BLOG No. FIVE

Welcome back to my fifth blog on anxiety and depression. In previous blogs we have learned that medical professionals, even psychiatrists, struggle with treating anxiety and depression. That is not meant to be disrespectful, but is just my observation. If all these medical professionals were doing an outstanding job treating anxiety and depression, you wouldn’t be reading this blog, now would you?

And we learned that the imbalance between the neurochemicals glutamate (stimulator) and GABA (relaxer) causes type 2 dopamine to elevate, which can then trigger rapid anger, mood changes, anxiety, panic attacks, etc. We also learned that meds originally designed to treat seizures (lamictal, trileptal, etc.) can balance out the glutamate and GABA, normalizing brain chemistry and evicting anxiety and depression from the brain. But there are other ways to do similar things.

No, Chardonnay is not the answer.

Why would you try a different method when we know the seizure medicines works so well?

It’s because nothing in medicine is perfect. A blood pressure medicine that works great on Joe may not work on John. People respond differently to the some medicines, so it’s always good have a backup plan. So if the seizure medicines are either ineffective or cause a side effect, there is another way to proceed.

There are medications that directly suppress type 2 dopamine, rather than doing it by balancing GABA and glutamate. Direct D2 suppressors do exactly as their title states. And a few of them also can raise serotonin.

So why didn’t I bring this up earlier?

Well, these medicines come with a little baggage. The fact that these same medicines can be used for bipolar and schizophrenia (at high doses), freaks people out. But we use medicines all the time for things that they were not originally intended to be used for. For instance, as a migraine expert, I use beta-blockers—blood pressure pills—to prevent migraines. I also use medications, originally made for Parkinson’s disease, at low doses to stop restless leg. This is called off label use and doctors do it all the time.

A man and his wife were at home having a glass of wine, when she suddenly said, “I love you so much, I don’t think I could live without you!” The husband asked, “Is that you or the wine talking?”

The wife answered, “It’s me talking. I’m talking to the wine.”

Using direct D2 suppressors to treat anxiety and depression works great, especially when the patient comes to me already on an SSRI. It is all about the chemistry. When these D2 suppressors are added to an SSRI, the serotonin and dopamine are balanced similarly to the seizure meds. In the end normal serotonin and normal D2 dopamine gives the human brain balance and frees the patient from anxiety and depression. Some of my favorite generic direct D2 suppressors are Abilify, Geodon, and low dose Seroquel. But the very best medicine in this family is called Vraylar, however, it can be expensive.

Most insurance companies do cover it.

Well I just received an alert on my phone, that my particular brand of Chardonnay has been recalled by the government. Evidently, it has been connected to a report that says it can cause erections that last for longer than four hours. I think I’m going to lay down my pen and go have a second glass. Tune in next time when I begin a discussion on if and how non-pharmacological methods can also balance neurotransmitters.

Until then, keep the faith.