Posted by ed_uk2010 on January 31, 2015, at 17:21:54
In reply to Re: feeling like im out of options » hello123, posted by europerep on January 31, 2015, at 16:22:03
Strattera's metabolite is a kappa opioid partial agonist. This could be one reason why the development of Strattera as an antidepressant was dropped.
I suppose some doctors may be more willing to prescribe Strattera than TCAs. Partly because it's less dangerous in overdose... and partly because doctors in the US seem to like prescribing new/advertised drugs rather than old ones ;)
Tricyclic antidepressants are extremely dangerous in overdose. It has to be said this doesn't sit well with pdocs who are feeling risk averse!
Desipramine vs nortriptyline:
Antihistamine effect: Desipramine, very low. Nortriptyline, moderate.
Selectivity as an NRI versus SRI. Desipramine, high. Nortriptyline, quite high.
Cholinergic receptor blockage. Desipramine, low. Nortriptyline, moderate.
Serotonin 5-HT2 receptor blockage. Desipramine, very low. Nortriptyline, moderate.
Alpha-1 adrenolytic. Desipramine, low. Nortriptyline, moderate.
Weight gain risk. Desipramine, low. Nortriptyline, moderate. If you didn't gain weight on cyproheptadine, you probably won't gain weight on either.
As you can see, desipramine is a more selective NRI than nortriptyline. Whether this is a good thing or a bad thing depends on the individual.
poster:ed_uk2010
thread:1075467
URL: http://www.dr-bob.org/babble/20150129/msgs/1075828.html