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Snris, Norepinephrine And Serotonin


Hoosierfan
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Can folks weigh on in why SNRIs (or SSRIs) help with Neurally Mediated Hypotension? If I take a look back over my history, it is the SNRI (Effexor) that has been the most effective for helping me feel "well" with the least side effects (like the Florinef migraine I've had for over a year....grrr). But, I'm wondering exactly WHY it helps -- I'm having trouble researching it but would like to get my docs as much info as possible....both my PCP and my Pdoc (who prescribes the Effexor) don't seem to know the "why" behind it works (and whether there is any way to determine the "right" dosage that will work).

Can you have your norepinephrine levels and serotonin levels tested, and, if so, how do they do it and what to the levels tell you? Again, I seem to be the one educating my docs.... ;)

If I get off the florinef and I start having syncope again, we may up my dose of Effexor...but before we would do that I'd like to at least have some guideline (i.e. blood test that shows low levels) other than "let's hazard a guess and try this." ;)

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Unfortunately from what I have been told there is really no way to test neurotransmitter levels. I have heard of spinal taps giving some indications, but this is rarely done. Serotonin is an important part of the mediation of the autonomic nervous system. The science behind that is way over my head, but it seems to help stabilize everything. I am on my third week of lexapro and am really starting to see improvement. Dosages, whether for depression or dysautonomia, seem to be trial and error.

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You can have your norepinephrine levels checked but not sure about serotonin. At the autonomic labs where they tested me, they started an i.v then had me lie in a dark/ quiet room for 30 minutes. Then they drew blood thru the i.v., then had me stand for 10 minutes and drew it again. I had tried to get the test done locally, but the docs and the lab here would only do the one lying down. Had no idea about the rest of it.

Haven't heard about a serotonin test being available. Whether the SSRIs or SNRIs are for depression or for ANS stuff, seems like all these neurotransmitter drugs are all trial and error.

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