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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by jay2112 on July 21, 2022, at 18:32:36
Dissociation Constants of Antidepressants at Monoamine Transporters in Nanomoles
GENERIC SERTNETDAT
Amitriptyline4.3353250
Atomoxetine8.92.031080
Bupropion4502613892784
Citalopram1.16407028100
Clomipramine0.28382190
Desipramime17.60.833190
Doxepin6829.512100
Duloxetine0.87.5240
Fluoxetine0.812403600
Fluvoxamine0.792443620
Imipramine1.4378500
Levominalcipran11.210.210000+
Mianserin4000719400
Milnacipran12320010000+
Mirtazapine1500+12501500+
Nefazodone200360360
Nortriptyline184.371140
Paroxetine0.13*405100
Sertraline0.294202548
Trazodonde16085007400
Venlafaxine8224807647
Vilazodone1.65637
Vortioxetine1.61131000+
(Sorry, this won't display in a table format)
Posted by linkadge on July 22, 2022, at 7:49:23
In reply to Binding of antidepressants, posted by jay2112 on July 21, 2022, at 18:32:36
Was there a link to this data?
Linkadge
Posted by Christ_empowered on July 22, 2022, at 8:21:29
In reply to Re: Binding of antidepressants, posted by linkadge on July 22, 2022, at 7:49:23
I dunno...
it isn't that I don't find the hard science aspect of psych drug treatment interesting (I do, although I also find it confusing...), so much as...
personally, I think a lot of "treatment success" stories aren't so much dependent (at least not completely) on matching individuals in distress to drugs that have the best possible binding profile, etc. so much as...
it seems that it depends on matching an individual's most distressing problems/"symptoms" (where "symptoms" can be understood as problems that respond to drug treatment, at least for a while...) to drugs that improve those symptoms without adding undue burdens, in and of themselves.
example: For whatever reason(s), my own "symptoms" seem to always and forever result in a neuroleptic prescription. it is what it is. Aripiprazole is, so far, the winner for me in that category.
OK. so, for me...a 10-20mgs/abilify dosage soothes agitation, takes the edge off low moods, and keeps my occasional upswings from getting ridiculous. below 10mgs seems to be pointless; above 20 seems to be chemically-induced hibernation, plus somehow ocd-ish stuff gets exacerbated.other people...do better with, say, risperidone. just as effective in the aggregate, so what gives? well...for people who can tolerate the risperidone without eps and td, etc., it seems that the risperidone is more calming, soothing...from what I've read and what I've observed in others, that seems to be especially true of people with intense trauma in their background. kind of like...
I read a "psychiatric survivor's" account of hospitalization in the early 60s. trauma, adolescent angst against the backdrop of social change and family disintegration. OK. so, when the younger set misbehaved enough, they were administered a low(ish) dosage of Thorazine. and...
-because- of the author's background, ongoing problems, age, and what sounds like a rather gloomy treatment setting, those low doses of Thorazine were often something of a mixed blessing. less agitation, less anxiety, the "de-activation" effect of neuroleptics at a low enough dosage to avoid the infamous "Thorazine shuffle," etc. problem? from my perspective, it sort of set a pattern of ongoing distress, maladaptive behavior, and then the tranquilizer. which is part of a larger issue that I have with inpatient care: even now -- and even in private settings -- I do think they're more interested in molding "good patients" than in helping people get on with life.
or back to antidepressants. I was prescribed the once standard 20mgs/Prozac for my mood and ocd-ish stuff. it was...not so great, honestly. On her way out, my prescriber said to just take more Lamictal and maybe avoid antidepressants in the future. so...what gives, there?
I didn't have drug induced psychosis, significant agitation, mania, or any of that jazz. Honestly? I think its because the "emotional novocaine" effect that many described with SSRI drugs (in particular) is something that I associate with intense depression. so...my thoughts weren't looping as much, the intensity of the low end was reduced, but...the overall effect -- I think especially with a neuroleptic on board -- "felt" too much like a downturn, and...no, no, no.
sorry to ramble. And...I'm -not- trying to criticize you or your post or your position so much as I am...
trying to think upon and articulate my own position. thanks. :-)
Posted by SLS on July 22, 2022, at 12:50:31
In reply to Re: Binding of antidepressants, posted by Christ_empowered on July 22, 2022, at 8:21:29
PDSP =
https://pdsp.unc.edu/databases/kidb.php
- Scott
Posted by Jay2112 on July 22, 2022, at 16:44:58
In reply to Re: Binding of antidepressants, posted by linkadge on July 22, 2022, at 7:49:23
> Was there a link to this data?
>
> LinkadgeSorry Linkadge...slipped me mind. :)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5044489/
Table 1 (just a short way down)
Jay
Posted by TriedEveryMedication on July 22, 2022, at 20:15:24
In reply to Re: Binding of antidepressants, posted by linkadge on July 22, 2022, at 7:49:23
Note the lower the number, the stronger the affinity
https://en.wikipedia.org/wiki/Pharmacology_of_antidepressants#Receptor_affinity
Posted by Jay2112 on July 23, 2022, at 0:02:21
In reply to Re: Binding of antidepressants, posted by Christ_empowered on July 22, 2022, at 8:21:29
> I dunno...
>
> it isn't that I don't find the hard science aspect of psych drug treatment interesting (I do, although I also find it confusing...), so much as...
>
> personally, I think a lot of "treatment success" stories aren't so much dependent (at least not completely) on matching individuals in distress to drugs that have the best possible binding profile, etc. so much as...
>
> it seems that it depends on matching an individual's most distressing problems/"symptoms" (where "symptoms" can be understood as problems that respond to drug treatment, at least for a while...) to drugs that improve those symptoms without adding undue burdens, in and of themselves.
>
> example: For whatever reason(s), my own "symptoms" seem to always and forever result in a neuroleptic prescription. it is what it is. Aripiprazole is, so far, the winner for me in that category.
>
>
> OK. so, for me...a 10-20mgs/abilify dosage soothes agitation, takes the edge off low moods, and keeps my occasional upswings from getting ridiculous. below 10mgs seems to be pointless; above 20 seems to be chemically-induced hibernation, plus somehow ocd-ish stuff gets exacerbated.
>
> other people...do better with, say, risperidone. just as effective in the aggregate, so what gives? well...for people who can tolerate the risperidone without eps and td, etc., it seems that the risperidone is more calming, soothing...from what I've read and what I've observed in others, that seems to be especially true of people with intense trauma in their background. kind of like...
>
> I read a "psychiatric survivor's" account of hospitalization in the early 60s. trauma, adolescent angst against the backdrop of social change and family disintegration. OK. so, when the younger set misbehaved enough, they were administered a low(ish) dosage of Thorazine. and...
>
> -because- of the author's background, ongoing problems, age, and what sounds like a rather gloomy treatment setting, those low doses of Thorazine were often something of a mixed blessing. less agitation, less anxiety, the "de-activation" effect of neuroleptics at a low enough dosage to avoid the infamous "Thorazine shuffle," etc. problem? from my perspective, it sort of set a pattern of ongoing distress, maladaptive behavior, and then the tranquilizer. which is part of a larger issue that I have with inpatient care: even now -- and even in private settings -- I do think they're more interested in molding "good patients" than in helping people get on with life.
>
> or back to antidepressants. I was prescribed the once standard 20mgs/Prozac for my mood and ocd-ish stuff. it was...not so great, honestly. On her way out, my prescriber said to just take more Lamictal and maybe avoid antidepressants in the future. so...what gives, there?
>
> I didn't have drug induced psychosis, significant agitation, mania, or any of that jazz. Honestly? I think its because the "emotional novocaine" effect that many described with SSRI drugs (in particular) is something that I associate with intense depression. so...my thoughts weren't looping as much, the intensity of the low end was reduced, but...
>
> the overall effect -- I think especially with a neuroleptic on board -- "felt" too much like a downturn, and...no, no, no.
>
> sorry to ramble. And...I'm -not- trying to criticize you or your post or your position so much as I am...
>
> trying to think upon and articulate my own position. thanks. :-)
>
Fair enough...I understand...I get it. But, these binding profiles have info that proves, not all SRI's ARE just SRI's!. Look at Zoloft (sertraline). Look at it's dopamine binding profile. WAY, way stronger than all other SRI's. Look at Paxil's norepinephrine binding, and throw in that it is also an anticholinergic. Not included here, but Luvox (fluvoxamine) binds to melatonin receptors...look at Vybriid's dopamine AND norepinephrine binding. Prozac has GABA properties.My point being, each of these are still quite unique, and, as well, possibly more effective in doses smaller than even starting doses. (A pill cutter comes in handy). The starting doses recommended are way too high, IMHO.
So, most of this doesn't seem to be taken into consideration, and I (like most of us) spent years combing over the studies. I am lucky to have an open minded doctor, who listens to my somewhat educated info, along with the studies I print out and bring with me to my appointments.
So, that's all YMMV, IMHO, etc. But, I think I am on the right track. :)
Best,
Jay
This is the end of the thread.
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