Posted by Quintal on February 26, 2007, at 9:41:22
In reply to Re: opiates for depression, posted by linkadge on February 25, 2007, at 10:57:43
>But, what I am saying is that you cannot say this drug is inneffecive simply because it fails to elevate dopamine in the neucleus accumbens. This drug doesn't work for other reasons.
I'm surprised you can be so confident.
I've noticed here for some time that people have a tendency to want to quit meds that no longer give them a feeling of euphoria (a recent example that springs to mind is ace wanting to quit and re-start Nardil to regain the euphoria he felt at the beginning of treatment), and also people constantly flitting from drug to drug despite having had a promising response to some. It makes one wonder what they are looking for, and the precise meaning of the term 'treatment resistant' in these individuals.
>If the lack of attention was purely due to reward dysfunction, then you'd be dealing with a different issue, ie depression. It a patient comes in saying that they can't concentrate *because* they feel worthless, and life isn't worth living, then this would be depression and not ADHD.
I don't think ADHD, depression and anxiety are *purely* due to defunct reward centres but I do think they play a role in varying degrees in many cases, with treatments that produce a sensation of euphoria and wellbeing in general being more effective and better tolerated than those that don't.
>I agree with you. My original point was that opiates may be treating depression in some yet undiscovered way, which may indeed have nothing to do with being euphoriants. I merely brougt in stimulants as a example of drugs which while are euphoriants, are not working solely because they are euphoriants.
I did not say those drugs work only by creating euphoria, but it does seem that drugs which give a subjective feeling of wellbeing in addition to other therapeutic mechanisms are more popular, produce more treatment responders (and are therefore perceived as being more effective) than drugs that cause emotional blunting or numbness etc (especially when treating depression and anxiety).
Q
poster:Quintal
thread:734151
URL: http://www.dr-bob.org/babble/20070224/msgs/736392.html