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Thread: Why do antidepressants cause a feeling of numbness?

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    Why do antidepressants cause a feeling of numbness? 
    #1
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    First off, I'm very very ignorant of all this. Suck at science. I know the basic "key-lock" model of receptors and whatnot but really I'm pretty ignorant, so I apologize if this is a stupid question.

    But yeah. Most antidepressants act by in some way increasing the amount of Serotonin in the brain (as well as, in many cases, Dopamine and Epinephrine). I understand that Serotonin is associated with feelings of euphoria and relaxation, Dopamine and Epinephrine with stimulation, a more excited euphoria, loss of appetite, etc. etc.

    But how come antidepressants can cause a numb, empty feeling if they're increasing the levels of neurotransmitters that cause feelings of euphoria? I just really don't understand this. I mean, they basically do the same thing in your brain as drugs like Cocaine do - inhibiting the reuptake of those neurotransmitters - but, while they can sometimes cause feelings of euphoria and jitteriness, they also can cause a numb, empty, mildly euphoric but mostly emotionless feeling.

    Why is this?
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    Bluelighter AfterGlow's Avatar
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    To answer your question, the amount of neurotransmitter modulators in a single dose is not high enough to give you euphoria. They are designed to be taken in small steady doses over a period of weeks to gradually bring your brain chemistry back into a normal balance. At least, that's the theory.

    The fact is that there is not alot of science which explains exactly how the modulation of neurotransmitters resolves various chronic depression and mental illnesses. Clinical trials by drug companies publish statistics that indicate the sedrugs are more effective at treating depression than a placebo. But I've also read medical articles which suggest that many bouts of depression would run its course and resolve itself without any psychoactive drugs. Even when you are prescribed antidepressants, you often find that the first one they give you doesn't produce the expected results and they'll keep switching meds until they find one that you tell them feels like it is working for you. So, the clinicians are basically just guessing at what might help you. You might actually get something that will make you feel worse! It's not quite as bad as going to a witch doctor, but they're just giving you what the drug companies want to sell and the FDA has approved. That doesn't mean it's the best thing for mild and occasional depression. good luck if you go on anti depressants.
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    #3
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    Quote Originally Posted by AfterGlow View Post
    To answer your question, the amount of neurotransmitter modulators in a single dose is not high enough to give you euphoria. They are designed to be taken in small steady doses over a period of weeks to gradually bring your brain chemistry back into a normal balance. At least, that's the theory.

    The fact is that there is not alot of science which explains exactly how the modulation of neurotransmitters resolves various chronic depression and mental illnesses. Clinical trials by drug companies publish statistics that indicate the sedrugs are more effective at treating depression than a placebo. But I've also read medical articles which suggest that many bouts of depression would run its course and resolve itself without any psychoactive drugs. Even when you are prescribed antidepressants, you often find that the first one they give you doesn't produce the expected results and they'll keep switching meds until they find one that you tell them feels like it is working for you. So, the clinicians are basically just guessing at what might help you. You might actually get something that will make you feel worse! It's not quite as bad as going to a witch doctor, but they're just giving you what the drug companies want to sell and the FDA has approved. That doesn't mean it's the best thing for mild and occasional depression. good luck if you go on anti depressants.
    I'm actually already on them lol.

    I totally understand where you're coming from. They're definitely overprescribed. My attitude used to be "be a man, deal with your problems, you don't need drugs." I did that for years, but it really didn't work. I could rationally see how profoundly irrational and stupid my thinking was, how I was always setting myself up for failure, etc, but, even though I could see that I was being irrational, I couldn't escape the feeling. And it really was a bad feeling, sometimes it got bad enough that I seriously thought about suicide.

    So now I am on antidepressants (specifically St. John's Wort), and it's helped a lot but I don't want to be on them forever, so I'm working on finding a good therapist. ALso there are side effects, like I was talking about in the original post: a feeling of carefree numbness and lack of motivation, though this isn't there all the time, and also I've only been on it for a week so it's possible that that feeling will improve (or worsen) with time. Also I did have some euphoric periods in my first few days on it: I've learned from past experiences with prozac that I'm extremely sensitive to anti-depressants (I was on 15mg and was a nervous wreck within three days). One of these euphoric periods was so damn pleasant I swear I was this close to sobbing with joy, it really was that intense. But those feelings are starting to go away, and at the time of day where I used to get that euphoric feeling I instead get a feeling of mildly euphoric but subdued and somewhat emotionless numbness.

    So that's what I'm really wondering about - why would a drug that inhibits the reuptake of serotonin cause a feeling of emptiness? I've never heard of people getting that feeling from MDMA or any other drug that works on Serotonin. Maybe it's something that happens when a drug is working on your serotonin 24/7 for days or weeks or months on end?

    Anyway, thanks for the response, I'm very curious about this.
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    #4
    There's no way to answer this unless you specify which antidepressants have made you feel this way.

    edit: Sorry, crossposted.
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    I've always liked THIS line of reasoning 
    #5
    On the antinociceptive effect of fluoxetine, a selective serotonin reuptake inhibitor

    Vijay Pal Singh, Naveen K. Jain and S. K. Kulkarni,
    Pharmacology Division, University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh 160 014, India

    Copyright 2001 Elsevier Science B.V. All rights reserved.

    Antidepressant drugs are reported to be used as co-analgesics in clinical management of migraine and neuropathic pain. The mechanism through which they alleviate pain remains unknown. The present study explores the possible mechanism of a selective serotonin reuptake inhibitor (SSRI) fluoxetine-induced antinociception in animals. Acetic acid-induced writhing, hot plate and tail-flick test were used to assess fluoxetine-induced antinociception. Fluoxetine (5–20 mg kg−1, i.p.) produced a significant and dose-dependent antinociceptive effect against acetic acid-induced writhing in mice. Fluoxetine (20 mg kg−1) also exhibited antinociceptive effect in tail flick as well as hot plate assays. Further, i.c.v. administration of fluoxetine showed significant antinociception against writhing test in rats. However, fluoxetine (1 μg/10 μl/rat, i.c.v.) did not exhibit any antinociceptive effect in serotonin-depleted animals. Further, pindolol (10 mg kg−1, i.p.) enhanced fluoxetine-induced antinociceptive effect. The antinociceptive effect of fluoxetine was sensitive to blockade by naloxone (5 mg kg−1, i.p.) and naltrexone (5 mg kg−1, i.p.). These data suggest that fluoxetine-induced antinociception involves both central opioid and serotoninergic pathways.
    Last edited by seep; 05-09-2009 at 06:29.
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    #6
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    Quote Originally Posted by seep View Post
    There's no way to answer this unless you specify which antidepressants have made you feel this way.

    edit: Sorry, crossposted.
    On St. John's Wort, an extract which is standardized for Hyperforin. Hyperforin inhibits the reuptake of Serotonin, Dopamine, Epinephrine, GABA, and Glutamate.

    As for the post below yours seep, that's interesting. So would the antinociceptive effect . . . does that apply only to physical pain or would it cause a feeling of emotional numbness too?

    Also I haven't felt weird or numb or hyper today at all, just normal
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    #7
    Quote Originally Posted by Fohat View Post
    So would the antinociceptive effect . . . does that apply only to physical pain or would it cause a feeling of emotional numbness too?
    I was trying to hint at the fact that central serotonin and opioid pathways are enmeshed in complex ways. I've been on every major type of antidepressant except MAOIs, and I've spent a large part of my life addicted to opioids (mostly heroin and methadone), though never on opioids and antidepressants simultaneously. To me, the cumulative emotional effects of continual opioid use and the emotional effects of (say) a month-old Prozac regimen are almost indistinguishable (many others have pointed this out as well). It's a feeling that gets old: a physical, psychological and existential detachment, a feeling of being unplugged. So instead of playing cat and mouse with specific neurotransmitters (which is how the first SSRIs were developed) it makes more sense to me take note of these confluences and speculate as to what may be going on, then investigate whether or not the speculation holds water.

    This is important because when patients discontinue an antidepressant regimen they'll tell often say, "I'm tired of the way the medicine makes me feel." So then why do heroin addicts who have disposable income and aren't at much risk of losing their jobs or their freedom--why do these addicts discontinue their regimens? For me, the answer has always been, "I'm tired of the way the dope makes me feel." In both cases, this regimen-breaking side effect is similar.

    There stands the possibility that a substantially effective type of antidepressant will be developed--a drug that mitigates the emotional void you describe. I wager that it'll be one that capitalizes on the dynamic interplay between opioid and serotonin pathways (a relationship far too complex to describe here because so much of it involves electrochemistry, flux and circulation densities, non-conservative field kinetics, etc). But since part of the enigma is psychosocial, some ambitious human trials are needed.

    So much of what I've written is subjective because I can't package the empty, ambivalent, solipsistic "world will end in ice" feeling into clinically precise language.
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    #8
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    I have experienced this same thing while being on antidepressants, lastly on Cymbalta.

    It caused me to feel really energetic and euphoric always when dosages were increased. But then after my brains got used to the drug, there was like a ceiling how "high" I could feel on normal life situations. Eventually this ceiling effect caused this "high" to dampen to a emotional stupor where I couldn't feel anything anymore.

    I think the ceiling effect comes from these things:
    -less neurotransmitters are released
    -serotonin doesn't flow freely, it is blocked almost completely by antidepressant
    -there are less neurotransmitter , mainly dopamine and serotonin , receptors
    -then there is a certain limit on how much serotonin can be transmitted and received in a single period - no intense feelings or emotions possible

    Now that I have quit using antidepressants I get huge emotional responses and feelings , bad and good , they can swing quite hard too. But it is lot better now
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    #9
    Bluelighter Smyth's Avatar
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    St Johns Wort is nothing. I dont fancy arguing over this point though. Im just expressing my opinion.

    Amitriptyline causes numbness, but im not sure how common this effect is with the other antidepressants.
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    #10
    Bluelight Crew negrogesic's Avatar
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    These data suggest that fluoxetine-induced antinociception involves both central opioid
    This sounds like a leap...
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    #11
    Quote Originally Posted by negrogesic View Post
    This sounds like a leap...
    I'm guessing there are no serotonin-depleted knockout humans. I wonder how they would feel after a morphine injection.
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    #12
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    Quote Originally Posted by Smyth View Post
    St Johns Wort is nothing. I dont fancy arguing over this point though. Im just expressing my opinion.

    Amitriptyline causes numbness, but im not sure how common this effect is with the other antidepressants.
    I've been on escitalopram, sertaline, bupropion, mirtazapine, trazodone, and nortriptyline. I've never really understood the cliche that antidepressants numb you to everything and turn you into a zombie. With the first three in particular, emotions seemed to be affecting me to a much higher degree.

    I guess it's possible that they do different things for different people, but I've always been inclined to see it more as myth than reality.

    Anti-psychotics on the other hand... that would be a pretty accurate description.
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    #13
    Quote Originally Posted by emjay View Post
    I've been on escitalopram, sertaline, bupropion, mirtazapine, trazodone, and nortriptyline. I've never really understood the cliche that antidepressants numb you to everything and turn you into a zombie. With the first three in particular, emotions seemed to be affecting me to a much higher degree.
    Not zombie-like, just anaesthetized and aloof. And just the SSRIs and SNRIs, and to some extent the tricyclics (so escitalopram and nortriptyline in your case, without coadministration of an antipsychotic). It's interesting when you take into account how 5-HT, NE and opioids (endo or xeno) all play a role in inhibiting the pain-relaying work of substance P and the neurokinin 1 receptor, peripherally and centrally. NK antagonists haven't been shown to effectively treat depression, but SNRIs are effective in treating neuropathies (we prescribe them for that purpose all the time down here). And opioids are sublimely effective in treating acute depression, especially if a lion eats you right before you go into withdrawal. And so but then I'm stuck trying to find the common mechanism between SNRIs/SSRIs and opioids.

    I'm in love with trazodone btw.
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    #14
    Bluelighter AfterGlow's Avatar
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    Don't forget that when you've been on an anti-depressant for a while, your brain might down regulate neurotransmitters and receptors in an attempt to re-establish it's own natural pre-drug treatment equilibrium. Some people have to switch antidepressants after a while because they can lose their effectiveness. Being on anti-depressants for a while can also make you feel numb and emotionless because your brain can adapt to the drug in a way that negatively affects your mood and emotions as a side effect.

    When I was suffering really bad depression, anxiety and panic attacks following my crazy abuse of ecstasy, I was given paxil which made me feel awful, then seroquel which turned me into a zombie, then mirtazapine which actually helped me tremendously. I was on that for about 2 years. It calmed my mind allowing me to think more clearly and I slept better than I had in YEARS. When I first went on it, I could feel a mild euphoria as it was kicking in. But After a year or so, it made me feel drowsy ALL the time so my dose was raised from 15mg to 30mg. The higher dose operates more on the norepinephine receptors making you feel less drowsy.

    But once I started feeling better, I decided that going OFF the antidepressants and learning how to change my way of thinking and viewing the world in a more positive light would be a better long term solution than staying on psychotic drugs all my life. I still get Xanax and use it sparingly, but I don't need it like I once did. I exercise regularly, eat well, and do some charitable service work. I try to live a more balanced and rewarding life. That seems to be working for me.

    I hope my story might be of some benefit to you. Don't simply rely on anti-depressants to cure all your mental ills. Use them to help get overcome severe depression and mental illness, but also work on those aspects of your psyche and lifestyle that might be the underlying cause of your depression.
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    #15
    Antidepressants don't cause a feeling of numbness in me; they can a feeling of not wanting to kill myself.

    but I think to best answer your question. Who said serotonin caused a feeling of euphoria. Find anything to prove it. If you find anything: look again, because you haven't. No purely serotonergic drug causes euphoria. Your best angle would be DOI, and I don't really think that counts as euphoria. And if you say MDMA you need to smack yourself.
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    #16
    Bluelighter Smyth's Avatar
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    p-iodoamphetamine maybe?
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    #17
    Yes the "serotonin-is-the-feel-good hormone" is an urban myth.Banana,Chocolate etc is good for your mood they also say,because it contains "serotonin" (actually Tryptophan) is the same hogwash.Take a few grams of Typtophan and what will it do? At best you can go to sleep easier.

    The serotonergic system is in my view "designed" for emotional fine-tuning.
    Last edited by hugo24; 10-09-2009 at 19:23.
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