Posted by JohnL on February 3, 2000, at 3:18:30
In reply to not sure, posted by nick on February 2, 2000, at 21:07:25
I've been reading every book I can find on depression lately. A very interesting thing I've discovered that has massive implications is this...depressions characterized by poor response to ADs very often respond best to the same treatments used for ADD or ADHD. Even in the absence of any signs of ADD or ADHD. The cause of the depression is failed NE/dopamine. Stimulants reverse the failure. Sometimes an antipsychotic is needed as well, to reduce dopamine (too much is bad just as too little is bad). A stimulant will increase NE/dopamine activity in malfunctioning parts of the brain, while the antipsychotic will reduce dopamine in other parts of the brain where increased activity is not good. It sounds strange...raising neurotransmitter function with a stimulant while simultaneously decreasing neurotransmitter function with an antipsychotic. But they work in different parts of the brain. That explains it.
The basic idea is that when a depression is stubborn, confusing, and not responding to antidepressants, a drug from the stimulant class has a high probability of working. They will target the chemical imbalance or chemical failure when antidepressants fail to do so. If the stimulant overcompensates too much, a tiny dose of an antipsychotic will balance it out. Just like ADs, if one stimulant isn't right, another will be.
Interesting reading. This is the direction I will be going with my new pdoc in a few weeks, as my history is much like yours. It just always seemed to me that if three or four antidepressants didn't do the job, I was barking up the wrong tree. Depression can be caused by many different chemical imbalances or malfunctions, and only some of those are addressed by antidepressants. JohnL
poster:JohnL
thread:20409
URL: http://www.dr-bob.org/babble/20000128/msgs/20433.html