Dopamine is the neurotransmitter responsible for providing motivation, drive, and focus. It plays a role in many mental disorders including depression, addictions, ADHD, and schizophrenia. The understanding of this molecule has come a long way and one medicine in particular is addressing this issue.
When I first began using Apomorphine, a medication very popular in Europe to treat sexual dysfunction, I was surprised by the feedback I was getting from both my male and female patients alike. The exact way this medication works is still not completely understood but it is thought to work by increasing dopamine levels in the brain. It is through this mechanism that it improves sexual function comparable to common medications used in the U.S. such as Viagra or Cialis. I use it for patients that have sexual inhibition in which hormonal support and replacement do not fix their libido. Apomorphine is also known to be a powerful booster in Human Growth Hormone in some patients so it is used in this way also. What was most shocking in my practice however was the voluntary reports from my patients that described an intense desire to hit the gym and the feeling of reward for doing so. They found that they are able to keep their focus, they have an improved outlook on exercise, and were able to push through the usual excuses not to wake up when it’s pitch dark and hit the gym before work. This, as it turns out, can be explained by the Dopamine Effect.
Dopamine has been called our “motivation molecule.” It boosts our drive, focus, and concentration. It enables us to plan ahead and resist impulses so we can achieve our goals. It gives us that “I did it!” lift when we accomplish what we set out to do. It makes us competitive and provides the thrill of the chase in all aspects of life — business, sports, and love.Dopamine is in charge of our pleasure-reward system.It allows us to have feelings of enjoyment, bliss, and even euphoria. But too little dopamine can leave you unfocused, unmotivated, lethargic, and even depressed.
Many common dopamine deficiency symptoms are similar to those of depression:
Dopamine-deficient lab mice become so apathetic and lethargic they lack motivation to eat and starve to death.Conversely, some people who are low in dopamine compensate with self-destructive behaviors to get their dopamine boost. This can include use and abuse of caffeine, alcohol, sugar, drugs, shopping, video games, sex, power, or gambling.
Serotonin is the brain chemical most associated with depression. Selective serotonin reuptake inhibitors (SSRIs) such as Paxil, Prozac, Zoloft, Celexa, and Lexapro are prescribed for depression and work by increasing brain levels of serotonin. But this only works in about 40% of patients who use them.
There’s a growing body of evidence that shows low dopamine and not low serotonin is the cause of depression for many. Bupropion (brand name Wellbutrin) has proven effective for patients who haven’t been helped by SSRIs by addressing dopamine deficiency.How to determine if your depression is more likely from serotonin versus dopamine deficiency? Serotonin-based depression is accompanied by anxiety and irritability, while dopamine-based depression expresses itself as lethargy and lack of enjoyment of life.
I believe this is why, for a large percentage of my patients who are taking apomorphine for sexual dysfunction, there also tends to be a significant change in mood. Some patients find that apomorphine resolves their depressive symptoms.
The flip side to the above case of possible dopamine deficiency can occur when Dopamine is beyond optimal. The symptoms are very schizophrenic-like with over-thinking leading to paranoia, overanalyzing, over creative ideas, etc. The cause of schizophrenia is unknown, but genetics and environmental factors are believed to play a role. One prevailing theory is that it’s caused by an over-active dopamine system.Supporting evidence for this theory is that the best drugs to treat schizophrenia symptoms resemble dopamine and block dopamine receptors.
There is not a lot of data on the use of apomorphine to objectively create motivation or add motivation but there are personal experiences and theories behind it. Apomorphine has a proven track record of safety and efficacy to improve drive towards sex which makes sense in those men and women with motivation-induced sexual dysfunction. Studies also suggest it may be the most powerful booster of HGH which makes it very useful as a daily or nightly supplement for some people. That fact that the 2 major side effects of yawning and nausea are mild and go away with regular use makes this an ideal medication if prescribed appropriately for those looking to increase their dopamine to improve motivation in their lives. Sublingual delivery is the delivery of choice nightly or in the morning if yawning not an issue. The importance of strong healthy motivation cannot be overemphasized.
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