Treatment options for dopamine system

You may need to bump up your dose of Wellbutrin to 300mg per day, that is what I am on and have been for years. I have looked into other ways to increase dopamine and the only one that is reliable is exercise. I am also on an SNRI, which works better for me than an SSRI - I think they have a little dopamine effect, also. I find the whole dopamine issue interesting, as my brother has early onset Parkinson's, which is also a dopamine disorder.

I have dysthymia, which is chronic depression, which started in childhood. I do have episodes of major depression but it is still different than classic major depressive disorder. It is not going to go away, sort of like any other chronic disease. 300 mg of bupropion is the most common dose, 450mg per day is the maximum dose. I have not suffered any consequences from being on this for the last 17 years. Bupropion is also one of the few antidepressants with few to no side effects regarding intimate relations.

Depression is a multifactorial disease: it doesn't have one specific cause. The reasons for a decrease in the neurotransmitters is not specifically known. There is a decrease in the specific receptors in the brains of people with depression and I don't know if that can be reversed. The question is sort of like the "chicken and the egg" - which came first - the depression or the decreased transmitters? That is why medical treatment focuses on increasing the amount of neurotransmitter available by blocking it's reuptake and sort of flooding the remaining receptors.

Many people with major depression do recover and only take antidepressants for months rather than years. So take heart. And also remember, that since depression is a multifactorial disease, it has other treatments that are just as effective as medication (especially when used in combination) such as talk therapy and exercise) I strongly suggest that you do one or both of these also.

I hope this helps and wasn't too preachy. Each one of us is different and treatment needs to be tailored specifically for you, so work closely with your provider and don't give up hope. And feel free to keep asking questions. If I can't answer them, at least I can commiserate.

Duloxetine/Cymbalta works on norepinephrine and serotonin, so you could consider that. My experience of duloxetine is that it worked better than SSRIs - at least for the first few months. Sadly after that my brain habituated to it and the depression and negative thoughts came back. After that, it was useless. So annoying that nothing seems to work long term for me.

Yes studies are being done that highlight sleep issues that are causive of depression conditions. Just went to a seminar on mental illness and sleep.

Sleep apnea is anorher causive element to a depressive condition or illness. No sleep no body healing and the rest of it is scientifically known.

These are either separate or tend to be protagonists in regards to a depressive diagnosis. Many aspects or reasons to a dx...and sometimes there's none.

With sleep disturbance apnea etc the likelyhood of a depressive condition is far more apparent....just in terms of rhe above...not in general.
HT