Posted by jay2112 on July 3, 2021, at 20:46:14
In reply to Mirtazapine worked so well for me,but liver issues, posted by TriedEveryMedication on July 2, 2021, at 10:01:49
> appeared. Also possibly stevens/johnson.
>
> 45mg was great. Slept well, anxiety in check anhedonia was fading and I was started to enjoy life. Plus a little adderall XR (10mg) - had motivation.
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> Except liver enzymes got very out of whack, plus some other issues that went away when I DXed mirtazapine.
>
> So now I'm on liver-friendly lexapro, except it doesn't do sh*t.
>
> My pdoc thinks it was maybe the 5-HT2C action what was helpful. I looked for other drugs that are antagonists for this and couldn't find much. Mianserin is very similar to mirtazapine and probably has the same liver issues.
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> The theory on the liver issues is that CYP1A2 or CYP3A4 creates some toxic metabolite.
>
> So anyway, my questions:
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> Do you think my psych is right that the 5-HT2C action in MIRT is what is helpful?
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> And if so, are there any alternatives that might be more liver friendly?
>
> Thank you. I hope everyone is holding up in these interesting times.Hello:
Risperdal is a 5-HT2C antagonist. So is the atypical antidepressant nefadazone, which binds to the receptor very stongly. (Serzone) It is available in the U.S., and around the world. The 5-HT2C receptor has been majorly implicated in social anxiety, as well as in illness' like Autism. Autism is on a spectrum, and I think this is the new, investigative way at looking at mental illness. The DSM categories need to be looked at in a state of flux.
Nefadazone was, sadly, taken off the market for 'possible' liver enzyme increase, but they found simple regular enzyme monitoring is all that is needed. The other reason, many suspect, is that nefadazone was 'in the way', back in the 1990's, of drug companies introducing all the new SRI's and SNRI's. So, if you can get it, I'd highly recommend giving it a shot!
Best wishes,
Jay
Humans punish themselves endlessly
for not being what they believe they should be.
-Don Miguel Ruiz-
poster:jay2112
thread:1115756
URL: http://www.dr-bob.org/babble/20210418/msgs/1115773.html