Posted by cache-monkey on March 6, 2005, at 14:33:10
In reply to Re: SSRI's that are also 5HT2C-receptor antagonists? » cache-monkey, posted by Sarah T. on March 5, 2005, at 20:21:48
Hey there,
So, I'm not sure how 5-HT2C relates to apathay/motivation. And Celexa should have been a relatively good 2C antagonist, too... I'm wondering if maybe what you're looking for is a 5-HT2A antagonist. (2A blockade => increased dopamine: see http://www.preskorn.com/columns/9803.html).
Which would make Serzone ideal, except for that pesky mCPP. I was on serzone for about 8 months and it made me really freaked out and anxious (and hypersexual and almost anorexic) the whole time. Based on what I read about mCPP, I think that was the root cause.
My stressed out response was probably a function of my liver chemistry. mCPP is cleared by the liver enzyme CYP-2D6. Based on my response to Serzone, I actually got a genetic test done on my (likely) liver enzyme capacity, and it turns out I'm (probably) pretty deficient in CYP-2D6. As a result I got mCPP overload. (All the parenths to say that these genetic tests only give likelihoods, not necessarily your actual capacity.)
Have you tried Serzone? For most people, I think the mCPP isn't much of an issue, just the poor/intermediate CYP-2D6 metabolizers. You might want to get tested for your 2D6 function, since lots of other antidepressants/psychotropics are metabolized by that enzyme. (A simpler test might be to consider whether a standard dose of nyquil really seems to knock you out for 12+ hours...)
Anyway, good luck with your AD quest.
Peace,
cache-monkey
> Hi Cache-Monkey. I really appreciate your reply. The reason I've been interested in drugs that antagonize this receptor is that I thought I might be able to get some of the benefits of serotonin WITHOUT the apathy and amotivational syndromes that are so common with many ssri's. Celexa was the worst in that respect. A few others were similar in effect but not as deadening as Celexa. Yes, I've read about that m-CPP metabolite of Serzone and Trazodone. If only they'd make Trazadone without that metabolite! Apparently m-CPP also causes INCREASED cortisol levels, which is the last thing I need right now.
poster:cache-monkey
thread:465324
URL: http://www.dr-bob.org/babble/20050304/msgs/467426.html