Posted by KaraS on December 8, 2004, at 22:28:46
In reply to Re: Nardil or Parnate decision, posted by SLS on December 8, 2004, at 8:05:03
> Hi Scott,
>
>> I'm not sure I would be so committed to the idea that your depression is caused by sensitive dopamine autoreceptors. Perhaps it is, but I don't think there is yet enough evidence that things are as simple as that. I doubt they are. I prefer to approach the brain as a phenomenon too complex to explain with the paucity of data and understanding that we currently have; that an empirical approach - trial and error - is still necessary to fully explore therapeutic strategies.
Absolutely. I think that the possibility of me having the dopamine autoreceptor problem is a good one (or if not that, then something else is not working which involves dopamine) but I don't think that this is my entire problem. I would bet that I have problems with all of the other major neurotransmitters plus other things I can't even begin to know about. I was depressed for many years before I developed the overwhelming anergic, no motivation depression that I have today. I wonder if long-term use of SSRIs led to my condition now but I was very depressed before the SSRIs so I already had plenty of issues.I'm concentrating on the dopamine autoreceptor theory because my biggest concern is getting some motivation (or at least it was until I got socked with all of this anxiety lately). I can find other antidepressants that would lift my mood somewhat but I've been so nonfunctional career-wise for so long that I've been feeling I have to make fixing that the priority. (I feel like it's now or never for me because of my age.)
>>What does this mean for you?
>
> I think you should choose the drug that evidence has indicated is best suited to treat your symptom cluster (Nardil), and not allow your autoreceptor theory to exclude any drug from future consideration.
But the complete lack of motivation is part of the symptom cluster too, isn't it?
>> You know, a good way to test your autoreceptor theory is to use a preferential DA antagonist like sulpiride or amisulpride at low dosages to see if they produces a clinically significant improvement. Another drug that would be selective for dopamine would be pemoline.
>>The problem with using psychostimulants and Wellbutrin to assess DA function is that each has significant effects on NE pathways as well.
Yeah, the Amisulpride or Sulpiride are better choices and they directly block the D2 autoreceptors, right? (Pemoline is so hard to get prescribed these days.)
>> I'd be curious to know how you came to your conclusion.That makes two of us!
> Good luck.
>
>
> - Scott
Thanks,Kara
poster:KaraS
thread:425971
URL: http://www.dr-bob.org/babble/20041206/msgs/426480.html