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Re: depressed, don't know what to do. » phidippus

Posted by SLS on April 13, 2012, at 14:42:50

In reply to Re: depressed, don't know what to do. » SLS, posted by phidippus on April 13, 2012, at 12:57:41

> I would love to add Lamictal, unfortunately, it makes my OCD unbearable (studies show Lamictal can cause or excacerbate OCD in Bipolar II patients).

Good to know. I don't think the studies I saw included bipolar subjects.

> I've had luck with Abilify in the past, but adding it would mean having 3 medications in my system agonising 5ht1a receptors-wouldn't that be bad?

I think lithium acts on postsynaptic receptors while vilazodone acts predominantly on autoreceptors, both presynaptic and somatodendritic.

Vilazodone seems to act preferentially on 5-HT1a receptors located in PFC and hippocampus. I don't know where Abilify acts with respect to 5-HT1a receptors. Being partial agonists instead of full agonists, I don't know if there would be much danger of over stimulation of receptors, even if the receptor reserve were saturated. That is just a guess, though. Taking your body temperature can act as an index of 5-HT1a agonism, as they are positively associated.

Because Abilify has such a long half life, you wouldn't want to take 20 mg loading doses, just in case there is a problem. If you do try Abilify, you might want to start at 2.5 mg.

I got some of my information from the following article. The serotonin system is complex, and I don't understand all of it. I would say that vilazodone acts to modulate rather than to stimulate serotonin activity because of its agonism is partial rather than full.

http://www.google.com/url?sa=t&rct=j&q=vilazodone%20autoreceptor&source=web&cd=4&ved=0CDYQFjAD&url=http%3A%2F%2Fwww.jain-resources.info%2Fuploads%2F3%2F3%2F5%2F8%2F3358541%2F5ht1a_-_dawson_review.pdf&ei=O3-IT8ThBMu70AHVxdHEBA&usg=AFQjCNEb1RSmXw6M06iN1_Swz_Y0kKbWXQ&cad=rja


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poster:SLS thread:1015433
URL: http://www.dr-bob.org/babble/20120411/msgs/1015536.html