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Re: Nierenberg - Clonidine for bipolar depression? » JohnX

Posted by Mitch on October 23, 2001, at 23:41:11

In reply to Re: Nierenberg - Clonidine for bipolar depression? » Mitch, posted by JohnX on October 23, 2001, at 19:20:50

>
> Heres what happens with things like Remeron,
> in case you are interested. The alpha-2 antagonism
> increases firing in an area of the brain predominately
> associated with (nor)adrenaline and the flight,or,
> fight mechanism. These nerve impulses actually
> propogate to serotonin neurons and increasing
> the firing rate of some serotonin neurons.
> The Remeron has a property that blocks a particular
> type of sertonin receptor (the 5ht-2 series), generally
> associated with anxiety. The increased serotonin
> firing hits the other receptors and a balance is
> supposed to be achieved that reduces anxiety in the
> net. But the two areas of the brain , the one with
> the noradrenaline, and the one with serotonin projections
> can reactly very differently amongst different people.
> In particular people with stress disorders will probably
> be hyperactive on the noradrenergic path and may
> experience anxiety on remeron.
>
> Interestingly, Buspar attempts
> to decrease the firing rate of those serotonin neurons
> to decrease anxiety, but one of its side metabolites
> is an alpha-2 antagonist. I think this could kill
> some of its anti-anxiety potential, but at higher
> doses for some people the alpha-2 antagonism is
> actually an anti-depressant (probably for people
> who aren't generally anxious too).
>
> -john


Well, it obviously turns on the *fight* response! I really felt concerned about the level of hostility I was experiencing with Remeron (and with Buspar). I was having fantasies about all sorts of violence. It almost became obsessive. I had several heated arguments (over nothing, really) at work that made me worried about getting fired. I really felt I had little control over physically assaulting somebody. The only time that happened (in an impulsive manner) was when I was in my early 20's and my Dad jumped my ass about something relatively piddly and I sucker-punched him. At the time I was being prescribed Valium and it seemed to make me very hostile occasionally. The ADHD I was dx'ed with (a few years ago)seems to fits this paradoxical reaction pattern. The only meds that I have ever found truly dangerous (in grave lack of impulse control) were Remeron, Buspar, Valium.

My question is do you have any more detail about how Wellbutrin *inhibits* NE firing with respect to the area of the brain you talked about earlier?

Mitch


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URL: http://www.dr-bob.org/babble/20011015/msgs/82134.html