Posted by SLS on February 20, 2014, at 3:41:31
In reply to Re: Switching from Abilify to Latuda - Failed, posted by LouisianaSportsman on February 19, 2014, at 23:39:57
Everyone - thanks for the good advice and well-wishes. We are definitely a nice group of people.
Saphris might make me feel worse, but I don't think it makes sense for me to skip over it. My doctor wants me to take 5 mg/day.
While we are on the subject...
Abilify, Latuda, and Saphris are all serotonin 5-HT7 receptor antagonists; Latuda being the most potent. Experiments indicate that 5-HT7 receptors are involved in depression and the therapeutic action of certain drugs. However, Latuda and Saphris are also antagonists of norepinephrine NE alpha-2 receptors, and thus acts like higher dosages of Remeron. Remeron and idazoxan (an experimental NE alpha-2 antagonist) both severely exacerbate my depression. Therefore, Latuda will have been the third drug with this action to make me feel worse. Unfortunately, this leaves open the possibility that Saphris will make me feel worse, too. I try not to exclude drugs from consideration based upon my silly little personal theories. Too little is understood about how drugs operate to treat depression, and I try to avoid being presumptuous. For example, it is only recently that the significance of 5-HT7 receptors in depression has been recognized. I would not have taken this into account previously.
One other concern of mine with Saphris is that it is a full antagonist at serotonin 5-HT1a receptors. This compares to the partial agonist properties of Geodon, Abilify, and Latuda, as well as Viibryd and Brintellix (also a 5-HT7 antagonist). 5-HT1a partial agonism does not seem to make me feel worse and might actually help. Saphris might produce an exacerbation of my depression because it operates on these receptors in the opposite manner.
Saphris might make me feel worse:1. 5-HT7 receptor antagonists have antidepressant properties.
2. Abilify, Latuda, and Saphris are all 5-HT7 antagonists.
3. NE alpha-2 receptor antagonists make me feel worse (idazoxan and Remeron).
4. Latuda and Saphris are both NE alpha-2 antagonists. Abilify is not.
5. Latuda makes me feel worse.
6. 5-HT1a receptor agonists have antidepressant properties.
7. 5-HT1a receptor partial agonists that made me feel better include Abilify, Geodon, and Viibryd.
8. Saphris is a 5-HT1a antagonist and operates in a manner opposite to the drugs that helped me.
* I don't think that Brintellix (vortioxetine) should be ignored in the treatment of depression. In addition to its SSRI-like inhibition of serotonin reuptake, it is also a 5-HT1a agonist and a 5-HT7 antagonist. It is also a 5-HT3a receptor antagonist, but I don't know the clinical significance of this. I would make Brintellix my next drug to try if I were not already taking Parnate. Serotonin syndrome would result were these two drugs to be combined.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1059698
URL: http://www.dr-bob.org/babble/20140214/msgs/1060902.html