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It's all a matter of balance » KaraS

Posted by Racer on August 3, 2004, at 12:19:26

In reply to Norepinephrine vs. Dopamine, posted by KaraS on August 2, 2004, at 16:47:03

Don't lose sight of the question of balance. I don't think that most of the mood disorders are caused by a simple deficiency in one or another of the neurotransmitters, so much as an imbalance of the ratios between them. My 'theory' is that that's why trial and error is so important in finding the right med or combo for each of us.

That said, Sad Panda has a point about dopamine being involved in the reward system, and it's involved in motivation. Norepinephrine is involved in the whole system that ends up producing adrenaline, so I would associate it with energy. (And, since I'd like the motivation to use the energy that I would like to have, I'd look at something that maybe tweaks both... But I'm not only not a scientist, I couldn't even play one on TV!)

The Terrible Trio of neurotransmitters associated with mood disorders -- serotonin, dopamine, and norepinephrine -- are all monoamines -- so one of the monoamine oxydase inhibitors will hit all of them. If you're interested in getting more narrow in the target you're gunning for, I agree that desimpramine or nortryptyline are good bets.

In general, though, I think the trial and error process will give you the best results. It's frustrating, and there are very few tests that can help guide the choices made, and very few doctors who bother with any of those tests, but the only way to find out if you'll benefit from a specific drug is to try it. And, while the different neurotransmitters do have different effects, which makes you think (well, makes me think) that your symptoms can guide the choice of a target, the reality is that behavior and emotions are too complex to be attributed to a single cause. My own lack of energy, for example, when depressed, is actually an overflow of anxiety -- which you'd think would give me energy, right? Not all of it is intuitive.

(Then again, I tend to think that serotonin gets too much attention -- those other molecules are so cute! We oughta be petting them, too, before they start to sulk.)


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