Posted by West on October 2, 2009, at 5:22:50
In reply to Re: Lets discuss cyproheptadine (Periactin)! Linka, posted by Brainbeard on October 1, 2009, at 16:37:01
> > It helped produce a qualitatively deeper sleep than hypnotics while on ssris. At the same time it stopped the ssri working, thus worsening depression.
> >
> > You might expect that from a drug described as antiserotonergic.
>
> Not quite. SSRI's are indirectly anti-serotonergic in their own ways. Long-term SRI treatment downregulates 5HT2A/C-receptors, which comes close to 5HT2A/C-antagonism. I've never heard that strong antiserotonergic drugs like mirtazapine (Remeron) or ziprasidon (Geodon) or Risperdal (all strong 5HT2A-antagonists) negate the antidepressant effectiveness of SSRI's. In fact, many of the older tricyclic antidepressants have both pro-serotonergic (SRI) and antiserotonergic (5HT2A-antagonism) actions, and the mix seems to work quite well. Stephen Stahl argues that SRI + 5HT2A-antagonism is a good combination.
>
> So there might be an other reason why cyproheptadine can counter the antidepressant effect of an SSRI. There have been made some suggestions higher up in this thread.
>
>'stopped the ssri working' is interchangable with return of depression, since the ssri treats it.
I'll go and read through the thread now!
poster:West
thread:521042
URL: http://www.dr-bob.org/babble/20091001/msgs/919383.html