Boosting Neurotransmitters?

Main Chapters:

Preliminary experiments in the 1950's suggested that drugs that depleted the brain of specific neurotransmitters could mimic symptoms of schizophrenia or depression, and that medications that restored those levels could treat those conditions. This lead to monoamine theories of mental illness, where levels of dopamine, serotonin, and norepinephrine were investigated as causes of mental health conditions.

For decades this approach dominated psychiatric pharmacologic research, even though these three neurotransmitters are used by only a tiny percentage of neurons in the brain. However, they are powerful systems, modulating much of the rest of brain circuitry, and their small size and discrete distribution made them easier to study than broader systems like glutamate or acetylcholine.

One might think that the easiest way to boost levels of a neurotransmitter would be to eat more of it. But digestion, absorption, first pass effects in the liver, passage through the blood brain barrier, and arriving at the proper neural connections generally renders that approach ineffective for boosting a neurotransmitter.

Most of our drugs that do boost neurotransmitters do so not by making more of these chemicals, but by allowing them to act for a longer period of time, thus making a stronger downstream signal. Two basic strategies for lengthening the duration of a neurotransmitter's active life are to prevent it's reuptake into the neuron that released it (hence reuptake inhibitors, like Prozac, fluoxetine) or by preventing the breakdown of the neurotransmitter (hence monoamine oxidase inhibitors).

Reuptake inhibition is a major route for how some of the "stimulant" and "nonstimulant" medications (amphetamine, methylphenidate, atomoxetine, buproprion, duloxetine) boost dopamine and norepinephrine levels.

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Videos Mentioned:

Acetylcholine and ADHD:

Monoamine Oxidase Inhibitors and ADHD:

Full Chapter list:

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Psychiatrist, neuroscientist, and author John Kruse, MD, PhD presents practical, actionable, well-researched information about treatment options that scientists and clinicians recommend for adult ADHD and other mental health conditions.

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