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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Francesco on September 5, 2003, at 14:15:25
I have posted in the past that Anafranil seemed to help my ADHD features while making me social phobic. I've read somewhere that I'm not alone. I have a question-theory (sorry if it's too semplicistic). Anafranil raises serotonin (just like SSRIs). When serotonin is raised, dopamine tends to be lowered. When you have low dopamine you have social phobia ... does it make any sense ? (Incidentally ... Is that the reason why I drink socially when I'm on meds ? to increase dopamine ?). Sorry if the question is too stupid : )
Posted by stjames on September 5, 2003, at 14:56:48
In reply to Dopamine and Serotonin, posted by Francesco on September 5, 2003, at 14:15:25
It's it for more complex that and raise or lower
issue. If it was mental illness would be cured.
Posted by Ame Sans Vie on September 5, 2003, at 16:13:58
In reply to Dopamine and Serotonin, posted by Francesco on September 5, 2003, at 14:15:25
Not a stupid question at all -- I suspect you're absolutely right. Though I think what stjames is trying to get across is that reuptake inhibitors don't actually *increase* the amount of any given chemical in the brain -- they simply work to make the most of the 5HT/DA/NE/etc that you *do* have.
We all know that serotonin reuptake inhibitors have the ability to cause horrible apathy/flat affect/blunted emotions, and that these are all common symptoms that often indicate a problem within the dopaminergic system. Schizophrenia (which is caused by over-activity/over-production of dopamine) often manifests 'negative' symptoms which include apathy, flat affect, and blunted emotion. Ironically, the same drugs used to treat this disorder (which antagonize dopamine) can cause these same symptoms.
I've felt the exact same apathy etc. on antipsychotics and SSRIs, which certainly leads me to believe that the SSRI causes downregulation in the dopaminergic system, and probably noradrenergic as well, to compensate for increased serotonergic activity (i.e. your brain is trying to find a balance).
So all that being said, if serotonin reuptake inhibition *does* adversely affect the dopaminergic system, and I certainly believe it does, then your social phobia theory makes perfect sense. I believe it's the D2 receptor that is primarily said to be hypoactive in social phobics... I wish I could find some more, solid information on this.
Posted by Francesco on September 5, 2003, at 17:25:18
In reply to Re: Dopamine and Serotonin » Francesco , posted by Ame Sans Vie on September 5, 2003, at 16:13:58
Thanks for answering me ... Which are the dopaminergic meds ? Wellbutrin and stims ? Is that the reason why some folks are treated with SSRIs and Wellbutrin ? In your opinion can this work in the LONG TERM ?
Posted by Ame Sans Vie on September 5, 2003, at 17:49:33
In reply to Re: Dopamine and Serotonin » Ame Sans Vie, posted by Francesco on September 5, 2003, at 17:25:18
> Thanks for answering me ...
No prob.
> Which are the dopaminergic meds ? Wellbutrin and stims ?
Wellbutrin and methylphenidate are both dopaminergic and noradrenergic; amphetamines affect DA, NE, and 5HT. Beyond that, the only purely dopaminergic meds are those for Parkinson's disease, mostly dopamine agonists such as pramipexole, ropinirole, cabergoline, bromocriptine, and amantadine. Deprenyl is an inhibitor of MAO-B and thus increases concentration of DA in the brain... then there are the precursors -- levodopa/carbidopa, tyrosine, and phenylalanine. Too bad amineptine isn't so easy to get ahold of these days...
> Is that the reason why some folks are treated with SSRIs and Wellbutrin ?
In many cases, yes, the Wellbutrin is added on to the SSRI to eliminate or decrease the sexual side effects and apathy. In fact, "Cel-Well" is a term that originated in California, I believe, to refer to a combination of Celexa and Wellbutrin, which is apparently very popular.
Stimulants and DA agonists are also very good augmenting and anti-side-effect agents combined with 5HT reuptake inhibitors.
> In your opinion can this work in the LONG TERM ?
Well, anything's possible... provided you manage to avoid the poop-out phenomenon, that is.
Posted by stjames on September 5, 2003, at 22:14:36
In reply to Re: Dopamine and Serotonin » Francesco , posted by Ame Sans Vie on September 5, 2003, at 16:13:58
> Not a stupid question at all -- I suspect you're absolutely right. Though I think what stjames is trying to get across is that reuptake inhibitors don't actually *increase* the amount of any given chemical in the brain -- they simply work to make the most of the 5HT/DA/NE/etc that you *do* have.
>Yes, that is part of what i am saying. The other part is that there has to be far more than reuptake inhibition happening here, as we know reuptake inhibition happens in hours but the effects take weeks to show themselves. So concentrating on these effects, as a way to pick meds, is flawed. Neuroprotective effects start to produce new cells in a month, so this may be part of the effects also.
Posted by Ame Sans Vie on September 6, 2003, at 8:22:19
In reply to Re: Re: Dopamine and Serotonin, posted by stjames on September 5, 2003, at 22:14:36
> Neuroprotective effects start to produce new cells in a month, so this may be part of the effects also.
Right, I'd forgotten about the new research... I have to admit I haven't read much into it. I really should do a little web-surfing on this.
Posted by stjames on September 6, 2003, at 12:22:59
In reply to Re: Re: Dopamine and Serotonin » stjames, posted by Ame Sans Vie on September 6, 2003, at 8:22:19
> Right, I'd forgotten about the new research... I have to admit I haven't read much into it. I really should do a little web-surfing on this.
>
What I am intrested is if the neuroprotective effects are common to all AD's, even if they do not
lift depression for a specific person. It could be that one needs both, an AD that adjusts the right NT (and causes the right cascade of effects) & neuroprotective effects to lift depression.
Posted by lostforwards on October 20, 2004, at 19:01:19
In reply to Re: Dopamine and Serotonin » Francesco , posted by Ame Sans Vie on September 5, 2003, at 17:49:33
Hi, I read some of your posts and you seem to know what you're talking about so I thought I'd pose a question for you.
When was being treated for bipolar I was taking 3mg Risperidal 1 week, and 2mg 2weeks, and 1mg for 1week, in the mornings along with a very low dose phenothiazine for sleep at night. I developed difficulty breathing, muscle weakness, and other eps like trembling in my fingers.
After quitting the antipsychotic I felt this horrible apathy that hasn't really lifted for 3 weeks.
Do you have any ideas what happened?
Will I get over this, or is this blunted feeling permanent?
Posted by lostforwards on October 20, 2004, at 19:02:53
In reply to Re: Dopamine and Serotonin » Francesco , posted by Ame Sans Vie on September 5, 2003, at 17:49:33
ooops I sent my post to the wrong person.
This is the end of the thread.
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