Brief Answer:
yes lexapro can help

Detailed Answer:
Dear XXXXXXX

Thanks for writing back to us.

You are right that solian acts on 5ht7 and 5ht2b but it is antagonism. Solian increases dopaminergic activity that is right but that is due to effect on D2 and D3 receptors.

If your symptoms are phobia/ocd like lexapro will likely help but it need higher doses. To treat such symptoms availability of more serotonin in synapse should be there. Lexapro can do this with action on 5ht1a autoreceptors.

There is no competitive action between these drugs on 5ht7 and 5ht2b receptors. Lexapro can eliminate symptoms approximately after 4 weeks when optimum dose is used.

Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.

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Brief Answer:
yes lexapro can of course help

Detailed Answer:
Hi XXXXXXX

Thanks for follow up.

Like most of the anti psychotic medicines solian can cause OC symptoms. In low doses (less than 300 mg), solian bind far more to the high affinity doapmine (DA) presynaptic autoreceptors (increasing the release of dopamine) than to the low affinity DA postsynaptic receptors (blockade of which results in antipsychotic activity). Thus, in low doses, these drugs INCREASE the DA tone. This action helps in negative symptoms of schizophrenia and depression. However at the same dose by blocking 5ht7 and 5ht2b receptors it may reduce (not confirm action) serotonin level and overall there is reduction in serotonin/dopamine ratio which is likely responsible for OC symptoms.
To treat OC symptoms we need to increase serotonin level. SSRI (lexapro) can do this. When lexapro is used in depression it regularizes serotinin tone through auto receptors but for OC symptoms like other SSRI it is required in higher dose than dose as antidepressant to increase serotonin level. Lexapro is the least used for OC among all SSRIs.

As there is no specific tool by which we can measure neurotransmitters in individual patient we need to rely on clinical improvement for increasing the dose. It is possible that you may respond well on 15 mg but if not so dose must be increased.

Hope this answer will help.

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Brief Answer:
aripirazole has probably the least dopaminergic activity

Detailed Answer:
Dear XXXXXXX

Thanks for good question.

Keppra does not cause any antidopaminergic effect as far as I know and I also confirmed from my books. It is mainly used for seizure disorder and myoclonic jerk. The exact mechanism by which levetiracetam acts in epilepsy is also unknown. However, the drug binds to a synaptic vesicle glycoprotein, SV2A and inhibits presynaptic calcium channels reducing neurotransmitter release and acting as a neuromodulator.
But yes you are right that according some studies keppra helps in involuntary movements (dyskinesia) associated with levodopa but mechanism is not clear.

There is no anti-psychotic medicine without dopaminergic effects (basically it is needed to treat some symptoms of schizophrenia). However aripirazole(abilify) which is D2 agonist has low dopaminergic effects than its counterpart.

take care.

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