Posted by Brainbeard on October 1, 2009, at 16:37:01
In reply to Re: Lets discuss cyproheptadine (Periactin)! Linka, posted by West on October 1, 2009, at 14:59:20
> It helped produce a qualitatively deeper sleep than hypnotics while on ssris. At the same time it stopped the ssri working, thus worsening depression.
>
> You might expect that from a drug described as antiserotonergic.Not quite. SSRI's are indirectly anti-serotonergic in their own ways. Long-term SRI treatment downregulates 5HT2A/C-receptors, which comes close to 5HT2A/C-antagonism. I've never heard that strong antiserotonergic drugs like mirtazapine (Remeron) or ziprasidon (Geodon) or Risperdal (all strong 5HT2A-antagonists) negate the antidepressant effectiveness of SSRI's. In fact, many of the older tricyclic antidepressants have both pro-serotonergic (SRI) and antiserotonergic (5HT2A-antagonism) actions, and the mix seems to work quite well. Stephen Stahl argues that SRI + 5HT2A-antagonism is a good combination.
So there might be an other reason why cyproheptadine can counter the antidepressant effect of an SSRI. There have been made some suggestions higher up in this thread.
poster:Brainbeard
thread:521042
URL: http://www.dr-bob.org/babble/20091001/msgs/919299.html