When I consider why the same SSRI can work for different disorders with different symptoms (to whatever extent it works better than placebo), I try to bear in mind that the therapeutic effect isn't a direct result of the acute SSRI action. Rather, it seems to be a result of the complex ways in which the brain responds to the SSRI during the first few weeks of administration--a long list of compensatory up- and downregulations of receptors.
And I take that to mean that the acute SSRI action is just a well-placed kick on the side of a malfunctioning TV set. It induces a somewhat mysterious chain of events, and perhaps those events are different in an anxious brain than in a depressive brain. If you ever need to remind yourself that the acute actions of SSRIs are relatively unimportant, consider the drug tianeptine. It's an effectve antidepressant/anxiolytic, but it's an SSRE--a selective serotonin-reuptake ENHANCER. Seems there's more than one way to kick the malfunctioning TV set. --David Epstein [EMAIL PROTECTED] --- To make changes to your subscription go to: http://acsun.frostburg.edu/cgi-bin/lyris.pl?enter=tips&text_mode=0&lang=english
