Posted by neuroman on September 20, 2005, at 12:45:14
In reply to Re: Name change... » neuroman, posted by KaraS on September 19, 2005, at 0:31:59
Hi,
> OK, scratch the TCA recommendation.Actually, I'm still keeping desiprimine as a possibility. I just won't take it for three years and then stop it in three weeks!
> I've never heard of guanfacine but why start with clonidine if you're only going to switch over? Why not just try guanfacine to begin with?
Good point. I think clonidine is stronger and will give a more certain indication that alpha2 agonism will help. But I guess one could try the guanfacine. Whatever I can get my hands on first will be the deciding factor. :-)
> I'll keep you posted as to whether I ever get a stimulant response from the Dexedrine. My fingers are crossed. Even if I feel calm on it but have some motivation, I'd be very happy.
Please do keep me posted. Hopefully we can learn from each others experiences. While no two brains are the same, some are more similar than others. Ours may be very similar... :-)
> I also wonder if the SSRIs are responsible for my low dopamine
While i doubt that they are responsible for your (or my) low dopamine, they certainly haven't helped the situation and probably made an underlying deficiency worse. I think Paxil is the worst offender. Prozac the least. IMHO that is. If you have high dopamine levels and are stressed they might be a good choice. But once dopamine levels are low they are a very bad choice.
> ...as well as the overactive fight or flight response.
Initially, one would think that this wouldn't be the case because they are often prescribed to have the exact opposite effect. (i.e. to suppress situational anxiety, social phobia, etc.) Paxil did seem to suppress my f/f response at first. Unfortunately, I was paying the price of further suppression of already low dopamine levels.
But putting dopamine aside for a moment there is also the matter of individual serotonin receptors. It has been shown in rats that 5-HT1a receptor agonists (such as buspirone) produce a marked enhancement of the acoustic startle response. Which is probably the last thing someone with an over the top f/f response or generalized anxiety or hypervigilance needs. This is probably because our 5-HT1a receptors are over-sensitized to begin with. Prozac desensitizes the 5-HT1a receptor with chronic treatment, whereas neither Paxil or Zoloft has this effect. They may make matters worse by increasing serotonin across the board without desensitizing the 5-HT1a receptor.
There may be problems with individual DA receptors also. You already know about sensitized autoreceptors, but there may be an imbalance of D1 (stimulatory) vs. D2 (inhibitory) receptors. In any event it all comes down to raising dopamine while suppressing the DA-NE-E stress response. It's not easy to do since most agents that supposedly suppress the stress response (serotonergic & gabaergic) also tend to suppress dopamine. This sucks...I just want to feel better...
> Heredity could be to blame as well since I've got an attention deficit issue, which I'm pretty sure I was born with.
I have no doubt that I was born predisposed toward anxiety.
> I wish you could find a doctor who would work with you on your level.
That has been my fervent and as of yet unanswered prayer. You know when a person desires something or expects a reward their dopamine goes up. When that desire is fulfilled or the expectation is met than their dopamine levels remain high. On the other hand, if those desires or expectations are not met than their dopamine levels plummet. In layman's terms this is called FRUSTRATION!!! Every time i made an appointment with a new doc i would feel good. ("Finally, i'll get some help and get to the bottom of this...") And every time i would end up being frustrated and bitterly disappointed. In this way, to someone whose life had already been filled with a disproportionate amount of frustration and disappointment, the medical community has done me great harm. I no longer have any desire or expecation of reward. I no longer feel much frustration. I no longer feel much of anything. In other words, complete catecholamine burnout.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15858403&query_hl=1
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16165291&query_hl=8Interesting how the areas dealing with frustration and emotional pain seem to overlap. Isn't our right brain supposed to be the emotional side? May explain why my physical pain is predominately on the left side of my body. Just speculation...
Paul
poster:neuroman
thread:556477
URL: http://www.dr-bob.org/babble/20050914/msgs/557278.html