[Guest]

Dr.,

Thanks for the reply. I see this is too complex an issue to be addressed in this forum, but, if possible, could you answer this last one on mechanisms?

- I understand the the Serotonin uptake blockade takes place immediately, but clinical effects are not realized for several weeks on the theory of "down regulation" of the receptors to the increased serotonin available. The question then is, once the receptors have down regulated to adjust for the uptake inhibition, it would seem that the net effect to serotonin transmission would be none - uptake inhibition creates more serotonin to receptors, but receptors become less sensitive and fewer, resulting in basically the same level of transmission. Or, do the receptors only down regulate to a degree (my understanding is that the inhibition is up to 80% blockade), do the receptors not down regulate by a equivalent proportion?

If this one is too complicated to address in this forum, I completely understand. Thanks as always.

[Guest]

Serotonin turnover is neither increased nor decreased after chronic SSRI use. There is a strong possibility that the focus on Serotonin receptors is a red herring and the real action occurs further downstream. I probably involves the turning on of genes and manufacturing of new proteins which may or may not be receptors.
[quote] Dr. ,

Thanks for the reply... [/quote]