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The "Traffic Light" Theory of Antidepressants
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1) Antidepressants regulate or balance one or more of three body/brain chemicals: serotonin, adrenaline or dopamine.
These can be compared to the colors on the traffic light.
2) SEROTONIN is like the RED or STOP light for our brain/mind and body. When low there may be trouble stopping unwanted feelings, thoughts or actions. Keeping your "cool", "chilling out" and "putting a lid on it" probably are related to serotonin. Ninety percent of serotonin is in the gastrointestinal track, five percent around the blood vessels, and five percent in the brain/spinal cord. Knowing where serotonin is explains "side effects" when starting or abruptly stopping some serotonin medication. Serotonin is also involved in regulating sleep, appetite and sexual function. 3) ADRENALINE is like the GREEN or GO light. It gives us the energy for "fight or flight" and keeps us aware, awake and alert. Too much causes agitation, anger and anxiety. 4) DOPAMINE is like the YELLOW or CAUTION light. It helps us be careful and cautious, pay attention, concentrate and focus. Dopamine is also connected to enthusiasm, motivation and pleasure. 5) Knowing this "Traffic Light" theory, as simple as it sounds, can direct your doctor to the right antidepressant for you or a loved one. Antidepressants take THREE to SIX weeks to work. The correct AMOUNT must also be given. Far too often one or both of these facts are ignored. If there is no improvement after giving a correct dose for three or four weeks the dose should be increased to the maximum before giving up on it. If this is not helpful or not tolerated, then switching to a different CLASS ofantidepressant makes the most since. The chances of success with the SAME CLASS are only about ten percent. |
| 6) | Classes of Antidepressants | Dose Range (mg) | Serotonin | Adrenaline | Dopamine |
| a. | Selective Serotonin Reuptake Inhibitors | ||||
| 1. Prozac (fluoxetine) | 10-80 | +++ | + - | ||
| 2. Zoloft (sertraline) | 50-200 | +++ | + - | ||
| 3. Paxil (paroxetine) | 10-80 | +++ | + - | ||
| 4. Celexa (citalopram) | 10-80 | +++ | |||
| 5. Lexapro (escitalopram) | 10-40 | +++ | |||
| b. | Serotonin-2-Antagonist | 400-600 | +++ | + | |
| c. | Serotonin-Adrenaline-Reuptake Inhibitor | ||||
| 1. Effexor XR (venlafexine) | 75-375 | +++ | ++ | + | |
| 2. Cymbalta (duloxetine) | +++ | ++ | |||
| d. | Adrenaline-Dopamine Regulator | ||||
| 1. Wellbutrin SR, XL | 300-400 | + | + | ||
| e. | Tricylcic | ||||
| 1. Anafranil (clomipramine) | 25-300 | +++ | + | ||
| 2. Elavil (amitriptyline) | 25-300 | ++ | + | ||
| 3. Tofranil (imipramine) | 25-300 | ++ | ++ | ||
| 4. Pamelor (nortriptyline) | 10-150 | + | ++ | ||
| 5. Surmontil (trimipramine) | 25-150 | ++ | + | ||
| 6. Vivactyl (protriptyline) | 10-150 | ++ | |||
| 7. Nopramin (desipramine) | 25-150 | ++ |