Talk:Duloxetine
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 | This article may be too technical for most readers to understand. (September 2010) |
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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]"
References
- ^ "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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Another version
"The duloxetine + mirtazapine combination is a particularly effective tool in the antidepressant arsenal.[1][2] 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,[3] resulting in increased serotonergic and noradrenergic neurotransmission, which results in improvements in mood, cognition, desire to work, motivation, energy, greater skill at performing tasks effectively, memory, alertness, and keenness, while also alleviating depression, anxiety, and obsessive-compulsive ideation.[4][5][6] 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.[7] 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.[8] After beginning use of this regimen, symptoms such as prolonged headache, fatigue, and even a periodic 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.[9]
- This is strange. This review "Anttila SA, Leinonen EV (2001). "A review of the pharmacological and clinical profile of mirtazapine". CNS Drug Rev. 7 (3): 249–64. PMID 11607047." does not even mention duloxetine?
- And neither does this one[1] Doc James (talk · contribs · email) 04:49, 16 December 2017 (UTC)
- ^ Meagher, David J; Hannan, Noel; Leonard, Maeve. "Duloxetine-mirtazapine combination in depressive illness: The case for Limerick 'rocket fuel'". Research Gate. Retrieved Dec 12, 2017.
- ^ "SNRI-NaSSA combination therapy for treatment-resistant depression". Opinion/Wiley. doi:10.1002/pnp.153/pdf.
- ^ Cite error: The named reference
pmid11750180was invoked but never defined (see the help page). - ^ Moret, Briley, Chantal, Mike (May 31, 2011). "The importance of norepinephrine in depression". Pub Med Center. doi:10.2147/NDT.S19619. PMC 3131098.
{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: unflagged free DOI (link) - ^ Jenkins, Trisha A.; Nguyen, Jason C.D.; Polglaze, Kate E.; Bertrand, Paul P. (January 20, 2016). "Influence of Tryptophan and Serotonin on Mood and Cognition". Nutrients. doi:10.3390/nu8010056. PMC 4728667. Retrieved December 14, 2017.
{{cite journal}}: CS1 maint: unflagged free DOI (link) - ^ "Low Norepinephrine and Depression: Is there a link?". Mental Health Daily.
- ^ Anttila SA, Leinonen EV (2001). "A review of the pharmacological and clinical profile of mirtazapine". CNS Drug Rev. 7 (3): 249–64. PMID 11607047.
- ^ Flockhart DA (2007). "Drug Interactions: Cytochrome P450 Drug Interaction Table". Indiana University School of Medicine. Retrieved on July 2011
- ^ Aiken, Chris. "SSNRI Profiles". Mood Treatment Center. Retrieved December 14, 2017.