Posted by bleauberry on January 3, 2008, at 19:24:25
In reply to Im numb again....., posted by your#1fan on January 2, 2008, at 19:52:05
I think one of the big mistakes doctors make in treating depression is....treating depression. Instead, they should treat the specific symptoms of the kind of depression the patient in front of them has. There are many different styles of depression. Yours is apparently vulnerable to emotional blunting. That is common with ssris. From the doctors point of view the AD is working because you aren't depressed. He has not been taught in medical school about emotional blunting. It is just recently becoming recognized as either a stand-alone symptom on its own, or a delayed side effect of too much serotonin.
Treat the symptoms, not the syndrome. In your case, treat emotional blunting, not depression (unless you are still depressed of course). Theories are that the excess serotonin gradually dulls down the dopamine system. I saw in one study that there is evidence serotonin actually gets forced by ssris to transmit through dopamine receptors, where it is not supposed to be, and thus crowding out dopamine.
Emotional blunting as best I understand it is basically a hypodopamine condition. It is impossible to predict which dopamine medication or mechanism would help, but some that would be on the list would be wellbutrin, provigil, ritalin, adderall, adrafinil, low dose deprenyl, mirapex. I have seen some scientific studies on this topic that showed the most rapid and effective treatments for emotional blunting are dopamine agonists. Worth noting is that contrary to theoretical logic, dopamine antagonists can also work, but usually only in the low dose range. Example, prozac plus zyprexa. A friend of mine does well with lexapro and risperdal. In any case, your symptoms probably mean messing with the dopamine system in one way or another.
If your medication has gotten you to a point where you are not depressed any more, then it might be wise to not mess with that. Instead, augment something with it to specifically target the cluster of emotional blunting, anhedonia and motivation.
poster:bleauberry
thread:803868
URL: http://www.dr-bob.org/babble/20071225/msgs/804071.html