Posted by english on September 29, 2009, at 19:16:19
In reply to Re: depression/adhd-pi options?, posted by desolationrower on September 29, 2009, at 17:55:59
hey,
thanks for the responses everyone. i've looked up everything suggested so far. what i forgot to mention is that i've narrowed my critera down a little further - i don't want to take anything with any marked anticholinergic effects whatsoever. i find that medications/substances which do this tend to be "dumb drugs", cause memory/focus problems, etc.
i've also responded very well to substances which do the opposite, such as piracetam, alpha-gpc, and other choline sources, finding they generally improve my focus, memory, and energy levels if not causing too much agitation. they also seem to become depressive after longterm use, probably due to 5HT or DA antagonism.
i'm really not willing to tolerate any medications which reduce cognition/clarity/memory. i'm starting college soon, and generally care a lot about retaining information that i've read or been exposed to. i'm also already really aloof and spacey and stuff that does this doesn't really seem to help in that department.
this cancels out the TCAs and the SSRIs. i really like very little of what i've read about the SSRIs, their efficacy seeming suspect and me not particularly liking how they cause dopamine depletion - that seems contridicted for adhd.
i'm considering selegiline, either with piracetam/alpha-gpc or in conjunction with an SSRI. i may want to add piracetam with the SSRI/selegiline combination as it increases acetlycholine receptor density which would cancel out the anticholinergic effects- i don't know if that would be contradicted or not. i doubt there has been any research, either.
i really like what i've read about nardil and parnate, as well, and feel like the potential hazards are way overplayed. it wouldn't be that big of a deal for me to emiminate tyramine containing foods or whatever. i've already dealt with a soy free, dairy free, preservative free, additive free, gluten free, meat free diet for over a year in the past (it didn't do a whole lot of good, btw), so i'm pretty sure i can handle it.
i do get the impression that the drugs tend to be used in very 'serious' cases, and i'm not sure if i qualify as this. i think my depression is largely nonendogenous, that is, i have a lot of problems which i think about a lot and which are very pervasive and mostly seem like they lack solutions or 'ways out', kind of being double-binds, paradoxes, etc. then again, my mood wasn't particularly great before any of these problems developed.
let me say a little more about my affect: it's frequently very flat. part of this, i think, is my personality (whether innate or part of some longer causal chain, whatever). my depression doesn't have a 'deep' quality too it, i wouldn't really even call it sadness. i really can't even feel sad most of the time. it's more just like aching. it's a lot of ego-ache, which is painful, and obviously very shallow, but not really "sad". it's mostly just like i'm empty. i don't really have anything which i sincerely care about. i used to be highly apathetic, and i feel like the only reason i'm not quite as apathetic anymore is because i feel so much need to overcompensate for all of damage i've done during the time that i was apathetic. i can't cry at all, only very rarely. most people see me as very stoic and unemotional, some have even jokingly referenced/made fun of the "thousand yard stare" that i seem to have. other times i can be more animated and engaging, depending on my mood.
it feels like i'm viewing the word though a shade of grey, not blue.
this was again really oversimplified but hopefully it paints a somewhat more clear picture of what kind of treatment i might need. my view of it is that i probably don't have enough dopamine. i need something stimulating, as well. i'm frequently downing coffee and chain smoking and stuff and never really seem to feel awake enough, i'm fairly lethargic most of the time.
so then about nardil/parnate: would i be overshooting was i to aim for getting one of these prescribed? what would happen if a moderately depressed person took one? would it be overkill? i'm attracted to nardil and parnate because neither of them seem like they have numbing qualities to them. they seem 'activating'. another thing is that i get the impression that they're not prone to decreasing your creativity like the SSRIs as known for. they also don't have any negative effects on cognition and seem stimulating, not numbing. is it possible any p-doc would even think of prescribing me one of these, given my limited medication history?
also, aside from the potential dietary interactions, is there also potential for particularly brutal side effects? from what i've read on here, it doesn't even seem like most people experience many, or that they'll go away in time. weight gain would actually be a plus for me, as i'm 6'4 and 155 and eat huge amounts of food and never seem to be able to gain any weight. that was another problem with the ADD meds. so, yeah: is it really that big of a deal supposing you follow the diet?
what do you guys think selegiline might do for me? it's available online for reasonable prices. i'm thinking 5 mg/day, so just selective mao-b inhibition.
i'm also working on finding a p-doc and setting up an appointment, so i'll probably hold on the l-deprenyl until i talk to him first. if i don't like the options he gives me i'll probably give selegiline a shot, or maybe combine an SSRI with selegiline.
poster:english
thread:918786
URL: http://www.dr-bob.org/babble/20090921/msgs/919016.html