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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Franz on August 20, 2005, at 14:30:05
Hello SLS and everyone reading,
Could you please explain in your Psychiatric and Associated Drugs chart (which is very helpful)
http://sl.schofield3.home.att.net/medicine/psychiatric_drugs_chart.htmlwhich is the difference between 5-HT release (alprazolam) and 5-HT increase (clonazepam)?.
Does it means alprazolam releases what already is there but clonazepam induces production?. What clinical differences can this cause?.
Thanks
Posted by SLS on August 20, 2005, at 21:23:40
In reply to Psychiatric and Associated Drugs chart -SLS, posted by Franz on August 20, 2005, at 14:30:05
> Hello SLS and everyone reading,
>
> Could you please explain in your Psychiatric and Associated Drugs chart (which is very helpful)
> http://sl.schofield3.home.att.net/medicine/psychiatric_drugs_chart.html
>
> which is the difference between 5-HT release (alprazolam) and 5-HT increase (clonazepam)?.Sometimes, science has not reached the point at which absolute understanding prevails. The best that I could glean from the literature at the time I put the chart together is that clonazepam somehow potentiated serotonergic neurotransmission and/or increased 5-HT content, but that the mechanism by which this occurs remained obscure. Some investigations actually report the reverse with clonazepam, wherein synaptic concentration is decreased while postsynaptic 5-HT1a receptors are downregulated. This might help explain why some people experience depression when taking clonazepam, but not other BZDs.
- Scott
Posted by Franz on August 21, 2005, at 8:21:07
In reply to Re: Psychiatric and Associated Drugs chart -SLS, posted by SLS on August 20, 2005, at 21:23:40
> > Hello SLS and everyone reading,
> >
> > Could you please explain in your Psychiatric and Associated Drugs chart (which is very helpful)
> > http://sl.schofield3.home.att.net/medicine/psychiatric_drugs_chart.html
> >
> > which is the difference between 5-HT release (alprazolam) and 5-HT increase (clonazepam)?.
>
> Sometimes, science has not reached the point at which absolute understanding prevails. The best that I could glean from the literature at the time I put the chart together is that clonazepam somehow potentiated serotonergic neurotransmission and/or increased 5-HT content, but that the mechanism by which this occurs remained obscure. Some investigations actually report the reverse with clonazepam, wherein synaptic concentration is decreased while postsynaptic 5-HT1a receptors are downregulated. This might help explain why some people experience depression when taking clonazepam, but not other BZDs.
>
>
> - ScottThanks Scott
I have tried both and alprazolam has a more positive effect on mood for me, maybe this is the explanation?.
Posted by med_empowered on August 21, 2005, at 14:29:40
In reply to Re: Psychiatric and Associated Drugs chart -SLS » SLS, posted by Franz on August 21, 2005, at 8:21:07
hi! Cool chart. As the benzos go, alprazolam has a bad reputation for "addiction" (the real problem I think is a combination of rebound anxiety between doses and poor prescribing habits on the part of docs--rx'ing to those who would be better served with therapy, and discontinuing the medication in those who would be best served by continuing it...it also seems some docs are really, really bad at benzo tapers). Alprazolam also has some data that indicate a dose-dependent anti-depressant effect. One study I read used large doses of alprazolam (10mgs+) for treating depressive symptoms in schizophrenia, which are *incredibly* difficult to treat. Anyway, the results were good; those who made it to the end of the study felt better, functioned better, and required lower doses of neuroleptics and fewer add-on meds. There's data showing that at lower doses, alprazolam can have a soothing, calming antidepressant effect...it also works *fast*, a major bonus for the chronically depressed. Clonazepam seems to make lots of people depressed, but apparently it helps treat some "treatment-resistant" depression cases...my hunch would be that that its "mood-stabilizing" (primarily anti-manic) properties "smooth out" certain symptoms in those with soft bipolar so they respond better to additional forms of intervention.
This is the end of the thread.
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