Posted by bleauberry on July 19, 2009, at 17:22:46
In reply to Re: Sick of searching}}Bleauberry, posted by Dima on July 19, 2009, at 1:25:54
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> I don't think norepinephrine is the problem. I forgot to say I've tried Cymbalta, an SNRI, recently, too. Adderall, Cymbalta, and Wellbutrin all increase norepinephrine levels, and they all make me anxious for no apparent reason.Well, there are some common misperceptions and untruths involved here.
Cymbalta is called an SNRI, but in fact its action on NE is negligible compared to its action on serotonin. It is basically a SSRI with a smidgen of NE in the background. You did not get much NE effect from Cymbalta. You did feel very potent serotonin.
Wellbutrin is commonly assumed to increase NE, but those effects are also very small even at high doses. Wellbutrin's true mechanism is still a mystery, but the NE and dopamine parts of it are way in the background in the distance, not front row seats.
To assume NE does not play a part in your symptomolgy based on experience with Cymbalta and Wellbutrin is a misled conclusion. Maybe NE isn't a part of it, maybe it is, but those drugs do nothing to say whether it is or isn't.
In addition, the interplay and synergism between NE and dopamine is important. It is difficult to separate them. They serve similar overlapping functions. A norepinephrine reuptake inhibitor will also increase dopamine levels, because in certain parts of the brain where dopamine is normally taken up into NE neurons because there are no dopamine neurons there (overlapping functions), if we block those neurons we increase both NE and dopamine.
All of this is paper theory and armchair quarterbacking however. What really matters is how we feel when we try a medication. Some medications can give us clues as to what chemistry to focus us. Your experiences hint that the serotonin route (SSRIs, Cymmbalta, etc) are not right. Wellbutrin doesn't count. If anything it probably means you don't need tweaking of nicotinic receptors or nitric oxide pathways. The reaction to Adderall speaks loud and clear, pointing to something like a Desipramine or Nortriptyline, or some combination with one of them in it, perhaps along with the Adderall. If nothing else, we have a fair amount of certainty what kinds of drugs you will not find help with...basically anything that has serotonin reuptake as its primary mechanism.
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> I'd like to figure out the story behind the depression. Something like hypothyroidism, or adrenal fatigue, or magnesium deficiency, etc. I'd much prefer to know exactly what's going on that makes me different from other people, rather than rely on some antidepressant which could stop working at any point for all I know.Yeah, I feel exactly the same way. I've spent a lot of money and time trying to figure it all out. First it was clear I had adrenal fatigue or hypoadrenalsim or whatever...low cortisol for whatever reason. It was odd that my response to ADs coincided exactly with my cortisol curve...bad in the morning, sinking in the afternoon, remarkable recovery in the evening. What I didn't yet know was that low cortisol usually has a cause...some kind of environmental insult. Upon looking in my mouth, my doctor concluded the silver fillings were a primary suspect. Sure enough, on a provoked urine test I had very high amounts of mercury and lead. The amalgams were removed quickly after that, I did a dozen rounds of low dose frequent dose chelation, and though I probably need a lot more at least the source of mercury is gone and I have cleaned some of it out of tissue stores.
So I thought I had it nailed. Adrenal fatigue, mercury. Of course there is depression. Duhh. But the biggest surprise was still to come. A strange rash looking like a bullseye on my leg got my attention. Didn't hurt, no swelling, no big deal. A couple months later I was bored and curious and surfed around the net looking for photos of rashes that looked as weird as mine did. I found them easily. They are the famous bullseye rashes that about 50% of Lyme disease sufferers experience. If not for that rash, I never would have found the real cause of my problems.
So an expert on Lyme gives me a clinical exam and a lab exam. Sure enough I am positive for Lyme. Now it is all making sense. Furthermore I discover that the Borellia bacteria of Lyme upset the hormones including cortisol, they all sequester mercury for their own defense, yeast in the gut love mercury so they have a feast and overgrow, all of this causing an assault of neurotoxic chemicals in the brain going where serotonin, NE, and DA are supposed to be going, and on and on. Complicated.
So, a few chelations later, a couple stabs at antibiotics, a current stab at yeast control, and a low dose of an old-time antidepressant that I can actually tolerate and is doing some good (Nortriptyline), I am finally making some forward progress.
There is much work ahead. More chelation. More antibiotics. More effort to keep yeast down. Dependence on medication assistance for current symptoms so I can work, live, and function throughout it all. It is analagous to a battlefield after the war is over, needing a lot of cleaning up, and not sure what damage will never repair.
I have no idea what your story is. The best way to find out is to assume nothing, get a lot of tests, many of which you will have to pay cash for, or go about methodically trying things one at a time...vitamins, supplements, antibiotic Tetracycline, anti-yeast Nystatin, antiyeast herbs, antibiotic herbs, minerals, take a look in your mouth at the fillings, and such. One clue leads to another, and sooner or later a picture is painted. For me it took about 3 years to do that.
If you want more detailed information on what kinds of tests can show important stuff and not cost much, let me know. Though the potential biological causes of depression are many, the most common ones are just a handful, in my opinion.
Going long here, sorry. Based on your history with meds and desire for natural, I applaud that. The road to discovery might take some time. In the meantime you might need some help for day to day living. That's where I think limiting the field of medicines to Nortriptyline, Desipramine, and Adderall, could save you a lot of time and pain. St Johns Wort is still on the radar screen and would see no reason to not give it a try before going the medication route. No way to preduct, but that is my hunch.
poster:bleauberry
thread:907300
URL: http://www.dr-bob.org/babble/20090709/msgs/907536.html