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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by ace on March 28, 2003, at 0:58:41
I've heard conflicting reports on this.
Whats the real 'lowdown'?
Ace.
Posted by cybercafe on March 28, 2003, at 16:47:02
In reply to Is Zyprexa a serotonin agonist or antagonist?, posted by ace on March 28, 2003, at 0:58:41
> I've heard conflicting reports on this.
>
> Whats the real 'lowdown'?
>
>
> Ace.zyprexa is a serotonin 2A antagonist which makes it a serotonin agonist
i.e. when serotonin is blocked from binding to the 2A receptors, there is more available in the synaptic cleft to bind to receptors that don't suck (2A sucks)
where the definition of suck is - causes sexual dysfunction, anxiety, hallucinations, nausea and so forth
i think 5ht2a receptors are the crappiest serotonin receptors
i think 5ht1a post-synaptic receptors are the coolest receptorsComments?
Posted by zeugma on March 28, 2003, at 19:55:55
In reply to Re: Is Zyprexa a serotonin agonist or antagonist?, posted by cybercafe on March 28, 2003, at 16:47:02
1A agonism, as provided by buspirone or the eagerly-awaited gepirone, is pretty cool.
2A antagonism is nothing to complain about either, though I'd hesitate to take an AP solely for that effect, there's plenty of other ways to get it:
e.g. Serzone and Remeron, or some of the much-maligned old tricyclics: http://www.psychotropical.com/notes/628.html
Posted by jonh kimble on March 29, 2003, at 1:26:45
In reply to Re: Is Zyprexa a serotonin agonist or antagonist? » cybercafe, posted by zeugma on March 28, 2003, at 19:55:55
Posted by cybercafe on March 29, 2003, at 2:14:58
In reply to Re: Is Zyprexa a serotonin agonist or antagonist? » cybercafe, posted by zeugma on March 28, 2003, at 19:55:55
> 1A agonism, as provided by buspirone or the eagerly-awaited gepirone, is pretty cool.
>
> 2A antagonism is nothing to complain about either, though I'd hesitate to take an AP solely for that effect, there's plenty of other ways to get it:
>
> e.g. Serzone and Remeron, or some of the much-maligned old tricyclics: http://www.psychotropical.com/notes/628.html
>
>ummm.. in my case, i havn't heard any mood stabilizing effects of serzone or remeron, so they're not appropriate
in ace's case, they would be contraindicated with an MAOI
i really wish they had gotten pure 5HT2A antagonist out (ritanserin, ketanserin, etc) but i hear they didnt' do well in trials
so maybe they wouldn't be that good after all
Posted by zeugma on March 29, 2003, at 8:37:55
In reply to Re: How about seroquel? (nm), posted by jonh kimble on March 29, 2003, at 1:26:45
Posted by Ame Sans Vie on March 29, 2003, at 11:01:31
In reply to Re: How about seroquel? (nm), posted by jonh kimble on March 29, 2003, at 1:26:45
Posted by zeugma on March 29, 2003, at 16:20:11
In reply to Re: Is Zyprexa a serotonin agonist or antagonist?, posted by cybercafe on March 29, 2003, at 2:14:58
> > 1A agonism, as provided by buspirone or the eagerly-awaited gepirone, is pretty cool.
> >
> > 2A antagonism is nothing to complain about either, though I'd hesitate to take an AP solely for that effect, there's plenty of other ways to get it:
> >
> > e.g. Serzone and Remeron, or some of the much-maligned old tricyclics: http://www.psychotropical.com/notes/628.html
> >
> >
>
> ummm.. in my case, i havn't heard any mood stabilizing effects of serzone or remeron, so they're not appropriate
>
> in ace's case, they would be contraindicated with an MAOII would be very wary of mixing an AP, even a new atypical one, with an MAOI. The side effects of either are potentially so serious- hypertensive crisis and serotonin syndrome for the one, irreversible TD for the other- that even if not absolutely contraindicated (I have no idea), it's just asking for neurological disaster.
>
> i really wish they had gotten pure 5HT2A antagonist out (ritanserin, ketanserin, etc) but i hear they didnt' do well in trials
> so maybe they wouldn't be that good after allSeems that 5HT2A by itself just helps with sleep rhythms (isn't that what ritanserin is for?) This can be very helpful for depressed people but I doubt it's enough to remit depression by itself.
Posted by cybercafe on March 30, 2003, at 0:21:18
In reply to Re: Is Zyprexa a serotonin agonist or antagonist? » cybercafe, posted by zeugma on March 29, 2003, at 16:20:11
> I would be very wary of mixing an AP, even a new atypical one, with an MAOI. The side effects of either are potentially so serious- hypertensive crisis and serotonin syndrome for the one, irreversible TD for the other- that even if not absolutely contraindicated (I have no idea), it's just asking for neurological disaster.
i felt great on parnate + zyprexa ... i know they are both serious medications... but i don't see a reason to believe that the risks increase when they are taken together
> Seems that 5HT2A by itself just helps with sleep rhythms (isn't that what ritanserin is for?) This can be very helpful for depressed people but I doubt it's enough to remit depression by itself.
i don't know anything about ritanserin ... where did you hear about it's use in sleep rhythms?
Posted by zeugma on March 30, 2003, at 15:53:10
In reply to Re: Is Zyprexa a serotonin agonist or antagonist?, posted by cybercafe on March 30, 2003, at 0:21:18
> > I would be very wary of mixing an AP, even a new atypical one, with an MAOI. The side effects of either are potentially so serious- hypertensive crisis and serotonin syndrome for the one, irreversible TD for the other- that even if not absolutely contraindicated (I have no idea), it's just asking for neurological disaster.
>
> i felt great on parnate + zyprexa ... i know they are both serious medications... but i don't see a reason to believe that the risks increase when they are taken together
>
That's good to hear. I believe you have been dx with ADD? Was the Parnate helpful for this disorder?> > Seems that 5HT2A by itself just helps with sleep rhythms (isn't that what ritanserin is for?) This can be very helpful for depressed people but I doubt it's enough to remit depression by itself.
>
> i don't know anything about ritanserin ... where did you hear about it's use in sleep rhythms?
>Ritanserin increases slow-wave sleep: http://link.springer-ny.com/link/service/journals/00213/contents/00/00633/s002130000633cl
It appears from this study that 5HT-2A antagonism won't help with anxiety or depression but can help with specific sleep problems.
Posted by zeugma on March 30, 2003, at 16:00:19
In reply to Re: Is Zyprexa a serotonin agonist or antagonist? » cybercafe, posted by zeugma on March 30, 2003, at 15:53:10
http://link.springer-ny.com/link/service/journals/00213/contents/00/00633/s002130000633ch002.html
That took me almost as long to type as it did to find, so it better work this time!
Posted by cybercafe on March 30, 2003, at 19:31:03
In reply to Re: Is Zyprexa a serotonin agonist or antagonist? » cybercafe, posted by zeugma on March 30, 2003, at 15:53:10
> > i felt great on parnate + zyprexa ... i know they are both serious medications... but i don't see a reason to believe that the risks increase when they are taken together
> >
> That's good to hear. I believe you have been dx with ADD? Was the Parnate helpful for this disorder?i'd say no.. but it was a lot better than feeling depressed.
> > > Seems that 5HT2A by itself just helps with sleep rhythms (isn't that what ritanserin is for?) This can be very helpful for depressed people but I doubt it's enough to remit depression by itself.
> >
> > i don't know anything about ritanserin ... where did you hear about it's use in sleep rhythms?
> >
>
> Ritanserin increases slow-wave sleep: http://link.springer-ny.com/link/service/journals/00213/contents/00/00633/s002130000633cl
>
> It appears from this study that 5HT-2A antagonism won't help with anxiety or depression but can help with specific sleep problems.hmmm.. i notice an antidepressant effect after i take 2.5 mg zyprexa ... maybe it's a placebo effect... or maybe when 5HT2A receptors are blocked there's enough to hit 5HT1A and other good receptors ... who knows
Posted by zeugma on March 30, 2003, at 20:45:51
In reply to Re: Is Zyprexa a serotonin agonist or antagonist?, posted by cybercafe on March 30, 2003, at 19:31:03
> > > i felt great on parnate + zyprexa ... i know they are both serious medications... but i don't see a reason to believe that the risks increase when they are taken together
> > >
> > That's good to hear. I believe you have been dx with ADD? Was the Parnate helpful for this disorder?
>
> i'd say no.. but it was a lot better than feeling depressed.
>
The reason I asked was because Parnate is often called "amphetamine-like" and it has been claimed that it metabolizes to amphetamines (there was a recent controversy about this on this board). I have severe inattentive ADD and am interested in any possible meds for this condition; I know MAOI's are used as a 'last-resort' option for ADD sometimes and Parnate seems like the logical choice.
> > > > Seems that 5HT2A by itself just helps with sleep rhythms (isn't that what ritanserin is for?) This can be very helpful for depressed people but I doubt it's enough to remit depression by itself.
> > >
> > > i don't know anything about ritanserin ... where did you hear about it's use in sleep rhythms?
> > >
> >
> > Ritanserin increases slow-wave sleep: http://link.springer-ny.com/link/service/journals/00213/contents/00/00633/s002130000633cl
> >
> > It appears from this study that 5HT-2A antagonism won't help with anxiety or depression but can help with specific sleep problems.
>
> hmmm.. i notice an antidepressant effect after i take 2.5 mg zyprexa ... maybe it's a placebo effect... or maybe when 5HT2A receptors are blocked there's enough to hit 5HT1A and other good receptors ... who knows
>Zyprexa is probably helping with your depression as well as any other problems. Drug 'classification' to a large degree is arbitrary...in fact antipsychotics have been shown to have efficacy in depression. A drug like lithium can help people with unipolar depression, too, even though it's classed as a mood stabilizer.
Posted by cybercafe on April 1, 2003, at 0:35:26
In reply to Re: Is Zyprexa a serotonin agonist or antagonist? » cybercafe, posted by zeugma on March 30, 2003, at 20:45:51
> > > That's good to hear. I believe you have been dx with ADD? Was the Parnate helpful for this disorder?
> >
> > i'd say no.. but it was a lot better than feeling depressed.hmmm... i did only take 30 mg of parnate.. and then i added zyprexa, so maybe that's to blame
but i found 40 mg of ritalin SR helped me concentrate a bit better ... it's hard to say, cuz neither one really worked :)
so maybe parnate would work for you
> The reason I asked was because Parnate is often called "amphetamine-like" and it has been claimed that it metabolizes to amphetamines (there was a recent controversy about this on this board). I have severe inattentive ADD and am interested in any possible meds for this condition; I know MAOI's are used as a 'last-resort' option for ADD sometimes and Parnate seems like the logical choice.
parnate seemed like a more "powerful" med... not just in knocking out depression... but i know it would give me insomnia whereas with ritalin i can still sleep 14 hours a day.. so in a really obvious way, it seemed more stimulating to me...
> > hmmm.. i notice an antidepressant effect after i take 2.5 mg zyprexa ... maybe it's a placebo effect... or maybe when 5HT2A receptors are blocked there's enough to hit 5HT1A and other good receptors ... who knows
> >
>
> Zyprexa is probably helping with your depression as well as any other problems. Drug 'classification' to a large degree is arbitrary...in fact antipsychotics have been shown to have efficacy in depression. A drug like lithium can help people with unipolar depression, too, even though it's classed as a mood stabilizer.yeah .. i think it's really important to try and understand the underlying mechanisms in why something works, so we can make predictions about our future responses to meds (because we neither have time to try all the hundreds of meds out there nor do we want to endure all the washout periods and ineffective drug trials)
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