Posted by zeugma on April 21, 2004, at 21:12:42
In reply to Re: Nuts on Wellbutrin - help! » zeugma, posted by King Vultan on April 21, 2004, at 13:01:28
I guess my theory for the problem with SSRIs lies in their very nature: they are so selective for serotonin that norepinephrine transmission gets left behind in the dust and winds up atrophying to some extent (obviously, SSRIs have negative effects on dopamine transmission as well, as evidenced by some of the sexual problems they can cause). Stahl talks about the interrelation between norepinephrine and serotonin extensively, and what I find striking is that norepinephrine naturally boosts serotonin, and there is an intimate relationship between the two that the action of SSRIs is somewhat at odds with, IMO. As he also mentions, they may be a synergistic advantage in working on multiple neurotransmitters rather than just one as SSRIs do.
Todd
This meshes well with the experience I have had on the NE reuptake inhibitors, nortriptyline and atomoxetine (Strattera). What I find curious is the fact that increase in NE also creates a rise in 5-HT: it must be a modest rise, since NRI's don't cause the same level of sexual dysfunction, nor (and I think this would be more significant, as the relative lack of sexual s/e could be explained by NE's relationship to dopamine) are they very effective for OCD. In any case, I haven't felt the 'serotonergetic' effect of decreased rejection sensitivity, or any real impact on my social anxiety at all.I have experienced a clearing effect, from the nortriptyline and especially from the Strattera, on my thought process. In fact Strattera can be downright frustrating in this regard: I become perfectly aware of the reasons for my anxiety as it occurs, but experience no diminishment of the anxiety at all. I thought Strattera would be the perfect drug to use during CBT, as CBT is all about making rational analyses of situations that cause the anxiety: but I found myself reflecting clearly on the causes of my anxiety even as it escalated to panic-attack proportions (I decided to ditch CBT at that point and start Klonopin, despite my pdoc's evident displeasure at this switch: Strattera made me much more determined to get my way! I suppose that is NE's connection to reversal of 'behavioral despair' in the animal models of depression, in which NRI's are so much more active than SSRI's.)
I also have ADD, as my 'brain fog' symptoms suggest. Do you find Nardil to have an anti-ADD effect? Theoretically, it should be very effective. I appreciate your insights-
z
poster:zeugma
thread:337963
URL: http://www.dr-bob.org/babble/20040417/msgs/338561.html