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Re: A collection of random med questions merpmerp

Posted by g_g_g_unit on January 3, 2011, at 19:32:05

In reply to A collection of random med questions, posted by merpmerp on January 3, 2011, at 10:24:35

Sorry, I'm still a pharmacological amateur, so I'm sure someone else could offer you more comprehensive replies . . but . .

> -Many TCAs work on both serotonin and norepinephrine. So how do they differ in mechanism from Effexor, Pristiq, Cymbalta, etc.?

TCA's are generally 'dirtier' and more scattershot in their binding affinities than the current class of SNRI's: so, in addition to their action at the serotonin and norepinephrine pumps, they also carry (sometimes unwanted) anti-histaminergic and anti-cholinergic effects, which may contribute to their therapeutic effects (i.e. sedation, lessening of rumination, etc.). Unlike SNRI's, they also have the additional property of being 5-HT2C and 5-HT2A antagonists.
>
> -How do TCAs as a class differ in their subjective effects from SSRIs? (I mean I've read things like they are not often subject to 'poopout' and they work better for melancholic depression - which I have - than for atypical depression.)

According to studies, TCAs are more suited to melancholic depression, whereas SSRIs (Prozac being the exception) are favored in atypical depression. TCAs may enhance sleep quality and onset, whereas SSRIs will often cause insomnia and compromise sleep integrity. TCAs are supposedly more 'brightening' and less emotionally numbing than SSRIs.

>
> -I keep reading conflicting things about Wellbutrin. Some sources say it works mainly on norepinephrine, other sources say it mainly works on dopamine. Which is it?

Wellbutrin is a norepinephrine releaser.

>
> -If Wellbutrin affects dopamine, might it help with attention and motivation? (I'm struggling with this a lot but don't want to mess with Ritalin or Adderall.)

There are conflicting accounts re: Wellbutrin and attention. Some people find it works well for that purpose; some people find that they become intolerably foggy (most likely due to the Nicotinic receptor antagonism). You'd have to try it and find out.

>
> -Is Wellbutrin as often subject to nastiness like *s* ideation or 'poopout', which I've had with SSRIs?

I'm not so sure about that, sorry.

>
> Thank you.

 

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