Posted by Caleb462 on September 2, 2003, at 23:47:25
In reply to Antidepressants, norepinephrine and efx on anxiety, posted by MB on September 2, 2003, at 16:59:47
> I had a doctor tell me that the more an antidepressant affects norepinephrine, the better it is at alleviating anxiety. He told me that because Lexapro is so selective for seratonin reuptake pumps, that it wouldn't be as effective an anxiolytic as an antidepressant that blocked reuptake of norepinephrine to some extent (I guess even some of the SSRIs bind to NE transporters to some degree).
Your docotor shouldn't be stating this as absolute fact, like everything - it varies from person to person. The only SSRI that binds to the NE transporter with any signifigant affinity is Paxil.
> Has anyone heard of this Norepinephrine-antianxiety connection. In a beginner's psychology class, we learned that too much NE released from the Locus Coeruleus causes anxiety, so I was really surprised when he told me this. He mentioned Effexor, but I've already had a nightmarish experience with *that* drug. He keeps mentioning Remeron. It's my understanding that Remeron sedation/anxiolysis is due to its antihistamine properties, and it seems that when people with anxiety issues reach that magical 45mg dose (where the noradrenergic properties kick in) their anxiety is exacerbated. So am I being too arrogant to think that maybe this doctor is wrong about the increased NE=decreased anxiety. It is a bad pattern of mine to think that I'm smarter than the doctors, and it has alienated me from quite a few. Any input?
>
> MBIt is not neccesarily a bad pattern, I've certainly believed myself to be smarter, or at least more educated about meds, than some doctors - including my current one.
But anyway... increased NE, in the SHORT-TERM, can increase or cause anxiety - yes. However, long-term effects of inhibiting NE reuptake show the opposite effect - decreased anxiety. The NE system "downregulates" in response to all this extra NE.
As for Remeron... I'm skeptical about it's anti-anxiety effect at high doses. Taking a alpha-2 antagonist (which Remeron is), has a strong effect, and seems too much like taking a stimulant on a regular basis. For instance, yohimbine is an alpha-2 antatgonist, but I've never heard anyone touting any anti-anxiety effects from it whether long-term or short-term. Quite the opposite, in fact. But I'm no pharmacologist, and this is just some thinking off the top of my head.
poster:Caleb462
thread:256394
URL: http://www.dr-bob.org/babble/20030902/msgs/256516.html