QUESTION: I have a pt with Labrix urinary test showing low levels of neurotransmitters across the board (I.e. low serotonin, dopamine, norepinephrine, epinephrine, gaba, glutamate). Has used ecstasy regularly in the past – though not a giant dose and not more than once every 6 weeks according to pt. Also used Provigil off-label for depression for 4 years. On Wellbutrin currently and does not feel depressed, just extremely fatigued. Extreme debilitating fatigue is main complaint. Cortisol levels are well within normal limits. Very low risk factors for Lyme – i.e. NEVER hikes or does outdoorsy things – grew up in Atlanta and has lived in LA and SF since. Does have Igs for CMV, EBV and HHV. EBV is not reactivated. Does have high-risk sexual behaviors (30-40 partners in in the last few months, some unprotected) and is a gay male. Has been thoroughly tested for STIs and is on Truvada for PREP. Does have hx of mold exposure in a basement apt but does not live there currently, has no congestion or environmental sensitivities, eats well. Would Wellbutrin suppress his neurotransmitter levels? Is there hope of recovering his neurotransmitter function? If so, is amino acid and cofactor supplementation the main way to go? Along with lifestyle things to support catecholamine and serotonin production i.e. good nutrition, exercise, good social relationships etc?
ANSWER: Basically yes. Your ideas are solid (broad amino acid support with B vits and trace minerals etc).