Mechanism of SSRIs: Monoamine Theory and the Role of BDNF
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- Опубліковано 15 жов 2013
- The Psychopharmacology Institute is an online platform offering unbiased, practical psychopharmacology updates for healthcare providers, with content updated monthly. It also presents opportunities to earn CME and SA credits.
This video explains the complex mechanism of selective serotonin reuptake inhibitors (SSRIs), from the monoamine theory of depression and the role of 5HT1A receptor down regulation to the breakthrough findings on the role of brain-derived neurotrophic factor (BDNF) in depression. Understand the link between the molecular action and the clinical effects of these widely used antidepressants.
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#SSRIMechanism #MonoamineTheory #5HT1AReceptor #Psychopharmacology
You, Sir, have just saved the day by providing the MOST comprehensive explanation of the "why" by filling in the gaps left by the literature and other videos. I appreciate this so much as perhaps some things deemed obvious by other video makers was not evident to me and left me stumped and unable to fully write my paper. Now I can. Thank you!
so if SSRi didnt work and no benefits whatever medication of it for 10 years , what that means , is that mean the problem is not with serotonin ? and if not what is the problem ?
SSRIs are used to treat presumably misfiring synapses in your brain. there are lots of alternatives.
Maybe dopamine.
@@d2xr theres no evidence at all for that.
I am still confused. So depression is caused by too many receptors taking the 5ht in the cleft? And having the 5 ht in the synapse is thought to boost the serotinin and improve mood? So are all ssris antagonists?
This is pretty amazing. It explains why SSRIs make you feel worse initially - because before 5HT1A downregulation occurs the 5HT1A is getting agonized and serotonin levels drop. It is only when you've essentially become addicted to the SSRI and your 5HT1A is downregulated enough that the drug starts "working". No wonder these things make you miserable at the start and it probably explains why they are such a pain to withdraw from. I'm guessing that other parts of the serotonergic system downregulate after getting used to increased serotonin levels, so once you stop taking the drug and the 5HT1A slowly begins to upregulate it is now inhibiting serotonin back to previous levels but in a system now more dependent on serotonin to function. God I hate SSRIs. A drug that makes you feel worse till you've become dependent on them, and then makes you feel worse when you try to kick that dependency. I always described SSRIs like an abusive and controlling spouse and this fits that model even more.
Please refrain from using your experience as a representation for everyone's experience with the drug, it has done wonders for my chronic and severe anxiety, and misinformation like this is what initially made me skeptical about getting treatment in the first place, by spreading health misinformation like this you are actively harming for those who want to get treatment.
@@ChristopherGray00 there’s no misinformation here. They are probably most effective in very bad cases of severe depression, but they only seem to work in 33% (same % as placebo might I add) of the cases and make depression worse in many.
I’m happy it’s working for you tho!
Theres zero evidence they are addictive,they have withdrawal effects but that is not addiction.Also,marked adverse effect on mood in the first few weeks is not something ive seen treating patients nor in taking every SSRI under the sun myself for 30 yrs.
@@willamschultz2169 they work to some extent in over 50% of cases,not 30.Its significantly more than placebo.
@@willamschultz2169 pubmed.ncbi.nlm.nih.gov/18922243/
pubmed.ncbi.nlm.nih.gov/33779577/
pubmed.ncbi.nlm.nih.gov/10362442/
All of these studies and analysis show that it is definitely effective for most people, not just 33%. If the subject in a study is higher than the placebo control, they are responding to the drug.
There are also more studies and meta analysis on various other SSRIs, however i've specifically chosen escitalopram just because it is my specific medication that i take. it is generally thought to be less effective than zoloft for some people but has far less side effects from what i've heard as well.
This is good, he knows a lot, but his accent sometimes gets in the way of understanding.
what you see is a try to explain the mechanism of ssri's to make people believe that these drugs are safe and well understood. Unfortuneately the reality is different.
Establishing the safety of a drug is entirely different from understanding its exact mechanism of action, if you knew anything in the field of pharmacology, you'd know that. Please stop making vague and baseless accusations to make people hesitant on getting treatment.
Well they were never fully undetstood since there is bo serotonin deficiency in most patients,they can work but its not by correcting a deficiency
In virtually all scientific literature SSRIs are considered to be proven safe, do your research, there are plenty of publicized papers of studies and meta analysis, do not spread misinformation.
@@ChristopherGray00 SSRIs, SNRIs, all depression drugs (misleadingly called antidepressants as they cause worse depressions) cause sexual problems were detected since the 1960s.
They cause persistent adverse effects, that don't resolve even many years after stopping the drugs.
This is widely documented in many studies non manipulated by pharma.
SSRIs sexual problems were detected and hidden on the trials (1980s 1990s) on the control groups: healthy people with no depression.
David Healy found about sexual issues from his patients in the early 2000s, most psychiatrists gaslight the patients, treating a person with a possibly temporary mental health crisis (think a family abuse, sexual abuse, money problems, etc.) like a complete lunatic.
Watch doctor David Healy, Peter Gotzsche, Peter Breggin UA-cam videos. They explain all with great detail.
There is a solution, stop prescribing these damaging drugs and ruining people's lives!!!
But sadly that is not going to happen until a very notorious catastrophe like Opioid crisis (1995 - current) happens, as these drugs make billions for the pharma companies.
Data, if you have any doubts, go to any damaged by drugs community (PSSD / PFS / PAS), and they will educate you.
pssdnetwork faq, Rxisk org, pssdinfo, etc. etc.
PSSD post SSRI/SNRI sexual dysfunction (which is not only sexual adverse effects, but those were the ones that most helped diagnose the damage these drugs cause)
PFS post finasteride syndrome
PAS post accutane (isotretinoin) syndrome
Best wishes.
@@ChristopherGray00 _In virtually all scientific literature SSRIs are considered to be proven safe, do your research, there are plenty of publicized papers of studies and meta analysis, do not spread misinformation._
Most studies are falsified by pharma. Many studies show these drugs are very damaging, they just don't get much publicity. Treat pharma sponsored studies as pharma marketing.
Read the studies cited on Rxisk, pssdnetwork faq, pssdinfo.
Just the medical leaflet and all the FDA black label warning are terrible enough to discorage anyone to take the poison they really are.
Best wishes.
Ssri cause PSSD
It could be the patient's just going through a tough time in life and needs to strategize a way to make their life better! As far as correcting physiological imbalances that affect neuronal function and psychology, could it be rooted in unhealthy food choices? No antidepressant can supplement a nutritionally deficient diet.
that's a very generalized way of viewing it
In clinical depression the brain has been changed even if its through lifestyle and the patient is stuck in these thinking patterns so the drugs help lots of patients get a lift out of that rut.Of course they then need to fix the cause.
Talk about the permanent damage these cause. Riiiiiigggghhhhtttttt
Do you care to substantiate this claim with any evidence at all? If not then i'm afraid i'm going to have to report your account for promoting dangerous health misinformation.
@@ChristopherGray00 lol censorship much?
@@IlanaFiske Yes my priority of human lives is higher than his comment, you're correct.
SSRI's are sadly disappointing- but make a tremendous amount of money.. MAOI's are THE best antidepressants, particularly Nardil (Phenelzine). They work extremely well for both depression and anxiety (panic disorder, phobic states, and OCD). Contrary to popular belief, they are also very safe medications when used correctly. TCA's are quite good as well, particularly Anafranil (Clomipramine).
U langs are you a doctor?
This is simply not true. MAOI or TCA may be more effective, but definitely less safe to use and with more severe side effects than SSRI.
Very true. MAOI's are extremely effective, and there is recent literature demonstrating that their side effects are comparable to SSRIs (Dr. Ken Gillman).
This is definately not true, SSRI have a much better tolerability profile
@@lebest8415 true but not as effective and none of them help more than 60 % of patients