Posted by Trotter on October 27, 2008, at 15:57:09
In reply to Re: Tianeptine and Agomelatine, posted by Trotter on October 27, 2008, at 14:31:02
I have spent a lot of time studying the nature of happiness. This has been motivated by a desire to be more happy (as in not depressed), but also because it is in my personality to want to understand things.
In my research I have indentified a paradox between desire and acceptance. Desire leads to purpose, meaning, goals, passion and energy, all of which can contribute to a sense of happiness. On the other hand, acceptance, as in feeling satisfied with oneself and one's world also gives one a sense of happiness. Yet there is much conflict between the two. A highly motivated, passionate person will have great difficulty feeling contentment, and vice versa.
Okay, you are no doubt thinking, where is he going with this? Well, I believe the desire system is largely controlled by dopamine, and acceptance/contentment is more a function of serotonin. If you suffer anxiety, low self-esteem and depression, then you will likely benefit from raising serotonin. If you suffer anhedonia, lack of energy, passion etc, then you will likely respond to increasing dopamine.
A problem with this is that I believe there is a conflict between dopamine and serotonin. Raise serotonin and you lower dopamine (SSRI emotional blunting). My understanding is that Tianeptine raises dopamine by lowering serotonin. This can address anhedonia, but risks causing anxiety and dissatisfaction (lower serotonin).
I tend to think whether one benefits more from a SSRI or Tianeptine is an individual thing based on one's relative lack of serotonin or dopamine. For me, I respond well to SSRIs, which probably predicts a poor response to Tianeptine. Does this make sense, or am I just rationalzing my decision to stop Tianeptine?
Of course many depressed people suffer low serotonin AND dopamine, not to mention noradrenaline. Perhaps this explains why most ADs do not result in remission.
Sorry if this reads like a psycho's babble. :)
Trotter
poster:Trotter
thread:855890
URL: http://www.dr-bob.org/babble/20081027/msgs/859498.html