# SSRI-induced ADHD / low dopamine?



## LostPancake (Apr 8, 2009)

I get the feeling I have SSRI-induced ADHD. I'm on paxil (paroxetine), increased from 30 to 35mg in January. The spring semester I had a _really_ hard time keeping up with homework, which is normally not so much of a problem (except for anxiety-induced missing of classes). It's been really hard to focus on anything or get up enough energy to accomplish things. My mood is okay - the antidepressant effect of the SSRI is about the right level, and anxiety levels are okay.

I learned a lot from reading on here about dopamine (thanks to rocknroll, medline, euphoria et al), and I get the feeling my dopamine levels dropped too low. Maybe if serotonin levels are high enough, your brain thinks, "alright man, everything's cool, no need to do anything dude, relax!" Hence it's a struggle to get yourself to do things.

I guess the most obvious thing to do is try 32.5mg for a few weeks and see if that helps.

OR try taking dopamine precursors, like tyrosine?

OR try an ADHD drug to increase dopamine levels?

I guess the safest thing to do is just drop the paroxetine levels a bit. Seems like too much serotonin would be bad for you anyway. At least at higher levels it can apparently cause damage to neurons (like from MDMA).

So I kind of answered my own question I guess, which sometimes happens when I write things out! But if anyone has any thoughts or experiences with this stuff I'd be interested to hear them also.


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## euphoria (Jan 21, 2009)

Try adding Wellbutrin or pramipexole. Tyrosine might also help, yeah.


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## Medline (Sep 23, 2008)

Low dose Selegiline would also be an option.


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## euphoria (Jan 21, 2009)

Dopamine responsiveness tends to decrease as you get older, eventually resulting in Parkinson's in the extreme. Selegiline definitely would be a good idea to preserve your dopamine function.


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## LostPancake (Apr 8, 2009)

euphoria said:


> Dopamine responsiveness tends to decrease as you get older, eventually resulting in Parkinson's in the extreme. Selegiline definitely would be a good idea to preserve your dopamine function.


Hmm, that's interesting. Actually, I forgot to mention another symptom from this spring - my handwriting would occasionally become _really_ bad - my hand would get kind of jittery, which I guess could be another sign of low dopamine levels.

But I'm _guessing_ it's the increased serotonin that's causing the dopamine to drop, or reduce the responsiveness to it. It seems to make sense in evolutionary terms - being happy means you don't need to be as motivated to do things. Which is what was making me think I should back off on the paroxetine before trying to increase dopamine levels. But, I could be wrong.

I also started exercising consistently a few weeks ago, which might enable me to back off on the paroxetine even more - so I'll probably experiment with it this summer. But if I can't find a good balance between anxiety and motivation, I'll try some of these dopaminergic things.


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## beaches09 (Feb 1, 2009)

Anything over 30mg Paxil had this same effect on me. Adding Wellbutrin kicked that effect in the butt big time and woke me up like a light switch.


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## Medline (Sep 23, 2008)

Low dose Amisulpride also increases dopaminergic neurotransmission. Would be interesting to find out what happens when Wellbutrin is combined with 50mg Amisulpride... could be fun, but the seizure threshold would probably be lowered.


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## radiohead (Dec 15, 2008)

Copy and paste eh.........genius!


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## LostPancake (Apr 8, 2009)

rocknroll714 said:


> Heightened serotonin levels actually indirectly suppress general dopamine activity by increasing the levels of the hormone prolactin. So any drug that boosts your serotonin levels without affecting dopamine at the same time is going to result in an imbalance between the two neurotransmitters; i.e., high serotonin and low dopamine, marked by sexual dysfunction, apathy/anhedonia (emotional blunting), and decreased motivation, among other side effects. The following is a list of potential drugs and supplements you can get to boost dopamine and correct the imbalance:


Hey thanks rocknroll, that's a great post - very helpful. And interesting about prolactin - sounds like another good drug target, heh. 

So...

weird genes/upbringing/environment/society -> weird social interactions -> social anxiety -> withdrawal -> not enough positive social interactions -> low serotonin -> take SSRI -> high serotonin / better mood -> downgrades HPA axis (reduces anxiety), but also high prolactin / sexual side effects -> low dopamine / low drive/energy -> take dopaminergics -> higher dopamine -> happiness, finally?

Sounds promising. If I had time I'd try reducing the paroxetine first, but I don't know if I can afford such an experiment, really. I'll probably see if I can get some Wellbutrin...

Thanks for all the suggestions, everyone.

[oh, plus CBT/exposure therapy and 25 years of struggling to learn more normal social interactions :roll]


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## beaches09 (Feb 1, 2009)

I went into psychosis after a period of a long caffeine addiction. I think it was the combination of the things though. 500mg-1g per day of caffeine with gingseng, ginkgo, guarana, milk thistle, taurine, and B vitamins. 

All the while with no food, no water or minimal at best, coupled with my serotonin deficiency. It was pretty freaky. I knew how my mind was changing but at the same time I couldn't control it.

*This was also after taking dxm a handful of times with a month*


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## beaches09 (Feb 1, 2009)

Yeah no kidding right? I really didn't think at the time that could have had anything to do with it, but then I looked it up and I guess it seems it is possible. But you know what I just realized and remembered.

**edit to the above. That was the short time period after screwing around with DXM. So that probably explains that actually. But possibly all that caffeine made it worse than it would have been otherwise. When I would take days off from drinking all that stuff I'd be ok but just blah. It's when I drank all that caffeine, gingseng, and ginkgo that it started to happen. I think without realizing I just blamed that as the cause.


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## Edwin (Jun 19, 2008)

rocknroll714 said:


> *L-Phenylalanine/L-Tyrosine/L-DOPA Supplements*: These (excluding the latter) can be picked up at most vitamin stores. They're the direct precursors to dopamine and norepinephrine (i.e., they're transformed into dopamine and norepinephrine once in the body). They're pretty good for boosting dopamine, but they're nowhere near as good as any of the above-mentioned drugs, in my opinion at least. Tolerance may also rapidly develop to these supplements.


Tolerance can develop for naturally occuring amino-acids? Could you elaborate?


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