![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 15 to 39 of 39. Go back in thread:
Posted by Jessica on January 29, 2000, at 19:17:18
In reply to Re: Which ADs affect dopamine and norepinephrine?, posted by Cam W. on January 29, 2000, at 16:03:50
Every seems to like Effexor. It did nothing for me, I took it for a couple of years. I took only 75 mg a day.
Is it possible to have no reaction to a medication at a low dose (i tend to only need low doses) and to have a good reaction at a greater dose?
I like the sound of Wellbutrin but I'm anorexic and my doctor is a 'by the book type'.
As for the MAOIs if manerix didn't work could the others? Food issues again?
Could prozac help me, considering the other SSRI type medications didn't? Well, they gave me a small taste of the good life.
Elavil sounds interesting.
Thanks!
Posted by Cam W. on January 29, 2000, at 21:55:59
In reply to Re: Which ADs affect dopamine and norepinephrine?, posted by Jessica on January 29, 2000, at 19:17:18
> Every seems to like Effexor. It did nothing for me, I took it for a couple of years. I took only 75 mg a day.
>
> Is it possible to have no reaction to a medication at a low dose (i tend to only need low doses) and to have a good reaction at a greater dose?
>
> I like the sound of Wellbutrin but I'm anorexic and my doctor is a 'by the book type'.
>
> As for the MAOIs if manerix didn't work could the others? Food issues again?
>
> Could prozac help me, considering the other SSRI type medications didn't? Well, they gave me a small taste of the good life.
>
> Elavil sounds interesting.
>
> Thanks!
>
>
Jessica - Your Effexor dose was low unless you are very sensitive to the effects of antidepressants. If this is the case Prozac, because of it's long half-life (the time it takes for half the drug to leave the body) and the long half-life of it's active metabolite, may not be a good choice for you. Also Prozac's lowest dose is 10mg which may be too much for you.Because of your sensitivity I would not recommend MAOIs, but I am more conservative in other people in their use. There are some possible cardiac problems with them and the diet it restricts you to can be a pain. I only recommend them as a last resort. They do work well in people that are refractory to other antidepressants (especially psychotic or atypical depressions) but try others first.
For an SSRI you could ask your doctor about Paxil, Zoloft or Celexa. Celexa is supposed to have the fewest side effects of the SSRIs, but people still do have side effects, especially at the initiation of treatment.
Elavil is fairly sedating, especially for about the first month. It also gives you dry mouth and dizziness and like the MAOIs, is toxic in overdose. The advantage it may have for you is that it comes in very low doses (10mg), which you can build up slowly. Researchers say that after six months of therapy the side effects that remain are similar to those that remain with the SSRIs or they disappear altogether. TCAs (like Elavil) can also cause or compound heart problems. Ask you doctor and follow his/her advice as your doctor will know your medical history, unlike me. Good luck - Cam W.
Posted by Sigolene on January 30, 2000, at 13:27:24
In reply to Re: Which ADs affect dopamine and norepinephrine?, posted by Scott L. Schofield on January 29, 2000, at 15:45:38
> > Which ADs affect dopamine and norepinephrine?
>
> This is an easy one.
>
> Monoamine Oxidase Inhibitors (MAOIs) - non-selective
>
> ------------------------------
>
>
> Effexor (venlafaxine)
>
> Effexor has been mentioned. This drug, in addition to inhibiting the reuptake of serotonin and norepinephrine, is sometimes reported to inhibit the reuptake of dopamine, albeit to a far lesser extent. One can argue that the degree to which Effexor affects either norepinephrine or dopamine may be less than its effects on serotonin. However, I'm not sure that it makes sense to discard the influence that Effexor has on these two neurotransmitters as it may possibly contribute to Effexor's antidepressant properties. I didn't dig very deep in Medline, but what I found indicates that its effects on norepinephrine are significant. I wouldn't be a bit surprised if Effexor's purported effects on dopamine may play some role in its reputation as producing a more rapid response.
>
>
> Wellbutrin (bupropion)
>
> Wellbutrin is a drug that is a bit of an enigma. I don't think many doctors feel too confident about how it works. It does inhibit the reuptake of dopamine, but not to the degree that other antidepressants do with the other neurotransmitters. One doctor told me that Wellbutrin seems to have both pro-dopaminergic and anti-dopaminergic effects. Others have implicated norepinephrine as playing a significant role in how Wellbutrin produces its clinical effects.
>
>
> Survector (amineptine) - no longer available
>
> Survector is a very potent reuptake inhibitor of both dopamine and norepinephrine. It was never marketed in the U.S. I think that it has recently been withdrawn world-wide because of concerns regarding addiction and its abuse in athletic events. It was used extensively in France for many years as a first-line choice. Survector, like the tricyclics, had a reputation as being effective in the more severe cases of depression.
>
>
> Merital (nomifensine) - no longer available
>
> Merital was marketed in the U.S. briefly in the mid 1980's. It inhibits the reuptake of both norepinephrine and dopamine. It also causes an increase in the release of dopamine. It was effective, but was withdrawn when cases of hemolytic anemia began to appear.
>
>
> Mazinor (mazindol) - not considered an antidepressant
>
> I just threw this in here because I've been curious if anyone has tried it - either as monotherapy or in a polypharmaceutical regime. It is a drug normally reserved for use in the treatment of obesity. Aside from suppressing appetite, it also exerts lipolytic effects by stimulating an increase in the metabolism occurring within BAT - brown adipose tissue. For a while, the drug manufacturer (Wyeth) was looking at a similar compound that they named ciclazindol. They claimed that clinical studies were not encouraging enough to continue development. Some investigators showed positive results, however.
>
>
> -----------------------------------------------------
>
>
> Perhaps some of those properties of a drug that we deem as being insignificant today will one day be discovered to be critical in terms of how the brain reacts to them.
>
>
> -ScottHi,
I'm very impressed by your post !
Where did you get all these knowledge about medications ?
Just one thing: I think that MAOI also affect serotonine, as well as NE and DA.Am I wrong ?
Sigolene.
Posted by Sigolene on January 30, 2000, at 13:29:17
In reply to Re: wellbutrin and zyban, posted by Noa on January 29, 2000, at 14:48:21
> Cam, do you know if wellbutrin and zyban are exactly the same? Same concentration and all? Are they dosed the same, come in the same strengths? Is it possible for someone in a country where wellbutrin is not available (England) to substitute zyban, even if it means converting the doses somewhat?
Hi,
Can you tell me which substance is contained in Zyban, maybe I can help you.
Sigolene
Posted by Noa on January 30, 2000, at 14:13:05
In reply to Re: wellbutrin and zyban, posted by Sigolene on January 30, 2000, at 13:29:17
I think they are both buproprion HCl.
Posted by Scott L. Schofield on January 30, 2000, at 14:59:24
In reply to Re: Which ADs affect dopamine and norepinephrine?, posted by Sigolene on January 30, 2000, at 13:27:24
> Hi,> I'm very impressed by your post !
Don't say things like that. I might begin to think that I have a brain.
> Where did you get all these knowledge about medications ?
1. Rutgers Medical School Library - a long time ago.
- I was able to concentrate and remember things better then than I can now. Even so, I was only able to work for between 30 and 45 minutes before my poor brain would give up and force me to go home.2. For several reasons, I felt very strongly that dopamine function played a critical role in my case. At the time, only a handful of investigators were looking into it as possibly being a contributing factor in the causes of depression. That is why I began to search for antidepressants or other drugs that possessed dopaminergic and norandrenergic properties.
2. I have seen too many doctors, although I feel very fortunate to have had the opportunity.
3. I guess if you throw enough sh_t against the wall, some of it is bound to stick.
> Just one thing: I think that MAOI also affect serotonin, as well as NE and DA.Am I wrong ?
No, you are not wrong. Either that, or we are both wrong.Serotonin (5-HT), norepinephrine (NE), and dopamine (DA) all belong to a family of molecules known as "monoamines". Monoamine oxidase (MAO) is an enzyme that is supposed to break-down these neurotransmitters to keep their levels stable. If MAO is prevented from doing so (inhibited), levels neurotransmitters increase.
Additionally, those MAOIs that can inhibit the MAO-A subtype enzyme, raise the levels of melatonin in the brain (pineal gland) by stimulating its biosynthesis.
- Scott
It's getting close to kick-off.
Posted by Cam W. on January 30, 2000, at 18:56:01
In reply to Re: Which ADs affect dopamine and norepinephrine?, posted by Scott L. Schofield on January 30, 2000, at 14:59:24
>
> > Hi,
>
> > I'm very impressed by your post !
>
> Don't say things like that. I might begin to think that I have a brain.
>
> > Where did you get all these knowledge about medications ?
>
> 1. Rutgers Medical School Library - a long time ago.
> - I was able to concentrate and remember things better then than I can now. Even so, I was only able to work for between 30 and 45 minutes before my poor brain would give up and force me to go home.
>
> 2. For several reasons, I felt very strongly that dopamine function played a critical role in my case. At the time, only a handful of investigators were looking into it as possibly being a contributing factor in the causes of depression. That is why I began to search for antidepressants or other drugs that possessed dopaminergic and norandrenergic properties.
>
> 2. I have seen too many doctors, although I feel very fortunate to have had the opportunity.
>
> 3. I guess if you throw enough sh_t against the wall, some of it is bound to stick.
>
>
> > Just one thing: I think that MAOI also affect serotonin, as well as NE and DA.Am I wrong ?
>
>
> No, you are not wrong. Either that, or we are both wrong.
>
> Serotonin (5-HT), norepinephrine (NE), and dopamine (DA) all belong to a family of molecules known as "monoamines". Monoamine oxidase (MAO) is an enzyme that is supposed to break-down these neurotransmitters to keep their levels stable. If MAO is prevented from doing so (inhibited), levels neurotransmitters increase.
>
> Additionally, those MAOIs that can inhibit the MAO-A subtype enzyme, raise the levels of melatonin in the brain (pineal gland) by stimulating its biosynthesis.
>
>
>
> - Scott
>
>
> It's getting close to kick-off.Everyone - Melatonin is closely related in structure to serotonin. - Cam W.
Posted by Kev on January 30, 2000, at 21:03:00
In reply to Re: Which ADs affect dopamine and norepinephrine?, posted by Sigolene on January 29, 2000, at 10:39:53
How exactly would one know that their particular situation required drugs that work on one or the other of these neurotransmitters (Serotonin, Dopamine, Norepinephrine)?
-Kev
Posted by Cam W. on January 30, 2000, at 21:40:29
In reply to Re: Which ADs affect dopamine and norepinephrine?, posted by Kev on January 30, 2000, at 21:03:00
> How exactly would one know that their particular situation required drugs that work on one or the other of these neurotransmitters (Serotonin, Dopamine, Norepinephrine)?
>
> -KevKev - You really can't tell for sure unless one does brain levels, which can be done easily. Symptoms of your depression can guide the choice. The only thing we do know is that serotonin levels (or at least a metabolite in the cerebral spinal fluid) is low, but not in every case. Since the tricyclic ADs (TCAs - eg Elavil) increase both serotonin and norepinephrine, and are generally regarded as the best of the chemical ADs, we are led to believe that norepinephrine plays a role in depression. Low levels of norepinephrine are not generally detected in depressed individuals. All neurotransmitters are linked to one another at various levels in the CNS (central nervous system), so by affecting norepinephrine and serotonin, we seem to be alleviating the symptoms of depression the best. But I believe the mechanism(s) of action of antidepressants have not yet been determined, we are just seeing the finally results and making educated guesses at how they may work. The only way to find what AD is best for you is to have adequate trials until one works. Sorry, there are no algorithms for depression, yet. We do know that certain subtypes of depression respond to certain ADs (MAOIs in psychotic and atypical depressions) but we haven't figured out all the subtypes of depression, yet, either. - Cam W.
Posted by michael on January 31, 2000, at 21:40:51
In reply to Re: Which ADs - Kev, posted by Cam W. on January 30, 2000, at 21:40:29
> > How exactly would one know that their particular situation required drugs that work on one or the other of these neurotransmitters (Serotonin, Dopamine, Norepinephrine)?
> >
> > -Kev
>
> Kev - You really can't tell for sure unless one does brain levels, which can be done easily. Symptoms of your depression can guide the choice. The only thing we do know is that serotonin levels (or at least a metabolite in the cerebral spinal fluid) is low, but not in every case. Since the tricyclic ADs (TCAs - eg Elavil) increase both serotonin and norepinephrine, and are generally regarded as the best of the chemical ADs, we are led to believe that norepinephrine plays a role in depression. Low levels of norepinephrine are not generally detected in depressed individuals. All neurotransmitters are linked to one another at various levels in the CNS (central nervous system), so by affecting norepinephrine and serotonin, we seem to be alleviating the symptoms of depression the best. But I believe the mechanism(s) of action of antidepressants have not yet been determined, we are just seeing the finally results and making educated guesses at how they may work. The only way to find what AD is best for you is to have adequate trials until one works. Sorry, there are no algorithms for depression, yet. We do know that certain subtypes of depression respond to certain ADs (MAOIs in psychotic and atypical depressions) but we haven't figured out all the subtypes of depression, yet, either. - Cam W.Hey Cam W.,
After your comment above, just wondering if you might know if there are certain types of AD's, or which neurotransmitters, etc., might be related, or more successful/useful with dysthymia?
michael
Posted by Cam W. on January 31, 2000, at 22:02:11
In reply to Re: Which ADs - Kev, posted by michael on January 31, 2000, at 21:40:51
> > > How exactly would one know that their particular situation required drugs that work on one or the other of these neurotransmitters (Serotonin, Dopamine, Norepinephrine)?
> > >
> > > -Kev
> >
> > Kev - You really can't tell for sure unless one does brain levels, which can be done easily. Symptoms of your depression can guide the choice. The only thing we do know is that serotonin levels (or at least a metabolite in the cerebral spinal fluid) is low, but not in every case. Since the tricyclic ADs (TCAs - eg Elavil) increase both serotonin and norepinephrine, and are generally regarded as the best of the chemical ADs, we are led to believe that norepinephrine plays a role in depression. Low levels of norepinephrine are not generally detected in depressed individuals. All neurotransmitters are linked to one another at various levels in the CNS (central nervous system), so by affecting norepinephrine and serotonin, we seem to be alleviating the symptoms of depression the best. But I believe the mechanism(s) of action of antidepressants have not yet been determined, we are just seeing the finally results and making educated guesses at how they may work. The only way to find what AD is best for you is to have adequate trials until one works. Sorry, there are no algorithms for depression, yet. We do know that certain subtypes of depression respond to certain ADs (MAOIs in psychotic and atypical depressions) but we haven't figured out all the subtypes of depression, yet, either. - Cam W.
>
> Hey Cam W.,
>
> After your comment above, just wondering if you might know if there are certain types of AD's, or which neurotransmitters, etc., might be related, or more successful/useful with dysthymia?
>
> michaelMichael - Many drugs claim success in dysthymic disorder. Instead of listing them here PubMed has 32 articles on drug therapy for dysthmia. PubMed can be accessed at www.mentalhealth.com and click on RESEARCH, then click on DISORDER RESEARCH and look under MOOD DISORDERS for DYSTHYMIC DISORDER, the click on DRUG THERAPY and the title of the articles will come up. To see the abstracts, just click the button beside ABSTRACTS. Then you can scroll to you heart's content. Lots of good reading and good ideas, but I haven't found anything definitive, yet. Good luck - Cam W.
Posted by Diane on February 2, 2000, at 16:19:33
In reply to Re: Which ADs affect dopamine and norepinephrine?, posted by Scott L. Schofield on January 29, 2000, at 15:45:38
> Mazinor (MAZINDOL**) - not considered an antidepressant
>
> I just threw this in here because I've been curious if anyone has tried it - either as monotherapy or in a polypharmaceutical regime. It is a drug normally reserved for use in the treatment of obesity. Aside from suppressing appetite, it also exerts lipolytic effects by stimulating an increase in the metabolism occurring within BAT - brown adipose tissue.
> -ScottMedications that affect catecholamine levels (such as phentermine, diethylpropion, and MAZINDOL** ) may cause symptoms of sleeplessness, nervousness, and euphoria (feeling of well-being). Sibutramine acts on both the serotonin and catecholamine systems, but unlike fenfluramine and dexfenfluramine, sibutramine does not cause release of serotonin from cells.
WHAT IS catecholamine ?? I never heard of it before.
Posted by Cam W. on February 2, 2000, at 20:46:54
In reply to what is CATECHOLAMINE? MAZINDOL. Scott, Cam , posted by Diane on February 2, 2000, at 16:19:33
> > Mazinor (MAZINDOL**) - not considered an antidepressant
> >
> > I just threw this in here because I've been curious if anyone has tried it - either as monotherapy or in a polypharmaceutical regime. It is a drug normally reserved for use in the treatment of obesity. Aside from suppressing appetite, it also exerts lipolytic effects by stimulating an increase in the metabolism occurring within BAT - brown adipose tissue.
>
> > -Scott
>
> Medications that affect catecholamine levels (such as phentermine, diethylpropion, and MAZINDOL** ) may cause symptoms of sleeplessness, nervousness, and euphoria (feeling of well-being). Sibutramine acts on both the serotonin and catecholamine systems, but unlike fenfluramine and dexfenfluramine, sibutramine does not cause release of serotonin from cells.
>
> WHAT IS catecholamine ?? I never heard of it before.Diane - A catecholamine is a group of sympathomimetic amines that act as neurotransmitters. Dopamine, serotonin and norepinephrine are all catecholamines. The aromatic portion of the molecule is called a catechol.-Cam W
Posted by Scott L. Schofield on February 2, 2000, at 20:58:33
In reply to what is CATECHOLAMINE? MAZINDOL. Scott, Cam , posted by Diane on February 2, 2000, at 16:19:33
> Medications that affect catecholamine levels (such as phentermine, diethylpropion, and MAZINDOL** ) may cause symptoms of sleeplessness, nervousness, and euphoria (feeling of well-being). Sibutramine acts on both the serotonin and catecholamine systems, but unlike fenfluramine and dexfenfluramine, sibutramine does not cause release of serotonin from cells.
>
> WHAT IS catecholamine ?? I never heard of it before.
Catecholamines are a class of molecules within a larger class known as monoamines. When the term "catecholamine" appears in reference to neurotransmitters, it usually refers to dopamine and norepinephrine. Serotonin, another of the major monoamine neurotransmitters, is considered to be an indoleamine.
- Scott
Posted by Lester on April 11, 2001, at 8:35:14
In reply to Re: what is CATECHOLAMINE? MAZINDOL. Scott, Cam , posted by Cam W. on February 2, 2000, at 20:46:54
What are the precursors to norepinephrine and dopamine? Do you know of any nutritional supplements that provide these precursors and will aid in the production ne and d?
Posted by blackjack on April 11, 2001, at 11:39:25
In reply to precursors, posted by Lester on April 11, 2001, at 8:35:14
Phenylalanine and tyrosine are the precursors of both DA and NE. You can get them as supplelemnts, but I don't think there is a lot of evidence that they have much value in treating depression. Unless you are on a very low protein diet, it is unlikely that you are not getting enough phenylalanine. Depression isn't so simple as being a NA or NE defficiency; it is a dyspunction in the entire cycle of these neurotransmitters in your system. Simply increasing the precursors probably won't help. It could even activate negative feedback mechanisms and slow your body's own production of these neurotransmitters.
Remember, Nutrasweet is mostly phenylalanine, and Diet Coke doesn't seem to be an antidepressant.
Posted by SalArmy4me on April 15, 2001, at 8:01:23
In reply to precursors, posted by Lester on April 11, 2001, at 8:35:14
Take a look at tyrosine, a supplement which is mentioned on the New York University Psychiatry Augmentation website: http://www.med.nyu.edu/Psych/aug/
> What are the precursors to norepinephrine and dopamine? Do you know of any nutritional supplements that provide these precursors and will aid in the production ne and d?
Posted by Michiel on May 7, 2001, at 7:04:16
In reply to Finding the right anti-depressant. ANY IDEAS?, posted by Jessica on January 29, 2000, at 11:37:15
Hi,
I am looking for serotonine reuptake selective inhibitors, that do'nt affect the liver et that do'nt interfere with sex leve.
Do you have an answer?
Thanks
Posted by sl on May 11, 2001, at 20:26:22
In reply to Re: Which ADs affect dopamine and norepinephrine?, posted by jamie on January 29, 2000, at 11:43:26
> Wellbutrin (Bupropion)
Which was going to be MY answer to the original question.
:)
Reprint from The SmithKlineBeecham website....Pharmacodynamics: Bupropion is a relatively weak inhibitor of the neuronal uptake of norepinephrine, serotonin, and dopamine, and does not inhibit monoamine oxidase. While the mechanism of action of bupropion, as with other antidepressants, is unknown, it is presumed that this action is mediated by noradrenergic and/or dopaminergic mechanisms.
sl
Posted by Elizabeth on May 12, 2001, at 19:36:52
In reply to Re: Which ADs affect dopamine and norepinephrine?, posted by sl on May 11, 2001, at 20:26:22
> Reprint from The SmithKlineBeecham website....
I thought Glaxo Wellcome owned bupropion. Did they sell it to SB? That seems odd.
> Pharmacodynamics: Bupropion is a relatively weak inhibitor of the neuronal uptake of norepinephrine, serotonin, and dopamine, and does not inhibit monoamine oxidase. While the mechanism of action of bupropion, as with other antidepressants, is unknown, it is presumed that this action is mediated by noradrenergic and/or dopaminergic mechanisms.
In other words, they haven't the slightest idea what its direct effects actually are! ("Relatively weak" means, more precisely, that its affinity for the monoamine transporters does not result in clinically significant reuptake inhibition.)
FWIW, I think bupropion might be a prodrug and that the pharmacologic activity of its metabolites ought to be studied.
-elizabeth
Posted by SLS on May 13, 2001, at 9:32:14
In reply to Re: Which ADs affect dopamine and norepinephrine?, posted by Elizabeth on May 12, 2001, at 19:36:52
> > Reprint from The SmithKlineBeecham website....
>
> I thought Glaxo Wellcome owned bupropion. Did they sell it to SB? That seems odd.
>
> > Pharmacodynamics: Bupropion is a relatively weak inhibitor of the neuronal uptake of norepinephrine, serotonin, and dopamine, and does not inhibit monoamine oxidase. While the mechanism of action of bupropion, as with other antidepressants, is unknown, it is presumed that this action is mediated by noradrenergic and/or dopaminergic mechanisms.
>
> In other words, they haven't the slightest idea what its direct effects actually are! ("Relatively weak" means, more precisely, that its affinity for the monoamine transporters does not result in clinically significant reuptake inhibition.)
>
> FWIW, I think bupropion might be a prodrug and that the pharmacologic activity of its metabolites ought to be studied.
>
> -elizabeth
Entire symposia have been dedicated to the mechanisms by which bupropion exerts its therapeutic effects. The drug remains a bit of a mystery.In the past, many researchers had the impression that, whatever are the direct actions of bupropion, they yield an increase in noradrenergic tone.
- Scott
Posted by sl on May 14, 2001, at 21:50:49
In reply to Re: Which ADs affect dopamine and norepinephrine?, posted by Elizabeth on May 12, 2001, at 19:36:52
> > Reprint from The SmithKlineBeecham website....
> I thought Glaxo Wellcome owned bupropion. Did they sell it to SB? That seems odd.Heh. SmithKline Beecham bought Glaxo Wellcome. ;)
Check out their website.
> FWIW, I think bupropion might be a prodrug and that the pharmacologic activity of its metabolites ought to be studied."FWIW" was the only part of that sentence I understood.
I think you need to find a pharmacist or a chemist to talk to instead of lil'ole me. ;)
sl
Posted by sl on May 14, 2001, at 22:02:46
In reply to Re: Which ADs affect dopamine and norepinephrine?, posted by Scott L. Schofield on January 29, 2000, at 15:45:38
> > Which ADs affect dopamine and norepinephrine?
>
> This is an easy one.If that's all there is, I'm in trouble.
Effexor I'm on now, and it's barely working
Wellbutrin I was on before and it worked great...for about 5 years and then it faded off.
So all there are left are drugs that are no longer producted or the one meant for morbidly obese people?? You didn't include the pharmacology on that, by the way, and I wanted to know. Anyway...am I really out of luck???
sl
> Monoamine Oxidase Inhibitors (MAOIs) - non-selective
>
> ------------------------------
>
>
> Effexor (venlafaxine)
>
> Effexor has been mentioned. This drug, in addition to inhibiting the reuptake of serotonin and norepinephrine, is sometimes reported to inhibit the reuptake of dopamine, albeit to a far lesser extent. One can argue that the degree to which Effexor affects either norepinephrine or dopamine may be less than its effects on serotonin. However, I'm not sure that it makes sense to discard the influence that Effexor has on these two neurotransmitters as it may possibly contribute to Effexor's antidepressant properties. I didn't dig very deep in Medline, but what I found indicates that its effects on norepinephrine are significant. I wouldn't be a bit surprised if Effexor's purported effects on dopamine may play some role in its reputation as producing a more rapid response.
>
>
> Wellbutrin (bupropion)
>
> Wellbutrin is a drug that is a bit of an enigma. I don't think many doctors feel too confident about how it works. It does inhibit the reuptake of dopamine, but not to the degree that other antidepressants do with the other neurotransmitters. One doctor told me that Wellbutrin seems to have both pro-dopaminergic and anti-dopaminergic effects. Others have implicated norepinephrine as playing a significant role in how Wellbutrin produces its clinical effects.
>
>
> Survector (amineptine) - no longer available
>
> Survector is a very potent reuptake inhibitor of both dopamine and norepinephrine. It was never marketed in the U.S. I think that it has recently been withdrawn world-wide because of concerns regarding addiction and its abuse in athletic events. It was used extensively in France for many years as a first-line choice. Survector, like the tricyclics, had a reputation as being effective in the more severe cases of depression.
>
>
> Merital (nomifensine) - no longer available
>
> Merital was marketed in the U.S. briefly in the mid 1980's. It inhibits the reuptake of both norepinephrine and dopamine. It also causes an increase in the release of dopamine. It was effective, but was withdrawn when cases of hemolytic anemia began to appear.
>
>
> Mazinor (mazindol) - not considered an antidepressant
>
> I just threw this in here because I've been curious if anyone has tried it - either as monotherapy or in a polypharmaceutical regime. It is a drug normally reserved for use in the treatment of obesity. Aside from suppressing appetite, it also exerts lipolytic effects by stimulating an increase in the metabolism occurring within BAT - brown adipose tissue. For a while, the drug manufacturer (Wyeth) was looking at a similar compound that they named ciclazindol. They claimed that clinical studies were not encouraging enough to continue development. Some investigators showed positive results, however.
>
>
> -----------------------------------------------------
>
>
> Perhaps some of those properties of a drug that we deem as being insignificant today will one day be discovered to be critical in terms of how the brain reacts to them.
>
>
> -Scott
Posted by Elizabeth on May 16, 2001, at 18:31:21
In reply to Re: Which ADs affect dopamine and norepinephrine? » Elizabeth, posted by sl on May 14, 2001, at 21:50:49
> > > Reprint from The SmithKlineBeecham website....
> > I thought Glaxo Wellcome owned bupropion. Did they sell it to SB? That seems odd.
>
> Heh. SmithKline Beecham bought Glaxo Wellcome. ;)
> Check out their website.Aww, Jeez! I guess I should follow this stuff, eh? < g >
> > FWIW, I think bupropion might be a prodrug and that the pharmacologic activity of its metabolites ought to be studied.
>
> "FWIW" was the only part of that sentence I understood.< g > Sorry about that! It means that I think that one or of WB's metabolites (such as hydroxybupropion), and not bupropion itself, might be responsible for its antidepressant effects, and therefore that the folks at (umm, they're calling it GSK now, right?) should be taking a close look at those metabolites.
> I think you need to find a pharmacist or a chemist to talk to instead of lil'ole me. ;)
A pharmacist? You must be kidding. Poor guys go to pharmacy school and learn all that stuff only to work for some big chain counting pills (and taking the legal blame when one of the techs steals some). Most retail pharmacists have forgotten all their pharmacology. It's even worse than doctors being reduced to HMO stooges (academicians like Dr. Bob are exceptions).
Anyway, what's this "lil'ole me" stuff? I'm the one who didn't even know about that big pharmaceutical co. merger!
-elizabeth (embarrassed)
Posted by sl on May 16, 2001, at 20:59:45
In reply to Re: Which ADs affect dopamine and norepinephrine? » sl, posted by Elizabeth on May 16, 2001, at 18:31:21
> > Heh. SmithKline Beecham bought Glaxo Wellcome. ;)
> > Check out their website.
> Aww, Jeez! I guess I should follow this stuff, eh? < g >*heh* Don't feel bad. The only reason I knew about it was cuz I'm changing meds and doing heavy research as to "what next". I went to the glaxowellcome website for the official pharmacology and found out they're not glaxowellcome anymore. :)
> < g > Sorry about that! It means that I think that one or of WB's metabolites (such as hydroxybupropion), and not bupropion itself, might be responsible for its antidepressant effects, and therefore that the folks at (umm, they're calling it GSK now, right?) should be taking a close look at those metabolites.
Ummm...Okay. And that means...they could maybe narrow it down and feed us less extra-stuff?
Or are you talking just from a "knowing what's doing what" standpoint?>steals some). Most retail pharmacists have forgotten all their pharmacology. It's even worse than doctors being reduced to HMO stooges (academicians like Dr. Bob are exceptions).
Again, I'm very spoiled, my pharmacists (I have two who know me and I know them) are really cool. Madison, WI is a great place to live if you want to patronize small non-chain businesses who really care. :)
> Anyway, what's this "lil'ole me" stuff? I'm the one who didn't even know about that big pharmaceutical co. merger!*grin* again, relax, it was a FLUKE that I found out at all.
sl
This is the end of the thread.
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