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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by TriedEveryMedication on June 25, 2018, at 14:59:48
my adhd-pi seems to respond to NRIs, especially desipramine.
I've tried atomoxetine which I've seen marketed as a "safer desipramine", but it just doesn't work as well.
the Ki for atomoextine for NET is 5 and for desipramine is like 0.2. (lower the constant, the greater the affinity)
reboxetine isn't available in the US and its binding profile with NET is 13, weaker than atomoxetine.
I guess Protriptyline is an option, its Ki is 1.4. still weaker than desipramine, though.
Posted by linkadge on June 25, 2018, at 15:40:10
In reply to any drugs with strong NRI action ?, posted by TriedEveryMedication on June 25, 2018, at 14:59:48
The Ki doesn't matter that much.
The ki just tells the drug's effect at a certain concentration. The concentration is a function of the metabolism of the drug and the dose.
In other words, with perhaps a higher dose of protriptyline, you are going to get the same NRI effect.
You may not need a higher dose, however, if protriptyline is better absorbed, or has a longer half life.
Linkadge
Posted by TriedEveryMedication on June 25, 2018, at 20:24:59
In reply to Re: any drugs with strong NRI action ?, posted by linkadge on June 25, 2018, at 15:40:10
> The Ki doesn't matter that much.
>
> The ki just tells the drug's effect at a certain concentration. The concentration is a function of the metabolism of the drug and the dose.
>
> In other words, with perhaps a higher dose of protriptyline, you are going to get the same NRI effect.
>
> You may not need a higher dose, however, if protriptyline is better absorbed, or has a longer half life.
>
>
> LinkadgeSo in theory, if desipramine works for me, atomoxetine should work for me with the right dose?
Unfortunately, this hasn't been my experience.
Posted by linkadge on June 26, 2018, at 15:48:00
In reply to Re: any drugs with strong NRI action ? » linkadge, posted by TriedEveryMedication on June 25, 2018, at 20:24:59
>n theory, if desipramine works for me, atomoxetine
>hould work for me with the right dose?That's not what I said. I said that the NRI action of the two drugs would be equivalent, at a certain dose.
However, even with so called 'selective' NRI's there are other actions which can contribute to their effects. For example , all TCAs interact with the opioid system. Also, they may have independent anti-inflammatory effects which atomoxetine doesn't have.
Linkadge
Posted by bleauberry on June 27, 2018, at 6:43:06
In reply to any drugs with strong NRI action ?, posted by TriedEveryMedication on June 25, 2018, at 14:59:48
Savella = Milnacipran. 1 part serotonin 3 parts norepinephrine. Feels sort of Ritalin-like. Studies suggest its effects are similar to Ritalin. Savella was actually the best prescription or overseas antidepressant I ever experienced in my 20 years of taking all these drugs. Nortrip, Desip, Protrip - none of these come anywhere close to Savella in terms of mood boost or ADHD management.
> my adhd-pi seems to respond to NRIs, especially desipramine.
>
> I've tried atomoxetine which I've seen marketed as a "safer desipramine", but it just doesn't work as well.
>
> the Ki for atomoextine for NET is 5 and for desipramine is like 0.2. (lower the constant, the greater the affinity)
>
> reboxetine isn't available in the US and its binding profile with NET is 13, weaker than atomoxetine.
>
> I guess Protriptyline is an option, its Ki is 1.4. still weaker than desipramine, though.
>
>
Posted by bleauberry on June 27, 2018, at 6:43:50
In reply to any drugs with strong NRI action ?, posted by TriedEveryMedication on June 25, 2018, at 14:59:48
...why not Ritalin?
Posted by Hordak on June 30, 2018, at 16:59:02
In reply to any drugs with strong NRI action ?, posted by TriedEveryMedication on June 25, 2018, at 14:59:48
Clomipramine with its metabolite! ;=)
"Although clomipramine shows around 100- to 200-fold preference in affinity for the SERT over the NET, its major active metabolite, desmethylclomipramine (norclomipramine), binds to the NET with very high affinity (Ki = 0.32 nM) and with dramatically reduced affinity for the SERT (Ki = 31.6 nM).[49][50] Moreover, desmethylclomipramine circulates at concentrations that are approximately twice those of clomipramine.[51] In accordance, occupancy of both the SERT and the NET has been shown with clomipramine administration in positron emission tomography studies with humans and non-human primates.[52][53] As such, clomipramine is in fact a fairly balanced SNRI rather than only a serotonin reuptake inhibitor (SRI).[54]"
https://en.wikipedia.org/wiki/Clomipramine
https://psychotropical.info/clomipramine-potent-snri-anti-depressant/
Posted by TriedEveryMedication on July 14, 2018, at 16:14:42
In reply to any drugs with strong NRI action ?, posted by TriedEveryMedication on June 25, 2018, at 14:59:48
just stopped prozac one day and started this the next.
I know it is early, but I think this drug is a loser
I feel my mood slowly going down hill and me caring less and less about things
This is the end of the thread.
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