Posted by zeugma on April 25, 2003, at 13:47:36
In reply to Anafrinil--most potent AD?????, posted by Jack Smith on April 25, 2003, at 12:31:48
> > Anafranil, besides the brilliant MAOIs, is known to be the most potent antidepressant (in addition to being THE anti-OCD med, and a derealization med, and a phobia med) - it does the job of the TCA's AND the SSRIs.
>
> I know it is supposed to be great for OCD but I have heard nothing about it being the most potent AD besides the MAOI's. Can anyone back this up with either personal experience or clinical evidence?\Anafranil is a very powerful 5-HT reuptake inhibitor, more powerful than most SSRI's. Its metabolite desmethylclomipramine is a secondary amine tricyclic, which means it's a powerful norepinephrine reuptake inhibitor. So it's actually a dual reuptake inhibitor, like Effexor, except that Anafranil is significantly more potent at each reuptake site. Check out this table: http://www.preskorn.com/books/ssri_s3.html#tab3-8 for comparison of clomipramine and desmethylclomipramine with SSRI's and their metabolites. Despite the fact that the most established mechanisms for antidepressant activity are 5-HT and NE reuptake inhibition, the drug that combines these mechanisms most powerfully is not licensed as an antidepressant, but an OCD treatment. I think that is the best illustration possible of the role that the accidents of marketing have played in the development and deployment of AD's.
poster:zeugma
thread:222185
URL: http://www.dr-bob.org/babble/20030423/msgs/222342.html