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Re: NE alpha-2 antagonism + reuptake inhibitors = AD++ SLS

Posted by King Vultan on September 1, 2004, at 23:19:50

In reply to NE alpha-2 antagonism + reuptake inhibitors = AD++, posted by SLS on September 1, 2004, at 20:16:29

> Here's a neat little piece I found:
> Alpha2-adrenergic receptor blockade markedly potentiates duloxetine- and fluoxetine-induced increases in noradrenaline, dopamine, and serotonin levels in the frontal cortex of freely moving rats.
> This provides a nice pharmacological rationale for the use of Remeron or Buspar (with its 1-PP metabolite) as augmentors.
> - Scott

Or possibly yohimbine--alpha-2/alpha-1 selectivity ratio ~ 45:1 (at least according to some study I read once). As for Remeron, Stahl in "Essential Psychopharmacology" states "The therapeutic actions of mirtazapine are thought to be mainly mediated through its alpha 2 antagonist properties." However, mirtazapine has other things going for it; the selective alpha-2 antagonists such as yohimbine and idazoxan are rather one dimensional in comparison and have not really demonstrated any kind of robust AD effects. Remeron, OTOH, apparently does, to a large enough extent to at least be classified as an antidepressant, and demonstrating AD efficacy in many cases just being used by itself.





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