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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by floatingbridge on January 8, 2011, at 22:48:40
I know I've asked this before in some form or another.
My depression is worsening. I ran across information that stated emsam at 6mg affects dopamine levels more than other transmittors. (Maybe true?)
The last time I repeated what two docs said to me, I was (kinda) ridiculed. They said I was a dopamine responder. I didn't and don't understand enough to know why this could be considered absurd.
Can one be low in dopamine? Not processing it efficiently?
Is it related to endorphines?
Thanks for any clarification or for pointing me towards some reading.
fb
Posted by tensor on January 9, 2011, at 2:29:16
In reply to can anyone explain dopamine's role in depression?, posted by floatingbridge on January 8, 2011, at 22:48:40
Posted by Lou Pilder on January 9, 2011, at 9:58:26
In reply to can anyone explain dopamine's role in depression?, posted by floatingbridge on January 8, 2011, at 22:48:40
> I know I've asked this before in some form or another.
>
> My depression is worsening. I ran across information that stated emsam at 6mg affects dopamine levels more than other transmittors. (Maybe true?)
>
> The last time I repeated what two docs said to me, I was (kinda) ridiculed. They said I was a dopamine responder. I didn't and don't understand enough to know why this could be considered absurd.
>
> Can one be low in dopamine? Not processing it efficiently?
>
> Is it related to endorphines?
>
> Thanks for any clarification or for pointing me towards some reading.
>
> fbFriends,
It is written here,[...depression worsening...thanks for any clarifiication or for pointing me towards some reading...].
If you are considering being a discussant in this thread or parallel threads, I am requesting that you view the following video. If you could, then the information in it that could be educational, I think could be helpful in this discussion.
Lou
To see this video,
A. Pull up Google
B.
Type in;
[youtube-Part 8 of 10 Psychiatry-Making a with Dr. Rima]
There wil be a picture ...it is 10 min...on January 16, 2009
Posted by Phillipa on January 9, 2011, at 11:13:40
In reply to can anyone explain dopamine's role in depression?, posted by floatingbridge on January 8, 2011, at 22:48:40
FB some call dopamine the "feel good neurotransmitter". EMSAM since it's a MAOI has all three but I am definitely not an expert on Maoi's. I think but not sure that pain meds also effect dopamine which would make me also one. Phillipa
Posted by Conundrum on January 9, 2011, at 12:29:18
In reply to can anyone explain dopamine's role in depression?, posted by floatingbridge on January 8, 2011, at 22:48:40
Hi FB,
while it is true at this dose that emsam at 6 mg effects dopamine more than any other neurotransmitter, its effect on mood is limiting. This is because it is MAO-B selective in certain regions of the brain that are not effective for enhancing ones mood.
There is a lot of incomplete information out there about MAOIs. Unfortunately most psychiatrists don't do a good job of explaining med functions to their patients, so we are left to try to figure this one out on our own. So both MAOA and B inhibition increase dopamine, but do so in different parts of the brain. MAOA inhibition will increase dopamine, along with norepinephrine, and serotonin in areas that help with the relief of depression. MAO B inhibition can help with parkinson's symptoms. Pure MAO-B inhibitors have not done well as antidepressants and that is the reason you need to take 9-12 mgs with emsam to get a good response, because it starts to lose its selectivity for MAOB and inhibits MAOA as well.
http://www.evetopf-center.org/Articles/Art_10042006152324.pdf
This article talks more about the difference between MAO B and A and also gives list of many MAOIs that are currently in use(about half way down). As you can see the ones that are used as ADs have MAO A inhibition or A with B, but the selective MAOB inhibitors are all parkinson drugs.
The role of dopamine in depression is difficult to pin down, because most drugs that effect dopamine effect other systems, and even a drug that is selective for serotonin like lexapro, will have an effect on dopamine.
That being said there are plenty of drugs that don't work on dopamine and plenty of drugs that do, so by process of elimination you can kind of guess what effects it has. It seems to be important for wanting to do things and drive(not necessarily liking), it also, seems to be important for social comfort, this is part of the reasons MAOIs are especially good for social anxiety. It is important in cognition and concentration. It seems to be important in reinforcing addiction and too much can cause one to become paranoid and delusional. That shooter in Arizona would probably have benefited from a drug that blocks dopamine.
So if you are having problems with concentration, anhedonia, social anxiety MAO A inhibition might be the way to go, but then you have to follow the dietary restrictions.
> I know I've asked this before in some form or another.
>
> My depression is worsening. I ran across information that stated emsam at 6mg affects dopamine levels more than other transmittors. (Maybe true?)
>
> The last time I repeated what two docs said to me, I was (kinda) ridiculed. They said I was a dopamine responder. I didn't and don't understand enough to know why this could be considered absurd.
>
> Can one be low in dopamine? Not processing it efficiently?
>
> Is it related to endorphines?
>
> Thanks for any clarification or for pointing me towards some reading.
>
> fb
Posted by floatingbridge on January 9, 2011, at 14:05:17
In reply to Lou's response-edu-cylihz-87b » floatingbridge, posted by Lou Pilder on January 9, 2011, at 9:58:26
Hi Lou,
Thanks for your interest in this thread. I don't watch many videos, so I've decided to decline your polite request and continue to participate in this thread without viewing.
Best to you,
fb
Posted by floatingbridge on January 9, 2011, at 14:21:16
In reply to Re: can anyone explain dopamine's role in depression? » floatingbridge, posted by Conundrum on January 9, 2011, at 12:29:18
Conundrum, thanks for taking the time to write that all down--. I can actually follow it :)
I don't know. An MAOI seems like the last stop on the line. And I truly mean no insult to anyone here or anywhere taking maoi's, nor am I implying anything about anyone. I'm just kinda scared.
(Not that your post could be read as a
recommendation.)My fear is probably more unnecessary baggage anyways.
Do you like film noir? If so, do you remember Double Indemnity?
Thanks, Conundrum.
Off to look at that link.
Posted by floatingbridge on January 9, 2011, at 14:25:13
In reply to No. :/ (nm) » floatingbridge, posted by tensor on January 9, 2011, at 2:29:16
Posted by floatingbridge on January 9, 2011, at 14:36:26
In reply to Re: can anyone explain dopamine's role in depression? » floatingbridge, posted by Phillipa on January 9, 2011, at 11:13:40
Hi Phillipa,
As I was reading Conundrum's post, I recalled something, somewhere about dopamine being necessary to the functioning of the other transmitters.
My own pdoc has said if we go with an maoi, he will not be comfortable prescribing a stimulant--the only (w/a
capital O) substance to ever draw me out of my own private Idaho. I know folks here who do both.... I know. I really have to admit my recovery seems to reversed itself.Thanks for your support :) I appreciate it.
fb
Posted by Phillipa on January 9, 2011, at 21:00:35
In reply to Re: can anyone explain dopamine's role in depression? » Phillipa, posted by floatingbridge on January 9, 2011, at 14:36:26
FB I think I understand your meaning. Clarification might be necessary. You know what I mean? Phillipa
Posted by Ron Hill on January 9, 2011, at 22:07:17
In reply to Re: can anyone explain dopamine's role in depression? » floatingbridge, posted by Conundrum on January 9, 2011, at 12:29:18
Conundrum,
Great article. Thanks for posting it.
> http://www.evetopf-center.org/Articles/Art_10042006152324.pdf
-- Ron
Posted by conundrum on January 11, 2011, at 16:38:10
In reply to thanx » Conundrum, posted by floatingbridge on January 9, 2011, at 14:21:16
> Conundrum, thanks for taking the time to write that all down--. I can actually follow it :)
>
> I don't know. An MAOI seems like the last stop on the line. And I truly mean no insult to anyone here or anywhere taking maoi's, nor am I implying anything about anyone. I'm just kinda scared.
> (Not that your post could be read as a
> recommendation.)
>
> My fear is probably more unnecessary baggage anyways.
>
> Do you like film noir? If so, do you remember Double Indemnity?
>
> Thanks, Conundrum.
>
> Off to look at that link.
>
Eh. My grandmom took nardil for at least 30 years and nothing bad happened. I don't know what meds you have tried, but I think if you have tried a SSRIs, wellbutrin, remeron, stims, it might be a wise next move. TCAs might be a good move but a lot of doctors don't like them, and you can't argue with the classic MAOI's effectiveness.Sorry I don't know that movie though. If you have any other questions feel free to babble mail me.
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