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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 53 to 77 of 77. Go back in thread:
Posted by GuardiAngel on November 7, 2009, at 13:15:01
In reply to Re: Do SSRI's cause dopamine depletion, posted by Alexanderfromdenmark on March 4, 2009, at 16:20:32
I have been taking Celexa for ten years. For the last three or so years I have been _extremely_ tired and sleepy (which was not my baseline pattern). This made me lose the will to live (though I was not suicidal---just waiting to die). Now, Wellbutrin has been added and I feel "normal". That made me think: maybe SSRI's somehow reduce dopamine levels/sensitivity...and so a google search brought me to this site and thread.This is very scary and tragic if true and must be added on top of severe withdrawal symptoms (panic attacks and more) I had two years ago when I was off celexa (in an attempt to switch to cymbalta).
I wish I had never been on SSRI's for such a long time. And I wish that both doctors and patients would realize that taking any anti-depressant is not a matter that should be taken lightly.
Posted by Deneb on November 7, 2009, at 16:13:02
In reply to Very sleepy and tired after long term celexa use, posted by GuardiAngel on November 7, 2009, at 13:15:01
Hello GuardiAngel
Welcome to Psycho-Babble! Sorry to hear the Celexa made you tired. That is scary because I've been on an SSRI close to 10 years too. I hope I don't get serious side effects from it. Right now I am finding I have a lot of lack of motivation. I don't know if it is from my meds.
Deneb
Posted by metafunj on November 7, 2009, at 16:29:24
In reply to Very sleepy and tired after long term celexa use, posted by GuardiAngel on November 7, 2009, at 13:15:01
Everything you say is true.
Posted by creepy on November 13, 2009, at 12:01:03
In reply to Very sleepy and tired after long term celexa use, posted by GuardiAngel on November 7, 2009, at 13:15:01
wow, I just posted a message exactly like this one.
same deal, sedation on celexa. No ideas so far =(
Posted by mtdewcmu on November 26, 2009, at 0:22:53
In reply to Very sleepy and tired after long term celexa use, posted by GuardiAngel on November 7, 2009, at 13:15:01
>
> I have been taking Celexa for ten years. For the last three or so years I have been _extremely_ tired and sleepy (which was not my baseline pattern). This made me lose the will to live (though I was not suicidal---just waiting to die). Now, Wellbutrin has been added and I feel "normal". That made me think: maybe SSRI's somehow reduce dopamine levels/sensitivity...and so a google search brought me to this site and thread.
>I think you may be awfulizing. A more straightforward explanation for what happened is that the Celexa pooped out on you and your depression returned. The same thing happened to me (poop out), and rather than continue to take Celexa, I have switched to all new meds and I am feeling better (after a grueling 3 months of trial and error).
Posted by mtdewcmu on November 26, 2009, at 0:39:06
In reply to Very sleepy and tired after long term celexa use, posted by GuardiAngel on November 7, 2009, at 13:15:01
>
> I have been taking Celexa for ten years. For the last three or so years I have been _extremely_ tired and sleepy (which was not my baseline pattern). This made me lose the will to live (though I was not suicidal---just waiting to die). Now, Wellbutrin has been added and I feel "normal". That made me think: maybe SSRI's somehow reduce dopamine levels/sensitivity...and so a google search brought me to this site and thread.
>
> This is very scary and tragic if true and must be added on top of severe withdrawal symptoms (panic attacks and more) I had two years ago when I was off celexa (in an attempt to switch to cymbalta).
>
> I wish I had never been on SSRI's for such a long time. And I wish that both doctors and patients would realize that taking any anti-depressant is not a matter that should be taken lightly.I do agree that the decision to take an antidepressant should not be taken lightly. Although, I don't see why anyone would continue to take the pills for an extended period if they didn't really need them. Case in point, my sister was having some issues of anxiety and low mood around the time she graduated college. This is a challenging time for anyone, I am sure. She saw a psychiatrist, who started her on Cymbalta, which she couldn't tolerate. Then she switched to Prozac, from which she derived some benefit. After seeing a therapist and psychiatrist for a number of months, and taking Ritalin and Concerta for a time (I don't know how she scored that one), she eventually quit taking all the meds of her own accord. My feeling is that she doesn't need medication, and she eventually realized this.
I, on the other hand, don't care to imagine life without meds. I guess I have to accept whatever long-term consequences there may be, because there is no alternative.
I am sure that occasionally it happens, but I can't see why someone would go on taking them for years if they could get along without them.
Posted by conundrum on November 26, 2009, at 6:15:55
In reply to Re: Very sleepy and tired after long term celexa use, posted by mtdewcmu on November 26, 2009, at 0:39:06
Some docs prescribe ritalin for SSRI induced anhedonia. THat could be how she got that script to counter prozac's side effects.
Posted by mtdewcmu on November 26, 2009, at 10:12:07
In reply to Re: Very sleepy and tired after long term celexa use » mtdewcmu, posted by conundrum on November 26, 2009, at 6:15:55
> Some docs prescribe ritalin for SSRI induced anhedonia. THat could be how she got that script to counter prozac's side effects.
That could be true, although she didn't describe any side effects to me, and we were in close contact during that time. I was under the impression that it was more related to attention problems, but who can really know what's in the mind of a pdoc?
Posted by neuro123 on February 7, 2010, at 10:55:02
In reply to Re: Do SSRI's cause dopamine depletion to d/r, posted by Meltingpot on May 17, 2009, at 10:25:42
SSRIs reduce dopamine production. This is one of the reasons they work well in patients with panic disorder and GAD, since dopamine is a precursor for norepinephrine. The reduction is dose-dependent. Down-regulation of dopamine is the reason behind the sexual side effects all SSRI produce + apathy. Dopamine primarily regulates prolactin and /affects/is affected by/ other sex hormones, like testosterone, therefore inducing sexual impairment. (Dopamine agonists are given for infertility in women). High levels of dopamine are associated with psychosis, hyperactivity, hypersexuality, mania,etc., while low levels - with apathy, low sex drive, slowed thinking,etc. There are no specific,long-term studies on permanent effects of SSRI/serotonin agents intake on dopamine production/receptors, but there are reported cases of sexual dysfunction long after a SSRI agent has been discontinued.
Posted by desolationrower on February 7, 2010, at 11:36:34
In reply to Re: Do SSRI's cause dopamine depletion to d/r, posted by neuro123 on February 7, 2010, at 10:55:02
well dopamine can also have anxiolytic effects
-d/r
Posted by Deneb on February 7, 2010, at 16:32:07
In reply to Re: Do SSRI's cause dopamine depletion to d/r, posted by neuro123 on February 7, 2010, at 10:55:02
Hello neuro123!
Welcome to Psycho-Babble! Thanks for all that information about dopamine! Do you know how atypical anti-psychotics like Risperdal affect dopamine?
Deneb
Posted by neuro123 on February 7, 2010, at 17:52:00
In reply to Re: Do SSRI's cause dopamine depletion to d/r » neuro123, posted by Deneb on February 7, 2010, at 16:32:07
> Hello neuro123!
>
> Welcome to Psycho-Babble! Thanks for all that information about dopamine! Do you know how atypical anti-psychotics like Risperdal affect dopamine?
>
> DenebAnti-psychotics mainly block dopamine from reaching it's destination - it's receptors,where it exerts its functions. As I mentioned above, when you are low on dopamine, you become apathetic and relaxed--but not in the good way. Also when your dopamine is completely blocked (with a neuroleptic like Pimozide or older anti-psychotics), your brain "blocks" too. This is followed by a train of side-effects, worst of which is a general cognitive disability, which remains long after a neuroleptic or anti-psychotic has been used, and also Parkinson's disease.
In general, my opinion is that you should NOT mess with dopamine, unless it's a last resort. Recovery from the cognitive dysfunction that anti-psychotics can bring to a normal person takes more than 6 months. Withdrawal from the older anti-psychotics can be worse than benzodiazepine (Xanax) withdrawal.For example - seroquel is given out like candy recently and it messes with your dopamine, serotonin,adrenal,histamine and mACh receptors all together.
I highly advocate against the general use of anti-psychotics for anything else than schizophrenia or psychosis--it's even in it's name.I don't know much about Risperdal.I'm sorry that I cannot be of more help, I just stopped following any info on anti-psychotics after finding out about their devastating effects on healthy people, when prescribed lightly.
As much as I know, is that the newer "atypical anti-psychotics" like Risperidal, work also mainly by blocking dopamine but more selectively and also with less strength, allowing a more "normal" physiological flow of dopamine to it's receptors, which I personally believe is *bull*.P.S. From what I researched quickly right now in order to be able to give you an answer, Risperidal sounds like a good choice compared to other atypical anti-psychotics, if you suffer from schizophrenia or psychosis.
Posted by ggggg123 on October 23, 2010, at 3:35:27
In reply to Re: Do SSRI's cause dopamine depletion to d/r, posted by neuro123 on February 7, 2010, at 10:55:02
Dopamine depletion is not good for GAD, the general misconception amongst doctors about GAD is that it is similar to physical anxiety, in fact the opposite is often true, GAD is mental anxiety without physical anxiety, the two are not totally related. Therefore it could be said that dopamine can in fact be very beneficial to gad, whilst it can have a negative impact on physical anxiety and social phobia. Ssri's increase serotonin beyond normal levels reducing mental anxiety but most likely increasing mental apathy.
Posted by susan55 on December 12, 2010, at 17:59:41
In reply to Re: Do SSRI's cause dopamine depletion to d/r » neuro123, posted by ggggg123 on October 23, 2010, at 3:35:27
> Dopamine depletion is not good for GAD, the general misconception amongst doctors about GAD is that it is similar to physical anxiety, in fact the opposite is often true, GAD is mental anxiety without physical anxiety, the two are not totally related. Therefore it could be said that dopamine can in fact be very beneficial to gad, whilst it can have a negative impact on physical anxiety and social phobia. Ssri's increase serotonin beyond normal levels reducing mental anxiety but most likely increasing mental apathy.
This article suggests that dopamine while it does not say exactly dopamine is lowered I think having a dual uptake of serotonin and dopamine when it should just be dopamine may one increase the amount of serotonin beyond expected maybe even beyond theraputic levels and 2 lower the dopamine as the reuptake is to be purely dopamine but is now being shared by serotonin so perhaps not as much dopamine is getting to the receptors I intend to look into this further.
Posted by susan55 on December 12, 2010, at 18:16:36
In reply to Re: Do SSRI's cause dopamine depletion, posted by Alexanderfromdenmark on April 8, 2009, at 17:28:11
Suspect the receptors become sensitized as there is less dopamine to receive to fix that the body increases the levels of sensitivity the body is very wise.
Posted by Drewfuss on February 9, 2011, at 20:02:53
In reply to Re: Do SSRI's cause dopamine depletion, posted by Amelia_in_StPaul on April 20, 2009, at 17:03:12
This is an important question to be asked. One that MD's and specifically psychiatrists rarely investigate or simply ignore.
SSRI's are likely to cause dopamine depletion as they purport an inhibitory effect of 5-HT on dopomine neuronal activity in the ventral tegmental area (VTA). The increase of 5-HT transmission likely causes a suppression of the firing activity of Dopamine neurons.Since the Dopaminergic system plays an important role in motivation and reward, a potential decrease in the firing of Dopamine neurons may contribute to decreased levels of motivation and exasperate existing depressive symptoms in individuals treated with SSRIs.
Reference:
Dremencov, E., El Mansari, M., Blier, P. (2009). Effects of sustained serotonin reuptake inhibition on the firing of dopamine neurons in the rat ventral tegmental area. Journal of Psychiatry & Neuroscience, (34), 223-229
Posted by EakinsOxley on April 2, 2011, at 20:45:45
In reply to Re: Do SSRI's cause dopamine depletion, posted by Drewfuss on February 9, 2011, at 20:02:53
Why isn't anyone paying attention to this link?
I've been on Paxil for 6 years and have hypersomnia for the last 5. Now I sleep 20 hours a day unless I take modafinil to regulate my dopamine.
Doctors I suggest this to just shake their heads and say there's no link. But there's also no investigation, no proof...
Posted by desolationrower on April 4, 2011, at 3:37:03
In reply to Re: Do SSRI's cause dopamine depletion, posted by EakinsOxley on April 2, 2011, at 20:45:45
hrm, i ignore things that are sort of like science, but doesn't use the the right lingo. in this case, DA 'depletion' vs. reduction in DA firing rate.
anyway, i'd take a stimulant or bupropion.
-d/r
Posted by chumbawumba on April 14, 2011, at 21:10:46
In reply to Re: Do SSRI's cause dopamine depletion, posted by EakinsOxley on April 2, 2011, at 20:45:45
I'd be interested in hearing what the collective babble-mind thinks of this:
http://www.neuroassist.com/Hinz-depression-050208IK-web.pdf
I got TMS about a year ago and the pdoc who did it put me on this supplement called NeuroReplete. Which is basically 5-HTP, Tyrosine, and some vitamin and mineral cofactors. I find it really helpful. I no longer take antidepressants. I had been on Prozac for about 8 years at dosages up to 120 mg a day. I've also tried about 20 other medications alone or in combination. SSRIs, SNRIs, tricyclics, stimulants, antipsychotics. This works the best IMO. And I thought yeah right, a nutritional supplement...baloney. I've always been a better living through chemistry kind of guy. Supplements were airy-fairy snake oil. A clever scheme to lighten my wallet. But I'll be damned if it doesn't work for me.
Posted by torridcalm on May 24, 2011, at 11:52:35
In reply to Re: Do SSRI's cause dopamine depletion, posted by chumbawumba on April 14, 2011, at 21:10:46
> I'd be interested in hearing what the collective babble-mind thinks of this:
>
> http://www.neuroassist.com/Hinz-depression-050208IK-web.pdf
>
> I got TMS about a year ago and the pdoc who did it put me on this supplement called NeuroReplete. Which is basically 5-HTP, Tyrosine, and some vitamin and mineral cofactors. I find it really helpful. I no longer take antidepressants. I had been on Prozac for about 8 years at dosages up to 120 mg a day. I've also tried about 20 other medications alone or in combination. SSRIs, SNRIs, tricyclics, stimulants, antipsychotics. This works the best IMO. And I thought yeah right, a nutritional supplement...baloney. I've always been a better living through chemistry kind of guy. Supplements were airy-fairy snake oil. A clever scheme to lighten my wallet. But I'll be damned if it doesn't work for me.
>
sugests that seritonin and dopamine precursers need to be taken together to maintain balance. gives a recipe vit C, B6, cysteine... I forget the rest of the recipe but it's a very convincing read
Posted by Babak on September 23, 2011, at 13:02:23
In reply to Re: Do SSRI's cause dopamine depletion, posted by metafunj on September 12, 2009, at 11:23:47
> Just thought I'd throw this in here. I posted it in the tread about dopamine depletion on SSRIs being a myth. I hope this helps to answer the initial question.
>
> http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T26-4FNW4KX-2&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=1009313094&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=bf1894ef55db5d4f4c51a0e41f6c6514
>
> Abstract
>
> Serotonin and dopamine transporter (SERT, DAT) availabilities have prospectively been investigated using [123I]β-CIT and single photon emission computed tomography in subjects with obsessivecompulsive disorder under treatment with the selective serotonin reuptake inhibitor citalopram. SERT availability decreased by a mean 36.5%, whereas DAT availability increased by about 40%. The data point at a citalopram induced modulation of both serotonergic and dopaminergic activity and support the notion of functional interactions of monoaminergic systems in the human brain.
>
> Keywords: Serotonin and dopamine transporters; Single photon emission computed tomography; β-CIT; Serotonin reuptake inhibitor; Obsessivecompulsive disorderI think different SSRIs have different effects on dopamine availablity. Citolopram is very different to Paxil.
Posted by babblefox9 on March 6, 2012, at 6:57:51
In reply to Re: Do SSRI's cause dopamine depletion to d/r, posted by susan55 on December 12, 2010, at 17:59:41
Dopamine and Serotonin do a bit of a balancing act, meaning (very simplistically) if one goes up, the other goes down. However, it's not quite that simple with SSRIs. Some of them actually enhance dopamine function to a degree (Prozac) while others leave it alone (Celexa). Some SSRIs are simply "cleaner" in their selectivity than others...generally the newer the SSRI, the more selective it is.
But, to answer your question, yes, LONG TERM use of an SSRI has been shown to produce a hypo-dopaminergic state in some users; names causing emotional blunting, amotivation, etc.
So, yes it's very possible, however it may be more useful to look for other confounding factors first.
This phenomenon seems to be fairly common, and some doctors add on Wellbutrin, an antidepressant active at the dopamine and norepinephrine reuptake sites. That way, you get global neurotransmitter activation.
I hope this helps.
Posted by PrettyLady on January 30, 2013, at 17:42:14
In reply to Do SSRI's cause dopamine depletion, posted by Alexanderfromdenmark on March 3, 2009, at 10:46:37
Alexanderfromdenmark,
I have similar issues, been taking SSRI's/ADs for the long term and am extremely tired and apathetic in the last couple years. Was wondering if you found a solution to this problem?
Posted by AlexanderS on January 31, 2013, at 13:17:12
In reply to Re: Do SSRI's cause dopamine depletion, posted by PrettyLady on January 30, 2013, at 17:42:14
> Alexanderfromdenmark,
> I have similar issues, been taking SSRI's/ADs for the long term and am extremely tired and apathetic in the last couple years. Was wondering if you found a solution to this problem?No, I wouldn't say i've found a solution to this problem. I'm coping with a lot of issues at the moment and I can only found ways to get the most out of a bad situtation.
I would say though that I found a surprising positive effect from this product(linked beneath) on things such as focus, concentration, motivation alertness, clarity and mental energy without side effects.
The product is illuminal as sold on this website. I would certainly recommend a trial.
Posted by PrettyLady on February 1, 2013, at 13:37:37
In reply to Re: Do SSRI's cause dopamine depletion, posted by AlexanderS on January 31, 2013, at 13:17:12
Hmm. Looks interesting. Are you taking any antidepressants anymore? Because this product has 5HTP in it, and it isn't recommended to take 5htp with any antidepressant for the high risk of serotonin syndrome. For this reason, I can't try this. (had it before).
My next stop is a gluten free diet. Have you tried? I talked to my doctor this week and she recommended it, and has before. Worth a shot apparently it does wonders, and did wonders for her.Are you taking something to increase your dopamine? And what are the symptoms of your fog?
Thank you, best of luck. Hopefully we can figure this out together.
This is the end of the thread.
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