Posted by Elizabeth on July 6, 2001, at 23:08:53
In reply to Re: Remeron - less sedation at higher dose?, posted by Lupercal on July 6, 2001, at 3:29:17
> > Anafranil. (It's a tricyclic with more effect on serotonin than most tricyclics.)
>
> Oh, ok. I have some of that here. It was prescribed for me once, but I never took it, after finding it on a list of ototoxic drugs (drugs which can actually cause hearing damage)I've never heard of hearing damage among the side effects (although there are many). That's interesting to know.
> I think I've been through everything there is to try with tinnitus.
What in particular (that you can recall < g >)?
> > > The first time I took Luvox it hit me the same night (the second time I took Luvox I got serotonin syndrome, so that wasn't exactly a fair trial).
> >
> > Really? What symptoms did you have?
>
> Anxiety, derealization, cold sweats, I can't remember too much about it.That doesn't sound like full-blown serotonin syndrome, unless you're really minimising it. A sort of activation/anxiety syndrome is common when people first start taking SSRIs. I've posted about the serotonin syndrome a couple times -- for example:
http://www.dr-bob.org/babble/20010612/msgs/66624.html
http://www.dr-bob.org/babble/20010625/msgs/68415.html
> The only thing different from the first time I took luvox is that, the second time, I'd come off pamelor about 2 weeks earlier - which ought to have been enough time, but it seems I am just ultra-sensitive to serotonergic drugs.
I think there were probably multiple factors. I had CSS (true serotonin syndrome, not just bad SSRI side effects) on Effexor the *second* time I took it (the first time I had stopped after a couple weeks, didn't have any kind of bad reaction).
> No, I'm sorry. I'm only going on the fact my pharmacist explained to me that these new SSRI's were coming soon, and that they have the properties I outlined above. If they're coming soon in Australia, chances are they're already available in the USA.
I'm afraid that I don't know what your pharmacist might have meant, then. The drugs you describe wouldn't be considered SSRIs.
> That isn't the way I understood it. Remeron is an agonist, but I thought SSRI's action - inhibiting re-uptake - was a different type of action.
That's right.
> Remeron, as I understand it, causes more serotonin to be produced, and therefore its effects on receptor sites would be indiscriminate (actually it wouldn't have any effects on them: they would just have more serotonin to deal with), but SSRI's don't affect the amount of serotonin being produced; they affect the amount of it which is eliminated.
In both cases, they increase the amount of serotonin available for binding at its receptors. The difference is that Remeron blocks types 2 and 3 receptors, so the available serotonin gets directed to the type 1 receptors. SSRIs just increase the available serotonin, which binds to all the different types of serotonin receptors.
> NB I did find a medical webpage tonight which, in relation to tinnitus, states that tinnitus is a more likely side-effect in AD's with a serotogenic action.
Yeah, I looked into that too and found out the same thing. Interesting to know.
-elizabeth
poster:Elizabeth
thread:68802
URL: http://www.dr-bob.org/babble/20010701/msgs/69235.html