Posted by zeugma on November 23, 2003, at 12:30:50
In reply to Re: Many men need T *decrease*, posted by linkadge on November 23, 2003, at 10:46:46
> Psychquackery, is that you ??
I had the same hypothesis.
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> Anyhow, your statement about low dopamine levels correlating with low serotonin levels isn't entirely acurate. Implulsive, agressive, and antisocial people tend to have high levels of dopamine, and low levels of serotonin. SSRI's are particularly effective for these people, because they tend to indirectly *lower* dopamine.
> Other people may not feel particulatly helpless, but chronically sad or blue. For these people SSRI's tend to be effective as they indirecly lower sypathetic amines such as dopamine, and norepinephrine, this is described at biopsychiatry.com as kind of a ssri induced parasympathetic responce.So on this account, TCA's would raise sympathetic amines, and help with the anhedonic, chronically helpless side of depression, right?
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> Infact there were a few studies that showed that response to SSRI's directly correlated with with dopamine *decrease*. The apathy effect that some people have with ssri's never happened with me. For me, it was a releif to be able to let things go for the first time.Apathy would occur in someone who probably would have responded better to a non-SSRI in the first place- someone who is already tipping towards apathy in his or her depression and needs a boost in the sympathetic amine side of things.
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> SSRI's are often very effective in depression with OCD features. These people often have a high sex drive with constant obessions with sex, religiion, supersition etc. Stimulation of the 5ht2a receptor is purported to be the theraputic response with SSRI's for these people. The relief from the obsessions again correlates with decrease in dopamine.
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I find this particularily interesting. Some TCA's, such as amitriptyline and nortriptyline, Serzone, trazodone, and Periactin are 5HT-2A blockers, as are many typical and atypical neuroloeptics. The 'negative symptoms' of deopression and schizophrenia are apathy, anhedonia, loss of interest in contact with others including sex, etc. So perhaps there are 'negative-dominant' and 'positive-dominant' depressives who needs either sympathetic-amine enhancing meds, and those who need SSRI's. THis theorizing is very crude, of course, but I am clearly a 'negative-dominant' depressive who loves to isolate, to sleep all day, and is given to feelings of chronic helplessness. My depression is TCA-responsive.> I don't know where you got the idea that I was bipolar. Lithium oftentimes is used as an augmenting agent to SSRI's, that is why the doctor perscribed it to me (as far as I know at least!)
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> As far as building my own rTMS machiene, I personally thought that was quite clever!. Some others thought so too, tons have emailed me for building instuctions. CTV had enough guts to devote most of their show to rTMs's implications, expecially its ability to increase grey matter, and neurotrophic factors. And even if it isn't effective, I find it to be a pretty good placebo!
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> I fully agree with you when you say there may be a substantial portion of depressed males over 30 who have borderline testosterone, and who may benefit from it.
It isn't clear that ALL AD's would lower testoterone. Wouldn't NE reuptake blockers raise it indirectly through the interaction of DA with the NE transporter? NE reuptake blockers have been shown to substantially raise DA levels in such areas as the prefrontal cortex. 5-HT 2A antagonism might be another way TCA's might raise DA levels.
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> But on the other side of the coin, excess testosterone can easily lead to depression, irritability, and anxiety on its own. Certainly you learned this from anti-steroids day in high school gym class.
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> I would argue that there is also a substantial portion of males who have quite normal testosterone, and who respond to SSRI's well.
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> Thats all
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> Whatever works for you, good luck,
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> Linkadge
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> Linkadge
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poster:zeugma
thread:282575
URL: http://www.dr-bob.org/babble/20031121/msgs/282840.html