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Re: SSRIs: Emotionless

Posted by darkhorse on November 16, 2004, at 7:45:34

In reply to Re: SSRIs: Emotionless, posted by Keith Talent on November 16, 2004, at 6:31:41

> Pardon me if I 'm wrong, but I thought that imipramine was less potent that clomipramine at blocking serotonin reuptake. Also, imipramine's metabolite desipramine is about on a par with clomipramine's metabolite desmethylclomipramine in terms of potency at blocking noradrenaline reupake.
>

Yes, what you say is right, but, the important thing here is the "BALANCE" between serotonin/noradernaline:

Because clomipramine is an extremley potent SSRI,while its metabolite is a weaker NRI, the end result is that clomipramine's overall effects are more serotonergic, that is why it has similar SSRI side effects (e.g sexual dysfunction,apathy..etc) and is better for pure OCD.

However,although imipramine is less potent than clomipramine in terms of serotonin,its noradrenaline is nearly as potent as serotonin and so you do not get SSRi side effects such as sexual problems and apathy : the NE boost eleminate them.
That is why imipramine works also for ADD,while clomipramine is less effective like all SSRis.

When doctors give an NE drug to an SSRI,all they are doing is actually trying to "balance" NE with 5ht to decrease apathy,sexual inhibition and increase concentration and energy, and that is exactly what imipramine does by itself.(but not like clomipramine,which is considered by some the godfather of SSRis - an SSRI with TCA structure).
Regards,
Adam.


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URL: http://www.dr-bob.org/babble/20041113/msgs/416586.html