Very interesting lecture found on YouTube – Dr. Roger McIntyre is a quite important guy in psychiatry here in Toronto. He is a Professor of Psychiatry and Pharmacology at the University of Toronto and Head of the Mood Disorders Psychopharmacology at UHN. He is also the director of the first Ketamine Infusion Therapy Clinic for depression in the GTA.
So in this lecture, which was posted in 2016, he talked about how just elevated C-reactive protein, a sign of general inflamamtion in the body, leads to anhedonia (inability to feel pleasure), apathy, and destuction in the brain of dopamine neurons. I wish more psychiatrists would actually listen to his lectures as well. I got a feeling, from personal experience, that some psychiatrists weren’t aware about the link between inflammaion and anhedonia, because they easily prescribed antipsychotics that cause severe weight gain. Dr. McIntyre actually speaks in the lecture against easily prescribing antipsychotics for depression, as weight gain is known to increase inflammation and therefore actually cause anhedonia/dysphoria.
So basically when an antipsychotic is described for depression – the antipsychotic reduces dopamine, since that is its function, and then further you can have death of dopamine neurons through inflammation, so that can result in complete dysphoria.
Prospective studies revealed that the average weight gain during the first year of treatment was 11.7 to 13.9 lb for clozapine, 15 to 26 lb for olanzapine, 4.4 to 5.1 lb for risperidone, 6.1 to 13.3 lb for quetiapine, and less than 2 lb for aripiprazole and ziprasidone.
Dr. Roger McIntyre: Mood Disorders and Metabolic-Inflammatory Comorbidity
Notes of a Neuropsychiatry Amateur 