![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 24 to 48 of 48. Go back in thread:
Posted by floatingbridge on March 28, 2010, at 1:27:54
In reply to Re: That warm fuzzy feeling, posted by conundrum on March 28, 2010, at 0:52:45
I'm sorry to hear about your grandmum.
Posted by ed_uk2010 on March 28, 2010, at 9:43:38
In reply to flow chart » ed_uk2010, posted by floatingbridge on March 28, 2010, at 0:40:36
> Yes, my pdoc showed me the one in vogue here....
>
> Not in the u.k.?Sort of, there's plenty of guidelines. Wellbutrin isn't used though.
Posted by ed_uk2010 on March 28, 2010, at 9:47:52
In reply to Re: That warm fuzzy feeling, posted by linkadge on March 27, 2010, at 16:13:26
> >You feel more loving after a yogurt Link?
>
> Yes, yes I do.
>
> LinkadgeHow curious :)
Posted by floatingbridge on March 28, 2010, at 10:14:18
In reply to Re: That warm fuzzy feeling, posted by ed_uk2010 on March 28, 2010, at 9:47:52
Possible ad campaign?
Posted by ed_uk2010 on March 28, 2010, at 14:26:36
In reply to Re: That warm fuzzy feeling » ed_uk2010, posted by floatingbridge on March 28, 2010, at 10:14:18
> Possible ad campaign?
I guess it would be more interesting than hearing about good digestive health.
Posted by morganator on March 28, 2010, at 14:27:18
In reply to Re: That warm fuzzy feeling))All responders » conundrum, posted by floatingbridge on March 28, 2010, at 0:55:04
I had no problems getting close to people and falling in love when I was on Zoloft. I actually would find myself wanting to hug people more. Then I again, I'm just naturally like this. I guess the better I feel on something and the better I feel in general, the more I feel like being intimate with other people and the more I get a good feeling in response to it. Everyone is different.
Posted by bulldog2 on March 28, 2010, at 18:12:58
In reply to Re: That warm fuzzy feeling))All responders, posted by morganator on March 28, 2010, at 14:27:18
> I had no problems getting close to people and falling in love when I was on Zoloft. I actually would find myself wanting to hug people more. Then I again, I'm just naturally like this. I guess the better I feel on something and the better I feel in general, the more I feel like being intimate with other people and the more I get a good feeling in response to it. Everyone is different.
The first ad I ever tried was zoloft at 50 mg. It was more like a drug experience than an AD experience. From the first day I felt this overflow of emotions. A woman I worked with brought her baby in and I got this rush of feelings about being paternal with the baby. I think this surprised me. Just felt this feeling about wanting to be closer with people. I am actually reclusive by nature and want to be alone. Eventually this feeling passed and I went back to the way I usually feel.This was over 10 years ago.
Now neurontin has been the closest to giving me that feeling to socialize with people. High dose neurontin gives me a dopamine type feeling. While wanting to socialize more, it is a more aggressive type feeling. The neurontin seems like it may finally be pooping out so I will be looking for a new med. May stick with anti convulsant type drugs since I had a good reaction to neurontin.
Posted by floatingbridge on March 28, 2010, at 19:16:03
In reply to Re: That warm fuzzy feeling))All responders, posted by bulldog2 on March 28, 2010, at 18:12:58
Just curious--what are other anti-seizure type drugs? (I did not know neurontin was considered in this class.)
I know depakote, trileptal (sp?), lamictal (?)
I could always google--but this place is the source!
Posted by floatingbridge on March 28, 2010, at 19:18:42
In reply to Re: That warm fuzzy feeling))All responders » bulldog2, posted by floatingbridge on March 28, 2010, at 19:16:03
Posted by conundrum on March 28, 2010, at 20:38:06
In reply to Re: That warm fuzzy feeling » conundrum, posted by floatingbridge on March 28, 2010, at 1:27:54
Thanks shes doing a lot better now. Just got out of the intensive care unit today.
Posted by bulldog2 on March 29, 2010, at 11:59:00
In reply to Re: That warm fuzzy feeling))All responders » bulldog2, posted by floatingbridge on March 28, 2010, at 19:16:03
> Just curious--what are other anti-seizure type drugs? (I did not know neurontin was considered in this class.)
>
> I know depakote, trileptal (sp?), lamictal (?)
>
> I could always google--but this place is the source!
Posted by bulldog2 on March 29, 2010, at 12:14:52
In reply to Re: That warm fuzzy feeling))All responders » bulldog2, posted by floatingbridge on March 28, 2010, at 19:16:03
> Just curious--what are other anti-seizure type drugs? (I did not know neurontin was considered in this class.)
>
> I know depakote, trileptal (sp?), lamictal (?)
>
> I could always google--but this place is the source!I don't think the last link worked. Here's another.
Posted by conundrum on March 29, 2010, at 18:50:14
In reply to Re: flow chart » floatingbridge, posted by ed_uk2010 on March 28, 2010, at 9:43:38
Well I just bumped pristiq up to 100 mgs today according to the flow chart. ;-)
It didn't give me the cool alert aroused feeling it did when I started the 50mg. I think my brain is swimming in too much serotonin right now. Have to wait it out a few weeks. Maybe then a TCA.
Posted by floatingbridge on March 29, 2010, at 20:58:37
In reply to Re: flow chart » ed_uk2010, posted by conundrum on March 29, 2010, at 18:50:14
Wishing you the best with this. My pdoc said that while the while the pristiq bump-up doesn't always work, it definitely works for some. Maybe you'll discover that your tendency toward atypical response a positive trait this time.
:)
Well I just bumped pristiq up to 100 mgs today according to the flow chart. ;-)
>
> It didn't give me the cool alert aroused feeling it did when I started the 50mg. I think my brain is swimming in too much serotonin right now. Have to wait it out a few weeks. Maybe then a TCA.
Posted by Economist on March 29, 2010, at 21:36:56
In reply to Re: That warm fuzzy feeling))All responders, posted by conundrum on March 27, 2010, at 10:02:22
"Anehdonia can almost make one suicidal in a way. Not that you are in so much pain that you want to die, but you are so apathetic, uninterested in the world around you, not trying to progress in your career and life that you just don't care. Death wouldn't seem too much different than how I already feel."
Wow, this describes me exactly. Was your anhedonia induced by SSRI?
I am on EMSAM/selegiline/Deprenyl right now because I thought it would help with my anhedonia. It's been a little over two weeks and so far no difference. With anhedonia, I am just waiting to die.
Posted by conundrum on March 29, 2010, at 22:27:12
In reply to Anhedonia » conundrum, posted by Economist on March 29, 2010, at 21:36:56
Yeh, I mean I didn't have it before taking prozac, but I also didn't have it while on prozac. Just after stopping it. So it could have been the drug causes changes in the brain that don't reverse, or it could have been the quick taper off. Either way, I doubt I would be feeling this way had I never taken prozac since i was mainly anxious before taking it. If I take it now I can only tolerate low doses and it does increase motivation but doesn't change anhedonia. I start doing more things but don't really know why. I'm interested in trying low dose prozac with a TCA or adrafinil.
Maybe you should decrease the amulsipride since at higher doses it blocks the D2 receptors from being activated by dopamine.
Have you considered trying anything adrenergic? Seems like you've done almost all you can with dopaminergic drugs, and haven't given adrenergic drugs a shot.
Another thing that might help similar to low dose prozac is a low dose of an AP that blocks serotonergic receptors, like zyprexa or something in that class. I think the thing that makes low dose prozac helpful for me is it blocks some serotonergic post synaptic receptors. Thats just a theory though.
Posted by Economist on March 29, 2010, at 22:33:57
In reply to Re: Anhedonia » Economist, posted by conundrum on March 29, 2010, at 22:27:12
If by adrenergic you mean something that works on norepinephrine, I've been on an SNRI (Cymbalta) and a DNRI (Wellbutrin). Neither helped.
Posted by conundrum on March 29, 2010, at 22:49:13
In reply to Re: Anhedonia » conundrum, posted by Economist on March 29, 2010, at 22:33:57
I was thinking of waiting for bleauberry to respond, but neither of those drugs are really good indicators of whether you respond to norepinephrine well. Cymbalta is much stronger on serotonin and probably washes out its adrenergic effects. Wellbutrin boosts dopamine weakly and does even less to boost norepinephrine. The names SNRI, DNRI are more marketing tools than indictions of what they do. I'm talking about trying something like Nortriptyline, Protriptyline, or Desipramine. They're fairly selective for norepinephrine.
Take a look at the study below. You can see that both effexor and symbalta bind much more strongly (the smaller number) to the serotonin transporter than norepinephrine. Cymbalta is 7.5 for NE(weaker) and 0.8 for serotonin (stronger).
Bupriopion seems to work on nitric Oxide pathways that is not clearly understood.
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T1J-4NN0WF3-2&_user=10&_coverDate=07%2F30%2F2007&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=1273803560&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=29fda8e917b616a24358232f1a53f9f5If you read you can see that only one of the doses given to the animals in this study increased norepinephrine. Obviously human brains are different.
Maybe I'm totally wrong though and none of what I'm saying matters. Maybe you haven't found the right dopaminergic drug yet or the right dose. But you have tried a number and it would be ashame to miss out on something that might work because you've already made up your mind that only one type of drug will work. I've done the same thing, could be doing it now. Who knows what will work?
Posted by conundrum on March 29, 2010, at 22:50:12
In reply to Re: Anhedonia » Economist, posted by conundrum on March 29, 2010, at 22:49:13
Forgot the link for the SNRI binding affinity study.
http://biopsychiatry.com/dulox.htm
Posted by floatingbridge on March 29, 2010, at 23:29:11
In reply to Re: Anhedonia » Economist, posted by conundrum on March 29, 2010, at 22:49:13
Thanks for the link--I've received mixed, unclear info from healthcare providers.
Posted by economist on March 30, 2010, at 12:13:43
In reply to Re: Anhedonia » Economist, posted by conundrum on March 29, 2010, at 22:49:13
Have you tried Nortriptyline before?
Does Pristiq help with your anhedonia?
Posted by conundrum on March 30, 2010, at 20:18:34
In reply to Re: Anhedonia » conundrum, posted by economist on March 30, 2010, at 12:13:43
I haven't tried nortrityline yet, however I did notice some interesting feelings during the first two weeks on pristiq. Normally I only feel emotions when I have during memories which last only seconds and give me a glimpse of how I used to feel. During the first two weeks of pristiq I experienced a major increase in these feelings. THe world felt much more vibrant. I wasn't cured but it was and improvement. I know this was do to norepinephrine because I have never gotten this feeling from an SSRI. It made the hairs on my head tingle. I also know because one of the first side effects I had was insomnia and increase heart rate, which is not something I get from SSRIs. Eventually it faded and I started to feel more and more like I was on an SSRI. I felt spacey started to get headaches, and trouble waking.
I think a drug that works primarily on NE and stronger would be helpful. I feel even more spacey now that I've gone up to 100 mgs with no added adrenergic effect. I'm thinking of calling this trial quits short because I already know SSRIs don't agree with me.
Posted by Economist on March 30, 2010, at 21:12:49
In reply to Re: Anhedonia » economist, posted by conundrum on March 30, 2010, at 20:18:34
Why don't you switch to something more norepinephrin-ergic (?) since the Pristiq has stopped working on you?
Also, does your anhedonia leave you with a chronic, incurable and agonizing boredom? Since nothing causes fun or pleasure, thus every activity is boring.
Posted by conundrum on March 30, 2010, at 22:10:47
In reply to Re: Anhedonia, posted by Economist on March 30, 2010, at 21:12:49
Yeh, im thinking of cutting this trial short. It just stopped doing anything about a week ago. My doc wanted me to go up to 100. I feel pretty spacey at that dose. I may give it another day and then try to ween off and see a psychiatrist again. Hopefully whoever I see will be open to suggestions.
Posted by conundrum on March 30, 2010, at 22:14:42
In reply to Re: Anhedonia, posted by Economist on March 30, 2010, at 21:12:49
Oh yeh the boredom. I don't really like to do much. Maybe watch tv or Pr0n. Nothing really interests me like music or hobbies. I should go back to school but I have no interest in studying or have a way to tell what subject I would like since I don't feel anything.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.