Posted by linkadge on January 15, 2007, at 21:02:40
In reply to Re: Depressives' sensitivity to stimulants!, posted by SLS on January 15, 2007, at 20:15:12
>Note that these mental giants were too dumb to >consider using amphetamine chronically to see if >it were useful as a long-term treatment. Perhaps >it never entered their minds.
But its not about just that. There are many more factors involved in the decision against the widspread use of amphetamines for depression. In order for a drug to be approved, it needs to be effective in a substantial proportion of patients, and generally be without abusability.
Consider amineptine. Arguably a very effective antideprssant, with remarkably few side effects. Especially effective in certain populations unresponsive to other treatments. Why was it taken off the market? Purely because of abuse *potential*. Did every patient who took it abuse it? Of course not.
Is that fair for the patient who would may have achieved long term remission with it? No. Its that psychiatry doesn't care about the exceptional patients. They only care about the all in one wonder drug fix-all.
Are we saying that investigators were too dumb to look at amineptine further? No, its just that they stopped when they encountered abuse potential.It was not removed for lack of efficacy. I don't even think it was removed because of any evidence of lack of long term efficacy.
If a potential antidepressant is shown to posess some abuse potential in mice, it is generally not investiaged further. Its just a no-no area. They have to make an overal rule.
It is interesting to note that amphetamine administration increases PEA concentrations, but that methylphenidate does not. I believe that long term amphetamine adminstration still affects PEA concentrations.
The activity of amphetamine also resembles the activity of PEA more than methyphenidate does. PEA concetrations are low in certain forms of depressive disorder, but not all.
http://www.neurotransmitter.net/adhdpea.html
Stimulants, urinary catecholamines, and indoleamines in hyperactivity. A comparison of methylphenidate and dextroamphetamine.
Children with attention deficit disorder with hyperactivity were given either methylphenidate hydrochloride or dextroamphetamine sulfate to compare the effects on urinary excretion of catecholamines, indoleamines, and phenylethylamine (PEA). Methylphenidate's effects were distinctly different from those of dextroamphetamine. After methylphenidate administration, both norepinephrine (NE) and normetanephrine (NMN) concentrations were significantly elevated, and there was a 22% increase in excretion of 3-methoxy-4-hydroxyphenylglycol (MHPG). In contrast, after dextroamphetamine treatment, MHPG excretion was significantly reduced and NE and NMN values were unchanged. Excretion of dopamine and metabolites was unchanged by either drug. Urinary PEA excretion was not significantly changed after methylphenidate treatment, but increased 1,600% in response to dextroamphetamine. Methylphenidate treatment did not significantly alter serotonin or 5-hydroxyindoleacetic acid excretion. Effects of dextroamphetamine were not tested." [Abstract]
Linkadge
poster:linkadge
thread:721931
URL: http://www.dr-bob.org/babble/20070113/msgs/722719.html