Posted by linkadge on October 15, 2011, at 15:23:38
In reply to Re: 5HT2C antagonism, Agomelatine, Antipsychotics, posted by dgramovska on October 14, 2011, at 16:30:36
>It seems that with its and norepinephrine >dopamine-releasing in the prefrontal cortex, it >should be possible for it to induce mania.
Well...possibly. The ability of atypicals to enhance cognative function in schizophrenia / bipolar is supposedly linked to their interaction with 5-ht2a/c.
I kind of think of the 5-ht2c effect as not being as strong as say the dopamine enhancing effect of stimulants (although I really have no comparison).
The antidepressant ketanserin is a relatively pure 5-ht2a/c antagonist. I think it has a low rate of mania, although it hasn't been used much clinically.
Talking with my doctor, drugs like tradazone, nefazaodone and remeron (which are all 5-ht2c antagonists) tend to produce less mania than the reuptake inhibitors. (He said he's never heard of a manic switch on trazadone).
Cyproheptadine is also a calcium channel blocker (which in theory could be antimanic).
Anyhow, I don't know how strong a pure 5-ht2c antagonist would be as an antidepressant.
Also, most 5-ht2c antagonists are also 5-ht2a antagonists which makes things confusing since 5-ht2a antagonists have some antimanic effects.
Some mania is actually caused by prefrontal hypofunction (executive dysfunction).Any of the drugs I've taken with 5-ht2c antagonist effects almost seems more like a mood stabilizer than a pure antidepressant.
Apparently lithium interacts (in an inhibitory way) with the 5-ht2c receptor.
Linkadge
poster:linkadge
thread:999547
URL: http://www.dr-bob.org/babble/20111006/msgs/999817.html