Posted by King Vultan on April 12, 2004, at 20:22:22
In reply to Re: Dopamine agonists » Michael Bell, posted by Geoffrey Ruch on April 12, 2004, at 1:39:26
My understanding is that Nardil is better for social phobia than Parnate for two reasons: 1) Nardil is skewed much more towards serotonin than is Parnate and 2) Nardil also works on GABA, while Parnate does not. Serotonin seems to be the neurotransmitter most identified with social phobia. Paxil, which is FDA approved for social anxiety disorder, is obviously a very powerful SSRI. Nardil's actions on GABA likely have further anti-anxiety effects, which it would have in common with the benzodiazepines.
As for norepinephrine and depression/panic/anxiety, I think this is a complex topic. While it's true that people who suffer from panic attacks are thought to perhaps have overactive norepinephrine systems, this is really a separate issue from that of depression and social anxiety. My own experience (which may be somewhat atypical), and as someone who mainly suffers from depression and social phobia is that I found NE reuptake inhibitors actually quite helpful for both conditions despite moderately increasing my overall anxiety levels. Blocking NE reuptake gave me both an antidepressant lift and an increase in self confidence, self esteem, and assertiveness.
I've also gotten an antidepressant lift from SSRIs and some relief from my social phobia, but for me, anyway, the NE reuptake inhibitors were more effective on the latter. I don't know if I am unique in this respect or if I necessarily have a good explanation for this. As far as Nardil's effects on social phobia, I think it's worth pointing out that if Nardil is highly serotonergic, it follows that it should have a similarly powerful effect on norepinephrine because both neurotransmitters are metabolized by MAO-A. Also, Paxil has the greatest affinity in absolute terms for the NE reuptake transporter of any of the SSRIs (it also has the greatest affinity for the serotonin reuptake transporter). I don't know if these effects on NE actually confer any real ability on social phobia, but I thought I would share the observation.
Todd
poster:King Vultan
thread:205134
URL: http://www.dr-bob.org/babble/20040412/msgs/335712.html