![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Janelle on March 27, 2002, at 1:37:23
Why one SSRI (say Prozac) will work for Person A, but not Person B, why Person B instead responds to say Paxil?
Do we or don't we know why different people respond to different SSRI's if SSRI's are fundamentally all designed to do the same thing???
And if we do know, then WHY??!!??
Posted by trouble on March 27, 2002, at 2:24:52
In reply to So, is the answer ''WE DON'T KNOW''??, posted by Janelle on March 27, 2002, at 1:37:23
Janelle,
who ARE you, you charming
and sweet seeker of truth? WELCOME and please stick even if all your answers are somehow answered, we need you.trouble
Posted by djmmm on March 27, 2002, at 9:39:54
In reply to So, is the answer ''WE DON'T KNOW''??, posted by Janelle on March 27, 2002, at 1:37:23
Hey Janelle...there could be several reasons why one ssri works for one person and not another...some may metabolize drugs better (or worse) than others, individual neurochemistry may effect efficacy, etc.
SSRIs all differ in potency and selectivity. Some people may respond better to a SSRI like Prozac that is less selective to serotonin--meaning, that it effects other neurotransmitter systems--while others only respond to more potent and selective SSRIs like Paxil or Celexa, or even a SSRI like Zoloft which has some effect on dopamine levels...
remember, the mechanism of these medications is still somewhat "in the air" The antidepressant effects from SSRIs may be a result of a chain reaction of sorts...only partially related to what they were fundamentally designed to do.
...but the official answer *is* "We don't know"
Posted by fachad on March 27, 2002, at 12:23:16
In reply to So, is the answer ''WE DON'T KNOW''??, posted by Janelle on March 27, 2002, at 1:37:23
The Scientific Answer Is...Intersubjective Variations.
Which means, everyone is *slightly* different in both their brain chemistry and how they perceive response to an AD.
So, we know that different SSRIs work for different people, but we do not know exactly why that is true.
> Why one SSRI (say Prozac) will work for Person A, but not Person B, why Person B instead responds to say Paxil?
>
> Do we or don't we know why different people respond to different SSRI's if SSRI's are fundamentally all designed to do the same thing???
>
> And if we do know, then WHY??!!??
Posted by OldSchool on March 27, 2002, at 21:37:55
In reply to So, is the answer ''WE DON'T KNOW''??, posted by Janelle on March 27, 2002, at 1:37:23
> Why one SSRI (say Prozac) will work for Person A, but not Person B, why Person B instead responds to say Paxil?
>
> Do we or don't we know why different people respond to different SSRI's if SSRI's are fundamentally all designed to do the same thing???
>
> And if we do know, then WHY??!!??While basically being the same medications, all of the SSRIs have subtle differences. For example, Prozac besides increasing serotonin, it also very mildly increases norepinephrine and has something called serotonin 2C agonist action. Paxil in addition to having potent serotonin reuptake, has mild norephinephrine reuptake as well as mild anti-cholinergic side effects. Zoloft has strong serotonin reuptake, but also some mild dopamine reuptake as well as "sigma action." Luvox has potent serotonin reuptake and also some sigma action.
So you can see that the SSRIs despite all being portrayed as the same drugs basically, are all not so selective drugs as you thought. Its not just serotonin these meds work on.
Posted by Janelle on March 28, 2002, at 1:26:13
In reply to Re: So, is the answer ''WE DON'T KNOW''??, posted by OldSchool on March 27, 2002, at 21:37:55
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.