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Adderall, naltrexone, etc. » paulk

Posted by Elizabeth on May 31, 2001, at 20:43:56

In reply to Re: Codeine for Depression Treatment » Elizabeth, posted by paulk on May 30, 2001, at 20:30:49

> >Adderal? That's a once-daily stimulant...why would there be a need for a slow-release formulation?
> No, it’s not – usually used 2 – 3 times a day – a mixture of different half-life amphetamines – the idea is to have a tapering effect – (which makes no sense if it is used in multiple dosages???).

According to the PDR (and common practise), Adderall (formerly Obetrol) can/should be used once or twice daily. The mixture of amphetamine salts (it's equal parts d-amphetamine saccharate, d,l-amphetamine aspartate, d-amphetamine sulfate, and d,l-amphetamine sulfate) makes it longer-acting than d-amphetamine or methylphenidate. As a result, it doesn't need to be taken as often, and the mood swings that sometimes accompany psychostimulant treatment are milder or absent. For unknown reasons, Adderall sometimes works better than plain Dexedrine.

> >Demerol has a toxic metabolite (normeperidine) that's very proconvulsant. ("Excitatory" just means that it increases neuronal firing, BTW.)
> It is a very big danger to anyone taking an MAOI. Single does have been fatal.

True (there was one very famous case of this in New York). There have been serious interactions with SSRIs and Effexor too. As a result morphine is the preferred analgesic for patients on ADs.

> >It's variable, obviously. I would expect it to be neutral at best, tho'. It came as a huge surprise to hear that some people got an AD effect from it. (To my knowledge, it only works in combination with an AD, but even that was something I never would have guessed.)
> I can only guess at the reasoning for it being a possible AD induced sex dysfunction remedy – perhaps some people get an endorphin response that could interfere with sex – makes some sense – orgasm produces lots of endorphin.

Naltrexone is an opioid *antagonist*. It blocks the effects of endorphins. This can be helpful for people with certain types of impulse-control problems (notably, self-mutilation) because it blocks stress-induced analgesia. Why it would act as an AD, though, is a mystery to me.

People who've added naltrexone to ADs say that it enhances the antidepressant effects, or brings them back following a loss of effect. I've never heard of anyone using it to help with SSRI-induced sexual dysfunction. That would be even more counterintuitive than using it as an AD. < g >





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