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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Iansf on November 3, 2004, at 23:21:44
Does anyone know why Gepirone was not approved by the FDA? I came across multiple studies demonstrating its effectiveness, but I can't uncover the reason for its rejection. I was looking forward with great interest to its release and am very disappointed we will never see it.
The same thing happened with flesinoxan a couple years ago- very promising studies but never a release. That was even more disappoinging since it had a reputation for being pro-sexual.
John
Posted by SLS on November 4, 2004, at 6:24:45
In reply to Gepirone, posted by Iansf on November 3, 2004, at 23:21:44
> Does anyone know why Gepirone was not approved by the FDA? I came across multiple studies demonstrating its effectiveness, but I can't uncover the reason for its rejection.
Actually, I think it was rejected for a lack of efficacy.
I was looking forward with great interest to its release and am very disappointed we will never see it.
I would have been hesitant to try gepirone because I react badly to Remeron. The metabolite of gepirone, 1-PP, is a potent antagonist of NE alpha-2 receptors, as is Remeron. You would think that this would promote an antidepressant effect for most people. However, it should be noted that Remeron also acts as an antagonist at serotonin receptors (5-HT2a and 5-HT3). This might differeniate the two and explain why gepirone is not as effective.
> The same thing happened with flesinoxan a couple years ago- very promising studies but never a release.
I know. I was even more disappointed by this outcome because flesinoxan is not metabolized into 1-PP.
Thanks for the info.
- Scott
Posted by linkadge on November 4, 2004, at 7:27:25
In reply to Re: Gepirone, posted by SLS on November 4, 2004, at 6:24:45
I was dissapointed too, as what we really do need are potent 5-ht1a agonists to help get the most of antianxiety, and antidepressant treatments.
Note: Blocking the 5-h1a receptor blocks virtually all the antidepressant responce in SSRI's
Linkadge
Posted by zeugma on November 7, 2004, at 13:16:18
In reply to Re: Gepirone, posted by linkadge on November 4, 2004, at 7:27:25
You can always try buspirone (unless that is yet another med your doctor NEVER prescribes). Buspirone is closely related to gepirone, although it is also a weak antagonist at the D2 receptor- this would probably help someone with DA autoreceptor hyperfunction, which may not be an issue for you, but could be for several others on this board.
-z
Posted by Iansf on November 7, 2004, at 13:38:37
In reply to buspirone, posted by zeugma on November 7, 2004, at 13:16:18
> You can always try buspirone (unless that is yet another med your doctor NEVER prescribes). Buspirone is closely related to gepirone, although it is also a weak antagonist at the D2 receptor- this would probably help someone with DA autoreceptor hyperfunction, which may not be an issue for you, but could be for several others on this board.
>
> -zHeaven knows if he'll prescribe it. Too many psychiatrists I've visited over the years have been astonishingly rigid, not to mention underinformed, or both. Given that I live in San Francisco, generally one of the most progressive cities in the U.S. and a center of intellectual experimentation, I expected to find a very open-minded psychiatric community. Unfortunately my experience has been the reverse. I have come across some wonderful exceptions, but overall psychiatrists have been some of the coldest, most doctrinaire people I've ever encountered and extraordinarily lacking in compassion. If I didn't constantly get bumped from insurance plan to insurance plan, I could stick with someone I like, but I've suffered through six changes of plans in 10 years. Very discouraging.
This is the end of the thread.
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