Posted by azalea on October 9, 2008, at 15:51:04
In reply to azalea: Antipsychotics with stimulants??, posted by qbsbrown on October 8, 2008, at 18:35:55
This gets messy. Here's my understanding (which may be incomplete). Atypical antipsychotics such as Seroquel and Zyprexa block dopamine receptors POST-synaptically. Stimulants like Dexedrine bind to PRE-synaptic dopamine transporters inhibiting reuptake and promoting dopamine release. So it seems like an antipsychotic and a stimulant would cancel out each other. The stimulant will increase dopamine in the synapse but the antipsychotic will prevent this dopamine from binding to the post-synaptic neuron.
With regard to Zyprexa-induced weight gain, I think the Zydis form will cause the same weight gain. Currently, beta-histine is being studied as a potential agent to prevent Zyprexa-induced weight gain. Here's the clinical trial if you're interested in reading more . . .
http://clinicaltrials.gov/ct2/show?cond=%22Body+Weight%22&rank=5Perhaps the decision is which mood stabilizer to use. Lithium and Lamictal are out; Zyprexa worked but caused weight gain; Depakote has cognitive side effects at therapeutic doses for you. So Trileptal or Seroquel seem like good options to consider.
> I would generally assume that the antipsychotic would cancel out the stimulant. But I read that Seroquel works on a different dopamine receptor than Dexedrine.
>
> Zyprexa worked well for me, minus the 40 lbs of weight gain. I wonder if the newer Zydis you don't gain as much.
>
> I did well on Zyprexa+Celexa+Provigil combination. I would imagine that I would only do better with substituting dexedrine for provigil. I experience much more concentration, focus, well being, and confidence on dexedrine.
>
> Thanks for the advice.
>
> Regards,
>
> Brian
poster:azalea
thread:854600
URL: http://www.dr-bob.org/babble/20081006/msgs/856621.html