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Re: @Vincent » Medline

Posted by kingcolon on January 27, 2009, at 23:16:33

In reply to @Vincent, posted by Medline on January 27, 2009, at 18:35:51

I have MDD and SAD. I'm impressed at your cocktail and knowledge of the mechanisms of action of all the drugs. Your reasoning makes sense, but I wonder about whether small doses in combination will really result in additive effects--eg, selegiline in low doses probably isn't very effective for depression and by inference, SAD, and meclobimide is also weak for SAD, so the combo seems to me might be weak.

That said, I myself use polypharmacy. I'm on:
buprenorphine, Zoloft, Wellbutrin, Provigil, Lamictal, and now I'm adding Lyrica, 600mg/d.
The Lyrica seems to be producing a pro=social effect, mild but definite. Buprenorphine has essentially eliminated my depression, given me a sense of well-being, and I think it has made me more assertive. I'm taking the Wellbutrin for its' noradrenergic effects, and Zoloft because I became irritable on buprenorphine. The PRovigil helps with fatigue. Lamictal helped with my depression initially, but I'm not sure it's doing anything beneficial in the combo now. I'm wondering if antagonizing glutamate (which it does) might decrease dopamine release caused by the buprenorphine and Wellbutrin. I can't make sense of NMDA/glutamate-dopamine interactions from reading the literature.

I used to take GBL and became addicted to it with severe withdrawal. I also had other addiction problems with sedatives, but actually not that badly with opioids (I did abuse them intermittently however in binges). I'm taking the buprenorphine for it's antidepressant effects. I've been in treatment for addiction for 9 years and abstinent throughout thanks to the help I"ve gotten from my "nonaddictive" cocktail. Seriously though, relief of my depression, and to a lesser extent, SAD, is the reason I've beaten the addiction. I truly believe that new agents for addiction treatment will often best be those that mimic the addictive substance's mood altering effects, but without the euphoria or dependency-producing actions. Buprenorphine is one of those, Provigil another, and Lyrica has mood effects not dissimilar to benzodiazepines. None of these drugs has significant addictive potential. I actually much prefer just feeling good to feeling high.

Good luck in your search to beat SAD. If you have any comments or suggestions, feel free to respond.


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poster:kingcolon thread:876329
URL: http://www.dr-bob.org/babble/20090104/msgs/876683.html