Posted by zeugma on December 9, 2004, at 20:01:24
In reply to Re: Nardil or Parnate decision » KaraS, posted by SLS on December 9, 2004, at 6:48:29
Hi all. if I rememeber correctly, imipramine and SSRI's upregulate post-synaptic DA receptors, which ought to compensate at least partially for hyper-sensitive DA autoreceptors. Presumably, the parkinson's-like DA hypofunction seen sometimes with SSRI's is related to other interactions within the 5-HT/DA system. In this context, I think it's interesting that Anafranil seems to work well for anhedonia as well as the symptoms that SSRI's tend to alleviate.
Since Anafranil, and TCA-SSRI combinations, have a good reputation for alleviating the 'negative' symptoms of depression, I would think Nardil would be a good bet for them too.
I don't think drugs that work directly on the DA system are really very good for anergia, or the other 'negative' symptoms of depression. Ritalin works for the pathological fatigue of narcolepsy, but I think this is because narcoleptics have severe dysregulation of global arousal systems, to a much greater degree than that present in atypical depression. TCA-MAOI combinations seem a lot more helpful than AD-stimulant combinations for atypical depression. Stims, in fact, can easily induce depression. I am convinced that Parnate's effects on atypical depression are at least as much a consequence of its effects on 5-HT as DA.
poster:zeugma
thread:425971
URL: http://www.dr-bob.org/babble/20041206/msgs/426926.html