Paxil & Pandas

I got the new National Geographic yesterday and the lead article was simply banner-titled: "Love." The text was about the neurochemistry of attraction and attachment, with connecting photos by Jodi Cobb. I have to admit that I was a bit puzzled on (a) what made this a NatGeo story (yeah, yeah, an easy one: to sell magazines. But why NatGeo instead of Cosmo then? Where's the market differentation?), and (b) why they sent Cobb out on this one, since the resultant photos of affection are, well, charming but hard to point as particularly specific to the topics in the article, and why would you need to fly around the world to get them? Anyway, to the Real Meat of this entry:

The article didn't cover any particularly new territory (it is a popular magazine), but it had some useful references on something I've been suspecting for a few years now (also not news for people who know more about neurology than I do): a potentially-harmful connection between selective serotonin re-uptake inhibitor antidepressants like Paxil and the ability to create, maintain, and enjoy attachments.

Attraction is known to be connected to the neurotransmitter serotonin — in some ill patients and in people feeling in love, serotonin levels are low. SSRI medications like Paxil and Prozac are designed to increase serotonin levels — the patient is less likely to feel depressed, but also loses their interest in sexual attraction and attachment.

These meds are among the most common presecribed today. Millions of people are on them.

Digging further I found these presentations on MedScape which describe a whole medical symposium held on this during 2005, titled "Sex, Sexuality, and Serotonin."

Helen Fisher's opening presentation at that link is a good reference because it lays out in detail a lot of medical understanding about the mechanisms of attraction and attachment, before getting to her concerns about anti-depressants (the other presentations are good too).

Now, if someone is very ill and needs to, say, avoid suicide because they are deeply depressed, well by all means they should be helped. But these side-effects expose a somewhat undefined element in our current notions about "health care" — namely, that they focus almost entirely on the individual "patient," without concern or even much awareness of the potential interaction effects between the patient and associated non-patients.

If a depressed patient is depressed becasue she's beaten at home, will Paxil solve her problem? Or if a patient has BPD or a related personality disorder, should their insurance cover the psychological harm they will inevitably inflict on the people in their families and workplaces? These are difficult questions that are largely left unasked and thus unresolved (perhaps because good answers to them may not benefit insurance companies).

Killing the ability to experience attraction suppresses not only a lot of the things we as humans consider "fun" but ultimately also the actions we consider at core of life's highest purposes — attachments, commitments, feelings of connection between one another and the universe. You can consider these aspects of a higher calling or just a natural expression of the presence of the appropriate amounts of dopamine; either way they are key to our well-being as human beings, or ability and sense of achievement, and the well-being of the other human beings around us.

Verifies my suspicion that if people in most any relationship were just more willing to generate a little oxytocin, even if they didn't feel like it, they'd feel better and their relationships would be stronger. But that starts to sound more like bar talk :)

I've had a few folks send me some tangentially-related Dilbert cartoons about a "never been cubicled" photographer...

January 19, 2006

 

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