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Re: Akathisia, meds , Pseudo-Parkinson and help pls.:( jay2112

Posted by PCB on October 18, 2020, at 14:27:49

In reply to Re: Akathisia, meds , Pseudo-Parkinson and help pls.:( linkadge, posted by jay2112 on October 17, 2020, at 17:21:47

>Interesting thing about Effexor...he said there is a bit of a >controversy on it's effects on norepinephrine, that it is a fair >bit weaker on norepinephrine than thought...even with the >dose escalation.(I'd have to look up the references.)

There is no controversy. Effexor and most of the SNRIs are very weak norepinephrine reuptake inhibitors. Here are the ratios of serotonin to norepinephrine reuptake inhibition:

Effexor/Venlafaxine 30:1 (serotonin:norepinephrine, higher number means more inhibition/stronger)
Duloxetine 10:1
Desvenlafaxine 10:1
Levomilnacipran 1:1

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4008300/#!po=1.61290
https://en.m.wikipedia.org/wiki/Clomipramine#Serotonergic_activity (under pharmacodynamics)

So really most of the SNRIs are just SSRIs with the exception of Levomilnacipran. Although some people do get blood pressure increases on a SNRIs due to the norepinephrine effect, so maybe in vitro the norepinephrine effect is significant. You could add Wellbutrin to a SSRI if you wanted more balanced reuptake of serotonin to norepinephrine.

But linkage would know better than I. He is the master! Sorry if you know all this already.

PCB


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