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nefazodone augmentation » SLS

Posted by JohnX2 on March 2, 2002, at 2:54:48

In reply to When is duloxetine to be approved?, posted by SLS on March 1, 2002, at 9:48:21


Hi Scott,

Have you looked into a nefazodone trial?
Maybe a good augmentation to Effexor before
dumping it.

I'm back on Serzone and its fixing my headaches
again. I'm hearing its the best med for PTSD,
which involves a very complex dysregulation of
the HPA axis. Its been the only AD I get a sustainable
response from.

Serzone is an interesting medicine to try, not
because it has a statistically less than stellar
track record, but because it is *unique*, i.e.
not another "me too" medicine.

I find it interesting because it has a metabolite
that blocks the 5ht-2a receptor and another mCPP
that bangs on the 5ht-2b and 5ht-2c receptor.
So its unique in that it has a post receptor
agonist, and I don't know if you've tried something
like this. Anyways your brain will adjust in
strange ways to an MAOI or SSRI/NRI, but with Serzone
there *always* will be this metabolite banging
away on these post synaptic receptors while
your brain is adjusting to the medicine (changes
in feedback mechanisms can't stop this). This could
cause some new and interesting things to happen
that hopefully can push things in the right
direction. Just a thought.

-John


> Hi.
>
> Here's something I thought I'd pass along from Medscape...
>
>
>
> 1. Duloxetine Significantly Reduces Symptoms of Depression
>
> http://www.medscape.com/viewarticle/411151
>
>
> From the verbiage used, it appears that duloxetine is similar to venlafaxine, not only with respect to the combined actions of the reuptake inhibition of both NE and 5-HT, but also with respect to efficacy in treating depression. Venlafaxine gets more people well and produces a greater degree of improvement than any of the SSRIs. These conclusions regarding venlafaxine are derived from a study involving over 2000 patients. That duloxetine showed itself to be superior to paroxetine in the studies referred to here indicates that both of these NE/5-HT reuptake inhibitors are superior to the SSRIs. I remember Andrew Nierenberg telling me in 1992 that venlafaxine was sort of a non-MAOI MAOI. Perhaps duloxetine will be as well. I might put off switching to Nardil from Effexor if approval of duloxetine is imminent.
>
> Does anyone know how close duloxetine is to reaching market?
>
>
> - Scott
>
>
> ----------------------------------------------
>
>
> <excerpts>
>
>
> "NEW YORK (MedscapeWire) Nov 26 — Data on duloxetine, an
> investigational balanced serotonin and norepinephrine reuptake
> inhibitor, suggest it is more effective than placebo and paroxetine
> in reducing depressive symptoms. In addition, duloxetine was found
> to be more effective than placebo in reducing the physical symptoms
> associated with depression. The data were presented at the 14th
> Annual US Psychiatric and Mental Health Congress in Boston,
> Massachusetts."
>
> "The studies also suggest that duloxetine provides balanced, potent,
> and tolerable effect at all doses, though the therapeutic evidence
> of duloxetine 60 mg/once daily dose was similar in magnitude to
> duloxetine 40 mg/taken twice a day (80 mg), indicating that a 60
> mg/once daily dosing regimen can be used. The data were measured by
> mean change on the 17-item Hamilton Depression Rating Scale
> (HAMD17)."
>
> "Duloxetine's dual mechanism of action offers the possibility for
> rapid onset of antidepressant effect, better response with pain
> symptoms, and higher remission rates than available with SSRIs that
> are most commonly prescribed today," said John H. Greist, MD,
> clinical professor of psychiatry, University of Wisconsin Medical
> School, who presented data on duloxetine at the Congress. "Because
> we recognize that serotonin blockade alone is not sufficient for
> everyone, and that physical symptoms of depression often go
> unresolved, duloxetine may become a potent first-line
> antidepressant therapy."
>
>
> ----------------------------------------------


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poster:JohnX2 thread:95939
URL: http://www.dr-bob.org/babble/20020301/msgs/96036.html