dopamine deficiency or dopamine receptor deficiency?

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    • #170832
      gibran.shah
      Participant

      Hello,

      First time poster here. I’ve recently started on medication and I’m experiencing tolerance. This has lead me to question the inner workings of my brain, and I’m on a quest to learn as much as I can.

      Here’s an example question: they say that ADHD is the result of low levels of dopamine in the brain, and to a lesser extent, norepinephrine. But I’m wondering if there is a subset of people with ADHD who have normal levels of dopamine (and norepinephrine) but low levels of dopamine receptors (or norepinephrine receptors). You would have the same effect–less stimulation of the recipient neurons.

      I think this might be me. It explains a lot of the differences between myself and most other people with ADHD. When most people with ADHD are described, it is said that they are under-stimulated because of low levels of dopamine. That part describes me as well. But then they go on to say that the hyperactive thrill-seeking of most people with ADHD is explained by the fact that the thrill-seeking behavior releases dopamine and brings their dopamine levels up to normal levels, and this can be very rewarding, and therefore addictive and hard to resist. But I’ve never been a thrill-seeker. The H is definitely lacking in AD(H)D for me. I don’t seek out stimulation. I seek out sleep. The low dopamine receptor theory explains this for me because it says that even with intermittent dopamine hits, it’s extremely difficult to get the recipient neurons to fire. Without an abundance of dopamine receptors, it would take an extraordinary amount of dopamine release to get those neurons firing. The only thing that gets to that level of dopamine is medication. So I’m wondering if I actually have normal levels of dopamine but I’m deficient in dopamine receptors.

      I’m experiencing really powerful tolerance effects to the Dexedrine, and to a lesser extent, methylphenidate. Most people report experiencing tolerance after several months of medication. I become completely tolerant to 20mg of Dexedrine per day after a week (and I mean COMPLETELY tolerant–like feeling NO effect whatsoever). Every doctor I talk to about this is completely floored by it. I had one doctor refuse to believe me. He said he’d never heard of such a thing.

      I understand tolerance to be the increase or decrease of neural receptors in reaction to over- or under-stimulation of those receptors. I’m started to suspect that, whatever the mechanism for keeping neural receptors in balance, mine is over-compensating to keep dopamine receptors (or maybe norepinephrine receptors) low. So it keeps the number of dopamine (or norepinephrine) receptors low under normal conditions (when I’m not taking any drugs), and it overreacts when it is kicked into gear due to an influx of Dexedrine or other drugs that increase the levels of dopamine receptors (or norepinephrine) in the brain. It overreacts by REALLY decreasing the amount of dopamine (or norepinephrine) receptors and decreasing it FAST.

      And BTW, I think this could possibly explain the difference between the typical ADHD person and those who are said to have “sluggish cognitive tempo” <– It’s not a commonly recognized term (even among professionals), but I didn’t make it up: https://www.webmd.com/add-adhd/child…ognitive-tempo. It shares a lot of symptoms in common with ADHD, but not all. It didn’t really catch on because, for one thing, no one could ever figure out whether it was its own condition that just looked like ADHD or was actually a sub-type of ADHD (maybe just another label for the inattentive type), and for another, treatment is the same regardless of the label (so it didn’t prove very useful). I find the distinction very useful, however, if only just to have a description of symptoms that I feel really does describe me. And I think that while the low dopamine theory is a good explanation of ADHD, the low dopamine receptor theory is a good one for SCT.

      Anyway, I guess if all this boils down to a question, it’s this: is there any research in the literature that supports what I’m saying? Have doctors and scientists ever looked at dopamine deficiencies compared to dopamine receptor deficiencies?

    • #170989
      Attention Disorder
      Participant

      Hi gibran.shah

      My first time posting here as well.

      Interesting discussion.

      Some questions I never thought about before.

      Thanks.

      I wounder if both, dopamine deficiency and dopamine receptor deficiency could be accurate depending on the context of the discussion?

      Attention Disorder

    • #171032
      Starsinhereyes
      Participant

      Hello gibran.shah until reading your post i had never heard of SCT before. I too have a strange tolerance that builds quite fast to any medication not just adhd meds. I was diagnosed with combination adhd as a child and an adult. Upon researching SCT which btw there is an informative article on this site about it it seems there has been no research what so ever done on the subject. Which is disheartening because i now too believe that is what i have. I do not have the thrill seeking behavior associated with inattentive adhd. My symptoms go hand in hand with the description provided for SCT. I am not sure of my dopamine levels but i do know that i either have abnormally low or fluctuating levels. I am hopeful though that research will start so we can move past this. The article did mention that ritalin helps reduce the symptoms of SCT as seen with patients suffering from it. Sorry i cant be of much help but thank you for shinning a light on something i would have never known about.

    • #171113
      Attention Disorder
      Participant

      I’ve wondered if some differences between people diagnosed with ADHD and people diagnosed with ADD are partly related to different ways people learn to respond during early life.

      Example, when scared people will respond by “freezing” and/or people will respond by running away (“flight”).

      I myself was diagnosed ADD (Inattentive) and tend to “freeze”, rather than to run away “flight”.

      (I do not smoke cannabis anymore, and do not recommend it), but in the past I would self medicate with cannabis, and can relate to “drug seeking”, but cannot relate to “thrill seeking”.

      While people diagnosed with AD(H)D Combined may relate to “drug seeking” and “thrill seeking”?

      Attention Disorder

      • #171656

        As a child I was 100% ADHD, I had to act on every one of those colored bouncy balls bouncing around that contained my thoughts, acts, emotions,etc… The end result was half chasing 100 rabbits and catching no rabbits.

        Around 35 years old or so I realized all the sudden I had switched to ADD, I still had all the bouncy colored balls bouncing around, but at some point I quit trying to chase all of those 100 rabbits at once and drive myself crazy, instead, I would kind of freeze up and just could not choose which one to start on??? Then never start on any!

        So I guess I flipped from ADHD to ADD, but in either case Dexedrine puts me back to center and on track.

      • #172091
        jwilli
        Participant

        Hi, This dopamine deficiency vs. dopamine receptor deficiency is a very interesting topic. I intend to do some research on this and see if I can add anything to our collective post.

        As for ADHD becoming more like ADD as we age I think perhaps there is something to that concept. I was a hyperactive child but didn’t get an official diagnosis for ADHD until I was in my twenties. That later diagnosis was partly due to the fact that ADD/ADHD wasn’t nearly as well identified in the late 60s, when I was a little kid.

        I’m now in my late 50s, and as a result of natural aging, I’ve slowed down a bit and along with that my super impulsive ADHD habits have somewhat diminished too. However, I still fidget and bounce my leg, and have trouble staying on tasks….So, I’m very much at least still ADD.

        I have recently been trying different dosages of Vyvance with very mixed results. I did much better with Adderall XR, but the stigma attached to it these days makes you almost feel guilty to bring it up with a doctor. Is anyone here currently taking Vyvance and if so can you share some of your experiences and insight with me. Because I’m still not settled with how it acts with me, and it’s pretty frustrating at times.

      • #172638
        angustaff
        Participant

        A year ago, Adderall XR became less and less effective for me. My doctor switched me to Vyvance for a month but I only made it about ten days before discontinuing. Unlike Adderall, which had no side effects, Vyvance use included aggressive thoughts and irritability. I always knew when it was wearing off because I invariably developed a severe headache. To top it all off, it only seemed active for two to three hours, no better than the Adderall.

        Scott

    • #171836
      gibran.shah
      Participant

      Thanks for the responses everyone. Glad I could lend some insight (if indeed that’s what I did).

      If anyone’s been on this board for a while, maybe you can answer a question for me: why can’t I respond to other threads?

      I want to respond to this one here: https://www.additudemag.com/forums/topic/vyvance-twice-daily/ …but can’t because it says “ERROR: Your reply cannot be created at this time.” Do I need to make a certain number of posts before I can reply to other people’s threads?

      Also, I’m having an interesting discuss over at https://www.bluelight.org/xf/threads/looking-for-substitutes-to-dexedrine.887616/ about switching to different drugs to combat tolerance. If anyone wants to join, you’re more than welcome.

      • #172040
        Penny Williams
        Keymaster

        You should be able to reply to other threads, as long as they’re still open.

        Penny
        ADDitude Community Moderator, Parenting ADHD Coach & Author, Mom to teen w/ ADHD, LDs, and autism

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