![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by linkadge on March 7, 2004, at 17:40:18
I am taking effexor but I am also taking a beta blocker atenolol. Will the atenolol completely negate the noradrenic effects of the effexor or are there other receptors that will benefit from higher noradrenic agonism.
Basically I am contemplating changing to an SSRI and atenolol, and am wondering weather there will be any difference.
Linkadge
Posted by King Vultan on March 7, 2004, at 18:04:26
In reply to Question about noredenic receports (smart people), posted by linkadge on March 7, 2004, at 17:40:18
> I am taking effexor but I am also taking a beta blocker atenolol. Will the atenolol completely negate the noradrenic effects of the effexor or are there other receptors that will benefit from higher noradrenic agonism.
>
> Basically I am contemplating changing to an SSRI and atenolol, and am wondering weather there will be any difference.
>
>
> Linkadge
>
>Noradrenergic agonists stimulate both alpha and beta adrenergic receptors. In both cases, there is the potential for cardiovascular and cognitive/emotional interactions. Taking the beta blocker will not necessarily completely negate the therapeutic benefits of stimulating beta adrenergic receptors, but it may reduce them to some degree. It really depends on the individual and the dosages of the drugs involved. Regardless, the alpha adrenergic interactions will still remain because there is no alpha blocker involved in this scenario.
I think there is a good chance you would notice a difference between Effexor + atenolol and an SSRI + atenolol, despite the beta blocker negating some of the therapeutic effects of the Effexor. The higher the dosage of Effexor you are on, and the lower the dosage of atenolol, the greater the likelihood you would notice a difference.
Todd
Posted by zeugma on March 7, 2004, at 20:54:45
In reply to Re: Question about noredenic receports (smart people) » linkadge, posted by King Vultan on March 7, 2004, at 18:04:26
So here's another question about noradrenergic receptors... a stidy I read recently about how imipramine corrects HPA axis dysregulation speculated that it did so by lowering levels of norepinephrine through agonism of the alpha-2 receptor which is inhibitory. But I have gotten a powerful boost in antidepressant effect by adding buspirone to a TCA and Strattera. One of buspirone's effects is alpha-2 antagonism, which would raise synaptic levels of NE (actually a metabolite does this); if this hypothesis about how TCA's correct HPA axis imbalances is on the right track (and assuming I have this imbalance, which is plausible enough) wouldn't adding buspirone or Remeron dysregulate things further?
This is the relevant passage from the article:
The mechanism by which imipramine decreases CRH secretion is uncertain. Imipramine blocks reuptake of norepinephrine into presynaptic neurons. In brainstem regions such as the locus coeruleus, which contain inhibitory -2 autoreceptors (27), accumulation of norepinephrine at the synapse would decrease the firing of noradrenergic neurons. Because norepinephrine is excitatory to CRH release (28), an imipramine-induced decrease in brainstem noradrenergic activation could contribute to the findings reported here. We cannot, however, rule out the possibility that the anticholinergic or antihistaminic effects of imipramine, or an indirect effect, could also account for these findings.
Here's a link to the whole article.
http://jcem.endojournals.org/cgi/content/full/82/8/2601
Posted by Sad Panda on March 8, 2004, at 4:01:36
In reply to Question about noredenic receports (smart people), posted by linkadge on March 7, 2004, at 17:40:18
> I am taking effexor but I am also taking a beta blocker atenolol. Will the atenolol completely negate the noradrenic effects of the effexor or are there other receptors that will benefit from higher noradrenic agonism.
>
> Basically I am contemplating changing to an SSRI and atenolol, and am wondering weather there will be any difference.
>
>
> Linkadge
>
>I R not a smart people but here is my 2 cents. :) Beta blockers mostly antagonise Beta-1 receptors which are mostly cardiovascular. They slow your heart & lower your blood pressure. There is still Alpha-1, Alpha-2, Beta-2 & a bunch of other NE receptors that haven't been discovered yet for NE to agonise so a Beta blocker may actually boost NE activity at these other receptors.
May I ask why are you taking a beta blocker?
Cheers,
Panda.
Posted by linkadge on March 8, 2004, at 6:54:49
In reply to Re: Question about noredenic receports (smart people), posted by Sad Panda on March 8, 2004, at 4:01:36
Anxiety/high blood pressure from effexor.
Linkadgd
Posted by Sad Panda on March 8, 2004, at 9:59:32
In reply to Re: Question about noredenic receports (smart people), posted by linkadge on March 8, 2004, at 6:54:49
> Anxiety/high blood pressure from effexor.
>
>
> Linkadgd
>
>Sounds like Effexor is not a good med for you. Does it give you any AD effect? It made me happy pretty quickly & so I persisted with it. Remeron has fixed all the bad side effects for me. I have high BP & take an ACE inhibitor for it, so I was worried about Effexor when I first started taking it, but I'm up to 225mg with no BP increase.
Cheers,
Panda.
Posted by Keith Talent on March 8, 2004, at 22:50:48
In reply to Re: Question about noredenic receports (smart people) » linkadge, posted by Sad Panda on March 8, 2004, at 9:59:32
AFAIK atenolol doesn't cross the blood-brain barrier (doesn't get into the brain), so it couldn't have any detrimental effect.
Posted by Questionmark on March 14, 2004, at 2:12:27
In reply to Re: Question about noredenic receports (smart people), posted by Keith Talent on March 8, 2004, at 22:50:48
> AFAIK atenolol doesn't cross the blood-brain barrier (doesn't get into the brain), so it couldn't have any detrimental effect.
Just want to say i'm pretty sure Keith is right. It either doesn't cross or crosses minimally. So you don't have to worry about it negating any of Effexor's central effects. Good luck with that.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.