![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by MightyKondrian on October 9, 2017, at 11:20:24
Not alot to say. I'm just tired I guess. Tired of waiting and waiting and......
See the doc Friday 13th (oh great! lol)
Last time he hinted about a stimulant addon.
I reminded him that I used to be a speed addict. I also build tolerance quickly whether its caffeine or speed or coke.
He mentioned a stimulant that I've never heard of and said he uses very small doses. Is tolerance the same on small stim doses too?
Not sure if I will need to come off or lower any of my current meds (signature). Esp bupropion.I will keep updated. All comments welcome.
Posted by Pontormo on October 10, 2017, at 7:46:19
In reply to MAOI + stimulant, posted by MightyKondrian on October 9, 2017, at 11:20:24
Which stimulant? Sounds like he's suggesting something he thinks might work, maybe at least he's willing to experiment. But it's hard to comment without knowing what drug you're referring to.
pontormo
Posted by MightyKondrian on October 10, 2017, at 16:09:25
In reply to Re: MAOI + stimulant, posted by Pontormo on October 10, 2017, at 7:46:19
> Which stimulant? Sounds like he's suggesting something he thinks might work, maybe at least he's willing to experiment. But it's hard to comment without knowing what drug you're referring to.
>
> pontormoI know. Sorry for the lack of info. I wish I wrote down its name. All I know is its not methamphetamine, amphetamine sulphate, Dexedrine or methylphenidate. What others are there (not Adderal)?
I will find out Friday and will let you all know.
For now lets assume its simply a psycho-stim, you pick. Or perhaps you choose the stim that you know something about combining with an MAOI. Forget the rest of what I'm taking for now.Mighty
Posted by porkpiehat on October 10, 2017, at 20:50:00
In reply to Re: MAOI + stimulant » Pontormo, posted by MightyKondrian on October 10, 2017, at 16:09:25
> > Which stimulant? Sounds like he's suggesting something he thinks might work, maybe at least he's willing to experiment. But it's hard to comment without knowing what drug you're referring to.
> >
> > pontormo
>
> I know. Sorry for the lack of info. I wish I wrote down its name. All I know is its not methamphetamine, amphetamine sulphate, Dexedrine or methylphenidate. What others are there (not Adderal)?
>
> I will find out Friday and will let you all know.
> For now lets assume its simply a psycho-stim, you pick. Or perhaps you choose the stim that you know something about combining with an MAOI. Forget the rest of what I'm taking for now.
>
> MightyPerhaps he meant provigil/nuvigil? It is a non-stimulant "wakefullness" agent.
Posted by MightyKondrian on October 11, 2017, at 8:16:19
In reply to Re: MAOI + stimulant » MightyKondrian, posted by porkpiehat on October 10, 2017, at 20:50:00
> Perhaps he meant provigil/nuvigil? It is a non-stimulant "wakefullness" agent.No it wasn't Modafinil. Been on it. Built tolerance quickly. Tried Adrafinil & Fladrafinil too. Same outcome though Fladrafinil is much stronger.
Posted by MightyKondrian on October 14, 2017, at 12:51:32
In reply to Re: MAOI + stimulant » porkpiehat, posted by MightyKondrian on October 11, 2017, at 8:16:19
My doc said no,though possibly atamoxetine in the future. I said pass to that coz I already tried it.
I will print out a heap of referenced studies about MAOIs + stims for next time! He did say however he would use a stimulant if I switched to an MAO-A inhibitor.
Anyway for now he gave me Clonidine. He said they found it helps GAD. I'll see what happens...MightyKondrian
Posted by phidippus on October 15, 2017, at 8:37:54
In reply to MAOI + stimulant, posted by MightyKondrian on October 9, 2017, at 11:20:24
If you're getting on a stimulant and are concerned about addiction, I would recommend, hands down, Vyvanse. You literally cabnnot get addicted to it. You can build up a tolerance to any dose, however if you're using a drug to get high tolerances build up quicker.
You won't need to lower your bupropion, unless you get an increase in anxiety. Bupropion raises norepenephrine primarily, not dopamine like Vyvanse would.
Eric
Posted by MightyKondrian on October 15, 2017, at 17:55:27
In reply to Re: MAOI + stimulant, posted by phidippus on October 15, 2017, at 8:37:54
Thanks Eric I'll look into that :)
Posted by porkpiehat on October 23, 2017, at 10:38:52
In reply to Re: MAOI + stimulant » phidippus, posted by MightyKondrian on October 15, 2017, at 17:55:27
Hey buddy I see that you are taking klonopin with your MAOI...There have been some studies saying it causes rapid HR and flushing, hotness.
Do you get these? I have been getting them pretty significantly since switching to Marplan, specifically at night
Posted by Melusine on October 29, 2017, at 5:19:46
In reply to Forget the 'MAOI + stimulant', posted by MightyKondrian on October 14, 2017, at 12:51:32
> My doc said no,though possibly atamoxetine in the future. I said pass to that coz I already tried it.
> I will print out a heap of referenced studies about MAOIs + stims for next time! He did say however he would use a stimulant if I switched to an MAO-A inhibitor.
> Anyway for now he gave me Clonidine. He said they found it helps GAD. I'll see what happens...Clonidine is a quirky drug. It's an alpha2-adrenergic agonist, a complex mechanism which gives it a long and varied list of indications. Besides ADHD some of the most common ones are high blood pressure; Tourette's; alcohol, benzo, opioid, and (of all things) nicotine withdrawal; and anxiety. It's sometimes used as a mild sedative. For people who have both ADHD and GAD (and some other anxiety disorders it doesn't help with panic disorder, though) who find that traditional treatments for each disorder exacerbate symptoms of the other, clonidine can be a godsend; it also helps when used in combination with a stimulant. Good luck with it; I hope it does the trick for you.
-Melusine
Posted by MightyKondrian on October 29, 2017, at 12:20:35
In reply to Re: MAOI + stimulant » MightyKondrian, posted by porkpiehat on October 23, 2017, at 10:38:52
> Hey buddy I see that you are taking klonopin with your MAOI...There have been some studies saying it causes rapid HR and flushing, hotness.
>
> Do you get these? I have been getting them pretty significantly since switching to Marplan, specifically at nightI was on marplan for about 10yrs. Never had any interaction with anything. Max 4mg of clonazepam. Clonies are weird. Never felt an uplifting effect. Not once. I get an uplifting effect from valium chlordiazepoxide temazepam and midazilam tho.
Indeed they are great for SA.
Posted by porkpiehat on November 2, 2017, at 13:46:17
In reply to Re: MAOI + stimulant, posted by MightyKondrian on October 29, 2017, at 12:20:35
> > Hey buddy I see that you are taking klonopin with your MAOI...There have been some studies saying it causes rapid HR and flushing, hotness.
> >
> > Do you get these? I have been getting them pretty significantly since switching to Marplan, specifically at night
>
> I was on marplan for about 10yrs. Never had any interaction with anything. Max 4mg of clonazepam. Clonies are weird. Never felt an uplifting effect. Not once. I get an uplifting effect from valium chlordiazepoxide temazepam and midazilam tho.
> Indeed they are great for SA.
>
> Are you saying these other benzos are better than Klon for SA? What did you take with your Marplan? I'm on my third week and finding the depression relief is good, the Parnate "detachment" has lifted and I'm engaged with family and friends again, but my anxiety and concentration are suffering.I was considering Nortriptyline but clonidine looks kind of interesting too. Or WB which has historically been a terrible add-on for me.
Posted by porkpiehat on November 2, 2017, at 14:01:57
In reply to Forget the 'MAOI + stimulant', posted by MightyKondrian on October 14, 2017, at 12:51:32
> My doc said no,though possibly atamoxetine in the future. I said pass to that coz I already tried it.
> I will print out a heap of referenced studies about MAOIs + stims for next time! He did say however he would use a stimulant if I switched to an MAO-A inhibitor.
> Anyway for now he gave me Clonidine. He said they found it helps GAD. I'll see what happens...
>
> MightyKondrianI'd love to hear about the clonidine when you get a handle on how it behaves...hope it works for you seems like a "magic bullet" possibly
Posted by SLS on November 2, 2017, at 17:49:17
In reply to Re: Forget the 'MAOI + stimulant' » MightyKondrian, posted by porkpiehat on November 2, 2017, at 14:01:57
One caveat:
Clonidine can cause depression, even in people who don't have a mood disorder. It does the exact opposite that Remeron (mirtazapine) does at NE alpha-2 receptors. That's not to say that it won't help you. Abnormal psychobiology can yield paradoxical reactions.
Posted by MightyKondrian on November 3, 2017, at 11:17:33
In reply to Re: Forget the 'MAOI + stimulant' » MightyKondrian, posted by porkpiehat on November 2, 2017, at 14:01:57
Well I don't the clonicidine did much. Felt great at 1st but now actually think it was 50/50 placebo or short lived. As a last resort I might ask add bupropion, mirtazepine or even trazodone. Or to switch to parnate. ĄThen dog knows what. I'm getting fed up
Posted by porkpiehat on November 3, 2017, at 20:11:56
In reply to Re: Forget the 'MAOI + stimulant', posted by MightyKondrian on November 3, 2017, at 11:17:33
> Well I don't the clonicidine did much. Felt great at 1st but now actually think it was 50/50 placebo or short lived. As a last resort I might ask add bupropion, mirtazepine or even trazodone. Or to switch to parnate. ĄThen dog knows what. I'm getting fed up
I know that feeling well! what would you be trying to accomplish with the trazodone?
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.