I'm currently on 10mg of lexapro (escitalopram) for social anxiety and OCD. I was on it a few years ago and it helped turn my life around in letting me socialize with others with much more moderate (normal) levels of anxiety, but my grades tanked, I developed an insatiable appetite for sugar and junk food, and generally went from an "over achieving neurotic" to a "sociable clown."
I can't consciously tell if the reduced focus on grades was due to a more general reduction in anxiety from the SSRI about my future that was previously causing me to stay up nights fretting over school work making sure I was getting it all done, or because of possible "cognitive impairment" in the realm of motivation/concentration impairment that may have come about as a side effect from the escitalopram SSRI.
Back on it now, I've noticed a similar and very welcomed decrease in social anxiety, but also a more general reduction in existential anxiety, again also in regard to academics that I suspect may partly be due to reduced dopamine transmission caused as a side effect of the SSRI.
While SSRI's do not acutely affect dopamine neurotransmission, or have a direct affinity for the receptor, the serotonin/dopamine systems are linked and there is a pretty well regarded study published a few years ago documenting exactly this effect.
Effects of sustained serotonin reuptake inhibition on the firing of dopamine neurons in the rat ventral tegmental area (2009) (Full article)
http://www.ncbi.nlm....les/PMC2674976/
And in conclusion, basically found that:
"5-HT reuptake inhibition can attenuate the firing activity of DA neurons in the VTA, although only escitalopram does so in a robust fashion. This inhibition might result in suppression of mesolimbic and mesocortical DA neurotransmission. On the one hand, because of the critical role of these DA pathways in the regulation of motivation and reward, such an effect may account, in some patients, for the lack of adequate response to SSRIs."
We all know here how important dopamine neurotransmission is to motivation/concentration and general cognitive ability, so I suspect that my "poorer academic performance" whenever taking lexapro is not a coincidence, and may be partly due to inhibited/impaired dopaminergic transmission. I know several people on these boards and elsewhere have noted a similar "cognitive impairment" or other motivation/memory issues as a side effect of SSRI use. Which leads me to the point of this topic, that I hope may be of interest or use to others here finding themselves in a similar situation, of how to reverse this inhibition of DA in the VTA and mesolimbic pathways?
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The authors of the above study were also studying a 5-HT2C receptor antagonist coadminstered with the SSRIs and noted a robust reversal of this dopaminergic inhibition:
"When we increased the dose of SB 242084 to 2 mg/kg/d, it completely reversed escitalopram-induced suppression of firing of DA neurons in the VTA."
I couldn't personally find any supplements/drugs that were 5-HT2C receptor antagonists (SB 242084), but I was hoping someone on here with more knowledge on this subject might.
Or if any others could recommended a better way to reverse dopaminergic inhibition in general, or specifically when occurring as a side effect from ssri administration?
A simple solution would be to simply cease SSRI use but it really does have a notable impact in decreasing my social anxiety, allowing me to actually enjoy social experiences and turning me into a relatively sociable person instead of a recluses, quality of life is definitely hugely improved, I would just rather it not be at the cost of intellect or general life motivation/ambition.
Edited by KYSkud, 08 December 2015 - 04:29 AM.