Posted by jrbecker76 on March 4, 2015, at 14:37:03
In reply to 5ht2c Agonists for BP Mania? (Lorcaserin), posted by PeterMartin on February 16, 2015, at 11:45:54
> I'd like to have a discussion about Lorcaserin a 5ht2c agonist (only one on the market?) and mania. Lorcaserin was approved in 2013 for obesity and I'm current on a trial. I have had manic episodes before but not since 2009 when I was still smoking pot/drinking (sober 5yrs). My doctor OKed Lorcaserin (Belviq) for weight loss about a month ago. Down about 15lbs so far.
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> I've been a little weary that Lorcaserin could potentially send me into mania but based on everything I've googled it seems 5h2c agonists might be more likely to +help+ prevent mania than the opposite. For example: http://otm.uic.edu/technologies/potent-safe-and-selective-5ht2c-agonists-treatment
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> Any thoughts on Lorcaserin/5ht2c agonists and their potential to cause (or prevent) mania? I've been a little spacey the past few days and I'm hoping it's due to coming off Marplan after 5yrs vs a side effect from Lorcaserin (On half dose since Jan 6th)
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> Thanks for the discussion.I've been looking into a lot of the peer reviews on Belviq(Lorcaserin) and it's been extremely interesting.
Much of the research on the 5-HT2c receptor is due to observing the drug m-CPP. m-CPP is an agonist at 5-HT2c, but also 5-HT1b, 2a, and to a lesser extent, an antagonist at 5-HT3. Most of the acute effects of m-CPP in both animals and humans showed increased anxiety/neuroses, dysphoria, blood pressure, etc. From this research, it has been proposed that antagonism at the 2c receptor can be both anxiolytic and antidepressant. This has been furthered by the observation that 2c antagonism increases dopaminergic activity in certain reward areas in the brain (i.e., nucleus accumbens) as well as the prefrontal cortex. To date, despite early development, there are no targeted 5-HT2c antagonist compounds that have reached ph II development (the phase in which it would be tested in the indicated population) to test this theory.
I took an interest in Belviq with the belief that a 5-HT2c agonist would indeed cause mood/anxiety problems based on these earlier presumptions. In fact, that has not been the case with online peer reports, quite actually, the opposite. While some users have reported an increase in anxiety within the the first few days of starting Belviq, there is definitely a frequent pattern of reporting for "feeling calmer," "in a better mood," and "sleeping better" even in users who have mentioned they suffer from depression and are taking it with antidepressants concurrently. Whether this is due to the mechanism of 2c agonism or eventual receptor downregulation is unknown, however, there is evidence in the literature to the latter occurring.
As for whether Belviq is prone to causing mania, I have not seen any evidence of this, but I don't think I've also come across a lot of users who have mentioned suffering bipolar symptoms.
Most common side effects in the online peer reports are headache, fatigue/somnolence, feeling cold, cognitive dysfunction/memory impairment, and constipation. Most users report that the side effects get better with time, but the fatigue and mild cognitive issues are also some events I've noticed can certainly linger to some degree.
One more thing I'll say is that Belviq definitely seems to work for its intended indication for most users. Appetite suppression and satiety definitely are impacted and users seem to continue to lose weight consistently.
There's a facebook private group that might interest you if you're looking for peer support and want to ask some questions.
Hope this helps.
poster:jrbecker76
thread:1076739
URL: http://www.dr-bob.org/babble/20150223/msgs/1077312.html