Antidepressants Can Increase Depression
Antidepressant medications which increase serotonin neurotransmitter levels can depress dopamine levels. Decreasing dopamine level can increase depression, impulsivity and suicide risk in depressed patients, who were previously dopamine deficient. "When physicians prescribe serotonin enhancement medications to dopamine deficient patients, patients sometimes become more depressed, impulsive and suicidal," said Dr. Rick Sponaugle, Medical Director of Florida Detox.
Many depressed patients do not improve with Selective Serotonin Reuptake Inhibitor (SSRI) Antidepressants, such as Prozac, Paxil or Zoloft. Prozac and Paxil only increase serotonin and norepinephrine activity. When serotonin is increased above normal levels with medication, the brain downregulates dopamine production. Dopamine downregulation explains why some patients become suicidal on "antidepressants."
Physicians must differentiate which "happy chemicals" require adjustment. There are five main "happy chemical" neurotransmitters, serotonin, dopamine, glutamate, norepinephrine and acetylcholine. Deficiency in any of these, can produce clinical depression.
Recent PET brain scan studies clearly reveal dopamine activates the human "pleasure center" (nucleus accumbens). The dopamine D2 receptor within the pleasure center appears to be our happy receptor. PET studies can accurately measure the difference in D2 activity among different patients.
Studies from the National Institute of Drug Addiction (NIDA) and several major universities identified subsets of our population suffering from dopamine deficient pleasure centers. A 2005 NIDA study demonstrated 300 pound females have approximately half the D2 happy receptor activity of normal weight females. A 2006 University of Virginia study revealed eating raises D2 happy receptor activity three times normal for a few hours, and sex increases D2 happy receptor activity ten times normal. Cocaine increases D2 happy receptor activity in the pleasure center to 100 times normal.
A 2006 NIDA study compared patients with normal levels of D2 activity and a group apparently born with half of normal D2 receptor activity. Both groups received intravenous Ritalin which increases dopamine activity. The group with normal D2 activity did not enjoy or wish to continue the Ritalin. The group who inherited half of normal D2 receptor activity felt normal for the first time in their life. These patients are predisposed to food, sex, gambling and drug addiction. Drugs causing dopamine release from brain cells to dopamine receptors on the next brain cell include pain medications like Oxycontin and Vicodin, cocaine, alcohol, marijuana, nicotine and methamphetamine. A NIDA study, revealed intravenous nicotine 0.7 mg (equivalent to lowest nicotine cigarettes) was preferred by rhesus monkeys over intravenous heroin and cocaine. Nicotine increases dopamine more than heroin or cocaine.
At Florida Detox a large majority of our addicted patients have been self medicating clinical depression with the above mentioned drugs. Previously, they had simply been diagnosed "drug addict" or "alcoholic" by multiple previous drug rehab programs. When these patients are correctly diagnosed with serotonin or dopamine deficiency and treated appropriately, they no longer crave drugs or alcohol.