The columns in this section discuss basic pharmacologic principles relevant to understanding the mechanistically defined classes of antidepressants. Anticipate what effects these medications will produce in a patient when used alone or in combination with other medications. Rationally move from one class of antidepressant to another in the event that the first one selected either did not produce an adequate response or aused treatment-limiting adverse effects. This column is based in part on material contained in two of my recent books and briefly reviews in vitro binding affinity and the concept of pharmacological selectivity. It is a term that becomes commonplace during political campaigns.
Companies naturally endeavor to portray their products in the most favorable light possible.
Sometimes, they can do this using compelling, straightforward data. For that reason, clinicians need to be able to critically examine the basis for promotional claims. The goal of this column and the others in this series is to present a way of critically thinking about the potential relevance of in vitro data to actual clinical use of a drug. The Venlafaxine Story - This column, examines the antidepressant medication, venlafaxine, to illustrate a drug with a binding affinity that sequentially affects two different neural sites of action over its clinically relevant dosing range. This column discusses how to assess the potential relevance of in vitro binding studies to the clinical use of a drug.