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Re: Serzone effect for Social Phobia? MA

Posted by JohnL on December 3, 1999, at 3:17:31

In reply to Re: Serzone effect for Social Phobia?JohnL again, posted by MA on December 2, 1999, at 7:07:18

> Afew questions if you don't mind...
> What does euthymic mean?

****Euthymic is a word that describes feeling perfectly normal. Not high, not depressed, just normal. So many clinical studies measure success as 50% improvement on symptoms. To me, that's not success. That should not be the goal. The goal should be euthymia, normalcy, absence of any residual symptoms.
> When you say....I should have stayed with it and added a dopamine agonist like amantadine or bromocriptine for the apathy and the sex.
> How do you know what to add? I keep trying to tell my doctor I need something with dopamine or norephinephrine. Even though I'm not really sure what the drugs will do. I just feel that SSRI's aren't enough on their own. Shouldn't he know these things???

****I think only a small percentage of doctors are truly pasionate about their work. They are the ones that seem enthused and up-to-date with all the tricks of the trade. Those are the kinds of doctors that show up at Dr Bob's Pharmacology Tips. That's where I have learned a majority of information, including uses of amantadine, bromocriptine, theories of causes of apathy, etc. I suspect most doctors have very limited psychopharmacology skills. Dr Bob's Tips really highlights doctors who seem to be in love with their work and therefore remain on the cutting edge.
> Briefly, what symptoms do serotonin, norepinephrine and dopamine target? I know it probably is not a simple thing to explain but the residual symptoms of depression for me have always been apathy, loss of focus, problem with memory...Vague, but very real, as you know.
> The depression goes away but I'm left with a feeling of not really being connected to the world. I function but don't enjoy things. Also I have trouble reading and understanding simple things. Come to think of it, I have always had to read things over and over before I get it. I seem to miss something in the process between reading and understanding.

****I'm not real knowledgable about the roles of serotonin, NE, and dompamine. But as I understand it, serotonin is generally involved with overall well-being, NE is involved with energy and reward, and dopamine is involved with pleasure and reward. However, they are all probably intriquately intertwined in mysterious ways we may never understand. For example, I felt awesome on 5HTP. That was mostly a serotonin thing. You would think a dopamine thing would work better on anhedonia. But it was a serotonin thing that worked. So why don't SSRIs do the same? They work on serotonin too, right? I don't get it. ??? Perhaps it's as basic as they say...a chemical imbalance between the three...and each of us has a unique balance of our own. But I suspect it's a whole lot more complex than that.

Hope your appointment went well. I would like to hear about it when you get a chance. Mine is in 4 hours. Fingers crossed for some kind of hope. Have a smooth day. JohnL




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