logic behind taking antipsychotics and stimulants together

[maybetinymaybesad]

i know that in a basic sense, stimulants increase dopamine in the brain while antipsychotics decrease it (or block the dopamine from hitting the receptors.) there are people who take them together who say that it works to control their symptoms (which are usually a combination of tiredness/ADD symptoms and paranoia/delusions or anxiety or aggression.) kids with bipolar disorder also often take stimulants with antipsychotics. why would this combination work? the only explanations i can think of is that the mediations are affecting different dopamine receptors (i think there are a bunch: D-1, D-2, D-3, D-4) or that the neurotransmitters the drugs affect secondarily (norepinephrine for stimulants, histamine/muscarine, etc depending on which antipsychotic) are really what is controlling the symptoms, in which case, shouldn't the drugs we use be targeting those in the first place?

also, we learned in pharmacology that dopamine is necessary for the anticipation and enjoyment of eating, so why, when a person is given an antipsychotic, is he/she likely to eat more than when not on the drug, given that they have less of the neurotransmitter necessary to anticipate and enjoy the food?

 

[fastandbulbous]

Personally, I can't see any logic in combining antipsychotics with psychostimulants (in the UK you don't get doctors prescribing the two together, as a rule) as they both tend to be rather crude tools in managing psychiatric disease states.

The anti-catecholamine effects of antipsychotics mean that the appetite is increased (the catecholamines are important factors in controlling the feeling of hunger and saiety), so that patients tend to eat more, even though they don't derive much in the way of pleasure from the act. That's why the centrally acting anorectic drugs tend to act on dopamine, noradrenaline and serotonin (some antipsychotics also have antagonist activity at some 5HT receptors)

 

[DexterMeth]

im sorry i dont have any "advanced" answer for you. But my old meth dealer sold seroquel pills all the time. They would really calm me down when in the midst of a binge.

 

[Tad R Fitzsimmions]

im sorry i dont have any "advanced" answer for you. But my old meth dealer sold seroquel pills all the time. They would really calm me down when in the midst of a binge.

same no advanced anwser but they do. calm you down far more than a normal benzo dose could.

 

[BilZ0r]

You could come up with a huge number of answers. The classical site of antipsychotics is the D2 receptor... not the D1 receptor... As far as I'm awear, we still don't know whether d1 or d2 receptors are more important in "addictive" behaviours in animals given cocaine/meth... But I think it is safe to say that the noradrenergic component is certainly going to be important (animals will still selfadminister the stims even under complete dopamine blockade).

 

[Dr. Beat]

I have taken chlorpromazine when i was crashing at the end of a big speed night, and it got me really fucking high !

i think it is because anti-psychotics blocks d2 auto receptors, so the dopamine neurons can go bezerk. after a few hours on speed or cocaine, your d2 auto receptors are going to be super over stimulated, so blocking them should help.

also ALOT of anti-psycotics block 5ht 2c receptors (example chlorpromazine and clozapine both strongly blocks them), and when they are blocked, they make your dopamine neurons fire alot more.

just my guess.

 

[maybetinymaybesad]

thanks for all your replies. i agree that taking an antipsychotic with/after using stimulants reduces the jitteriness and all. my friend and i used to have a grand time on seroquel/ritalin/ambien. but i am still scracthing my head over why a doctor would give it to someone. i guess it is clear that stimulants and antipsychotics don't totally cancel each other out.