Posted by MB on September 3, 2003, at 1:33:13
In reply to Re: Antidepressants, norepinephrine and efx on anxiety, posted by Caleb462 on September 2, 2003, at 23:47:25
> 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.
Hmmm, Paxil...interesting. With its affinity to NE transporters and transporter downregulation, I wonder if that is why it was the SSRI that was approved by the FDA to treat GAD. Have any others been approved for GAD (I haven't kept up)? I *did* read in the PDR that there is some NE transporter downregulation with chronic Zoloft treatment. I wonder what the mechanism is. It is the next in line behind Paxil (I looked it up) as far as NE transporter binding goes, but it is still way behind Paxil (looks like it binds to DA transporters before it binds to NE transporters). Maybe it affect NE transporter density indirectly via modulation of the seratonin system. It just goes to show that these systems (the 5HT system, the NE system and the DA systems) are interconnected networks rather than isolated pathways: tinker with one, affect another, etc.
The downregulation thing makes sense, though. That must be why I first felt more anxious on Paxil before it helped the anxiety.> 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.
I've taken an alpha-2 adrenoceptor agonist before and found it very sedating (I took it to assuage the withdrawal symptoms of stopping methadone). The idea of taking an alpha-2 antagonist gives me piloerection just thinking about it. Yuck.
MB
poster:MB
thread:256394
URL: http://www.dr-bob.org/babble/20030902/msgs/256544.html