Posted by Peter on March 29, 2003, at 20:11:41
Hi all:
Well, it's been about 2-3 weeks on Prozac. I'm now up to 10mg. It has helped me get out of the horrid, deep depression I was in, but I still have specific, negative mood tendencies.
What seems to be happening often is that I get very socially withdrawn and dull-feeling. At least I can get myself to go out to a restaurant with a friend, which I couldn't even do before out of social anxiety and depression. But, once I'm there, I feel like getting out and isolating - not so much out of social anxiety like before; now, it's more that dull, withdrawn feeling that causes me to feel like I can't carry on a conversation, and I'm just disinterested in everything. Also, I'm noticing that I very easily and quickly get a feeling of 'sensory overload,' like I just want to be alone in silence and close my eyes.
I discussed this with my pdoc, and he said it's indicative of a dopamine-deficiency. I already take 40 mg adderall daily, which I would have thought would make up for any dopamine deficiency. But my doc said that stimulants like adderall 'mimic' temporary surges in dopamine, while a drug like Wellbutrin has been known to actually permanently and consistently raise the base level of dopamine in the brain.
I've tried Wellbutrin before, but only for a few weeks, and it made me feel jittery and anxious. But the wierd thing is that the adderall does benefit me, but only for a very short time - like at the onset of its action - and then it leaves me even more socially withdrawn. That very short period when it seems to help is characterized not by euphoria, but by a temporary lifting of depression and an increase in focus and social interest.
But I wonder why it's beneficial effects are so short-lived for me (like under 1 hour)? Is this a possible attestment to my need for a dopamine-inducing med more along the lines of wellbutrin? BTW, my pdoc in the past tried a few dopamine agonists on me - mirapex, etc. I don't recall them helping my mood much, but I guess they work on a different receptor?
I don't even know for sure if my problem boils down to a dopamine deficiency. As time goes by, we're going to see if the Prozac helps me - my doc says it raises dopamine in some people, but lowers it in others; the whole serotonin-dopamine relationship isn't so predictable and linear.
But I just wonder: even though the adderall helps me get going in the morning, helps me work, and decreases depression, does the fact that it only helps me for such a short time mean that it might be ultimately LOWERING my dopamine to below-normal levels in the long run? I'd appreciate anyone's opinions and/or suggestions.
thanks,
Peter
poster:Peter
thread:214166
URL: http://www.dr-bob.org/babble/20030329/msgs/214166.html