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List of current antidepressants and effected neurotransmitter
Apr 18, 2004

I have undergone medical treatment for depression and anxiety more precisely, dysthymia with onset of major depression for the past 7 years. So far, the medications provided (including treatment for a misdiagnosed bipolar disorder) have been insufficient. In the mean time, I have taken the time to study the basics of psychology, neuroanatomy, and the underlying neurotransmitter pathways.

It has come to my attention that depression is a generalized classification of a group of symptoms with a variety of underlying, multifactorial causes. It seems that, at least in my case, the prescribing doctors have a tendency to come to an initial "diagnosis" and treatment, never to re-examine the effectiveness or try different medications. (This may be partly the result of changes in insurance coverage over the course of the decade.)

I have been treated with Prozac, and Lexapro which, like Prozac, are SSRIs and work on one or more of the seretonine pathways. I have finally been put on an alternative medication, Wellbutrin, which works on the norepinephrine and dopamine pathways. I have become aware that Effexor and Serzone function in the serotonine and norepinephrine pathways.

Given that it is necessary that I personally manage this lifelong pursuit of depression treatment, I am interested in finding a more comprehensive list of currently available medications and the underlying neurotransmitter pathways. Where may I find such a listing?

More specifically, my present list includes limited combinations of serotonine/dopamine/norepinephrine reuptake inhibitors. Theoretically, there can be a total of seven basic combinations. (Not including possible "intensities" of effect) Even more specifically, as I examine the three medications that I am now aware of, I see one particular combination that is out of my reach, this being a medication which works on the dopamine and serotonine pathways. Are you aware of such a medication?

Thank you

Response from Dr. Horwath

You have clearly done a lot of study on this subject. It is important to point out that much has been written about the various neurotransmitters that are affected by antidepressants, but that this is mostly theoretical in so far as it concerns the mechanism of action of antidepressants and clinical treatment of depression. There is very little evidence that one can construct more effective treatments based upon hand-picked neurotransmitter effects.

What you need is a good psychiatrist with clinical experience in treating depression to help you choose an effective treatment. If Prozac, Lexapro, and Wellbutrin have not worked for you, then Effexor may be an appropriate next choice. But you need to review it with your doctor, to see if you have any contraindications for this or other drugs.

If you'd like to read more, try http://www.nami.org and related links, which you'll find there.



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