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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by DP on April 14, 2002, at 22:11:50
Hi Everyone,
Just out of curiousity, do anyone know if there are any new antidepressants in development out there. When I say "new", I mean drugs that would not not fall into a category of a TCA, MAOI or an SSRI.
I'd be interested in reading up on this subject if anyone has any references.
Thanks,
Jimmy
Posted by dennison on April 14, 2002, at 22:56:38
In reply to New Antidepressants in Development?, posted by DP on April 14, 2002, at 22:11:50
Hi - Reboxetine is a biggy, the selective norepinephrine reuptake inhibitor, used in europe but currently not fda approved in usa:( bummer. There simply are no selective norepinephrine reuptake inhibitors currently avaliable in usa, reboxetine was supposedly on track for approval but as others at psychobabble have posted it was untracked from the final part 3 fda approval, yet reason seems to be a mystery..................................................................Ok other biggy is ""duloxetine"" from eli lilly the norepinephrine serotonin reuptake inhibitor, which should be avaliable in coming months . It should be quite popular because unlike effexor the norepinephrine component starts at same time as does serotonin reuptake inhibition, no need to inc. the dose to rather high level to get the norepinephrine to come into play, starts right from the initial dosage. Those are the two biggest drugs on forefront- but there's many others involving other putative mechanisms, not monoamine based, but they're a bit further off in future as far as becoming clinically avaliable!!!
Posted by DP on April 14, 2002, at 23:02:06
In reply to Re: New Antidepressants in Development? » DP, posted by dennison on April 14, 2002, at 22:56:38
Why do you suppose that is? Why do we not see Selective Norepinepherine Reuptake Inhibitors or Dopamine Reuptake Inhibitors?
> Hi - Reboxetine is a biggy, the selective norepinephrine reuptake inhibitor, used in europe but currently not fda approved in usa:( bummer. There simply are no selective norepinephrine reuptake inhibitors currently avaliable in usa, reboxetine was supposedly on track for approval but as others at psychobabble have posted it was untracked from the final part 3 fda approval, yet reason seems to be a mystery..................................................................Ok other biggy is ""duloxetine"" from eli lilly the norepinephrine serotonin reuptake inhibitor, which should be avaliable in coming months . It should be quite popular because unlike effexor the norepinephrine component starts at same time as does serotonin reuptake inhibition, no need to inc. the dose to rather high level to get the norepinephrine to come into play, starts right from the initial dosage. Those are the two biggest drugs on forefront- but there's many others involving other putative mechanisms, not monoamine based, but they're a bit further off in future as far as becoming clinically avaliable!!!
Posted by dennison on April 14, 2002, at 23:47:08
In reply to Re: New Antidepressants in Development?, posted by DP on April 14, 2002, at 23:02:06
Hi - well first obvious thought reflects that for many years serotonin bandwagon was name of game and if drug was not serotonin based then it would lack the hype and thus the popularity. Another idea about norepinephrine reuptake inhibitors, not being on market would be high resistance from current serotonin based drug manufactures as norepinephrine based drugs would be unique and thus consume a portion of the valuable market share. No drug makes it to the market unless it has a target population or a niche otherwise profits simply will never become significant to justify expense of bringing the drug onto the market..............................................................Dopamine drugs, why there's few of them ever even proposed as putative antidepressants-simple ""abuse potential"", though nomifensine in early 80's did hit market and was a dopamine based anti-depressant,unfortunately a few people had bad rxn's, it was a highly effective antidepressant and had great potential to help specific types of depression--:(:( ...................................................................Ok there's a couple quick thoughts I'll think of more in depth ones , lol latter but those I mentioned are valid!!!!!......................................Geez I almost forgot to mention ""amineptine"" survector---an excellent antidepressant dopamine based , but this beauty was indeed removed simply because it had abuse potential, but treating and relieving depression certainly wouldn't be abuse ---would it----but , oh well they removed it from clinical use anyway:(:(. It was used for a time in europe, now it's basically avaliable nowhere, occassionally seen in underground, but who wants to live underground:), bit of humor there. It's a crying shame though amineptine "survector" could have helped an awful lot of people!!!!!!!!!
Posted by zero on April 15, 2002, at 13:31:16
In reply to New Antidepressants in Development?, posted by DP on April 14, 2002, at 22:11:50
(hope this long list is informative - zero)
CenterWatch's comprehensive Directory of Drugs in Clinical Trials:
Company Name Trade Name Generic Name Condition(s), Phase(s)
GlaxoSmithKline Paxil, Seroxat paroxetine Depression, III
Yamanouchi Pharmaceutical N/A YM-992 Depression, II
Wyeth Research Effexor XR venlafaxine HCl Depression, FDA approved
Janssen Pharmaceutica N/A YKP-10A Depression, IIa completed
Merck N/A substance P antagonist candidates Depression, IIa
Merck N/A MK-869 Depression, III
Cephalon Provigil modafinil Depression, II
Boehringer Ingelheim N/A flibanserin Depression, II
Merck KgaA N/A anti-depressant Depression, II
Sanofi-Synthelabo Pharmaceuticals N/A SR 58611 Depression, II b
Eli Lilly N/A duloxetine HCl, LY-248686 Depression, NDA submitted
Innapharma N/A INN-00835 Depression, II completed
NeuroSearch A/S N/A NS-2389 Depression, II
Eli Lilly Zyprexa olanzapine Depression, III
Neurocrine Biosciences N/A NBI-34041 Depression, I
NPS Pharmaceuticals N/A NPS 1506 Depression, Ib completed
Kyowa Hakko N/A KW-6002 Depression, II
Forest Laboratories N/A escitalopram Depression, NDA submitted
AstraZeneca N/A robalzotan, NAD 299 Depression, II
Solvay Pharmaceuticals N/A SLV 308 Depression, II
Takeda Chemical Industries N/A TAK-637 Depression, II
Organon Ariza 5HT-1A partial agonist Depression, III
Annovis N/A amino-cyclopropane carboxylic acid Depression, I
GlaxoSmithKline N/A GW 597599 Depression, I
GlaxoSmithKline N/A SB 243213 Depression, Discontinued
GlaxoSmithKline N/A SB 659746A, EMD 68843 Depression, II
GlaxoSmithKline N/A GW 650250 Depression, II
Janssen Pharmaceutica N/A R 107474 Depression, Discontinued
Janssen Pharmaceutica N/A CRF receptor antagonist, NBI-37582 Depression, I
Pfizer N/A NGD 98-1 Depression, II
Eli Lilly Prozac Weekly fluoxetine HCI Depression, FDA approved
Eli Lilly Prozac fluoxetine HCl Depression, FDA approved
Eli Lilly N/A Olanzapine-fluoxetine combination Depression, III
Fabre-Kramer Pharmaceuticals N/A gepirone Depression, III completed
Pfizer N/A JO-1784, CI-1019 Depression, Discontinued
Dainippon Pharmaceutical N/A moclobemide Depression, II
Pfizer N/A CP-122,721 Depression, II
Hoffmann-La Roche N/A NK-1 Depression, I
Otsuka America Pharmaceutical N/A OPC-14523 Depression, II
Organon N/A ORG-12962 Depression, II
Cortex Pharmaceuticals N/A ORG-24448, CX-619 Depression, I
Organon N/A ORG-34167 Depression, I
Organon N/A ORG-34517 Depression, II
Pharmacia Vestra reboxetine Depression, FDA denied
Mitsubishi Chemical Corporation N/A MCI-225 Depression, II
Somerset Pharmaceuticals Emsam selegiline Depression, NDA denied
GlaxoSmithKline N/A SB723620 Depression, I
Sepracor N/A (R)-sibutramine metabolite Depression, II
Posted by Bob on April 15, 2002, at 16:19:27
In reply to Re: New Antidepressants in Development?, posted by zero on April 15, 2002, at 13:31:16
Boy! Looking at this list below is kind of frustrating. There aren't many truly novel drugs in phase III; most of them are in the earlier phases. I suspect this is because they get weeded out by the time they get to phase III. Also, it annoys me how long something takes to come to market, even when it does pass phase III. I think it is typically 1 to 2 years. What a waiting game!!!
> (hope this long list is informative - zero)
> CenterWatch's comprehensive Directory of Drugs in Clinical Trials:
>
>
> Company Name Trade Name Generic Name Condition(s), Phase(s)
>
> GlaxoSmithKline Paxil, Seroxat paroxetine Depression, III
>
> Yamanouchi Pharmaceutical N/A YM-992 Depression, II
>
> Wyeth Research Effexor XR venlafaxine HCl Depression, FDA approved
>
> Janssen Pharmaceutica N/A YKP-10A Depression, IIa completed
>
> Merck N/A substance P antagonist candidates Depression, IIa
>
> Merck N/A MK-869 Depression, III
> Cephalon Provigil modafinil Depression, II
>
> Boehringer Ingelheim N/A flibanserin Depression, II
>
> Merck KgaA N/A anti-depressant Depression, II
> Sanofi-Synthelabo Pharmaceuticals N/A SR 58611 Depression, II b
>
> Eli Lilly N/A duloxetine HCl, LY-248686 Depression, NDA submitted
>
> Innapharma N/A INN-00835 Depression, II completed
>
> NeuroSearch A/S N/A NS-2389 Depression, II
>
> Eli Lilly Zyprexa olanzapine Depression, III
>
> Neurocrine Biosciences N/A NBI-34041 Depression, I
>
> NPS Pharmaceuticals N/A NPS 1506 Depression, Ib completed
>
> Kyowa Hakko N/A KW-6002 Depression, II
>
> Forest Laboratories N/A escitalopram Depression, NDA submitted
>
> AstraZeneca N/A robalzotan, NAD 299 Depression, II
>
> Solvay Pharmaceuticals N/A SLV 308 Depression, II
>
> Takeda Chemical Industries N/A TAK-637 Depression, II
>
> Organon Ariza 5HT-1A partial agonist Depression, III
>
> Annovis N/A amino-cyclopropane carboxylic acid Depression, I
>
> GlaxoSmithKline N/A GW 597599 Depression, I
>
> GlaxoSmithKline N/A SB 243213 Depression, Discontinued
>
> GlaxoSmithKline N/A SB 659746A, EMD 68843 Depression, II
>
> GlaxoSmithKline N/A GW 650250 Depression, II
>
> Janssen Pharmaceutica N/A R 107474 Depression, Discontinued
>
> Janssen Pharmaceutica N/A CRF receptor antagonist, NBI-37582 Depression, I
>
> Pfizer N/A NGD 98-1 Depression, II
>
> Eli Lilly Prozac Weekly fluoxetine HCI Depression, FDA approved
>
> Eli Lilly Prozac fluoxetine HCl Depression, FDA approved
>
> Eli Lilly N/A Olanzapine-fluoxetine combination Depression, III
>
> Fabre-Kramer Pharmaceuticals N/A gepirone Depression, III completed
>
> Pfizer N/A JO-1784, CI-1019 Depression, Discontinued
>
> Dainippon Pharmaceutical N/A moclobemide Depression, II
>
> Pfizer N/A CP-122,721 Depression, II
>
> Hoffmann-La Roche N/A NK-1 Depression, I
>
> Otsuka America Pharmaceutical N/A OPC-14523 Depression, II
>
> Organon N/A ORG-12962 Depression, II
>
> Cortex Pharmaceuticals N/A ORG-24448, CX-619 Depression, I
>
> Organon N/A ORG-34167 Depression, I
>
> Organon N/A ORG-34517 Depression, II
>
> Pharmacia Vestra reboxetine Depression, FDA denied
>
> Mitsubishi Chemical Corporation N/A MCI-225 Depression, II
>
> Somerset Pharmaceuticals Emsam selegiline Depression, NDA denied
>
> GlaxoSmithKline N/A SB723620 Depression, I
>
> Sepracor N/A (R)-sibutramine metabolite Depression, II
Posted by Jaynee on April 15, 2002, at 17:05:57
In reply to New Antidepressants in Development?, posted by DP on April 14, 2002, at 22:11:50
This list is from 2000, but it is good
http://www.phrma.org/searchcures/newmeds/newMedsView.phtml?newmedsrindex=12
Posted by mat on April 16, 2002, at 3:48:12
In reply to Re: New Antidepressants in Development? » zero, posted by Bob on April 15, 2002, at 16:19:27
hi
according to this list, reboxetine was not approved by the fda for the treatment of depression.
i want to start rebox (edronax) in the following weeks and would really like to know why the fda decided this way.
was it ineffective in clinical in trials? (i know of no reports where rebox did much worse than other antidepressants).
where there any intolerable side-effects?
thank's for your answers-mat
Posted by DP on April 16, 2002, at 9:38:23
In reply to Re: New Antidepressants in Development?, posted by mat on April 16, 2002, at 3:48:12
I'd really like to know the answer to Mat's question too. It would seem to me that a new class of antidepressants like that not being approved would have a lot to do with red tape.
> hi
> according to this list, reboxetine was not approved by the fda for the treatment of depression.
> i want to start rebox (edronax) in the following weeks and would really like to know why the fda decided this way.
> was it ineffective in clinical in trials? (i know of no reports where rebox did much worse than other antidepressants).
> where there any intolerable side-effects?
> thank's for your answers-
>
> mat
Posted by mat on April 16, 2002, at 10:04:20
In reply to Re: New Antidepressants in Development? » mat, posted by DP on April 16, 2002, at 9:38:23
hi
according to my pdoc reboxetine is a widely used antidepressant here in austria, especially suitable for persons with comorbid social phobia.
what is "red tape"?mat
Posted by DP on April 16, 2002, at 11:04:19
In reply to Re: New Antidepressants in Development? » DP, posted by mat on April 16, 2002, at 10:04:20
Hi Mat-
I want to move to Austria! Red Tape refers to a procedure that gets delayed because of bureaucracy
or overly complex, unneccesary rules.Is there absolutely NO way that someone in the United States can get a hold of Reboxetine, even as a clinical trial sort of thing?
Jimmy
> hi
> according to my pdoc reboxetine is a widely used antidepressant here in austria, especially suitable for persons with comorbid social phobia.
> what is "red tape"?
>
> mat
Posted by geno on April 16, 2002, at 15:12:30
In reply to Re: New Antidepressants in Development? » mat, posted by DP on April 16, 2002, at 11:04:19
From what i understand, isnt reboxatine similar to the tca desipramine, a selective norepinephrine medication?? or i could be wrong.
geno
Posted by fachad on April 16, 2002, at 16:19:19
In reply to Re: New Antidepressants in Development?, posted by geno on April 16, 2002, at 15:12:30
Both desipramine and reboxetine are SNRIs.
Desipramine is far more potent at blocking NE reuptake than Reboxetine. The 1/K values are 120 for desipramine and only 14 for reboxetine. So desipramine is more than 8 times more potent than reboxetine. For comparison Elavil is 3, Paxil is 2.5, and Prozac is 0.5.
Reboxetine is also less selective than desipramine. The ratio of selectivity NE:5-HT is 21 for desipramine, and it is 8 for reboxetine.
I don't really know what all the hype is about reboxetine, because it is less potent and less selective than desipramine. It is, however, more profitable because it is still under patient. That probably explains the hype.
> From what i understand, isnt reboxatine similar to the tca desipramine, a selective norepinephrine medication?? or i could be wrong.
> geno
Posted by mat on April 16, 2002, at 17:09:51
In reply to SNRIs: Desipramine vs. Reboxetine » geno, posted by fachad on April 16, 2002, at 16:19:19
hi fachad
everything you posted is of course true and is exactly what my pharmacology-textbooks says, but remember:
1. the affinity of desipramine for muscarinic receptors is about 34 times higher
2. for h1-receptors about 3 times higher
3. for alpha1-receptors about 90 times higher
maybe that makes the difference, and is the reason for the hype (is there really a hype about reboxetine? and-do you know any reasons why the fda rejected its approval?)
thank's for your reply
mat
Posted by SLS on April 16, 2002, at 22:18:03
In reply to Re: SNRIs: Desipramine vs. Reboxetine » fachad, posted by mat on April 16, 2002, at 17:09:51
> hi fachad
> everything you posted is of course true and is exactly what my pharmacology-textbooks says, but remember:
> 1. the affinity of desipramine for muscarinic receptors is about 34 times higher
> 2. for h1-receptors about 3 times higher
> 3. for alpha1-receptors about 90 times higher
> maybe that makes the difference, and is the reason for the hype (is there really a hype about reboxetine? and-do you know any reasons why the fda rejected its approval?)
> thank's for your reply
> mat
Hi Mat.The manufacturer of reboxetine presented the FDA with plenty of statistics from the clinical trials it performed in Europe. However, the FDA required that they contribute numbers produced by trials performed in the US. Unfortunately for the manufacturer, the investigation they performed ended up being a "failed" study. The results of a placebo-controlled investigation of reboxetine versus fluoxetine showed neither drug to be more effective than placebo. Since fluoxetine *is* more effective than placebo, these results were meaningless, and another lengthy series of trials would be required by the FDA. This was several years ago. I don't know what has been going on more recently.
I know I say this all the time, but I don't think it makes sense to use in simplistic fashions the known properties of prospective antidepressants to deduce their potential effectiveness. There's just too much going on in there. Empirical observation is still the only reliable way to screen for effective drugs.
I don't think much of reboxetine in general, but I'm sure there are people for whom it is a miracle drug.
- Scott
Posted by JohnX2 on April 17, 2002, at 4:40:38
In reply to Re: New Antidepressants in Development?, posted by zero on April 15, 2002, at 13:31:16
note: flibanserin looked like an interesting medicine to me but was discontinued from clinical studies. The manufacturer did not state why.John
> (hope this long list is informative - zero)
> CenterWatch's comprehensive Directory of Drugs in Clinical Trials:
>
>
> Company Name Trade Name Generic Name Condition(s), Phase(s)
>
> GlaxoSmithKline Paxil, Seroxat paroxetine Depression, III
>
> Yamanouchi Pharmaceutical N/A YM-992 Depression, II
>
> Wyeth Research Effexor XR venlafaxine HCl Depression, FDA approved
>
> Janssen Pharmaceutica N/A YKP-10A Depression, IIa completed
>
> Merck N/A substance P antagonist candidates Depression, IIa
>
> Merck N/A MK-869 Depression, III
> Cephalon Provigil modafinil Depression, II
>
> Boehringer Ingelheim N/A flibanserin Depression, II
>
> Merck KgaA N/A anti-depressant Depression, II
> Sanofi-Synthelabo Pharmaceuticals N/A SR 58611 Depression, II b
>
> Eli Lilly N/A duloxetine HCl, LY-248686 Depression, NDA submitted
>
> Innapharma N/A INN-00835 Depression, II completed
>
> NeuroSearch A/S N/A NS-2389 Depression, II
>
> Eli Lilly Zyprexa olanzapine Depression, III
>
> Neurocrine Biosciences N/A NBI-34041 Depression, I
>
> NPS Pharmaceuticals N/A NPS 1506 Depression, Ib completed
>
> Kyowa Hakko N/A KW-6002 Depression, II
>
> Forest Laboratories N/A escitalopram Depression, NDA submitted
>
> AstraZeneca N/A robalzotan, NAD 299 Depression, II
>
> Solvay Pharmaceuticals N/A SLV 308 Depression, II
>
> Takeda Chemical Industries N/A TAK-637 Depression, II
>
> Organon Ariza 5HT-1A partial agonist Depression, III
>
> Annovis N/A amino-cyclopropane carboxylic acid Depression, I
>
> GlaxoSmithKline N/A GW 597599 Depression, I
>
> GlaxoSmithKline N/A SB 243213 Depression, Discontinued
>
> GlaxoSmithKline N/A SB 659746A, EMD 68843 Depression, II
>
> GlaxoSmithKline N/A GW 650250 Depression, II
>
> Janssen Pharmaceutica N/A R 107474 Depression, Discontinued
>
> Janssen Pharmaceutica N/A CRF receptor antagonist, NBI-37582 Depression, I
>
> Pfizer N/A NGD 98-1 Depression, II
>
> Eli Lilly Prozac Weekly fluoxetine HCI Depression, FDA approved
>
> Eli Lilly Prozac fluoxetine HCl Depression, FDA approved
>
> Eli Lilly N/A Olanzapine-fluoxetine combination Depression, III
>
> Fabre-Kramer Pharmaceuticals N/A gepirone Depression, III completed
>
> Pfizer N/A JO-1784, CI-1019 Depression, Discontinued
>
> Dainippon Pharmaceutical N/A moclobemide Depression, II
>
> Pfizer N/A CP-122,721 Depression, II
>
> Hoffmann-La Roche N/A NK-1 Depression, I
>
> Otsuka America Pharmaceutical N/A OPC-14523 Depression, II
>
> Organon N/A ORG-12962 Depression, II
>
> Cortex Pharmaceuticals N/A ORG-24448, CX-619 Depression, I
>
> Organon N/A ORG-34167 Depression, I
>
> Organon N/A ORG-34517 Depression, II
>
> Pharmacia Vestra reboxetine Depression, FDA denied
>
> Mitsubishi Chemical Corporation N/A MCI-225 Depression, II
>
> Somerset Pharmaceuticals Emsam selegiline Depression, NDA denied
>
> GlaxoSmithKline N/A SB723620 Depression, I
>
> Sepracor N/A (R)-sibutramine metabolite Depression, II
Posted by turalizz on April 17, 2002, at 9:49:13
In reply to SNRIs: Desipramine vs. Reboxetine » geno, posted by fachad on April 16, 2002, at 16:19:19
> Both desipramine and reboxetine are SNRIs.
>
> Desipramine is far more potent at blocking NE reuptake than Reboxetine. The 1/K values are 120 for desipramine and only 14 for reboxetine. So desipramine is more than 8 times more potent than reboxetine. For comparison Elavil is 3, Paxil is 2.5, and Prozac is 0.5.
>
> Reboxetine is also less selective than desipramine. The ratio of selectivity NE:5-HT is 21 for desipramine, and it is 8 for reboxetine.
>
> I don't really know what all the hype is about reboxetine, because it is less potent and less selective than desipramine. It is, however, more profitable because it is still under patient. That probably explains the hype.
>
Fachad, did you personally compare desipramine to reboxetine yourself? Or are you just talking about the "theoretical" stuff you read from some book?cem
Posted by SLS on April 17, 2002, at 21:45:11
In reply to Re: SNRIs: Desipramine vs. Reboxetine, posted by turalizz on April 17, 2002, at 9:49:13
> > Both desipramine and reboxetine are SNRIs.
> >
> > Desipramine is far more potent at blocking NE reuptake than Reboxetine. The 1/K values are 120 for desipramine and only 14 for reboxetine. So desipramine is more than 8 times more potent than reboxetine. For comparison Elavil is 3, Paxil is 2.5, and Prozac is 0.5.
> >
> > Reboxetine is also less selective than desipramine. The ratio of selectivity NE:5-HT is 21 for desipramine, and it is 8 for reboxetine.
> >
> > I don't really know what all the hype is about reboxetine, because it is less potent and less selective than desipramine. It is, however, more profitable because it is still under patient. That probably explains the hype.
> >
> Fachad, did you personally compare desipramine to reboxetine yourself? Or are you just talking about the "theoretical" stuff you read from some book?
>
> cem
Hi Cem.I think the point you make is important. Without going into my usual monolog regarding the inadvisability of presuming sufficient understanding of the brain, its diseases, and the medications used to treat them so as to predict with certainty clinical utility (squeezed it in there anyway), I can report that I responded to desipramine and reboxetine quite differently. Desipramine has always been at least somewhat helpful to me, and along with Parnate afforded me my only substantial remission. By contrast, reboxetine precipitated an exacerbation of my depression within days of starting it which included anxiety and suicidality, two features that have not been characteristic of me historically. These things disappeared within 36 hours of my discontinuing it. For me, desipramine prevents suicidality while reboxetine promotes it.
Desipramine and reboxetine each do a bunch of different things in addition to inhibiting the reuptake of norepinephrine. One thing that frequently escapes attention is not only what drugs do, but where they do it. All drugs are not distributed throughout the brain identically, and despite identical pharmacological effects when viewed locally, produce significantly different outcomes.
- Scott
Posted by mat on April 18, 2002, at 6:52:24
In reply to Re: SNRIs: Desipramine vs. Reboxetine, posted by SLS on April 17, 2002, at 21:45:11
hi scott
interestingly, i recently experienced the same worsening of my depression, but while taking another drug that's often prescribed here in austria-milnacipran (a serotonin and noradrenalin ri).
there was no anxiety, but i think i was suicidal for the first time in my life. i discontinued it-and felt MUCH better on the next morning (neither i nor my pdoc could believe that). of course, nobody can predict how one will react to a specific drug, but i nevertheless
do think that the noradrenergic component of milnacipran was at least partially reponsible for my exacerbation. maybe that's a simplicistic view of how antidepressants work, but at least it's a method for me to (try to) understand what could go wrong in my brain (and THAT'S very important for me!)
Posted by SLS on April 18, 2002, at 10:00:18
In reply to Re: SNRIs: Desipramine vs. Reboxetine » SLS, posted by mat on April 18, 2002, at 6:52:24
> hi scott
> interestingly, i recently experienced the same worsening of my depression, but while taking another drug that's often prescribed here in austria-milnacipran (a serotonin and noradrenalin ri).
> there was no anxiety, but i think i was suicidal for the first time in my life. i discontinued it-and felt MUCH better on the next morning (neither i nor my pdoc could believe that). of course, nobody can predict how one will react to a specific drug, but i nevertheless
> do think that the noradrenergic component of milnacipran was at least partially reponsible for my exacerbation. maybe that's a simplicistic view of how antidepressants work, but at least it's a method for me to (try to) understand what could go wrong in my brain (and THAT'S very important for me!)
Hi Mat.I think it is very useful to observe trends in how one reacts to medication and look for associations based upon what is known about them. However, I have sometimes reacted to drugs in ways that seem counterintuitive or contradictory to the pharmacological properties that are currently described for them. I would not exclude Celexa from the drugs I will try in the future (if necessary) simply because I did not respond adequately to Prozac and Paxil. There are a huge number of people whom respond to one SSRI after having failed to respond to other SSRIs previously.
Specific people react to specific drugs for specific reasons. I think this should be the theorem upon which the pursuit of understanding is based. I just don't think we are there just yet.
- Scott
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
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