Posted by tensor on March 21, 2012, at 14:18:49
In reply to Re: Doxepin, posted by SLS on March 21, 2012, at 13:52:17
> Venlafaxine does not block serotonin 5-HT2a receptors the way nortriptyline does.
>
> Since trimipramine is a TCA stripped of reuptake inhibition, this is a clue that TCA might exert some of their therapeutic effects through other mechanisms.
>
> I try not to be "too smart" when making treatment decisions. It is not so important what I know as what I don't know. Different is different. Why someone responds to Paxil and not to Zoloft is not well understood. Are they exactly the same drug with exactly the same pharmacology? Obviously not, even if the differences between the actions of these drugs are not yet understood.
>
>
> - ScottYes. And no. One can not be 'too smart' when making decisions about treatments. I agree it's no point in getting too hardcore about receptor affinities. However, it does feel better (for me) if you have some neuroscientific basis when choosing (whatever is left) your next poison. I believe there are some pharmachological differencies between paroxetine and sertraline but I guess that's not your point.
One can not simply add mechanisms from several meds to substitute another, that's something I have learned the hard way.
/t
poster:tensor
thread:1013487
URL: http://www.dr-bob.org/babble/20120316/msgs/1013561.html