Posted by Sunnely on April 22, 2001, at 22:35:17
In reply to Re: Geodon and nausea, anyone? » Sunnely, posted by SLS on April 22, 2001, at 19:30:00
Scott,
I am sure you know that Geodon is both a reuptake inhibitor of serotonin and norepinephrine. This, along with its other pharmacologic actions, 5-HT1D antagonist and 5-HT1A agonist, would predict antidepressant and anxiolytic actions as well.[1,2]
I have no scientific study to support my hunch. But allow me to express my 2-cent opinion. Between the 2 (serotonin and norepinephrine), Geodon's reuptake norepinephrine inhibition is most probably the main player. Antidepressants with norepinephrine reuptake inhibition tend to be more activating than sedating. For example, bupropion (Wellbutrin) tends to aggravate the anxious or "agitated" type of depression but a good choice for the "retarded" type of depression. Reboxetine (Vestra, Edronax) is a selective norepinephrine reuptake inhibitor which is also activating, along with its effect on the heart (tachycardia or rapid heart beat and increased in blood pressure). Although venlafaxine (Effexor) is both serotonin and norepinephrine reuptake inhibitor, at higher doses (e.g., >300 mg/day), the norepinephrine effect takes over and therefore, more activating. Also at this dose, it tends to increase blood pressure. This is the reason why it is recommended to check blood pressure periodically if Effexor is used >300 mg/day.
Although Geodon may be effective in depressed schizoaffective or bipolar patients, theoretically, there is a risk of inducing mania or rapid-cycling because of its serotonin and norepinephrine reuptake inhibition.
Again, above opinion is just a "hunch" and needs to be supported by scientific study.
References:
1. Package Insert, Geodon (ziprasidone HCl), Pfizer, February 2001.
2. Essential Psychopharmacology, 2000, second ed., Stephen M. Stahl, Cambridge University Press, Cambridge, UK.
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> Dear Sunnely,
>
> > My hunch is, its reuptake inhibition of serotonin and norepinephrine may be playing a major role.
>
> How do you know it does that?
>
>
> - Scott
poster:Sunnely
thread:60754
URL: http://www.dr-bob.org/babble/20010417/msgs/60815.html