Feeling meh? Do this to get rid of apathy!

Meh!

That’s your brain in serotonin.

Do you want to run away from your emotions, or still have emotions?

SSRIs are one of the most common prescribed class of drugs for almost any kind of mental condition.

Feeling a bit off today? Here an SSRI!

It’s like house of Oprah.

Although SSRI are helpful for blunting some of the bad emotions that someone might be experiencing, it also has a high risk of blunting the good emotions.

One of the main reasons why people say SSRI drugs work, is because it makes them numb. It numbs their fear, anxiety, anger, depression, etc., but few know that it can also blunt the good emotions.

Do you enjoy music, food, sex, etc? Say goodbye to those on SSRIs.

Do you know who commits suicide? People that feel numb, but with lots of supressed, unresolved pain.

To be fair, not everyone experiences anhedonia from SSRIs. In a study by Fava et al (R), which consisted of participants in both the United States and Italy, nearly one-third on any antidepressant reported apathy, with 7.7 percent describing moderate-to-severe impairment, and nearly 40 percent acknowledged the loss of motivation, with 12.0 percent describing moderate-to-severe impairment.

If you had 2 other buds, which one of you will get apathy, or some of the other side effects of associated with SSRI use? That’s too big a risk to gamble IMO.

Apathy induced by SSRI

There are 2 kinds of apathy induced by SSRI (both induced at the same time), namely a behavioral and emotional perspective.

The behavioural aspect is indifference, apathy, loss of motivation and anhedonia (R).

The emotional aspect is decreased emotional range, loss of motivation, loss of intellectual curiosity (R).

I would like to add a third aspect here, namely physical anhedonia. Not the same as apathy, but mental apathy is basically the same as physical anhedonia. This includes sexual dysfunction, such as erectile dysfunction, genital numbness, anhedonic orgasms, etc.

Opbroek et al6 describe a diminution in emotional responsiveness.6 Price and Goodwin7 describe a reduction in emotional sensitivity as well as a sense of numbing or blunting of the emotions.7 Price et al8 note that affected patients oftentimes describe a restricted range of emotions, including those emotions that are a part of everyday life.8 The preceding authors also describe a number of distinct emotional themes in affected patients, including a general reduction in the intensity or experience of all emotions, both positive and negative; a sense of emotional detachment; “just not caring;” and diminished emotionality in interpersonal relationships, both in personal and professional relationships. While some of these effects may be beneficial at times (e.g., the blunting of an anger response in a volatile patient), they may be detrimental at other times (e.g., emotional indifference at the funeral of a close family member).” (R)

Why SSRI drugs cause apathy and anhedonia

A few reasons include:

  • Increase in prolactin (serotonin increase prolactin though 5-HT2A and C)
  • Dysregulation of the dopaminergic system, often including neurological damage. Dopamine is also the main antagonist of prolactin
    • Hoehn-Saric et al offer a plausible model suggesting dual impact of SSRIs on the frontal cortex, 1 via the serotonergic system and other by the indirect modulation of the midbrain dopaminergic systems projecting to the prefrontal cortex. This SSRI-induced hypodopaminergic state leads to symptoms of apathy. Furthermore, dopaminergic agents, such as methylphenidate, have been reported to treat apathy independent of depression.” (R)
    • This article highlights the relationships between changes in dopaminergic neurotransmission induced by SSRIs and the occurrence of certain side effects such as hyperprolactinemia, extrapyramidal symptoms, sexual and cognitive dysfunction, galactorrhea, mammary hypertrophy, and, more rarely, gynecomastia. “Dopamine-dependent” side effects of selective serotonin reuptake inhibitors.” (R)
    • Other catecholamine agonists that can treat the symptoms of apathy include amantadine [11], bromocriptine [12], levodopa [13], selegiline [14], and bupropion [15].” (R)
  • Reduction/imbalance with noradrenaline, which is involved in motivation and drive (R)
  • Reduced blood flow in the brain (R)
  • Reduced acetylcholine, which can also lead to lower dopamine
  • Dysregulation of the glutamate system connecting to the dopaminergic system (R)

Conclusion

Serotonin has general constrictive and inflammatory effects in the body, including the brain. It constricts your personality and gives you tunnel vision about the future. How exciting does a gray determined future look like? Not very great.

Dopamine on the other hand is involved with excitement, motivation, drive, life enjoyment, pleasure, mental sharpness, openmindedness and much more.

Serotonin is known to contribute to apathy and anhedonia amongst many other even worse side effects, such as blood clotting, PSSD, worsen suicide risk, enhance viral infections and the inflammatory response, asthma and COPD, PTSD, etc.

And it’s not the serotonin to dopamine ratio, but serotonin in general that causes problems. If serotonin remains for too high long term, then it might contribute to long term dysfunction of the dopaminergic system.

SSRI are a big failure for depression and that’s why many other alternatives are being explored at the moment, such as anti-inflammatories, ketamine, Agomelatine, adamantane derivatives (Bromantane, memantine, adamantine, etc.), dopaminergics, noradrenaline uptake inhibitors, etc.

But the thing is, the more neurotransmitters and receptors are being modulated at the same time, the less likely things will turn out to work.

Other compounds that restore proper energy metabolism, such as methylene blue, niacinamide, succinic acid, magnesium, vitamin B1, creatine, etc., all have any depressant effects without the possibility of dopamine antagonism and apathy/anhedonia.

My favorite anti-serotonin stack include:

  • Vitamin B1
  • Magnesium
  • Aspirin
  • Zinc and manganese (that I get from meat and maple syrup respectively)
  • Salt (sodium is a cofactor for SERT, the enzyme that clears serotonin from the synaptic cleft)

If I need something more potent, then I’d add:

  • 10-30mg Tianpetine sulfate (It reduces free serotonin)
  • 1mg cyproheptadine

So simply having carbs, protein and salt and getting out in nature doing breathing will shift the balance away from depression towards excitement and euphoria.

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