Posted by KaraS on January 30, 2005, at 20:06:20
In reply to Re: atenolol is cardioselective » KaraS, posted by emme on January 30, 2005, at 17:07:48
> > >
> > > > Actually I did a little more research and there is still a chance of it causing depression -
> > >
> > > Yes, depression is listed as a potential s/e for all beta blockers.
> > >
> > > > just not as much chance as if you took a nonselective beta blocker.
> > >
> > > Not so. Selectivity has to do with whether it blocks beta-1 receptors (selective) or both beta-1 and beta-2 receptors (nonselective). Beta-1 receptors are primarily cardiac. Beta2-receptors are are located on a number of tissues including bronchial and gastrointestinal. I haven't read anything on exactly how strict the selectivity is, but it does say to use atenolol with caution if one has asthma.
> > >
> > > CNS effects, such as depression, are more likely if the drug crosses the blood-brain barrier readily. This is different from whether the drug is selective. Lipophilic = crosses readily. Hydrophilic = not so readily. 'Course no filtering system is absolutely perfect and apparently some people get depressed on atenolol (which is hydrophilic).
> > >
> > > It just so happens that of the beta-blockers mentioned here most often, atenolol is both cardioselective *and* hydrophilic, and propranolol and pindolol are both nonselective and lipophilic.
> > >
> > > Okay, I'll shut up now. :) I hope I wasn't too incoherent.
> > >
> > > > Did you notice any increased depression when you took it?
> > >
> > > I really don't think so. YMMV. I was just thinking that sometime soon I might stop taking it for several days just to see what happens since I'm not taking anything outrageously acitvating at the moment.
> >
> >
> > Emme,
> >
> > Wow! I'm impressed. You sure do know your beta-blockers.
>
> Thanks. I can actually remember beta-1 and beta-2. I don't even pretend to keep the serotonin receptors straight. :) My knowledge of pharmacology is not superb.
>
> > Are you having any success with memantine or is it too soon to tell yet?
>
> Yes, it's doing something. It's helped the depression and I'm less apathetic. But I feel vaguely depersonalized all the time, like I'm a stranger in my body. I feel detached from my emotions. And I'm tired. I'm waiting to see if this will subside. It does beat the heavy depression. If you're thinking about trying it, don't let what I've written here scare you off because YMMV. Word is that my pdoc is seeing some positive results in her patients.
>
> em
Em,
Anything is better than the deepest depression. I'd forgotten how low I could go when not on medication. The depersonalization is a strange side effect. I think I had that somewhat with the tricyclics years ago and it did go away. Have your pdoc's other patients had that side effect?
Memantine is definitely on my list of things to try. I was thinking more of using it as an augmentor but you're using it alone, right?
Have you tried MAOIs at all or are those on your list somewhere?K
poster:KaraS
thread:448161
URL: http://www.dr-bob.org/babble/20050128/msgs/450331.html