Posted by SLS on April 17, 2002, at 21:45:11
In reply to Re: SNRIs: Desipramine vs. Reboxetine, posted by turalizz on April 17, 2002, at 9:49:13
> > Both desipramine and reboxetine are SNRIs.
> >
> > Desipramine is far more potent at blocking NE reuptake than Reboxetine. The 1/K values are 120 for desipramine and only 14 for reboxetine. So desipramine is more than 8 times more potent than reboxetine. For comparison Elavil is 3, Paxil is 2.5, and Prozac is 0.5.
> >
> > Reboxetine is also less selective than desipramine. The ratio of selectivity NE:5-HT is 21 for desipramine, and it is 8 for reboxetine.
> >
> > I don't really know what all the hype is about reboxetine, because it is less potent and less selective than desipramine. It is, however, more profitable because it is still under patient. That probably explains the hype.
> >
> Fachad, did you personally compare desipramine to reboxetine yourself? Or are you just talking about the "theoretical" stuff you read from some book?
>
> cem
Hi Cem.I think the point you make is important. Without going into my usual monolog regarding the inadvisability of presuming sufficient understanding of the brain, its diseases, and the medications used to treat them so as to predict with certainty clinical utility (squeezed it in there anyway), I can report that I responded to desipramine and reboxetine quite differently. Desipramine has always been at least somewhat helpful to me, and along with Parnate afforded me my only substantial remission. By contrast, reboxetine precipitated an exacerbation of my depression within days of starting it which included anxiety and suicidality, two features that have not been characteristic of me historically. These things disappeared within 36 hours of my discontinuing it. For me, desipramine prevents suicidality while reboxetine promotes it.
Desipramine and reboxetine each do a bunch of different things in addition to inhibiting the reuptake of norepinephrine. One thing that frequently escapes attention is not only what drugs do, but where they do it. All drugs are not distributed throughout the brain identically, and despite identical pharmacological effects when viewed locally, produce significantly different outcomes.
- Scott
poster:SLS
thread:103083
URL: http://www.dr-bob.org/babble/20020416/msgs/103378.html