Posted by karaS on September 28, 2004, at 17:17:47
In reply to Re: Cymbalta and REM sleep - dreaming? » karaS, posted by zeugma on September 28, 2004, at 4:26:36
> How do you see an SNRI like Cymbalta fitting in here? Just as much potential for those "ominous long-term side effects" or could the addition of NE change things? If I'm interpreting what you wrote above correctly, then it can only make things worse, no?
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> Kara
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> Kara,
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> I think that probably the addition of noradrenergic effects helps the dopaminergic side of things because norepinephrine and dopamine are closely related (NE is one of the building blocks of dopamine). Imipramine, amitriptyline and clomipramine are dual reuptake inhibitors and have been around for many years without producing reports of REM behavior sleep disorder. Although admittedly I am less sure about clomipramine- it may be one of the 'serotonergetic AD's' referred to in the abstract. But if I had to guess, I would say that Cymbalta's dual reuptake inhibition helps to maintain the balance of monoamines in the brain.
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> -z
I also think that the SSRIs are highly overrated. It seems that way too many people get the hypodopaminergic, flat affect, no motivation effect from taking them exclusively. I read in Michael J. Norden's "Beyond Prozac" that he estimates the number of those experiencing poop-out from SSRIs as being around 20%. (He gave the low dopamine explanation as the probable reason for the poop-out.)It seems to me that the 20% figure is way too low - or maybe that's just my take on it from reading this board that is composed disproportionately of TRDs. I'm always amazed when I do hear of someone who has been taking only an SSRI for many years and it is still helping them without causing the low dopamine side effects. I wonder why they're able to benefit like this without the repercussions that many others of us have experienced.
-K
poster:karaS
thread:395372
URL: http://www.dr-bob.org/babble/20040927/msgs/396447.html