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
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> Effexor (venlafaxine)
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> 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.
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> Wellbutrin (bupropion)
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> 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.
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> Survector (amineptine) - no longer available
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> 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.
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> Merital (nomifensine) - no longer available
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> 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.
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> Mazinor (mazindol) - not considered an antidepressant
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> 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.
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> 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.
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> -Scott
poster:sl
thread:19950
URL: http://www.dr-bob.org/babble/20010507/msgs/62994.html