Posted by SLS on August 7, 2004, at 7:19:44
In reply to some people just don't do well with norepinephrine, posted by linkadge on August 6, 2004, at 7:31:44
Hi Linkadge.
> I thought that effexor would be better than celexa because I would get more energy and perhaps a better AD effect.
>
> Quite the opposite. It made me very depressed and melancholic, something like what some people report with reboxetine. Effexor made me ANGRY, something that the SSRI's never did. Some people mistakenly think that they need a noradrenic boost, when in reality they are like me very highly motivated to begin with, and need something to push the pause button.I would like to offer the suggestion that things are not always that simple when it comes to psychobiology. For instance, one of the few medications that have helped me is desipramine. By contrast, reboxetine exacerbated my depression and pushed me into an anxious suicidal state. Both of these drugs are considered to be selective NE reuptake inhibitors, yet, for me, they affected me in opposite ways. On the other hand, as you have noted, there are often trends in someone's history of drug reactions that can serve to guide treatment selection. I would just hate to see anyone try to guess their way out of a potentially successful treatment by using an overly simple and often unreliable model of psychopharmacology to errantly exclude effective alternatives. (This is not a commentary on your post so much as it is an observation of mine that this approach has been pervasive among publishing investigators for years).
Someone here posted something quite provocative the other day that has stuck in his mind. His doctor described the differences between the NE actions of nortriptyline and atomoxetine in the following manner:
nortriptyline - NE - brainstem = antidepressant
atomoxetine - NE - cortex = anti ADD/ADHDI'm not sure of the accuracy of these statements, but they do serve to illustrate the importance of determining not only WHAT a drug does, but also WHERE it does it. Location, location, location. You have a good grasp of the division of brain functions among circuits and anatomical structures. When you read the data offered by investigations in psychobiology, take note of where in the brain ligands accumulate or measures of functional change occur. You should be able to do a great deal with this kind of information.
- Scott
poster:SLS
thread:374053
URL: http://www.dr-bob.org/babble/20040805/msgs/375001.html