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Re: What do I do now? Sherry

Posted by JohnL on July 21, 2001, at 19:11:44

In reply to Re: What do I do now? » JohnL, posted by Sherry on July 21, 2001, at 15:10:45

> Hey JohnL,
>
> If SSRIs hold existing serotonin in place, how do MAOIs work? Do they stimulate the release as well as inhibit MAO to prevent breakdown? What about Effexor and Serzone? I suffer from atypical depression, but I feel my body and brain are far too dependent on carbs for emotional well being. I can actually feel my insulin levels fluctuate throughout the day. So, my thinking is I need something that stimulates the release of serotonin. Most of the reuptake inhibitors make me dumb as dirt.
> I hope you are doing well.
>
> Sherry

Hi Sherry,
MAOIs are similar to SSRIs in the respect that they allow accumulation of existing serotonin, as well as NE and dopamine too. They do not stimulate the release. MAOIs prevent the natural breakdown process of neurotransmitters.

Effexor is primarily an SSRI, but it also has some reuptake inhibition of norepinephrine, and at higher doses some reuptake inhibition of dopamine. Effexor does not stimulate release.

Serzone is an SSRI, plus a slight norepinephrine reuptake inhibitor, and it also stimulates serotonin a little. The thing I do not like about Serzone is that it also blocks alpha receptors, which in itself can make people depressed. In the last couple years I've seen a pattern here at this board of people who actually got worse on Serzone. Including me. Some people like it though. Strangely, one of the meds in my successful cocktail is Adrafinil, which does the opposite of Serzone. That is, it helps the alpha receptors instead of blocking them. I think mine were blocked to begin with, and maybe that was a problem all along. Adrafinil unblocked it.

But I have also come to realize in my own trials that what looks good on paper, and what looks good in theory, isn't that much help. It can help to steer you in the right direction, for example in choosing which category of meds to try (i.e. SSRIs, antipsychotics, stimulants, etc). But the only way to find out for sure is a real life trial of the drug. I wish there was a better way.

And yes, I am doing well. Finally. 1990 to 2000 was pure hell. 2001 is looking great. Thank goodness for Prozac, Zyprexa, and Adrafinil. Sometimes I still like to do a dose of Amisulpride now and then, simply because it feels like a mile stimulant and gives me an extra boost if I need it.

I hope YOU are doing well today.
John


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poster:JohnL thread:71077
URL: http://www.dr-bob.org/babble/20010720/msgs/71243.html