Posted by kavinsky99 on February 19, 2014, at 19:27:31
In reply to Re: cymbalta+lithium+? some advice please » Elanor Roosevelt, posted by Phillipa on January 23, 2014, at 21:36:04
Actually, it's more likely serotonin is the culprit. Not that serotonin increasing medications are responsible for lower dopamine (the motivation/pleasure seeking neurotransmitter), but serotonin itself, when it's high, triggers the body to lower dopamine. It's a big part of the apathy SSRIs (and SNRIs, such as Cymbalta) cause.
So I'm guessing Cymbalta is causing it. You could try to counterbalance it with another medication, one that acts on dopamine or norepinephrine alone.
Wellbutrin (bupropion) and stimulants (aka amphetamines, such as Adderall, Ritalin, Dexedrine) are the main dopamine enhancers. Beware, though, if you're an anxiety sufferer, these will cause a big increase in it. More dopamine = more anxiety.
That's why I mentioned norepinephrine targeted medication. More norpinephrine tends to "toss around" more dopamine at specific parts of the brain.
Cymbalta should be a norpinephrine reuptake inhibitor (more norepinephrine), though, at the higher doses (up to an specific dose I can't rememebr, Cymbalta only messes with serotonin. After said dose, it starts the norepinephrine increasing too). But, some say reuptake inhibition isn't as good for motivation and dopamine distribution as pure norepinephrine release.Lithium shouldn't hit the dopamine receptors that much, but it does increase serotonin in some areas of the brain. However, it can "dull" most perceptions and sensations.
Personally, I kind of expect any SSRI and SNRI to cause severe apathy and lack of enjoyment. I tend to see them as "casts" for my "broken brain" that I use when anxiety, depression and PTSD get too intense. Then I endure the awful "zombie" period for a while, knowing eventually I'll be able to "break the cast" and switch to less debilitating medication. However, I do have excelent days on these medications. Not exciting days, but days where I feel really good in a very relaxed way, and things just seem to "move" again.
poster:kavinsky99
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