Posted by linkadge on May 27, 2008, at 20:48:11
In reply to Re: The best Tricyclic for anxiety.... » linkadge, posted by johnj on May 27, 2008, at 20:14:32
Well one theory suggests that serotonergic medications can actually increase certain forms of anxiety via stimulation of certain serotonin receptors.
Stimulation of the central 5-ht2a/c 5-ht3 receptors can cause anxiety.
Peripherially, stimulation of 5-ht3 receptors in the stomach can cause nausia.
Atypical antipsychotics are sometimes used to mitigate these side effects. Zyprexa/seroquel blocks 5-ht2a/c and 5-ht3, Risperidal blocsk 5-ht2c etc. Remeron also blocks 5-ht2a/c and 5-ht3 receptors and is somtimes used to reduce the side effecs of SSRI's.
Imirpamine is a TCA but is somewhat like effexor in that it doesn't block any serotonin receptors. By blocking the reuptake of serotonin it increases serotonin signalling at every serotonin receptor in the body. Other TCA's like doxapin, trimipramine, amitryptaline clomipramine etc, block certain serotonin receptors which can sometimes result in a more comprehensive antianxiety effect.
5-ht2a blockade can improve sleep. 5-ht2c blockade can reduce psychomotor agitation. 5-ht3 blockade can reduce nausia (peripherially) and anxiety centraly.
So I guess the bottom line is that if imipramine made anxiety worse another TCA may act differently.
Linakdge
poster:linkadge
thread:831465
URL: http://www.dr-bob.org/babble/20080519/msgs/831509.html