Posted by allisonm on February 12, 2001, at 8:59:02
In reply to Re: RZIP : ) , Allisonm , and others ..., posted by willow on February 11, 2001, at 21:37:20
> > > Okay I can understand that, but does the medication have serotonin in it? And what is serotonin? And why isn't effexor an SSRI? You explained the SSRI thing so that I could understand, hope you don't mind the added questions.< <
If you don't mind an oversimplified version from a laywoman, here goes...
Mood is affected primarily by three chemicals in your brain: serotonin, norepinephrine, and dopamine. Some folks with depression may need more norepinephrine and less serotonin and dopamine. Others might need more serotonin, etc.
Drugs affect the level of these chemicals in varying degrees by regulating the different neurons/synapses in your brain that take each of these chemicals up (there are different ones for each chemical). They can act on one or two of the chemicals or they can act on all three, but usually if they act on all three, they have a stronger effect on one or two of the three. They also effect the brain in other ways by causing other chemical changes. This is the most simple way I can explain it.
So then it becomes an educated guessing game to see which chemicals in each person's brain need boosting. Effexor, for example, works more on norepinephrine and serotonin. Reboxetine is an NRI -- a norepinephrine reuptake inhibitor. Remeron affects all three, but not so much on serotonin. Celexa is considered different from SSRIs because it is "clean" and works only on serotonin reuptake. Wellbutrin works, but they don't know how yet. I think it has something to do with dopamine and norepinephrine.
Doctors have a series of drugs they usually try according to the symptoms. For depression, they often will try one or more SSRIs first, then Effexor and/or Remeron, for example. If they get a partial response, they may increase the dose. Then they may augment with another drug such as lithium or Wellbutrin because those seem to boost the effectiveness of other drugs. Or they could add another AD. They also could add a mood stabilizer. They may try the older types of drugs -- tricyclics and MAOIs, which can be very effective for some people. I think Scott (aka SLS) wrote a really good explanation a while back on how MAOIs work. You might do an archive search for it.
To find what the different drugs work on, you also might go to: http://mentalhelp.net/guide/pro22.htm
which lists most all of the psychopharmacologic drugs and gives online sources that have descriptions of each. I usually try the Rxlist first if I am looking up a drug. If you go to the Rxlist for a particular drug, go to the clinical pharmacology section at the top of the page, and that will tell you how the drug works. If you run into words like "noradrenergic" and "adrenergic," they have to do with norepiniphrine. "Serotonergic" has to do with serotonin."Dopaminergic" has to do with dopamine.> > "I wish you hadn't asked it."< <
I was kidding -- mostly -- when I said that. It is a constant thought in the back of my head that the relationship between me and my psychiatrist is not real. There is a book out called "Mockingbird Years" by Emily Fox Gordon in which the author describes her life and all of the therapists she went through. She said something that still bothers me: "...therapy was a sad, manipulative parody of authentic relation." I don't want to believe that.> > > so I start opening up and he acts interested etc, but the psych isn't a friend, right? It adds confusing emotions into an already confused mind.< <
I agree a zillion percent.
> > > Maybe I'm "analyzing" too much into it? Maybe I should just enjoy it as it is?< <
I don't have an answer to that because I probably analyze too much too.
poster:allisonm
thread:4509
URL: http://www.dr-bob.org/babble/social/20010209/msgs/4570.html