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Re: 'anything can happen with psych drugs...' Jay2112

Posted by SLS on April 17, 2022, at 20:10:00

In reply to Re: 'anything can happen with psych drugs...', posted by Jay2112 on April 17, 2022, at 12:53:00

> > > direct quote from my newest (professional, probably temporary) prescriber.
> > >
> > > what's the point, again?
> >
> > To find relief, as far as possible?
> >
> > -undopaminergic
> >
>
> YES...that oh so desperate, sweet relief! That is really the heart of it all. I still remember, on the day of my first psych appointment. I was in such depressive tatters, soulfully exhausted on a scorching hot summer day in 1994. At about 4 in the afternoon, I took my first psych drug ever, lorazepam, and it was like the hand of god gently lay me into my bed. That evening, I took my first dose of amitriptyline, and I slept a sweet sleep that I so deeply needed. Like "st. joeseph's aspirin for the soul", as weeks went by, my life became, well, "LIFE", again.
>
> I still take amitriptyline (and other meds as well) to this day, and it is my absolutely MOST reliable medication!! A recent study found the drug to likely be the most reliable antidepressant available....with some give and take. But, 'tis life!
>
> Jay


Was clomipramine (Anafranil) among the drugs mentioned?

In general, I think clomipramine is the strongest TCA. The side effects suck, though. You end up getting the side effects of both a TCA and SSRI, including sexual side effects.

There is one drug that is rarely spoken about nowadays, but is probably the most potent antidepressant agent in existence. It is a MAOI called clorgyline. The NIH used it as their "ace-in-the-hole" for their most difficult cases. They gave it to me. I responded to it at a time when I was refractory to every other drug. However, it never became a marketed drug. Clorgyline is specific (as opposed to selective) for the MAO-A subtype. It is incapable of inhibiting MAO-B. The lesson to be learned from clorgyline is that inhibiting MAO-A without affecting MAO-B is sufficient to produce a robust antidepressant response. Interestingly, EMSAM (selegiline), an MAO inhibitor that is selective for MAO-B at low dosages, does not exert an antidepressant effect until the dosage is high enough to begin inhibiting MAO-A. Both enzymes break down dopamine and norepinephrine. However only MAO-A breaks down serotonin.

As I mentioned, clorgyline never made it to market. No drug company ever tried to develop it. Since the patent on clorgyline expired, there was no incentive to develop it. The only source of a preparation made for human consumption was at the NIH. Unfortunately, some patients who were taking it experienced cardiological adverse events. The research clinicians never gave me any details. I'm guessing that it was some sort of valvulopathy. Only some lucky rats get clorgyline now.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

The only thing necessary for the triumph of evil is that good men do nothing.

 

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