Dr. Gurpreet Singh Padda, MD Publishes The Dopamine Brain: Dopamine Is Not the Pleasure Chemical We Thought

The newest volume in The Brain Series, The Dopamine Brain, follows a single reversal through food, addiction, Parkinson’s therapy, and the intensive care unit

ST. LOUIS, MO, UNITED STATES, October 5, 2026 /EINPresswire.com/ — Dr. Gurpreet Singh Padda, MD, MBA, MHP, has published The Dopamine Brain: Wanting: Why You Chase What You Don’t Enjoy, the fourth volume in his series The Brain and the first of them to be organized around a single sentence that most of medicine and nearly all of popular health writing stillget backwards. Dopamine is not the pleasure chemical. It tells you what to get. It does not tell you what to enjoy.

The distinction sounds academic for about one paragraph. Then it starts dismantling things. If wanting and liking are separate systems, then a patient who keeps returning to a food, a drug, or a behavior they no longer enjoy is not weak, not in denial, and not insufficiently motivated. They are running an intact pursuit circuit attached to a pleasure response that has already gone quiet – and every intervention built on the assumption that people chase pleasure is aimed at the wrong target.

The experiment that should have settled it, in 1998

The book’s opening chapters return to a study that has been available for more than twenty-five years and has been absorbed by almost no one. Animals with their dopamine systems disabled still produced normal facial reactions to sweetness. They still learned what they liked and disliked. They stopped pursuing any of it. The authors’ conclusion is quoted in the book as one of the most important sentences in the field: dopamine systems are necessary for wanting incentives, but not for liking them or for learning new likes and dislikes (Berridge & Robinson, 1998).

A second finding from the same year cuts even harder. Rats were shown to self-administer a compound that lowered dopamine in the nucleus accumbens, leading those authors to conclude that changes in accumbens dopamine do not correlate with a stimulus’s capacity to induce reward or aversion (Marinelli et al., 1998). The chemical that the popular account treats as the body’s reward signal does not reliably move in the direction of reward.

Where the error shows up in a clinic

The Dopamine Brain follows the correction into settings where it changes what a physician should do on Monday morning.

In a controlled inpatient study where meals were matched for calories, sugar, fat, fiber, and macronutrients, adults ate 508 calories a day more on the ultra-processed diet and gained weight on it – and did not rate that food as more pleasant (Hall et al., 2019). Liking was not the variable. Something about the delivery was.

In Parkinson’s disease, where dopamine agonists are given deliberately, the same circuit produces documented harm. Following patients who began with no impulse control disorder, 46.1 percent had developed one within five years. By exposure, that was 51.5 percent among patients ever treated with a dopamine agonist, versus 12.4 percent among those never treated (Corvol et al., 2018)—roughly one in two.

And in the intensive care unit, the book reconstructs the rise and fall of low-dose “renal dose” dopamine, where across 61 trials and 3,359 patients the drug raised day-one urine output by 24 percent and changed neither dialysis nor survival (Friedrich et al., 2005). The book declines to stop where standard teaching stops, and keeps the distinction that survives the retraction of the paradigm: inside vascular shock, perfusion pressure itill weeps a kidney intact.

A book that publishes its own evidence rule

The Dopamine Brain carries 98 figures across 31 chapters, and it was built under an editorial rule Dr. Padda is making public with the book: a chart may only plot numbers already quoted in that chapter’s citation manifest: no derived values, no estimated values, no confidence intervals drawn where the source published none. Four charts were rebuilt during production because they failed that rule, and the failures are treated in the book’s own account as the reason the rule exists.

A code at the end of every chapter opens the matching technical supplement at no cost, drafted for the reader to bring to their own physician and hosted at thedopaminebrain.com. Quantities in the text carry the population they were measured in: no detox, no protocol to buy, no screen-time panic, and nothing to sign up for. Every chapter has also been filmed, and the 31 episodes run on the Addictionology Center channel at https://www.youtube.com/playlist?list=PLMY0wlArEz-M with a mirror on Padda Institute at https://www.youtube.com/playlist?list=PLIqgZZwKVN5I.

“Half of how we counsel patients about food and relapse is built on the wrong verb,” Dr. Padda said. “We tell people to find something they enjoy more. The circuit that dragged them back was never asking about enjoyment. It was asking what to get. Until we separate those two things, we will keep writing plans that fail and then blaming the patient for the failure. That one is on us.”

AVAILABILITY

The Dopamine Brain: Wanting: Why You Chase What You Don’t Enjoy by Dr. Gurpreet Singh Padda, MD, MBA, MHP is available now on Amazon in Kindle and paperback editions. Paperback ISBN: 978-0-9832058-3-8. Published by Nectar Media Group. 401 pages, 31 chapters, 98 figures. Book and technical supplements: https://thedopaminebrain.com
Chapter video series (31 episodes, Addictionology Center): https://www.youtube.com/playlist?list=PLMY0wlArEz-M
Mirror (Padda Institute): https://www.youtube.com/playlist?list=PLIqgZZwKVN5I

It is the fourth volume in The Brain, following The Starved Brain, The Pained Brain and The Angry Gut, and preceding the forthcoming The Humbled Brain.

ABOUT DR. GURPREET SINGH PADDA, MD, MBA, MHP

Dr. Gurpreet Singh Padda, MD, MBA, MHP is an interventional pain physician, anesthesiologist, and addiction medicine specialist in St. Louis. Board certified in anesthesiology, pain medicine, interventional pain management, addiction medicine, and obesity medicine, and a certified Metabolic Health Practitioner, he treats chronic pain, addiction, obesity, and type 2 diabetes as one collision of epidemics driven by metabolic inflammation. He has led the Center for Interventional Pain Management since 2001, directed the Center for Regenerative Medicine since 2004, and delivered the ASIPP keynote, Metabolic Inflammation and the Hedonic Treadmill. He is faculty in the KCU Freeman Health System psychiatry residency for pain and addiction, and founder of the Sevadar Foundation.

Gurpreet Singh Padda
Padda Institute
+1 314-481-5000
email us here
Visit us on social media:
LinkedIn
YouTube

Addictionology Center Dopamine Brain Playlist

Media gallery