So imagine you're on Wellbutrin... It is a dopamine reuptake inhibitor. This means that the dopamine that is produced in your body is blocked from being recycled by the body as fast as it normally does so that it can help keep you happier longer. It would be like eating sugar and having the high last twice as long as usual. Over time, dopamine begins to build up which is meant to lift you out of depression...

So now your body realizes that it is not recycling the dopamine as quickly as it should and in response, your body generates more dopamine receptors to process the dopamine because it wants to balance and process normally as our bodies naturally seek homeostasis. Now you have more and more dopamine receptors processing the dopamine than before. If all you take is Wellbutrin this is what happens when you need more and more for the same effect over time.

Lets now assume at the same time you take Wellbutrin you are on a typical antipsychotic and it is a dopamine antagonist which means it keeps the body from producing as much dopamine as it did before. So now your body has more receptors for dopamine than it did and it wants more and more dopamine for the hightened feelings, but it no longer makes enough because you are blocking production with the AP.

This is kinda the perfect storm for depression. Decreased dopamine and increased demand for it. Your body cannot get the dopamine it expects, so you get depressed. So now what do you do? Lower the AP to allow for more dopamine, or increase the Wellbutrin?

It is like playing with one big chemistry set. The problem is the prescribers don't always factor in how the body changes to accommodate this stuff over time. There's no way for them to k ow how many receptors you have for any given neurotransmitter at any one time. It isn't always the chemicals that are imbalanced like they claim. Oftentimes it is the body's ability to use and effectively recycle the chemicals that is off.

So we talked about antipsychotic medication withdrawal the other day and how a withdrawal symptom is psychosis. The same imbalanced and body homeostasis response comes into play there as well. You take the AP for a long time and dopamine production is slowed and the body reduces the dopamine receptors to accommodate the decreased production rate. You then withdraw quickly without allowing the body to catch up by creating new receptors because the dopamine production is no longer blocked by the drug. There are many fewer receptors now and the brain gets flooded by dopamine and then BAM. Mania and psychosis return. A doctor sees this and puts you back on an AP to balance things back out when maybe this could have been avoided with a baby steps withdrawal process.

So... Hopefully that sheds a little light. Its all about supply and demand and how the body shifts to accommodate. Our bodies get out of whack all of the time, but our bodies shift to accommodate. Culturally, we are quick to medicate without allowing our minds and bodies time to rebalance. We do a lot of damage that way in my humble opinion. We get ourselves stuck in these med dependent teeter totter loops that are hard to get out of... Sometimes I think providers forget to take a step back and look at the big picture.