Posted by SLS on October 18, 2016, at 6:35:06
In reply to Re: Doctor thinks I need a phenylpiperazine? Help!?, posted by SLS on October 18, 2016, at 6:02:22
Sorry for the error. 5-HTa is supposed to be 5-HT2a. I corrected it in the passage below.
> I forgot to mention that nortriptyline, a tricyclic antidepressant (TCA), also blocks 5-HT2a receptors, but I don't know to what extent. I'll try to find out. There is also Periactin (cyproheptadine).
Both amitriptyline and nortriptyline block 5-HT2a receptors about as much as mirtazapine and cyproheptadine. Of course, using Zyprexa (olanzapine) or clozapine (Clozaril) are options if an antipsychotic is indicated for mania or a schizoid disorder. These two drugs are generally the best for psychosis, but the worst for weight-gain and the development of diabetes. Glucophage (metformin) might counteract these side effects. Its use for this remediation is somewhat controversial, but I think it is worth a try.
Interestingly, as a TCA, amitriptyline is unique in that it acts as an agonist at TrkA and TrkB receptors, and thus promotes BDNF neurotrophism. It is thought that this action produces its superior antidepressant effect relative to imipramine.
- Scott
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> > Did you see the article I posted to you regarding the treatment of akathisia?
> >
> > Saphris is less likely to produce akathisia at the same rate as Abilify. For me, the mild akathisia I experienced with Abilify disappeared completely withing a week. I started at 20 mg/day. If Abilify (aripiprazole) helps improve symptoms, and you are looking for a replacement drug, you might try Rexulti (brexpiprazole) instead. On paper, it should produce akathisia at a reduced rate. I haven't seen enough people on it to know for sure. I would still give Saphris a try if you haven't already. If it is going to work for depression, it should do so within a week provided you are taking a therapeutic dosage.
> >
> > Regarding the article I posted, it is proposed that drugs that block serotonin 5-HT2a receptors can act to reduce akahisia. Abilify is not very potent at blocking these receptors, so you might try adding low-dose Remeron (mirtazapine) as a remedy for Abilify-induced akathisia.
> >
> >
> > - Scott
Some see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1092616
URL: http://www.dr-bob.org/babble/20160928/msgs/1092656.html