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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 25 of 77. This is the beginning of the thread.
Posted by Alexanderfromdenmark on March 3, 2009, at 10:46:37
I'm asking about this because it was discussed in another thread, I'm wondering whether in clever and knowledgeable people here know any real research that proves that long-term SSRI use can deplete dopamine and how it does it.
Also if they do deplete dopamine, how can one replenish it..
And thirdly? Do SSRI medications and all reuptake inhibtors in the long run simply exhaust the brain of neurotransmitters?
Posted by desolationrower on March 4, 2009, at 10:46:06
In reply to Do SSRI's cause dopamine depletion, posted by Alexanderfromdenmark on March 3, 2009, at 10:46:37
neurotransmitters are synthesized all the time, its not like eggs where you have a supply and when you run out you don't have any more
only time i can think that this might happen is high dose of relseaser, like a meth binge
-d/r
Posted by Alexanderfromdenmark on March 4, 2009, at 13:34:13
In reply to Re: Do SSRI's cause dopamine depletion, posted by desolationrower on March 4, 2009, at 10:46:06
> neurotransmitters are synthesized all the time, its not like eggs where you have a supply and when you run out you don't have any more
>
> only time i can think that this might happen is high dose of relseaser, like a meth binge
>
> -d/rOkay, what I mean then is do SSRI's downregulate dopamine pathways or generally reduce activity of the cathelomine system? I don't know much about neuroscience, I'm just trying to understand the SSRI inscued apathy and secual dysfunction.
Posted by bulldog2 on March 4, 2009, at 16:00:48
In reply to Do SSRI's cause dopamine depletion, posted by Alexanderfromdenmark on March 3, 2009, at 10:46:37
> I'm asking about this because it was discussed in another thread, I'm wondering whether in clever and knowledgeable people here know any real research that proves that long-term SSRI use can deplete dopamine and how it does it.
>
> Also if they do deplete dopamine, how can one replenish it..
>
> And thirdly? Do SSRI medications and all reuptake inhibtors in the long run simply exhaust the brain of neurotransmitters?Yes ssris do lower dopamine production.
Posted by Alexanderfromdenmark on March 4, 2009, at 16:20:32
In reply to Re: Do SSRI's cause dopamine depletion, posted by bulldog2 on March 4, 2009, at 16:00:48
> > I'm asking about this because it was discussed in another thread, I'm wondering whether in clever and knowledgeable people here know any real research that proves that long-term SSRI use can deplete dopamine and how it does it.
> >
> > Also if they do deplete dopamine, how can one replenish it..
> >
> > And thirdly? Do SSRI medications and all reuptake inhibtors in the long run simply exhaust the brain of neurotransmitters?
>
> Yes ssris do lower dopamine production.Is the lowered dopamine production due to SSRIs reversed when the SSRI is discontinued?
Posted by myco on March 4, 2009, at 16:38:57
In reply to Do SSRI's cause dopamine depletion, posted by Alexanderfromdenmark on March 3, 2009, at 10:46:37
I can't answer them all but I will try some...
You can "replenish", as you say, dopamine by augmenting. Various rx augments exist like DA agonists, antagonists and uptake inhibitors...my preference (if they work well enough) is always 'natural' forms. Try using a natural precursor to dopamine. In order to understand this consider this biochem pathway:
Tyrosine -> L-Dopa -> Dopamine -> Norepinephrine -> Epinephrine
So you want to increase dopamine...how do you do it? Well you "add", via herbs or supplements, something that provides your body with a precursor for dopamine. Based on the synthesis pathway you want to give your body additional tyrosine or L-dopa. I've actually been researching this exact thing lately. I'm augmenting with L-Tyrosine to boost my neuros. I notice at a very low dose (150mg - still to much actually) I first get a slight increase in heart rate, minor flushing....then within minutes comes sleepyness/relaxation (a known dopamine side effect) then later, within an hour, I get energy combined with focus and ideas of all kinds (relates to dopamine and norepinephrine)...I haven't been able to distinguish the epinephrine (adrenaline) effect yet but it may be the irritation I get a few hours later but I dont know. This one works the best if you only take it a day or two then take a break for a day or two and go again. You can also add further up the path with L-dopa (not sure if it's an actual supplement itself or not) by adding something like Mucuna pruriens ("velvet bean"). Has L-Dopa in it (useful in parkinson's) and is claimed to improve depression and increase sexuality from a dopamine perspective. Just remember when adding a supplement like these you want to provide it with it's proper cofactors (vitamins & minerals) that it requires to "get to where it needs to go", so to speak. For example, you want to take Tyrosine with vit B6, vit B12, folic acid, and copper...a simple loaded multivitamin will do the trick (take at same time) and take on an empty stomach as proteins will hinder proper absorbtion and distribution.
Apathy and sleep issues are more disturbances caused by seratonin than dopamine I believe as these two issues are more common on SSRI's and MAOIS than TCA's (don't touch seratonin to much/any extent as far as I know in general).
I wouldn't argue SSRI's exhaust neuro's but i'm not sure...sounds like a recent discussion on the med board somewhere actually.
That's all I 'got' lolmyco
> I'm asking about this because it was discussed in another thread, I'm wondering whether in clever and knowledgeable people here know any real research that proves that long-term SSRI use can deplete dopamine and how it does it.
>
> Also if they do deplete dopamine, how can one replenish it..
>
> And thirdly? Do SSRI medications and all reuptake inhibtors in the long run simply exhaust the brain of neurotransmitters?
Posted by myco on March 4, 2009, at 16:41:13
In reply to Re: Do SSRI's cause dopamine depletion, posted by Alexanderfromdenmark on March 4, 2009, at 16:20:32
> Is the lowered dopamine production due to SSRIs reversed when the SSRI is discontinued?
Yes. It will take some time depending on your own physiology and the amount of time you have spent on the SSRI but all your neuro's will return to a "normal" state - the state at which they were before medication.
Posted by desolationrower on March 4, 2009, at 20:54:14
In reply to Re: Do SSRI's cause dopamine depletion, posted by myco on March 4, 2009, at 16:41:13
i'm not sure we know things return to normal, sris increase serotonergic dendritic branching, and i don't know how much that reverses. generally that is considered part of the positive effect reversing depression. there is not much in the way of long-term research on antidepressants. its expensive enough doing a 6 week trial. this is one reason there is little research done on balding, it takes 6 months for effects to be seen, which makes any trial quite costly.
some 5ht neurons exert an inhibitory effect on DA neurons.
there are 5ht receptor antagonists that have positive effect on DA levels in some situations. The other main avenue is more direct activation of DA neurons, something like bupropion is the most common option.
-d/r
Posted by myco on March 5, 2009, at 13:35:17
In reply to Re: Do SSRI's cause dopamine depletion, posted by desolationrower on March 4, 2009, at 20:54:14
I think I read something about this...ssri's causing regrowth or neurons and "repair" of damaged ones...leading into a theory of a neuroprotection of sorts and extended remission after med withdrawal.
Question would be do you think this has more to do with the reuptake inhibition characters of the newer meds? Do you think the same idea could be proposed for MAOI's aswell? At this point, I have no qualms about remaining on nardil for the long term.
myco
> i'm not sure we know things return to normal, sris increase serotonergic dendritic branching, and i don't know how much that reverses. generally that is considered part of the positive effect reversing depression. there is not much in the way of long-term research on antidepressants. its expensive enough doing a 6 week trial. this is one reason there is little research done on balding, it takes 6 months for effects to be seen, which makes any trial quite costly.
>
> some 5ht neurons exert an inhibitory effect on DA neurons.
>
> there are 5ht receptor antagonists that have positive effect on DA levels in some situations. The other main avenue is more direct activation of DA neurons, something like bupropion is the most common option.
>
> -d/r
Posted by Alexanderfromdenmark on March 6, 2009, at 10:38:05
In reply to Do SSRI's cause dopamine depletion, posted by Alexanderfromdenmark on March 3, 2009, at 10:46:37
I must say this concerns me a bit
"Chronic treatment with fluoxetine (Prozac) has been shown to cause persistent desensitization of 5HT1A receptors even after removal of the SSRI in rats.[25] These long-term adaptive changes in 5-HT receptors, as well as more complex, global changes, are likely to be mediated through alterations of gene expression.[26][27][28][29][30] Some of these gene expression changes are a result of altered DNA structure caused by chromatin remodeling,[31][32] specifically epigenetic modification of histones[33] and gene silencing by DNA methylation due to increased expression of the methyl binding proteins MeCP2 and MBD1.[34] Altered gene expression and chromatin remodeling are also involved in the mechanism of action of electroconvulsive therapy (ECT).[35][36]
Because described gene expression changes are complex, and can involve persistent modifications of chromatin structure, it has been suggested that SSRI use can result in persistently altered cerebral gene expression leading to compromised catecholaminergic neurotransmission and neuroendocrine disturbances,[11] such as decreased testosterone levels[37], reduced sperm counts[38], and reduced semen quality with damaged sperm DNA[39]. However, without detailed neuropsychopharmacological, pharmacogenomic and toxicogenomic[40] research, the definitive cause remains unknown."
Posted by Phillipa on March 7, 2009, at 12:55:48
In reply to Re: Do SSRI's cause dopamine depletion, posted by Alexanderfromdenmark on March 6, 2009, at 10:38:05
So we should go off all ad's? Phillipa
Posted by Alexanderfromdenmark on March 8, 2009, at 5:49:25
In reply to Re: Do SSRI's cause dopamine depletion » Alexanderfromdenmark, posted by Phillipa on March 7, 2009, at 12:55:48
> So we should go off all ad's? Phillipa
No, of course not if they help
Posted by Phillipa on March 8, 2009, at 19:34:49
In reply to Re: Do SSRI's cause dopamine depletion » Phillipa, posted by Alexanderfromdenmark on March 8, 2009, at 5:49:25
They don't. Phillipa
Posted by Alexanderfromdenmark on March 9, 2009, at 9:25:59
In reply to Re: Do SSRI's cause dopamine depletion » Alexanderfromdenmark, posted by Phillipa on March 8, 2009, at 19:34:49
> They don't. Phillipa
Then what's the point of being on them? This isn't topic about bashing SSRIs, it's just about trying to understand, how they work and how they affect the brain long-term, but if they aren't benefitting you, I don't see any reason not to go off them or switching med strategy.
Posted by sowhysosad on April 5, 2009, at 16:39:40
In reply to Re: Do SSRI's cause dopamine depletion, posted by Alexanderfromdenmark on March 9, 2009, at 9:25:59
SSRI's also render D2 dopamine receptors supersensitive, which they think might contribute to the antidepressant effect.
That said, so does CBT alone according to some other research, so maybe it's some healing mechanism of the brain as it recovers from depression.
Posted by Alexanderfromdenmark on April 6, 2009, at 3:06:33
In reply to Re: Do SSRI's cause dopamine depletion » Alexanderfromdenmark, posted by sowhysosad on April 5, 2009, at 16:39:40
> SSRI's also render D2 dopamine receptors supersensitive, which they think might contribute to the antidepressant effect.
>
> That said, so does CBT alone according to some other research, so maybe it's some healing mechanism of the brain as it recovers from depression.
Perhaps, depends on the SSRI of course. A drug like prozac has actually been shown to an "atypical" antidepressant in that it also inhibits reuptake of noradrenalin and dopamine.My own experience with lexapro has been quite catastropic in that it just numbed me up, made me fatigued and apathectic, and has caused me secondary hypogonadism and lowered my thyroid hormone t3. Antidepressant my *ss.
Posted by sowhysosad on April 6, 2009, at 15:08:47
In reply to Re: Do SSRI's cause dopamine depletion, posted by Alexanderfromdenmark on April 6, 2009, at 3:06:33
> > SSRI's also render D2 dopamine receptors supersensitive, which they think might contribute to the antidepressant effect.
> >
> > That said, so does CBT alone according to some other research, so maybe it's some healing mechanism of the brain as it recovers from depression.
>
>
> Perhaps, depends on the SSRI of course. A drug like prozac has actually been shown to an "atypical" antidepressant in that it also inhibits reuptake of noradrenalin and dopamine.
>
> My own experience with lexapro has been quite catastropic in that it just numbed me up, made me fatigued and apathectic, and has caused me secondary hypogonadism and lowered my thyroid hormone t3. Antidepressant my *ss.
>Pretty much all the SSRI's sensitise D2 receptors from what I've read, or at least fluoxetine, citalopram and paroxetine do:
http://www.ncbi.nlm.nih.gov/pubmed/15820269
As for fluoxetine and noradrenaline/dopamine, you're right in saying it increases levels of those neurotransmitters, at least in the prefrontal cortex. However, it doesn't significantly inhibit reuptake of catecholamines, so it must be doing it through some other mechanism.
Posted by Alexanderfromdenmark on April 8, 2009, at 17:28:11
In reply to Re: Do SSRI's cause dopamine depletion, posted by sowhysosad on April 6, 2009, at 15:08:47
> > > SSRI's also render D2 dopamine receptors supersensitive, which they think might contribute to the antidepressant effect.
> > >
> > > That said, so does CBT alone according to some other research, so maybe it's some healing mechanism of the brain as it recovers from depression.
> >
> >
> > Perhaps, depends on the SSRI of course. A drug like prozac has actually been shown to an "atypical" antidepressant in that it also inhibits reuptake of noradrenalin and dopamine.
> >
> > My own experience with lexapro has been quite catastropic in that it just numbed me up, made me fatigued and apathectic, and has caused me secondary hypogonadism and lowered my thyroid hormone t3. Antidepressant my *ss.
> >
>
> Pretty much all the SSRI's sensitise D2 receptors from what I've read, or at least fluoxetine, citalopram and paroxetine do:
>
> http://www.ncbi.nlm.nih.gov/pubmed/15820269
>
> As for fluoxetine and noradrenaline/dopamine, you're right in saying it increases levels of those neurotransmitters, at least in the prefrontal cortex. However, it doesn't significantly inhibit reuptake of catecholamines, so it must be doing it through some other mechanism.But what is the significance of sensitizing d2 receptors? Generally I seem to find that studies show that ssri's downregulate dopamine, as such there is less dopamine and not more, sensitizing d2 receptors ot not.
on the subject on dopamine depletion take a look at this.
Posted by sowhysosad on April 8, 2009, at 21:36:35
In reply to Re: Do SSRI's cause dopamine depletion, posted by Alexanderfromdenmark on April 8, 2009, at 17:28:11
> But what is the significance of sensitizing d2 receptors? Generally I seem to find that studies show that ssri's downregulate dopamine, as such there is less dopamine and not more, sensitizing d2 receptors ot not.
>
> on the subject on dopamine depletion take a look at this.
>
> http://ajp.psychiatryonline.org/cgi/content/full/162/9/1755I'm not entirely sure what the significance is Alexander and the research is quite vague, just speculating that it "contributes to the antidepressant effect" in some way. I'd imagine it makes the brain more sensitive to the effects of what dopamine remains, and thus helps with energy, concentration and sleep regulation.
Interesting article about dopamine depletion. I've suffered some of those symptoms recently, which lends weight to my theory that my dopamine levels are low.
Posted by Amelia_in_StPaul on April 20, 2009, at 17:03:12
In reply to Re: Do SSRI's cause dopamine depletion » Alexanderfromdenmark, posted by sowhysosad on April 5, 2009, at 16:39:40
Not all of the SSRIs do the same thing. Fluoxetine has a different effect on dopamine than other SSRIs.
Fluoxetine as monotherapy in psychotic depression:
Report of 4 cases(Excerpt) Recent studies demonstrate that serotonin exhibits a regulatory dopaminergic action by inhibiting the release of dopamine through 5-HT2A somatodendritic receptors in the surface of dopaminergic neurons; thus 5-HT2A antagonists (Altanserin) and 5-HT1A agonists (which may exert subtle inhibitory effects on dopaminergic cell bodies in the substantia nigra by means of autoreceptors ; Kelland, M.D. et al., 1990) or injury to the serotonergic tracts (Dray, A. et al., 1978), produce a disinhibition of dopaminergic neurons in the middle brain with modest increases in the release (Ennis, C. et al.,1981) and possibly in the synthesis of dopamine (Spampinato, U. et al., 1985) in the nucleus accumbens and the prefrontal cortex (Waldmeier, P.C. & Delini-Stula, A.A., 1979; Nedergaard, S. et al., 1988; Kelland, M.D. et al., 1990; Leysen, J.E. et al., 1994). On the other hand, some of the effects of the serotonin in the dopaminergic system can be mediated in indirect form through the modulation of the GABA and the cholinergic system (Dewey, S.L. et al., 1993). Fluoxetine and its active metabolite, norfluoxetine, have a serotonergic profile inhibiting serotonin reuptake the synaptic cleft (Lucas, R.A., 1992). However, the effect of the fluoxetine on other monoaminergic systems is not clearly established. Fluoxetine has been associated with the development of bradykinesia and rigidity, akathisia, shuffling gait, cogwheeling, tremor and akathisia, possibly by the activation of 5-HT2a receptors in dopaminergic neurons (Bouchard, R.H. et al., 1989; Lipinski, J.F. Jr. et al., 1989; Arya, D.K., 1994; Coulter, D.M. & Pillans, P.I., 1995) in a proportion similar to 1 out of 1000 individuals that consume SSRIs (Choo, V ., 1993). Fluoxetine, by increasing the serotonergic activity in the projections toward the substantia nigra from the dorsal raphe nuclei, can inhibit the firing rate of dopaminergic neurons, in such a way that the dopamine blockers in combination with fluoxetine can lead to extrapyramidal effects in patients even when they havent experienced adverse effects when treated only with antipsychotics (Levinson, M.L. et al., 1991). In spite of such findings, fluoxetine has relatively few side effects, especially when compared with the tricyclic antidepressants (Cooper, G.L., 1988) or with Amoxapine (Anton, R.F. & Burch, E.A., 1990).
Effects of fluoxetine on dopamine D2 receptors in the human brain: a positron emission tomography study
We have previously reported that repeated dosing with the selective serotonin reuptake inhibitor (SSRI) citalopram decreases striatal [11C]raclopride binding in healthy volunteers. As the SSRI-class antidepressant drugs are believed to have a similar mechanism of action, we wanted to explore whether the prototype SSRI drug, fluoxetine, shares the effects of citalopram on subcortical dopamine neurotransmission. Eight healthy male volunteers were studied using a randomized double-blind placebo-controlled study design. Striatal and thalamic D2-receptor binding was measured at baseline, after a single oral dose (20 mg) of fluoxetine, and after repeated dosing (2 wk, 20 mg/d). The D2-receptor binding potential (BP) was assessed using [11C]raclopride and 3D positron emission tomography. Repeated dosing of fluoxetine decreased BP in the right medial thalamus (p=0.022). Fluoxetine did not decrease striatal BP, but there was a trend (p=0.090) towards increased BP in the left putamen after repeated dosing. A single dose of fluoxetine did not affect BP in the thalamus or striatum. Fluoxetine appears to have a regionally selective effect on the dopaminergic neurotransmission in various areas of the brain. The current results after fluoxetine together with our previous data on citalopram suggest that the modulatory effects of these drugs on striatal dopaminergic neurotransmission are different upon repeated dosing and further substantiates pharmacological differences between SSRI-class drugs.
Posted by sowhysosad on April 21, 2009, at 7:08:07
In reply to Re: Do SSRI's cause dopamine depletion, posted by Amelia_in_StPaul on April 20, 2009, at 17:03:12
> Not all of the SSRIs do the same thing. Fluoxetine has a different effect on dopamine than other SSRIs.
...which would explain why many people find they're more motivated and energetic on fluoxetine than with other SSRI's ("activating" in the marketing spiel), and why it seems to work pretty well for atypical depression.
Posted by sowhysosad on April 21, 2009, at 7:26:14
In reply to Re: Do SSRI's cause dopamine depletion, posted by sowhysosad on April 21, 2009, at 7:08:07
Due to sleep deprivation and general stupidity I just posted without even reading the research, thinking it was this old chestnut:
Résumé / Abstract
Rationale: The selective serotonin uptake inhibitor (SSRI) fluoxetine has been shown to not only increase the extracellular concentrations of serotonin, but also dopamine and norepinephrine extracellular concentrations in rat prefrontal cortex. The effect of other SSRIs on monoamine concentrations in prefrontal cortex has not been thoroughly studied. Objective: The aim of this study was to compare the ability of five systemically administered selective serotonin uptake inhibitors to increase acutely the extracellular concentrations of serotonin, norepinephrine and dopamine in rat prefrontal cortex. Methods: The extracellular concentrations of monoamines were determined in the prefrontal cortex of conscious rats using the microdialysis technique. Results: Fluoxetine, citalopram, fluvoxamine, paroxetine and sertraline similarly increased the extracellular concentrations of serotonin from 2- to 4-fold above baseline. However, only fluoxetine produced robust and sustained increases in extracellular concentrations of norepinephrine and dopamine after acute systemic administration. Fluoxetine at the same dose blocked ex vivo binding to the serotonin transporter, but not the norepinephrine transporter, suggesting that the increase of catecholamines was not due to non-selective blockade of norepinephrine uptake. Prefrontal cortex extracellular concentrations of fluoxetine at the dose that increased extracellular monoamines were 242 nM, a concentration sufficient to block 5-HT2C receptors which is a potential mechanism for the fluoxetine-induced increase in catecholamines. Conclusion: Amongst the SSRIs examined, only fluoxetine acutely increases extracellular concentrations of norepinephrine and dopamine as well as serotonin in prefrontal cortex, suggesting that fluoxetine is an atypical SSRI.I'm far too tired to get my head around that second piece of research that Amelia posted - is it contradicting other studies which say SSRI's reduce D2 receptor availability? Does the reduced binding potential mean the fluoxetine is acting as a D2 antagonist? I've also previously read that SSRI's supersensitise D2 receptors. My brain hurts...
Posted by Alexanderfromdenmark on April 26, 2009, at 17:43:58
In reply to Re: Do SSRI's cause dopamine depletion, posted by sowhysosad on April 21, 2009, at 7:26:14
> Due to sleep deprivation and general stupidity I just posted without even reading the research, thinking it was this old chestnut:
>
> Résumé / Abstract
> Rationale: The selective serotonin uptake inhibitor (SSRI) fluoxetine has been shown to not only increase the extracellular concentrations of serotonin, but also dopamine and norepinephrine extracellular concentrations in rat prefrontal cortex. The effect of other SSRIs on monoamine concentrations in prefrontal cortex has not been thoroughly studied. Objective: The aim of this study was to compare the ability of five systemically administered selective serotonin uptake inhibitors to increase acutely the extracellular concentrations of serotonin, norepinephrine and dopamine in rat prefrontal cortex. Methods: The extracellular concentrations of monoamines were determined in the prefrontal cortex of conscious rats using the microdialysis technique. Results: Fluoxetine, citalopram, fluvoxamine, paroxetine and sertraline similarly increased the extracellular concentrations of serotonin from 2- to 4-fold above baseline. However, only fluoxetine produced robust and sustained increases in extracellular concentrations of norepinephrine and dopamine after acute systemic administration. Fluoxetine at the same dose blocked ex vivo binding to the serotonin transporter, but not the norepinephrine transporter, suggesting that the increase of catecholamines was not due to non-selective blockade of norepinephrine uptake. Prefrontal cortex extracellular concentrations of fluoxetine at the dose that increased extracellular monoamines were 242 nM, a concentration sufficient to block 5-HT2C receptors which is a potential mechanism for the fluoxetine-induced increase in catecholamines. Conclusion: Amongst the SSRIs examined, only fluoxetine acutely increases extracellular concentrations of norepinephrine and dopamine as well as serotonin in prefrontal cortex, suggesting that fluoxetine is an atypical SSRI.
>
> I'm far too tired to get my head around that second piece of research that Amelia posted - is it contradicting other studies which say SSRI's reduce D2 receptor availability? Does the reduced binding potential mean the fluoxetine is acting as a D2 antagonist? I've also previously read that SSRI's supersensitise D2 receptors. My brain hurts...I think all this far too complicated for us depressed brain foggers. Fx, the insomnia caused by the SSRI's could cause increased dopamine in the following day, because the brain is compensating for the lack of sleep. However I do feel that most SSRI side effects and things like hyperprolactima are definite pointers toward inhibition of dopamine.
Posted by Alexanderfromdenmark on April 26, 2009, at 17:48:50
In reply to Re: Do SSRI's cause dopamine depletion, posted by Alexanderfromdenmark on April 26, 2009, at 17:43:58
Also I think there's a difference between acute admnistration and long term adminitstration. Fx the brain in reponse to the huge increase in serotonin made say "F*ck man, lets pump out some dopamine to balance things out", so you get an increase dopamine, then you take an SSRI again and the brain again says "F*ck it man, keep that dopamine going, pump it up!", then after a period of weeks or months "The adujustment period", the brain just says"f*ck it, no more, we'll just get used to all that f*ck*ng serotonin and stop pumpting the dopamine" and that's when stuff like SSRI apathy, fatigue and PSSD complications set in.
Posted by sowhysosad on April 26, 2009, at 22:30:20
In reply to Re: Do SSRI's cause dopamine depletion, posted by Alexanderfromdenmark on April 26, 2009, at 17:48:50
> Also I think there's a difference between acute admnistration and long term adminitstration. Fx the brain in reponse to the huge increase in serotonin made say "F*ck man, lets pump out some dopamine to balance things out", so you get an increase dopamine, then you take an SSRI again and the brain again says "F*ck it man, keep that dopamine going, pump it up!", then after a period of weeks or months "The adujustment period", the brain just says"f*ck it, no more, we'll just get used to all that f*ck*ng serotonin and stop pumpting the dopamine" and that's when stuff like SSRI apathy, fatigue and PSSD complications set in.
You could be right. Weirdly though, SSRI's can also increase dopamine through other mechanisms. As I understand it, the dopamine reuptake pump starts to soak up some of that excess serotonin floating around, thus preventing reuptake of dopamine and leaving more in the synapse. Maybe that's how fluoxetine boosts dopamine in some parts of the brain?
After 3+ years on escitalopram followed by a lovely bout of sertraline-induced akathisia, it feels like I've been in a hypodopaminergic state for like 8 months now. All the symptoms seem to bear this out. Other AD's I've taken in the meantime seem to have somehow made it worse. As I mentioned elsewhere, NADH seems to be reversing the effect, thank f***.
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Dr. Bob is Robert Hsiung, MD,
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