When dealing with neurotransmitters, which is more important, that they in the proper balance, or that there is an ample supply of each?

I’m curious since nearly all Mental health issues focus on the neurotransmitters dopamine, serotonin, and norepinephrine when medicating.

As far as ADD/ADHD meds go:

Stimulants seem to generally affect dopamine levels.
Staterra affects norepinephrine re-uptake.
Wellbutrin works by inhibiting the reuptake of dopamine, serotonin, and norepinephrine.

Serotonin is produced from Tryptophan an essential amino acid
Dopamine, Epinephrine & norepinephrine are produced from Tyrosine a Non-essential amino acid.

Seems to me that if:

Dopamine is what you need, then a combination of Wellbutrin & a stimulant would be the answer.

Serotonin is what you need then Wellbutrin or an SSRI plus Tryptophan would be the answer.

If Norepinephrine is what you need then Wellbutrin or Straterra should do the trick.

If they need to be properly balanced then that’s where things get real tricky.

Seems to me that finding the right Meds is first and foremost, then find the proper dose. The correct med, even in an incorrect dose should yield “some” benefit.

Both are important. Neurotransmitter levels need to fluctuate, so you need both an equlibrium and ample supply in case that equilibrium needs to be shifted for compensation. For example, dopamine levels should be at , let's say, 120 ppm during normal activity, but when one tries to concentrate that level should be boosted to 250-350 ppm and remain there until the activity is completed.

The problem with the drug combination is that it is not that strait forward. Drugs react differently with each person. For example, you could take 40mg of Adderall and be fine, but I could only need to take 10mg. And some drugs work on some people entirely different than other. Theoretically, your idea is correct but when you export it out in to practicum it no longer holds true. Thus is the dilemma of physicians and scientists.:):)

Originally posted by InattentiveType

As far as ADD/ADHD meds go:

Stimulants seem to generally affect dopamine levels.
Staterra affects norepinephrine re-uptake.
Wellbutrin works by inhibiting the reuptake of dopamine, serotonin, and norepinephrine.


:confused: This is different from what my doctor has told me about the effects of these drugs. I want to show her this and see what she says.

OK, my Dr says that stimulants effect norepinephrine like Straterra. That is why Strattera is a substitute for stimulant treatment. I take Strattera with Effexor ( instead of Welbutrin) because I need more norepinephrine.

Originally posted by Barbette
OK, my Dr says that stimulants effect norepinephrine like Straterra.
Um. I'm no doctor, but stimulants are thought to affect norepinephrine AND dopamine. I've seen that many places. Carol Watkins, MD at the following site says this: "Atomoxetine (Strattera) does not appear to affect the dopamine systems as directly as do the stimulants...." http://www.baltimorepsych.com/Strattera.htm
It's a pretty good site. It compares/contrasts Strattera with stimulants.

The site also says that Strattera has a secondary effect on dopamine levels. "Although Atomoxetine’s direct effect only seems to be with norepinephrine, it appears to cause a secondary increase in dopamine levels in the ... part of the brain [that] is associated with the ability to mentally rehearse responses, and inhibit impulsivity. The area is also associated with working memory."

My personal experience with Strattera is that it helps a lot with focus but not so much with memory.

I could talk for hours on this..and I'm no doctor!!

Below is an excellent explanation of neurotransmitters, how they work, and the different componenets. Take note that stimulants are agonsists when reading. Whereas Staterra is a re-uptake inhibitor.

http://www.beatcfsandfms.org/html/BrainChem.html

Sleepz

It only matters which arameter falls to a threshhold level where in it alters the performance of the system. Which is more important is a false choice. They are boh important, in their dependent settings. When the paramenter is independent, they don't matter at all.

(Like when it is a matter of brain structure rather than neurotransmitters that is making the difference.)

How much windex does it take to fix a shattered windshield?

Windex can't fix a shattered windsheild.

How many new wipperblades does it take to clean you windows without squirts?

How much squirts does it take to clean your windsheild without wippers?

Some alternate paths might eventually get you there anyway. Others siply never interesct the solutions space.

Ask a more targeted restrictive qestion and you can get an up or down answer to the question. Ask too braodly based a question and the answer will always be "it depends on other things."

I agree with whell, but think a lot more simpler.

Until more is known what is broken with the neurotransmitter system, then trying to fix it by upping the neurotransmitters won't necessarily fix it.

I will credit the question as an excellent step on a long path to understanding more about the WHY of ADD, but there is still more unknown than is known.

Back to wheel, a more targetted wustio would be....

Does anyone have an understanding what the current medical opinion is in regards to what is faulty/broken with the dopaminergic system that allows stimulants such as Adderall to work?

Sleepz