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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Elanor Roosevelt on April 8, 2014, at 22:16:34
One of the 2 doctors I saw last week told me that Brintellix is not much different from Lexapro.
???????
Posted by Phillipa on April 9, 2014, at 9:40:03
In reply to Brintellix vs Lexapro, posted by Elanor Roosevelt on April 8, 2014, at 22:16:34
I thought Brintellix also targeted norepinephrine? I don't know? Phillipa
Posted by porkpiehat on April 9, 2014, at 12:21:34
In reply to Re: Brintellix vs Lexapro » Elanor Roosevelt, posted by Phillipa on April 9, 2014, at 9:40:03
> I thought Brintellix also targeted norepinephrine? I don't know? Phillipa
I was told it was like SSRI+buspar without the stupid buspar side effects. I start Thursday/Friday so I'll let you know!
Posted by herpills on April 9, 2014, at 13:56:36
In reply to Brintellix vs Lexapro, posted by Elanor Roosevelt on April 8, 2014, at 22:16:34
> One of the 2 doctors I saw last week told me that Brintellix is not much different from Lexapro.
> ???????
I think maybe it's not that much different from Viibryd?? Which in many ways is like Lexapro but does something extra like a built in buspar action?
Posted by Porkpiehat on April 9, 2014, at 15:41:45
In reply to Re: Brintellix vs Lexapro » Elanor Roosevelt, posted by herpills on April 9, 2014, at 13:56:36
Wait so is there any appreciable difference between viibryd and brentillex?
Posted by LouisianaSportsman on April 9, 2014, at 19:40:07
In reply to Brintellix vs Lexapro, posted by Elanor Roosevelt on April 8, 2014, at 22:16:34
Today is Day 38. I am about to write a comprehensive review of Brintellix, but no PDOC in their right mind can should say that it's "not much different from Lexapro". Sure, it sure shares some serotonin reuptake inhibition, but it's very different as far as ADs go.
Also, it depends on how many ADs you have been on. I could not recommend that such a novel, brand-new antidepressant like Brintellix be chosen as a first-line treatment for a beginning patient over a proven antidepressant like Lexapro. Especially when the data on it is so limited. If you have already tried a SSRI, different story.
In case you're wondering, I have done well on Brintellix.
Posted by porkpiehat on April 10, 2014, at 12:28:31
In reply to Re: Brintellix vs Lexapro, posted by LouisianaSportsman on April 9, 2014, at 19:40:07
> Today is Day 38. I am about to write a comprehensive review of Brintellix, but no PDOC in their right mind can should say that it's "not much different from Lexapro". Sure, it sure shares some serotonin reuptake inhibition, but it's very different as far as ADs go.
>
> Also, it depends on how many ADs you have been on. I could not recommend that such a novel, brand-new antidepressant like Brintellix be chosen as a first-line treatment for a beginning patient over a proven antidepressant like Lexapro. Especially when the data on it is so limited. If you have already tried a SSRI, different story.
>
> In case you're wondering, I have done well on Brintellix.
I CAN'T WAIT! I was supposed to start tonight but pdoc cancelled. I'm still trying to discern the difference between viibryd and Brintellix.Sex drive issues?
Posted by Louisiana Sportsman on April 10, 2014, at 13:37:52
In reply to Re: Brintellix vs Lexapro, posted by porkpiehat on April 10, 2014, at 12:28:31
I know I haven't wrote my comprehensive report yet, but I will get to it!
If you're trying to discern the difference between Viibyrd (vilazodone) and Brintellix (vortioxetine), perhaps I can shed some light?
Vilazodone shares serotonin reputake inhibition and 5-HTa partial agonism with Brintellix, but that's about it. This is what makes it the "Buspar" of AD's. It's also listed has sharing 5-HTd receptor antagonism, but in the one study that showed this-- the effect was so negligible that a ki value was not determined; therefore, it is safe to assume it does not contribute to its mechanism of action compared to vortioxetine's 54nm.
Brintellix (vortioxetine), unlike Viibyrd also does:
5-HT1A receptor high-efficacy partial agonist/near-full agonist Ki = 15 nM, IA = 80%
5-HT1B receptor partial agonist Ki = 33 nM
5-HT1D receptor antagonist Ki = 54 nM
5-HT3A receptor antagonist Ki = 3.7 nM
5-HT7 receptor antagonist Ki = 19 nM5-HT1a as well as 5-HT1b agonists have been termed serenics because of their selective ability to inhibit aggressive behavior without sedation in rats and mice. The 5-HT1a is the prototypical receptor involved with Buspar.
5-HT1d antagonists act on the central nervous system, and affect locomotion and most key: anxiety.
5-HT3 receptor antagonists, including those at the a subtype, may have potential anxiolytic, antidepressant, and cognitive effects.
5-HT7 receptor antagonists may be involved in mood regulation, suggesting that they may be useful in the treatment of depression. There is also evidence that they increase cognition.
Worth mentioning also is vortioxetine's 46nm affinity at b1 adrenergic_receptor (which may contribute to side effects) and negligible NET blockade.
Both are novel ADs, sure, but Brintellix significantly differs from Viibyrd.
Posted by porkpiehat on April 10, 2014, at 14:09:28
In reply to Re: Brintellix vs Lexapro, posted by Louisiana Sportsman on April 10, 2014, at 13:37:52
Buspar caused severe irritability/anger with me. Is there any indication that Brintellix...with all of it's different modes of action...wouldn't?
Thanks. I await your report! Any sneak preview about the sexual aspects??
Posted by LouisianaSportsman on April 11, 2014, at 0:46:11
In reply to Re: Brintellix vs Lexapro » Louisiana Sportsman, posted by porkpiehat on April 10, 2014, at 14:09:28
Wow! I thought I was gonna write my input on it, but I end up doing so much work earlier on the computer. If it's not up by Monday, I will never post here again. :)
Sexual side effects? ZERO!!! NONE
Posted by phidippus on April 11, 2014, at 14:14:03
In reply to Brintellix vs Lexapro, posted by Elanor Roosevelt on April 8, 2014, at 22:16:34
That's insane. Brintellix targets far many more specific receptors than Lexapro does.
Eric
Posted by LouisianaSportsman on April 14, 2014, at 22:59:12
In reply to Re: Brintellix vs Lexapro, posted by Louisiana Sportsman on April 10, 2014, at 13:37:52
Hey, porkie!
I thought about you when I just read "Electrophysiological Investigations on the Role of Selected Serotonin Receptors and the Serotonin Transporter on Serotonin Transmission in the Rat Brain" which is a study by Maurice Lecours who works at the University of Ottawa, Institute of Mental Health Research. It compared Brintellix to Lexapro's pharmacological effects.
Link:https://www.ruor.uottawa.ca/en/bitstream/handle/10393/30400/Lecours_Maurice_2014_thesis.pdf?sequence=3
What I found most interesting from his fascinating research were the following excerpts:
"These findings indicate that either the co-administration of an SSRI in addition to a 5-HT3 receptor antagonist or a multimodal agent that acts as a SSRI and 5-HT3 receptor, such as vortioxetine, could enhance 5-HT neurotransmission to produce AD and antiemesis effects, similar to that of litoxetine, after long-term administration."
To me, it seems that Lecours is suggesting that augmenting a SSRI such as escitalopram to Brintellix might be a good idea because you have to keep this excerpt in mind (also excerpted from the same study):
"This study has demonstrated that selective 5-HT agents alone, such as escitalopram, and multimodal agents, such as vortioxetine, alter 5-HT neurotransmission through different receptors and exert different actions, via transporter and/or receptor activity, on the serotonergic system in the hippocampus consistent with other antidepressant strategies and with a unique pharmacological profile."
Additionally, compared to other SSRIs, this study revealed: "vortioxetine has a low occupancy for the 5-HTT, escitalopram was used at a dose of 5 mg/kg in order to better mimic the effects of low occupancy alone."
I'm suggesting, based upon these excerpts I've provided from Lecours' study, that augmentation of Lexapro would perhaps enhance vortioxetine's unique pharmacological effects? Maybe the conjugation of Brintellix with Lexapro co-administered could theoretically provide a more potent antidepressant/anxiolytic effect for patients not responsive or who did achieve full remission of their symptoms when prescribed Brintellix?
Just a theory I came up with when I read this relevant research.
This is the end of the thread.
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