Posted by zeugma on October 3, 2003, at 19:09:09
In reply to Re: My grand theory about SSRI vs Tricyclics, posted by loolot on October 3, 2003, at 18:10:55
it's been observed by many that SSRIs' and MAOI's work better for atypical depression, while tricyclics work well for 'endogeneous' or 'vital' depression (these are old terms that were more widely used when the tricyclics where the AD's of choice).
It's now thought by some that SSRI's, through boosting 5-HT, diminish dopaminergic transmission (this is thought to be responsible for SSRI 'poopout,' which parenthetically DOES seem to be more of a problem for this class of medication than for any other.)
On the other hand, it's now thought that tricyclics and other NRI's boost dopaminergic transmission indirectly, because the NE reuptake mechanism actually has a higher affinity for dopamine than for norepinephrine. This is thought to explain why Effexor and tricyclics are so much more effective for anhedonic, melancholic depressions (the ones that used to be called 'endogeneous'). This also may account for the fact that TCA's and other NRI's can be effective in the treatment of ADHD- thought to be primarily a dopaminergic disorder. Here's a link to an article which tries to point out the differential actions of these drugs on aspects of depression:
http://psychservices.psychiatryonline.org/cgi/content/full/52/11/1469
poster:zeugma
thread:265309
URL: http://www.dr-bob.org/babble/20030928/msgs/265342.html