![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 25 to 49 of 49. Go back in thread:
Posted by underthewave on November 17, 2004, at 7:59:37
In reply to Re: dopamine -- tell me more please » underthewave, posted by King Vultan on November 16, 2004, at 22:57:31
Thanks Todd. I did some research yesterday and did find that the WB was dopaminergic. PDOC and I talked last night and I don't want to be on an MAO. In the past we have discussed Provigil but for now we are going to try bumping up the Cymbalta and see what happens. God, I've been on so many meds. You'd think with all of the research that has been done there would be 1 pill that would work on all 3 neurotransmitters. Doc said most of the dopaminergics were used for Parkinsons and schizoprenia..thanks for the info.
Posted by pablo1 on November 17, 2004, at 11:44:01
In reply to Re: why not dopamine for depression?, posted by Shalom34Israel on November 12, 2004, at 19:08:45
Americans are prudes. It's the Protestant Work Ethic & all that. If it feels good it must be dangerous and bad and risk sending you to hell.
Nonsense!
Posted by pablo1 on November 17, 2004, at 12:04:33
In reply to Re: why not dopamine for depression?, posted by tsirch on November 11, 2004, at 14:41:53
tsirch,
Not all dopamine drugs feel good I think, it is odd how differently they act. Certainly many norepenephrine drugs have all sorts of icky side effects. Did you talk your doc into these for depression somehow? My overseas dopamine meds are definitely nice happy pills. Probably not available here because they feel good, only the icky dopamine drugs are allowed here. Ritalin & Amphetamines are probably the only exceptions but they require triplicate forms for prescriptions even though the side effects are no where near as bad as so many other icky feeling drugs.
> I just started taking sinemet, 50/200mg. 50mg of carbidopa, and 200mg levodopa. Thease pills give the brain a blast of dopamine and you would think that it would put you in a better mood. Its an anti-parkinson's. Ive been taking one in the morning for two days now along with my neurontin. Nothing, no difference yet. Dopamine sucks.
Posted by Iansf on November 17, 2004, at 18:29:40
In reply to Re: why not dopamine for depression?, posted by pablo1 on November 17, 2004, at 12:04:33
> My overseas dopamine meds are definitely nice happy pills. Probably not available here because they feel good, only the icky dopamine drugs are allowed here. Ritalin & Amphetamines are probably the only exceptions but they require triplicate forms for prescriptions even though the side effects are no where near as bad as so many other icky feeling drugs.
>What dopamine drugs are you taking?
Posted by Dr. Bob on November 17, 2004, at 20:55:10
In reply to Re: why not dopamine for depression?, posted by pablo1 on November 17, 2004, at 11:44:01
> Americans are prudes.
Please don't post anything that could lead others to feel put down.
If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
Follow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above post, should of course themselves be civil.
Thanks,
Bob
Posted by Sleepless in the ATL on November 30, 2004, at 20:15:48
In reply to Re: why not dopamine for depression? » pablo1, posted by Iansf on November 17, 2004, at 18:29:40
What overseas dopamine meds (nice happy pills) are you taking? I have been getting pretty disgusted with what I've been finding out about American pharmaceutical companies. I'm starting to see the patterns of ridiculous overmarketing, over-prescribing, often more side effects than benefits and then lawsuits, etc. I can't understand why they are so against something that will make you feel happy, not just numb. If they're worried about addiction, most of the prescription antidepressants have severe withdrawal. I know from personal experience and from the countless experiences of others. It's like, "here, take this pill, you will have the will to work and be responsible, maybe you'll quit smoking or drinking or getting into abusive relationship, fill in the blank, but, I'm sorry you won't have a sex drive at all but you won't really care, so that's ok, you're hair might fall out, might get insomnia and tired all day, etc etc etc." You know what I'm saying. I just keep trying to understand the motivation. Sorry for the rant....just frustrated. Anybody feel me?
> > My overseas dopamine meds are definitely nice happy pills. Probably not available here because they feel good, only the icky dopamine drugs are allowed here. Ritalin & Amphetamines are probably the only exceptions but they require triplicate forms for prescriptions even though the side effects are no where near as bad as so many other icky feeling drugs.
Posted by gromit on December 1, 2004, at 2:01:39
In reply to Re: why not dopamine for depression?, posted by Sleepless in the ATL on November 30, 2004, at 20:15:48
> What overseas dopamine meds (nice happy pills) are you taking? I have been getting pretty disgusted with what I've been finding out about American pharmaceutical companies. I'm starting to see the patterns of ridiculous overmarketing, over-prescribing, often more side effects than benefits and then lawsuits, etc. I can't understand why they are so against something that will make you feel happy, not just numb. If they're worried about addiction, most of the prescription antidepressants have severe withdrawal. I know from personal experience and from the countless experiences of others. It's like, "here, take this pill, you will have the will to work and be responsible, maybe you'll quit smoking or drinking or getting into abusive relationship, fill in the blank, but, I'm sorry you won't have a sex drive at all but you won't really care, so that's ok, you're hair might fall out, might get insomnia and tired all day, etc etc etc." You know what I'm saying. I just keep trying to understand the motivation. Sorry for the rant....just frustrated. Anybody feel me?
Maybe they don't want to waste time and money on things not likely to get approved? Our government has gone to the supreme court to take medication away from cancer patients. In my mind that says it all.
Rick
Posted by Sleepless in the ATL on December 1, 2004, at 7:44:44
In reply to Re: why not dopamine for depression?, posted by gromit on December 1, 2004, at 2:01:39
Exactly. A friend of mine recently took a co-worker to the emergency room because her migraines were so bad she was crying in pain. They refused to give her anything stronger than Tylonol and sent her on her way with a $700 bill. Couldn't they have just saved her the time and money and just cut her off at the door?
Posted by linkadge on December 1, 2004, at 10:34:13
In reply to Re: why not dopamine for depression?, posted by Sleepless in the ATL on December 1, 2004, at 7:44:44
I'm not sure that dopaminergics are the best things for depression.
Think of the number of people in this counry who are using the caffiene/cigarettes combo.
Believe it or not, this is one hell of a dopamine boost. First you have two stimulants caffiene, and nicotine, and you also have the MAO-B inhibiting properties of cigarettes which keep the dopamine alive. Many of our current day depressives are the ones that are junked out on cigarettes and caffiene.
I think the real problem with the SSRI's is that they raise serotonin at every receptor instead of just the ones that are required for an AD effect.
Don't get me wrong, dopamine has its place, but if we were to swich everyone in the country from serotogenics to dopaminergics, we might be in for problems ?
Linkadge
Posted by lostforwards on December 1, 2004, at 11:02:07
In reply to Re: why not dopamine for depression?, posted by linkadge on December 1, 2004, at 10:34:13
We'd be overrun with Munsters.
What are the effects at the receptor level of stress? Stress is a pre-condition for the development of depression isn it? What "neurotransmitter systems" are affected most.
I thought that dopmaine would be affected since chronic stress would result in dopamine-norepinephrine conversion, and the drop in dopamine, if the brain can't produce enough to cope, would lead to compensatory changes in the number of receptors.
SSRIs downregulate dopamine receptors in the pfc by increasing dopamine in that part of the brain, that's part of what makes them effective.
How is serotonin influenced by stress?
Posted by jujube on December 1, 2004, at 14:43:29
In reply to Re: why not dopamine for depression? » linkadge, posted by lostforwards on December 1, 2004, at 11:02:07
I think one Munster is enough! With respect to stress and depression, let's not forget about the role our hormones, including the adrenals and thyroid, play in regulating our moods, our motivation and our ability to cope with stress and anxiety. I may be wrong, but if the adrenal glands are in a state of exhaustion, how can a person respond adequately to AD treatment without first addressing the physiological deficiences? And, at the risk of sounding stupid, if a person's body is nutritionally depleted after, say, years of alcohol or drug abuse or poor/inadequate eating habits, how effective can an AD be if neurotransmitters are depeleted? I mean, how can something like a SSRI work if there is minimal serotonin to block the reuptake of? (Sorry if what I have just said is stupid and inane, it is just something I have wondered for a while.)
Tamara
> We'd be overrun with Munsters.
>
> What are the effects at the receptor level of stress? Stress is a pre-condition for the development of depression isn it? What "neurotransmitter systems" are affected most.
>
> I thought that dopmaine would be affected since chronic stress would result in dopamine-norepinephrine conversion, and the drop in dopamine, if the brain can't produce enough to cope, would lead to compensatory changes in the number of receptors.
>
> SSRIs downregulate dopamine receptors in the pfc by increasing dopamine in that part of the brain, that's part of what makes them effective.
>
> How is serotonin influenced by stress?
Posted by lostforwards on December 1, 2004, at 16:40:10
In reply to Re: why not dopamine for depression? » lostforwards, posted by jujube on December 1, 2004, at 14:43:29
No, nothing you said was stupid.
I ask and say "stupid" things all the time. I come here for information, especially if the questions something really strange that I won't get an answer to by just typing it into google. And you've just helped me. ( though I guess I could probably go and sift through the net if I was really intent on learning more about depression )
A while back somebody posted ( linkadge? ) something about a tryptophan depletion study. It didn't matter if people were on or off their SSRIs, they were still depressed. That would be an example of how nutrional depletion can mess with the effectiveness of an AD.
Posted by jujube on December 1, 2004, at 16:53:55
In reply to Re: why not dopamine for depression?, posted by lostforwards on December 1, 2004, at 16:40:10
I think part of the problem when someone is being treated for mental illness, particularly depression and anxiety, is that the patient is not treated in a wholistic manner. You will see a pdoc who will give you an AD, a benzo and maybe a mood stabilizer, but nothing is done to address other aspects of the illness. I mean, it is not unusual for someone in a depressive or anxious state to not be eating, to not exercising, to not be practicing good sleep hygiene, and to be completely neglecting their nutritional and emotional needs. If the medical community really wanted to see people getting healthy, perhaps what should be done is to provide patients with access to a comprehensive package of services - pdoc, nutritionalist, talk therapist. I don't know, maybe such an approach would yield better and longer-term results in some cases.
Tamara
> No, nothing you said was stupid.
>
> I ask and say "stupid" things all the time. I come here for information, especially if the questions something really strange that I won't get an answer to by just typing it into google. And you've just helped me. ( though I guess I could probably go and sift through the net if I was really intent on learning more about depression )
>
> A while back somebody posted ( linkadge? ) something about a tryptophan depletion study. It didn't matter if people were on or off their SSRIs, they were still depressed. That would be an example of how nutrional depletion can mess with the effectiveness of an AD.
>
>
>
>
>
>
>
Posted by lostforwards on December 1, 2004, at 18:07:29
In reply to Re: why not dopamine for depression? » lostforwards, posted by jujube on December 1, 2004, at 16:53:55
I totally agree with a wholistic approach. I have bipolar and I when I tried Omega 3s, they worked really well for me. I woke up feeling great within days of using them. I also gave Taurine a try and it smoothed things out a lot too. I think alternatives nutritional treatments are too often neglected.
What's good sleep hygiene? Do you mean staying up a lot? I've never heard it reffered to that way before.
Posted by jujube on December 1, 2004, at 18:22:39
In reply to Re: why not dopamine for depression? » jujube, posted by lostforwards on December 1, 2004, at 18:07:29
I recently came across an article on the web written by Margo Kidder in which she describes her approach to dealing with her manic-depression (bipolar). She has decided to treat it with diet and nutritional supplements, including amino acids, instead of meds. That approach may not be for everybody, but it seems to be working for her. I should have bookmarked the site. In my opinion, the foods that a person eats are even more important than the supplements a person takes. Supplements are meant to augment what a person is getting from their daily food intake. However, I know myself that I don't eat right (although I am working on that), and taking supplements helps ensure that I am getting the vitamins/minerals I need on a daily basis.
In answer to your question, about good sleep hygiene, as I understand it, it is basically taking the necessary steps to ensure a good night's sleep, including blocking out anything that could disrupt sleep (e.g., noise, light), adjusting the temperature of the room, ensuring you have a good pillow and a good mattress, getting to bed at a decent hour (I read somewhere that even getting to bed after ten at night can be disruptive - having something to do with corisol), not eating heavy foods or stimulating drinks or foods (e.g. caffienated drinks, chocolate, carbs, etc.) before bed, etc.
Tamara
> I totally agree with a wholistic approach. I have bipolar and I when I tried Omega 3s, they worked really well for me. I woke up feeling great within days of using them. I also gave Taurine a try and it smoothed things out a lot too. I think alternatives nutritional treatments are too often neglected.
>
> What's good sleep hygiene? Do you mean staying up a lot? I've never heard it reffered to that way before.
>
>
>
Posted by Cruz on December 1, 2004, at 19:01:09
In reply to Re: why not dopamine for depression? » lostforwards, posted by jujube on December 1, 2004, at 18:22:39
The majority of the people on this board have struggled with finding successful treatment. It is natural for us to search for any tips that might be helpfull. I think we all crave to understand what is wrong with our bio-chemistry. Unfortunatley the understanding of the causes of mood disorders is non existant. Focusing on seratonin, NE and dopamine is certainly not broad enough. I know my own form of depression is a hormonal disorder but the endocrine system is not understood any better than neurotransmitters.
Posted by jujube on December 1, 2004, at 19:31:06
In reply to Re: why not dopamine for depression? » jujube, posted by lostforwards on December 1, 2004, at 18:07:29
I had bookmarked the web page with the article by Margot Kidder, in which she outlines her supplement regime. You can find it at the following website if you are interested:
www.alternativementalhealth.com/articles/aminobipolar.htm
Posted by lostforwards on December 2, 2004, at 18:57:44
In reply to Re: why not dopamine for depression? » lostforwards, posted by jujube on December 1, 2004, at 19:31:06
You know..I visited that site a while ago. I'm kind of sad to see it again.
Some events beyond my control led me into the hospital again this summer. It had nothing to do with alternative treatments. It had everything to do with not taking anything under stress, missing sleep, and then having a change in mood.
I looked through the bipolar section again I really want to give the alternatives a try, but I'm stuck with my pdoc because 1) my parents want me to see her, and 2) I'd feel bad about leaving cause she's a very caring doctor.
I just really want to try the alternatives. Mostly because before I had my first mood swing for 2 years I was vegetarian, and would have a large fries, gravey and dressing for lunch at school. ( I was a naive vegetarian. )
I think nutritional treatments would work for me and I really want to try everything alternative, and as small a possible dose of lithium ( 0mg if possible ) since it has some unpleasant side-effects at my usual dose.
The only problem now is I may have side-effects from the AP I was on. And when I look back at that site I keep thinking about how healty I was before I was put through this round of drugs.
It's really upsetting.
Posted by lostforwards on December 2, 2004, at 19:02:21
In reply to Re: why not dopamine for depression? » lostforwards, posted by jujube on December 1, 2004, at 19:31:06
Oh yeah... and when I was trying those alternatives a while back I didn't give a damn how they worked. I cared about side-effects I could feel, if they'd work, and if they were safe. That's it. I'm trying them again. My readmission had nothing to do with them not working. I was off treatments altogether, and under a HUGE amount of stress which I can't explain to anyone because it's impossible to BECAUSE the events are really unbelievable. Fate's trying to do me in.
Posted by jujube on December 2, 2004, at 19:14:01
In reply to Re: why not dopamine for depression? » jujube, posted by lostforwards on December 2, 2004, at 18:57:44
I didn't mean to upset you by posting the site. I just found her approach interesting. Perhaps you can discuss alternative approaches or a combination of natural supplements/medications with your pdoc based on the research you have done.
Other books you might want to have a look at are: "The Diet Cure" by Julia Ross and "The Mood Cure" (I think this one is also by Julia Ross). I have read the Diet Cure, and it is very interesting. It details a program to rebalance the body chemistry in order to end food cravings, weight problems and mood swings. It sets forth a theurapeutic approach based on amino acid and vitamin/mineral supplementation and diet.
I don't regret having had to go on medication. The medication I have been on for depression/anxiety has helped me. Nevertheless, I continue to research alternative approaches, which I discuss with my doctor. In all fairness, I think the problem most doctors face when being presented with alternative approaches is the lack of data and clinical trials substantiating the effectiveness of the approach.
Tamara
> You know..I visited that site a while ago. I'm kind of sad to see it again.
>
> Some events beyond my control led me into the hospital again this summer. It had nothing to do with alternative treatments. It had everything to do with not taking anything under stress, missing sleep, and then having a change in mood.
>
> I looked through the bipolar section again I really want to give the alternatives a try, but I'm stuck with my pdoc because 1) my parents want me to see her, and 2) I'd feel bad about leaving cause she's a very caring doctor.
>
> I just really want to try the alternatives. Mostly because before I had my first mood swing for 2 years I was vegetarian, and would have a large fries, gravey and dressing for lunch at school. ( I was a naive vegetarian. )
>
> I think nutritional treatments would work for me and I really want to try everything alternative, and as small a possible dose of lithium ( 0mg if possible ) since it has some unpleasant side-effects at my usual dose.
>
> The only problem now is I may have side-effects from the AP I was on. And when I look back at that site I keep thinking about how healty I was before I was put through this round of drugs.
>
> It's really upsetting.
Posted by SLS on December 3, 2004, at 9:41:12
In reply to Re: why not dopamine for depression?, posted by Sleepless in the ATL on December 1, 2004, at 7:44:44
My gut feeling is that dopaminergic limbic and prefrontal pathways represent circuits that are downstream and secondary from the primary pathology. As such, agents that target these pathways exclusively are more palliative than corrective. Perhaps this is why psychostimulants and DA receptor agonist usually produce incomplete and short-lived antidepressant effects.
- Scott
Posted by zeugma on December 3, 2004, at 18:20:12
In reply to Re: why not dopamine for depression?, posted by SLS on December 3, 2004, at 9:41:12
> My gut feeling is that dopaminergic limbic and prefrontal pathways represent circuits that are downstream and secondary from the primary pathology. As such, agents that target these pathways exclusively are more palliative than corrective. Perhaps this is why psychostimulants and DA receptor agonist usually produce incomplete and short-lived antidepressant effects.
>
>
> - Scott
I'm inclined to agree with this. Drugs that target the noradrenergic system, such as nortriptyline and atomoxetine, have a definite antidepressant effect, while Ritalin most certainly does not give an AD 'boost'. Even the much maligned buspirone is more of an AD, in my opinion, than Ritalin.Among the psychostimulant class, I would attach a question mark to Provigil. It may be an antidepressant. And despite the many and unsettling side effects I experienced during my trial of it, I had remarkably little anxiety. This, again, is in complete contrast with Ritalin.
By the way, I have often seen posters attribute Ritalin's anxiogenic effect to NE reuptake inhibition or release. This theory does not work for my case at least, because NE reuptake inhibitors have a strong antipanic effect, and an effect which, if not anxiolytic, is at least not anxiogenic.
Posted by abstract on December 3, 2004, at 19:23:48
In reply to Re: why not dopamine for depression? » SLS, posted by zeugma on December 3, 2004, at 18:20:12
This is a very interesting thread. I have often wondered and researched myself about the dopaminergic qualities of various medications and their affect on depression. I have some catching up to do but wanted to reply to several posts. Please forgive...this is going to be a little long.
First a little background. I have been diagnosed with several illnesses however only a few 'stuck' thru various psychiatrists over 10 years and several hospitalizations. First I was diagnosed bipolar. Im not. Then obsessive compulsive which is true as I was a checker of stoves and door locks as a kid and started having irrational fears in my adult life which included full blown panic attacks, anxiety, obsessive worrying....you know the drill. For the last 2 years the anxiety has been gone (probably due to my ex-wife being out of my life ha ha) and mostly depression remained.
Im not a doctor but just another person who has been forced to dedicate many years of his life studying this crap but here is what I have found....
I currently take provigil, effexor and abilify. Provigil has caused no anxiety. Rather it has taken me out of the slump I have found myself in over the last few years. I noticed a difference after > 3 days <. I started on Paxil along with the benzos many years ago which worked for a while. After a few years paxil stopped working and I switched to Effexor which I continue to take. About 1 1/2 months ago my doc started me on provigil. Its has done good things but not drastic. The MOST interesting thing about Provigil is that noone knows how it works. This is pretty scary but I think that many medical professionals do not know how most of this stuff works anyway.The latest additive to the mix is Abilify. Actually an anti-psychotic with stats on treating depression. I started taking this several weeks ago only to stop after 4 days because of anxiety. HOWEVER, after 3 days of being off it I had an AWESOME 3 days. Energy, high mood lift, almost hypomanic which coming from depression I would take in a hearbeat (not mania, hypomania). I started researching dopamine heavily. Abilify's main action is to regular the dopamine receptors. At first I didnt think it was going to work for me as most schizophrenics have too high a level of dopamine and these drugs limit the level.
I started taking Abilify again after telling my doctor I wanted to test it again but at half the dose. I am on my 5th day now and am STARTING to feel the same affects I did before after stopping. (basically starting to feel pretty good) Its my own little experiment with the docs approval.
I tested out L-Tyrosine which is supposed to be a precursor to dopamine but it didnt do anything for me. I dont know if I took the correct amount or stayed with it long enough but decided I didnt want to add to the mix of an already complicated problem I am trying to solve. You see, I have for the most part given up on the psychiatrists. I go to one regularly and she is very good at letting me say my 2 cents about what I feel is working. I would be interested in anyone else's experience with L-Tyrosine and other natural supplements.
Anxiety is usually caused by too much norepinephrine which Wellbutrin is very good at acting on directly, effexor also works on this chemical. I took wellbutrin several years ago but it shot my anxiety so high I was in bad shape and had to stop. This makes sense now seeing what it does. It is a wonderful drug for many people. I actually thought about starting on it again as my illness has somewhat 'migrated' to a less-anxious depression. Not sure. Effexor is supposed to work on the same chemical and it hasnt caused me anxiety either.
If I have mistated anything I welcome any comments, corrections, questions etc...im on the path to learning more about this just like everyone else.
Ryan
Posted by jujube on December 4, 2004, at 8:36:27
In reply to Re: why not dopamine for depression?, posted by SLS on December 3, 2004, at 9:41:12
If anyone is interested - a long read entitled Dopamine Receptors: From Structure to Function found at:
Posted by mindevolution on January 16, 2007, at 4:48:08
In reply to Re: why not dopamine for depression?, posted by jujube on December 4, 2004, at 8:36:27
what is the difference between mdma and mdea?
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.