Posted by schleprock on August 30, 2012, at 17:03:58
In reply to Re: Nortriptyline, Buspar, Serotonin » schleprock, posted by SLS on August 30, 2012, at 15:42:12
> > > > Buspar blocks seretonin receptors, it soesnt inhibit reuoptake, so I doubt nortriptyline + buspar would = clominramine
> > > >
> > > > nortriptyline + sertaline or another ssri *might* work, but realy, the only substitute for clomipramins is more clomipramine
> > >
> > > Buspar is infrequently used as an augmenter to SSRIs. It is a partial agonsist at serotonin 5-HT1a receptors, as is Viibryd. Viibryd might therefore confer anxiolytic as well as antidpressant properties. The SSRI component of Viibryd is fairly potent, and from reports, acts to alleviate OCD. Viibryd is like a combination of SSRI + Buspar, but without the D2 antagonism. Personally, I found Viibryd to be a rather clean drug without the usual SSRI side effects of apathy and flat affect. Happily, there were no sexual side effects either. In combination with nortriptyline, Viibryd might act much like clomipramine. On paper, it is an interesting proposition. I believe the therapeutic window for this combination will be wider than with clomipramine, as side effects often limit clomipramine use. Studies of adding nortriptyline to a SSRI - or even clomipramine - demonstrates an earlier onset of clinical improvement and greater reduction in symptoms of OCD.
> > >
> > > journals.tums.ac.ir/pdf/3511
> > >
> > > http://www.ncbi.nlm.nih.gov/pubmed/9786103
> > >
> > > www.irmj.ir/browse.php?a_id=131&slc_lang=en&sid=1...
> > >
> > >
> > > - Scott
> >
> > I'm still not sure, but by being an "agonist" would Buspar, however slightly, raise the amount of serotonin?
>
> - Receptor = a site upon which specific molecules bind to.
> - Ligand = a molecule that attaches to a receptor.
> - Agonist = a ligand that stimulates a receptor to act.
> - Antagonist = a ligand that blocks a receptor and inhibits it from acting.
> - Partial agonist = a ligand that acts as a buffer at the receptor. It can both stimulate and inhibit it, depending on the receptor location, conformational state, and synaptic neurotransmitter concentration.
>
> http://www.healthieryou.com/mhexpert/exp1041502a.html
>
> > I already had a bad experience trying to switch over to clomipramine
>
> What happened?
>
> > I think I have to try something more mild. I have a lot of symptoms that are consistant with low serotonin,
>
> Which symptoms?
>
> > but not OCD.
>
> Okay.
>
> > SLS, are you currently on an effective regimen that includes nortriptyline?
>
> Yes.
>
> Parnate 80 mg/day
> nortriptyline 150 mg/day
> Lamictal 200 mg/day
> lithium 300 mg/day
> Abilify 10 mg/day
> minocycline 100 mg/day
>
> I am currently experiencing a moderate antidepressant response that seems to be improving day by day. It is the addition of minocycline that has accelerated the rate of my recovery. I have been able to discontinue prazosin for now. I am doing better on minocycline than I was on prazosin. If the course of my improvement stalls, I will add back the prazosin. There is evidence that minocycline can work to augment an anti-glutamatergic drug (Lamictal) and a pro-noradrenergic drug (nortriptyline).
>
>
> - ScottI'm currently suffering from most of the symptoms associated with meloncholic depression (except psychomotor disturbance) and some degree of anxiety. I've usually had most of these symptoms in tandem if I was in a high GAD phase; but this is the first time that I'm suffering from a high degree of ahedonia and a moderate degree of anxiety. For all I know this might be some atypical form of GAD rather than depression.
This seems to have come out of nowhere about four months ago. I'd had some initial relief from atenolol and\or slight raise in nortriptyline dosage, then some relief through a llow dose clanazepam, which I have continuously increase, then some short term relief through risperidone until that med started making me worse.
The clomipramine I jusr couldn't handle. I woke up with a severe panic attack following my second dose (only 25mg) and some really bad sedation and anxiety after my fourth dose. This really put me off from my plan of replacing my 150mg nortriptyline with an equivalent dose of clomipramine.
Next up is Lyrica. I tried a few just before I came up with my clomipramine idea. I tried it at the smallest dose, and it may have been slightly helping. Took one last night, but I don't feel as much.
I just can't tell whether all this is due strictly to anxiety (which has been my primary problem), or some additional depression related imbalance. I don't think I've ever felt this way before, and certainly not for so long...
poster:schleprock
thread:1024421
URL: http://www.dr-bob.org/babble/20120830/msgs/1024484.html