Posted by psychobot5000 on January 18, 2009, at 10:42:09
Hi all,
Been looking up atypical antipsychotics for potential antidepressant augmentation. The best bets seem to be, based on receptor binding affinities, abilify (for its distinctive d2 effects and relatively low side-effect profile) and geodon/ziprasidone. Possibly also olanzapine.
For my purposes (I'm looking for 5ht-2c blockade with few side-effects), ziprasidone/Geodon seems the obvious choice. Based on what I've read, it has the best 5ht-2c binding of atypical APs, with relatively low risks of sedation (H1 binding) and metabolic disorders. Taken at low doses (i.e. 20mg), it could hit 5ht2a and 2c without really affecting D2, they say. However, some sources claim it has a substantial SRI effect (which is anathema to me). Anyone know anything about this, specifically how its SRI effect compares to other APs--and nefazodone? I don't do well with serotonin reuptake inhibition--it gives me nasty side-effects--but I believe I need something with substantial 5ht-2c antagonism (to augment and 'balance' my night-time dose of agomelatine during the day). Anyone know what the best antipsychotic (or other med) for 5ht2c blockade--with lowest relative serotonin reuptake inhibition might be? Or even just how low-dose ziprasidone's numbers might compare with low-dose nefazodone's (i.e. which is likely to have the lowest SRI)
Currently I'm trying around 100mg nefazodone per day, and while it seems to be helpful, it has some fairly unpleasant SSRI-like side-effects (i.e. sweating all night), even though nefazodone's SRI effect is relatively modest.
Thanks for any input,
Psychobot5000
poster:psychobot5000
thread:874727
URL: http://www.dr-bob.org/babble/20090104/msgs/874727.html