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Re: pharmaceutical industry and their 'reinventions'. » Hordak

Posted by SLS on April 14, 2018, at 0:41:12

In reply to Re: pharmaceutical industry and their 'reinventions'., posted by Hordak on April 13, 2018, at 18:10:01

> > > How the f*ck is Vilazodone totally different?
> > > It's an SSRI with some 5HT partial agonism...

> > In what ways were you disappointed by vilazodone?

> I am not disappointed in it, because I haven't tried it

Would the world be a better place without vilazodone? I don't know.

> but it's nothing "new".

Perhaps it is new enough for some people.

Again, I would like to express the sentiments of research clinicians that for each new antidepressant that becomes available, a certain percentage of people who were previously TRD will respond to it. Why not just get rid of all SSRIs other than Prozac? That would be a bad idea, of course. A bunch of people who failed to respond to Prozac went on to respond to Zoloft when it came out.

Perhaps vilazodone is cleaner than SSRI + buspirone with respect to side effects (mental and physical). I wouldn't know, but it is conceivable. I found vilazodone to be cleaner than any SSRI I tried. Unfortunately, my response to it was short-lived. Still, it "felt" different than Lexapro.

> Take an old SSRI and add Buspirone and you get Vilazodone.

In my experience, things are not always so tidy, but I understand your logic. Buspirone is a full antagonist at dopamine D2 receptors last I heard. I don't think I would want that. It depends on dosage, I guess. The lower the dosage of buspirone, the more likely it is to produce an increase in DA activity (presynaptic biased). At higher dosages, it lowers activity. The question is, at what dosage does 5-HT1a partial agonism become potent enough to have a therapeutic antidepressant effect? Will it be so high that you get antipsychotic effects?

I would be interested to see an investigation: SSRI + buspirone (low-dose) versus SSRI + buspirone (high-dose) versus vilazodone.

I understand people's frustrations with old and new drugs alike.

What do you think of vortioxetine?

If I get stuck, I think I'll ask my doctor to experiment with low-dosage buspirone in combination with Effexor.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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