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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Conundrum on December 1, 2010, at 11:29:59
Ok so both prozac and remeron increase motivation in me. Prozac is weaker, but it doesn't poop out. Remeron makes me way more motivated but poops out.
I'm curious as to why that is. My guess is that perhaps remeron blocks a lot of post synaptic receptors at first, maybe more than prozac but quickly upregulate. Prozac blocks 5 HT2A/C receptors but also indirectly agonizes them at the same time so maybe that prevents any upregulation? Also it indirectly agonizes the 5 HT1A receptor which may increase NE/DA release even more and perhaps, continuously in the PFC, where remeron cannot directly agonize that receptor, so maybe these two reasons, 1. Remeron is more likely to cause upregulation, and 2. it does not agonize strongly any 'good' serotonergic receptors.
Another thought was that perhaps one of these drugs is just an antagonist and the other an inverse agonist. Maybe prozac continues to work chronically because it is an inverse antagonist, or maybe remeron is the inverse antagonist and thats why it had some more"ooomph" to it when I started it.
This is purely and intellectual exercise, I'm just curious if this makes any sense.
Posted by Phillipa on December 1, 2010, at 12:07:19
In reply to prozac/remeron question, posted by Conundrum on December 1, 2010, at 11:29:59
To those that understand neuroreceptors it will. I just know that prozac was too stimulating for me and remeron just stopped after 30 days at 15mg as noticed nothing. I tried to google prozac with dopamine and norepenephrine last night and had no luck as curious to see how one SSRI could be what seems so different to me. Any idea what search words would bring it up? Sorry I just don't understand I guess you'd call it the science behind it? Phillipa
Posted by Conundrum on December 1, 2010, at 12:13:37
In reply to Re: prozac/remeron question » Conundrum, posted by Phillipa on December 1, 2010, at 12:07:19
http://www.preskorn.com/books/ssri_s3.html
This shows the effects of different reuptake inhibitors on serotonin, norepinephrine and dopamine pumps. The smaller the number the more potent.
Fluoxetine has a fairly high number for the serotonin transporters compared to the rest of the SSRIs, but a relatively moderate number for the NE/DA reuptake pumps. So its a milder SSRI with some moderate effects on NE/DA. Citalopram has a high NE/DA number, so virtually no effect on those pumps, and a small SERT number, so its a very potent and selective serotonin reuptake inhibitor.
For infomation on fluoxetine and NE/DA release google : fluoxetine, 5 HT2C, dopamine
> To those that understand neuroreceptors it will. I just know that prozac was too stimulating for me and remeron just stopped after 30 days at 15mg as noticed nothing. I tried to google prozac with dopamine and norepenephrine last night and had no luck as curious to see how one SSRI could be what seems so different to me. Any idea what search words would bring it up? Sorry I just don't understand I guess you'd call it the science behind it? Phillipa
Posted by Phillipa on December 1, 2010, at 19:58:19
In reply to Re: prozac/remeron question, posted by Conundrum on December 1, 2010, at 12:13:37
Having hard time interpresting but sent the link to me. Also how come no lexapro listed as it effects me differently from celexa? Thanks for taking the time and trouble. Really appreciate it. Also wrote down the google search Phillipa
Posted by Conundrum on December 1, 2010, at 21:14:39
In reply to Re: prozac/remeron question, posted by Conundrum on December 1, 2010, at 12:13:37
Lexapro is on there if you just look at the data for S-citalopram. pretty low number for the serotonin transporter(SERT) and very high for the norepinephrine and dopamine transporters, NET and DAT.
> http://www.preskorn.com/books/ssri_s3.html
>
> This shows the effects of different reuptake inhibitors on serotonin, norepinephrine and dopamine pumps. The smaller the number the more potent.
>
> Fluoxetine has a fairly high number for the serotonin transporters compared to the rest of the SSRIs, but a relatively moderate number for the NE/DA reuptake pumps. So its a milder SSRI with some moderate effects on NE/DA. Citalopram has a high NE/DA number, so virtually no effect on those pumps, and a small SERT number, so its a very potent and selective serotonin reuptake inhibitor.
>
> For infomation on fluoxetine and NE/DA release google : fluoxetine, 5 HT2C, dopamine
>
> > To those that understand neuroreceptors it will. I just know that prozac was too stimulating for me and remeron just stopped after 30 days at 15mg as noticed nothing. I tried to google prozac with dopamine and norepenephrine last night and had no luck as curious to see how one SSRI could be what seems so different to me. Any idea what search words would bring it up? Sorry I just don't understand I guess you'd call it the science behind it? Phillipa
>
>
Posted by Phillipa on December 1, 2010, at 21:55:25
In reply to Re: prozac/remeron question, posted by Conundrum on December 1, 2010, at 21:14:39
So in your opinion do you feel that I should continue on the lexapro with luvox and keep trying to lower benzos. I know to the best of my knowledge that you are just a well educated person. And I thank you graciously Phillipa
Posted by Conundrum on December 1, 2010, at 22:21:39
In reply to Re: prozac/remeron question » Conundrum, posted by Phillipa on December 1, 2010, at 21:55:25
> So in your opinion do you feel that I should continue on the lexapro with luvox and keep trying to lower benzos. I know to the best of my knowledge that you are just a well educated person. And I thank you graciously Phillipa
I don't know, aren't they helping with anxiety anymore? Are the SSRIS helping? If the side effects of the drugs aren't bad and they're helping keep anxiety at bay, I would stay on them, if not try something else.
Posted by Phillipa on December 2, 2010, at 18:17:38
In reply to Re: prozac/remeron question, posted by Conundrum on December 1, 2010, at 22:21:39
It just doesn't sound like prozac would be good for anxiety unless took infrequently. Thanks. Phillipa
Posted by KathrynLex on December 2, 2010, at 19:49:51
In reply to Re: prozac/remeron question » Conundrum, posted by Phillipa on December 2, 2010, at 18:17:38
Phillipa, I took Prozac for anxiety and it worked well for a couple of years. When I first started taking it I had trouble sleeping and even felt a little anxious, I wanted to to stop taking it but my pdoc suggested that I combine it with Xanax for the first few weeks. I gave it a shot and it worked really well.
Prozac isn't for everyone, but it's one of the best medications I've ever been on.
Posted by Phillipa on December 2, 2010, at 20:15:25
In reply to Re: prozac/remeron question )Phillipa, posted by KathrynLex on December 2, 2010, at 19:49:51
Took it when first out and first day lots of energy, second day anxiety, third day panic. Stopped it. Was on low dose xanax at the time and felt great. But now my Daughter who hasn't taken benzos went on 20mg of prozac and looks and feels great. That's where that whole thread about brain damage started from. Me telling and asking pharmacist why. But also asked about the bioidenticals. I goggled last night sent myself an article as C suggested the search engine and need to really study it. Phillipa.
Posted by KathrynLex on December 3, 2010, at 1:19:03
In reply to Re: prozac/remeron question )Phillipa » KathrynLex, posted by Phillipa on December 2, 2010, at 20:15:25
It's so tricky to find the right balance of meds. (But it can be done!) I hope you find something that works for you.
This is the end of the thread.
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