Carol and others- I also think you got close to the answer (see other correction re- 
plasticity vs up- down- regulation). However, I think that the more likely correct 
factors (you did reference them) in "withdrawal" symptoms to antidepressants are the 
metabolically factors. The timing for up or down regulation is simply too long (4 - 6 
weeks is more like it) and too subtle to explain withdrawal symptoms as they are most 
frequently reported. For example, the hepatic, renal, hematological and other 
genetic/metabolic processes adapting to the withdrawal of the medication are far more 
likely culprits (if I'm reasoning correctly- I'm not sleepy but did just end a bike 
ride so I'm bushed!). Surely though, given the complexity of the issue, what with all 
the different compounds we currently use one would have to know the specific 
anti-depressant to which one is showing withdrawal, the dosing, the length of time on 
the medication, and other relevant factors in order to accurately explain withdrawal 
effects. I doubt very seriously if there is a single good answer to the question posed 
by the student(s). Why do I think that answer doesn't help much? :) Tim

        -----Original Message----- 
        From: DeVolder Carol L [mailto:[EMAIL PROTECTED] 
        Sent: Sun 3/14/2004 12:33 PM 
        To: Teaching in the Psychological Sciences 
        Cc: 
        Subject: RE: Withdrawal from antidepressants
        
        

        Good point--my mistake, thanks for correcting it. I told you I was still 
asleep! 
        Thanks again, 
        Carol 


        -----Original Message----- 
        From:   David Epstein [mailto:[EMAIL PROTECTED] 
        Sent:   Sun 3/14/2004 12:56 PM 
        To:     Teaching in the Psychological Sciences 
        Cc:     
        Subject:        RE: Withdrawal from antidepressants 
        On Sun, 14 Mar 2004, DeVolder Carol L went: 

        > the body adjusts to the med--it changes in dendritic structure as 
        > well as metabolism. The change in dendritic structure may include 
        > "upregulation" (becoming more sensitive by adding new dendrites) or 
        > "downregulation" (becoming less sensitive by reducing dendrites). 

        Close, but no axon. :)  Upregulation and downregulation refer to 
        increases and decreases in numbers of receptors--a receptor being a 
        single molecule. 

        Gross morphological changes can also occur (usually in the form of 
        increased numbers of dendritic spines, which are bumpy outgrowths 
        along dendrites), but such changes are usually referred to with the 
        term "plasticity." 

        As for the occurrence of withdrawal symptoms in the absence of other 
        symptoms of dependence--sure, that can happen, and it does happen with 
        many antidepressants.  See the DSM-IV criteria for substance 
        dependence, in which withdrawal symptoms are neither necessary nor 
        sufficient for a diagnosis, though they may contribute to it. 

        --David Epstein 
          [EMAIL PROTECTED] 


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