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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Amigan on March 30, 2008, at 17:43:32
I would like to learn about the neurochemical processes which are implicated in the development of hypomania.
Which neurotransmitters are involved? Is dopamine the prime factor?
Why antidepressants can cause hypomania?
Posted by dbc on March 30, 2008, at 19:45:46
In reply to Mechanisms on hypomania?, posted by Amigan on March 30, 2008, at 17:43:32
To be honest we really dont know much.
Dopamine is the best theory but hypomania is a vague term. Even the most experianced researcher has no concrete reason that certain medications cause hypomania (other than the obvious stimulants). I flip into hypomania for a few days when upping my dose of lamictal a drug used specifally for managing bi-polar disorders.
Posted by undopaminergic on March 30, 2008, at 20:42:05
In reply to Mechanisms on hypomania?, posted by Amigan on March 30, 2008, at 17:43:32
I'm inclined to think that glutamate is a more direct factor than dopamine, and that changes in dopamine function may be a secondary effect. Stimulant-induced energy, activity and mood elevation at best simulate classic hypomania or manic symptoms, but not the dysphoric or mixed mania or hypomania that is a more relevant complaint in practice. Therefore, it's logical to look at other factors than dopamine elevation; these factors remain largely unknown, but there are some clues: one of them is the fact that mood stabilisers, such as lamotrigine, tend to diminish glutamate release (interestingly, dopamine stimulates it).
Posted by Amigan on March 30, 2008, at 20:43:17
In reply to Re: Mechanisms on hypomania?, posted by dbc on March 30, 2008, at 19:45:46
> To be honest we really dont know much.
>
> Dopamine is the best theory but hypomania is a vague term.Yes, but.. what about Dopamine, exactly? Increase? Decrease in the synaptic cleft?
> Even the most experianced researcher has no concrete reason that certain medications cause hypomania (other than the obvious stimulants).But is it not well know and documented that serotoninergic antidepressants can cause hypomania in certain individuals?
Posted by undopaminergic on March 30, 2008, at 23:51:24
In reply to Re: Mechanisms of hypomania?, posted by Amigan on March 30, 2008, at 20:43:17
>
> But is it not well know and documented that serotoninergic antidepressants can cause hypomania in certain individuals?
The Zoloft prescribing information claims it occurred in 0.4% of those receiving the drug during premarketing.
Posted by dbc on March 31, 2008, at 12:09:03
In reply to Re: Mechanisms on hypomania?, posted by undopaminergic on March 30, 2008, at 20:42:05
> I'm inclined to think that glutamate is a more direct factor than dopamine,<
Wouldnt that simply mean in the end it inhibits all neurotransmition so more or less its just guessing which one may or may not be partially responsible?
Posted by Amigan on April 1, 2008, at 1:17:10
In reply to Re: Mechanisms on hypomania?, posted by undopaminergic on March 30, 2008, at 20:42:05
> I'm inclined to think that glutamate is a more direct factor than dopamine, and that changes in dopamine function may be a secondary effect. Stimulant-induced energy, activity and mood elevation at best simulate classic hypomania or manic symptoms, but not the dysphoric or mixed mania or hypomania that is a more relevant complaint in practice. Therefore, it's logical to look at other factors than dopamine elevation; these factors remain largely unknown, but there are some clues: one of them is the fact that mood stabilisers, such as lamotrigine, tend to diminish glutamate release.
I think you are right! I did some search about the treatment of hypomania and found out that mood stabilizers are the first choise, and most meds of this class decrease glutamine.
>(interestingly, dopamine stimulates it).
Perhaps, that's why antipsychotics are also used for this condition? They decrease glutamine, by decreasing dopamine? Possibly..
Posted by undopaminergic on April 2, 2008, at 6:06:25
In reply to Re: Mechanisms on hypomania? ) undopaminergic, posted by dbc on March 31, 2008, at 12:09:03
> > I'm inclined to think that glutamate is a more direct factor than dopamine,<
>
> Wouldnt that simply mean in the end it inhibits all neurotransmition so more or less its just guessing which one may or may not be partially responsible?
>I'm not quite sure I'm following, but no, it doesn't get as far as inhibition of all neurotransmission, and yes, it's a matter of guessing which one may be responsible - or what process may be triggering the chain of events - and what events are part of that chain, and so on.
This is the end of the thread.
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