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Re: Medications that don't touch the 5HT1 receptor?

Posted by tom2228 on June 4, 2015, at 0:43:49

In reply to Re: Medications that don't touch the 5HT1 receptor? tiopenster, posted by SLS on June 2, 2015, at 6:26:15

This kind of thinking is unproductive. Believing that the effects, or lack thereof, at the 5-HT1 receptor are responsible for your response to these medications is as logical as guessing that they don't work because they don't affect bloodflow to your toes. Guessing the 5-HT1 receptor is about as random any of the other receptors that these medications may or may not affect.

And Remeron likely does affect serotonin release at 5-HT1a neurons via downstream effects from alpha-2 antagonism, Geodon surely affects the 5-HT1a receptor, as are desipramine and nortriptyline SRIs. A med is either going to work for you or it's not. For example, I react badly to bupropion (Wellbutrin) -- this could lead me to determine that norepinephrine reuptake inhibition was responsible for this. The reality is that I respond favorably to other medications that inhibit norepineprhine reuptake, such as desipramine, nortriptyline, and select stimulants. So I could take another stab at it and say hey, well maybe it's that Wellbutrin is a dopamine reuptake inhibitor.... while truthfully I do respond to other meds that block dopamine uptake. All my 3 failed trails with Wellbutrin indicate is that I do not respond to Wellbutrin.

Especially for meds that have multiple receptor targets, picking one or two and generalizing from there is not helpful. Two or more drugs may affect very similar receptor targets yet produce significantly different effects and responses for any given person. A more realistic way of thinking about this is that each medication has a unique neurochemcial signature, affecting different combinations of neurochemical targets to varying degrees (affinities). For example, take Cymbalta and desipramine, two drugs that affect both reuptake of serotonin and norepineprhine, but to different extents -- Cymbalta affecting the reuptake of serotonin to a greater extent than that of norepinephrine, and the opposite for desipramine. Bearing in mind other explanations such as the fact that particularly desipramine has other neurochemical targets, this difference in balance among the affects of the different actions of these drugs *may* offer an explanation of why a particular person may respond to one drug and not the other.

If you go a med trial thinking that it's not going to work out because of a particular chemical property, well, you're f*ck*d.

In the end it's trial and error, which is difficult to sit with. Just don't give up. You'll find something that works for you. It's taken me 10 years and 52 medications but I'm at last responding to treatment, very very well! Good luck



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poster:tom2228 thread:1079343
URL: http://www.dr-bob.org/babble/20150520/msgs/1079431.html