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Hello Friends:

It looks as if Kevin may be rejoining the writing world. He has now written something new on his blog. Even though it is only a request for someone to give him a CD player, it is a step in the right direction. I am glad you are writing again Kevin!

Also, he has mentioned the idea of getting anti-depressant medications. That could be an excellent idea... as long as he DOES take the medication when prescribed. There are two likely classes of anti-depressants Kevin could be supplied with:

SSRI MEDICATIONS

These are also often refered to as SRUI medications and both acronyms state something similar... these medications are serotonin reuptake inhibitor compounds. They come in several forms, but the most common are Prozac, Zoloft, and Paxil. The pharmacology behind these medications is to selectively affect dopaminergic neurons in the brain that release and/or respond to the neurotransmitter serotonin. Serotonin helps to agonize or antagonize different neurons in the thalamus and hypothalamus that govern mood. In the depressed, it is believed that their brains are too efficient at removing serotonin from the synapses of these neurons, thereby short changing their powerful "happiness" inducing effect. The medications attempt to hinder this reuptake (removal) thereby allowing serotonin to have more chance to get the person "happy".

This type of medication takes several weeks to build up in the metabolism. But, they are relatively safe medications (even though there are now relatively new warnings for children who take SRUIs). If Kevin were to be prescribed this medication class, it is pretty safe... the effects of NOT taking the medication consistently are relatively mild. By being homeless, it will likely be a far greater challenge for Kevin to take medication regularly... and added to the mix is his sometimes distrusting nature and it is very possible that Kevin may go some periods of time where he refuses his medication. The SRUIs are relatively safe for sproradic ingestion.

BIPOLAR MEDICATIONS

The second class of medications are designed specifically for the mental illness of bipolar disorder.... a condition where people have extreme bursts of energy and creativity and also extreme pits of despair and depression. The most common medication for this type of condition is Lithium. From the writing Kevin has done in the past, it is *possible* that his "depression" is actually bipolar disorder. However, I would be very cautious in prescribing Kevin lithium.... because it is a drug whos efficacy is VERY dependant on consistant dosage. A missed dose or two may have only minor effect, but if a person stops taking the medication for any length of time, they typically induce a sharp episode of EXTREME mania followed by even more EXTREME depression. As a homeless person, and with having a nature prone to dislike medication, Kevin would *in my opinion* be at high risk if prescribed this type of medication (Lithium). To have this medication be successful, you need DILIGENT, CONSISTENT, and DETERMINED dosages... plus blood level monitoring on regular intervals to ensure homeostatic concentrations in the plasma.

I hope that Kevin is firmly committed to taking his medication whichever class he is eventually prescribed. It could definetly turn his life around. As a neurobiologist/endocrinologist, I have read a great deal about these medications in both clinical and real-world settings, and the benefits have been ENORMOUS and widespread. Countless thousands have had their lives turn around and their emotions reverse direction to point them towards happiness. Happiness is truly something I and many others wish for Kevin.

PipeTobacco