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Re: Finally trying vortioxetine -- initial impressions

Posted by SLS on December 27, 2022, at 22:25:07

In reply to Re: Finally trying vortioxetine -- initial impressions, posted by undopaminergic on December 23, 2022, at 13:03:13

> I found this article (free full text available) to be a good summary review of vortioxetine, including pre-clinical and clinical aspects:
> "Vortioxetine, a novel antidepressant with multimodal activity: review of preclinical and clinical data".
> -undopaminergic

Around the same time vortioxetine was approved, there was an increased interest in the properties of the 5-HT7 receptor as a site to exploit to treat depression as an antagonist. To my knowledge, vortioxetine is the only antidepressant possessing this property. Another drug with this property is lurasidone, an antipsychotic. Lurasidone has been advertised as a treatment of bipolar II depression. However, I have not seen any great successes with lurasidone for this indication. I dont know how well it has proven to treat schizophrenia. People with depression often report being able to think more clearly (improved cognition) with vortioxetine before an improvement in depression occurs. I dont know why.

Has anyone spoken about lumateperone (Caplyta) for depression here? It is rather unique as an antipsychotic. It is a modulator of glutamate neurotransmission as well as for dopamine and serotonin. As secondary effects, it increases both dopamine and glutamate activity in the medial prefrontal cortex. Lumateperone is supposed to effect an antidepressant effect for both Bipolar I depression and Bipolar II depression. I think it might be worth taking a look at. I have not researched clinical trials for depression, so I dont know how effective it is statistically. It is currently used for bipolar depression as monotherapy or combined with lithium or valproate.

Im beginning to think that low-dosage lithium should be tried routinely in people for whom treatment-resistance has been demonstrated - and leave it there in the background. The stresses that lithium places on the kidneys and thyroid gland are dosage-dependent. At 300 mg/day, the risks are virtually 0%. I was on lithium 300 mg/day by accident, but it turned out to be crucial for my attaining remission. At the very least, it will promote neurogenesis in the hippocampus, which is almost universally shrunken in depression. The hippocampus, in addition to being the primary site for memory, also regulates emotion. Lithium also slows or prevents neurodegeneration and acts as and prevents oxidative. The list of things that lithium does in the brain is very long. Lithium is like aspirin for the brain. Unbelievably, lithium *lengthens* telomeres. Telomeres form a cap at the end of each arm of a chromosome, and serves to contain the DNA strand from unwinding. As one ages, the length of telomeres shortens, and is an index of apoptosis (programmed cell death). Lithium reduces the risk of getting Alzheimers Disease, and is being looked at for Parkinsons and other neurodegenerative diseases. It was the reduction in my risk of contracting Alzheimers Disease that was precisely the reason why I had been taking it. That it turned out to be a critical component of my successful treatment of bipolar depression was serendipitous and an unexpected gift.

- 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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