The Noradrenergic Paradox

One of the most influential models in psychiatry’s history for understanding brain dysfunction is the monoamine hypothesis.  In short, it proposes that deficiencies or excess of certain neuromodulating agents, in particular the monoamines serotonin, dopamine, and norepinephrine (AKA noradrenaline) drive many psychiatric disorders.  The paper I will primarily reference is a publication by the same name in 2016 by Montoya, Bruins, Katzman, and Blier in Neuropsychiatric Disease and Treatment.  Its basic proposal is that, at the time of publication, there were at least 52 controlled clinical trials published that consistently showed a benefit of using SNRIs (like venlafaxine and duloxetine) and NERIs (like atomoxetine and reboxitine) for reducing anxiety in patients without the expected side effect of noradrenergic agents: to increase anxiety.  This is a paradox. Please leave feedback at https://www.psydactic.com or send any comments to [email protected] and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com.  All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else.  We reserve the right to be wrong.  Nothing in this podcast should be treated as individual medical advice.