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Re: New SNRI approved for ADHD: Viloxazine

Posted by linkadge on April 9, 2021, at 13:59:07

In reply to Re: New SNRI approved for ADHD: Viloxazine, posted by SLS on April 9, 2021, at 13:04:03

It's difficult to say whether the 5-ht actions confer any added benefit over NRI activity. Other selective (or nonselective) NRIs seem to work for ADHD.

If 5-ht activities were to be pursued, I would think that 5-ht1a or 5-ht1b receptors would be the first target. 5-ht2c agonism could decrease appetite, which tends to be an undesirable side effect of traditional stimulants. 5-ht2c agonism would also decrease dopamine release in the prefrontal cortex (which you wouldn't think would benefit ADHD). However, mice lacking the 5-ht2c receptor exhibit a hyperactive phenotype and irritability. They are also more prone to seizures. This drug may have some anticonvulsant effect, which could benefit ADHD comorbid with epilepsy. It might also be good in ADHD with comorbid obesity. 5-ht2c agonism is purportedly involved in synaptic pruning. It can enhance declarative memory, but can sometimes also be anxiogenic. Both 5-ht2c agonism and antagonism can have antidepressant effects depending on the paradigm. I know that 5-ht2c antagonists can be good for sleep regulation (they tend to advance the sleep cycle). 5-ht2c agonists may delay the sleep cycle (which would not benefit many ADHDers who tend to be night owls already).

I would tend to think of 5-ht2c agonism as an unrelated target, but I don't really know for sure. Also, there may be subtypes of ADHD which benefit from it.





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