Posted by jb on March 29, 2001, at 8:37:15
In reply to Re: Table: -- Thanks!, posted by Chaston on March 29, 2001, at 7:54:09
Hi, Chaston. Had I engaged my brain at the time I posted my note and the table, I would have put a general disclaimer about many individuals having different side effects. However, I'm sure I would not have done so as well as you. So, thanks.
By the way, I, too, am finding it important to understand at least some of the pharmacology of different medications, so I can have a better understanding of side effects, in particular. My feeling is side effects are much more predictable than is therapeutic efficacy. I think the therapeutic predictions are more difficult due to the complex interactions of various neurotransmitters, as well as response differences among individuals due to their particular brain chemistry. However, regarding side effects, I think many, such as sexual dysfunction and weight gain, are quite predictable, particular at specific dosages and assuming monotherapy. For example, 5HT2a agonism will cause sexual side effects. Overly stimulated young males may like this, others may not.
Also, I think the significance of side effects is, for the most part, grossly under-reported in research as well as various literature on the Internet. I'm sure the pharmacologists and neuro-scientists whose research is posted on PubMed (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi), would not have forgetten to mention the sexual anasthesia of Nardil, if they had taken it for eight weeks before publishing their work. Now, wouldn't that make for an interest criterion in order to publish?????
As you mentioned, I'm sure many patients, in trying different meds, would at least like to know if there is some predisposition to weight gain and sexual dysfunction. And, for many meds, such as Nardil, the side effects apply almost universally. By the way, the part on side effects really hit home when, the other day, my pharmacologist mentioned "well, if you really want to get away from sexual side effects, you should try Serzone, since it antagonizes or blocks 5HT2a, and exhibits only weak reuptake inhibition." I felt like saying, "Why didn't we discuss this little itsy bitty fact before I started playing ring-around-the-rosy with AD's?"
Again, thanks for your thoughtful and well-worded caveat, as well as your remarks about my introductory summary.
JB
> jb -- Thanks for posting the link, and your interesting observations.
> While it's true that individuals often have different responses to these meds, it helps to have these average profiles as starting points, since we can't each try every AD.
>
> > It's not good to accept everything on tables like that as the iron-clad truth. People respond so differently to ADs. For example, I had bad sexual dysfunction on Remeron. Tables like that simplify things too much. They may be GENERALLY true, but remember they are generalizations.
> >
> > > Hi JB,
> > >
> > > Thanks much -- this is an excellent article, as well as the one which follows (SJW & drug interactions).
> > >
> > > Ted
> > >
> > >
> > > >The article can be found at
> > > >http://pharmacy.orst.edu/dur/news/2_3/2_3.htm
poster:jb
thread:57775
URL: http://www.dr-bob.org/babble/20010327/msgs/57896.html