Posted by jerrympls on January 27, 2004, at 22:32:43
In reply to Re: Do anti-psychotics act on dopamine the same as » jerrympls, posted by scott-d-o on January 27, 2004, at 22:10:35
> antipsychotics are dopamine antagonists and sometimes have effects at a bunch of other receptors as well, usually in hopes of reducing the risk of tardive dyskinsia.
>
> of the drugs you mention, one of them, mirapex, is a dopamine agonist, and the other is an indirect dopamine agonist; really it is the opposite action from antipsychotics.
>
> however, your pdoc is right that at *low doses* antipsychotics can increase dopaminergic transmission because they antagonise these receptors in yo brain called presynaptic or "autoreceptors." These receptors are located on dopamine-producing neurons and act as a feedback mechanism for how much dopamine is in the synaptic space (i.e. between neurons.) antagonizing *these specific receptors* causes the neuron to release more dopamine, therefore there is more dopamine in the synaptic space to "agonize" the postsynaptic receptors naturally.
>
> you just have to be careful because some antipsychotics don't preferentially antagonise autoreceptors at any dose, and in any case, taking a dose past the point where more postsynaptic receptors are being antagonized than presynaptic ones can really f*ck up a person who has a dysfunctional dopaminergic system (ask me how I know)....
>
> dopamine agonists *may* actually cause a *decrease* in dopamine transmission using the same logic.. obviously higher doses would be desirable in their case if increasing dopamine transmission is your goal.. understand?
>
> scott
Hey Scott-Thanks for the info. Yeah I understand. I used to know all this stuff - however all these meds have my brain in a fog. I certainly believe that my dopamingeric system is wy out of whack. Amphetamines help - but after a while it seems as if they cause the opposite reaction - as described by the negative feedback system you explain above. So I'm wondering about Ritalin/Concerta because it blocks reuptake of dopamine as well as release it - from what I understand. THEN I'm thinking about augmenting with Mirapex - about which I have heard some extraordinarily postive stories from others on this board - saying that it renewed their creativity, pleasure, motivation, etc.
My depression is rescurrent/refractory/resistant - you name it - and SSRI's just dull me. SNRI's aren't much different from SSRI's for me. Opiates work very well.
I don't want to add an anti-psychotic to be honest. I'm already on 200mg of Seroquel for insomnia. My doc said that Geodon or Abilify may help - but all I can imagine is brain dulling and sleepiness and/or akathesia.
So, we agreed to start Adderall XR 10mg. I've been on Adderall before at this dose and it had a MUCH MUCH more powerful effect the first time I was on it (about 3 years ago). Now it's like I'm taking nothing. My receptors are all screwed up.
What to do? What to try? ugh....
But thanks for your help....I greatly appreciate it.
Jerry
poster:jerrympls
thread:306217
URL: http://www.dr-bob.org/babble/20040127/msgs/306266.html