# Benzodiazepines and their effect on Dopamine, Noradrenaline and Serotonin



## Inshallah (May 11, 2011)

I was always under the impression they lowered levels of all 3 of them. My psychiatrist however recently told me they have *no effect whatsoever* on either DA, NA or SERT.

So far I have read that (in credible academic sources, can't remember the benzo's in question unfortunately):

- a certain BZD lowered SERT 
- a certain BZD upped DA
- a certain BZD lowered NA

So, which is it really? (+ provide some credible proof as well please )


----------



## basuraeuropea (Jul 25, 2012)

your psychiatrist is misinformed. the benzodiazpines have effects on all three neurotransmitters in question.

benzodiazepines suppress serotonin and norepinephrine.



> The anxiety-reducing effects of minor tranquilizers in the rat conflict test were mimicked by serotonin antagonists and by _p_-chlorophenylalanine, an inhibitor of serotonin synthesis; the depressant effects of the minor tranquilizers were mimicked by norepinephrine antagonists.
> Tranquilizers may exert their anxiety-reducing effects by a reduction of serotonin activity in a behaviorally suppressive punishment system, and they may exert their depressant effects by a reduction of norepinephrine activity in a behaviorally facilitatory reward system.


http://www.sciencemag.org/content/177/4044/180.abstract
http://www.jneurosci.org/content/24/28/6343.full.pdf
http://europepmc.org/abstract/MED/242201/reload=0;jsessionid=rXAo29jDlG8MvDEWsume.8

it seems as though benzodiazepine use decreases mesolimbic dopamine turnover rates, although this mechanism isn't responsible for the therapeutic actions of the drugs, in contrast to the effects the drugs have on ne and 5ht.



> Benzodiazepines are known to decrease the dopamine turnover in the mesolimbic dopaminergic system in stimulated rather than in basal conditions.


http://www.ncbi.nlm.nih.gov/pubmed/8185409
http://www.ncbi.nlm.nih.gov/pubmed/1658299
http://www.ncbi.nlm.nih.gov/pubmed/1362661


----------



## Inshallah (May 11, 2011)

That's what I already thought (and unfortunately, felt as well)) as well as soon as I started taking Tranxene and soon after Xanax. They almost completely neutralized the positive mood effects of 120 mg/day Methylphenidate and 40 mg/day Escitalopram. (although I was only on this for about 1 week, but still, the previous times I took Escitalopram, I always had mood improvements in week 1 already)

This was with 15 mg Tranxene and 0.5 mg FYI, so not even high benzodiazepine doses.

I'm going to confront my psychiatrist next week with all of the stuff you provided, thx bro!


----------



## jim_morrison (Aug 17, 2008)

basuraeuropea said:


> your psychiatrist is misinformed. the benzodiazpines have effects on all three neurotransmitters in question.
> 
> benzodiazepines suppress serotonin and norepinephrine.


My understanding is the same as yours, weird thing is this article seems to suggest something different may be going on. Like opioids and cannabinoids, diazepam and other benzodiazepines take the brakes off activity of dopamine-producing neurons.



> Both inhibitory interneurons (labeled GABA) and dopaminergic neurons (labeled DA) are subject to the restraining influence of the inhibitory neurotransmitter GABA. A key difference, however, is that GABA influences the inhibitory interneurons largely via the alpha-1 subset of GABAA receptors and the dopaminergic neurons largely via the alpha-3 subtype. _(Right Image)_ Benzodiazepines currently on the market do not interact strongly with alpha-3 GABAA receptors on dopaminergic neurons and so have no direct impact on dopamine release. However, the drugs do interact strongly with alpha-1 GABAA receptors, thereby curtailing inhibitory interneurons' release of GABA into synapses with dopaminergic neurons. The net result is a lessening of GABA restraint on the dopaminergic neurons and an increase in dopamine release.


----------



## basuraeuropea (Jul 25, 2012)

jim_morrison said:


> My understanding is the same as yours, weird thing is this article seems to suggest something different may be going on. Like opioids and cannabinoids, diazepam and other benzodiazepines take the brakes off activity of dopamine-producing neurons.


i was about to include that article, but then realised it was sourced by the us drug abuse programme and decided that it might have been slanted in an unfair fashion so i removed it.

the contents are notable though - it would be very interesting to see them replicated by a task force that isn't backed by the war on drugs. i mean, i know the article sources studies, although i can't find what the article is purporting in the abstracts. so, well... although i don't doubt the information is in there, but neither am i sure that the studies weren't financially backed by the us government.


----------



## jim_morrison (Aug 17, 2008)

basuraeuropea said:


> i was about to include that article, but then realised it was sourced by the us drug abuse programme and decided that it might have been slanted in an unfair fashion so i removed it.
> 
> the contents are notable though - it would be very interesting to see them replicated by a task force that isn't backed by the war on drugs. i mean, i know the article sources studies, although i can't find what the article is purporting in the abstracts. so, well... although i don't doubt the information is in there, but neither am i sure that the studies weren't financially backed by the us government.


Yeah I'm not liking the source either, for the most part I think the 'addictive nature of benzodiazepines' stance is way overblown (not referring to physical dependance ofcourse but that's another thing entirely). Nevertheless the article itself seemed to have some interesting info so I thought I'd mention it.


----------



## Inshallah (May 11, 2011)

The links basuraeuropea provided do however make the common practice of prescribing/taking AD's, in combination with benzodiazepines that lower those same neurotransmitters the AD's are upping pretty inconceivable. The patient is not supposed to know but if even the psychiatrist doesn't know it ... ?


----------



## basuraeuropea (Jul 25, 2012)

Inshallah said:


> The links basuraeuropea provided do however make the common practice of prescribing/taking AD's, in combination with benzodiazepines that lower those same neurotransmitters the AD's are upping pretty inconceivable. The patient is not supposed to know but if even the psychiatrist doesn't know it ... ?


then it's time for a new psychiatrist!


----------



## Inshallah (May 11, 2011)

basuraeuropea said:


> then it's time for a new psychiatrist!


She's very human and really cares + she's openminded and willing to try psychopharmaceutical approaches with which she has no experience whatsoever (she's only about 35 or so) and probably unknown to most psychiatrists in Belgium. Even with my entire history, I don't too think too many psychiatrists would prescribe even someone in my shoes the combination I'm on, let alone in these doses.

Her occasional mistakes are no problem, I'm able to look up everything myself and spot possible mistakes immediately, contact her about the mistake, she sincerely excuses herself for the mistake and so it's all good.

It's human and it's correct (emotionally), the factual mishaps are not that big of a deal.

I'd rather have her or someone like her than what is sort of the stereotypical psychiatrist, will make no real mistakes, but also doesn't care, only prescribes meds for HIS/HER reasons instead of for the patients', etc.


----------

