![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 31 to 55 of 72. Go back in thread:
Posted by SLS on October 3, 2006, at 6:12:30
In reply to Re: Nicotine and Depression SLS, posted by MrBrice on October 3, 2006, at 5:28:20
> k scott,
>
> i'm meeting my doc today, i'll be discussing this very thing with him.
>
> he'll probably keep me on nicotine i think, we'll see..
>
> greets ;)Good luck.
Maybe you can bring him this:
-------------------------------------------
Psychopharmacology (Berl). 2006 Sep 15; [Epub
Transdermal nicotine attenuates depression symptoms in nonsmokers: a double-blind, placebo-controlled trial.
McClernon FJ, Hiott FB, Westman EC, Rose JE, Levin ED.
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA, mccle011@mc.duke.edu.
RATIONALE: Despite established links between nicotine dependence and depression, little research has examined the effects of nicotine on depression symptoms. OBJECTIVE: This study evaluated the acute and chronic effects of transdermal nicotine in nonsmokers with baseline depression symptoms during a 4-week, double-blind, placebo-controlled trial. METHODS: Nonsmokers with scores >/=10 on the Center for Epidemiological Studies Depression scale (CES-D) were recruited from the community. Mood and cognitive performance were measured at baseline (day 0) and at 1, 8, 21, and 28 days. Participants were randomly assigned to wear a placebo or nicotine patch for 4 weeks (3.5 mg/day during weeks 1 and 4; 7 mg/day during weeks 2 and 3). The final sample consisted of 11 nonsmokers with a mean baseline CES-D score of 27.36 (SD=10.53). RESULTS: Salivary nicotine levels indicated the majority of participants were compliant with treatment. Acute nicotine did not alter mood. After adjusting for baseline values, chronic nicotine resulted in a significant decline in CES-D scores at day 8 (3.5 mg/day), but returned to placebo levels by the last visit. This return to baseline levels was coincident with a decrease in nicotine administration from 7 to 3.5 mg/day. A similar trend for improved response inhibition as measured by the Conners Continuous Performance Task was also observed. Reported side effects were infrequent and minimal. CONCLUSION: These findings suggest a role for nicotinic receptor systems in the pathophysiology of depression and that nicotinic compounds should be evaluated for treating depression symptoms.
PMID: 16977477 [PubMed - as supplied by publisher]
Posted by florence on October 4, 2006, at 1:28:37
In reply to Re: Nicotine and Depression, posted by SLS on September 17, 2006, at 11:15:39
> The mistake that I see often made in the interpretation of such studies is that they are demonstrating that a system must be intact for a drug to work. It does not demonstrate that that system is the site of action of the drug. That was the mistake made with Provigil (modafinil) and NE alpha-1 receptors.
>
>
> - Scott
Scott, could you explain the mistake with Provigil and NE alpha-1 receptors or give me a link Thanks...Florence
Posted by SLS on October 4, 2006, at 6:14:16
In reply to Re: Nicotine and Depression » SLS, posted by florence on October 4, 2006, at 1:28:37
Hi Florence.
> > The mistake that I see often made in the interpretation of such studies is that they are demonstrating that a system must be intact for a drug to work. It does not demonstrate that that system is the site of action of the drug. That was the mistake made with Provigil (modafinil) and NE alpha-1 receptors.
> Scott, could you explain the mistake with Provigil and NE alpha-1 receptors or give me a link Thanks...Florence
In the early 1990s, several investigators pronounced that modafinil produced increased alertness and vigilence via the direct stimulation of central NE alpha-1 receptors and that it was thus a ligand agonist. They based this conclusion on the observation that the increase in locomotor activity seen in mice when modafinil was applied was reversed by prazosin, a NE alpha-1 antagonist. This was an inappropriate conclusion. At most, this only demonstrated that pathways containing NE alpha-1 receptors needed to be intact for modafinil to exert its locomotor properties.
For what it is worth, around the year 2000, a friend of mine met with one of the developers of adrafinil and modafinil at a conference. The developer confirmed that the conclusion by investigators had been incorrect, and that the exact mechanisms of drug had not been worked out. However, by that time they had already been looking at glutamate and hypocretin. Now, I believe much of the focus is on hypocretin and the hypothalamus, although it does promote the release of glutamate in the thalamus.
The manufacturer's label goes out of its way to explain the historic error:
"Modafinil does not appear to be a direct or indirect alpha-adrenergic agonist. Although modafinil-induced wakefulness can be attenuated by the a1-adrenergic receptor antagonist, prazosin, in assay systems known to be responsive to a1-adrenergic agonists, modafinil has no activity."
http://www.rxlist.com/cgi/generic2/modafinil_cp.htm
- Scott
Posted by SLS on October 4, 2006, at 7:32:29
In reply to Re: Nicotine and Depression SLS, posted by MrBrice on October 3, 2006, at 5:28:20
> k scott,
>
> i'm meeting my doc today, i'll be discussing this very thing with him.
>
> he'll probably keep me on nicotine i think, we'll see..
>
> greets ;)
Well, what did the doctor have to say?
- Scott
Posted by FredPotter on October 4, 2006, at 15:13:06
In reply to Re: Nicotine and Depression SLS, posted by SLS on October 3, 2006, at 1:17:18
An AD that takes a year to work is NO USE at all to a depressed person. 4-6 weeks is asking an awful lot, particularly if suicidal
Posted by SLS on October 4, 2006, at 16:05:30
In reply to Re: Nicotine and Depression SLS, posted by FredPotter on October 4, 2006, at 15:13:06
> An AD that takes a year to work is NO USE at all to a depressed person. 4-6 weeks is asking an awful lot, particularly if suicidal
Can you amplify your remarks?
- Scott
Posted by FredPotter on October 4, 2006, at 16:30:01
In reply to Re: Nicotine and Depression SLS, posted by SLS on October 4, 2006, at 16:05:30
Scott I just meant that it's too long to wait when you're in mental agony Fred
Posted by MrBrice on October 5, 2006, at 5:39:13
In reply to Re: Nicotine and Depression SLS » MrBrice, posted by SLS on October 4, 2006, at 7:32:29
> > k scott,
> >
> > i'm meeting my doc today, i'll be discussing this very thing with him.
> >
> > he'll probably keep me on nicotine i think, we'll see..
> >
> > greets ;)
>
>
> Well, what did the doctor have to say?
>
>
> - Scott
>
He told me that nicotine is for the moment probably the best i can take for now.
He is sure that his dosulepin-plan will work and thus will keep me on it for at least another 4 months. During those 4 months he wants to stretch time and keep me happy with the nicotine.I myself am in doubt of wether or not an maoi would be good for me. I've heard they have some terrible side-effects (insomnia for example, man i would hate that) so i don't really know what is the best for me.
After some research i did find out why it probably is the nicotine is helping me. There are 2 reasons:
First the nicotine stimulates a whole series of receptors in the brain, including ofcourse the nicotine receptor itself. This causes a release of noradrenaline i believe. This gives me a small boost and keeps me focused, it's nice when you need to 'be cool' and stay focused.Secondly, after +- 30 minutes, the noradrenaline is broken off into dopamine. This injection i feel very well, and it makes me relaxed and more enjoyable.
I wouldn't know what would be best for me right now, but for the moment, i will follow my doc and just go on with my current treatment.
If it fails, after 4 months we will know, we will switch to nardil and take away the sulpiride and dosulepin.grtz,
Brice
Posted by MrBrice on October 5, 2006, at 5:41:29
In reply to Re: Nicotine and Depression SLS, posted by FredPotter on October 4, 2006, at 16:30:01
> Scott I just meant that it's too long to wait when you're in mental agony Fred
you're completely right fred, it's hard allright. + I don't believe that if the AD doestn't work after 7 months, it will after 1 year.
Posted by SLS on October 5, 2006, at 6:21:13
In reply to Re: Nicotine and Depression SLS, posted by MrBrice on October 5, 2006, at 5:39:13
My thing with nicotine is that, if it is going to be an effective antidepressant, it has to produce a broad spectrum of action, and be consistent all day long, every day. Now, these guys used a patch at 7.0mg per day. The improvement they observed at 8 days disappeared by 28 days, but they had, for some unexplained reason, lowered the dose to 3.5mg. I want nicotine to work. If it works for you, it might work for me. It is still my suspicion, though, that it has only acute and subacute effects. Basically, you'll get a buzz off of it whenever you take it after a period of abstinence (over a period of hours) and perhaps a feeling of slight improvement that will last a week or so. However, if it will bring you any kind of relief, perhaps it makes sense to use it as a bridge until you find an antidepressant that works well.
How do you plan to administer the nicotine?
Nicoderm® nicotine comes in 7mg/day, 14mg/day, and 21mg/day patches.
It would be a big help if you could keep a daily log of your progress.
- Scott
Posted by SLS on October 5, 2006, at 7:52:36
In reply to Re: Nicotine and Depression SLS, posted by FredPotter on October 4, 2006, at 16:30:01
> Scott I just meant that it's too long to wait when you're in mental agony Fred
I had thought you were talking about the nicotine.
:-)
Yes, this is the first time that I have heard of a doctor assert with such confidence that a drug treatment would take 1 year to work such that he actually prescribes that way.
You know, it seems that VNS might take 6-12 months to work for some people with TRD. For the life of me, I don't know what motivated them to stay on it for so long without results. I guess once you spend $15,000 and accept having wires routed through your neck and a pulse-generator implanted in your chest, it's not such an easy decision to just quit.
- Scott
Posted by MrBrice on October 5, 2006, at 9:13:22
In reply to Re: Nicotine and Depression » MrBrice, posted by SLS on October 5, 2006, at 6:21:13
> My thing with nicotine is that, if it is going to be an effective antidepressant, it has to produce a broad spectrum of action, and be consistent all day long, every day. Now, these guys used a patch at 7.0mg per day. The improvement they observed at 8 days disappeared by 28 days, but they had, for some unexplained reason, lowered the dose to 3.5mg. I want nicotine to work. If it works for you, it might work for me. It is still my suspicion, though, that it has only acute and subacute effects. Basically, you'll get a buzz off of it whenever you take it after a period of abstinence (over a period of hours) and perhaps a feeling of slight improvement that will last a week or so. However, if it will bring you any kind of relief, perhaps it makes sense to use it as a bridge until you find an antidepressant that works well.
>
> How do you plan to administer the nicotine?
>
> Nicoderm® nicotine comes in 7mg/day, 14mg/day, and 21mg/day patches.
>
> It would be a big help if you could keep a daily log of your progress.
>
>
> - Scott
>
i'm happy to do that if it is of any help to you scott.For now, i HATE the fact that i have to take my microtabs (i take little sublingual tablets of 2 mg's) every 1-2 hours.
A patch that lasts all day would be perfect, i didn't know it existed...?i'll keep you updated.
grtz,
Brice
Posted by Questionmark on October 6, 2006, at 1:35:31
In reply to Re: Nicotine and Depression SLS, posted by MrBrice on October 5, 2006, at 5:39:13
Brice,
I have to say what a few others have in that I have never heard of a doctor advocating one year on a psychiatric drug in order for it to be effective or even fully effective. And it really makes very little practical sense to me-- much less pharmacological sense (though of which of course i am no expert). Even with complex receptor changes and adaptations, it seems like *any* drug would begin to show benefit after several months or so.
That said, however, the confidence that your doctor has in this treatment route makes me wonder if he actually has some substantiated basis for it-- as in, maybe previous patients have, for whatever reason, derived benefit from this medication after such a length of time. ... Either that or he is displaying another extreme example of psychiatric hubris.
I really think you should ask him, though, why he thinks that it will or should begin to work after 3 or 4 more months-- is it anecdotal experience with past patients, a convincing body of literature, or something else?. It might be helpful to know if he has any good reasons for this recommendation.Oh and just so you know, I must tell you that nicotine is relatively nothing like an MAOI, especially Nardil.
And in regard to nicotine's actions: one of its most well-known and probably significant (and definitely addictive) properties is its stimulation of dopamine release in the reward areas of the brain (e.g., nucleus accumbens). This is almost definitely the primary reason behind its euphoric properties as well. Also, the (cholinergic) nicotine receptors are involved in cognition, and their stimulation/agonism promotes enhanced cognitive capabilities (enhanced focus, etc.).
I don't know of any direct involvement with norepinephrine (but there very well may be)-- or any other specific actions, although I'm sure there are. But the two mentioned above are I think two of the most significant if not the most.By the way, yes, at least in the U.S. here nicotine pathes are readily available over-the-counter and in many stores & pharmacies. They are quite expensive however.
(I have something else to say on nicotine tolerance but i'll save that for the next post).
In any case, good luck!
> He told me that nicotine is for the moment probably the best i can take for now.
> He is sure that his dosulepin-plan will work and thus will keep me on it for at least another 4 months. During those 4 months he wants to stretch time and keep me happy with the nicotine.
>
> I myself am in doubt of wether or not an maoi would be good for me. I've heard they have some terrible side-effects (insomnia for example, man i would hate that) so i don't really know what is the best for me.
>
>
> After some research i did find out why it probably is the nicotine is helping me. There are 2 reasons:
> First the nicotine stimulates a whole series of receptors in the brain, including ofcourse the nicotine receptor itself. This causes a release of noradrenaline i believe. This gives me a small boost and keeps me focused, it's nice when you need to 'be cool' and stay focused.
>
> Secondly, after +- 30 minutes, the noradrenaline is broken off into dopamine. This injection i feel very well, and it makes me relaxed and more enjoyable.
>
> I wouldn't know what would be best for me right now, but for the moment, i will follow my doc and just go on with my current treatment.
> If it fails, after 4 months we will know, we will switch to nardil and take away the sulpiride and dosulepin.
>
> grtz,
> Brice
Posted by Questionmark on October 6, 2006, at 2:26:23
In reply to Re: Nicotine and Depression » florence, posted by SLS on October 4, 2006, at 6:14:16
I've always wondered about that (when reading some abstract or article/study that draws its conclusions of receptor action of a drug from this sort of over-simplicity)! It just didn't make any sense to come to those conclusions based on that. It never made any sense to me. These guys (with biochemistry and pharmacology Ph.D.s or whatever else) couldn't really be that illogical and naive, could they? So in my own naivete probably, I usually just assume that I'm probably just missing something and they know what they're doing and they know all the other factors for why that methodology works. But reading your post on this really gets me wondering again. Could they really be that illogical?! I mean, it shouldn't be something that difficult for any rational thinking person to identify, if they work in that field. I don't understand it. ARE we missing something?
Goodness no wonder psychiatry is so messed up! The practitioners are getting much of their information from a gross logical error (and monies, pressure, and advertising from the largest corporate sector in the world [or at least in the U.S.]).
But seriously though-- this really concerns me. When I think about it it seems like MANY of our modern theories about neuropharmacology and receptor pharmacology might have been derived from studies using this method. Is it possible that a lot of what we take for granted as being true regarding the receptor pharmacology of different psychiatric drugs is NOT necessarily true or substantiated?? ... This probably isn't the case now that I think about it-- when I try to think of specific examples. But I still wonder for some of them if this is true. What do you think?
This is probably why you get multiple varying pharmacological descriptions of certain drugs, especially the ones with several receptor actions (like some Atypical antipsychotics for instance).Anyway, I'll stop my rant now. But I'd really like to hear what your and others' specific thoughts are on this.
And I'm glad you mentioned that info about modafinil and NE alpha-1 receptors. I wasn't aware of that. .. Do you know how many times I read that modafinil is an alpha-1 agonist? Many. I always did think it was kind of strange too. Other drugs that stimulate alpha-1 Rs don't promote wakefulness and all that! In fact that action is responsible for some of their side effects!
Man we need more logicians in drug research. There need to be logicians that oversee & supervise these people. Okay i'll stop.Anyway, great point and thanks for bringing it to our attention.
> > > The mistake that I see often made in the interpretation of such studies is that they are demonstrating that a system must be intact for a drug to work. It does not demonstrate that that system is the site of action of the drug. That was the mistake made with Provigil (modafinil) and NE alpha-1 receptors.
>
> > Scott, could you explain the mistake with Provigil and NE alpha-1 receptors or give me a link Thanks...Florence
>
> In the early 1990s, several investigators pronounced that modafinil produced increased alertness and vigilence via the direct stimulation of central NE alpha-1 receptors and that it was thus a ligand agonist. They based this conclusion on the observation that the increase in locomotor activity seen in mice when modafinil was applied was reversed by prazosin, a NE alpha-1 antagonist. This was an inappropriate conclusion. At most, this only demonstrated that pathways containing NE alpha-1 receptors needed to be intact for modafinil to exert its locomotor properties.
>
> For what it is worth, around the year 2000, a friend of mine met with one of the developers of adrafinil and modafinil at a conference. The developer confirmed that the conclusion by investigators had been incorrect, and that the exact mechanisms of drug had not been worked out. However, by that time they had already been looking at glutamate and hypocretin. Now, I believe much of the focus is on hypocretin and the hypothalamus, although it does promote the release of glutamate in the thalamus.
>
> The manufacturer's label goes out of its way to explain the historic error:
>
> "Modafinil does not appear to be a direct or indirect alpha-adrenergic agonist. Although modafinil-induced wakefulness can be attenuated by the a1-adrenergic receptor antagonist, prazosin, in assay systems known to be responsive to a1-adrenergic agonists, modafinil has no activity."
>
> http://www.rxlist.com/cgi/generic2/modafinil_cp.htm
>
>
> - Scott
Posted by Questionmark on October 6, 2006, at 2:56:44
In reply to Re: Nicotine and Depression » MrBrice, posted by SLS on October 5, 2006, at 6:21:13
> My thing with nicotine is that, if it is going to be an effective antidepressant, it has to produce a broad spectrum of action, and be consistent all day long, every day. Now, these guys used a patch at 7.0mg per day. The improvement they observed at 8 days disappeared by 28 days, but they had, for some unexplained reason, lowered the dose to 3.5mg. I want nicotine to work. If it works for you, it might work for me. It is still my suspicion, though, that it has only acute and subacute effects. Basically, you'll get a buzz off of it whenever you take it after a period of abstinence (over a period of hours) and perhaps a feeling of slight improvement that will last a week or so. However, if it will bring you any kind of relief, perhaps it makes sense to use it as a bridge until you find an antidepressant that works well.
>
> How do you plan to administer the nicotine?
>
> Nicoderm® nicotine comes in 7mg/day, 14mg/day, and 21mg/day patches.
>
> It would be a big help if you could keep a daily log of your progress.
>
>
> - Scott
Yeah I was going to mention the same thing. I personally doubt that nicotine could have *much* sustained benefit over a continuous period of time-- probably some: mostly cognitive, but little if any mood benefits over time (though I could be wrong of course).
And in regard to the nicotine & depression study you posted Scott, I wonder if the depression scores would have gone closer to baseline & placebo by the end even IF the nicotine dosage was not lowered. I imagined the reason for the lowering was to help offset habituation, i.e., kind of give a gradual withdrawl, but who knows.I remember in the period when I only smoked a cigarrette once in a great while (once every month or so approximately), I would do it deliberately for self-medicative purposes (this came after the doing-it-for-euphoria period), and when I did I would get a very significant boost in mood, confidence, sociability, and cognition **for hours**-- often for the rest of the day. I don't know how or why, but i know it wasn't placebo. ... But eventually, I began to smoke about once or twice a week-- and EVEN AT THAT LEVEL I no longer received the benefits I had previously. I mean I would still get the wonderful "cigarrette buzz", but after that, when the cigarrette was finished, there would be nothing beneficial remaining.
There you go-- 1st-hand anecdotal evidence of the tolerance of nicotine (well 2nd-hand for you all but whatever).
I think nicotine may cause some REAL profound and long-lasting receptor changes in the brain.
I believe this is why an ex-smoker can have cravings and automatic conditioned responses related to smoking even after YEARS of being abstinent. I'd give some good examples but I've already been typing way too much about nicotine.
Posted by MrBrice on October 6, 2006, at 8:04:04
In reply to Re: Nicotine and Depression » MrBrice, posted by Questionmark on October 6, 2006, at 1:35:31
> Brice,
> I have to say what a few others have in that I have never heard of a doctor advocating one year on a psychiatric drug in order for it to be effective or even fully effective. And it really makes very little practical sense to me-- much less pharmacological sense (though of which of course i am no expert). Even with complex receptor changes and adaptations, it seems like *any* drug would begin to show benefit after several months or so.
> That said, however, the confidence that your doctor has in this treatment route makes me wonder if he actually has some substantiated basis for it-- as in, maybe previous patients have, for whatever reason, derived benefit from this medication after such a length of time. ... Either that or he is displaying another extreme example of psychiatric hubris.
> I really think you should ask him, though, why he thinks that it will or should begin to work after 3 or 4 more months-- is it anecdotal experience with past patients, a convincing body of literature, or something else?. It might be helpful to know if he has any good reasons for this recommendation.
>
My doc indeed has a LOT of expercience and qualifications and so far he really hastn't done a bad job with me, so i guess his choice will probably be well overtought and based on his experciences.
But i share your scepticism, it's unlikely for a med to take effect after 1 year, when it doestn't after 6 months...
> Oh and just so you know, I must tell you that nicotine is relatively nothing like an MAOI, especially Nardil.
>
> And in regard to nicotine's actions: one of its most well-known and probably significant (and definitely addictive) properties is its stimulation of dopamine release in the reward areas of the brain (e.g., nucleus accumbens). This is almost definitely the primary reason behind its euphoric properties as well. Also, the (cholinergic) nicotine receptors are involved in cognition, and their stimulation/agonism promotes enhanced cognitive capabilities (enhanced focus, etc.).
> I don't know of any direct involvement with norepinephrine (but there very well may be)-- or any other specific actions, although I'm sure there are. But the two mentioned above are I think two of the most significant if not the most.
>Aren't you speaking contradictious here? The nicotine raises the dopamine and thus gives a feeling of calm- and contentness.
Nardil also raises the dopamine levels, so one would expect it to have similar effects...it's a reasonnable theory right?greets,
Brice
Posted by SLS on October 6, 2006, at 8:33:13
In reply to Re: Nicotine and Depression Questionmark, posted by MrBrice on October 6, 2006, at 8:04:04
> Aren't you speaking contradictious here? The nicotine raises the dopamine and thus gives a feeling of calm- and contentness.
I think nicotine causes the RELEASE of dopamine via nicotinic ACh receptors located on dopaminergic neurons. It does not increase the amount of dopamine.
> Nardil also raises the dopamine levels,Yes. It increases the amount of dopamine available for release by preventing its degradation.
The two drugs work very differently.
- Scott
Posted by florence on October 6, 2006, at 15:13:38
In reply to Re: Nicotine and Depression » florence, posted by SLS on October 4, 2006, at 6:14:16
Thanks Scott
I'm totally confused- before being dxed with Hashimto's thyroid disease; i was given every ad, etc. for "depression" when all i complained about was fatigue.
provigil got me out of bed 3 yrs ago: but it always always gives me a mood drop (anxiety and depression) so i am having a hard time stopping it. Cold turkey makes me hostile.
anyhow, mind not so clear right now...Provigil makes me smoke even more.. Wellbutrin(Zyban) took away craving yrs ago. I actually held a cigarette in my hand and had to desire to smoke it....but got anxiety and fatigue from wellbutrin ..still dont know what dopamine does and what NE does...
i did read many yrs back that melatonin has something to do with why people smoke..dont remember the web page.... people smoke for 2 reasons: some people need a boast: others need to calm down..
personally, i think i smoked cuz my metabolism was gradually getting worse cuz of undiagnosed Hashi's disease...
provigil right now is making me appear like i have ADD which i dont....
still dont have Hashi's under control.
Check your thyroid antibodies guys.or find info on Stop the Thyroid Madness website.
Thanks again Scott.....Florence
Posted by MrBrice on October 6, 2006, at 15:51:19
In reply to Re: Nicotine and Depression Questionmark, posted by SLS on October 6, 2006, at 8:33:13
> >-
> The two drugs work very differently.
>
>
> - Scott
>
>so, there's no indication here that nardil would be a good drug for me? Istn't the nicotine working an indicator?
grtz
Posted by Questionmark on October 6, 2006, at 16:41:42
In reply to Re: Nicotine and Depression Questionmark, posted by MrBrice on October 6, 2006, at 15:51:19
"> Aren't you speaking contradictious here? The nicotine raises the dopamine and thus gives a feeling of calm- and contentness.
Nardil also raises the dopamine levels, so one would expect it to have similar effects...it's a >reasonnable theory right?
> greets,
> Brice "> > >-
> > The two drugs work very differently.
> >
> >
> > - Scott
> >
> >
>
> so, there's no indication here that nardil would be a good drug for me? Istn't the nicotine working an indicator?
>
> grtzNot at all really. In fact, Nardil is highly serotonergic and ultimately not very dopaminergic. Although still much different, an SSRI would probably give one of the best indications as to how you would react with Nardil. But Nardil is a complicated drug and has much more wide ranging effects than SSRIs, including effects on NE, epinephrine, GABA, and even alanine, as well as serotonin and dopamine. (Incidentally it probably has a more potent effect on NE than DA, too). But in my opinion it is more similar to the SSRIs than it is to other drugs (except some other MAOIs like Marplan)-- probably even Parnate.
Nicotine is probably more related to Parnate than Nardil, as Parnate is more stimulatory and highly dopaminergic. But even so, dopamine has a wide array of effects and roles in the brain and in my opinion is a very complicated neurotransmitter. *** One drug that stimulates dopamine release can be much different than another that does. In fact, almost all if not all addictive substances increase dopamine output (in the reward centers of the brain)-- from opiates to amphetamines to nicotine and alcohol-- but many of these are of course extremely different substances, with the only real commonality being that they can induce euphoria.
And in my own experience I know that DA *agonists* are subjectively much much different than psychostimulants, which increase dopamine release [among other things] (directly or through reuptake inhibition or both)-- and in theory BOTH should result in the activation of more dopamine receptors & should consequently have quite similar effects.. but that is not the case.So, basically my point of this long tangent is that your reaction to nicotine can really tell you very little if anything about what your reaction to MAOIs or other drugs will be, particularly Nardil. The only thing it will tell you is how you will react to drugs that stimulate nicotine receptors.
... (Oh, which reminds me-- you might want to look into galantamine, of which I have no experience but which is believed to sensitize nicotinic receptors. It is primarily a cholinesterase inhibitor as are other Alzheimer's drugs, so it is also probably much different than nicotine and may not be beneficial, but it's something to look into. It's also not approved in the U.S. [as a pharmaceutical-- there are herbal supplements you can find it in], but it is in other countries.)
Posted by SLS on October 6, 2006, at 17:17:49
In reply to Re: Nicotine and Depression Questionmark, posted by MrBrice on October 6, 2006, at 15:51:19
> > >-
> > The two drugs work very differently.
> >
> >
> > - Scott
> >
> >
>
> so, there's no indication here that nardil would be a good drug for me? Istn't the nicotine working an indicator?
I really don't know. Sometimes we get a little too smart for ourselves. I would say that if you have never tried Nardil, and you have already tried several SSRIs, Effexor, and Wellbutrin, then I think it makes sense to give it a try. If you feel particularly bad in the mornings with trouble sleeping, don't eat much, have psychomotor retardation, and are melancholic or are constantly dwelling on negative thoughts, then you might want to try a tricyclic first.
- Scott
Posted by MrBrice on October 7, 2006, at 22:19:58
In reply to Re: Nicotine and Depression Questionmark, posted by SLS on October 6, 2006, at 17:17:49
I've just come home from a night of party, and i noticed it really really istn't the nicotine that's doing me well, it's the dopamine allright.
Since i have the feeling that many of the repliers here have experience with dopamine-medication, i'll ask it here-: what's the best way to increase my dopamine, witheout having to stop the treatment that my doc is so sure about.
I read something on bromocriptine, might this be a solution for me?
thanks,
Brice
Posted by Questionmark on October 11, 2006, at 0:05:17
In reply to Re: Nicotine and Depression Questionmark, posted by MrBrice on October 7, 2006, at 22:19:58
Bromocriptine, pramipexole (Mirapex), ropinirole (Requip), and cabergoline (Dostinex) & others are all dopamine agonists that you could try (each affecting somewhat different combinations of DA receptors), and amantadine (Symmetrel) is a dopamine releaser. Parnate and selegeline are highly dopaminergic MAOIs. And, of course, the psychostimulants such as Adderal, dextroamphetamine, and Ritalin/methylphenidate have significant effects on dopamine as well.
As I've said before though, the dopamine agonists are often not quite like what one would expect-- at least for me, especially.
You also might look into the amino acids tyrosine & phenylalanine, and the supplement NADH.
> I've just come home from a night of party, and i noticed it really really istn't the nicotine that's doing me well, it's the dopamine allright.
>
> Since i have the feeling that many of the repliers here have experience with dopamine-medication, i'll ask it here-: what's the best way to increase my dopamine, witheout having to stop the treatment that my doc is so sure about.
>
> I read something on bromocriptine, might this be a solution for me?
>
> thanks,
> Brice
Posted by MrBrice on October 11, 2006, at 0:51:26
In reply to Re: Nicotine and Depression Questionmark » MrBrice, posted by Questionmark on October 11, 2006, at 0:05:17
Hey thanks for the advice questionmark, but i just saw my pdoc and he doestn't want to add a dopamine medication.
he even thinks i might have too MUCH dopamine, since i am quite paranoide.
Maybe were gonna take some weird and very difficult urine sample test to check on my dopamine levels (never heard of it)?The med that he hastought of for me are injections, on weekly base, that would stimulate me and make me produce more transmitters myself.
Posted by laima on October 11, 2006, at 9:39:23
In reply to Re: Nicotine and Depression Questionmark, posted by MrBrice on October 11, 2006, at 0:51:26
Hi,I didn't read the whole thread yet, so forgive me if I am off-base or missed something. But this dopamine thing-caught my eye quick- my doctor for awhile suspected dopamine issues for me due to reasons ranging from sleep problems involving movement, motivational issues, and self-reported cognitive fuzziness (though that part has improved with use of Emsam with small amount of ritalin-and trying to do puzzles and reading more again.) Last week I got results back from blood test indicating low iron, almost anemia. He said that low iron can prevent the body from producing or even utilizing dopamine effectively, and put me on iron pills.
Bummer is, the iron pills (ferrous sulphate) seem to make me really nauseous. I have always been a big eater of red meat, take my vitamins, etc- but I guess none of that was enough somehow. I hope they help!!! Thank goodness they are supposed to only be temporary until I rebuild my stores.What injections are you being offered? Just curious. Maybe the answer is in the thread, I'm gonna look.
Best wishes,
laima
> Hey thanks for the advice questionmark, but i just saw my pdoc and he doestn't want to add a dopamine medication.
>
> he even thinks i might have too MUCH dopamine, since i am quite paranoide.
> Maybe were gonna take some weird and very difficult urine sample test to check on my dopamine levels (never heard of it)?
>
> The med that he hastought of for me are injections, on weekly base, that would stimulate me and make me produce more transmitters myself.
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