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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by jonh kimble on November 26, 2002, at 17:55:33
Hi, Im wondering if anyone here knows why booze has a stimulating effect? I know its related to increase dopamine but how is this accomplished? Because for me alcohol fills me with positivity, energy, self confidence, much improved concentration, mood lift, and I can just focus my mind on what I want to so much better. In short, a miracle drug for all my symptoms. Other dopaminergics just dont do anything or for a very short while.
The reason I ask is because maybe this could help me identify what my problems are caused by and what could help. Thanks so much, Tom
Posted by snowden on November 26, 2002, at 20:15:08
In reply to alcohol and stimulant effect, posted by jonh kimble on November 26, 2002, at 17:55:33
Posted by bluedog on November 26, 2002, at 22:07:52
In reply to alcohol and stimulant effect, posted by jonh kimble on November 26, 2002, at 17:55:33
hellelujah. You've hit the nail on the head. Alcohol is a miracle drug!!!
If it weren't for the brain damage, liver damage, hangovers and depression it causes me I would ditch all my antidepressant and anxiolytic medications and just go to work in the mornings with a bottle of scotch under my arm. The positive effects of this would be as follows:
1. I would be filled with self confidence.
2. Even better than self confidence I would have a sense of euphoria as I went through the day. This is obviously what happiness actually feels like.
3. I would be able to relate to all manner of people with great ease including clients colleagues and bosses. All these people would view me as a great guy as I would have a very pleasant and relaxed "air" about me. I would no longer repel people because I would no longer have "just something" that people can't really explain that makes them uncomfortable around me. Of course, because because people will actually want to be around me I will never again have to endure loneliness and depression.
4. I would be able to avoid the tension headaches and muscle aches and pains that dog me by the end of the day because all my muscles would be naturally relaxed.
5. I would no longer have to endure boredom at work because my perception of life would be so wonderful that boredom would simply be a thing of the past.By the way, I suffer from social anxiety and for some reason alcohol hits the pleasure centres deep in my brain in a way that is so profound that it probably comes pretty close to a religious experience. Just one drink will send a message to my entire being that I have become enlightened. (social anxiety?? Who me?? NO WAY!!)
Too bad it's just an illusion hey?
Posted by JonW on November 26, 2002, at 23:52:23
In reply to alcohol and stimulant effect, posted by jonh kimble on November 26, 2002, at 17:55:33
Pretty much everyone with social anxiety knows that alcohol works, unfortunately it isn't a practical cornerstone for the pharmacological treatment of the illness. My pdoc Dr. Liebowitz, who's name carries some weight when it comes to social anxiety, says it's OK for people with SP to use alcohol. Not in a way that you can't function socially without it, though. It's pretty important to attack SP from both sides at the same time. If I could give you some advise, I would suggest you try putting equal importance on both therapy (CBT) and medication. I was so focused on medications, this receptor and that receptor, this study and that study, if this drug had this effect and that drug had that effect then that suggests this drug should be helpful, or maybe this drug in combination with that drug, etc, etc... I scoffed at anyone who even brought up CBT, or therapy. Been there, done that -- I read "Feeling Good" and even saw a CBT therapist for awhile. Maybe CBT works for minor cases, but my problem is much worse. My problem is much more biological and and needs the right medication.
If you do CBT with a therapist who has special training for treating people with SP at the same time you do the meds with your pdoc, you may find the medication suddenly becomes much more effective. It's true, CBT + meds is more effective than either alone, and particularly potent when it comes to treating SP. The best move I ever made was to start working with Dr. Liebowitz and Carla Daichman who are both part of Klein, Liebowitz psychiatric associates. Putting my pharmacologic care in the hands of an expert (Liebowitz) and seeing Carla Daichman who works with me and helps Dr. Liebowitz with info for med adjustments, etc. has probably been the best decision I've ever made. I don't know how exactly you view your illness, but I thought I'd share my experience because I wouldn't want you to unnecessarily miss out on what has saved me.
Good Luck,
Jonp.s. Alcohol makes me euphoric, too... It's amazing how powerful SP is, though. I remember being falling down drunk, and it would still be with me...
Posted by djmmm on November 27, 2002, at 7:42:18
In reply to alcohol and stimulant effect, posted by jonh kimble on November 26, 2002, at 17:55:33
Alcohol is postulated to act by facilitating GABA-A function, by interacting with the GABA-A receptor, but at a site different from the GABA binding site or the benzodiazepine binding site. This results in the activation of the DA neurons in the mesolimbic system. This is involved in the sedative and anxiolytic effects and the rebound hyperexcitability seen during withdrawal.
The effect of alcohol on the DA system is not directly with the DA receptors, but rather indirectly by increasing DA levels in the mesocorticolimbic system. This increase is associated with the reinforcing and rewarding effects of alcohol
The interaction of alcohol with the opioid system is also indirect and results in activation of the opioid system. This is associated with reinforcing effects (probably via mu-receptors) and aversive effects (probably via kappa receptors). The opioid system is also involved in the craving for alcohol, and opioid antagonists, such as naloxone and naltrexone block the rewarding effects and craving for alcohol
Alcohol's effect on the NMDA system has also been studied. Alcohol inhibits the NMDA receptor, not by direct interaction with the glutamate binding site, but rather by modifying the way glutamate binds to its site on the receptor complex (allosteric effect). This interaction is thought to mediate the sedative/hypnotic effects of alcohol, as well as neuroadaptation. The NMDA system is also important in withdrawal.
The serotonin system is also thought to play a role in the pharmacology of alcohol. The mechanism for this is unknown, but thought to modulate DA release. What is known is that increasing serotonin levels at the synapse decreases alcohol intake. These data are mostly obtained in animal studies and need further investigation
Acute alcohol is also known to affect the hypothalamic-pituitary axis, possibly involving the hormone CRF (corticotrophin releasing factor). This action probably underlies the stress-reducing effects of alcohol
This is the end of the thread.
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