The musings and rants of Julie Marie Miller, Special Needs Specialist, Parenting Expert & Mental Health Caregiver
  • Julie Marie Miller

That's Dope: featuring Guest Author Kathryn Defea, PhD

a compound present in the body as a neurotransmitter and a precursor of other substances including epinephrine.

I have the distinct pleasure of counting among my closet friends Katie Defea; also known as Dr. Kathryn Defea, I confide in Katie regularly and although she often speaks another language (known as microbiology) at warped speed (so I ask her to email me) she supports my gut instincts about these medication trials with science. I asked her today if there was a diagnostic technique that could take place - a brain scan? a mini-brain in a petri dish? Any other option than to torture my daughter through being a human pincushion through these medication trials.

This is my daughter on medication:

We took her off the medication immediately. Fortunately the medications wore off yesterday and we reported to her psychiatrist. Today, she went ice skating (to assure readers she is better than this recording).

With Dr. Defea's permission I share the following with you:

Wellbutrin=inhibits uptake of dopamine+Noradrenalin; so elevates both dopamine and noradrenalin

Effexor=inhibits uptake of serotonin and noradrenalin; so elevates both serotonin and noradrenalin 

SSRIs-Zoloft, Celexa, Lexapro, Prozac etc=inhibits uptake of serotonin so elevates serotonin levels;

Paxil=inhibits uptake of serotonin and some other mechanism no one understands; 

MAO inhibitors-Eldepryl and Marplan and Nardil=stop serotonin, dopamine and noradrenalin from being degraded so elevates levels of all 3. 

With MAO inhibitors, the transmitters can still be taken back up into the neurons and with SSRIs or Wellbutrin , the transmitters  can still be degraded. So with each of these types of drugs there is still something around that can keep their levels in check. That’s why you shouldn’t take them together! 

Other anti-psychotic drugs can act almost in the opposite way. For example, Haldol blocks dopamine from acting on its receptors in the brain and that makes it turnover more but it essentially dampens the brain response to dopamine. That’s the opposite of what Wellbutrin does. 

"Your body always tries to maintain homeostasis."

So, abusing anti-depressants can eventually lead to too much of the transmitters in your system which can cause a host of problems. Doing it long term has a suppressive effect. Basically, if you were to abuse something like an SSRI or welbutrin and hyper-elevate your serotonin/dopamine/noradrenalin levels, your the receptors for those transmitters would desensitize- in order to stop responding to the excess stimulus. Your body always tries to maintain homeostasis. And you would down regulate production of the transmitters as well. So you’d end up with a very pronounced version of what you were trying to cure with the drugs in the first place. Too many docs mixing and matching meds can also give you problems. Some work well together-like Zoloft and welbutrin can be a gentler way of achieving the same result as the MAO inhibitors-with the ability to vary the doses individually. But taking Haldol and Wellbutrin would just screw everything up.

The above audio is the medication effects not her, not who she wants to be. Who she can be.

This is why I can't, won't give up on her. 

I believe when her Autism is supported the mental health piece is under control; for example, like in her SEAS/ED class in middle school and her experience at The Winston School of Del Mar. And I've been saying as much to SDRC, CMH, her doctors, and to Mental Health professionals - how do I create this highly structured 4-to-1 ratio for her on a daily basis? That's the question no one seems to be able to help me answer; they suggest Adult Day Care Programs and Intensive Outpatient Programs and she almost ended up in a BHU - but no one, they admitted, understood the Autism piece so they allowed me to take her home.  

She needs an environment full of structure, routine and external reminders and supports, not medication trials, not institutionalization. Not the psych ward, not lithium. I KNOW she can have a life that resembles "normal" but I cannot continue to watch the med trials and I have no valid arguments for the points she makes in the first, awful, sad video. But I KNOW this isn't what she wants - she wants HOMEOSTASIS. She wants the suffering to end; the suffering from the meds.

To read more articles from Dr. Defea's organization visit

Education and Training

B.A., University of California, Berkeley, 1986

Ph.D., Endocrinology, University of California, San Francisco, 1994

Postdoctoral Fellow, Stanford University, 1994-97

Postdoctoral Fellow, University of California, San Francisco 1997-2000.

On a side note, {wearing one of my other hats as a business consultant), my partner Karen and I were privileged to participate in the creation, design and launch of a brand a few years back featured in this post. Visit to get your "Hooked on Dope" and other #shamelesssobriety merchandise and Sobriety gear. A portion of the proceeds from your purchase supports the service programs at Hold My Beer Foundation, including our Dignity Bag project.

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