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Re: Finally trying vortioxetine -- initial impressions » SLS

Posted by undopaminergic on December 28, 2022, at 12:58:03

In reply to Re: Finally trying vortioxetine -- initial impressions » undopaminergic, posted by SLS on December 28, 2022, at 12:01:22

> >
> > > 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?
>

I cannot say for sure. But here is one that *is* available:

https://www.ema.europa.eu/en/medicines/human/EPAR/reagila

and I imagine there would be a corresponding page for lumateperone if it were approved.

The EMA (European Medicines Agency) is a kind of EU "FDA".

> 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.
>

Yes, France is interesting from a psychopharmacological point of view. David Pearce (author of The Good Drug Guide) is a great fan of amineptine. It's my understanding that he was able to acquire a load of Survector (brand amineptine) from Brazil, but I think he is now using amineptine from the chemical market.

Tianeptine, a drug structurally related to amineptine, is also from France. I haven't seen it mentioned here but it probably has been.

Both amineptine and tianeptine are tricyclics, but are not generally meant to be included when the term "TCA" is used, as they have little (beyond their structure) in common with typical tricyclics.

> 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.
>

Really? I don't recall seeing nomifensine mentioned much in neuroscience. Usual probes are amfonelic acid and GBR-12909, but even cocaine is often used, despite its lack of selectivity.

>
> 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.
>

In my experience, fluoxetine is the least apathising SSRI.

-undopaminergic


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