Posted by Ron Hill on March 29, 2003, at 20:57:37
In reply to question about dopamine, posted by Peter on March 29, 2003, at 20:11:41
Peter,
What you describe sounds similar to the emotional blunting I experience from all of the SSRIs. Even with a good functioning moodstabilizer in place, the slightest pinch of an SSRI gives me a couple days of hypomania (euphoric type), followed by a couple days of normal non-depressive state, and then it turns me into what my wife affectionately calls her "do nothing boy". In the latter state, I'm not really depressed and I'm not irritable. But I have no motivation, my energy is low, and I'm completely numb emotionally. By contrast, when I'm healthy (i.e.; not depressed and not on an SSRI), I am an emotional person.
I attribute these adverse SSRI side effects to the fact that; “Chief among the brain’s reactions to artificially elevated serotonin levels is a compensatory drop in dopamine.” I took this quote from page 20 of the introduction in a book entitled "Prozac Backlash" by Joseph Glenmullen, M.D. He is a clinical instructor in psychiatry at Harvard Medical School, is on the staff of Harvard University Health Services, and is in private practice in Harvard Square. His credentials look impressive, but he appears to be somewhat extreme in his views regarding the dangers of SSRIs. If you want, you can read the Introduction and Chapter 1 in their entirety for free at the Amazon.com hyperlink provided above. I thought it was worth the time I spent scanning the available portions of his book.
If I sent this information to you a few months ago, please excuse the duplication.
-- Ron
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> 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 What seems to be happening often is that I get very socially withdrawn and dull-feeling.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there, I feel like getting out and isolating - not so much out of social anxiety like before; now, it's more that dull, withdrawn feeling that causes me to feel like I can't carry on a conversation, and I'm just disinterested in everything.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:Ron Hill
thread:214166
URL: http://www.dr-bob.org/babble/20030329/msgs/214182.html