[maybetinymaybesad]

Bill, on 07 November 2009 - 09:13 AM, said:

i am wondering since it is possible to have ocd/anxiety/pstd,etc low serotonin disorders with mania. maybe low serotonin allows high dopamine and norepinephrene (mania) but then ssris trigger mania

i wouldn't call ocd/anxiety/ptsd, etc 'low-serotonin' disorders. there hasn't been much, if any, definitive proof that low-serotonin causes any of those problems, and the fact that ssris treat them doesn't mean that low serotonin is the cause - after all, bipolar disorder isn't a 'low-lithium' disorder.

[Bueler]

I have to agree with the comment that bipolar isn't a "low-lithium" disorder any less or more than ocd, etc. are "low-serotonin" disorders. Although, certainly low levels of serotonin have been shown to be associated with these things. Someone actually found a way to measure serotonin, although it's very expensive and only done in a clinical setting (Not something you can measure unless Forest Laboratories throws you millions of dollars for studies ).

Additionally, the level of serotonin doesn't *cause* different levels of other neurotransmitters, although serotonin is affected by things like light and sleep. And, norepinephrine is affected by things like stress and excitement.

Usually serotonin is associated with anxiety, feelings of vulnerability, anxiousness. Anxiety could probably be related to mania, but if anything I would think that low levels of serotonin would not cause mania but may actually inhibit it. Antipsychotic drugs, for example inhibit 5-HT (they are 5-HT receptor antagonists), and antipsychotics can bring mania under control.

But in general, I would say that bipolar and various disorders are much more complicated than how much serotonin is in the brain. That's only one piece of the picture.

[lostinthoughtandjaded]

CAUTION: I am not, nor have I ever been, a psychopharmacologist. Take me with a grain of salt...

maybetinymaybesad, on 07 November 2009 - 09:35 AM, said:

Bill, on 07 November 2009 - 09:13 AM, said:

i am wondering since it is possible to have ocd/anxiety/pstd,etc low serotonin disorders with mania. maybe low serotonin allows high dopamine and norepinephrene (mania) but then ssris trigger mania

i wouldn't call ocd/anxiety/ptsd, etc 'low-serotonin' disorders. there hasn't been much, if any, definitive proof that low-serotonin causes any of those problems, and the fact that ssris treat them doesn't mean that low serotonin is the cause - after all, bipolar disorder isn't a 'low-lithium' disorder.

TOTALLY agree. I've put it this way to people before almost word for word.

Bueler, on 07 November 2009 - 10:39 AM, said:

...the level of serotonin doesn't *cause* different levels of other neurotransmitters...
...Usually serotonin is associated with anxiety, feelings of vulnerability, anxiousness...
...But in general, I would say that bipolar and various disorders are much more complicated than how much serotonin is in the brain...

I've always felt that the levels of chemicals and neurotransmitters are affected by each other in a way similar to the equalizer on your stereo. If you bump up the 22 kHz frequency, you might need to bump up the 100 Hz frequency too to make the "shape" of the sound more pleasing than if you had only bumped up the high end. Sorta like how all of us have different "cocktails" that work in tandem with each other. Taking caffeine to speed up the absorption of acetaminophen. Adding Wellbutrin to Prozac to change how your mood progresses throughout the day. Things like that.

I'm on a low dose of Prozac mostly to address chronic anxiety issues, and only partly as an actual "anti-depressant". It took us a while to figure out how to use it without jacking me up, but it has had a wonderful overall effect on stabilizing my anxiety and paranoia.


***ADDED NOTE: I screwed up my serotonin really bad from using ecstasy and meth and a crapload of other dirty dirty drugs, so the addition of an SSRI was more logical for me than others, perhaps. And we also added the clonazepam to take the edge off the anti-depressants, cause the stimulating effects can wind me right up...***

(very sorry if the above is all gibberish..... and all references to "us" and "we" refer to me and my pdoc....)

[AirMarshall]

We know that the 'neurotransmitter model" of medicating is not adequate to explain what is going on with mental illness is obvious because we can give one person an SRRI/NRI/MRI/Lithium etc, and it works yet for another person the same drug doesn't work. The model is still useful just as Newtonian physics is fine for every day use, but won't work at the atomic level, you need Quantum mechanics.

Dr. Manji, head of the NIMH medications research branch, gave a lecture four years ago reviewing their current research. Twenty meds or med targets were in development. None of them were aimed at the nerve synapse level like present meds. They are working to solve the processes that occur inside the nerves, which are complex. They have many clues based on the reactions to present meds.

Presently we use meds with a shotgun approach. Future meds will be target at specific deficits in the nerve machinery leading to better precision, better effectiveness and fewer side effects. He is a dynamic speaker and it is highly encouraging to see the progress they are making.

a.m.