Re: Suggestions for a depressed HIV+ person on disability

[Guest guest]

Thanks, Phil, for bring up the topic of dopamine. The research of Dr.

Breggin has shown that, in addition to the well known dangers of SSRIs, their

mechanism is not one of helping the brain but rather of impairing it. Dopamine

has a much longer history of use and research which, as the poster points out,

is largely neglected in the treatment of depression. My father had Parkinson's,

so I know something about dopamine and how remarkable the dopamine-boosting

drugs are until, alas, they stop working.

As emphasized here by and others, it is always prudent to rule out often

overlooked causes of depression, such as nutritional and hormonal (e.g. thyroid,

testosterone) deficiencies, before targeting the brain directly. I am aware of

the selegeline patch, but I did not know that it took so long to have an effect.

If that is the case, you can test whether you will respond to a dopamine boost

by trying the Aryuvedic herb, mucuna pruriens, aka dopa bean. You will know

within hours whether it improves your mood. A standard extract of mucuna

contains 15% l-dopa. The product that I use is 333 mg, so a capsule contains 50

mg l-dopa. One capsule taken on an empty stomach in the morning at least an hour

before consuming protein, I have better mood and energy throughout the day,

particularly toward the evening when I typically am at my lowest. I have taken

up to two capsules, but it is too stimulating for me. In addition to its mood

enhancing effects, dopamine also lowers blood pressure, lowers blood sugar, and

lowers prolactin. It also can result in more vivid dreams, so I don't know how

it might affect sleep in a person taking Sustiva.

Mucuna, like all dopamine substrates, should probably not be taken every day. If

you look around you'll find lots of information and advice. Some people say they

have taken it every day for years without diminishing effectiveness. Research on

mucuna and Parkinson's suggests that this may be because mucuna contains other

botanicals in addition to l-dopa, some of which may not be well understood but

could contribute to the herb's more lasting effectiveness versus the

pharmaceutical derivatives. I prefer to exercise caution, however, as dopamine

receptors, like other neurotransmitter receptors, can burn out or shut down.

Generally I only take it on days when I feel I will need it, though I have also

taken it on a 5-day on, 2-day off schedule.

Selegeline, by the way, is also available as a compounded transdermal lotion. I

use it every day, whether or not I take mucuna. Both selegeline lotion and

mucuna pruriens were recommended to me by Dr. Eugene Shippen, an outstanding

endocrinologist whom some here will know.

in SF