Posted by Brainbeard on July 1, 2009, at 5:06:58
In reply to Re: Can serotonin reuptake inhibition be countered? » Brainbeard, posted by garnet71 on June 30, 2009, at 18:46:27
>The problem is, I think the zoloft has had some kind of long-term affect on my dopamine. though I quit taking it last Dec., my motivation never came back 100%; it improved greatly, but I'm still only about 50%?
The SSRIs cause brain changes that take time to be reversed after withdrawal; anecdotal evidence delivered by the hypersensitive (I am among them) points to at least six months for a more or less full recovery. More or less, because further anecdotal evidence - and this time I'm talking about myself only - points to some more permanent changes after long-term SSRI therapy. For instance, my sense of hunger has never returned to normal after years of Paxil. I used to be very hungry before a meal, but after Paxil I often have to look at the clock to see if it's time to eat. Also, I suspect that my motivational problems have permanently gotten worse after Paxil.
The brain is a plastic thing, but plastic doesn't mean elastic - and even a rubber band can break..> Since seratonin agents work for anxiety in my case, do you think this means I will always have to take something for dopamine simulataneously?
You mean something that works AGAINST dopamine? Not necessarily. The connection between the serotonin and the dopamine system is too complex for that. Only with schizofrenia and psychosis it seems that anti-dopaminergic meds are (for many) a necessity.
In my case, pro-dopaminergic meds can help with anxiety short-term, but when the pendulum swings to the other side, they worsen it.The TCA's are very effective drugs, but their side-effects can suck very bad. They do tend to be more or less cognitively debilitating, which is not good for school, depending on how much IQ it would leave you with. Nortriptyline might be an option: it's anxiolytic because of its 5HT2A-antagonism, but it's also stimulating because it's an NRI. And as a secondary amine TCA it's not very debilitating cognition-wise. You might need to add some SRI to it though, if you have the OCD kind of anxiety.
>My current PDoc, while new and just refilling my scripts from last doctor, said he could get wellbutrin to work again w/a small dose of Prozac (5 mgs?). I'm wondering if he was just thinking of that as a placebo though, since I couldn't find any research on that combo.
Low dose Prozac raises noradrenaline and dopamine levels in certain parts of the brain more than inhibiting serotonin reuptake. Even a 2.5mg dose would be enough. Some people got good results with even less. Buspar, perhaps unexpectedly, when taken in combination with Prozac, helps to raise DA and NA levels even more. So your doc might be right. The thing is that this stimulation is not very likely to help with anxiety in the long run.
I was on such a low dose of Prozac + Buspar myself for a while. I gained weight on it very fast though. And I didn't like the 2D6-inhibition, which meant there were many drugs I couldn't take, at least not in normal doses.
poster:Brainbeard
thread:901465
URL: http://www.dr-bob.org/babble/neuro/20090701/msgs/904162.html