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Re: Savella good for social anxiety study says: » Lamdage22

Posted by SLS on September 29, 2015, at 15:29:22

In reply to Re: Savella good for social anxiety study says:, posted by Lamdage22 on September 29, 2015, at 11:44:22

> I thought you dont take Brintellix, Scott???

I wasn't too crazy about how Brintellix looked on paper. Previously, I had failed to respond robustly to Viibryd, and switched back to high-dose Parnate. Since then, Brintellix was approved, but I need to see enough clinical success with it to entertain the idea of coming off of Parnate again.

Some TRD people have reported a miraculous improvement while taking Brintellix. Brintellix binds to a lot of serotonin (5-HT) receptors as well as inhibiting the reuptake of serotonin. 5-HT7 antagonism and 5-HT1a full agonism have captured my interested, only because I have never taken a drug with these properties. I would, of course, need to discontinue Parnate to avoid serotonin syndrome, but I would keep taking everything else.

> You are wondering wether to withdraw from Parnate. Is SSRI + Nortriptyline a good idea?

Nortriptyline goes well with SSRI and SNRI.
Wellbutrin goes well with SSRI and SNRI
Remeron goes well with SSRI and SNRI.

I have seen nortriptyline, Wellbutrin, and Remeron act more potently when added to SNRIs than to SSRIs. These are just my impressions from personal observation of others and myself.

I am not so sure about taking combinations of nortriptyline, Wellbutrin and Remeron in the absence of SSRI, SNRI, and MAOI.

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Excerpted from Brintellix (vortioxetine) prescribing information:


"12 CLINICAL PHARMACOLOGY

12.1 Mechanism of Action The mechanism of the antidepressant effect of vortioxetine is not fully understood, but is thought to be related to its enhancement of serotonergic activity in the CNS through inhibition of the reuptake of serotonin (5-HT). It also has several other activities including 5-HT3 receptor antagonism and 5-HT1A receptor agonism. The contribution of these activities to vortioxetines antidepressant effect has not been established.

12.2 Pharmacodynamics Vortioxetine binds with high affinity to the human serotonin transporter (Ki=1.6 nM), but not to the norepinephrine (Ki=113 nM) or dopamine (Ki>1000 nM) transporters. Vortioxetine potently and selectively inhibits reuptake of serotonin (IC50=5.4 nM). Vortioxetine binds to 5-HT3 (Ki=3.7 nM), 5-HT1A (Ki=15 nM), 5-HT7 (Ki=19 nM), 5-HT1D (Ki=54 nM), and 5-HT1B (Ki=33 nM), receptors and is a 5-HT3, 5-HT1D, and 5-HT7 receptor antagonist, 5-HT1B receptor partial agonist, and 5-HT1A receptor agonist. In humans, the mean 5-HT transporter occupancy, based on the results from 2 clinical PET studies using 5-HTT ligands ([ 11 C]-MADAM or [ 11 C]-DASB), was approximately 50% at 5 mg/day, 65% at 10 mg/day and approximately 80% at 20 mg/day in the regions of interest."

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- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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poster:SLS thread:1082969
URL: http://www.dr-bob.org/babble/20150929/msgs/1083020.html