Posted by Elizabeth on September 12, 2001, at 3:15:03
In reply to Cam, could you please explain me something?, posted by mgrueni on September 7, 2001, at 5:46:18
> I am a pharmacist assistant, so I do know the basics about how antidepressants work.
Hi there. I think that most people who post to this board have a basic understanding of the pharmacodynamics of ADs, or if not, they develop such an understanding quickly after they start reading!
> I am asking for a particular reason. One of my friends is taking Effexor XR (150mg/day) and has massive sleep disorder (*broken* sleep plus waking up at 5:00 am and couldn`t get back to sleep again)
> Now I wonder, whether Effexor could be the cause of this problems (or at least increasing them, as he had this problems before, but they got worse under Effexor)Effexor can certainly cause frequent awakenings. Like the SSRIs, it causes a number of peculiar effects on sleep architecture and is often associated with exacerbation of insomnia.
A common solution is to add a sedating drug at bedtime. Some such drugs are: low-dose Remeron (7.5-15 mg, usually), trazodone (usually starting at 50 mg), benzodiazepines (e.g., Klonopin 1-2 mg), Ambien (about 10 mg), an antihisamine (such as Benadryl or Atarax, about 25-50 mg), a tricyclic antidepressant (e.g., doxepin or amitriptyline, about 25-50 mg I think), or clonidine (about 0.1 mg). If none of these provides relief without intolerable side effects, a more extreme measure would be to use an atypical antipsychotic drug in a low dose: for example, Zyprexa 5 mg or Seroquel 50 mg.
> * what exactly does Serotonine do (physical and psychological effects)
This is a *very* complicated question. Serotonin seems to regulate certain biorhythms, though, such as the circadian cycle. It is also involved in emotional regulation, with negative associations to agitated dysphoric states. Chronic use of serotonergic drugs can lead to an "apathy syndrome" that has been described in some places. Some anxious people appear to be hypersensitive to serotonin.
> * what effects does noradrenaline has on one`s psyche?
Another complicated one. It is generally associated with alertness and energy.
> And, what do you think about Kava-Kava to help his sleep disorder?
I'm not well-versed about this one, but I believe it enhances GABA-A binding. It can have dangerous interactions with benzodiazepines. The serotonin syndrome is not an issue as far as I'm aware, but the herb may have some noradrenergic activity. I can find no citations in the literature regarding which enzymes are involved in its metabolism.
It's thought to be a reversible MAO-B inhibitor; this should not cause any interactions with serotonergic drugs.
-elizabeth
poster:Elizabeth
thread:78136
URL: http://www.dr-bob.org/babble/20010907/msgs/78623.html