Psycho-Babble Medication Thread 78856

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Re: grouch's rebound effect

Posted by andys on September 30, 2001, at 12:52:36

In reply to Re: andy's answer to all #2 » andys, posted by Grouch on September 20, 2001, at 21:26:20

I think I understand the phenomenon you referred to as “withdrawal positive rebound” (I figured it out myself, observing my own phenomena, for what it’s worth): When I quit a drug, the blood-level drops to the point where the side-effects go away, and the benefits (that were being masked by the side effects), show through. Because brain-levels are slower to clear out, you get the drug’s benefit for a short period, while the brain-level-concentration coasts down to a non-therapeutic level. (For me, the benefit lasts 4-5 days). Of course, if others have no side effects, my theory doesn’t hold water.
Also, for others who are very sensitive to side effects: Most pdocs will have you lower the dose, to better tolerate side effects over time, then titrate back up. I find it much more effective to completely quit the drug for 2-4 weeks. This seems to “re-set” my body, to better tolerate the drug for a second trial.
Regarding my anti-depressant response to Dexedrine, I really couldn’t characterize it as brief or sustained, since it’s just more of a “boost”, that will “nudge” me away from depression, in general. (I can “generally” say that I tend to be less depressed while on Dexedrine).

 

Re: grouch's rebound effect

Posted by SLS on October 1, 2001, at 8:06:43

In reply to Re: grouch's rebound effect, posted by andys on September 30, 2001, at 12:52:36

> I think I understand the phenomenon you referred to as “withdrawal positive rebound” (I figured it out myself, observing my own phenomena, for what it’s worth): When I quit a drug, the blood-level drops to the point where the side-effects go away, and the benefits (that were being masked by the side effects), show through. Because brain-levels are slower to clear out, you get the drug’s benefit for a short period, while the brain-level-concentration coasts down to a non-therapeutic level. (For me, the benefit lasts 4-5 days). Of course, if others have no side effects, my theory doesn’t hold water.
> Also, for others who are very sensitive to side effects: Most pdocs will have you lower the dose, to better tolerate side effects over time, then titrate back up. I find it much more effective to completely quit the drug for 2-4 weeks. This seems to “re-set” my body, to better tolerate the drug for a second trial.
> Regarding my anti-depressant response to Dexedrine, I really couldn’t characterize it as brief or sustained, since it’s just more of a “boost”, that will “nudge” me away from depression, in general. (I can “generally” say that I tend to be less depressed while on Dexedrine).


Hi.

The withdrawal rebound is most likely being produced by physiological processes in the brain that cause a shift in neural function in the direction of improvement. It might have something to do with the changes in receptor numbers or function that result from chronic exposure to the drug persisting for a few weeks after the drug is withdrawn. I am sure that it is not an illusion or unmasking due to the waning of side effects. It can be thought of as an "unspringing" of a coil spring resulting from the removal (withdrawal) of the physiological "weight" of the drug that had been compressing it. The spring ends up reaching a height greater than its initial ground state (baseline).


- Scott

 

Re: Scott's rebound effect

Posted by andys on October 1, 2001, at 11:17:51

In reply to Re: grouch's rebound effect, posted by SLS on October 1, 2001, at 8:06:43

Scott,
To clarify my theory about feeling the benefits of a drug after it is stopped: The theory being that the benefit is actually happening, but because of serious side effects (like severe sedation), I can’t “feel” the benefit. Then when the side effect lifts (yet the brain-level of the drug is still high), I feel the benefits for 5-7 days.

Can you tell me where I can read further about the “withdrawal rebound” effect? This is really important to me, because I plan on starting a painfully long trial on Mirapex, trying to overcome it’s sedation, thinking that I’ll get this wonderful response, if I ever am able to tolerate the sedation, over time. If your “unspringing” theory is true, then a long term trial isn’t necessarily going to get me the benefit I hope for, so I won’t bother with Mirapex.
-Andy

 

Re: Scott's rebound effect » andys

Posted by SLS on October 1, 2001, at 16:45:31

In reply to Re: Scott's rebound effect, posted by andys on October 1, 2001, at 11:17:51

> Scott,
> To clarify my theory about feeling the benefits of a drug after it is stopped: The theory being that the benefit is actually happening, but because of serious side effects (like severe sedation), I can’t “feel” the benefit. Then when the side effect lifts (yet the brain-level of the drug is still high), I feel the benefits for 5-7 days.
>
> Can you tell me where I can read further about the “withdrawal rebound” effect? This is really important to me, because I plan on starting a painfully long trial on Mirapex, trying to overcome it’s sedation, thinking that I’ll get this wonderful response, if I ever am able to tolerate the sedation, over time. If your “unspringing” theory is true, then a long term trial isn’t necessarily going to get me the benefit I hope for, so I won’t bother with Mirapex.
> -Andy


Hi Andy.

At this point, I don't think it makes sense to draw any conclusions as to the effectiveness of Mirapex based upon hypotheses. If anything, there might be some predictive power behind the appearance of sedation. I don't know that there is any real evidence to substantiate that there is any, although some of us here were trying to establish an association. There may be none. However, I don't think I've seen anyone for whom sedation appeared early in treatment go on to respond well to Mirapex. Without anything definitive, though, I guess it makes sense to continue with it, especially if you have already failed to respond to many drugs.

A number of different drugs cause a rebound of one sort or another upon their discontinuation. For instance, when someone takes a benzodiazepine like Xanax or Klonopin to treat anxiety, the anxiety that appears upon the discontinuation of these drugs can be much higher than that which existed before treatment. Some sleeping pills can allow for rebound insomnia when they are discontinued. In fact, the shorter acting drugs like Halcion can produce a rebound awakening that same night as it leaves the blood stream.

If you find anything on the Internet regarding withdrawal rebound, I'd be interested to read it. Believe it or not, some people experience such a potent physiological rebound upon the discontinuation of antidepressants, that they actually become manic, even though they are not bipolar.


- Scott

 

Re: grouch's rebound effect » SLS

Posted by Grouch on October 1, 2001, at 20:42:10

In reply to Re: grouch's rebound effect, posted by SLS on October 1, 2001, at 8:06:43


> Hi.
>
> The withdrawal rebound is most likely being produced by physiological processes in the brain that cause a shift in neural function in the direction of improvement. It might have something to do with the changes in receptor numbers or function that result from chronic exposure to the drug persisting for a few weeks after the drug is withdrawn. I am sure that it is not an illusion or unmasking due to the waning of side effects. It can be thought of as an "unspringing" of a coil spring resulting from the removal (withdrawal) of the physiological "weight" of the drug that had been compressing it. The spring ends up reaching a height greater than its initial ground state (baseline).
>
>
> - Scott


Hi Scott & Andy. I agree w/Scott on this one that improvements during withdrawal are more likely due to re-regulation of receptors rather than "brain/blood levels" or unmasking of side effects.

 

Re: Scott's rebound effect

Posted by Zo on October 2, 2001, at 15:18:13

In reply to Re: Scott's rebound effect » andys, posted by SLS on October 1, 2001, at 16:45:31

This whole thread does bring up the interesting quanundrum (sp?) of long, painful drug trials.
And upon what basis to accept them.

Zo

 

Re: NADH for dopamine

Posted by andys on October 2, 2001, at 18:54:36

In reply to Re: Scott's rebound effect, posted by Zo on October 2, 2001, at 15:18:13

Zo, since you brought up painful drug trials, a few thoughts:
I have done about 30-40 drug trials over the last 15 years, suffering through long periods of painful, debilitating side effects, to the point where I dread any new drug trial, and get increasingly pessimistic about being able to tolerate a therapeutic dose of anything. (Except for my precious few : klonopin, seroquel, and low-dose lamictal).

It’s safe to say that I generally don’t tolerate prescription psych meds, so I have supplemented the ones I do take with nutritional supplements. I take a full array of vitamins, “just in case”. And 4 months ago, started high-dose fish oil, because a clinical trial showed it to be helpful for bipolars.

Anyway, this isn’t an introduction to a success story. I haven’t experienced any real benefits from the fish oil, but figure it is at least giving any other drugs a better chance of working.

But here’s what MAY be interesting:
I just started (and am still researching) the supplement NADH, which is supposed to raise brain dopamine, with no side effects. I’ve been on it for only 10 days, and maybe am experiencing a little benefit, but it’s too soon to say.
I emailed Dr. Birkmeyer (the “guru” of NADH, and whose father did the research of L-dopa for Parkinson’s), and did get a brief email back, although he normally doesn’t respond to emails.
He claimed that NADH was highly effective and without Mirapex’s side effects (claiming Mirapex has been taken off the market in Germany, due to it’s side effects).

There’s some good info., and a pretty impressive bio of Dr. Brinkmayer at www.nadhinfo.com. But anyone that doesn’t want to baother researching it, I’m continuing the trial, and will keep you posted….
-Andy

 

Re: NADH for dopamine » andys

Posted by Zo on October 3, 2001, at 15:50:38

In reply to Re: NADH for dopamine, posted by andys on October 2, 2001, at 18:54:36

Please do. Thus far, I don't know of any precursor that works. Interesting research news yesterday re: Alzheimer's and medicating the shrinking dopamne levels earlier. I'm waiting til the two uses clinically connect.. . I mean, I think they will. How can they nopt.

Zo

 

p.s. - I flunked the Omega-3 trial (nm) » andys

Posted by Zo on October 3, 2001, at 15:51:46

In reply to Re: NADH for dopamine, posted by andys on October 2, 2001, at 18:54:36

 

Re: dopamine supplement: NADH

Posted by andys on October 22, 2001, at 19:17:11

In reply to dopamine drugs or supplements, posted by andys on September 16, 2001, at 12:51:57

This is a followup of my trial on the supplement NADH:

Just a reminder of my past postings: The most dramatic anti-depressant responses I’ve had are to dopaminergic drugs: phentermine (quit, due to severe insomnia), Mirapex (quit, due to severe sedation). I have since tried the supplement NADH, which is supposed to raise dopamine levels, and after 2 weeks, got a dramatic anti-depressant effect. But it also triggered hypomania (which most anti-depressants do to me). But the important point for those of you who are super-sensitive to side effects, NADH has virtually no side effects. But you’d better be on a good mood stabilizer, if you’re prone to go manic on anti-depressants. (Mirapex was very unique for me, in that it also acted as a mood stabilizer).

So now, I’ll get back on neurontin (which, my research shows is dopaminergic), to try to get more mood stabilizer augmentation, before tackling a therapeutic dose of NADH again. (Still, Mirapex was probably the best drug overall, but I can’t bear the thought of being a “television-vegetable” for 2-3 months, while I try to tolerate the sedation).

I have pasted all the NADH research into a Word document, if anybody is interested, I can email it to you (it’s 12 pages long, though!)
-Andy

 

Re: modafinil

Posted by per ekstrom on November 12, 2001, at 3:42:53

In reply to Re: modafinil » SalArmy4me, posted by Jane D on September 17, 2001, at 17:18:07

Modafinil has an indirect but likewise very important effect on dopamine. Its via glutaminergic mechanism that inhibits GABA release which in turn enhance dopaminergic activity.


> > Modafinil does not work on dopamine at all: http://www.rxlist.com/cgi/generic2/modafinil_cp.htm It is useless in depression unless one has trouble with drowsiness.
>
> Sal,
> Could you elaborate. Do you mean Modafinil was useless for you? That it is useless for most people? That it has not been studied yet for this indication? I'm sure you don't mean that it will not work for anyone since that is something you can't possibly know.
>
> I looked at the web site you referred to and I wasn't sure that it really said this didn't affect dopamine at all. Also, while it was very interesting to read, I didn't see any author's name on that entry. I admit I didn't search the entire site. Do you know where I could find that information?
>
> Finally I do know of one reference to Modafinil and depression. Check out
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10847314&dopt=Abstract
> for a description of Modafinil as an augmenter. Personally, I don't take a case series of 7 all that seriously but you have listed similar articles many times in the past so I assume that you do think that these reports are important.
> -Jane

 

Re: dopamine supplement: NADH » andys

Posted by Leor on January 6, 2003, at 16:16:28

In reply to Re: dopamine supplement: NADH, posted by andys on October 22, 2001, at 19:17:11

> This is a followup of my trial on the supplement NADH:
>
> Just a reminder of my past postings: The most dramatic anti-depressant responses I’ve had are to dopaminergic drugs: phentermine (quit, due to severe insomnia), Mirapex (quit, due to severe sedation). I have since tried the supplement NADH, which is supposed to raise dopamine levels, and after 2 weeks, got a dramatic anti-depressant effect. But it also triggered hypomania (which most anti-depressants do to me). But the important point for those of you who are super-sensitive to side effects, NADH has virtually no side effects. But you’d better be on a good mood stabilizer, if you’re prone to go manic on anti-depressants. (Mirapex was very unique for me, in that it also acted as a mood stabilizer).
>
> So now, I’ll get back on neurontin (which, my research shows is dopaminergic), to try to get more mood stabilizer augmentation, before tackling a therapeutic dose of NADH again. (Still, Mirapex was probably the best drug overall, but I can’t bear the thought of being a “television-vegetable” for 2-3 months, while I try to tolerate the sedation).
>
> I have pasted all the NADH research into a Word document, if anybody is interested, I can email it to you (it’s 12 pages long, though!)
> -Andy

I would be most gratful for your file on NADH.
Please e-mail this to
savant_au@yahoo.com

By the way... are you still using NADH for
treatment

Thanks

Leor

 

Re: dopamine supplement: NADH

Posted by rotem on January 7, 2003, at 7:04:47

In reply to Re: dopamine supplement: NADH » andys, posted by Leor on January 6, 2003, at 16:16:28

I would also be gratful for your file on NADH.
my e-mail is: netaor@hotmail.co.il

 

Andys: Please send me your NADH information

Posted by Leor on January 7, 2003, at 14:36:37

Sorry to single you out. Thought that because
you've not responded to a follow up post I
made on a message of yours from 2001
(reproduced below) that perhaps you've switched
your e-mail address. This seemed like the only
reliable way to reach you.

Please send the files about NADH (mentioned
at the very end of the post below) to me @
savant_au@yahoo.com

Many Thanks!

Leor

---------------------------------------
Re: dopamine supplement: NADH

Posted by andys on October 22, 2001, at 19:17:11

In reply to dopamine drugs or supplements, posted by andys on September 16, 2001, at 12:51:57

This is a followup of my trial on the supplement NADH:

Just a reminder of my past postings: The most dramatic anti-depressant responses I’ve had are to dopaminergic
drugs: phentermine (quit, due to severe insomnia), Mirapex (quit, due to severe sedation). I have since tried the
supplement NADH, which is supposed to raise dopamine levels, and after 2 weeks, got a dramatic
anti-depressant effect. But it also triggered hypomania (which most anti-depressants do to me). But the important
point for those of you who are super-sensitive to side effects, NADH has virtually no side effects. But you’d
better be on a good mood stabilizer, if you’re prone to go manic on anti-depressants. (Mirapex was very unique
for me, in that it also acted as a mood stabilizer).

So now, I’ll get back on neurontin (which, my research shows is dopaminergic), to try to get more mood stabilizer
augmentation, before tackling a therapeutic dose of NADH again. (Still, Mirapex was probably the best drug
overall, but I can’t bear the thought of being a “television-vegetable” for 2-3 months, while I try to tolerate the
sedation).

I have pasted all the NADH research into a Word document, if anybody is interested, I can email it to you (it’s 12
pages long, though!)
-Andy

 

Re: dopamine supplement: NADH

Posted by disney4 on January 11, 2003, at 13:11:30

In reply to Re: dopamine supplement: NADH » andys, posted by Leor on January 6, 2003, at 16:16:28

I have heard that NADH is a very good AD, but no one seems to know if it is made from animal products. I am mainly concerned with contamination. I have heard many products use the ENADA NADH, which is supposed to be the best form. Which brand are you using and do you know what it is made from?

 

Re: dopamine supplement: NADH » disney4

Posted by andys on January 11, 2003, at 17:49:10

In reply to Re: dopamine supplement: NADH, posted by disney4 on January 11, 2003, at 13:11:30

Yes, ENADA NADH is definitely the way to go. I couldn't take it though, because its anti-depressant effect gave me an anxious hypomania (I'm bipolar), but I plan to try it again, if my current drug trial on aripiprazole doesn't work. (The next time, I'll raise my mood stabilizers, in hopes of avoiding the hypomanic reaction.

In terms of being made from animal products, I haven't a clue. You'd be best to email the company, and ask them directly. But be aware, the ENADA NADH isn't cheap (you'll see various prices, if you google search on ENADA NADH).

 

Re: dopamine supplement: NADH » andys

Posted by Leor on January 11, 2003, at 18:15:51

In reply to Re: dopamine supplement: NADH » disney4, posted by andys on January 11, 2003, at 17:49:10

> Yes, ENADA NADH is definitely the way to go. I couldn't take it though, because its anti-depressant effect gave me an anxious hypomania (I'm bipolar), but I plan to try it again, if my current drug trial on aripiprazole doesn't work. (The next time, I'll raise my mood stabilizers, in hopes of avoiding the hypomanic reaction.
>
> In terms of being made from animal products, I haven't a clue. You'd be best to email the company, and ask them directly. But be aware, the ENADA NADH isn't cheap (you'll see various prices, if you google search on ENADA NADH).

What pray tell is the difference between
ENAD and NADH. I know that NADH can be
ordered online from Swanson'sfor about $20.00 US.

Thnaks,

Leor

 

Re: dopamine supplement: NADH

Posted by andys on January 13, 2003, at 7:44:02

In reply to Re: dopamine supplement: NADH, posted by disney4 on January 11, 2003, at 13:11:30

in response to Leor and disney4:
Sorry for the short answer, I’ve been depressed lately, so limited energy.
The main benefit for the ENADA, is they claim their special process crosses the blood-brain barrier (so that it actually increases BRAIN dopamine. (take that with a grain of salt). Dopamine deficiency is usually related to lack of motivation (as opposed to sadness, or other aspects of depression).

If you’ve never tried supplements for mood therapy, I would start with omega-3 fatty acid, since it has been CLINICALLY proven to have benefits for bipolar. I take omegabrite (an enhanced EPA formula, optimized for mood benefit).
Their phone number is (800) 383-2030. The benefit I get from Omegabrite is small, but important. I quit it, after being on it for a year, because I felt it wasn’t doing any good. Only to find that it WAS protecting me from “black hole” depression. After feeling suicidal, I decided it was worth the money, to go back on it (easy decision). I take 5 Omegabrite a day, which is about $70.00 a month. They recommend taking 800 I.U. vitamin e and some vitamin C along with it.

But I would definitely consider the ENADA NADH as my second option (given my symptom of low motivation).

I’m so into supplements, because I have done about 20 drug trials, and get very limited results from the 4 drugs I’m on now. Which has forced me to look in other directions. Besides, the Omega-3’s have other health benefits as well (cholesterol, etc.)
I have a Micosoft Word document on both NADH and Omega-3, from LOTS of internet research, but both are about 12 pages long. So if you REALLY, REALLY want it, please send me a request, at andys@gotnet.net, and specify which you would like. But please have mercy on me, I've been really low energy lately, so don't ask for it, if you're not REALLY serious.

 

Avoiding NADH-incuced side effects

Posted by Leor on June 8, 2003, at 16:29:18

In reply to Re: dopamine supplement: NADH, posted by andys on January 13, 2003, at 7:44:02

I have been using NADH to boost my motivation and stamina. My current dosage is 2.5 mg every two days (dose is taken at around 1700). Often, I feel highly irritable in the hours immediately following the dose. This state is characterised by a feeling of exhaustion (though not sleepiness) and difficulty tolerating stress. I would like to find a substance that can offset these effects. Unfortunately, neither TMG nor DMG is an option for me (they are contraindicated for people suffering from overmethlylation disorder). Does anybody know of other substances worth a try? Alternately, can anyone suggest a better timing or dosing for the NADH so that one can avoid encountering this kind of problem.

For those using NADH and/or other natural mood enhancing substances I highly recommend "the natural pharmacist" (probably available at your public library) as a referemce.. Many thanks!

Leor

 

Help, Amisulpride with Parnate?

Posted by EERRIICC on August 17, 2004, at 14:15:06

In reply to Re: andy's answer to all #2, posted by andys on September 20, 2001, at 9:50:38

Can Amisulpride be added to Parnate? My doctor is hesistant to try anything dopaminergic as an augmenting agent, why?. High dose Parnate (150mg) has just stopped working for me and I don't know what to augment it with.

Thanks,Eric

 

Re: Help, Amisulpride with Parnate?

Posted by SLS on August 20, 2004, at 12:02:27

In reply to Help, Amisulpride with Parnate?, posted by EERRIICC on August 17, 2004, at 14:15:06

> Can Amisulpride be added to Parnate? My doctor is hesistant to try anything dopaminergic as an augmenting agent, why?. High dose Parnate (150mg) has just stopped working for me and I don't know what to augment it with.
>
> Thanks,Eric


Eric, I don't see any reason why you couldn't augment Parnate with any antipsychotic. Actually, I would be more afraid of using Abilify or Geodon than amisulpride. They possess pro-serotoninergic properties and can be produce mania and psychosis.

Do you know what specifically he is afraid will happen? Psychosis? Hypertension?

lithium
lamotrigine
desipramine
amphetamine
bromocriptine
thyroid

I have tried all of these with Parnate 120-150mg. Aggressive yes. Lethal no. I would try lithium first. Desipramine is probably the most potent of these drugs to add. Parnate + desipramine was the only thing to ever work for me. If you add it in gradually, you should have no problem.

How long did Parnate work for you?

- Scott

 

Re: Help, Amisulpride with Parnate? » EERRIICC

Posted by ace on August 22, 2004, at 0:00:43

In reply to Help, Amisulpride with Parnate?, posted by EERRIICC on August 17, 2004, at 14:15:06

> Can Amisulpride be added to Parnate? My doctor is hesistant to try anything dopaminergic as an augmenting agent, why?. High dose Parnate (150mg) has just stopped working for me and I don't know what to augment it with.
>
> Thanks,Eric

Hi Eric!

I don't believe there is any problem adding Amisulpride to Parnate. I added 50mg to Nardil for a couple of months (it didn't do much but) It works great for some.

There are heaps of options- Lithium, Reboxetine, TCA (except Anafranil), Remeron, Clonidine, Pindolol

Good luck whatever you do friend!

Ace

 

Re: Help, Amisulpride with Parnate?

Posted by EERRIICC on August 22, 2004, at 15:10:27

In reply to Re: Help, Amisulpride with Parnate?, posted by SLS on August 20, 2004, at 12:02:27

I began Parnate at the same time I started the trial for Cyberonics' attempt to expand their Vagus Nerve Stimulator into the lucrative depression market. One of the worked so I gambled on it being the VNS and lost. I had the VNS turned off and began Parnate again and stabalized.

Good luck with Cymbalta Scott. Did you ever try a higher dose of memantine (>50mg)?

 

Re: Help, Amisulpride with Parnate? » EERRIICC

Posted by SLS on August 22, 2004, at 15:34:37

In reply to Re: Help, Amisulpride with Parnate?, posted by EERRIICC on August 22, 2004, at 15:10:27


> Good luck with Cymbalta Scott. Did you ever try a higher dose of memantine (>50mg)?

I went up to 40mg. I felt like I was stoned or drunk or something. No good.

Thanks for the well wishes. I need it bad!


- Scott

 

Re: Scott's rebound effect

Posted by pablo1 on August 31, 2004, at 23:58:34

In reply to Re: Scott's rebound effect » andys, posted by SLS on October 1, 2001, at 16:45:31

This was the case for me coming off effexor. I had a tremendous dopamine mania.

> Believe it or not, some people experience such a potent physiological rebound upon the discontinuation of antidepressants, that they actually become manic, even though they are not bipolar.


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