![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 2 to 26 of 26. Go back in thread:
Posted by SalArmy4me on August 7, 2001, at 19:00:08
In reply to Serotonin vs. Dopamine Deficiency - Symptoms?, posted by Buster on August 7, 2001, at 18:45:24
Its thought that dopamine deficiency leads to ADHD, thus the need for dopamine-enhancing medications like methylphenidate and dextroamphetamine. Also, dopamine deficiency may lead to apathy and indifference (sometimes due to SSRI depletion of dopamine).
> Has anyone come across either an article in Medline or a Web page that compares the symptoms that are associated with a deficiency of serotonin vs. the symptoms that are associated with a deficiency of dopamine?
Posted by terra miller on August 8, 2001, at 11:37:04
In reply to Serotonin vs. Dopamine Deficiency - Symptoms?, posted by Buster on August 7, 2001, at 18:45:24
> Has anyone come across either an article in Medline or a Web page that compares the symptoms that are associated with a deficiency of serotonin vs. the symptoms that are associated with a deficiency of dopamine?
what a great question. i hope you get a web page linked here. i can speak from personal trial/error to that. i've been at this a little over a year and based on different types of meds and the levels i was/wasn't able to get to and side-effects i was able to determine that it wasn't so much serotonin that i needed as probably something else. it took some trial and error to figure that out, but once i did i've found it extremely helpful in narrowing down which meds will and will not help me. food for thought. -terra
Posted by jojo on August 8, 2001, at 20:32:44
In reply to Serotonin vs. Dopamine Deficiency - Symptoms?, posted by Buster on August 7, 2001, at 18:45:24
> Has anyone come across either an article in Medline or a Web page that compares the symptoms that are associated with a deficiency of serotonin vs. the symptoms that are associated with a deficiency of dopamine?
I'm afraid that it's not that simple, Buster. Changing one neurotransmitter seems to change the availability of others. Otherwise, all SSRIs would be expected to behave somewhat the same. It may be called an "SSRI", but the eventual effects vary among the various drugs.
jojo
Posted by DP on August 14, 2001, at 18:11:37
In reply to Re: Serotonin vs. Dopamine Deficiency - Symptoms? » Buster, posted by jojo on August 8, 2001, at 20:32:44
> Has anyone come across either an article in Medline or a Web page that compares the symptoms that are associated with a deficiency of serotonin vs. the symptoms that are associated with a deficiency of dopamine?
I'd really like to know the answer to this question. Web address anyone?
Posted by JohnL on August 15, 2001, at 18:07:10
In reply to Re: Serotonin vs. Dopamine Deficiency - Symptoms?, posted by DP on August 14, 2001, at 18:11:37
> > Has anyone come across either an article in Medline or a Web page that compares the symptoms that are associated with a deficiency of serotonin vs. the symptoms that are associated with a deficiency of dopamine?
>
> I'd really like to know the answer to this question. Web address anyone?I too would like to see some research on this topic. I think the entire psychiatric community is missing the boat by not focusing on exactly what you are asking about.
From my own anecdotal experience, I think dopamine deficiency is more related to symptoms of blahness, lack of pleasure, anhedonia, dysthymia. Dopamine deficiency is not really like being depressed, but it's more like just being blah, lifeless, and nothing at all is enjoyable. You ask a good question. I wish we had some solid answers. But I am firmly convinced that symptoms related to dopamine represent a totally different beast than symptoms related to serotonin, even though nearly all doctors at this point lump them into the same group.
John
Posted by jojo on August 15, 2001, at 22:53:05
In reply to Re: Serotonin vs. Dopamine Deficiency - Symptoms?, posted by JohnL on August 15, 2001, at 18:07:10
> > > Has anyone come across either an article in Medline or a Web page that compares the symptoms that are associated with a deficiency of serotonin vs. the symptoms that are associated with a deficiency of dopamine?
> >
> > I'd really like to know the answer to this question. Web address anyone?
>
> I too would like to see some research on this topic. I think the entire psychiatric community is missing the boat by not focusing on exactly what you are asking about.
>
> From my own anecdotal experience, I think dopamine deficiency is more related to symptoms of blahness, lack of pleasure, anhedonia, dysthymia. Dopamine deficiency is not really like being depressed, but it's more like just being blah, lifeless, and nothing at all is enjoyable. You ask a good question. I wish we had some solid answers. But I am firmly convinced that symptoms related to dopamine represent a totally different beast than symptoms related to serotonin, even though nearly all doctors at this point lump them into the same group.
> JohnCheck this out.
http://www.biopsychiatry.com/mechnov.htmjojo
Posted by ChrisK on August 16, 2001, at 3:39:35
In reply to Re: Serotonin vs. Dopamine Deficiency - Symptoms?, posted by JohnL on August 15, 2001, at 18:07:10
I agree with John from an anecdotal standpoint. My anhedonia/apathy only lifted with the addition of Mirapex which is a Dopamine agonist. SSRI's never did a thing for me. I guess that it's true that everyone's depression and reaction to meds is unique.
> > > Has anyone come across either an article in Medline or a Web page that compares the symptoms that are associated with a deficiency of serotonin vs. the symptoms that are associated with a deficiency of dopamine?
> >
> > I'd really like to know the answer to this question. Web address anyone?
>
> I too would like to see some research on this topic. I think the entire psychiatric community is missing the boat by not focusing on exactly what you are asking about.
>
> From my own anecdotal experience, I think dopamine deficiency is more related to symptoms of blahness, lack of pleasure, anhedonia, dysthymia. Dopamine deficiency is not really like being depressed, but it's more like just being blah, lifeless, and nothing at all is enjoyable. You ask a good question. I wish we had some solid answers. But I am firmly convinced that symptoms related to dopamine represent a totally different beast than symptoms related to serotonin, even though nearly all doctors at this point lump them into the same group.
> John
Posted by Emmah on August 16, 2001, at 6:50:23
In reply to Serotonin vs. Dopamine Deficiency - Symptoms?, posted by Buster on August 7, 2001, at 18:45:24
> Has anyone come across either an article in Medline or a Web page that compares the symptoms that are associated with a deficiency of serotonin vs. the symptoms that are associated with a deficiency of dopamine?
Hi Buster,
I have been searching the internet to find out about the symptoms of noradrenalin deficiency. I use Effexor, which in lower doses works mainly on the serotonin, in higher doses also on the noradrenalin and in real high doses even the dopamine seems to be effected. I came across these sites which I found very useful in determining if I might benefit from a raise in my dose. Hope you will find some info there too.
Takje care,
Emmahhttp://www.healthsmith.com/hsweb/htm/mood_inventory.htm
http://www.wings.buffalo.edu/aru/P402chpt15.htm
http://www.beatcfsandfms.org/html/BrainChem.html
Posted by Rosa on August 16, 2001, at 7:36:25
In reply to Serotonin vs. Dopamine Deficiency - Symptoms?, posted by Buster on August 7, 2001, at 18:45:24
No, but you may want to check www.drkoop.com Drug Checker, which is extremely helpful in finding drug interactions. You may be able to find some information on Serotonin and Dopamine there.
Rosa
------------------------> Has anyone come across either an article in Medline or a Web page that compares the symptoms that are associated with a deficiency of serotonin vs. the symptoms that are associated with a deficiency of dopamine?
Posted by Cam W. on August 16, 2001, at 10:58:46
In reply to Serotonin vs. Dopamine Deficiency - Symptoms?, posted by Buster on August 7, 2001, at 18:45:24
Buster - I believe that, in most common mental disorders, that a lack (or excess) of a neurotransmitter is only a symptom of the disorder. The monoamine theory of mental illness is inadequate and a broader picture of intracellular signaling dysfunction may need to be addressed. Saying that a lack of dopamine or a lack of serotonin is causing depression is like saying your local gas station is causing the price of gas to go up. In a way, the gas staion and the price of gas are linked are linked, but no "direct" cause/effect is occurring.
When we use medications designed to raise serotonin or dopamine, we are only addressing the "effects" of the illness, not getting to the root of the problem. This may be a reason why our current armamentum for fighting mental disorders is inadequate in many cases. I believe that scientists are now seeing that the reductionist view of the monoamine theory is the wrong approach, and possibly (probably?) only a symptom of most disorders.
So, to look at neurotransmitter deficiency symptoms, to decide how one needs to be treated, may be a misguided way to approach treatment. Although you may tackle some of the disorder symptoms using the deficiency approach; such an approach may not be the best treatment.
My 2¢ - Cam
Posted by Mitch on August 16, 2001, at 12:16:44
In reply to Re: Serotonin vs. Dopamine Deficiency - Symptoms? » Buster, posted by Cam W. on August 16, 2001, at 10:58:46
> Buster - I believe that, in most common mental disorders, that a lack (or excess) of a neurotransmitter is only a symptom of the disorder. The monoamine theory of mental illness is inadequate and a broader picture of intracellular signaling dysfunction may need to be addressed. Saying that a lack of dopamine or a lack of serotonin is causing depression is like saying your local gas station is causing the price of gas to go up. In a way, the gas staion and the price of gas are linked are linked, but no "direct" cause/effect is occurring.
>
> When we use medications designed to raise serotonin or dopamine, we are only addressing the "effects" of the illness, not getting to the root of the problem. This may be a reason why our current armamentum for fighting mental disorders is inadequate in many cases. I believe that scientists are now seeing that the reductionist view of the monoamine theory is the wrong approach, and possibly (probably?) only a symptom of most disorders.
>
> So, to look at neurotransmitter deficiency symptoms, to decide how one needs to be treated, may be a misguided way to approach treatment. Although you may tackle some of the disorder symptoms using the deficiency approach; such an approach may not be the best treatment.
>
> My 2¢ - Cam
Cam,What do you think about the "sticky switch" hypothesis (that left and right hemispheres are not "sharing" properly, i.e.) in relation to bipolar disorder (and perhaps others)?
Is the "structure" and "function" of the brain ("geographically") now starting to be studied more than just the neurochemistry? Are there any developments outside the receptor model that are new that would be interesting to share?
Mitch
Posted by Cam W. on August 16, 2001, at 16:24:12
In reply to Re: Serotonin vs. Dopamine Deficiency - Symptoms? » Cam W., posted by Mitch on August 16, 2001, at 12:16:44
Mitch - The "sticky switch" theory that you mention is just one of several possibilities of things going on in the brain. I have read a few articles that have shown some problems with information sharing problems between brain hemispheres. It may explain some cases, but not all.
There are many different theories coming to light, especially with the much higher resolution of today's imaging techniques and the invention of compounds that bind very specifically to individual receptors (although both techniques have not been perfected).
I think the biggest advances are being made in the relationship of different neurotransmitter systems to each other, and the specific interactions of these systems in various brain structures (esp. the anterior cingulate cortex and it's connections to various parts of the hippocampus and thalamus).
The picture is far from complete and I know of no single journal article (so far) that paints even a rough sketch of everything that is going on. Cytokines and the effect of the immune system on emotional states is very interesting. Nitric oxide's actions as a nontraditional neurotransmitter/neuromodulator and it's function in relaxation therapy and possibly the placebo effect. The relationship of glucocorticoid receptor concentrations to mood disorders. New developments in GABAergic and cholinergic neurotransmitter systems and their relationship to the traditional 3 neurotransmitters is neat.
Many of the articles, where I have read a lot of information is on Neuroscion.com ( http://www.neuroscion.com ) in the library section. You have to sign up, but they give you full access to about 25 articles, and scanning the abstracts is free. Most of the journals are fairly techinical, but for a geek like me, they are facinating. Journals like "Neuropsychopharmacology", "The European Journal of Pharmacology", "The Journal of Psychiatric Research" "Brain Research Reviews", and "Clinical Neuroscience Research", as well as a number of others, often have good articles.
I hope that this is of some help. There are just too many areas being looked at to give a synopsis of what is going on. The one common theme of many of these research avenues is that we've gone as far as the monoamine hypothesis will take us and it is now time to look at different avenues of research. - Cam
Posted by susan C on August 16, 2001, at 16:44:55
In reply to Re: Serotonin vs. Dopamine Deficiency - Symptoms? » Cam W., posted by Mitch on August 16, 2001, at 12:16:44
Cam,
Susan here,I have been trying to decipher some of what you are saying, educating myself as I and my doc try to figure out what is going on with me. He is not convinced I am bipolar 2, and is investigating seizure related cause of mood. Depakote helped some. I have not taken Keppra long enough yet to get anything but side effects.
Other than the observations of my pdoc/neurologist I have yet to talk to anyone here who is/has tried Keppra. I know it is an antiseizure med, used 'off lable' for mood. I have read the paperwork and the references on the web.
I am not a medical professional. I curious if you have an opinion of this chemical in relationship to your readings and observations made in this thread re: my gas station is not causing the price to go up..that made me lol...
Thank you.
-s
> > Buster - I believe that, in most common mental disorders, that a lack (or excess) of a neurotransmitter is only a symptom of the disorder. The monoamine theory of mental illness is inadequate and a broader picture of intracellular signaling dysfunction may need to be addressed. Saying that a lack of dopamine or a lack of serotonin is causing depression is like saying your local gas station is causing the price of gas to go up. In a way, the gas staion and the price of gas are linked are linked, but no "direct" cause/effect is occurring.
> >
> > When we use medications designed to raise serotonin or dopamine, we are only addressing the "effects" of the illness, not getting to the root of the problem. This may be a reason why our current armamentum for fighting mental disorders is inadequate in many cases. I believe that scientists are now seeing that the reductionist view of the monoamine theory is the wrong approach, and possibly (probably?) only a symptom of most disorders.
> >
> > So, to look at neurotransmitter deficiency symptoms, to decide how one needs to be treated, may be a misguided way to approach treatment. Although you may tackle some of the disorder symptoms using the deficiency approach; such an approach may not be the best treatment.
> >
> > My 2¢ - Cam
>
>
> Cam,
>
> What do you think about the "sticky switch" hypothesis (that left and right hemispheres are not "sharing" properly, i.e.) in relation to bipolar disorder (and perhaps others)?
>
> Is the "structure" and "function" of the brain ("geographically") now starting to be studied more than just the neurochemistry? Are there any developments outside the receptor model that are new that would be interesting to share?
>
> Mitch
Posted by Cam W. on August 16, 2001, at 17:57:38
In reply to Cam, other areas and Keppra Levetiracetam, posted by susan C on August 16, 2001, at 16:44:55
Susan - I have no experience with Keppra, outside of the little blurbs I Have read (ie. little chance of pharmacokinetic drug-drug interactions and mechanism of action related to GABA system, but unknown).
I know of no one who has tried it, but since I work in the community, that is not unusual for a new drug, especially for off-label use. Theoretically, enhancing GABAergic transmission should work in both epilepsy and bipolar disorder, by stabilizing neuronal membranes (nerve cells).
Sorry, but you'll be my guinea pig on this one. Perhaps start a new thread and ask others, especially Europeans, about Keppra.
Good luck - Cam
Posted by susan C on August 16, 2001, at 20:16:20
In reply to Re: Cam, other areas and Keppra Levetiracetam » susan C, posted by Cam W. on August 16, 2001, at 17:57:38
...but I hadn't quite realized how hard. I knew it was new, but hadn't quite accepted it.
It will be three weeks this Saturday, two at 250mg (500 was too sedating, so 'we' are going slower) He has 5 TR that have found it helpful. The main reason, and also listed in literature, for stopping, is the sedation. I am at 500 now and am not really sure what to think. I am going to give it a good go. I have my 'journal' in four different places and just found one from a post on this board, for the computer, that I think will be good. I suppose it is an improvement that I am trying to figure this all out. Plus I have found tremendous help here on this board. Just trying to write and answer and articulate is a challenge for me verbally, so to write and edit takes me time, also is very revealing when I am going through a rough patch, I can hardly type.
We are such an unusual mix,babblers, everybody is so different, but so similar. Thank you again for your input. I will call out to the European Union to see if I can get some response. Now I am curious and more confident. It has been a long struggle. Do I see a light?
Warmest Regards in this Odd Place Called Cyberspace - Susan C
> Susan - I have no experience with Keppra, outside of the little blurbs I Have read (ie. little chance of pharmacokinetic drug-drug interactions and mechanism of action related to GABA system, but unknown).
>
> I know of no one who has tried it, but since I work in the community, that is not unusual for a new drug, especially for off-label use. Theoretically, enhancing GABAergic transmission should work in both epilepsy and bipolar disorder, by stabilizing neuronal membranes (nerve cells).
>
> Sorry, but you'll be my guinea pig on this one. Perhaps start a new thread and ask others, especially Europeans, about Keppra.
>
> Good luck - Cam
Posted by ShaneS on August 17, 2001, at 11:51:05
In reply to Re: Serotonin vs. Dopamine Deficiency - Symptoms?, posted by ChrisK on August 16, 2001, at 3:39:35
Hi ChrisK,
I have been suffering from anhedonia for the past six years, but did not
no what it was until a year ago. For the past five years i had been told it was depression
and give another SSRI to try with no effect. I was fortunately referred by a friend to a
qualified therapist who was able to diagnose me with anhedonia within the first visit. Thanks to
that and your postings about mirapex on this wonderful site, I now have my life back. I am taking 1.5 mg
of mirapex a day (.5mg x 3) and have about 40% of my emotions back. I have not however had my labido return
yet and was wondering if you had. If so, at what dosage of mirapex did it return. Mirapex is th only med i'm taking.Thanks,
ShaneS
Posted by AndrewB on August 19, 2001, at 13:35:16
In reply to Re: Serotonin vs. Dopamine Deficiency - Symptoms?, posted by ShaneS on August 17, 2001, at 11:51:05
Shane,
Glad to hear you are being helped by Mirapex. I believe I was the first one who wrote on psychobabble about Mirapex and its potential as an anti-depressant. This was about two years ago. It is good to see people are giving this med. a chance.
Your ideal dosage may be quite a bit higher than what you are taking now. One study found that 5mg. a day, taken in three divided doses gave the best mood improvement response.
Mirapex lowers prolactin, elevated prolactin can decrease libido.
If the raised dosage of Mirapex does not result in the return of your libido, consider getting your prolactin levels checked. If it is elevated you may wish to add on cabergoline, a very effective prolactin lowering drug that rarely causes side effects.
On a related topic, it is my supposition that mirapex, like amisulpride, generally has enhanced effect when combined with an arousal agent. The paticular arousal agent will depend on the individual but these include: adderall, adrafinil, dexedrine, selegiline (2.5 to 10mg./day), adrafinil, provigil (and, possibly, wellbutrin).
The combo. of mirapex and amisulpride may be more effective for you at bringing your emotions back than either med alone. When I tried the two together I didn't find additional benefit but you may well have a different experience.
Andy
Posted by ShaneS on August 19, 2001, at 15:40:59
In reply to Re: Serotonin vs. Dopamine Deficiency - Symptoms? » ShaneS, posted by AndrewB on August 19, 2001, at 13:35:16
>Hi Andy,
thanks for your information on prolactin and about adding a stimulant to mirapex. I had already considered that might be necessary as well based on the info here from other people. I go back to my pdoc in a month and i think he will double my mirepex dosage. He is very open to try new things but titrates at a slow pace, which is good i think. If a dosage of 3mg a day doesn't do it, i wiil ask for a stimulant.
- ShaneShane,
>
> Glad to hear you are being helped by Mirapex. I believe I was the first one who wrote on psychobabble about Mirapex and its potential as an anti-depressant. This was about two years ago. It is good to see people are giving this med. a chance.
>
> Your ideal dosage may be quite a bit higher than what you are taking now. One study found that 5mg. a day, taken in three divided doses gave the best mood improvement response.
>
> Mirapex lowers prolactin, elevated prolactin can decrease libido.
>
> If the raised dosage of Mirapex does not result in the return of your libido, consider getting your prolactin levels checked. If it is elevated you may wish to add on cabergoline, a very effective prolactin lowering drug that rarely causes side effects.
>
> On a related topic, it is my supposition that mirapex, like amisulpride, generally has enhanced effect when combined with an arousal agent. The paticular arousal agent will depend on the individual but these include: adderall, adrafinil, dexedrine, selegiline (2.5 to 10mg./day), adrafinil, provigil (and, possibly, wellbutrin).
>
> The combo. of mirapex and amisulpride may be more effective for you at bringing your emotions back than either med alone. When I tried the two together I didn't find additional benefit but you may well have a different experience.
>
> Andy
Posted by PuraVida on August 20, 2001, at 14:41:51
In reply to Re: Serotonin vs. Dopamine Deficiency - Symptoms?, posted by DP on August 14, 2001, at 18:11:37
I have read a book by Joel Robertson called Natural Prozac that has really interested me. I can't find any website, etc, but this is what he says:
Low serotonin - declines in mood, depression, low energy, fatigue, and self-esteem, poor concentration, confusion, difficulty making decisions, fluctuations in appetite (cravings for carbs, no interest in other foods), decreased sex drive, excessive feelings of guilt and unworthiness.
Low dopamine - depression,low energy, muscular disturbances and Parkinson's, excess need for sleep, withdrawal, suicide or thought of.
Low Norepinephrine - depression, low energy, weight gain, changes in menstruation, deceased sex drive. Chronic low levels can cause chronic, severe depression, short-term memory loss, dull or slow thought process, male impotence.
Obviously I can't review the whole book here, but it is very interesting and talks about different types of depression...I highly reccommend it - just wish there was more of his info on the web -
> > Has anyone come across either an article in Medline or a Web page that compares the symptoms that are associated with a deficiency of serotonin vs. the symptoms that are associated with a deficiency of dopamine?
>
> I'd really like to know the answer to this question. Web address anyone?
Posted by AndrewB on August 21, 2001, at 3:00:02
In reply to Info on symptoms » DP, posted by PuraVida on August 20, 2001, at 14:41:51
I've seen plenty of sites that try to categorize and compare the symptomology of low dopamine, low serotonin and low norepinephrine. Unfortunately, such simplistic distinctions tend to be more misleading than useful. Depression has a lot of different 'flavors'. You will find a great variety of symptomologies and individual responsiveness to meds (even with people having similar symptomologies). This is because depression can result from the dysregulation of receptors of numerous subsets of neurotransmitter systems. Sorry but its true. And it not just the serotonin, norepinephrine, and dopamine, that can contribute to depression. Hormonal (i.e. stress, sex, and thyroid hormones)factors, other neurotransmitters systems (glutaminergic, cholinergic, and opiate) and yet other factors basic to our metabolism (peptides, cellular energy production, etc.).
This view goes a long way towards explaining why so many people are not responsive, only partially responsive, or can’t tolerate first-line antidepressants(i.e. SSRIs). It is as if much of the medical community rests on the assumption that the depression is serotonin based (with a possible norepinephrine contribution). So many doctors will try these types of meds on their patients and when met with a poor response they ask the patient to accept their condition. It is a shame. It is as if those that have been given a whole tool box only will grab the hammer and nail.
My advice to you is to pay very close attention to the receptor subtypes that a particular med effects or the site in the brain of its action. After a while pieces start falling together. And yes there are some symptomologies that give clear or very strong indication of certain conditions. For example someone with a combo of social avoidance, low self-esteem/constant negative thoughts, low motivation and anhedonia would with fair certainty have hypofunction of the D2 (and D3) dopamine receptors along the mesocortical-limbic dopamine pathway. Even that being said, many other systems effect the function of this pathway and can contribute to it dysfunction or rehabilitation. Likewise, panic disorder and post-traumatic stress syndrome will have a dominant component of locus coeruleus hyperactivity and can be treated with meds that act on a subtype norepinephrine receptor.
In short, I encourage you to learn what you can about your illness. There are rarely simple explanations that will serve as clear roadmaps to your recovery. But if you are patient yet motivated to learn about your condition and the potential meds that will help.... and also judicious yet willing to trial different meds and different combo of meds, the chances are very much in your favor of finding recovery, perhaps a greater recovery than you ever dared imagine.
Best wishes,
AndrewB
Posted by JohnL on August 21, 2001, at 4:30:36
In reply to Re: Info on symptoms, posted by AndrewB on August 21, 2001, at 3:00:02
Andrew, your post is absolutely excellent!
John> I've seen plenty of sites that try to categorize and compare the symptomology of low dopamine, low serotonin and low norepinephrine. Unfortunately, such simplistic distinctions tend to be more misleading than useful. Depression has a lot of different 'flavors'. You will find a great variety of symptomologies and individual responsiveness to meds (even with people having similar symptomologies). This is because depression can result from the dysregulation of receptors of numerous subsets of neurotransmitter systems. Sorry but its true. And it not just the serotonin, norepinephrine, and dopamine, that can contribute to depression. Hormonal (i.e. stress, sex, and thyroid hormones)factors, other neurotransmitters systems (glutaminergic, cholinergic, and opiate) and yet other factors basic to our metabolism (peptides, cellular energy production, etc.).
>
> This view goes a long way towards explaining why so many people are not responsive, only partially responsive, or can’t tolerate first-line antidepressants(i.e. SSRIs). It is as if much of the medical community rests on the assumption that the depression is serotonin based (with a possible norepinephrine contribution). So many doctors will try these types of meds on their patients and when met with a poor response they ask the patient to accept their condition. It is a shame. It is as if those that have been given a whole tool box only will grab the hammer and nail.
>
> My advice to you is to pay very close attention to the receptor subtypes that a particular med effects or the site in the brain of its action. After a while pieces start falling together. And yes there are some symptomologies that give clear or very strong indication of certain conditions. For example someone with a combo of social avoidance, low self-esteem/constant negative thoughts, low motivation and anhedonia would with fair certainty have hypofunction of the D2 (and D3) dopamine receptors along the mesocortical-limbic dopamine pathway. Even that being said, many other systems effect the function of this pathway and can contribute to it dysfunction or rehabilitation. Likewise, panic disorder and post-traumatic stress syndrome will have a dominant component of locus coeruleus hyperactivity and can be treated with meds that act on a subtype norepinephrine receptor.
>
> In short, I encourage you to learn what you can about your illness. There are rarely simple explanations that will serve as clear roadmaps to your recovery. But if you are patient yet motivated to learn about your condition and the potential meds that will help.... and also judicious yet willing to trial different meds and different combo of meds, the chances are very much in your favor of finding recovery, perhaps a greater recovery than you ever dared imagine.
>
> Best wishes,
>
> AndrewB
>
Posted by PuraVida on August 21, 2001, at 12:44:17
In reply to Re: Info on symptoms, posted by JohnL on August 21, 2001, at 4:30:36
I agree - the hammer and nail theory you mention, Andrew, is alive and well. Too bad, because there are so many "tools" that are ignored in managing depression.
>"But if you are patient yet motivated to learn about your condition and the potential meds that will help.... and also judicious yet willing to trial different meds and different combo of meds, the chances are very much in your favor of finding recovery, perhaps a greater recovery than you ever dared imagine"
I would change "meds" to "meds and therapies" - such as cognitive therapy and counseling, hypnotherapy, diet, excercise, aven accupressure and massage. If you hurt, why not try to do all you can to feel better?
Now, I read and listen to everything I can about meds AND natural remedies, put it all in the tool box, and try it if I think it makes sense. You can see by the title of the book I mentioned "Natural Prozac", that the author discusses natural way to, as he says " release your body's own depressants." He does try to categorize the "flavors" of depression, and then gives suggestions for dealing with each naturally: identifying trigger situation (cognition), diet, different types of activities and exercise, music, etc.
I really liked this book - another was Beyond Prozac by Michael J Norden. Take what you will from each - just more tools (non-med) you might want to have in the tool box, just in case.
Going on six years of meds, I'm certain that, at least for myself, meds will be there to help keep me from sliding into the hole, but as far as having a really "normal" life, I've got to include all of the "natural" things the rest of the of the people in the world do to keep sane and healthy... they really do help.
Good luck -
> Andrew, your post is absolutely excellent!
> John
>
> > I've seen plenty of sites that try to categorize and compare the symptomology of low dopamine, low serotonin and low norepinephrine. Unfortunately, such simplistic distinctions tend to be more misleading than useful. Depression has a lot of different 'flavors'. You will find a great variety of symptomologies and individual responsiveness to meds (even with people having similar symptomologies). This is because depression can result from the dysregulation of receptors of numerous subsets of neurotransmitter systems. Sorry but its true. And it not just the serotonin, norepinephrine, and dopamine, that can contribute to depression. Hormonal (i.e. stress, sex, and thyroid hormones)factors, other neurotransmitters systems (glutaminergic, cholinergic, and opiate) and yet other factors basic to our metabolism (peptides, cellular energy production, etc.).
> >
> > This view goes a long way towards explaining why so many people are not responsive, only partially responsive, or can’t tolerate first-line antidepressants(i.e. SSRIs). It is as if much of the medical community rests on the assumption that the depression is serotonin based (with a possible norepinephrine contribution). So many doctors will try these types of meds on their patients and when met with a poor response they ask the patient to accept their condition. It is a shame. It is as if those that have been given a whole tool box only will grab the hammer and nail.
> >
> > My advice to you is to pay very close attention to the receptor subtypes that a particular med effects or the site in the brain of its action. After a while pieces start falling together. And yes there are some symptomologies that give clear or very strong indication of certain conditions. For example someone with a combo of social avoidance, low self-esteem/constant negative thoughts, low motivation and anhedonia would with fair certainty have hypofunction of the D2 (and D3) dopamine receptors along the mesocortical-limbic dopamine pathway. Even that being said, many other systems effect the function of this pathway and can contribute to it dysfunction or rehabilitation. Likewise, panic disorder and post-traumatic stress syndrome will have a dominant component of locus coeruleus hyperactivity and can be treated with meds that act on a subtype norepinephrine receptor.
> >
> > In short, I encourage you to learn what you can about your illness. There are rarely simple explanations that will serve as clear roadmaps to your recovery. But if you are patient yet motivated to learn about your condition and the potential meds that will help.... and also judicious yet willing to trial different meds and different combo of meds, the chances are very much in your favor of finding recovery, perhaps a greater recovery than you ever dared imagine.
> >
> > Best wishes,
> >
> > AndrewB
> >
Posted by Zo on August 21, 2001, at 21:22:44
In reply to Re: Info on symptoms, posted by AndrewB on August 21, 2001, at 3:00:02
Andrew,
Excelent post, and I totally agree. . Except for one thing: I would have never known what was possible, for my mind, my thoughts, my very awareness itself, had I not *tried* Dexedrine.
It's a crime that Wellbutrin is the only dopamine enhancing AD. . . .Only because Prozac took off, so the rest of the drug companies followed suit.
SSRIs are only half -- or less -- the story. And people suffer, as a result. As well as SSRIs being worthless, or worse, in many cases, like mine.
What can be done? Well, for one, no shilly-shallying about "stimulants." There have been enormous, major discoveries in the last few years about dopamine -- I recall when it was a Time cover story -- as the "reward" chemical. . with huge implications for all manner of addiction and reward-seeking behaviors. There was even the discovery at Brookhaven of the genetic glitch on one of the dopamine alles (sp?) (receptor sites.)
Did any new meds come out as a result? Are you kidding?
Zo
Posted by LightShifter on November 6, 2003, at 23:25:51
In reply to Re: Serotonin vs. Dopamine Deficiency - Symptoms?, posted by ChrisK on August 16, 2001, at 3:39:35
Well, if no one has started a list of what symptoms are associated with what, why don't we?
There's an interesting paper out there entitled "Mechanisms of Actions of Antidepressants: Beyond The Receptors" which talks about dopamine deficiency being related to:
- psychomotor retardation
-anhedonia
-hypersomnia
-cognitive slowing
-inattention
-pseudodementia
-cravingI guess this is why Wellbutrin and the stimulants work well with these symptoms as well as with ADHD. Wellbutrin works with norepinephrine too which is why I guess it helps with the anxiety associated with ADD as well.
I started taking Strattera which works exclusively on norepinephrine and it immediately got rid of a tremendous amount of anxiety. Wellbutrin works on both which I'm going to try to use because of my ADD issues in addition to my anxiety.
Here's the PDF web page address:
http://lokman.cu.edu.tr/psychiatry/derindex/kpb/fulltext/2002/12(4)/6.pdf
Very interesting article if you can hack through the psycho-jargon a little.
Blessings, ...Dan
Posted by KimberlyDi on November 7, 2003, at 8:26:55
In reply to Re: Serotonin vs. Dopamine Deficiency - Symptoms?, posted by LightShifter on November 6, 2003, at 23:25:51
I've long been interested in dopamine, though my research came from investigating dopamine and alcoholism. Dopamine, being a "reward" center of the brain, rewards a person for drinking, even though it's killing the body. AD's that increase dopamine flow or inhibits reuptake help with alcohol cravings.
Trusting to my faulty memory to have posted the above correctly... Dopamine is very important.
KDi in TX
> Well, if no one has started a list of what symptoms are associated with what, why don't we?
>
> There's an interesting paper out there entitled "Mechanisms of Actions of Antidepressants: Beyond The Receptors" which talks about dopamine deficiency being related to:
> - psychomotor retardation
> -anhedonia
> -hypersomnia
> -cognitive slowing
> -inattention
> -pseudodementia
> -craving
>
> I guess this is why Wellbutrin and the stimulants work well with these symptoms as well as with ADHD. Wellbutrin works with norepinephrine too which is why I guess it helps with the anxiety associated with ADD as well.
>
> I started taking Strattera which works exclusively on norepinephrine and it immediately got rid of a tremendous amount of anxiety. Wellbutrin works on both which I'm going to try to use because of my ADD issues in addition to my anxiety.
>
> Here's the PDF web page address:
>
> http://lokman.cu.edu.tr/psychiatry/derindex/kpb/fulltext/2002/12(4)/6.pdf
>
> Very interesting article if you can hack through the psycho-jargon a little.
>
> Blessings, ...Dan
>
>
This is the end of the thread.
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