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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by SLS on September 9, 2005, at 8:10:08
Would anyone like to comment on the use of reserpine to treat depression?
Thanks.
- Scott
Posted by linkadge on September 9, 2005, at 10:41:21
In reply to Reserpine for depression, posted by SLS on September 9, 2005, at 8:10:08
I thought this agent caused depression ?
In conjunction with an MAOI?
Did not know it could be used for depression.
Linkadge
Posted by SLS on September 9, 2005, at 10:59:21
In reply to Re: Reserpine for depression, posted by linkadge on September 9, 2005, at 10:41:21
> I thought this agent caused depression ?
It does.
> In conjunction with an MAOI?
I don't know how safe it would be. The initial flood of catecholamines might produce a hypertensive event. However, I am yet dubious that this is a genuine concern.
> Did not know it could be used for depression.It has been used to treat resistant depression by being administered for 3-4 days while taking a TCA. It has also been used as a pretreatment to the initiation of TCA treatment.
What I am wondering is if the destruction of possibly defective synaptic vesicles might provoke the manufacturing of new ones with improved function, especially in an environment that is being altered by an antidepressant.
My renewed interest in reserpine and presynaptic terminal function comes from the observation that Keppra (levetiracetam) has produced a mild antidepressant effect for me. Keppra binds to a synaptic vesicle protein - SV2A. This transmembrane protein probably serves to modulate vesicular release and the influence that Ca2+ ions have on vesicular function.
- Scott
Posted by Racer on September 9, 2005, at 13:15:36
In reply to Reserpine for depression, posted by SLS on September 9, 2005, at 8:10:08
I don't know anything about using it for depression -- actually, I don't know anything about using it in humans :^0 -- but I do know that it's got a problem when used in horses:
Reserpine is sometimes used as a long-term sedative in horses, for example when they're being shipped long distances, or recovering from surgery or an injury. It's effective enough, but has one danger: if the horse is chilled or stressed, he can develop a weird kind of pneumonia that has a very bad habit of being quickly fatal. Quickly as in by the time you realize there's something really wrong and the vet gets there, it's often too late to do much of anything. I don't know the mechanisms, and I do know that horses are kinda prone to weird pneumonias due to their size and weight, but that's what's always kept me from using reserpine. I don't know if any such thing would be a problem in people, though.
In horses, because their bodies are large and heavy, their lungs can be stressed fairly easily -- we don't like to see horses lie down too long, for example, because their lungs can't deal with the pressure of all that weight for too many hours. (Horses will doze on their feet, and even sleep that way, but they also have to lie down to get good quality rest. They've evolved to sleep in short bursts, though, because they're prey animals, and sleeping too long or too deeply at any one time puts them at risk from predators.) If they stay down too long, they'll get mechanical pneumonia as fluid builds up in the lungs.
I know that's not what you were asking, but it's the only thing I know about the drug in question. Hope it's at least interesting for you...
Posted by Ilene on September 9, 2005, at 15:49:59
In reply to Reserpine for depression, posted by SLS on September 9, 2005, at 8:10:08
> Would anyone like to comment on the use of reserpine to treat depression?
>
> Thanks.
>
>
> - ScottReserpine is supposed to cause depression in some people.
I.
Posted by zeugma on September 9, 2005, at 18:21:36
In reply to Re: Reserpine for depression » SLS, posted by Ilene on September 9, 2005, at 15:49:59
hi Scott,
you are a true troublemaker- I had sworn off the med board, but this thread is too delicious.
There was a study done in the mid 50's at the Maudsley psych hospital that was one of the first randomized placebo-controlled tests ever conducted on depression- and the result was the that the drug was an anxiolytic and antidepressant. The drug also had a reputation as a neuroleptic and was used as such by Nathan Kline, discoverer of the AD effects of the first MAOI.
On the PI sheet for nortriptyline, it is reported that reserpine in combination with a TCA can produce a 'stimulating' effect.
Now that I've gratified you with historical arcana, can either you or linkadge (or possibly Chairman MAO) explain how modafinil works. Other than the headache-inducing effects it shares with MSG-laced Chinese food. The local No.1 Chinese Restaurant never did much for my wakefulness.
-z
Posted by linkadge on September 9, 2005, at 20:20:07
In reply to Re: Reserpine for depression » SLS, posted by Racer on September 9, 2005, at 13:15:36
The book I have here (Drugs and the Brain - Solomon H. Snyder) theoriezes that reserpine causes the primary monoamines to 'leak' out of the storage vessicles.
It seems to say that on its own it can cause depression because the neurotransmitter is not quickly released (transmitted) it gets quickly metabolized, but when combined with a MAOI or uptake inhibitor the net effect is more synaptic monoamines.
Linkadge
Posted by SLS on September 10, 2005, at 7:53:24
In reply to Re: Reserpine for depression, posted by zeugma on September 9, 2005, at 18:21:36
Thanks, Zeugma.
> There was a study done in the mid 50's at the Maudsley psych hospital that was one of the first randomized placebo-controlled tests ever conducted on depression- and the result was the that the drug was an anxiolytic and antidepressant. The drug also had a reputation as a neuroleptic and was used as such by Nathan Kline, discoverer of the AD effects of the first MAOI.
I was unaware of the study you described. I find it exciting that reserpine by itself showed an antidepressant effect in some individuals. It would be interesting to know whether or not there was a latency between the initiation of treatment and therapeutic effect. I would expect the anxiolytic and antipsychotic effects to be immediate, but not the antidepressant effect.
I was once under the care of a Nathan Kline protege named Baron Shopsin.
> can either you or linkadge (or possibly Chairman MAO) explain how modafinil works. Other than the headache-inducing effects it shares with MSG-laced Chinese food. The local No.1 Chinese Restaurant never did much for my wakefulness.
Modafinil has been attributed with the ability to increase the release of glutamate in the hypothalamus. I think this is the property first hypothesized to be associated with its promotion of wakefulness. However, now most believe that it stimulates the secretion of hypocretin (orexin), a hypothalamic neurohormone that acts on the reticular formation in the thalamus and areas of the cerebral cortex. These would be the modes by which modafinil would treat narcolepsy. For depression, it is the promotion of glutamate release in the thalamus and hippocampus that might give rise to a reduction in anhedonia and depression in general, as activation of these areas yields increases in dopamine release in the nucleus accumbens.
- Scott
Posted by Seamus2 on September 10, 2005, at 8:09:35
In reply to Reserpine for depression, posted by SLS on September 9, 2005, at 8:10:08
AIR, it dumps vesicle contents and inhibits production of new amines, like metryrosine, but I don't recall the method.
Long time ago I used it for a few days to jump-start Nardil and did notice a stimulating effect. Had I taken more, I suspect I might have gone manic.
Posted by SLS on September 10, 2005, at 8:25:44
In reply to Re: Reserpine for depression, posted by Seamus2 on September 10, 2005, at 8:09:35
Thanks, Seamus.
> AIR, it dumps vesicle contents and inhibits production of new amines, like metryrosine, but I don't recall the method.
>
> Long time ago I used it for a few days to jump-start Nardil and did notice a stimulating effect. Had I taken more, I suspect I might have gone manic.
>
Posted by ed_uk on September 10, 2005, at 9:20:09
In reply to Re: Reserpine for depression, posted by SLS on September 10, 2005, at 7:53:24
Hi Scott,
How easy would it be for you to get hold of reserpine? Is it available as a generic in the US? If not, you might still be able to get hold of a reserpine/diuretic combination. Perhaps as a generic or maybe a brand.
Are any of the following diuretic/reserpine brands still available in the US?
Demi-Regroton, Diupres, Diutensen-R, Hydro-Serp, Hydropres, Hydroserpine, Metatensin, Regroton, Renese R, Salutensin.
Tetrabenazine (Nitoman, Xenazine) is available in Canada and the UK. It has a lot in common with reserpine. It is mainly used to treat severe movement disorders, notably tardive dyskinesia and Huntington's disease. Depression is a common side effect of tetrabenazine.
'Tetrabenazine and reserpine act by depleting the supply of dopamine, norepinephrine, and serotonin in nerve terminals, thereby decreasing the amount available for release. Tetrabenazine may also block both D1 and D2 receptors.'
Posted by ed_uk on September 10, 2005, at 9:26:15
In reply to Re: Reserpine for depression » SLS, posted by ed_uk on September 10, 2005, at 9:20:09
>Is it available as a generic in the US?
Hmmm. Perhaps you can still get the 250mcg reserpine tablets.
~ed
Posted by SLS on September 10, 2005, at 9:36:10
In reply to Re: Reserpine for depression, posted by SLS on September 9, 2005, at 10:59:21
> > In conjunction with an MAOI?
> I don't know how safe it would be. The initial flood of catecholamines might produce a hypertensive event.
I just read that reserpine does not cause catecholamines to be released into the synapse. It prevents catecholamine uptake into the vesicles by inactivating the vesicular pump. This results in catecholamine depletion as the unprotected catecholamine in the cytosol is subject to deamination by MAO.
- Scott
Posted by SLS on September 10, 2005, at 9:38:53
In reply to Re: Reserpine for depression, posted by SLS on September 10, 2005, at 9:36:10
Does anyone know the rate of synaptic vesicle turnover? How many days does it take to manufacture and replace old vesicles?
Thanks.
- Scott
Posted by Chairman_MAO on September 13, 2005, at 14:10:47
In reply to Reserpine for depression, posted by SLS on September 9, 2005, at 8:10:08
Reserpine destroys the neurotransmitter storage vesicles in monoaminergic neurons! This INDUCES depression. Stay away from rauwoulfia alkaloids (except rauwoulscine, and perhaps others)!
Posted by Chairman_MAO on September 13, 2005, at 14:12:19
In reply to Re: Reserpine for depression, posted by SLS on September 9, 2005, at 10:59:21
Re: your theory. I will ask a psychopharm professor about it.
All-in-all, I think there are better things to try. This seems very sketchy to me.
Posted by Chairman_MAO on September 13, 2005, at 14:15:19
In reply to Re: Reserpine for depression - vesicular turnover?, posted by SLS on September 10, 2005, at 9:38:53
I believe this takes several weeks, if I remember my schooling correctly.
This is the end of the thread.
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