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The primary focus on serotonin deficiency as the main cause of depression has created treatment failure in many depressed and addicted patients. Other happy (excitatory) neurotransmitters are often ignored and some patients become more depressed when treated with medication. The classic depressive disorder patient who presents to Florida Detox ® is Susan, a 42-year-old professional female who seeks medical attention for depression from her local physician. Dr. Jones immediately assumes that she would benefit from a serotonin enhancer such as Paxil, Prozac, or Lexapro. If indeed this patient suffers from low serotonin levels, her depression should respond within 2-4 weeks of treatment with the serotonin enhancer. Typically, prescribed a medication like Paxil (20 mg per day), she returns one month later insisting her depression is worse. Dr. Jones raises the Paxil to 40 mg per day. Frequently these patients are prescribed extremely high doses (60 mg to 80 mg per day) in the physician’s effort to conquer the problem. Unfortunately Dr. Jones disregards the continuous report from the patient that they are not feeling any better and may actually feel more depressed. What is the problem? If serotonin is unilaterally elevated above normal levels with the mediation, the brain will down regulate production of dopamine. This makes the patient with dopamine deficiency even more dopamine deficient. These patients will typically begin to self medicate with dopaminergic drugs like Percocet, Vicodin, or OxyContin to counteract the decreased production. All of these drugs produce increased dopamine activity in the brain’s pleasure center (nucleus accumbens). When these patients are accurately diagnosed with their genetic dopamine/glutamate deficiency and treated with appropriate dopamine/glutamate enhancing medication, they quickly experience cessation of their depression and lose the craving (psychological and biochemical) for drugs and alcohol. Treatment results in better relapse statistics with the application of this scientific approach to addiction and depression. Unilateral elevation of serotonin without dopamine level protection will result in markedly elevated prolactin levels. Prolactin will increase appetite and decrease sex drive. When dopamine levels are enhanced to normal levels, sex drive will return as will better appetite control.
Celeste Castillo Lee is an individual who has battled end stage kidney disease for over 30 years and currently receives in-center hemodialysis. She has been on peritoneal dialysis, hemodialysis, and had a transplant for 10 years. She is a former faculty member for the Institute for Patient and Family-Centered Care and a patient advisor to non-profit health organizations, governmental agencies, research projects, peer mentor and advocate nationally, and internationally; this includes serving as Board Member and Chair of the Patient & Family Partnership Council for the Kidney Health Initiative, a public/private partnership with the FDA and the American Society of Nephrology, a member of the Phase I National Patient Advisory Council for PCORnet, and a member of the steering committee for the Vasculitis Patient-Powered Research Network (V-PPRN). Celeste is the former Program Manager for Patient and Family Centered Care at the University of Michigan Health System where she provided leadership, strategy and implementation of Patient and Family Centered Care philosophies, practice and change. This included administrative and operational oversight for PFCC Program, Adult Services, peer mentor strategic coordination, quality, program development, education, performance improvement, research collaborations with stakeholders, and care models. She is committed to helping health systems, academic medical centers, industry and others partner with patients and families to re-envision the future of healthcare.