Talk:Duloxetine: Difference between revisions
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{{Technical|date=September 2010}} |
{{Technical|date=September 2010}} |
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Unclear what sources support this stuff? |
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[[User:Doc James|<span style="color:#0000f1">'''Doc James'''</span>]] ([[User talk:Doc James|talk]] · [[Special:Contributions/Doc James|contribs]] · [[Special:EmailUser/Doc James|email]]) 01:12, 7 December 2017 (UTC) |
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"The duloxetine + [[mirtazapine]] combination is a particularly effective tool in the antidepressant arsenal. Duloxetine is a very high affinity blocker of both the serotonin and norepinephrine transporters, at 0.8 for the SERT and 7.5 for the NET respectively, resulting in increased serotonergic and noradrenergic neurotransmission, which results in improvements in mood, cognition, desire to work, motivation, greater skill at performing tasks effectively, memory, alertness, and keenness, while also alleviating depression, anxiety, and obsessive-compulsive ideation. Mirtazapine’s antagonism of the α<sub>2</sub> receptors further preserves and enhances serotonergic and noradrenergic neurotransmission and its very high antagonism of the 5-HT<sub>2</sub> receptors also alleviates depression and anxiety. Importantly, duloxetine is a moderate affinity inhibitor of the [[CYP2D6]] enzyme, thereby increasing the plasma concentration of the substrate, mirtazapine, to between 2-5 times the normal levels. After beginning use of this regimen, symptoms such as prolonged headache, fatigue, and even a worsening of psychological symptoms tend to predominate for 3 weeks before going away. Therapeutic effects set in 3-4 weeks after beginning use, even if one has just discontinued a previous antidepressant.<ref name="Nassa + SNRI for TR depression">{{cite journal|title=SNRI-NaSSA combination therapy for treatment-resistant depression.|journal=Opinion/Wiley|doi=10.1002/pnp.153/pdf|url=http://onlinelibrary.wiley.com/doi/10.1002/pnp.153/pdf}}</ref><ref name="SR Explained">{{cite web|last1=Stahl|first1=Steven|title=Serotonin Receptors Explained.|website=http://www.universitypsychiatry.com/clientuploads/stahl/Stahl_3rd_ch12_Part2.pdf.|publisher=University Psychiatry|accessdate=December 6, 2017}}</ref>" |
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 | This article may be too technical for most readers to understand. (September 2010) |
Heading
Unclear what sources support this stuff?
Doc James (talk · contribs · email) 01:12, 7 December 2017 (UTC)
"The duloxetine + mirtazapine combination is a particularly effective tool in the antidepressant arsenal. Duloxetine is a very high affinity blocker of both the serotonin and norepinephrine transporters, at 0.8 for the SERT and 7.5 for the NET respectively, resulting in increased serotonergic and noradrenergic neurotransmission, which results in improvements in mood, cognition, desire to work, motivation, greater skill at performing tasks effectively, memory, alertness, and keenness, while also alleviating depression, anxiety, and obsessive-compulsive ideation. Mirtazapine’s antagonism of the α2 receptors further preserves and enhances serotonergic and noradrenergic neurotransmission and its very high antagonism of the 5-HT2 receptors also alleviates depression and anxiety. Importantly, duloxetine is a moderate affinity inhibitor of the CYP2D6 enzyme, thereby increasing the plasma concentration of the substrate, mirtazapine, to between 2-5 times the normal levels. After beginning use of this regimen, symptoms such as prolonged headache, fatigue, and even a worsening of psychological symptoms tend to predominate for 3 weeks before going away. Therapeutic effects set in 3-4 weeks after beginning use, even if one has just discontinued a previous antidepressant.[1][2]"
- ^ "SNRI-NaSSA combination therapy for treatment-resistant depression". Opinion/Wiley. doi:10.1002/pnp.153/pdf.
- ^ Stahl, Steven. "Serotonin Receptors Explained". http://www.universitypsychiatry.com/clientuploads/stahl/Stahl_3rd_ch12_Part2.pdf. University Psychiatry.
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