Posted by JohnL on August 21, 2001, at 4:30:36
In reply to Re: Info on symptoms, posted by AndrewB on August 21, 2001, at 3:00:02
Andrew, your post is absolutely excellent!
John> I've seen plenty of sites that try to categorize and compare the symptomology of low dopamine, low serotonin and low norepinephrine. Unfortunately, such simplistic distinctions tend to be more misleading than useful. Depression has a lot of different 'flavors'. You will find a great variety of symptomologies and individual responsiveness to meds (even with people having similar symptomologies). This is because depression can result from the dysregulation of receptors of numerous subsets of neurotransmitter systems. Sorry but its true. And it not just the serotonin, norepinephrine, and dopamine, that can contribute to depression. Hormonal (i.e. stress, sex, and thyroid hormones)factors, other neurotransmitters systems (glutaminergic, cholinergic, and opiate) and yet other factors basic to our metabolism (peptides, cellular energy production, etc.).
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> This view goes a long way towards explaining why so many people are not responsive, only partially responsive, or can’t tolerate first-line antidepressants(i.e. SSRIs). It is as if much of the medical community rests on the assumption that the depression is serotonin based (with a possible norepinephrine contribution). So many doctors will try these types of meds on their patients and when met with a poor response they ask the patient to accept their condition. It is a shame. It is as if those that have been given a whole tool box only will grab the hammer and nail.
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> My advice to you is to pay very close attention to the receptor subtypes that a particular med effects or the site in the brain of its action. After a while pieces start falling together. And yes there are some symptomologies that give clear or very strong indication of certain conditions. For example someone with a combo of social avoidance, low self-esteem/constant negative thoughts, low motivation and anhedonia would with fair certainty have hypofunction of the D2 (and D3) dopamine receptors along the mesocortical-limbic dopamine pathway. Even that being said, many other systems effect the function of this pathway and can contribute to it dysfunction or rehabilitation. Likewise, panic disorder and post-traumatic stress syndrome will have a dominant component of locus coeruleus hyperactivity and can be treated with meds that act on a subtype norepinephrine receptor.
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> In short, I encourage you to learn what you can about your illness. There are rarely simple explanations that will serve as clear roadmaps to your recovery. But if you are patient yet motivated to learn about your condition and the potential meds that will help.... and also judicious yet willing to trial different meds and different combo of meds, the chances are very much in your favor of finding recovery, perhaps a greater recovery than you ever dared imagine.
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> Best wishes,
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> AndrewB
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poster:JohnL
thread:74037
URL: http://www.dr-bob.org/babble/20010814/msgs/75750.html