![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by Agomelatinehope on September 3, 2012, at 13:43:30
Hi
I tried antipyschotics (geodon) and had to withdraw because of the terrible side effects (Akathisia, insomnia, confusion, tachycardia, muscle pain, etc) and the fear of developing permanent tardive diskinesia. However, I loved some of its positive effects (I had more motivation, pro social skills and more sexual desire).
Is there any other way of increasing my dopamine levels?
Meds I tried and results:
-Agomelatine: Although it makes you sleepy, you end up waking up very early in the morning and cannot sleep again (4am), and this ruins your day. The activating effect is not very noticeable.
-Mirtazapine: The main problem with this med is the terrible sleepiness/dizziness which does not go away during the treatment no matter the dose (even with higher doses). The activating feeling was very good BUT when I was on it I suffered from tachichardya and I once was about to have a heart attack, very scary.
-Trazodone: The main problem is sleepiness and the risk of developing priapism. I always woke up during night with painful erections.
Is there an alternative less risky?Thank you
Posted by SLS on September 3, 2012, at 14:45:36
In reply to Increase dopamine for motivation without risks?, posted by Agomelatinehope on September 3, 2012, at 13:43:30
What kinds of risks are you trying to avoid?
You might consider combining Lamictal with Wellbutrin.
You could then add Focalin or Dexedrine if necessary.
Adding Abilify will theoretically boost dopaminergic neurotransmission when the concentration of dopamine is low. It's potential to produce movement EPS is low, although akathisia can be a problem.
Have you ever tried Prozac?
- Scott
Posted by Phillipa on September 3, 2012, at 18:11:02
In reply to Increase dopamine for motivation without risks?, posted by Agomelatinehope on September 3, 2012, at 13:43:30
For depression? Are these the only meds you have tried or are there a lot others? Phillipa
Posted by phidippus on September 3, 2012, at 23:19:57
In reply to Increase dopamine for motivation without risks?, posted by Agomelatinehope on September 3, 2012, at 13:43:30
Mirapex and requip are dopamine agonists you can try.
Nuvigil binds to dopamine.
Why do you want to raise your dopamine levels?
Eric
Posted by Agomelatinehope on September 4, 2012, at 3:28:19
In reply to Re: Increase dopamine for motivation without risks? » Agomelatinehope, posted by phidippus on September 3, 2012, at 23:19:57
> Mirapex and requip are dopamine agonists you can try.
>
> Nuvigil binds to dopamine.
>
> Why do you want to raise your dopamine levels?
>
> EricMainly for anhedonia, lack of motivation and lack of sexual desire. (All 3 symptoms induced by long term use of SSRI)
Mi diagnosis is mainly Anhedonia and GAD
Posted by SLS on September 4, 2012, at 6:25:13
In reply to Re: Increase dopamine for motivation without risks?, posted by Agomelatinehope on September 4, 2012, at 3:28:19
> > Mirapex and requip are dopamine agonists you can try.
> >
> > Nuvigil binds to dopamine.
> >
> > Why do you want to raise your dopamine levels?
> >
> > Eric
>
> Mainly for anhedonia, lack of motivation and lack of sexual desire. (All 3 symptoms induced by long term use of SSRI)
>
> Mi diagnosis is mainly Anhedonia and GAD
I found that Nardil produced increases in motivation and sex drive, and a reduction in anhedonia. Nardil also can effectively treat GAD.
- Scott
Posted by schleprock on September 4, 2012, at 10:20:42
In reply to Re: Increase dopamine for motivation without risks? » Agomelatinehope, posted by SLS on September 4, 2012, at 6:25:13
> > > Mirapex and requip are dopamine agonists you can try.
> > >
> > > Nuvigil binds to dopamine.
> > >
> > > Why do you want to raise your dopamine levels?
> > >
> > > Eric
> >
> > Mainly for anhedonia, lack of motivation and lack of sexual desire. (All 3 symptoms induced by long term use of SSRI)
> >
> > Mi diagnosis is mainly Anhedonia and GAD
>
>
> I found that Nardil produced increases in motivation and sex drive, and a reduction in anhedonia. Nardil also can effectively treat GAD.
>
>
> - ScottIsn't Nardil an MAOI? I always thought that was something as a last resort.
Posted by SLS on September 4, 2012, at 10:41:57
In reply to Re: Increase dopamine for motivation without risks?, posted by schleprock on September 4, 2012, at 10:20:42
> > > > Mirapex and requip are dopamine agonists you can try.
> > > >
> > > > Nuvigil binds to dopamine.
> > > >
> > > > Why do you want to raise your dopamine levels?
> > > >
> > > > Eric
> > >
> > > Mainly for anhedonia, lack of motivation and lack of sexual desire. (All 3 symptoms induced by long term use of SSRI)
> > >
> > > Mi diagnosis is mainly Anhedonia and GAD
> >
> >
> > I found that Nardil produced increases in motivation and sex drive, and a reduction in anhedonia. Nardil also can effectively treat GAD.
> >
> >
> > - Scott
>
> Isn't Nardil an MAOI? I always thought that was something as a last resort.
I don't know if leaving Nardil for last is always such a good plan. It definitely makes sense to try other drugs first. I think the timing of bringing Nardil into the picture will depend upon symptom cluster and treatment history. MAOIs went out of favor in the 1990s after Prozac and Wellbutrin came out. Many, if not most, psychiatrists simply don't have the experience in using these drugs. I think things might be moderating today. There is a growing appreciation for the high rate of success of using MAOIs. I have been on MAOIs on and off since 1982. I have had only one hypertensive tyramine reaction when I carelessly ate a few slices of pepperoni on a pizza. Otherwise, pizza is fine.I can't recommend when is the right time for you to consider a MAOI, but I do think it should have a place in your decision making process.
- Scott
Posted by phidippus on September 4, 2012, at 16:28:05
In reply to Re: Increase dopamine for motivation without risks?, posted by Agomelatinehope on September 4, 2012, at 3:28:19
Then try Nuvigil for the anhedonia - Orexin neurons are activated by Nuvigil. Orexinergic neurons are found exclusively in the lateral hypothalamic area. Their activation is associated with enhanced pleasure-seeking and motivation as well as arousal. Orexinergic fibers project to the entire central nervous system.
For the GAD I'd recommend an antidepressant.
Eric
Posted by schleprock on September 4, 2012, at 18:17:02
In reply to Re: Increase dopamine for motivation without risks? » Agomelatinehope, posted by phidippus on September 4, 2012, at 16:28:05
I'm sort of in the same boat as you. Here's a response I got from a similar query at... another forum.
schleprock, on 03 September 2012 - 11:09 AM, said:
Severe panic attack (not mere anxiety, but the really acute attacks that come out of nowhere and typically have people scrambling for the ER.)
>In this case, though, a chemical imbalance is unlikely. Or at least is probably not the root cause, because if it were you'd always be anxious to some degree.
schleprock, on 03 September 2012 - 11:09 AM, said:melancholic-like depression symptoms (esp. anhedonia, loss of interest in activities)
>My money is on too little dopamine in general, or at some specific receptor, being one of, if not the major cause of ahnedonia.
schleprock, on 03 September 2012 - 11:09 AM, said:Gradual loss of libido (let's say over a period of six months.)
>This one is complicated. First it can have nothing to do with neurotransmitters or testosterone. If neurotransmitters are a factor it can be too little dopamine and/or too much serotonin at you 5-HT2A receptors. Nortriptyline is a fairly potent anticholinergic, and anticholinergics can kill your libido as well. Long-term use of benzodiazepines can cause sexual dysfunction. Or not. Benzos can even treat various sex problems. Like all anticonvulsants it's a crapshoot about whether they'll cause or fix some things.
Posted by AlexCanada on September 5, 2012, at 0:51:13
In reply to Increase dopamine for motivation without risks?, posted by Agomelatinehope on September 3, 2012, at 13:43:30
someone mentioned Nuvigil. I've tried Provigil/Modafinil which is said to be very similar. For me it definitely had given more motivation, cognitive boost, energy and some very mild increase in interest. For me it's too expensive though.
And yes I deal with strong anhedonia with my melancholic depression.
Provigil and Nuvigil suppossedly have effect on dopamine and it may have been noredrenaline? Not sure. There are many people whom have had success with provigil/nuvigil. Thus it may be worth a try. Side effects are also very minimal. For me after 8 hours or so I would feel a bit of a crash where a day which was more productive than usual i'd end up feeling empty, bit sad and quite procrastinated. Some of this may have been due to other factors such as how my evenings usually were worse during parnate (i took provigil/modafinil with it) but they seemed ''worse'' evenings than the non-provigil days.
For some people it may build tolerance quickly though and after a week or two you may need to give it a break for a few days and start up again.
Also Rhodiola Rosea which is said to be an herbal MAOI is one of the very best supplements I have ever tried and I have wasted much, much money on countless supplements, vitamins, herbals etc which did not work. Rhodiola works for most people within the first day and full effects can be witnessed after a week or two. motivation, cognition, energy, and greater ability to actually speak to people since my mind wasn't in the gutter. Arctic Root is the brand which was used in clinical trails I believe.
> Hi
>
> I tried antipyschotics (geodon) and had to withdraw because of the terrible side effects (Akathisia, insomnia, confusion, tachycardia, muscle pain, etc) and the fear of developing permanent tardive diskinesia. However, I loved some of its positive effects (I had more motivation, pro social skills and more sexual desire).
>
> Is there any other way of increasing my dopamine levels?
>
> Meds I tried and results:
>
> -Agomelatine: Although it makes you sleepy, you end up waking up very early in the morning and cannot sleep again (4am), and this ruins your day. The activating effect is not very noticeable.
>
> -Mirtazapine: The main problem with this med is the terrible sleepiness/dizziness which does not go away during the treatment no matter the dose (even with higher doses). The activating feeling was very good BUT when I was on it I suffered from tachichardya and I once was about to have a heart attack, very scary.
>
> -Trazodone: The main problem is sleepiness and the risk of developing priapism. I always woke up during night with painful erections.
>
>
> Is there an alternative less risky?
>
> Thank you
>
>
>
>
Posted by Agomelatinehope on September 5, 2012, at 4:17:39
In reply to Re: Increase dopamine for motivation without risks? » Agomelatinehope, posted by AlexCanada on September 5, 2012, at 0:51:13
> Also Rhodiola Rosea which is said to be an herbal MAOI is one of the very best supplements I have ever tried and I have wasted much, much money on countless supplements, vitamins, herbals etc which did not work. Rhodiola works for most people within the first day and full effects can be witnessed after a week or two. motivation, cognition, energy, and greater ability to actually speak to people since my mind wasn't in the gutter. Arctic Root is the brand which was used in clinical trails I believe.Thanks for your replies.
I have just ordered some Rhodiola natural pills since I read a lot of good reviews about it. I have also ordered some Maca since it says it helps with the libido.
Thank you very much
Posted by phidippus on September 5, 2012, at 14:54:31
In reply to Re: Increase dopamine for motivation without risks? » Agomelatinehope, posted by AlexCanada on September 5, 2012, at 0:51:13
>I've tried Provigil/Modafinil which is said to be >very similar.
Provigil and Nuvigil are both based on the drug Modafanil, so have similar modes of action.
Modafinil induces wakefulness in part by its action in the anterior hypothalamus. Its dopamine-releasing action in the nucleus accumbens is weak and dose-dependent.
Modafinil has central alpha 1-adrenergic agonist effects i.e. it directly stimulates the receptors. Modafinil also inhibits the reuptake of noradrenaline by the noradrenergic terminals on sleep-promoting neurons of ventrolateral preoptic nucleus (VLPO). More significant, perhaps, is its ability to increase excitatory glutamatergic transmission. This reduces local GABAergic transmission, thereby diminishing GABA(A) receptor signalling on the mesolimbic dopamine terminals.
Orexin neurons are activated by modafinil. Orexinergic neurons are found exclusively in the lateral hypothalamic area. Their activation is associated with enhanced pleasure-seeking and motivation as well as arousal. Orexinergic fibers project to the entire central nervous system.
Eric
Posted by AlexCanada on September 6, 2012, at 15:11:05
In reply to Re: Increase dopamine for motivation without risks? » AlexCanada, posted by phidippus on September 5, 2012, at 14:54:31
With the information you've provided do any of the mechanisms of action have potential to effect someone negatively? especially someone with melancholic depression, poor cognition/drive/motivation/interest/pleasure/energy?
modafinil sometimes would make things look ''darker'' and my ability to enjoy things would not necessarily improve. possibly worse. Yet my motivation, energy, ability to think would benefit usually.
> Provigil and Nuvigil are both based on the drug Modafanil, so have similar modes of action.
>
> Modafinil induces wakefulness in part by its action in the anterior hypothalamus. Its dopamine-releasing action in the nucleus accumbens is weak and dose-dependent.
>
> Modafinil has central alpha 1-adrenergic agonist effects i.e. it directly stimulates the receptors. Modafinil also inhibits the reuptake of noradrenaline by the noradrenergic terminals on sleep-promoting neurons of ventrolateral preoptic nucleus (VLPO). More significant, perhaps, is its ability to increase excitatory glutamatergic transmission. This reduces local GABAergic transmission, thereby diminishing GABA(A) receptor signalling on the mesolimbic dopamine terminals.
>
> Orexin neurons are activated by modafinil. Orexinergic neurons are found exclusively in the lateral hypothalamic area. Their activation is associated with enhanced pleasure-seeking and motivation as well as arousal. Orexinergic fibers project to the entire central nervous system.
>
> Eric
Posted by phidippus on September 6, 2012, at 15:37:40
In reply to Re: Increase dopamine for motivation without risks? » phidippus, posted by AlexCanada on September 6, 2012, at 15:11:05
The only negative effect I can seem to find in the literature is nervousness/anxiety as a possible side effect.
Eric
Posted by SLS on September 6, 2012, at 19:21:35
In reply to Re: Increase dopamine for motivation without risks? » phidippus, posted by AlexCanada on September 6, 2012, at 15:11:05
> With the information you've provided do any of the mechanisms of action have potential to effect someone negatively? especially someone with melancholic depression, poor cognition/drive/motivation/interest/pleasure/energy?
>
> modafinil sometimes would make things look ''darker'' and my ability to enjoy things would not necessarily improve. possibly worse.I and a few other posters on Psycho-Babble have had dreadful reactions to modafinil. I became more depressed, dysphoric, and cognitively impaired. It was mind-numbing. Not only that, but these effects persisted for several weeks after I discontinued modafinil. This is obviously atypical, but it does happen.
- Scott
Posted by AlexCanada on September 7, 2012, at 4:24:31
In reply to Re: Increase dopamine for motivation without risks? » AlexCanada, posted by SLS on September 6, 2012, at 19:21:35
Thanks for the info. I been considering whether I should bother refilling my prescription. It allows me to be productive but not sure if the pros outweigh the cons. One of the biggest benefits is how it prevents me from feeling often constantly lethargic which is what I deal with along with often a full spectrum of strong Melancholic Depression symptoms.
For me the effect may be slightly similar to yours for the times I've taken it. Often I'd initially feel a small boost to my mood but aside from energy + cognitive boost (yet with some different type of impairment accompanying it ironically), it does make me feel sometimes dysphoric and empty. When i'd give it a break and start it up again I'd have a significant boost to motivation and productivity.
I am very conflicted on it. I started it this year at various times with temporary very positive benefit but it doesn't usually last. Also I tried it many years ago with initial subtantial positive results but cannot remember why I stopped it. I think it may have been worsening my depression in the end after initial benefits.
Yesterday I had 50mg (sensetive to meds) and I was able to finally be a bit productive and even speak to people a bit! Normally I am so dysphoric and detached, unmotivated, and so cognitively impaired that I cannot even construct proper emails. Today I took 25mg and was able to be bit produtive too but my very poor ability to enjoy things feels compromised. I can write more responses on this forum. Communicate w people a bit more. Not ignore emails. Not as much as yesterday but still better ability to ''do'' things. But it's a darker type of world than my lethargic, dull, dumb, tired, unmotivated, uninterested typical self.
It's so frustrating. Tomorrow I will likely go without any modafinil just to try and see difference as I also start up Zoloft later in the day (been weaning off of parnate). I been really in need of some relief. I have not been able to do much lately. Rhodiola Rosea used to help me so much in many symptoms (only mildly for interest). It even made me feel like a genius at times but it just doesn't have much benefit after a year of use and I been dropping it too.
Only on ritalin and valium right now. Zoloft starts tomorrow. Valium has some mood benefit, anx benefit obviously, ironically sometimes increases anxiety (rarely), headaches, causes tiredness but I've tried withdrawl and the withdrawal is so long and intense. become so dysphoric, world becomes so dark, intense anxiety, moderate panic attacks, mostly these would arrive a week after withdrawal. Initially I'd feel better but it comes on fierce. I wonder if some of it is not withdrawal but a return of pre-benzo symptoms where I'd have much anxiety and be in a very dysphoric world but that doesn't explain why there would be some initial improvement to my symptoms upon reduction of valium. Of cours when I started taking it again (this was few months ago)... a 2.5mg dose made me feel so much better temporarily, and I was back to taking it. If I didn't have severe memory issues i'd be able to figure this out much more easily. I can't even do much research because it only sticks with me for a day. so many stupid notes. antero grade memory loss. bordering on a subtype of antero grade amnesia caused by bilateral ECT many years ago.
gingko helps a ''bit'' and rhodiola used to. but I am so sick of this type of empty life. i will keep trucking along as usual. at least i don't have the scorching pains that always plagued me and it felt torturous to be alive. at least one thing has subsided after all these years.
Any advice on how to deal with Long Term Memory issues? my short term memory is not too bad. But the Antero Grade Memory Loss (difficulty retaining/learning new information) is a constant problem that plagues me every day. No matter which medication has helped me in the past for various symptoms this one big issue has always remained a constant problem. Whenever happens today... i'll forget most of it tomorrow. Rinse and repeat... That is my Damn life. If I saw a tv show a few months ago it will feel quite fresh now.
What meds might possibly help?
> > With the information you've provided do any of the mechanisms of action have potential to effect someone negatively? especially someone with melancholic depression, poor cognition/drive/motivation/interest/pleasure/energy?
> >
> > modafinil sometimes would make things look ''darker'' and my ability to enjoy things would not necessarily improve. possibly worse.
>
> I and a few other posters on Psycho-Babble have had dreadful reactions to modafinil. I became more depressed, dysphoric, and cognitively impaired. It was mind-numbing. Not only that, but these effects persisted for several weeks after I discontinued modafinil. This is obviously atypical, but it does happen.
>
>
> - Scott
>
Posted by SLS on September 7, 2012, at 8:07:57
In reply to Modafinil Issues Ugh. Also need help w Memory!! » SLS, posted by AlexCanada on September 7, 2012, at 4:24:31
> Any advice on how to deal with Long Term Memory issues? my short term memory is not too bad. But the Antero Grade Memory Loss (difficulty retaining/learning new information) is a constant problem that plagues me every day.
>
> No matter which medication has helped me in the past for various symptoms this one big issue has always remained a constant problem.For me, memory was one of the last things to recover when I experienced a full remission. It took about three months. I knew I was okay once I was able to learn and recall phone numbers.
> Whenever happens today... i'll forget most of it tomorrow. Rinse and repeat... That is my Damn life. If I saw a tv show a few months ago it will feel quite fresh now.
I completely understand.
:-(
> What meds might possibly help?
You are very badly afflicted. I am guessing that you are experiencing psychomotor retardation. I doubt that I would have much to offer regarding treatment alternatives for you. For melancholic depression, tricyclics seem to be more effective than SSRIs. However, I would not rule-out combining a noradrenergic tricyclic (desipramine, nortriptyline) with SRI (Zoloft, Effexor). In my way of thinking, you would be a candidate for treatment with Parnate combined with a tricyclic (desipramine or nortriptyline). Parnate + desipramine is rather harsh with respect to autonomic side effects, particularly elevated heart rate. Nortriptyline is less harsh. However, it is not uncommon that someone will respond to one TCA, but not another. It was Parnate + desipramine that brought about a full remission for me. Adding low-dose lithium (300 - 600 mg/day) to these two drugs (separately or together) sometimes triggers a robust response. I continue to take 300 mg/day for its antidepressant effects and neuroprotective and neurogenensis properties. I am also motivated to take lithium for its potential to reduce the risk of developing of Alzheimer's Dementia. Otherwise, depression increases this risk by a factor of 2 - 3.
What has been your experience with Wellbutrin? This is another drug that can produce good results when combined with SRIs. Combining Abilify and/or Lamictal is worth considering, especially if you were responsive to Wellbutrin. Dopaminergic activation seems to be a common thread amongst these drugs.
I have found prazosin 6 - 12 mg/day to be remarkably helpful. This drug seems to be effective for people who have developmental PTSD as well as acute PTSD. More recently, I have started taking minocycline. It seems to be working such that I was able to discontinue the prazosin and am contemplating the discontinuation of Abilify. Minocycline might work particularly well when combined with Lamictal. Both drugs are antiglutaminergic, and may work synergistically. Minocycline also displays anti-inflammatory and neuroprotective properties. Among the tetracyclines, minocycline is uniquely active in tests screening for antidepressants. Its antibiotic property, which is unrelated to these others, may not be contributory to its therapeutic effect when treating depression, although it would be helpful when Lyme disease is present.
My current regime:
Parnate 80 mg
nortriptyline 150 mg
Lamictal 200 mg
lithium 300 mg
Abilify 10 mg
minocycline 200 mg.
- Scott
Posted by phidippus on September 7, 2012, at 16:36:44
In reply to Modafinil Issues Ugh. Also need help w Memory!! » SLS, posted by AlexCanada on September 7, 2012, at 4:24:31
Less far along in the development pipeline is Memory Pharmaceuticals' experimental drug, MEM 1414. It's currently in phase I trials, which are designed to test safety in people.
MEM 1414 works by blocking phosphodiesterase, an enzyme that breaks down an important brain chemical, cyclic AMP. It appears to work in the area of the brain where new memories are formed. "It's very important for facts and events," says Axel Unterbeck, PhD, president and chief scientific officer of Memory Pharmaceuticals.
"In order to be able to form new long-term memories -- which are memories lasting for more than three hours, by definition ... the [brain] also processes that information for facts and events to be stored long term, he says. "If you enhance this pathway, you get, potentially, enhancement of this very function."
Posted by SLS on September 7, 2012, at 22:55:14
In reply to Re: Modafinil Issues Ugh. Also need help w Memory!! » AlexCanada, posted by phidippus on September 7, 2012, at 16:36:44
> MEM 1414 works by blocking phosphodiesterase, an enzyme that breaks down an important brain chemical, cyclic AMP.
Check out rolipram. It is an old antidepressant that never made it to the US. It is a PDE-4 inhibitor that has been sold in Japan for quite a few years.
- Scott
Posted by AlexCanada on September 8, 2012, at 18:17:56
In reply to Re: Modafinil Issues Ugh. Also need help w Memory!! » AlexCanada, posted by SLS on September 7, 2012, at 8:07:57
> You are very badly afflicted. I am guessing that you are experiencing psychomotor retardation. I doubt that I would have much to offer regarding treatment alternatives for you. For melancholic depression, tricyclics seem to be more effective than SSRIs. However, I would not rule-out combining a noradrenergic tricyclic (desipramine, nortriptyline) with SRI (Zoloft, Effexor). In my way of thinking, you would be a candidate for treatment with Parnate combined with a tricyclic (desipramine or nortriptyline). Parnate + desipramine is rather harsh with respect to autonomic side effects, particularly elevated heart rate. Nortriptyline is less harsh. However, it is not uncommon that someone will respond to one TCA, but not another. It was Parnate + desipramine that brought about a full remission for me. Adding low-dose lithium (300 - 600 mg/day) to these two drugs (separately or together) sometimes triggers a robust response. I continue to take 300 mg/day for its antidepressant effects and neuroprotective and neurogenensis properties. I am also motivated to take lithium for its potential to reduce the risk of developing of Alzheimer's Dementia. Otherwise, depression increases this risk by a factor of 2 - 3.
TCAs I been considering. Ixel isn't available in Canada but I've read many promising things. Desipramine also is a candidate but I been trying to recall if I tried it before. I don't think I have. Nortipiline did not work well for me. I don't recall the details of the experience. Lithium I've tried in the past as an add-on for paxil I believe, and I felt worse. Possibly my dose was too high since I respond better to low doses.
>
> What has been your experience with Wellbutrin? This is another drug that can produce good results when combined with SRIs. Combining Abilify and/or Lamictal is worth considering, especially if you were responsive to Wellbutrin. Dopaminergic activation seems to be a common thread amongst these drugs.Wellbutrin made me worse the longer I took it. I could not handle a full 4 week trail.
Abilify rapidly made me worse as an add-on for parnate. I felt a lot of anxiety among other symptoms which I can't recall right now. Much of this is buried in my journals somewhere.
I wonder if abilify may still be worth trying again, if it's one of those cases of ''worse before it gets better''. Since risperadal helped me a long time ago in terms of interest and bit motivation but I felt very dull and not quite ''connected'' to the world. Risperadal wasn't used as an add-on though. it was a mono therapy with likely a benzo back then many years ago.
prazosin i will have to read up on.
i been wanting to try memantine from various positive things i've heard (especially for cognition + memory) but my doctor wants me to convince him w studies. i only been able to find one indicated for depression. DLPA also been considering
>
> I have found prazosin 6 - 12 mg/day to be remarkably helpful. This drug seems to be effective for people who have developmental PTSD as well as acute PTSD. More recently, I have started taking minocycline. It seems to be working such that I was able to discontinue the prazosin and am contemplating the discontinuation of Abilify. Minocycline might work particularly well when combined with Lamictal. Both drugs are antiglutaminergic, and may work synergistically. Minocycline also displays anti-inflammatory and neuroprotective properties. Among the tetracyclines, minocycline is uniquely active in tests screening for antidepressants. Its antibiotic property, which is unrelated to these others, may not be contributory to its therapeutic effect when treating depression, although it would be helpful when Lyme disease is present.
>
> My current regime:
>
> Parnate 80 mg
> nortriptyline 150 mg
> Lamictal 200 mg
> lithium 300 mg
> Abilify 10 mg
> minocycline 200 mg.
>
>
> - Scott
>
>Minocycline I haven't tried either. I'll have to read up on it.
Thanks for your input. It's difficult to piece things together.
Oh and here is a summary list of what I tried. Likely not complete.
Treatments Tried:
Benzo- Valium, Ativan, Klonopin, Xanax
SSRI- Celexa, Paxil, Zoloft,
SNRI/Other/Alternative- Wellbutrin, Effexor, Stablon, Remeron, Lithium, Adrafinil, Gabapentin, Narproxen, Vivarint, Buspar, Trivistal LA, ECT, rTMS, Reboxetine, Mirapex,
NRI- Reboxetine,
MAOI- Parnate, Nardil
Stimulant- Ritalin, Dexedrine, Provigil
Anti-Psychotics- Zyprexa, Risperidal, Abilify (as a low dose add-on), Seroquel,
Natural/Herbal- Rhodiola Rosea, Omega 3, Omega Complex, Korean Ginseng, Magnesium Glycinate, Royal Jelly, Niacin, Gingko Biloba, Bee Pollen, L-Arginine, Resveratrol, D3, Maca Root,Sensitivities: Vitamin A, Sunlight,
----Treatment Results:
Worse: Celexa (gradual worsening of depression and burning pain), Effexor (rapid worsening of depression and burning pain), Abilify (rapid worsening of depression when taken w Parnate), Cymbalta (gradual worsening of depression), Seroquel, ECT (Severely damaged my long term memory and overall cognition perminently), Nortriptyline, Lithium,
Better: Risperidal (some ability to enjoy things but overall would still be largely lacking), Parnate, Ritalin (first time this or Dexedrine was taken I was able to feel a bit like my old self, ability to experience pleasure, positive outlook, return of old hobbies, Was able to appreciate being alive), Dexedrine (similar to ritalin), Valium (some mood improvement, some anxiety improvement, most benzos have had similar effect), Ativan (was more social on this than other benzos while also on Paxil), Rhodiola Rosea (herbal similar to an MAOI) (A small miracle for mood, energy, cognition, general well being, would still be lacking pleasure. Has lost much effect over time), Gabapentin (tremendous cognitive improvement, imagination, more emotions, less cloudy thought process, feeling of greater intellectual capacity. Some improvement to mood, ability to be social. Although rapid tolerance onset, inconsistent, ironically sometimes cognitive impairment.), Vivarint (some mood improvement, massive improvement to sex drive),
Mixed Results: Remeron (sluggish on low doses, more active on higher doses, very mild mood improvement, impulsive spending), Zyprexa (some mood improvement, lot of lethargy, cognitive slowness, food tasted wonderful), Stablon, Modafinil (increased Cognition, Energy, Motivation but may compound dysphoria)
Negligible or Unsure: Zoloft, Nardil, Adrafinil, Narproxen, Buspar, rTMS (could not access any tangible improvement), Reboxetine, Mirapex, Piribedil, Klonopin, Wellbutrin,
Needs confirmation (not sure if taken): Prozac,
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.