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Re: What really is the most potent antidepressant?

Posted by harryp on July 6, 2004, at 10:01:04

In reply to What really is the most potent antidepressant?, posted by 1980Monroe on July 3, 2004, at 18:19:32

If you have truly serious depression, I honestly believe the tricyclics and MAOI's (plus lithium and some others) are the only drugs worth bothering with.

No credible study exists showing improved efficacy (or SE profile/in most cases)for modern AD's in treating severe depression.

The TCA's are active on NE and serotonin to varying degrees depending on the drug. I would highly recommend more than one TCA trial before going to Effexor (which would be my last choice of AD, period).

The MAOI's work quite differently from all other AD's by inhibiting oxidation of all amine neurotransmitters rather than their reuptake. I suspect this is responsible for their low "psychological side effect" profile.

The MAOI's DO affect Dopamine--I suspect that is why they turned out to be uniquely effective for me personally.

I have also heard of dopamine agonists like Mirapex being used for depression.


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