Posted by Mistermindmasta on September 15, 2004, at 21:38:23
In reply to Re: Cymbalta honeymoon is over » steve12, posted by alesta on September 15, 2004, at 3:25:33
> hi,steve,:)
>
> if it hasn't worked by now, it's not going to..it doesn't have a long half-life like the SSRIs..it's supposed to take only 2 to 3 weeks to work..i would start tapering slowly down now, b/c you might be in for a bumpy ride due to discontinuation syndrome..
>
> and i would pick a med that includes enhancement of dopamine or gaba or both..i don't believe serotonin or norepinephrine alone tend to be very helpful for anxiety..
>
> an added note: i believe many depressives might need dopaminergic meds as well (as well as norepinephrene enhancement for energy)..but that is speculation on my part...i think serotonin may not play a very important role in mood, but more, perception..but that is just a theory..
>
> amy:)
>Actually, if you look at anxiety as being a "brain circuit" based problem as opposed to a "neurotransmitter" based problem, you see that serotonin and norepinephrine play a role. Anxiety is thought to mostly stem from increased activation of the amygdala. Increased GABA transmission slows firing in the amygdala. On the other hand, increasing firing of the serotonin 1a receptor also increases GABA activity in the amygdala, thus indirectly lowering anxiety (after a few weeks). How norepinephrine reuptake inhibitors lower anxiety is beyond me. I suspect that it might have to do with the prefrontal cortex... increasing NE there will lower activity in the amygdala. I might be wrong on that one, though.
poster:Mistermindmasta
thread:390747
URL: http://www.dr-bob.org/babble/20040915/msgs/391311.html