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Re: Pamelor - How does it work

Posted by KaraS on July 15, 2004, at 1:33:28

In reply to Re: Pamelor - How does it work, posted by King Vultan on July 11, 2004, at 0:50:02

> > Just wondering how Pamelor works chemically in the brain...Thanks
> It's a selective norepinephrine reuptake inhibitor, meaning it selectively targets the neurotransmitter norepinephrine by a factor of at least 10x more than it does serotonin. SSRIs such as Lexapro and Prozac OTOH target serotonin.
> Pamelor (nortriptyline) also blockades histamine receptors (meaning it is an antihistamine), which is responsible for some of the sedative and anti-anxiety effects of the drug. It also has a couple of other blockades of note--it blockades serotonin-2 receptors, which has a number of effects, including adding to the sedative and anti-anxiety effects of the histamine blockade. It also blockades alpha-1 adrenergic receptors, which is responsible for the lower blood pressure and dizziness that some experience on the drug, as well as further adding to sedation.
> So the drug has a totally different pharmacologic profile from that of the common SSRIs, which have none of these characteristics. In general, Pamelor is sedating, calming, and works on a different neurotransmitter than do the SSRIs, albeit, one that is equally or more important. It can be a good choice for people who have a lack of response to SSRIs or tolerate SSRI side effects poorly.
> Todd

Why does it produce tachycardia in some people (like me) and not in others? (That's probably not a fair question since many of us can be fairly idiosyncratic in our reactions.) Also, I'm assuming that the tachycardia is in response to NE activity and I'm wondering if I will react to all meds that act on NE that same way (even though I desperately need to stimulate NE activity).




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