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Re: Zyprexa *never* for depression! Tye

Posted by JohnX2 on March 31, 2002, at 9:04:33

In reply to Re: Zyprexa *never* for depression! JohnX2, posted by Tye on March 31, 2002, at 8:44:24

> > Given a Zyprexa, minus the noradrenergic alpha-1 antagonism (which for some may induce sedation), and the dopamine antagonism (potential for tardive dyskinesia), would you retract your statement? I.e. a clean medicine that blocks the Serotonin 5-ht2a and 5-ht2c receptors, thus relieving a lot of anxiety and side effects from the current generation of antidepressants?
> Hey John,
> Nah, I wouldn't retract my statement. I agree 5-HT2 antagonism reduces anxiety, I am not sure it improves mood directly. Other 5-HT2 antagonist are not antidepressants per say.
> Although, this is just my opinion and I could very well be completely wrong! You are very well informed/intelligent, and I enjoy reading all of your posts.
> Tye

Hi Tye,

I don't think the medicine alone would be effective for vanilla depression (it would for many other disorders). In fact this has already been shown with medicines like Ketanserin. But the sertonin system has been studied, and there is a greater understanding of what makes the SSRI medicines "suck". Blocking out a few receptors would substantially alleviate side effects like anxiety, sexual dysfunction, insomnia, etc. Many people can not tolerate taking SSRIs for Panic disorder, even though they are effective medicines because initially the SSRIs will increase serotonin conductance on these anxiety causing receptors. So these people go after the benzos instead. Also, non compliance from SSRIs from the side effects is a huge issue.

The atypical APs are potentially useful *adjuncts* (not primary medicines in general) for non-pychotics and manics, mainly for their sertonergic blocking properties. The chemical structures that achieve this most always block dopamine receptors however. I have seen a few clean medicines in the pipeline that might not mangle the dopamine system.

But i also agree that the risk of TD is something to take seriously. But they do work fast, and a quick trial of an AP beats taking the long road of an AD for some issues. Also, I have seen many people with depression, generally comorbid with certain other disorders, do well on APs (as well as have bad experiences) just like every other medicine, so I'm not sure what you base your statement regarding efficacy on.





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