Depression Clinical Trial. Serotonin vs Dopamine ?
Q.I recently started taking Lexapro, serotonin based pill for depression. I wonder why most medication for depression seem to focus on serotonin uptake inhibitors rather than adding dopamine?
A.I don't know, but I know that there is a very popular dopamine re- uptake inhibitor, but it's illegal in most countries. It's called cocaine. Dopamine is "added" only if you have problems with various non-depression diseases (such as Parkinson's disease). I can't answer your question, but its worth noting that the effectiveness of SSRI's (and SNRI's as well) for treating a variety of conditions has been established largely through clinical trial-and-error without a complete understanding of exactly how or why they work -- at least that's true of those which I am familiar with, which does not include escitalopram. It's possible that drugs which target dopamine have actually been tried but weren't as effective in clinical trials, or had nastier side-effects. They used to prescribe amphetamines. I don't think long term treatment is manageable that way. The non-selective uptake inhibitors do, in fact, inhibit dopamine uptake. Clinical work shows the serotonin selective inhibitors to be more effective. They also used to prescribe lobotomy a little more time before. Somehow I don't have much trust in psychiatrists... I can handle psychotherapy, and I believe it does some good. I have a therapist I can trust, I can tell him everything. But psychopharmaca I do not trust. All the popular antidepressants do cause sexual dysfunction in me (like they do in many others). It's called impotence to be perfectly clear, sorry if that's too much information for you. Just thought that anyone who is confronted with these substances should know. If you do get used to these drugs it's going to be a bitch to get *unused* to them eventually, as well. Do not go "cold turkey" on them!
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