Posted by SLS on March 7, 2001, at 6:57:16
In reply to Re: Prozac Geodon combo? - Cam » Sunnely, posted by dj on March 7, 2001, at 0:33:46
Hi Steve.
Regarding combining Wellbutrin and Prozac, I can't characterize its statistical comparison to combinations of Wellbutrin with the other SSRIs. Wellbutrin is considered to be almost a universal augmentation agent. It can be combined with just about everything, including MAO-inhibitors. Many people have had success combining it with Zoloft. A particularly efficacious combination seems to be that of adding Wellbutrin to Effexor. I don't know to what extent Wellbutrin would offset the weight-gain that some people experience with SSRIs, but I imagine that it can help by suppressing appetite somewhat.
I share your thoughts regarding Geodon (ziprasidone). It is touted as being a new Zyprexa without the weight gain. You probably already know this, but Geodon possesses a sort of purified buspirone (Buspar) property to stimulate postsynaptic (somato-dendritic) serotonergic autoreceptors. Buspirone is considered by some to be occasionally effective as an augmenting agent to antidepressants.
Personally, I sometimes wonder if for some people, a number of their serotoninergic (5-HT) pathways are actually over-active or poorly regulated in that direction. A property often focused on regarding the mechanism of actions of certain antidepressants is the antagonism (blockade) of postsynaptic 5-HT2a receptors. It is proposed that this serotonin *inhibiting* regulatory property is partially responsible for the antidepressant properties of Serzone, Remeron, Desyrel, Zyprexa and Risperdal. Like Zyprexa and Risperdal, Geodon also antagonizes these receptors. However, Geodon also serves to agonize (stimulate) the 5-HT1a receptors which inhibits the neuron even further. I guess it is possible that a drug that exhibits both of these properties might produce a synergism that would make Geodon a more efficacious augmenting agent than Zyprexa or Rispersal. Of course, this is nothing more than a "soft" argument. Perhaps some of our more pioneering people will give us some answers as to whether or not is effective in real life.
Regarding stimulation versus inhibition of serotonergic neurons, perhaps any "push" or "pull" of the serotonin system trips a reset mechanism to force a reregulation of these neurons to nominal operation.
Just my morning mental calisthenics...
- Scott
poster:SLS
thread:55673
URL: http://www.dr-bob.org/babble/20010302/msgs/55823.html