Posted by SLS on October 20, 2005, at 19:24:56
In reply to Re: Triple reuptake inhibitors and MAOIs, posted by Iansf on October 20, 2005, at 18:34:27
Hi Iansf.
> > I agree with Tom. Triple reuptake inhibitors will not be similar to MAOIs.
> But will be the difference between them and, say, combining an SSRI with bupropion? Especially since for so many people, the real issue is side effects. A new med with the same side effects as existing ones isn't that much of an advance if it only does what a med cocktail can do already.
First of all, I doubt we can consider Wellbutrin to be a true DA reuptake inhibitor the way nomifensine and amineptine were. It is weak at best. Second of all, different is different. Some people respond to one SSRI and not another. Adding more complete and balanced monoamine uptake inhibitors can only improve an individual's chances of attaining remission. I usually welcome any addition to our arsenal, even if other people regard them as "me too" drugs. The adding or subtracting of a single atom can make all the difference in the world when it comes to therapeutic effect.
Regarding side effects, I believe that drug companies are indeed trying to "clean up" their drugs by doing things like separating out enantiomers and rejecting the one that is not responsible for the therapeutic effect in an effort to reduce side effects. One such example is Forest Labs and their Celexa -> Lexapro. Eli Lilly tried the same thing with Prozac, but ran into problems with dosing. Cephalon is in the process of doing the same thing with Provigil -> Nuvigil. People debate as to whether these efforts have offered true benefits.
There are several truly novel drugs in the research and development pipeline that attack depression from completely different angles. You might find some hope in looking at the following webpage:
www.neurotransmitter.net/newdrugs.html
Agomelatine is a novel antidepressant drug that should become available very soon in Europe. I believe the drug company will shortly thereafter begin work on getting it approved in the US. Agomelatine is a 5-HT2b/c antagonist and a melatonin M1/M2 agonist.
Believe me when I tell you, I feel the same as most other people here that the pace of drug discovery is too slow. Development seems to come in waves of drugs that are similar to each other. That is just the nature of the drug companies to reflect the direction of knowledge and theory that emerges from neuroscience and psychopharmacology.
- Scott
poster:SLS
thread:568913
URL: http://www.dr-bob.org/babble/20051017/msgs/569474.html