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Re: Finally trying vortioxetine -- initial impressions » undopaminergic

Posted by SLS on December 28, 2022, at 12:01:22

In reply to Re: Finally trying vortioxetine -- initial impressions, posted by undopaminergic on December 28, 2022, at 10:52:39


> > 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.
> >
> I tried lurasidone, and it was a disappointment. It didn't have any notable adverse effects though.
> > 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.
> >
> Yes. It seems to be related to the action of 5-HT3 agonism.
> > Has anyone spoken about lumateperone (Caplyta) for depression here?
> >
> It does not seem to be available in Europe.
> -undopaminergic

Is this something that would appear in any kind of EU formulary? Nowhere in Europe?

What about France? In the 1980s, France was the leader in developing novel psychotropic compounds for treating depression and making them available to the public. I would call the France of the 1980s as being the biggest source of novel antidepressants compounds and a liberal mindset to get them to market. One French antidepressant stands out: amineptine. Amineptine is a selective dopamine reuptake inhibitor. It worked. Unfortunately, it was also used recreationally and for enhancing athletic performance. After it was banned from the Olympics, amineptine became a villain, and was taken off the market in France. The problem was that amineptine was available nowhere else. The tragedy is that many of the people for whom no other drugs worked were condemned to return to life of depression and hardship.

Something similar happened with nomifensine (Merital). When it was approved in the United States, many previously treatment-refractory cases of depression responded robustly to it. The main mechanism of action for nomifensine dopamine reuptake inhibition. Nomifensine has been around for a very long time. It was used as the gold standard for biological probes assaying dopamine function in the brain. Within a year, there were reports in Germany that hemolytic anemia appeared in association with nomifensine use. From what I understand, the incidence was rare, and may not have really been sufficient cause for its withdrawal from market. However, I imagine the company didnt want nomifensine to become the next thalidomide.
The first true SSRI was introduced to Europe in 1982. It was called zimelidine (Zelmid). It had one major problem, though. There were reports of GuillainBarré syndrome developing early in treatment. Zimelidine was withdrawn in 1983.

Fluoxetine (Prozac) was originally one of a series of compounds synthesized from diphenhydramine (Benadryl). It was announced in 1972 by Eli Lilly and patented. It hit the market in 1988. In my opinion it is a tragically underutilized drug in 2022.

- 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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