EasyDoes Posted February 11, 2014 Share Posted February 11, 2014 I understand the difference between Selective drugs. IE Lexapro and Not so selective drugs, Fluoxetine. But where do these drugs start working? Did I read correctly they start working on the right side of the brain? Then work their way to the left..? Link to comment Share on other sites More sharing options...
mcjimjam Posted February 14, 2014 Share Posted February 14, 2014 Did I read correctly they start working on the right side of the brain? Then work their way to the left..? I don't think this is right, no. I don't think my understanding of the way SSRIs work is complete enough for me to explain what they do do, but I haven't heard anything like that. I'll just copy-paste something from the Mayo Clinic website. "SSRIs ease depression by affecting naturally occurring chemical messengers (neurotransmitters), which are used to communicate between brain cells. SSRIs block the reabsorption (reuptake) of the neurotransmitter serotonin in the brain. Changing the balance of serotonin seems to help brain cells send and receive chemical messages, which in turn boosts mood. Most antidepressants work by changing the levels of one or more of these neurotransmitters. SSRIs are called selective because they seem to primarily affect serotonin, not other neurotransmitters." http://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825 Link to comment Share on other sites More sharing options...
jt07 Posted February 14, 2014 Share Posted February 14, 2014 I'm not a doctor, but my understanding is that they work on serotonin receptors where ever they happen to be. They don't "start" any where but work everywhere including the intestines (which is why SSRIs often cause GI upset). Link to comment Share on other sites More sharing options...
EasyDoes Posted February 16, 2014 Author Share Posted February 16, 2014 Yeah.. thanks for the info. I don't think I was very articulate when saying it. What i meant was they begin to saturate the right side of the brain and overtime the full brain's effected by the medicine. Sounds like crazy talk... well we are on the crazy boards Did I read correctly they start working on the right side of the brain? Then work their way to the left..? I don't think this is right, no. I don't think my understanding of the way SSRIs work is complete enough for me to explain what they do do, but I haven't heard anything like that. I'll just copy-paste something from the Mayo Clinic website. "SSRIs ease depression by affecting naturally occurring chemical messengers (neurotransmitters), which are used to communicate between brain cells. SSRIs block the reabsorption (reuptake) of the neurotransmitter serotonin in the brain. Changing the balance of serotonin seems to help brain cells send and receive chemical messages, which in turn boosts mood. Most antidepressants work by changing the levels of one or more of these neurotransmitters. SSRIs are called selective because they seem to primarily affect serotonin, not other neurotransmitters." http://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825 Link to comment Share on other sites More sharing options...
Velvet Elvis Posted February 16, 2014 Share Posted February 16, 2014 No, that's not how it works. Prozac and Lexapro are both SSRIs. They are "selective" in that they only effect particular receptor sites, unlike earlier drugs which were active on a much wider group of receptors, thereby causing more side effects. Link to comment Share on other sites More sharing options...
EasyDoes Posted February 16, 2014 Author Share Posted February 16, 2014 No, that's not how it works. Prozac and Lexapro are both SSRIs. They are "selective" in that they only effect particular receptor sites, unlike earlier drugs which were active on a much wider group of receptors, thereby causing more side effects. I seee Link to comment Share on other sites More sharing options...
quiet storm Posted February 20, 2014 Share Posted February 20, 2014 All SSRI's do a good job of just messing with serotonin and serotonin only compared to older TCA's. TCA's are what I like to call "Dirty" compared to SSRI's. It's like a shotgun approach. But SSRI's, depending on which one, do still hit on other things a bit. For example, Zoloft, besides mainly working on serotonin, can almost be classified as mild dopamine reuptake inhibitor as well. Paxil, besides mainly working on serotonin, can almost be classified as a mild norepinephrine reuptake inibitor. It is true that lexapro is the most selective of the SSRI's. It does that best job of just messing with serotonin and serotonin only. Link to comment Share on other sites More sharing options...
Velvet Elvis Posted February 21, 2014 Share Posted February 21, 2014 All SSRI's do a good job of just messing with serotonin and serotonin only compared to older TCA's. TCA's are what I like to call "Dirty" compared to SSRI's. It's like a shotgun approach. But SSRI's, depending on which one, do still hit on other things a bit. For example, Zoloft, besides mainly working on serotonin, can almost be classified as mild dopamine reuptake inhibitor as well. Paxil, besides mainly working on serotonin, can almost be classified as a mild norepinephrine reuptake inibitor. It is true that lexapro is the most selective of the SSRI's. It does that best job of just messing with serotonin and serotonin only. Zoloft works on dopamine to a degree comparable to what wellbutrin works on serotonin. It's pretty negligible. As far as Paxil goes, are you sure you aren't thinking of Effexor or Cymbalta? I'm getting my info here: http://www.preskorn.com/books/ssri_toc.html Link to comment Share on other sites More sharing options...
quiet storm Posted February 21, 2014 Share Posted February 21, 2014 (edited) I think its debatable on whether the small amount of dopamine that zoloft works on makes any difference for most folks. The same for norepinephrine and paxil. It's just something I've seen referenced(especially the dopamine and zoloft part) over the years. From message boards, other studies and Jerod over on CM even references it in his description of zoloft. That table from preskorn shows that zoloft by far has more action on dopamine than any other SSRI or TCA in that table(Note: The lower the number, the higher the affinity). Again, how much this really means in the real world is debatable and probably depends on the person. I wouldn't totally disregard the small amount of dopamine reuptake inihbition zoloft performs. As far as paxil, I believe that its action on norepinephrine might be even lighter than zolofts action on dopamine. Not sure it amounts to much, but again that norepinephrine chart from preskorn shows its doing more than any other SSRI on that table. But anyway, in relation to this thread, its very true that some SSRI's are more selective. That was all I was trying to say. Edited February 21, 2014 by quiet storm Link to comment Share on other sites More sharing options...
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