Posted by SLS on January 20, 2009, at 7:24:05
In reply to Re: Atypical APs with lowest SRI - for AD augment, posted by psychobot5000 on January 19, 2009, at 23:01:02
> > One more thing.
> >
> > Would you please report any changes in body weight?
> >
> > 5-HT2c receptors help control blood leptin levels.
> I don't understand this side of things. Does this mean that Agomelatine might have some of the metabolic risks of atypical antipsychotics?Leptin is a hormone secreted by fat cells (adipocytes). It was originally thought that its sole purpose was to decrease hunger. It is now known that leptin initiates several cascades of events, of which stimulating STAT3 transcription factor is one. When this signaling pathway is activated, the body changes the way it processes energy. The result of inhibiting this pathway is obesity and diabetes; the diabetes being a direct effect and not an effect secondary to obesity. Some people have a genetic polymorphism that make them more sensitive to this disruption.
The question is, are there other properties of atypical APs that act synergistically to amplify the 5-HT2c antagonism and its resulting reduction in circulating leptin levels.
Zyprexa is a potent 5-HT2c receptor antagonist. Risperdal is moderate. Seroquel, not so much. Even Abilify demonstrates 5-HT2c antagonsim. That's probably why I am retaining the weight I gained on nortriptyline and Nardil, which I no longer take. However, ziprasidone, a 5-HT2c antagonist as potent as olanzapine, is least liable to produce weight gain. Clearly 5-HT2c antagonism is not sufficient to produce weight gain or diabetes.
D4 receptor antagonism, maybe?
- Scott
poster:SLS
thread:874727
URL: http://www.dr-bob.org/babble/20090104/msgs/875104.html