Reason meds take so long and why you feel rubbish

Hi everyone, here’s something I found online which you may find intersting.  Its about why you feel so rubbish when taking these meds, why your mood is up and down, why it takes so long and the process it all goes through.

Sorry its a long post.

When starting an SSRI or increasing it's dose often makes people feel really rubbish, which can cause a great deal of stress as you begin to wonder whats happening, why is their illness getting worse, are these meds working etc.

Somone recently posted a great post explaining what these meds do in our brains, and I’d like to add further to this.  So, as already posted ….. the brain is basically a big dense bundle of nerves which carry electrical signals around our brain and body.  The nerve cells don’t touch each other, leaving a small gap between each cell, called a synapse.  So how do signals get from one nerve to another?

Neurotransmitters are chemicals released by nerve cells that tell a neighbouring nerve cell to pass the signal along.  A bit like pass the parcel.  Serotonin is one such neurotransmitter.   So when an electrical signal reaches the end of a nerve cell that deals with serotonin, that cell releases serotonin into the gap (synapse), which then crosses the gap and interacts with the nearby nerve cell and tells it to pass the signal along.

Once the serotonin has done it's job, the serotonin is then reabsorbed from the gap so that no more signals are passed until the next one comes down the nerve.  SSRIs, (Selective Serotonin Reuptake Inhibitors) interfere with this reabsorbtion process and thus it stays in the gap longer, which equates to more serotonin and more signals.

So furthering on from there ….. why do you feel so rubbish?

So, along with the releasing of serotonin, and reabsorbing it, nerve cells also have parts that detect an increase in serotonin level and tell the nerve cell to stop producing anymore serotonin until the level drops.  These are called autoreceptors, which are the reason you feel like so rubbish.

So the SSRI will increase the amount of serotonin that’s gathered in the synapses between nerve cells, but unfortunately the autoreceptors of the nerve cell pick up on this increase and tell the nerve cell to stop producing serotonin.  The result of this is that when you first start taking an SSRI your serotonin levels drop.

How do they go up again?

Eventually with continuous use of the SSRI medication, the autoreceptors become desensitised, that is to say they've continually told the nerve cell to stop producing serotonin but yet serotonin is still there.  In short they simply give up.  They stop telling the nerve cell to stop producing serotonin and your serotonin levels start to increase.

This desensitisation takes time, it doesn't happen over night and it won't even begin to happen until the SSRI levels have stabilised.  This is why you feel so rubbish, and is why your mood drops and your anxiety increases (also fuelledd by the fear of not knowing whats going on).  Your mood will be up and down as the seronotin continues to try to stablise.

So, to summarise:

SSRIs cause your serotonin levels to drop when you first start taking them.  Your serotonin levels will not rise until the autoreceptors in your brain have stopped working (become desensitised), all of which takes lots and lots of time.  Everyone is different, so for some it can be many weeks and other months.

I hope this helps some people to understand what these meds are doing and why you don't get instant results, compared to other meds that work in different ways which is the reason they can have a more immediate effects (benzos for example).

K x 

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