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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 ace on February 26, 2003, at 19:43:16
Contemplating something to augment my Nardil for OCD I cam across the idea of Zyprexa.
Nardil is a serotonin/dopamine/norepenephrine agonist? Right? It increase levels of these neurotransmitters.
Zyprexa is a serotonin/dopamine antagonist? Right? It decreases levels of these neurotransmitters.
So what the heck is using Zyprexa going to do? It's going to take away serotonin I need for OCD therapy. Wouldn't it be detrimental?
Same with the SSRIs - they increase serotonin whilst zyprexa decreases it. Are they not working against each other?
Wouldn't it be more sensible to add a powerful serotoninb agonist to the MAOI or SSRI for OCD therapy?
What is the deal?
Ace.
Posted by cybercafe on February 26, 2003, at 21:06:50
In reply to MAOI or SSRI + Zyprexa - aren't they opposites?, posted by ace on February 26, 2003, at 19:43:16
actually if you block a receptor you leave more of the ligand for other receptors
Posted by Thomas123 on February 26, 2003, at 21:20:24
In reply to Re: MAOI or SSRI + Zyprexa - aren't they opposites?, posted by cybercafe on February 26, 2003, at 21:06:50
There are about 15 different serotonin receptors and there are five different dopamine receptors.
Nardil increases levels of dopamine and serotonin generally and thereby affects all the different serotonin and dopamine receptors. SSRIs increase levels of serotonin affecting all the serotonin receptors.
Zyprexa antagonizes specific serotonin and dopamine receptors, leaving the Nardil to work against other sertonin and dopamine receptors.
Yes, there is antagonism between Nardil and Zyprexa but the antagonism is far from complete. Or at least this is the rational for using the two together. A similiar argument would apply for Zyprexa and and SSRIs.
Posted by ace on February 26, 2003, at 21:36:06
In reply to Re: MAOI or SSRI + Zyprexa - aren't they opposites?, posted by Thomas123 on February 26, 2003, at 21:20:24
Posted by Thomas123 on February 26, 2003, at 23:54:15
In reply to Re: so zyprexa still plausible for OCD? (nm), posted by ace on February 26, 2003, at 21:36:06
I think Risperdal is a better bet. There is less diabetes associated with Risperdal compared to Zyprexa. Also there is less increase in cholesterol levels.
Theoretically APs and ADs can work together for OCD.
As to the actual efficacy of antipsychotics for OCD all I know is what I have learned from this board. Some with OCD seem to swear by antipsychotics.
Keep the AP dose low if you take one. This will minimize side-effects.
Posted by cybercafe on February 27, 2003, at 23:56:44
In reply to Re: so zyprexa still plausible for OCD?, posted by Thomas123 on February 26, 2003, at 23:54:15
> I think Risperdal is a better bet. There is less diabetes associated with Risperdal compared to Zyprexa. Also there is less increase in cholesterol levels.
>
> Theoretically APs and ADs can work together for OCD.
>
> As to the actual efficacy of antipsychotics for OCD all I know is what I have learned from this board. Some with OCD seem to swear by antipsychotics.
>
> Keep the AP dose low if you take one. This will minimize side-effects.it seems risperdal is the worst for movement disorders.... why not seroquel, geodon, etc?
This is the end of the thread.
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