Posted by Elizabeth on February 9, 2002, at 1:15:32
In reply to Which antidepressant is right for you?, posted by torenada on February 7, 2002, at 17:37:03
First let me second what Spike says.
Torenada:
Hi there.
The three neurotransmitters you named are the only ones *that we know of* that are affected *directly* by the *standard* antidepressants. As Spike pointed out, we don't know of that many neurotransmitters. A drug may have effects that we don't know about, even effects on neurotransmitter systems that we didn't even know existed (and therefore couldn't look for).
Some people get antidepressant effects from drugs that are not monoaminergic (that don't have direct effects on serotonin, dopamine, or norepinephrine). These drugs exert their primary effects in other ways -- on other neurotransmitters that are not monoamines (e.g., gamma-aminobutyric acid; acetylcholine; neuropeptides such as endorphins and enkephalins), or in ways that are completely different and don't involve neurotransmitters (or that involve second messengers instead of first messengers). Some people find relief with hormones such as estrogens or triiodothyronine.
A drug that affects one neurotransmitter directly is likely to be having indirect effects on other neurotransmitter systems. It may also have different long-term effects on the system that it affects directly than the primary effect. So for example, I can't conclude that if Prozac works for me, I must be deficient in serotonin -- there could be any number of explanations why Prozac would work (and in fact, we don't know why *any* antidepressant works in the people for whom it works).
So in short, it's all even more complicated than we think, and there's pretty much no hope of figuring out what will work except by trial and error. (Not trying to be pessimistic or cynical or anything... :-) )
-elizabeth
poster:Elizabeth
thread:93221
URL: http://www.dr-bob.org/babble/20020208/msgs/93388.html