Going to get to talk with the great attraction of Truluck's on McKinney with me Wednesday, July 12, truly a great seafood place. A new idea will be that ziprasidone's stimulation of the 5-HT1b receptor is what causes sedation or activation (in ~ half the patients). This occurrence relates to my low dose roll in of the drug for a patient and clinical examples will be given. Primary references supporting the neuropharmacological discussion are Stahl's J. Clin Psychiatry article and Richard Green's Neuropharmacology of Serotonin with more modern Abstracts on animals transfected to have increased 5HT1b receptors in the dorsal raphe, also ziprasidone being the only neuroleptic studied that is a partial agonist at the 5HT1b receptor, the rest inverse agonists. Special attaboys for seeing in the structure of Stahl's really very informative paper an interesting deficiency in his discussion of the 5-HT2c/D2 blockade balance section of his article which seems, for several reasons, in error. The role of cryptic mixed bipolar in treatment resistant depression mentioned, example given.
Update: Kim Collins, Joe, Norris and others from the second year came.
Update: Put the ideas off in a prospective letter to the Editor at The Journal of Clinical Psychiatry, 9-4-06
Update on talk, 10-20-06: Received 'congratulations' from Dr. Gelenberg 'to the authors of the manuscript. It is accepted for publication.'