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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by Francesco on August 12, 2003, at 8:01:58
Today I stopped Wellbutrin (after seven days of craziness). I don't know if I did the wrong think but I didn't manage to tolerate it. I hated all the people around me and I simply couldn't wait two months. I experienced all the range of the worst sensations I have ever experienced, kind of psychotic. In the first part of the day I was very aggressive and in the second really stupid and dumb. I felt like people were very distant from me, like objects, and I writed like a 6 years old child. No sense of humour at all, it was horribile. I seriously compromised a relationship already compromised by my previous attempts to find the right med. This girl doesn't want to see me anymore and the worst thing is that I can easily understand her. Anyway. I'm looking for suggestion at the moment.
Reading your posts I could understand several things. I'm not depressed and I'm not obsessed. My main problem is adhd but I have more than a doubt about being also bipolar II and soft (hope so) borderline personality (what a bad word to say). my main syntompts are that I can't concentrate when I really want to do it and I have also some problem about deep relationships (love-hate, fear to depend and need to depend). I feel quite good when I'm with people and quite bored when I'm alone. I become stressed when I think about the things I should do and avoidance and procrastionation are my favourite strategies.
Sometimes I feel depressed thinking about my situation but it usually lasts only until I don't have a nice chat with somebody. I strongly depends on other's acceptance and support. I am quite witty and sharp but I can't do anything with it. I am very fond of with daydreaming and that's the reason why I like so much to write. I'm not anxious if I don't do what I should but rather I feel good (very strong 'don't care attitude', kind of happy nihilism).Let's talk about ADs now. Anafranil helped a lot for me but the cost was to high. Lot of weight gained, lack of sexual desire (I should rather say "sex avoidance" or "sex phobia"). I devoloped also social phobia which, as I said before, is not a problem I usually have. I became very 'snob' and mysantropist, people didn't like me at all. But I took it for so many years that I forgot it was not a problem of mine. I became anxious too and quite obsessive, and my life was sad but 'efficient'. another problem is that when I was on it I usually drank a lot to contrast my social phobia and hostility towards people. When I'm not on meds I don't find alcohol so necessary and I don't crave for it. Another 'strange' thing is that I usually feel more depressed when I'm on ADs and the depression I experience is far more worse and more 'absolute'.
Trying also Prozac with some success with AHDH but it also made me too excited and agitated (without any reasons). So I stopped it within 6 months (remember also some psychotic episode when I was on it, maybe also because I used to mix it with alcohol).
Lot of problems with Paxil (I became a potential serial killer) and Celexa (I forgot I was living).
Any suggestion ? I'm not sure about trying stims also because in Italy, where I am, they are not easily prescribed and I fear that my experience with them could be similar to the one I had with Wellbutrin.
Maybe a mood stabilizer ? Maybe only benzos ? Maybe nothing at all ? Maybe cannabis ? I just don't know. I'm 27 and sometimes I think I had experienced more mood states than a 75. Thanks
Posted by DSCH on August 12, 2003, at 12:54:15
In reply to what helps for adhd ? , posted by Francesco on August 12, 2003, at 8:01:58
In my non-medical-degreed-opinion I would say you are perfectly justified in stopping the Wellbutrin based upon what you have written. Patience to achieve the delayed action efficacy is one thing. Dangerous side effects in the here-and-now are another.
Before talking about ADs, it would perhaps be worth taking a closer look at what your symptom profile was before you started taking medication and then going forward and seeing if any changes have happened as you have discontinued various medications (i.e. like what seems to be happening to linkadge coming off lithium and Celexa) as well as noting what the good/bad side of each treatment scheme was. Find some time and write up a personal history, it doesn't have to be great writing, but the more detailed it is regarding your feelings and sensations the more helpful it will be, because it gives clues as what to is going on in YOUR case relative to all other cases of ADHD out there.
You might want to give this questionairre a try, inputing what you were like *before* taking Anafranil.
http://www.brainplace.com/bp/checklist/checklist_page1.asp
Having gone from Anafranil to Prozac to Paxil to Celexa to Wellbutrin, it might be good to have an extended drug holiday and let your brain achieve some kind of homeostasis before starting on another med. It's the brain's achievement of a new stable operating condition in response to the input of an AD that causes the time delay in actual improvement. (I believe "poop-out" is the result of this new operating condition being too stressful on the brain to maintain over the long haul.) Conversely, you won't have an accurate picture of what the real problem is until brain functions have fully adjusted to the withdrawl. Since non-linear systems like the brain are path dependent, the problem might be somewhat different from what it was before you began these different treatments.
To switch from my, perhaps, overly-didactic side to some empathy, I *know* what you are going through. I struggled through stress, relationships, ineffective medications, and ADD symptoms in graduate school too. It was too much for me as I didn't seek help soon enough and didn't bring as much as I might have been able to in the way of intelligence and dedication to seek effective help as I could have. With my treatment finally going somewhere now I am amazed at the difference in energy and clarity over what I had before. And writing this is taking way too long due to the sugary breakfast I had this morning. LOL That's another thing that will have to go! :-)
Posted by Francesco on August 15, 2003, at 12:27:48
In reply to Re: what helps for adhd ? » Francesco , posted by DSCH on August 12, 2003, at 12:54:15
Thanks for empathy and suggestion. I did appreciate both. So, what are you currently on ?
Posted by DSCH on August 16, 2003, at 15:28:54
In reply to Re: what helps for adhd ? » DSCH, posted by Francesco on August 15, 2003, at 12:27:48
> Thanks for empathy and suggestion. I did appreciate both. So, what are you currently on ?
I have stopped taking my medication and instead have started on diet, exercise, and nutrional supplements. I realize now that my ADD symptoms (which were really of adult onset... that should have raised an alarm bell) most likely stem from adrenal exhaustion and excess serotonin caused by stress and "Syndrome X"/"Metabolic Syndrome".
I would advise you to carefully consider what the nature of your problems really are rather than hopping around from drug to drug in the hopes of finding something that works. This isn't psychological navel gazing but a rational consideration of your behavioral, dietary, and health history. In my case, I think I was finally able to draw all the clues together, but only after experiencing improvement in a serendipidous manner!
Have you checked out Dr. Amen's site?
Posted by Francesco on August 16, 2003, at 16:10:56
In reply to Re: what helps for adhd ? » Francesco , posted by DSCH on August 16, 2003, at 15:28:54
I had checked Amen site before and I did test (can't remember the exact output, but I was positive in two different kind of Adhd). Anyway I live in Italy and here this disturbance is not very well known so I suppose it's no use going to my doc and say which kind of Adhd I think I have because he will likely have never heard of this kind of stuff. I'm quite skeptikal about "natural remedies" but and I'm far more skeptikal about my ability in maintaining a diet and exercize and so on ;-) so I think I will try Parnate because at the moment, what I really really want is come back to the good life (I must study because I'm payed for it). If Parnate will not work (and if I will not die because of tyramine ;-) I think I'll go back to the meds like Anafranil or Prozac which helped my ADHD in the past. you have been very kind, thanks a lot
Posted by DSCH on August 16, 2003, at 19:51:36
In reply to Re: what helps for adhd ? » DSCH, posted by Francesco on August 16, 2003, at 16:10:56
> I had checked Amen site before and I did test (can't remember the exact output, but I was positive in two different kind of Adhd). Anyway I live in Italy and here this disturbance is not very well known so I suppose it's no use going to my doc and say which kind of Adhd I think I have because he will likely have never heard of this kind of stuff. I'm quite skeptikal about "natural remedies" but and I'm far more skeptikal about my ability in maintaining a diet and exercize and so on ;-) so I think I will try Parnate because at the moment, what I really really want is come back to the good life (I must study because I'm payed for it). If Parnate will not work (and if I will not die because of tyramine ;-) I think I'll go back to the meds like Anafranil or Prozac which helped my ADHD in the past. you have been very kind, thanks a lot
At the same time as you want to go on an MAOI you say you are skeptical about maintainting a diet!!
If you blow off your dietary restriction just once on Parnate and eat a large portion of something loaded with tyromine you have a high probability of KILLING yourself.
MAOIs are nothing to screw around with! Look what happened to you on Wellbutrin, something considered rather innocous in comparison.
Who is it that gives you whatever drug you walk in and ask for?!
I STRONGLY council you to be very catious!
Posted by francesco on August 16, 2003, at 21:00:17
In reply to Re: what helps for adhd ?, posted by DSCH on August 16, 2003, at 19:51:36
If I take Parnate I'll maintain my diet because I will be forced to do it : ) Anyway, as I posted somewhere else Parnate is the only MAOI available in Italy and it's mixed with an antipsychotic (they call it Parmodalin or something like that). I discovered this issue this evening and therefore I'm not sure to take it anymore. The pdoc who suggested it is one of the most famous in my country (but this can mean anything at all ... he listened to me for just 20 minutes and asked me an enourmous amount of money). My previous pdoc didn't use MAOIs at all, so everybody has its own opinion and sometimes I think they are simply guessing ("trials and errors") just like we would do. anyway, sorry for my being so frustrating and frustrated, hope tomorrow it will be better, maybe I'm just tired 'cause here is 3.46 am. Thanks a lot for your concern. I will do the Amen test again and see what it says. my adhd problem anyway is very long dated, I had problem with concentrantion since I was 12 (at least). so I don't think it depends on something I eat or I don't. when I was a baby I experienced also OCD and there must be some OCD problems too in my ADHD disorder. the whole think makes me depressed, but in a mild way, cause I know I can come back to my Anafranil dreams. Sorry for the book I've just finished to write. thanks again
Posted by DSCH on August 16, 2003, at 21:30:44
In reply to Re: what helps for adhd ? » DSCH, posted by francesco on August 16, 2003, at 21:00:17
Anafranil is mentioned by Dr. Amen as one of the things he's used to treat abnormalities in the cingulate gyrus. Put cingulate gyrus trouble and attention defecit together and you get this according to his scheme:
http://www.brainplace.com/bp/atlas/ch12.asp
"Overfocused ADD, with symptoms of trouble shifting attention, cognitive inflexibility, difficulty with transitions, excessive worrying, and oppositional and argumentative behavior. There are often also symptoms of inattention and hyperactivity-impulsivity. Brain SPECT imaging typically shows increased activity in the anterior cingulate gyrus and decreased prefrontal cortex activity. This subtype typically responds best to medications that enhance both serotonin and dopamine availability in the brain, such as venlafaxine or a combination of an SSRI (such as fluoxetine or sertraline) and a psychostimulant."
http://www.mindfixers.com/amensub3.html
"Overfocus ADD, according to Dr. Amen
People with ADD, overfocused subtype, tend to get locked into things and they have trouble shifting their attention from thought to thought.This subtype has a very specific brain pattern, showing increased blood flow in the top, middle portion of the frontal lobes (cingulate area of the brain). This is the part of the brain that allows you to shift your attention from thing to thing. When this part of the brain is working too hard, people have trouble shifting their attention and end up "stuck" on thoughts or behaviors.
This brain pattern may present itself differently among family members. For example, a mother or father with ADD overfocused subtype may experience trouble focusing, along with obsessive thoughts (repetitive negative thoughts) or compulsive behaviors (hand washing, checking, counting, etc.).
The son or daughter may be oppositional (get stuck on saying no, no way, never, you can't make me do it). Another family member may find change very hard for him or her.
This pattern is often made worse by the stimulant medications. The problem is not inattention, but over-attention. When you give them a stimulant medication they tend to focus more on the thoughts they get stuck on.
The best medications for this subtype tend to be the new "anti-obsessive antidepressants," which increase the neurotransmitter serotonin in the brain. I have nicknamed these medications "anti-stuck medications."
At the time of this writing there are 9 medications which are commonly used to increase serotonin in the brain. These medications include Effexor (venlafaxine), Prozac (fluoxetine), Paxil (paroxetine), Zoloft (sertraline), Anafranil (clomipramine), Desyrel (trazodone), Serzone (nefazodone)), Remeron (mirtazapine) and Luvox (fluvoxamine).
My personal favorite of these medications for overfocused ADD is Effexor. Effexor increases serotonin in the brain which is helpful for shifting attention, it also increases norepinephrine and dopamine, which are more stimulating neurotransmitters and more helpful with attentional problems. Serzone and Remeron have also been found to increase serotonin and norepinephrine.
It is important to note that, in my experience, those medications which exclusively increase serotonin (Prozac, Paxil, Zoloft, Anafranil, Desyrel and Luvox) often make people with ADHD and ADD without hyperactivity worse. They tend to have more problems concentrating and they may experience decreased motivation."
Posted by francesco on August 17, 2003, at 6:28:53
In reply to So Anafranil helped, OK.... » francesco, posted by DSCH on August 16, 2003, at 21:30:44
I did the test again. I have Cingulate System Hyperactivity. This explains why I had benefits from Anafranil (and Prozac too). But I'm also inattentive type (prefrontal cortex). (and that's strange because the suggested diet is quite the opposite). So I have a problem with dopamine and seritonin. What's your tip ?
The strange thing about Anafranil is that it had made me a social phobic ... Should I have to take (theoretically speaking) stims + anafranil ?
Here combos aren't very popular (and stims are barely out of law) and I could have some problem in finding a pdoc opened to this kind of experiments.
Thanks again for support and info. Very opened to any suggestion : )
Posted by Francesco on August 17, 2003, at 7:13:49
In reply to Re: So Anafranil helped, OK.... » DSCH, posted by francesco on August 17, 2003, at 6:28:53
So, I think I should try Effexor (dopamine and serotonin too). I'll ask for it (and about it) to my next pdoc.
Posted by DSCH on August 17, 2003, at 11:11:57
In reply to sorry you have already answered me : ) , posted by Francesco on August 17, 2003, at 7:13:49
> So, I think I should try Effexor (dopamine and serotonin too). I'll ask for it (and about it) to my next pdoc.
As you bump up the dose of Effexor, you'll see increasing reuptake inhibition (RI) for the neurotransmitters (NTs) going in this order:
Serotonin (5-HT)
Norepinepherine (NE)
Dopamine (DA)At high theraputic dose, the 5-HT RI will be powerful (Fortissimo!), the NE RI strong (Forte or Mezzo Forte), but the DA RI will be somewhat weak (Mezzo Piano to Pianissimo). ;-)
From my own experiences this past week when my NTs where going all over the place, I got the impression that NE is more important than DA for short term memory, impulse-control, focus, and planning. DA I think helps your physical coordination, energy level, sense of well being, and the speed of your cognitive process. This would explain why a selective NE RI (Strattera) is now being prescribed for ADHD here in the US. The consensus on the most effective stims for ADD/ADHD is for the amphetamines and methylphenidate, which effect NE as well as DA.
Among Psychobabble's links list is one to a folder with Effexor tips.
Nutritional supplements you can try that would add some punch and/or help you fine-tune the Effexor would be:
1) L-phenylalanine or racemic phenylalanine (DLPA)
2) Vitamin B3 or NADH
3) Vitamin B6 or PLP (aka P5P)
4) Vitamin C
I would HIGHLY recommend having your pdoc in on it if/when you add these supplements to the Effexor. I discovered myself that these can appear much more powerful than "normal" people notice when you have NT imbalances and medication going.
If the doc doesn't understand the rationale behind this selection, print these out for him (as well as for your own study):
http://www.mind-boosters.com/chapter_13.html
Figure 13.1 is the key figure.
http://www.mind-boosters.com/chapter_9.html
To help isolate which NTs are too high/too low you can check your symptoms against these charts.
http://www.nutritional-healing.com.au/neurotransmitters.htm
You might want to exchange experiences and tips with other folks on the board who have similar symptoms by getting their attention using subject line keywords like "Overfocused ADD/ADD+OCD". Get to "know" them! :-)
I hope this helps you out, Francesco.
Posted by DSCH on August 17, 2003, at 11:26:22
In reply to sorry you have already answered me : ) , posted by Francesco on August 17, 2003, at 7:13:49
Posted by DSCH on August 17, 2003, at 11:49:30
In reply to sorry you have already answered me : ) , posted by Francesco on August 17, 2003, at 7:13:49
If Effexor doesn't suit you, Serzone might be worth a trial if its excepted/available in Italy.
http://sl.schofield3.home.att.net/medicine/psychiatric_drugs_chart.html
Serzone (nefazodone)
phenylpiperazine:
5-HT reuptake inhibition +
NE reuptake inhibition +
5-HT2a antagonist +++
5-HT1a antagonist ++
NE-alpha1 antagonist ++
* mCPP metabolite:
5-HT2b agonist ++
5-HT2c agonist ++If all else fails, I'd say go back to Anafranil and try out nutritional supplements/diet.
Posted by McPac on August 17, 2003, at 12:54:10
In reply to So Anafranil helped, OK.... » francesco, posted by DSCH on August 16, 2003, at 21:30:44
I am taking Remeron now for OCD and depression (I also have many ADD characteristics)......so far I have found Remeron to be very "weak", simply not very powerful in helping the depression, obsessive thinking AND the add symptoms...I'm taking 45 mg right now...what a lame anti-dep......maybe I need to go higher? I don't care for the NE "jittery" feeling, if that is what causes the jitters on this med.........Zoloft and other SSRI's worked MUCH, MUCH better at mood-lift and the ocd (but they caused me TERRIBLE anger and I HATED that).....might have to try Remeron at a higher dose, if that doesn't work then probably try Lexapro again (started to feel the 'anger' and stopped it once before)......if only remeron weren't such a DUD.
Posted by McPac on August 17, 2003, at 13:04:09
In reply to DSCH, Re: So Anafranil helped, OK...., posted by McPac on August 17, 2003, at 12:54:10
I should add that the Remeron also causes me irritability/anger at higher doses....aside from using Remeron as a low-dose sleep aid, the drug seems rather worthless to me. Maybe it's time to crank up the St John's Wort?
Posted by DSCH on August 17, 2003, at 14:58:22
In reply to Re: DSCH, Re: So Anafranil helped, OK...., posted by McPac on August 17, 2003, at 13:04:09
McPac,
Gimme some time to ponder on it. I'm not making any strong connections between what you have said and with what I have read about/learned/experienced.... Yet. ;-) I'll give a shout out to ya if something hits me.
Posted by McPac on August 18, 2003, at 15:30:13
In reply to Lameron » McPac, posted by DSCH on August 17, 2003, at 14:58:22
Looks like agitation and aggression seen often...
The pharmacovigilance of mirtazapine: results of a prescription event monitoring study on 13554 patients in England
by
Biswas PN, Wilton LV, Shakir SA.
Drug Safety Research Unit, Bursledon Hall,
Southampton, London, UK.
pipasha.biswas@dsru.org
J Psychopharmacol. 2003 Mar;17(1):121-6.ABSTRACT
Mirtazpine is the first noradrenaline and serotonin specific antidepressant. We monitored the safety of mirtazapine as reported in primary practice in England.The exposure data were provided by monitoring the dispensed prescriptions issued between September 1997 and February 1999. Questionnaires sent to GPs provided outcome data. Drowsiness/sedation and malaise/lassitude were the most frequent ADRs (116, 71 respectively) and had the highest incidence density (per 1000 patient-months) in the first month of treatment (58.1, 27.8 respectively). Agitation (73), aggression (70), rash (20), hallucinations (13) and abnormal dreams (31 were unlabelled AES while abnormal liver function tests (12), syncope (8), abnormal behaviour (4) and visual disturbance (3) were labelled AES possibly due to mirtazapine use. Serious suspected ADRs reported were facial oedema (5), allergy (3), bone marrow toxicity (2) and myelodysplasia (1).
Posted by McPac on August 18, 2003, at 15:55:20
In reply to Dsch, Re: Lameron, posted by McPac on August 18, 2003, at 15:30:13
More Remeron-induced anger/agitation (these studies are fine but my FIRST-HAND, personal experience means more to me...others here have mentioned this effect too, take care!
Int Clin Psychopharmacol. 2002 Nov;17(6):319-22. Related Articles, Links
Dysphoric mania induced by high-dose mirtazapine: a case for 'norepinephrine syndrome'?Bhanji NH, Margolese HC, Saint-Laurent M, Chouinard G.
Clinical Psychopharmacology Unit, Allan Memorial Institute, McGill University Health Center, McGill University, Montreal, Quebec, Canada. nadeem.bhanji@mail.mcgill.ca
The antidepressant mirtazapine antagonizes central presynaptic alpha2-adrenergic auto- and heteroreceptors resulting in increased central norepinephrine and serotonin activity. Histamine H2 receptors are also antagonized, as are postsynaptic serotonin 5-HT2 and 5-HT3 receptors, leading to serotonergic activity primarily via 5-HT1A receptors. Based on the case report of a patient who developed mania with higher than recommended dosage of mirtazapine, we review the literature on the atypical nature of manic symptoms with mirtazapine. Eight subjects, including those in our study, were identified as having developed mirtazapine-induced mania with atypical features, consisting of dysphoria, irritability, insomnia, psychomotor agitation and abnormal gait. Predisposing features may have included the presence of underlying brain dysfunction and certain selective serotonin reuptake inhibitor-mirtazapine combinations. Dysphoric mania with atypical features may be induced by mirtazapine, providing support for a common hypothesis such as 'central norepinephrine hyperactivity' as the basis for development of mania with mirtazapine.
PMID: 12409687 [PubMed - indexed for MEDLINE]
Posted by DSCH on August 19, 2003, at 0:03:40
In reply to Dsch (more), Re: Dsch, Re: Lameron, posted by McPac on August 18, 2003, at 15:55:20
So you would characterize your problems as OCD + ADD + depression, right? What would be the order of severity? What are the symptoms you assign to the "depression" component?
Do have you any health problems other than the high histamine levels that would be complicating your picture?
What's your diet and Pfeiffer treatment package like?
With those questions out of the way, here's what comes to my mind on the "first pass":
I look at Remeron on SLS's chart and see 5HT and NE antagonisms. I would think that aggravates the OCD and ADD and maybe the depression as well. I don't see a rationale for taking it.
I would be thinking about Effexor at a stiff dose, 5HT-RI for the OCD component and NE-RI for the ADD component. Have you tried it? If you suffer from psychomotor retardation and anenergia from the depressive component, then you'd probably want dopamine action too. A real high Effexor dose will provide a bit of DA-RI.
Posted by DSCH on August 19, 2003, at 7:48:45
In reply to DSCH, Re: So Anafranil helped, OK...., posted by McPac on August 17, 2003, at 12:54:10
OK so SSRIs helped overall mood and OCD but you started getting angry.
I'm not familar with what might be going on there.
I suppose Effexor would end up making you angry too, then.
Back to the drawing board.
Posted by McPac on August 19, 2003, at 12:31:20
In reply to Hmmmmmmmmm » McPac, posted by DSCH on August 19, 2003, at 0:03:40
"I look at Remeron on SLS's chart and see 5HT and NE antagonisms. I would think that aggravates the OCD and ADD and maybe the depression as well. I don't see a rationale for taking it".
>>>>>>>>>>> Dsch, Re: 5HT and NE 'antagonisms'---does antagonism (in simple speak, lol) mean that it will INCREASE the serotonin and NE activity?
"I would be thinking about Effexor at a stiff dose, 5HT-RI for the OCD component and NE-RI for the ADD component".
>>>>>>>>>>>>>> 5HT-RI increases serotonin activity (right?), so NE-RI would increase NE activity (correct?) Question Please: WHAT is the difference between 5HT antagonism and 5HT-RI (in simple speak again, please?)
I like Remeron at a LOW DOSE (7.5 or 15 mg) but HATE it at a higher dose (45 mg for SURE, don't know about 22.5-30mg or so, don't recall what it feels like there).
Posted by McPac on August 19, 2003, at 13:45:40
In reply to Dsch, Re: Hmmmmmmmmm, posted by McPac on August 19, 2003, at 12:31:20
Do you have any idea at what DOSAGE Remeron really starts to increase NE? (I know it may be an individual type of thing, dependent on the person...but is there some 'ballpark' dose where the NE really INCREASES? (Thank you as always! Mucho appreciato)
Posted by DSCH on August 19, 2003, at 14:42:29
In reply to Dsch, Re: Hmmmmmmmmm, posted by McPac on August 19, 2003, at 12:31:20
OK, definition time...
Two neurons are seperated by a synaptic gap. Neurotransmitters transfer information across the gap. There is some storage within the neuron from which these molecules get released and receptors they plug into on the far side to transfer the message.
Some of the molecules released from storage to relay a message are sucked back into the same storage space before they can cross the gap. This is called 'reuptake'. A REUPTAKE INHIBITOR is supposed to reduce the chances of this ocurring, thus causing an increase in signal conveyed across the gap.
A RELEASE AGENT stimulates the neuron to release more molecules of a given type from storage each time a message needs to be conveyed and thus increases the signal that way. Note if the storage is running low, this isn't going to accomplish much, so your results from this sort of drug are limited by your processing of amino acids to synthesize the neurotransmitters in the first place.
These two types focused on the upstream side of the synaptic gap. Downstream, where the receptors are, you can do two other things. You can introduce molecules that will temporary bind into given types of receptor(s) and stimulate it (thus acting as a stand-in for the associated neutrotransmitter molecule) and these are called AGONISTS and increase signal. Or you can use a molecule that will also temporarily bind into given types of receptor(s), but not stimulate it and also shield the receptor from being stimulated by the upstream neuron's own molecules while it is bound in. You can decrease signal with these and they are called ANTAGONISTS.
Agonist and Antagonists effects vary depending upon what sort of activity occurs if a particular class or classes of receptors is stimulated/blocked-off.
In the case of Remeron (according to SLS's chart), it is an antagonist of the following receptor types: NE-alpha2, 5-HT2a, 5-HT2c, 5-HT3, and H1. The only one I am familar with is H1, which is for histamine. You'd be less likely to have an asthma or allergy attack on Remeron but also tend to be sedated as histaminergic neurons in the hypothalamus help to regulate the sleep/wake cycle and stimulate the pre-frontal cortex to full attention. I'm not sure what those others do though. I'm afraid I'm out of my current knowledge range at that point. :-p
Hope that helps.
Posted by McPac on August 19, 2003, at 21:36:34
In reply to Reuptake Inhibition, Release, Agonist, Antagonist » McPac, posted by DSCH on August 19, 2003, at 14:42:29
This is the end of the thread.
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