Www Clinical Depression, 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: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. I was on another SSRI (Effexor) for several years, and stopped about 6 months ago. I plan to go back on it, even with the laundry list of side effects. The symptoms of clinical depression are a bitch, even when you know how to recognize them. I am impotent without the drugs, radiation therapy for prostate cancer. At 72 long term problems seem the least of my concerns. I seem to be more level in my emotional response to stress. That is helpful, but I nap often and have little interest or curiosity. I have 2 goals: ability to take care of myself, living independent (this includes getting some more energy); develop some interests to occupy the day. I am working with a PA who is working with my doctor, not off on my own. I plan to ask about dopamine, but that is a week and a half away. I have 2 books that tout the related symptoms for which dopamine is associated, so I got curious. This group often has valuable experiences and insights, so here I am, hat in hand. In cases of clinical depression, "the problem" can hardly ever be solved *at all*. Sometimes, in some people, antidepressant drugs can help mitigate the symptoms of the depression, be the "lesser of evils". But they only work in some individuals, and not in others and so far noone has any method to predict how any patient will respond to the treatment prior to trying it for at least two months. For some people, like perhaps VoR above, some of these drugs work well. They are "lucky" to find the drug that works for them, often after years of experimentation with all sorts of chemical treatment. This is one of those areas in modern medicine where quite a bit of voodoo is still practiced. Because there really are no alternatives.

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