Posted by linkadge on May 30, 2008, at 16:32:11
In reply to Re: Mirapex vs. Seroquel for SSRI-induced anhedoni, posted by satsumas on May 30, 2008, at 14:42:51
>i think that stimulation of the 5ht2a/c >receptors is what causes ssri induced apathy, >zyprexa blocks these receptors increasing >cortical dopamine which should help with the >apathy you are experiencing, the d2 antagonism >is only active for a few hourse after taking a >dose, usually while you are asleep, so i wouldnt >worry about that too much
If you are referring to loose dissociation (or whatever) of the antipsychotic I don't think this has ever been demonstrated with zyprexa. Seroquel is supposedly better for this but I don't know.
The point is that the drug is going to antagonize 5-ht2a/c for as long as it will antagonize the dopamine receptors.
It is true that the 5-ht2a/c antagonism of zyprexa/seroquel will increase dopamine/norepinephrine release in certain areas of the brain, but a certain degree of that neurotransmitter is going to be blocked by the drug. Zyprexa has a long half life so you are still going to get dopamine antagonism during the day.
For SSRI anhedonia, I would not really recomend an AP at all. They can augment SSRI's for depression, but I don't think there is much research showing they improve anhedonia.
I'd first start by lowering the dose of the SSRI to the absolute lowest efective dose. Then perhaps augment with mirapex, mirtazapine, TCA, bupropion, folic acid, omega 3, etc.
I'd stay away from AP's, they're not worth the risks, unless you really need them.
Linkadge
poster:linkadge
thread:832091
URL: http://www.dr-bob.org/babble/20080528/msgs/832107.html