A cure for love

--Doctor, doctor, give me the news // I've got a bad case of lovin' you

--Let's try Paxil 20mg qd, expect possible nausea, somnolence, asthenia, abnormal ejaculation, and sweating, call the receptionist to report any suicidal thoughts, come back in a month and let me know how you're doing. Next!

I'm reading "Why we love", by Helen Fisher, a fascinating book on the chemistry of romantic love. The author is an anthropologist who's done a variety of studies on the nature of love, including some very interesting fMRI work on the brains of undergraduates in love. Interspersed with zillions of quotes from the romantic literature, she reviews what's known about the chemical and neural circuitry of love. There are three principal molecular actors:

• dopamine, associated with focussed attention and goal directed behavior, exhilaration, hyperactivity, mania -- it's involved with all chemical addictions;
  
• norepinephrine, which is closely related to and has roughly similar effects to dopamine
  
• serotonin, whose levels are reduced in love, just as in individuals with obsessive-compulsive disorder (OCD).
  

These three are interlinked: dopamine and epinephrine in positive feedback, and repressing serotonin levels. Identifying the individual chemicals giving particular responses helps us understand the individual aspects of an experience which, without the molecular basis, would be an indivisible whole.

This is fascinating stuff, explaining the eternal mysteries, all that. But the pharmacologist in me (doesn't everyone have an inner pharmacologist?) wants to apply this knowledge. Love potions are the historical goal, and perhaps the second half of the book might give ideas as to how to create love. Easier might be easing the pangs of love once it's started. Love isn't all good, in fact, when unreciprocated or the circumstances aren't right, it's just pain. It'd be nice to be able to turn it off, when desired. Fortunately, for the lowered-serotonin obsessive thought patterns, there's an entire class of drugs, the selective serotonin reuptake inhibitors (SSRIs). Although licensed for use against defined accepted illnesses such as depression, anxiety, OCD, etc., they might well work fine against pathological love. I don't know if serotonin feeds back into the dopamine/norepinephrine cycle, to stop the root cause, or if an SSRI would just allow you to concentrate on other things, but it seems clear to me that it would be helpful. Prescribing a drug "off-label" for a new indication is very common and entirely acceptable, if the physician thinks it would help the patient.

If you don't like physicians and well-tested, commercially pure drugs, you still aren't out of luck. There are a wide variety of things sold in health food stores, some of which are known to have antidepressant or SSRI like properties. St. John's Wort extracts have had the most clinical testing, but there are others as well (5-HT, eg). The traditional salve for a broken heart is alcohol, but experimenting with something with a little better biochemical basis seems like a good idea.

In fact, it's such an obvious idea, that I wonder if it hasn't been done already. Certainly there've been points in my life when I could've used something.

-- No pill's gonna cure my ill // I've got a bad case of lovin' you


-- Give it a month. We'll see.