Posted by SLS on March 28, 2006, at 7:02:01
In reply to Re: amotivational syndrome » lostforwards, posted by jedi on March 28, 2006, at 2:24:02
I guess I was wrong. These abstracts indicate that the amotivational/apathy syndrome is dosage-dependent. The problem is, none of them reported finding a therapeutic window within which one can obtain an antidepressant response without the appearance of amotivation.
It is important to note that one of the abstracts describes a reversal of the syndrome using Zyprexa (olanzapine). One can only guess at which properties are responsible for this. I first thought of the ability of Zyprexa to block 5-HT2a receptors. However, it also produces an increased release of dopamine in the prefrontal cortex. I guess that if adding Remeron does not mitigate amotivational effects of SSRIs, then perhaps it is the DA release that is important.
- Scott
> Here are several abstracts concerning the apathy syndrome and SSRIs:
>
> Selective serotonin reuptake inhibitor-induced apathy: a pediatric case series.
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16553543&query_hl=18&itool=pubmed_docsum
>
> SSRI-induced apathy syndrome: a clinical review.
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15330228&query_hl=18&itool=pubmed_docsum
>
> Olanzapine in the treatment of apathy in previously depressed participants maintained with selective serotonin reuptake inhibitors: an open-label, flexible-dose study.
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12019662&query_hl=30&itool=pubmed_docsum
>
> Amotivational syndrome associated with selective serotonin reuptake inhibitors in children and adolescents.
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11436958&query_hl=30&itool=pubmed_docsum
>
> Apathy and indifference in patients on fluvoxamine and fluoxetine.
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=2124218&query_hl=30&itool=pubmed_DocSum
>
>
>
>
poster:SLS
thread:624520
URL: http://www.dr-bob.org/babble/20060322/msgs/625421.html