily, at least ten or twenty minutes.
Think your OCD is 'interfering with life'?
If you had any idea how hard life has been for me, you would actually listen to this advice.
Working out will adjust even the most horrific state of mind.
It increases both serotonin and dopamine!
So now you know what you can do.
Exercise on a regular basis, get sunlight for several hours per day, and sleep at night.
All of our ancestors had to do each of things, regardless of what they wanted.
Do you think they experienced depression?
Not like we do.
Learn from their example and PUSH YOURSELF.
Hard.
And you will not feel OCD or the need for anti-depressants.
I know this to be true.
Good luck Starlett7.
