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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by zeugma on February 6, 2003, at 10:18:43
I'm curious about the effects of 5HT 2 antagonism. According to SLS' drug info sheet, nortriptyline causes 5HT2 antagonism but I have been having trouble finding out what possible effects this could have. Is it responsible for nortriptyline's beneficial effects on the gastrointestinal system? Before I started taking it I was very prone to nausea and severe GI pain, but it is much diminished. The last day I missed work due to nausea was the day I started taking nortrip. So something in that chemical is steadying my GI tract. Thanks in advance,
z
Posted by Ritch on February 6, 2003, at 22:40:47
In reply to 5HT 2 antagonism?, posted by zeugma on February 6, 2003, at 10:18:43
> I'm curious about the effects of 5HT 2 antagonism. According to SLS' drug info sheet, nortriptyline causes 5HT2 antagonism but I have been having trouble finding out what possible effects this could have. Is it responsible for nortriptyline's beneficial effects on the gastrointestinal system? Before I started taking it I was very prone to nausea and severe GI pain, but it is much diminished. The last day I missed work due to nausea was the day I started taking nortrip. So something in that chemical is steadying my GI tract. Thanks in advance,
>
> zAmitriptyline (nortriptyline's parent drug), is frequently used for IBS. I am not sure if it is the single most effective agent for it or not, but it is close. The anticholinergic effects of TCA's are usually attributed to why they work so well to "settle" GI symptoms.
Posted by Stan on February 7, 2003, at 0:09:30
In reply to 5HT 2 antagonism?, posted by zeugma on February 6, 2003, at 10:18:43
> I'm curious about the effects of 5HT 2 antagonism. According to SLS' drug info sheet, nortriptyline causes 5HT2 antagonism but I have been having trouble finding out what possible effects this could have. Is it responsible for nortriptyline's beneficial effects on the gastrointestinal system? Before I started taking it I was very prone to nausea and severe GI pain, but it is much diminished. The last day I missed work due to nausea was the day I started taking nortrip. So something in that chemical is steadying my GI tract. Thanks in advance,
>
> z
>>>>>>>>>>>>>>
drugs which antagonize the 5HT2 receptors generally provide some degree of relief from anxiety, restlessness, insomnia, and agitation. commonly used psych-meds which have this mode of action as part of their package are serzone, remeron, trazodone, certain TCAs (apparently including the one you're taking), and certain atypical antipsychotics. SSRIs, on the other hand, stimulate the 5HT2 receptors, which is why many people taking them experience the side effects of anxiety, restlessness, insomnia, and agitation listed above.....along with sexual dsyfunction and other unpleasantries.it's actually the *5HT3* receptors which are implicated in much serotonin-mediated nausea and GI distress. SSRI's stimulate these receptors too, unfortunately. remeron antagonizes them, which is a good thing, but i'm not aware of other psychiatric meds which do the same thing. there are drugs which are potent antagonists of 5HT3 and they are used primarily as antiemetics (sp?) to prevent vomiting in patients receiving certain treatments for cancer. sometimes they have been used by pdocs -- ondansetron (sp again?) is one -- frightfully expensive though! there was a fellow here a few months back who swore it lifted his anxiety and depression like magic after he tried everything else in the book -- not sure how he's doing now...
there are a lot of these 5HT3 receptors in the gut....i'm don't think the TCA you're taking actually acts as an antagonist against them, but if you switched from a SSRI (which stimulates them) to the TCA, perhaps just making that move was enough to give you some relief from nausea.
hope that helps a bit
STan
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