Posted by Jack Smith on April 25, 2003, at 14:50:37
In reply to Re: Anafrinil--most potent AD?????, posted by zeugma on April 25, 2003, at 13:47:36
>
> Anafranil is a very powerful 5-HT reuptake inhibitor, more powerful than most SSRI's. Its metabolite desmethylclomipramine is a secondary amine tricyclic, which means it's a powerful norepinephrine reuptake inhibitor. So it's actually a dual reuptake inhibitor, like Effexor, except that Anafranil is significantly more potent at each reuptake site. Check out this table: http://www.preskorn.com/books/ssri_s3.html#tab3-8 for comparison of clomipramine and desmethylclomipramine with SSRI's and their metabolites. Despite the fact that the most established mechanisms for antidepressant activity are 5-HT and NE reuptake inhibition, the drug that combines these mechanisms most powerfully is not licensed as an antidepressant, but an OCD treatment. I think that is the best illustration possible of the role that the accidents of marketing have played in the development and deployment of AD's.
>Interesting. So, if it is stronger than effexor, and I suppose it is stronger than duloxetine, you would think it would be used more often. Side Effects of sedation, I guess, turn people off. By the way, it IS licensed for depression and also OCD.
poster:Jack Smith
thread:222185
URL: http://www.dr-bob.org/babble/20030423/msgs/222355.html