Posted by Sunnely on April 1, 2001, at 23:11:22
In reply to Re: If Zyprexa BLOCKS dopamine, what good is it? » Sunnely, posted by SLS on March 31, 2001, at 10:33:51
Hi Scott,
I believe imipramine's reuptake inhibition of NE and 5HT is much stronger than Geodon, although I don't have the exact figures on these.
Re: Moban as an "augmenter" for antidepressant - Unless you have a diagnosis of major depression with psychotic features or schizoaffective disorder, depressed type or schizophrenia with concurrent depression, I will shy away from Moban and the other older antipsychotic drugs. In treatment-resistant or partial-responders depression, the older antipsychotics are not only poor "augmenters" of antidepressants but may even worsen depression. All of them have minimal or devoid of serotonergic effect and are more potent D2 antagonists than any of the existing atypical antipsychotics. As a consequence, they may tend to worsen depression.
Re: Moban and EPS, TD - Virtually all of the older antipsychotic drugs have been reported to cause EPS and TD. In general, the following people are the highest risk for developing TD: 1) older people, especially women; 2) those with neurological conditions; 3) those who are developmentally disabled (e.g., mental retardation); 4) those with diagnosis of affective disorder (e.g., depression, bipolar disorder); 5) those who experience acute EPS; 6) those who have been taking high dosage of antipsychotics for a long time. According to Kane et. al. study (1984 and 1988), the incidence of TD increases as the length of antipsychotic treatment increases. For the first several years, this appears to be a linear progression. The following is the incidence of TD: 5% after 1 year; 10% after 2 years; 15% after 3 years; 19% after 4 years; and 26% after 6 years.
Among the atypical antipsychotics, people on risperidone may be at higher risk in developing future TD compared to other atypical antipsychotics (e.g., clozapine, olanzapine, quetiapine, and ziprasidone).
On the positive note, among the antipsychotics (old and new), Moban, Loxitane, and Geodon appear to be the least to cause weight gain.
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> Are the magnitudes of reuptake inhibition for NE and 5-HT by Geodon comparable to imipramine (IC50)?
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> Hmmm.
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> I was thinking of adding Geodon to my current regimen that includes Parnate 80mg and nortriptyline 100mg. I have taken a combination of Parnate 120mg and imipramine 300mg in the past. My concern here is that Geodon will increase the potential for untoward effects, although I have not yet experienced any with my current combination.
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> I will say this, though, while taking Parnate 120mg, I took the teeniest, tiniest little nibble of a tablet of Effexor. I wanted to test the potential for serotonin syndrome. I was desperate. I chose Effexor because if something nasty happened, its short half-life would quickly terminate the trial. How smart I was to choose Effexor. How stupid I was to try Effexor. Major serotonin syndrome. I became incoherent and babbled nonsense. My body temperature rose, but did not exceed 100 degrees F. I couldn't get myself to move when I tried to get out of bed. I am not sure if this was because of some sort of vertigo or because of any hypertonia. I think it was vertigo. I had to know.
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> Thanks for any feedback regarding Geodon.
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> Two more last questions. What do you think of using Moban in the role of augmentor for depression? What is its potential for EPS and TD?
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>
> - Scott
poster:Sunnely
thread:57880
URL: http://www.dr-bob.org/babble/20010327/msgs/58397.html