Posted by Racer on January 25, 2008, at 14:09:44
In reply to Re: oops. » Racer, posted by Phillipa on January 25, 2008, at 12:12:53
> Racer seriously what do you make of this Deplin on it too one day third felt like doing something and some energy then poof gone. Aren't you on a similar new med for a different condition?
I take Metan-X, which is a similar medical food marketed primarily towards diabetics, since it helps regulate homocysteine levels. Like Deplin, it includes methylfolate, but it also incorporates pyridoxal 5'-phosphate and methylcobalamin -- forms of B6 and B12. My pdoc likes it better than Deplin because it does contain these other elements, which some people benefit from adding to Deplin.
Forewarned is forearmed -- you know you have an awful lot of anxiety about medications, so you can remind yourself that an awful lot of your reactions to medications stem from anxiety, rather than direct effects of the medications. That's true for many of us here on these boards, so please don't take it as a personal affront -- it's human nature, and it's common. Deplin is made up of a form of B vitamin -- it's not going to act like a traditional medication, it's going to be a lot more subtle than that. I would suggest trying to average your response over weeks, not days.
>I feel I need help and no one to give it.
That's not a good place to be. Have you discussed this with your doctors? That you're not feeling confidence in them, because you want a fuller explanation than they're giving you?
The bad news is that you may never get the level of information you're looking for. You seem to have a very low tolerance for uncertainty, and psychiatry is made up of an awful lot of uncertainty. No one can answer all of the questions you've asked on this board about Deplin -- because no one really knows all the answers to those questions. It might be in your best interest to make a list of those questions, prioritize them -- "these are things that I feel it is important for me to know; these are things I'd like to know for my own satisfaction; these things over here are really idle curiosity" -- and then accept that you'll be well if if you can get some answers in the first category. Learning to cope with uncertainty would be a good skill to work on.
> Don't want a stimulant as that is what I take dopamine to be.I think you've been confused by a lot of what's posted on these boards about dopamine. First of all -- probably most of what's said about the workings of the brain is based more on speculation and hypothesis than on verifiable fact. That's just the state of current research: what's known so far suggests certain things, but it seems as though every week there's a new discovery that implodes an older hypothesis. *No one knows exactly how any of this works.*
Keeping that in mind, here's what I think I know regarding dopamine and stimulants, and all that.
First of all, saying that dopamine is a stimulant is not at all accurate. Dopamine is one of the Big Three neurotransmitters believed to be involved in depression. Dopamine is actually the most confusing of the three, too, so don't feel bad if it hasn't made sense to you: dopamine *is* a neurotransmitter -- nerve cells release it to communicate messages to other nerve cells, hence the name "neuro-transmitter." It's fairly recently been discovered to be a neurotransmitter, though, because dopamine is *also* a precursor to norepinephrine. Our bodies create neurotransmitters from elements in the foods we eat. Tryptophan is the dietary element that we make serotonin from; tyrosine is the element that makes dopamine, some of which is then made into norepinephrine.
Stimulants increase the release of dopamine and norepinephrine, and inhibit their reuptake. (Reuptake happens when other molecules between nerve cells come along and bind to the neurotransmitter in question, then transport it back to the cell which released it. Each of the Big Three has its own reuptake molecule -- unimaginatively but descriptively named "dopamine transporter," "norepinephrine transporter," and "serotonin transporter." Once the used neurotransmitter is returned to the originating cell, MAO breaks it down to its component parts.) So, stimulants affect dopamine, but dopamine is not a stimulant.
The reason you read some much about dopamine on these boards has to do with the brain functions dopamine affects. Again, remember that most of this is not fully understood, so it's a lot more complex than anything I write here. Dopamine is involved in an awful lot of functions, many involving things like movement, sleep, milk production, etc. The functions that are probably best known, though, involve mood, attention, motivation, and addiction. Dopamine is popularly known as the "reward" neurotransmitter, which I think is why so many people here are interested in it -- if you suffer from anhedonia (lack of pleasure), it makes sense to take something that should trigger activity in the reward system of your brain, right?
Here's the thing: the brain is not a simple thing. The individual neurotransmitters are probably not nearly as important as the ratios between them, the areas of the brain where they're active, the interplay between the three neurotransmitters we usually talk about here and other biochemicals in the brain, etc. If you take L-Dopa, the form of dopamine precursor which can cross the blood brain barrier, you can't say, "Hey, you, L-Dopa -- go to the substantia nigra and beef up the dopamine production there." It's not yet possible to target any specific symptom that precisely. (And, of course, since we're talking about dopamine here, some of the L-Dopa would become norepinephrine anyway, but that's beside the point.) Some studies have strongly suggested, for instance, that methylphenidate (Ritalin, et al) actually works by down-regulating dopamine receptors (ie: making them less sensitive) and thus increasing the ratio of serotonin activity in comparison. Other studies have suggested that SSRIs work by down-regulating serotonin receptors and thus increasing the ratio of dopamine activity.
The only thing anyone really knows so far about these medications is that they are helpful for a certain percentage of people who take them. Exactly how that works is not yet fully understood. As of now, there's no way to know which will be helpful for any given person except to try them at an adequate dose for an adequate amount of time. Sometimes you can make certain predictions, but the degree of accuracy is not necessarily all that high.
> Correct my idiot mistakes. I maybe do need the deplin if they are thinking of using it for alzheimers too according to that pdocs I see.
There are things you can do to reduce your risk of developing Alzheimers, many of which would improve your quality of life under any circumstances.
Intellectual stimulation helps -- play chess, do Sudoku puzzles, do logic puzzles, learn a foreign language.
Social interaction helps -- get out of the house, go join a club, meet new people, get involved in something involving other people. I know you've got some agoraphobia issues, and that it's difficult for almost anyone to find new people, but there are options out there.
--Go to MeetUp.com and join a group that shares your interests.
--Go to your local community education campus and take a class.
--Learn to knit: many yarn stores have "stitch and bitch" sessions where everyone sits, knits, and talks.
--Volunteer in your community. There are opportunities in most communities for any interest.
--If you're brave, go hang out in almost any independent coffee house and you'll find someone to talk to.
The important thing in all that, of course, is that you have to go out and do it. That's hard, but it is possible.
Good luck. I hope my explanation was helpful.
poster:Racer
thread:808567
URL: http://www.dr-bob.org/babble/neuro/20080114/msgs/808875.html