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Re: Why antipsychotics for Depression, Panic, OCD...? SLS

Posted by Skeletor on May 13, 2020, at 14:51:17

In reply to Re: Why antipsychotics for Depression, Panic, OCD...?, posted by SLS on April 10, 2020, at 19:18:21

> > What is the rationale behind prescribing antipsychotics for Depression, Panic, Anxiety and OCD?
>
> Abilify is a chemical compound. It doesn't know that it's an antipsychotic. It is a drug that has been labeled an antipsychotic, but it might also have other effects.
>
> That's a pretty good way to look at any drug. Many chemical compounds have more than one biological effect and multiple sites of activity. With the brain, things become very complicated because a single mechanism can have opposite effects in two different people.
>
> Anyway, whether or not any of the compounds categorized as antipsychotics can help with depression is a question whose answer will depend upon the clinician answering it. My depression improved upon the addition of Abilify to my treatment. It was a mild, but unmistakable improvement. I decided to come off of it because my triglycerides were extremely high and I gained a lot of weight. For unipolar depression, my doctor uses 5 mg/day on his patients. He wouldn't continue to use it if he didn't think he was observing positive results. He could be wrong, of course. I guess the question to be asked is how long does such an improvement last? I'm not sure, but I think one needs to consider that Abilify does more than just antagonize D2 receptors. In fact, it is actually a partial agonist at that receptor. Unlike the older antipsychotics, it has a higher affinity at the D3 receptor as an antagonist. It is also a partial agonist at NE alpha-1 receptors, and an antagonist at 5-HT2a receptors.
>
> I think a double bind clinical trial is more valuable than any attempt to predict the effects of a drug based upon what receptors it affects. Perhaps the drug does more biologically than what is currently known about it.
>
> I think there is a place for anecdotal reports in the absence of clinical trials.
>
>
> - Scott

Indeed. Good comment!

Is Aripiprazole (and Rexulti) the only one with partial agonism at D2?


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poster:Skeletor thread:1109302
URL: http://www.dr-bob.org/babble/20200511/msgs/1110092.html