![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by sac on August 14, 2020, at 9:57:49
I'm just wondering if there are instances where dopamine agonists and antagonists might be used together in psychiatry? Mainly, I'm wondering if the blunted effect one might get from DA antagonists might be helped by adding in a DA agonist.
Posted by undopaminergic on August 14, 2020, at 10:15:37
In reply to Dopamine agonists and antagonists...used together?, posted by sac on August 14, 2020, at 9:57:49
> I'm just wondering if there are instances where dopamine agonists and antagonists might be used together in psychiatry? Mainly, I'm wondering if the blunted effect one might get from DA antagonists might be helped by adding in a DA agonist.
>Yes, but it is pretty rare. When an agonist is added, it may be necessary to increase the dose of the antagonist, if there is an increase in "positive" symptoms (ie. psychosis).
-undopaminergic
Posted by SLS on August 15, 2020, at 13:32:44
In reply to Re: Dopamine agonists and antagonists...used together?, posted by undopaminergic on August 14, 2020, at 10:15:37
> > I'm just wondering if there are instances where dopamine agonists and antagonists might be used together in psychiatry? Mainly, I'm wondering if the blunted effect one might get from DA antagonists might be helped by adding in a DA agonist.
> >
>
> Yes, but it is pretty rare. When an agonist is added, it may be necessary to increase the dose of the antagonist, if there is an increase in "positive" symptoms (ie. psychosis).
>
> -undopaminergicI think a partial DA agonist might be a better way to go.
Vraylar; Abilify; Rexulti
Vraylar was taking me down a dark path, so I aborted the trial after 2-3 days. I knew that Vraylar has an incredibly long half-life, so I didn't want to commit myself to 2 weeks of misery.
-Scott
Posted by undopaminergic on August 16, 2020, at 4:28:24
In reply to Re: Dopamine agonists and antagonists...used together?, posted by SLS on August 15, 2020, at 13:32:44
> > > I'm just wondering if there are instances where dopamine agonists and antagonists might be used together in psychiatry? Mainly, I'm wondering if the blunted effect one might get from DA antagonists might be helped by adding in a DA agonist.
> > >
> >
> > Yes, but it is pretty rare. When an agonist is added, it may be necessary to increase the dose of the antagonist, if there is an increase in "positive" symptoms (ie. psychosis).
> >
> > -undopaminergic
>
> I think a partial DA agonist might be a better way to go.
>
> Vraylar; Abilify; Rexulti
>It's worth a try. But they won't substitute for something more potent, such as dextroamphetamine, which among other things can improve working memory.
-undopaminergic
Posted by SLS on August 16, 2020, at 22:31:30
In reply to Re: Dopamine agonists and antagonists...used together?, posted by undopaminergic on August 16, 2020, at 4:28:24
> > > > I'm just wondering if there are instances where dopamine agonists and antagonists might be used together in psychiatry? Mainly, I'm wondering if the blunted effect one might get from DA antagonists might be helped by adding in a DA agonist.
> > > >
> > >
> > > Yes, but it is pretty rare. When an agonist is added, it may be necessary to increase the dose of the antagonist, if there is an increase in "positive" symptoms (ie. psychosis).
> > >
> > > -undopaminergic
> >
> > I think a partial DA agonist might be a better way to go.
> >
> > Vraylar; Abilify; Rexulti
> >
>
> It's worth a try. But they won't substitute for something more potent, such as dextroamphetamine, which among other things can improve working memory.
>
> -undopaminergicYou are right about labeling amphetamine an agonist. I have become accustomed to using "agonist" and "antagonist" as though they referred only to neurotransmitter receptor binding. That's the way it is currently used, but it was more generalized at first.
I would still consider using one of the dopamine partial agonists before abandoning the idea of manipulating the dopamine synapse. A partial agonist will act to block DA receptors from being stimulated when the levels of dopamine in the synapse is too high, and act to stimulate DA receptors when the levels of dopamine are too low. That was the initial characterization of the mechanism of action of these drugs. Early on, Steven Stahl labelled Abilify (aripiprazole) as a dopamine system stabilizer (DSS). I imagine the theories are more complex now.
For now, it appears that Abilify is the best of the bunch for depression at low to moderate dosages.
- Scott
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.