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Re: Switiching medications.. please help

Posted by banga on May 1, 2005, at 13:23:33

In reply to Re: Switiching medications.. please help, posted by Jaymee on May 1, 2005, at 10:34:16

Nutshell version:
There are many neurotransmitters--substances that conduct messages from one brain cell to another--in the brain. Three major neurotransmitters that are targeted by psychotropic medications are dopamine, norepinephrine and serotonin--especially these latter two.

Most of the newer antidepressants out there target serotonin, including Prozac and Zoloft. They are called serotonin reuptake inhibitors, or SSRIs. The result of inhibiting serotonin reuptake, in short, leads to higher levels of serotonin in various sites in the brain. Some target both serotonin and norepinephrine--again inhibiting their uptake and increasing concentration in the brain.

So Zoloft is an SSRI, but Effexor acts on both serotonin and norepinephrine. In terms of efficacy, it truly depends on the individual; the difference in their efffectiveness is not very big.

We simply do not know much. All we see is there is a connection (but not necessarily a clear cause-effect relationship) between depression and levels of these neurotransmitters, and *some* people are helped by these medications that increase levels of norepinephrine and serotonin. But it is not simple, because why, for instance, are some people helped by one SSRI and not the next? And why then are some people not helped at all?

And, as you will note if you keep reading posts here, for many, there are side effects; medications often are effective for a while but then no longer work (poop-out); and some are simply not helped at all by these medications. Aslo there are many other things that can be related to depression, such as hypothyroidism, hypoglycemia, etc....

There are many, many other details that have been observed, this is truly a short version of a very, very complex topic. That is why many of us spend so much time on the board, to learn and try and guess what might be helful in our individual case.

But again to answer your original question, Zoloft primarily on increases serotonin, and Effexor increases both serotonin and norepinephrine. But just because Effexor acts on both does not mean necessarily that it works better. Some may say Zoloft works a little better in the case of having anxiety as well as depression. But believe me, it is really really dependent on the individual.

If it were so simple that one works better than another this board would not exist!! And there are many other substances in the brain that can affect mood, but knowing these two gets you started. Then from there you can read on others that affect mood, and there are also subtypes of sites that these neurotransmitters work...etc.

Good luck, remember that it usually takes around a month to see if a particular medication works for you. Then you and your doctor look at either trying something else--or adding another medication.

I don't have a study abstract handy to give you an example of a study investigating the two--I am sure other people here know websites you can look at studies.

B.


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poster:banga thread:492173
URL: http://www.dr-bob.org/babble/20050428/msgs/492331.html