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Discussion Starter · #1 ·
Right, so I'm reading various articles and I've read a few SSRI/SNRI medication can inhibit dopamine at high dose, whether this is effective or noticeable remains to be seen, but the two in question are:

Effexor:

http://www.drugs-forum.com/forum/showthread.php?t=36429

Zoloft:

http://www.dr-bob.org/babble/20070119/msgs/724214.html

So since I'm out of options in regarding anything outside SSRI/SNRIs and Mirtazapine, I'm thinking of going back to either Zoloft or Effexor. Trouble is, as mentioned before in other threads, Zoloft previously wasn't really any help for my anxiety right upto 100mg and with Effexor I had problems with certain generic brands at the 75mg dose. So I could try them again, but there is risk of encountering the same problems again, but I am hoping at the higher doses I will not experience any problems. For all I know Zoloft might start working better at the higher doses or Effexor might have better generic options at the higher doses, I just don't know.

Maybe I am wasting my time? I mean I really don't know enough about the dopamine inhibition and reuptake at the higher doses, and what doses you have to be at specifically for dopamine to start being targeted. I also don't even know if it's worth the trouble, especially if the dopamine action is extremely small or limited.

So if anyone knows, that'd be great.
 

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First of all, yes both Zoloft and Effexor can have actions on dopamine, albiet pretty mild ones.

Out of the "new generation" antidepressants Zoloft is by far the most potent dopamine reuptake inhibitor, unfortunatly it's serotonin reuptake inhibition is about 50 times more potent, so to get up to a dose of zoloft which would cause any theraputic benefits from dopamine would be unlikely, without the negative serotonin effects getting in the way.

As for Effexor, at doses above 300 mg, it will mildly work as a triple reuptake inhibitor and may have some theraputic benefits, and may be worth a try provided you can stand the side effects at that dosage.

If you really want an antidepressant with dopamine benefits though, your better of going with an irreversable MAOI such as nardil or parnate.
 

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Discussion Starter · #3 ·
You just confirmed my fears, so a MAOI is the only way to go really? Unless I try something like Bupropion/Wellbutrin along with an SSRI/SNRI, but it isn't prescribed here for that, it's only licensed for people with obesity or are trying to quit smoking - which I was told when I asked my doctor about trying it. :/
 

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well you could try becoming obese or taking up smoking :p, just kidding.
But yeah you could try out an SSRI + wellbutrin, if you can get your hands on it, can't hurt.

Wellburtin is fairly mild on the dopamine reuptake, but on the bright side, it doesnt hit any other receptors very potently either so it doesnt have much competition, so a high dose will probably help.
 

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Edit: According to http://www.crazymeds.us/zoloft.html -

"According to Dr. Stahl in Essential Psychopharmacology and Essential Psychopharmacology of Depression and Bipolar Disorder and Dr. Preskorn's online book on Clinical Pharmacology of SSRI's Zoloft works on dopamine reuptake inhibition enough that it should be classified as a serotonin & dopamine reuptake inhibitor"
 
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