Posted by johnj on June 1, 2008, at 18:53:55
In reply to Re: The best Tricyclic for anxiety.... » torachan, posted by SLS on June 1, 2008, at 16:34:56
"It would have been interesting to be able to combine an SSRI with gepirone or ritanserin. Unfortunately, gepirone (a 5-HT1a partial agonist) is deemed not-approvable by the FDA, and the patent on ritanserin (5-HT2 antagonist) has run out. I don't know the percentages, but a minority of people have a robust anti-anxiety response to buspirone (DA antagonist / 5-HT1a partial agonist). The one problem with gepirone and buspirone is that their major metabolite, 1-PP, is a potent NE alpha-2 antagonist. Some people can't handle the activation of certain NE pathways. It can make depression worse. I don't know about anxiety, though."
I always wondered why some people say buspar increased their depression, thank you. I would love to try it but I definatley don't need the anxiety gone and a worse depression. Drugs can be so frustrating.
Do you know if the NE pathway for buspar is the same as NE drugs like some of the tcas? So, for anxiety some drugs like nortryptiline, desipramine which increase NE actually flood the pathway like srri's do with serotonin and this takes time to down regulate? Is it possible it never down regulates?
The hardest thing for me was the anxiety increasing aspect of ssri's as benzo's do not work well for me anymore and it was too much to handle. Luvox never lost it's physical anxiety even after a month on only 12.5-mg. I know it is a very, very small dose but when I raised it to 25 I basically stopped sleeping. I actually felt kind of giddy on 25 mg of luvox. I am afraid to try another one even though celexa or lexapro intrigue me.