Posted by Racer on December 20, 2008, at 19:30:16
In reply to Re: How high are the chances venlafaxine might wor » softheprairie, posted by Onestone on December 19, 2008, at 16:47:25
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> However, I just don't believe the venlafaxine will work. Why should it, nothing else has?This sounds a lot like a self-fulfilling prophecy. Venlafaxine is a great drug for a lot of people -- even people who have had no luck with other medications.
Even the SSRIs are not all the same -- Lexapro left me far more depressed AND nearly catatonic, Paxil left me lethargic, Prozac on starting had me twitching out of my skin, and Zoloft was pretty benign and partially effective. All have the same mechanism of action, but very, very different subjective effects on the one human being typing this. It's the same within every class of meds, at least for me: Adderall increased my depression, Dexedrine was fine, etc.
Just because the medications you've tried so far have not been effective, it does not mean that the others will be equally ineffective. And even if they are not perfect, maybe you'll get enough relief that you can make some changes in your life that help augment and sustain the effects.
As for using opioids to boost dopamine, while you very likely would feel better for a time, that doesn't mean it's a good answer. For one thing, the concerns regarding tolerance are valid. Becoming addicted to an opioid, ON TOP OF your existing depression, would truly add a whole new level of misery to your life. That alone would lead me to urge you to consider other alternatives first.
Another thing to remember is that dopamine is far, far more than "the feel-good" neurochemical. Dopamine is associated with the positive symptoms of schizophrenia, for example, and it's necessary for movement -- thus Parkinson's when the dopamine producing cells start to die off.
The most valuable lesson I learned in biopsych classes is this: I do not know far more than I do know, and that sentence would be echoed by most of the researchers out there. There are no simple equations in finding the right medication. "I feel no pleasure, therefore I should boost the activity of dopamine" is a very nice idea. It's unlikely to translate into effective pharmacotherapy, though...
I wish you the best, and hope you find that venlafaxine is effective when you do try it.
poster:Racer
thread:869422
URL: http://www.dr-bob.org/babble/20081214/msgs/869928.html