Great explanation on how these drugs damage the people by down regulation of following receptors: 1. 5HT2A: Anxiety, insomnia, overstimulation, emotional numbness by dopamine downregulation 2. 5HT1A: Effects on autonomic functions 3. 5HT3: Vomiting, diarrhoea, gut disorders 4. 5HT2C: Sexual dysfunction, decreased appetite A healthy brain consists of clear signalling through neurotransmitter release and reuptake. When you block the reuptake of neurotransmitters, the effects are neurotoxic (agitation, sedation) are already signs of brain damage and the ZNS will fight back with receptor downregulation and neurotransmitter reregulaton trying to get some kind of homeostasis again ....
I took ssris for over 10 years. Now my head jerks when i move it up and down from discontinuation of the drug. I went to a functional neurology clinic in the netherlands. And they diagnosed me with with left basil ganglia damage and right side cerabellum damage. I was also diagnosed with serotonin toxicity. To fix all these issues i am on b11&b12 drops under the tongue twice a day and im on serotonin natural serotonin that the doctor makes himself, i have seen a major difference with myself and i slowly gaining process of me getting back to normal like i should be. The most important thing for someone to do if they have so called dystonia toxicity from taking these drugs is to do hbo2 therapy its very important as it regenerates brain tissue that has been damaged in the brain and your symptoms could dissapear just from doing this!!
I sometimes say, with regards to coming off of the medication, why come off? if it isn't broke, don't fix it. As long as you're not experiencing side effects. I'm on Amitriptyline myself, a much older and different class of antidepressant.
Love the video; very educational. I'm excited to see what other topics you continue to put out and, as someone interested in psychiatry, will gladly subscribe to the channel. Please consider not including music or using more relaxing music and tuning it way, way down. It is sooo loud and distracting that it is difficult to hear your wonderful explanations.
Rachel you may be interested in this summary of mechanisms of antidepressants psychscenehub.com/psychinsights/summary-21-antidepressants-network-metaanalysis/
Could you also provide info on how use of Ssri's can down regulate receptors permanently. Longterm side effects including (Pssd) years after ceasing ssri medication
Ben Wallace there isn't much around this in terms of mechanisms except that it is a recognised syndrome. Also there may be nor adrenergic and cholinergic actions at play. Also raises the possibility of long term structural change of receptor after long term use of SSRIs. I'll keep looking. Here is one based on discussion at RCpsych conference. psychscenehub.com/psychinsights/stopping-psychotropic-medication-the-wrong-way-and-the-right-way-highlights-from-rcpsychic-2019/
Thanks for your feedback. 🙏🏼. I've recorded these - just have to release soon 😁 here is a brief one on tms - we have several other conversations on TMS on this channel What is Transcranial Magnetic Stimulation and How Does it Work? | Practical Demonstration of TMS ruclips.net/video/x5t8ht1wsnE/видео.html
Is it possible that serotonin levels increase, leading to improvement in depression but the 5HT receptors don't down regulate leading to persisting side effects?
It's a lot more complex than that as there are also genetic differences with regards to 5HT transporters. There are 14 different serotonin receptors with multiple different actions and cross talk with glutamate, dopamine, NA. Also low doses have a different effect while higher doses can lead to side effects. It's a good topic - I might consider a video.
@@PsychiatrySimplified Thanks for the response. Looking back at the video, I meant is it possible for 5HT1A to downregulate but the others don't since 5HT1A needs to downregulate to maintain high serotonin? The genetics thing makes sense, both me and my grandfather have faced this problem.
do you mean in the Raphe nucleus firing area? because if you do, then how do ssri ever get serotonin up high enough to down regulate the problem receptors ht2a 2c 7 1b d etc...
The 5HT1A receptor presynaptic autoreceptor downregulation is responsible for the serotonin neurotransmission from Pre to post . But read here as there are more nuances. Serotonergic receptor are 14 and they are linked to other neurotransmitters - serotonin acts as a modulator . psychscenehub.com/psychpedia/mechanism-of-action-of-selective-serotonin-reuptake-inhibitors-ssris-the-latest/
@@PsychiatrySimplified So if the POST synaptic 5-ht1a down regulate too then is this why ssri snri causes anxiety? as I read they are needed for anxiolytic effect.
Anxiety is also mediated through serotonergic pathways so modulating serotonin receptors can help in panic disorder. Although psychological therapies should be combined or considered first line
DG Samples thanks for the feedback. There are newer antidepressants like vortioxetine and agomelatine which rank favourably on efficacy and tolerability psychscenehub.com/psychinsights/agomelatine-mechanism-action/
@@PsychiatrySimplified Thank you for fast feedback. Already have some positive and negative experiences with vortioxetine. It was great for cognitions but not for anxiety after 2 months. Too much stimulations. As i see, it has lower block on SERT, maybe this is the reason why my depression came back when i lowered the dose. Agomelatin sounds good, unfortunatelly I have comorbid MDD-GAD/OCD symptoms, don't know melatonin could help on this condition. At this moment it caused by bad connectivity of serotonergic system, isn't it?
DG Samples agomelatine is evidence-based for MDD and anxiety; also helps with OCD ( important though that mixed features are ruled out ) psychscenehub.com/psychinsights/generalised-anxiety-disorder-diagnosis-and-management-2/
Your libido is low also your testosterone thats why you have erectile dysfunction mine was low and i fixed it by taking shilajit twice a day on an empty stomach. It is important to buy natural shilajit and lab tested as the cheaper version have heavy metals in them and can do damage to your body!
Great explanation on how these drugs damage the people by down regulation of following receptors:
1. 5HT2A: Anxiety, insomnia, overstimulation, emotional numbness by dopamine downregulation
2. 5HT1A: Effects on autonomic functions
3. 5HT3: Vomiting, diarrhoea, gut disorders
4. 5HT2C: Sexual dysfunction, decreased appetite
A healthy brain consists of clear signalling through neurotransmitter release and reuptake. When you block the reuptake of neurotransmitters, the effects are neurotoxic (agitation, sedation) are already signs of brain damage and the ZNS will fight back with receptor downregulation and neurotransmitter reregulaton trying to get some kind of homeostasis again ....
Thank you so much! I have been struggling with the down regulation concept and you made it clear for me.
Great video. Very informative
The background music is a bit too much though
Yes it is - this is the older videos so we have made changes to the newer ones. Thanks for the feedback
I took ssris for over 10 years. Now my head jerks when i move it up and down from discontinuation of the drug. I went to a functional neurology clinic in the netherlands. And they diagnosed me with with left basil ganglia damage and right side cerabellum damage. I was also diagnosed with serotonin toxicity. To fix all these issues i am on b11&b12 drops under the tongue twice a day and im on serotonin natural serotonin that the doctor makes himself, i have seen a major difference with myself and i slowly gaining process of me getting back to normal like i should be. The most important thing for someone to do if they have so called dystonia toxicity from taking these drugs is to do hbo2 therapy its very important as it regenerates brain tissue that has been damaged in the brain and your symptoms could dissapear just from doing this!!
I sometimes say, with regards to coming off of the medication, why come off? if it isn't broke, don't fix it. As long as you're not experiencing side effects. I'm on Amitriptyline myself, a much older and different class of antidepressant.
Love the video; very educational. I'm excited to see what other topics you continue to put out and, as someone interested in psychiatry, will gladly subscribe to the channel.
Please consider not including music or using more relaxing music and tuning it way, way down. It is sooo loud and distracting that it is difficult to hear your wonderful explanations.
Thank you for that feedback. We have taken that on board. In many of our newer videos, we have taken out music.
Fantastic. I needed this. Very helpful. Thanks 🙏🏾
Rachel thanks for the feedback 🙏
Rachel you may be interested in this summary of mechanisms of antidepressants psychscenehub.com/psychinsights/summary-21-antidepressants-network-metaanalysis/
Could you also provide info on how use of Ssri's can down regulate receptors permanently. Longterm side effects including (Pssd) years after ceasing ssri medication
Ben Wallace there isn't much around this in terms of mechanisms except that it is a recognised syndrome. Also there may be nor adrenergic and cholinergic actions at play. Also raises the possibility of long term structural change of receptor after long term use of SSRIs. I'll keep looking. Here is one based on discussion at RCpsych conference. psychscenehub.com/psychinsights/stopping-psychotropic-medication-the-wrong-way-and-the-right-way-highlights-from-rcpsychic-2019/
Great video thank you! Now I know why I have side effects from Zoloft
Great video
Learning alot
Thank you for your feedback
Thanks Sanil….good work explaining psychopharmacology. Please do more on ketamine, psilocybin and TMS. Thank you
Thanks for your feedback. 🙏🏼. I've recorded these - just have to release soon 😁 here is a brief one on tms - we have several other conversations on TMS on this channel What is Transcranial Magnetic Stimulation and How Does it Work? | Practical Demonstration of TMS
ruclips.net/video/x5t8ht1wsnE/видео.html
Crisp and honest
The music sounds like serotonin transduction in progress!
Sorry! 😀
Thank you so much.
Is it possible that serotonin levels increase, leading to improvement in depression but the 5HT receptors don't down regulate leading to persisting side effects?
It's a lot more complex than that as there are also genetic differences with regards to 5HT transporters. There are 14 different serotonin receptors with multiple different actions and cross talk with glutamate, dopamine, NA. Also low doses have a different effect while higher doses can lead to side effects. It's a good topic - I might consider a video.
@@PsychiatrySimplified Thanks for the response. Looking back at the video, I meant is it possible for 5HT1A to downregulate but the others don't since 5HT1A needs to downregulate to maintain high serotonin? The genetics thing makes sense, both me and my grandfather have faced this problem.
Do post synaptic 5-ht1a receptors down regulate too? not just the presynaptic auto receptors?
Yes when activated they do
do you mean in the Raphe nucleus firing area? because if you do, then how do ssri ever get serotonin up high enough to down regulate the problem receptors ht2a 2c 7 1b d etc...
The 5HT1A receptor presynaptic autoreceptor downregulation is responsible for the serotonin neurotransmission from Pre to post . But read here as there are more nuances. Serotonergic receptor are 14 and they are linked to other neurotransmitters - serotonin acts as a modulator . psychscenehub.com/psychpedia/mechanism-of-action-of-selective-serotonin-reuptake-inhibitors-ssris-the-latest/
@@PsychiatrySimplified So if the POST synaptic 5-ht1a down regulate too then is this why ssri snri causes anxiety? as I read they are needed for anxiolytic effect.
I can see why they would help with depression, but why are they recommended for panic disorder?
Anxiety is also mediated through serotonergic pathways so modulating serotonin receptors can help in panic disorder. Although psychological therapies should be combined or considered first line
informative
I can read it on your face "Oh poor ppl who taking this."
Please make a new antidepressant class, ssris are hell meds.
Anyway nice presentation!
DG Samples thanks for the feedback. There are newer antidepressants like vortioxetine and agomelatine which rank favourably on efficacy and tolerability psychscenehub.com/psychinsights/agomelatine-mechanism-action/
DG Samples vortioxetine psychscenehub.com/psychinsights/vortioxetine-mechanism-of-action-2/
@@PsychiatrySimplified Thank you for fast feedback. Already have some positive and negative experiences with vortioxetine. It was great for cognitions but not for anxiety after 2 months. Too much stimulations. As i see, it has lower block on SERT, maybe this is the reason why my depression came back when i lowered the dose.
Agomelatin sounds good, unfortunatelly I have comorbid MDD-GAD/OCD symptoms, don't know melatonin could help on this condition. At this moment it caused by bad connectivity of serotonergic system, isn't it?
DG Samples agomelatine is evidence-based for MDD and anxiety; also helps with OCD ( important though that mixed features are ruled out ) psychscenehub.com/psychinsights/generalised-anxiety-disorder-diagnosis-and-management-2/
DG Samples if mixed features are present with anxiety and OCD - lamotrigine add can be useful, of course do discuss all this with your doctor
The music is distracing
Yes agree. We've made changes since
Ssris caused me permanent sexual dysfunctions.
I have PSSD (POST SSRI SEXUAL DYSFUNCTION)
My life is ruined!
What are your symptoms?
@@vasiak.2089 m.ruclips.net/video/5mmV-5BnWv8/видео.html -
Your libido is low also your testosterone thats why you have erectile dysfunction mine was low and i fixed it by taking shilajit twice a day on an empty stomach. It is important to buy natural shilajit and lab tested as the cheaper version have heavy metals in them and can do damage to your body!
sir what if you make a video about "why the antidperessants start showing their effects 2 to 3 weeks later?"