Our expert says:
Some ADs primarily affect the effective brain levels of a specific one o the neurotransmiters ( chemicals which in tiny amounts at the right places, keep us functioning ). Like Cilift, and Prozac. Some more significantly affect more than one at a time, like Wellbutrin. Sadly, the more we learn about it, the more complex it gets, affecting one neurotransmitter indirectly affects others, anyway. And we seem to vary in the profile of how our different relevant neurotransmiters are affected witnin our own Depression, so it is hard to predict exactly how we will reaspond to a particular AD, or which will suit us best. Thus generally there needs to be some experimentation to find which one suits you and your particular chemistry, best.
Now, there's a thing called the Blood-Brain Barier, which basically means that in various ways, the levels of chemicals in the bloodstream does not usually affect the levels of the same chemical in the barin --- some substances are effectively excluded from the brain, some enter it very easily. Generally, blood levels don't orrelate well with effective brain levels. And remember, the amounts that are relevant in the brain are, at any one nerve cell, truly micriscopic, and so variations in levels which would have a huge impact in brain would be too tiny to even measure in the blood. And obviously, taking brain samples to measure chemitry isn't thought to be a good idea !
The only psych drug where this actually does work quite well, for complex reasons, is Lithium, which can be quite easily measured in the blood, and we know the levels below which it will have no benefit, and above which it is likely to have severe side-effects. At one time they tried measurin blood levels of some of the ADs, but it did not prove to be practical or useful.
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