Posted by bleauberry on May 8, 2011, at 5:23:40
In reply to Why do some norepinephrine drugs cause anxiety??, posted by jms600 on May 7, 2011, at 9:28:14
Norepeniphrine can worsen anxiety or improve it. It depends on the particular mechanism involved. Something that releases more of it, such as remeron and sometimes antipsychotics, yohimbe, etc, anything that blocks the receptors causing more release, that kind of mechanism can cause worsened anxiety.
Reuptake can be different. It forms a pool of NE which in turn causes the feedback loops to slow down the release of NE. So you're getting more NE at the synapse, but less globally. Keep in mind, NE turns to epinephrine and adrenaline, so you don't necessarily want more of it except at the synapse.
I will use Milnacipran as my own personal example. Yes, for the first three days, the increased NE did in fact worsen everything you would expect adrenaline to worsen....nervousness, on edge, anxiety, agitation, disturbed sleep. But at about 3 days the feedback loops kicked in. Things started to adjust. Now for the first time in a very long time, my waking morning anxiety crap was gone. My days were calm, yet with improved energy.
So whether NE will worsen your symptoms or not is, in my opinion, dependent upon the particular mechanism of the med.
Nortriptyline above 10mg seriously worsened my anxiety and in fact created some that wasn't there previously. Milnacipran did the opposite. That is, at the right dose. Too high of a dose and there are problems. We might need some NE to help us feel better, but too much is just as bad as not enough. So it's not just a mechanism thing, but a dosing thing also. I think you have to go into it open minded and completely disregard what others tell you are "normal" doses. Remeron frequently comes with complaints of agitation and feeling wired. Same with antipsychotics. I remember on all the antipsychotics it was so bizarre for me....on one hand I was calm and sedated, yet on the other hand wired and nervous....all at the same time. Bizarre. Some might call that akathesia. I call it too much NE being released.
poster:bleauberry
thread:984777
URL: http://www.dr-bob.org/babble/20110502/msgs/984892.html