Here's how depression works in people without PD:
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A combination strategy was something I'd been sharing with medical students and patients for years. It arises from understanding the role of what I call "the three tenors," the three key neurotransmitters in the brain that regulate mood--serotonin, dopamine and norepinephrine. As an opera lover, I like to see them as voices singing in the mind. When they sing in harmony and balance, they can make a person feel comfortable in life. But when one of the tenors is out of sync, the music can be disturbing, even frightening.
It may be ordinary knowledge for a psychiatrist to appreciate how each neurotransmitter works--that serotonin regulates worry and anger, that dopamine is critical for initiative and pleasure and that norepinephrine controls alertness and energy. But this information is rarely shared with those being treated. It should be, because it is often the foundation for a successful treatment, one that manages to work even after many others have failed.
...in the last several years many quiet discoveries have been made in the clinical practice of psychiatry. First, it was discovered that not all antidepressants are effective for severe depressions. Also, that antidepressants with dual action--those that influenced two tenors, like serotonin and norepinephrine--often performed better than the antidepressants that target a solo tenor. And further, that combining antidepressants often worked better than using a single one.
]From "The Three Tenors"
By Alen J. Salerian
Special to The Washington Post
Tuesday, June 20, 2000; Page Z09
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Now, from the dictionary link at the top of the page:
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Catecholamines include adrenaline, noradrenaline and dopamine, with roles as hormones and neurotransmitters.
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and serotonergic means
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Related to the action of serotonin or its precursor l-tryptophan.
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So those of us who receive serotonergic medications might have tons of serotonin running around our brains, but perhaps insufficient amounts of the other two of the "three tenors," namely dopamine and norepinephrine. I'm no doctor, don't even work in the health field, and when I did it was in Medical Records. So ask your doctor about this.
Jaye
Note: olsen posted a much better reply while I was typing.