Brief Answer:
Impact of nortriptyline on dopamine exists

Detailed Answer:
Good morning from Milano, ITALY! I'm actually a neurologist from XXXXXXX but am traveling this week to cheer on my daughter in an international CrossFit competition here in Milano!

Let me inform you that NORTRIPTYLINE does IMPACT in a couple of major ways the effects of dopamine by 3 major mechanisms.

The first is an interaction which is UNCLEAR from a clinical perspective because each drug INDEPENDENTLY can cause an INCREASE in sedation (nortriptyline) as well as a DECREASE in sedation (dopamine) so that one would think that the net effect might be something like NO sedative effect at all. But of course, the body doesn't work quite that simplistically so there are factors with receptor sensitivity of the individual as well as dopamine and the DOSES of each in order to predict where there might be some type of overall good, bad, or NO net effect when combining.

The SECOND mechanism that nortriptyline affects DOPAMINE by is in BLOCKING its reuptake indirectly by slowing down or stopping the REUPTAKE of NOREPINEPHRINE (cousin to dopamine) from going back into the nerve terminals from whence they were released. This tends to PROLONG the effects of the dopamine at its target site (whatever that might be...often times excitatory) and so the use of both these drugs together should be monitored.

Finally, and in 3rd place, Nortriptyline is also known to have one of the STRONGEST DIRECT pharmacological effects on BLOCKING dopamine reuptake in terms of the tricyclic antidepressant class of medications. It can, through this mechanism cause an acute increase in dopamine levels in the frontal cortical regions of the brain and facilitate stimulatory effects which is why it may have a positive effect on mood in patients being treated for PARKINSON'S DISEASE.

I noticed also a comment you made about a DATSCAN result and thought it might be instructive to give you perhaps, an unsolicited piece of feedback which may or may not relevant to your questions on nortriptyline, dopamine, and your diagnosis of PD.

DATSCANS was approved by the FDA in 2011 as a test to be performed in patients with PD. However, it has a very narrow interpretive capacity which is to help the clinician distinguish BETWEEN the tremor of PARKINSON'S DISEASE and the tremor of ESSENTIAL TREMOR. A DATSCAN is not indicated nor should it should be used in the DIAGNOSIS or not of PD. That is the sole responsibility and territory of the clinician to make that call. The DATSCAN should be invoked only where there is a concern that perhaps ESSENTIAL TREMOR may be the source of the parkinsonian tremor vs. that from PD.

If I've provided useful or helpful information to your questions could you do me the utmost of favors by CLOSING THE QUERY along with a few positive words of feedback and maybe even a 5-star rating if you feel it is deserving? I am definitely interested in getting updated information on your condition if you'd care to drop me a line at www.bit.ly/drdariushsaghafi and let me know how things turned out.

You can always reach me at the above address for this and other questions. I wish you the best with everything and hope our discussion has aided in your understanding of a few concepts related to your concerns.

Regards
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