Posted by Sad Panda on January 29, 2004, at 1:09:59
In reply to doxepin, remeron, whatever.. thread is off-topic » Sad Panda, posted by scott-d-o on January 29, 2004, at 0:43:09
> > > how about switching the effexor to the old tricyclic doxepin.. it blocks reuptake of serotonin and norepinephrine, like effexor does, however it is also a very potent antihistamine (sedative), and also has alpha-1 antagonism (which I assumed was the reason seroquel helps your insomnia.) In fact, the only reason effexor was supposed to be an improvement over older tricyclics, such as doxepin, is because effexor doesn't have the sedative and anticholinergic action of TCA's. doxepin also happens to be a 5-HT2a antagonist, again like seroquel, and this should help with the insomnia as well.. sounds like the best of both meds for you..
> > >
> >
> > Doxepin is an extremely weak serotonin reuptake inhibitor but it is powerful at blocking histamine, the only thing stronger is Mirtazapine. Efexor is a weak norepinephrine reuptake inhibitor. Benzos don't make me drowsy but Mirtazapine certainly does.
> >
> > Cheers,
> > Panda.
> >
>
> not sure what you're correcting from my post, I believe my exact words were that doxepin is a "very potent antihistamine."
>
> mirtazapine isn't nearly as strong an antihistamine as doxepin, doxepin binds very strongly to both histamine receptors, while mirtazapine only has a weak action at the h1 receptor.
>
> the antagonism at 5-HT2/3 serotonin receptors is probably more responsibile for the drowsiness you experience from remeron.. and by no means is effexor a "weak" NE reuptake inhibitor, although it does like the serotonin transporter a bit more.. you are right however if you were just pointing out that, comparitively, doxepin has a higher affinity for the NE trans, and effexor has a higher affinity for the SERT rather than the NET.
>
> scottScott, I think if you do some research you will find that Mirtazapine is stronger than Doxepin at blocking H1. 5-HT2a is similar for both while the 5-HT3 abilites of Mirtazapine is great for reversing SSRI & Efexor induced nausea.
>>>how about switching the effexor to the old tricyclic doxepin.. it blocks reuptake of serotonin and norepinephrine, like effexor does
These 2 meds are nearly opposite to each other. Efexor main effect is on Serotonin while Doxepin has practically no effect on Serotonin.
Karen, if you haven't tried either Mirtazapine or Doxepin for sleep then I think they are worth a try.
Cheers,
Panda.
poster:Sad Panda
thread:306217
URL: http://www.dr-bob.org/babble/20040127/msgs/306759.html