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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by SLS on September 1, 2004, at 20:16:29
Here's a neat little piece I found:
Alpha2-adrenergic receptor blockade markedly potentiates duloxetine- and fluoxetine-induced increases in noradrenaline, dopamine, and serotonin levels in the frontal cortex of freely moving rats.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9375697
This provides a nice pharmacological rationale for the use of Remeron or Buspar (with its 1-PP metabolite) as augmentors.
- Scott
Posted by zeugma on September 1, 2004, at 20:51:47
In reply to NE alpha-2 antagonism + reuptake inhibitors = AD++, posted by SLS on September 1, 2004, at 20:16:29
I found the addition of buspirone to nortriptyline produced an amplified AD response... definitely something to think about.
-z
Posted by King Vultan on September 1, 2004, at 23:19:50
In reply to NE alpha-2 antagonism + reuptake inhibitors = AD++, posted by SLS on September 1, 2004, at 20:16:29
> Here's a neat little piece I found:
>
> Alpha2-adrenergic receptor blockade markedly potentiates duloxetine- and fluoxetine-induced increases in noradrenaline, dopamine, and serotonin levels in the frontal cortex of freely moving rats.
>
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9375697
>
>
> This provides a nice pharmacological rationale for the use of Remeron or Buspar (with its 1-PP metabolite) as augmentors.
>
>
> - Scott
Or possibly yohimbine--alpha-2/alpha-1 selectivity ratio ~ 45:1 (at least according to some study I read once). As for Remeron, Stahl in "Essential Psychopharmacology" states "The therapeutic actions of mirtazapine are thought to be mainly mediated through its alpha 2 antagonist properties." However, mirtazapine has other things going for it; the selective alpha-2 antagonists such as yohimbine and idazoxan are rather one dimensional in comparison and have not really demonstrated any kind of robust AD effects. Remeron, OTOH, apparently does, to a large enough extent to at least be classified as an antidepressant, and demonstrating AD efficacy in many cases just being used by itself.Todd
Posted by SLS on September 2, 2004, at 6:38:32
In reply to Re: NE alpha-2 antagonism + reuptake inhibitors = AD++ » SLS, posted by King Vultan on September 1, 2004, at 23:19:50
> > This provides a nice pharmacological rationale for the use of Remeron or Buspar (with its 1-PP metabolite) as augmentors.
> As for Remeron, Stahl in "Essential Psychopharmacology" states "The therapeutic actions of mirtazapine are thought to be mainly mediated through its alpha 2 antagonist properties."So, is he discounting 5-HT2a antagonism as being contributory?
> However, mirtazapine has other things going for it; the selective alpha-2 antagonists such as yohimbine and idazoxan are rather one dimensional in comparison and have not really demonstrated any kind of robust AD effects. Remeron, OTOH, apparently does, to a large enough extent to at least be classified as an antidepressant, and demonstrating AD efficacy in many cases just being used by itself.
The multiple actions of Remeron probably confer its superior antidepressant properties, but I thought it was interesting to see how the isolation of NE alpha-2 antagonism itself specifically potentiated the effects that the monoamine reuptake inhibitors have on neurotransmitter levels in frontal cortical areas of the brain. It represents a discreet building block in understanding the synergies that multiple actions can have.
- Scott
Posted by alesta on September 2, 2004, at 14:15:03
In reply to Re: NE alpha-2 antagonism + reuptake inhibitors = AD++ » King Vultan, posted by SLS on September 2, 2004, at 6:38:32
good job finding that info, scott!
you didn't respond to my question asking how you were doing on cymbalta? what do you not like me or something...:)? just kidding, i know you do your separate progress reports...
amy :)
Posted by linkadge on September 2, 2004, at 16:16:37
In reply to Re: NE alpha-2 antagonism + reuptake --sls, posted by alesta on September 2, 2004, at 14:15:03
I added remeron to celexa. While it did give a more robust AD effect, it left me a little manic and agitated. If I recall, alpha-2 antagonism can be a little anxiogenic. When given to PTSD vetrans, yohimbine resulted in a rapid return of symtpoms.
Linkadge
Posted by SLS on September 2, 2004, at 17:20:08
In reply to Re: NE alpha-2 antagonism + reuptake --sls, posted by alesta on September 2, 2004, at 14:15:03
> good job finding that info, scott!
>
> you didn't respond to my question asking how you were doing on cymbalta? what do you not like me or something...:)? just kidding, i know you do your separate progress reports...
>
> amy :)
I Amy. :-)I found your post "upstairs" and gave you a quick answer. Today hasn't presented the improvements I noticed yesterday, but recovery is rarely a smooth process.
- Scott
Posted by Sad Panda on September 3, 2004, at 12:08:02
In reply to NE alpha-2 antagonism + reuptake inhibitors = AD++, posted by SLS on September 1, 2004, at 20:16:29
I found Remeron's NE alpha-2 antagonism to be irritating, but some say it's stimulating.
Cheers,
Panda.
Posted by SLS on September 3, 2004, at 12:26:22
In reply to Re: NE alpha-2 antagonism + reuptake inhibitors = AD++, posted by Sad Panda on September 3, 2004, at 12:08:02
Has anyone ever seen someone on a combination of:
Effexor + Remeron + Wellbutrin?
- Scott
Posted by EERRIICC on September 15, 2004, at 21:31:02
In reply to NE alpha-2 antagonism + reuptake inhibitors = AD++, posted by SLS on September 1, 2004, at 20:16:29
Scott, can I combine memantine with parnate? Hope Cymbalta is working for you.
Eric
Posted by SLS on September 16, 2004, at 14:48:37
In reply to To SLS » SLS, posted by EERRIICC on September 15, 2004, at 21:31:02
Hi Eric.
I addressed your post in the thread you started below.
http://www.dr-bob.org/babble/20040915/msgs/391304.html
- Scott
This is the end of the thread.
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