Dopamine-blocking drugs

01-02 April 2013 [Bank Holiday Monday - Tuesday]
When my thoughts and feelings were less restrained by dopamine-blocking medication - that is in the years preceding 2011 - I was very concerned that I might be made to have dopamine-blocking medication as I had been over decades up to my parents’ deaths and that it would affect me very badly as it had then. This fear (to say genuinely what it was) was combined with anger that I had been made to have such medication in those decades and that it had resulted in a terrible and empty experience for me of life then.
I am now being given the minimum dosage of Risperdal Consta injection, which is 25mg every two weeks, and I can see that it is improving life for me. This contrasts with the conclusion I had reached, that any dosage of a dopamine-blocker would do the opposite of help me.
My concern now is that - especially as I am moving home soon - a new psychiatrist may increase the dosage and thereby again consign me to hurt. Up to about a year ago I was on a higher dosage of Risperdal Consta - in fact it was 37.5mg every two weeks - and it made for an unpleasant experience of life for me, doing me hurt not good. I wish to set down the effects of the higher dosage in a version I can make available to any doctor who might think to put me on a higher dosage than 25mg. (This is especially so when at the time I am on the higher dosage I cannot formulate words and sentences adequately to convey what I mean.) It strikes me such a description might be of help to others if published on the internet - not that everybody responds the same to the same dosage but still it would be a warning of the possible adverse effects of too high a dosage for the individual - and a description of the helpful effects of a successful dosage (25mg for me) might be an encouragement too, for example to patients who have encountered nothing but hurt from the dosages (too high I mean) prescribed by psychiatrists who may be insufficiently caring and attentive. For now though I defer a description of the helpful effects.
The main results in me of the higher dosage of Risperdal were those I read reported as side-effects of reserpine, that is depression and anxiety (but anxiety not accompanied by the usual physiological symptoms such as increased heart rate and increased breathing rate). Also I was markedly underactive - going to bed early in the evening because I could find nothing of interest to do and not pursuing my usual interests such as those connected with computing - and indecisive. I found it difficult to engage in conversation because thoughts did not come to mind: my mind in fact was a blank. If I was in a context of requiring to talk to people - as I was because matters arose relating to the bungalow I owned and occupied, in 2011 specifically - I lost track of what I had to say and could not draw together the facts of the case in my mind as the conversation (what passed for a conversation) progressed.
It seems plain to me that the way the brain works one thought leads to another - or ideas presented from other people through language or other symbols set off chains of thought - through a mechanism where neural structures are physically linked by dopaminergic connections. Blocking some dopaminergic synapses weakens the connections so that the excitement of neural structures downstream from some stimulation is reduced, and blocking too many synapses results in thoughts petering out before they really get going. This effect was very apparent to me through introspection in the years when I was given very high dosages of dopamine-blocking drugs.
As regards anxiety, my experience of it since being on dopamine-blocking medication (but not at the current low dosage) is that it arose because the little degree of mental ‘processing’ I did resulted in no decisions being come to - I did not (and could not) think things through enough to reach conclusions - so I was in a constant state of uncertainty. On top of that because of underactivity I did not do things I should have done in preparation for any known up-coming need, so that I was unprepared for things which might arise even when I knew beforehand that they were going to arise. Examples of that would include getting together (that is I did not get them together, because I was underactive) ready for some application I was going to make (say a form I had to fill in, or to be more specific phoning a workman for help with my central heating).
Regarding depression: I am sure nature (or rather evolution) has made it a pleasure to mentally ‘process’ (up to a certain degree). What I think happens in the absence of dopamine-blocking is that as one becomes aware of problems or decisions to be taken the dopamine turnover in the brain increases. This corresponds to ‘processing’ to try to resolve what is perceived as needing resolution (an example which could be tested being the presentation of and the attempt to solve some mathematical puzzle). When the problem is perceived as solved - when some final decision is come to - the level of dopamine drops, sometimes quite suddenly. This gives a surge of serotonin, which is experienced as pleasure. But it is the ebb and flow of dopamine which gives rise to surges of serotonin, and a constant low level of dopamine does nothing for serotonin (and for completeness I remark that a constant high level of dopamine - corresponding to having puzzling problems which never get resolved - equally means there are no surges of serotonin).
Returning to the phenomenon of anxiety, I remark that the more usual origin of anxiety is, not insufficient ‘processing’ to come to any conclusion or decision, but rather, constant ‘processing’ on and on without ever coming to a conclusion or decision because there are too many factors in the ‘processing’, that is too much going on in the mind, in a mutually contradictory and self-defeating range.
In summary, too high a dosage of dopamine-blocking medication causes my mind to be empty. I do not do things I need to do and I do not reach any conclusions, this manifesting as anxiety; I cannot find anything to contribute to a conversation; and life is nothing but depression - death-in-life with very high dosages - because it is so unstimulating.