3 ms·
> tl;dr: It's an SNRI, like Effexor or Cymbalta. The mechanism of action section specifically says that it did not block norepinephrine reuptake in the studied
by PragmaticPulp 6y ago
> tl;dr: It's an SNRI, like Effexor or Cymbalta.
The mechanism of action section specifically says that it did not block norepinephrine reuptake in the studied brains of rats (only in heart tissues) and that the serotonin reuptake inhibition was very weak. The mechanism of action is more complex, involving 5-HT2B antagonism and 5-HT2C agonism and some downstream upregulation of GABA-B in certain brain areas. It's likely there are additional mechanisms that are not fully understood yet.
tl;dr: It's nothing like an SNRI like Effexor or Cymbalta. Always defer to actual patient outcomes in clinical studies instead of trying to infer a drug's effects based on binding affinities.
- NeutronStar 6y ago> It is a selective norepinephrine reuptake inhibitor (NRI).[1] From the first paragraphe on wikipedia...
- lazide 6y agoIt’s a real shit show is what it is. If you compare those side effects the ACTUAL side effects of stimulants in kids and adults with ADHD (for instance, it reduces drug dependency, addiction, hyperactivity in ADHD folks while having the opposite effect on those who do not have ADHD), it’s clear this should be unethical to prescribe for anyone stimulants would be effective on. The only reason it even really comes up is the OMG stimulants are evil crowd who don’t want to even look at the reality of the situation.
- PragmaticPulp 6y agoPlease don't try to guess treatment outcomes based on binding affinities. > it’s clear this should be unethical to prescribe for anyone stimulants would be effective on. This is wrong in so many ways. Again, please don't try to guess outcomes based on binding affinities. For what it's worth, some of the non-stimulant ADHD medications such as Guanfacine are strikingly effective for ADHD when titrated properly, some times even moreso than traditional stimulants. The challenge is that titration can take time and the effects are not immediately apparent from the first dose, whereas stimulant medication follows the opposite trajectory where the first dose is the most effective and subsequent dosing has reduced effects due to tolerance. Parents often mistake the instant response of stimulants for superior efficacy in treating ADHD, whereas instrumented tests show that medications like Guanfacine are actually quite good if the patient is given time to adapt.
- The_rationalist 6y agoAre there long term comparative studies? Any reference benchmarck?
- astrange 6y agoI actually moved off guanfacine and onto Strattera because it has so many side effects - for instance, it makes you very weak to alcohol and it affects your heart rate. It's also physiologically addictive and you have to ramp off it for a week or two, which is a problem if you've forgotten to get a refill since, you know, you have ADHD. Ironically these are all things people think Adderall does which it doesn't do.
- lazide 6y agoI wasn’t guessing outcomes based on binding affinities, I was going off the data they posted in the article AND multiple large controlled studies on stimulants in ADHD populations. For instance - stimulants in ADHD populations do not cause suicidal ideation. Which is nice. This drug does for a non trivial number of folks who get it.
- Daho0n 6y agoThis sounds very good until you actually read the fact that is or has been sold as an antidepressant.