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Re: Duloxetine

Posted by SLS on March 2, 2002, at 17:15:51

In reply to Duloxetine, posted by Bob on March 2, 2002, at 14:02:48

> What is expected from Duloxetine that we don't already get from Effexor, except possibly a slightly different response profile?

I don't know about the rest of the world, but I expect duloxetine to get some people well whom had not previously responded to anything else. I would like to avail myself of the opportunity to try it. Some people have responded to Zoloft whom had not responded to Prozac; Paxil to Zoloft; Celexa to Paxil; Prozac to Celexa etc. Duloxetine might not appear especially novel with respect to monoamine reuptake inhibition in test-tubes, but I'm not sure that anyone understands the brain and actions of psychotropics well enough to draw firm conclusions about a drug's worth based upon what little is assumed to be understood. Laboratory test paradigms using rats are currently more reliable than deduction, although far from infallible.


> Effexor has many problems for many people, and I don't see how Duloxetine will be any better.

During a consultation, Patrick McGrath of Columbia-Presbyterian stated to me that for every new drug that appears, a certain percentage of people whom had previously been refractory to treatment responds well to it.

> I hate to be negative, but I can't really help it anymore.

Of course I'm frustrated that there are so few new drugs with novel mechanisms of action available or in development. It's obvious to me that the mechanisms of those that are currently available ain't hitting my target.

How does it hurt me to allow the drug companies and the FDA to release hundreds of drugs that are similar to each other? Capitalism just about insures that drug companies will still be working feverishly to develop novel drugs to break away from the pack. I don't think it is at all negative to be frustrated with the limitations of the current pharmacopeia and want to see drugs with very different mechanisms of action appear. I do, however, think it is negative to prevent drugs of only slightly differing mechanisms of action be brought to market. Slightly different might be different enough for some people. I have a vested interest in seeing duloxetine make it to the pharmacist's shelves. It's one more tool to work with.


- Scott

 

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