Hi kvc - Depression is a very complicated disease. From other posts, you seem to have a good grasp of physiology - so I don't want to blab about things you already know. There are many different neurotransmitters (maybe not all discovered yet) - and there is no definite test to find out what is out of whack. (I just learned this week that most doctors are taught that ALL fibromyalgia patients are depressed! That may be putting the cart before the horse!) I think throwing antidepressants at a patient is a bad idea - it MAY help, and obviously from the posts here, it helps a lot of people. But if your serotonin and norepinephrine levels are OK and you get an SNRI, then you will get abnormally elevated levels - and be thrown off balance and feel terrible. However, it seems to be the "hot" approach. (I won't rant about the FDA….but….)
I read about brain mapping. That might be at least a stab at a solid diagnosis. Before you can treat anything, you need the proper diagnosis (that's how the OLD doctors were) -- nobody has time for that anymore.
So here's what I recommend, and excuse the long post. I hope you get some helpful ideas!
First, try to diagnose yourself exactly. Books I recommend:
(1) Magnificent Mind at Any Age by Dr. Daniel Amen. This will help you figure out what parts of your brain are problematic, and offers natural and medical solutions. You state you have a dopamine problem. For that Dr. Amen recommends a high protein diet; intense aerobic exercise (if you can do that with fibro, let me know! LOL!). He lists supplements, but says only try these ONE AT A TIME, and discuss with your dr. He lists: L-tyrosine; DL-phenylalanine; L-theanine; SAM-e. You said you think you have several neurotransmitters that are low. This book will help you correlate behavioral symptoms with neurotransmitters. Amen is doing great research in this area.
A note about SAM-e. Take a brand that has a STABLE formulation. I tried one that had no effect. Life Extension has tested some, and besides their own brand, they recommend Nature Made - it comes in blister packs to prevent drug degradation - I use it. Take on an empty stomach. I take 400 mg in the AM and 400 mg in the PM, and sometimes 400 mg mid-day. I am NOT SURE, but think I read some people need as much as 1600 mg/day. (It is expensive!) 800mg/day ALONG WITH A STRICT GLUTEN FREE DIET, in my opinion, cured my lifelong depression, along with some supplements I list below. It took about a year to get free of the drugs and learn the diet tricks. After the end of the 2nd year, I really noticed a difference with much less fibro muscle pain, less depression and my extra weight melted off. If I have one slice of bread, I get to start all over again.
(2) I've been watching Brenda Watson on PBS and am looking for her book. She approaches everything from gut health. She recommends high doses (50 billion) of many different strains of probiotics - again, you need a reliable, well-formulated brand. She has a website.
(3) I joined Life Extension, for $75, well worth it. They sent me a HUGE book. Their monthly magazines have great research. You can call 24/7 and arrange to speak with a doctor for free. (I DO NOT recommend listening to the "health care consultants" as their main focus is to sell you stuff, insist on a doctor. They will even consult with YOUR doctor!) I researched my symptoms, and listed the recommendations. (Amazingly, differing symptoms often had similar treatments! So they must be somehow connected in the body.)
(4) I used the Vitamin Shoppe website and researched their database, including symptoms, drugs, interactions, etc. I do not buy their products because they are "gluten free" but NOT wheat free, as far as I can find out.
So, I did a lot of research and formulated a plan that fit my symptoms. I also kept diaries to see how I was doing, and added things one at a time.
Because I have malabsorption issues, I take a ton of supplements, vitamins/ minerals. (For me, 5-HTP and St Johns Wort caused serotonin syndrome. That's funny, since I had been on SSRIs for years. So my serotonin is fine, I guess.)
I'll tell you what has really helped me with my energy level, brain fog and depression. But you have to research everything and see what fits FOR YOU, and what you want to risk, because anything you put in your body has a risk. I also buy the more "expensive" vitamins, because a lot of these supplements are not good quality. (I don't have luxuries, but I have supplements!) I have done well with these brands: Jarrow formula; Source Naturals; Nature Made; some Life Extension (but not their complex formulas - too many variables); Solgar; Solaray - and a few others. Make sure they state no wheat, no gluten…etc.
DHEA (which is controversial. Some drs. say never take more than 5 mg. Some have used up to 150 mg. I take 10 mg w/ no side effects and it HELPS. It is used for adrenal exhaustion, depression, insulin resistance and high cortisol levels. There is an unproven risk of cancers - this IS a steroidal hormone. John McCain, among others, has been trying to take it off the market because some abuse it. However, for me, it has been an enormous help. I can tell a difference when I don't take it. I will take the risks associated because I feel SO much better. Wikipedia has a good article.)
acetyl-L-carnitine & alpha-lipoic acid
Gotu Kola & Ginseng
Ubiquinol (a better version of Co-Q10)
Bilberry, Gingko Biloba, Eyebright
Hydraplenish Hyaluronic Acid (for joint pain)
Everyone is different, so I can't prescribe for you. This is the result of my months of research and experimentation on myself. I went through the drug withdrawals just by riding it out. It may take longer than that "2 weeks" they tell you - especially if your liver is overloaded and not breaking down drugs properly. Hang in, it will get better.
Many of the drugs we take (and I still take a few) interfere with liver enzymes; and we may not rid our bodies of drugs easily - adding to the interaction problems - and stretching out withdrawal symptoms. Dextromethorphan (cough syrup) interacts with antidepressants. Tylenol even in small amounts damages the liver. To support my liver I take milk thistle. Glutathione ( for the liver) is not well absorbed; some say take NAC (it's smelly, a sulfur compound, like MSM). I have read that higher levels of Vit. D3 work in your body to increase your glutathione levels - I take at least 5,000 units a day. Also, melatonin helps with sleep, and I think many other things - but the evidence is conflicting, so research it.
Again, I apologize for this very long post. I hope this will give you (and maybe others) some ideas TO RESEARCH. (TO EACH HIS OWN!! PLEASE DO NOT TAKE MY REGIMEN WITHOUT CHECKING WITH YOUR DOCTOR.)
GOOD LUCK TO EVERYONE HERE! I WISH WE COULD ALL GET A GOOD CURE FOR THIS ROTTEN DISEASE!! ...Not shouting, I just love caps for emphasis! :)