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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 John Doughboy on May 13, 2008, at 14:11:05
I've only ever used SSRI (or low dose SNRI) as antidepressants, and I basically understand how they work. The massive amounts of serotonin in the synapses from the uptake pump being blocked lets all that serotonin hit the post synaptic receptors. After several weeks, different sub- types of these receptors upregulate or downregulate (becoming more or less sensitive,respectively) Some receptors, like many of the sub-types of the 5HT-1 upregulate,which helps with anxiety and whatnot. Much of the 5HT-2 downregulate,which can be seen as a good think because it helps with obsessions in OCD, and a bad thing because it may be responsible for some of the sexual side effects and it may act as a hetero receptor so that less dopamine releases downstream.
I know it's way more complicated than that and I'm leaving all kinds of things out like "the neurogenesis theory", but you get the point.
How the hell do norepinephrine reuptake blocking meds work? I hear they are good for people who need more drive,motivation,and energy, but I don't see how they do that. Do they just leave so much extra NE hanging around that all the NE receptors downregulate over time and become less sensitive? That would make sense because they are used for anxiety and some people even claim they make them slightly sleepy,but how does that work for motivation and anhedonia and stuff like that? Do these meds make more dopamine available downstream after chronic dosing or anything like that?
Someone please explain this to me. I'm starting Wellbutrin and the dopamine component of that med I won't even get started on. It just seems like any other drug like that(methylphenidate,amphetamine) would just decrease dopamine over time.
Are there NE and DA sub-types that have different (opposing) properties like the serotonin system?
Please help me understand how NE/DA ADs work!
Posted by bleauberry on May 16, 2008, at 4:08:18
In reply to mechism of action of norepinephrine selective ADs, posted by John Doughboy on May 13, 2008, at 13:59:44
Good questions! I wish I had the answers. Someone here probably has some good explanations.
As you said, things are complicated. For example, while it generally thought that NE/DA is related to anhedonia/energy and such, there are people who get lethargic and anhedonic instead. While a lot of us seem to get dull and numbed on SSRIs, there are some people who just come to life full of joy and emotion.
I can understand how acute NE or DA can boost energy or mood in many people, but how it works on a chronic basis I have no idea. Surely feedback loops must kick in, receptors reregulate one way or the other, downstream effects are put into motion, and of course it is impossible to affect one neurotransmitter system without indirectly impacting the others. Way over my head.
Posted by Molybdenum on May 16, 2008, at 4:08:19
In reply to mechism of action of norepinephrine selective ADs, posted by John Doughboy on May 13, 2008, at 13:59:44
I have found this book to be useful. My knowledge of chemistry is very limited, but maybe it would answer your questions :)
"Stephen M Stahl Essential Psychopharmacology"
Here's the PDF:
http://www.fulldls.com/torrent-ebooks-342648.html
Posted by Amigan on May 16, 2008, at 4:08:19
In reply to Re: mechism of action of norepinephrine selective ADs » John Doughboy, posted by Molybdenum on May 14, 2008, at 20:44:55
> I have found this book to be useful. My knowledge of chemistry is very limited, but maybe it would answer your questions :)
>
> "Stephen M Stahl Essential Psychopharmacology"
>
> Here's the PDF:
>
> http://www.fulldls.com/torrent-ebooks-342648.html
>I think that i have this book. It's good.
This is the end of the thread.
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