The third neurochemical I will discuss is dopamine. This is an important chemical to balance in order to achieve optimal results with regard to feeling your best. I nickname dopamine the "pleasure chemical". The term "Dope" comes from dopamine, as illicit substances can temporarily balance this chemical, leading to pleasurable feelings.

I often add medications that balance dopamine to other baseline medications such as SSRI's and SNRI's, which I discussed the last two blogs. (Review the last three blogs if you haven't read them yet). The only norepinephrine and dopamine reuptake inhibitor, which focuses mostly on dopamine, is Wellbutrin XL( or generic Bupropion in various forms). The result expected of taking it if it is the right fit can be improved energy, focus, motivation, joy, passion for life, improved sex drive, happiness and reduction in feelings of depression. Since an SNRI such as Pristiq, Cymbalta or Effexor XR focuses more on de-stressing the body and mind, the SNRI-Bupropion combination is what I nickname the "dynamic duo" of medications, and is the top combination I prescribe to my patients. Less commonly SSRI's are better than SNRI's in certain patients. In some Wellbutrin works well on its own, but it's usually better when combined with other medications.

The other dopamine-balancing medications work by slowing down dopamine when it goes too fast through the nervous system, and this regulation of dopamine results in it flowing more normally, resulting in a calming of anxiety and stress, improvement of sleep, control of "racing thoughts", improvement of mood in general such as a reduction of depression and anxiety, and improved energy and happiness. I refer to dopamine as the "sex, drugs and rock-and roll" chemical. There are several medications in this class, and the ones I prescribe the most are Abilify, Seroquel, Saphris, Zyprexa, Risperidone, Geodon, Invega and Latuda. They are indicated for "treatment resistant" depression and anxiety, Bipolar disorder and other indications.

I often add one of these to others I mentioned for the best results, what I refer to as the "Wow". Refer to my book for further details. The combination of Wellbutrin and one of these balances dopamine "24/7", which means that dopamine is optimally balanced all day and evening every day. The secret with prescribing and taking medications is understanding the importance of combining them together properly, referred to as the "rational polypharmacy" approach. The goal is "full remission", which means feeling the real you or your old self, or even better than that. I see that happening every day in my office. Next time I will wrap up this series by discussing GABA. Bye for now.