Posted by bulldog2 on January 24, 2009, at 11:21:41
In reply to Re: Desipramine vs Strattera for adult ADD. » psychobot5000, posted by SLS on January 24, 2009, at 10:09:09
> > > 2. A NE reuptake inhibitor is not a NE reuptake inhibitor, etc. Surely, atomoxetine, desipramine, reboxetine, viloxazine, and nisoxetine all have different clinical profiles. Preclinical studies demonstrated that they all had antidepressant properties during development. Clearly, atomoxetine and reboxetine are not as potent as desipramine when treating depression. So, different is different. Here, I suggest that it is not only what a drug does neurochemically that matters, but also where it does it. Atomoxetine accumulates in the prefrontal cortex more than it does elsewhere. This is probably why it is not an effective antidepressant for most people. Here, its inhibition of the NE transporter results in a simultaneous rise in diffused interstitial dopamine as it is taken up by the NE transporter there. I think one needs to look at the localization of drugs in the brain and the circuits they represent. Determining circuitry is equally important to determining what neurotransmitters and receptors facilitate those circuits.
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> > Thought my own experience might be slightly useful, at least in confirming this idea of differences among NRIs. I haven't taken Desipramine, but I've taken nortriptyline, Strattera, and Reboxetine, and they all felt very different. Nortrip felt like...a TCA, for the most part. Reboxetine made me unpleasantly wired, and did not noticeably help with attention. Strattera gave me very mild euphoria (or relative euphoria) combined with sleepiness during the first two days' treatment. Without that sleepiness, it might have been helpful for inattention. But in any case, the positive effects (the mild euphoria, mostly) disappeared completely within three days, leaving only the bizarre sedation. It was an odd experience.
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> > Sorry I can't comment directly on Desipramine. But those NRIs felt qualitatively very different from each other.
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> Desipramine has always managed to make me feel better with more energy, even if only for a few days before pooping-out. It has never been noxious to me. I became suicidal on reboxetine. It came over me very quickly and included a disgusting type of anxiety. Suicidality resolved within 36 hours of discontinuing the drug. Strattera did nothing for me. Oh, wait a minute, yes it did. It made me feel tired, sleepy and fatigued.
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> - ScottHow about a time released version of ritalin. It's a reuptake inhibitor and I believe can be safely used with parnate.
Or go back to nortriptyline since it worked!
poster:bulldog2
thread:875152
URL: http://www.dr-bob.org/babble/20090104/msgs/875794.html