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Re: Vortioxetine (Brintellix-Trintellix) undopaminergic

Posted by SLS on November 18, 2021, at 12:21:53

In reply to Re: Vortioxetine (Brintellix-Trintellix) SLS, posted by undopaminergic on November 18, 2021, at 10:25:47

> > That's a great perspective.

> What are you referring to?

> > Prior to the 1950s, there were no true antidepressants.

> Well, the classification as antidepressant or something else is pretty arbitrary. For example, some primarily antihistaminic drugs have been classified as antidepressants.

Arbitrary? In what way? I think the most histaminergic tricyclic is doxepin. Were the clinical trial directors providing the drug company with fraudulent information when the company reported sufficient efficacy for the FDA to approve it as an antidepressant? How many antipsychotics are histaminergic? Is the classification of quetiapine as an antipsychotic arbitrary? How many drugs, after their FDA approval for one indication, were found to be effective for another indication? Drugs are repurposed all of the time.

Prazosin (Minipress) was approved for hypertension decades ago. In the last 10 years, it has been used to treat PTSD, especially nightmares. I don't think the FDA has approved prazosin for PTSD yet.

By the way, if you know anyone who is taking prazosin 3 mg at bedtime only for nightmares, and they suffer residual anxiety or depression during the day, prazosin can significantly relieve those symptoms by taking it 5-10 mg t.i.d. 30 mg/day is probably the sweet-spot, but a few researchers have gone as high as 40 mg/day.

I don't know why you challenge the FDA for its approval practices and established indications.

> > Amphetamines and cocaine had been used in the past. Chlorpromazine (Thorazine), the first antipsychotic, was first introduced in 1952 in France. The first antidepressant approved for depression was iproniazid, a MAOI, in 1958. Imipramine, the first tricyclic, was introduced in 1959. MAOIs and TCAs. That was it. SSRIs didn't emerge in the United States until the approval of fluoxetine in 1987.

> Right. And they had chloral hydrate before barbiturates!

Chloral hydrate is not pleasant. I have taken it.

Doxepin is a pretty crappy antidepressant. It had become used more often as a sleep-aid than an antidepressant. However, you never know how any many individuals will respond to an approved antidepressant - like doxepin. I don't happen to know how many respond to doxepin. Maybe no one, but that is not the issue you brought up.

I don't mind your scrutinization. It makes for good dialectic.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

The only thing necessary for the triumph of evil is that good men do nothing.

 

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poster:SLS thread:1117445
URL: http://www.dr-bob.org/babble/20211102/msgs/1117490.html