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Strattera/nortriptyline difference?


hypercat

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What are the advantages of Strattera over a tricyclic like nortriptyline, apart from the side effects? They both enhance the levels of norepinephrine in the brain, right? Do they work in different parts of the brain?

Couldn't find anything on the net.

Just curious.

Greetings

hypercat

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What are the advantages of Strattera over a tricyclic like nortriptyline, apart from the side effects? They both enhance the levels of norepinephrine in the brain, right? Do they work in different parts of the brain?

One of the big differences is that Strattera is a selective norepinephrine reuptake inhibitor. Effects

on other neurotransmitters are then mostly limited to those signalled by norepinephrine, or perhaps by

a compensatory decrease in conversion of dopamine to norepinephrine.

Most of the TCAs get their varying effect and side effect profiles by acting on multiple neurotransmitters

at once in different proportions. So "activating" TCAs like desipramine, , nortriptyline (Pamelor), and

protripyline (Vivactil) will still inhibit serotonin uptake to some degree and will also have a measure

of antihistamine/anticholinergic effects ... along with the accompanying secondary effects. Likewise,

even "sedating" TCAs like chlomipramine/Anafranil and doxepin/Sinequan (stronger antihistamine

than Benadryl) will have some effect toward raising serotonin, norepinephrine, and dopamine levels

(whether that makes much of a difference ?) So, by affecting different neurotransmitters differently, and

those neurotransmitters having different functions in different parts of the brain ... it wouldn't be totally

wrong to say they work more effectively on different parts of the brain.

Maybe consider it more of a focussed approach vs. broad-spectrum (and the fewer things altered, the

less likely to hit on some complicating wierdness peculiar to the patient ?)

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