Posted by jrbecker76 on January 22, 2013, at 13:56:37
In reply to Does lithium reduce motivation and activity level?, posted by SLS on January 21, 2013, at 13:30:53
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> This is what I am currently taking:
>
> Parnate 80 mg/day
> nortriptyline 150 mg/day
> Lamictal 200 mg/day
> lithium 300 mg/day
> Abilify 10 mg/day
> prazosin 15 mg/day
> minocycline 200 mg/day
>Hi Scott,
long time since we last connected. I have more of a question than a comment. I can only relate to my experience with Minocycline, Lamictal, and Abilify. Minocycline was definitely adding to a sense of apathy and malaise for me. Abilify was tricky. I had periods of apathy at times as well as streaks of feeling more motivated. I would err on the side of it being more apathy-inducing in the end for me though.
My specific question relates more to your experience with prazosin. Given that it's an alpha-1 blocker, I'm assuming you're using it as anxiolytic. Alpha-1 blockers have had some great utility with panic and PTSD sufferers, however, there are drawbacks. As you know, alpha-1 blockade can produce tiredness, hypotension, and sometimes mood issues. There is some evidence that alpha-1 blockade reduces motivation/drive (pre-clinically at least). More anecdotally, there are reports that patients taking alpha-1 blockers for certain indications (e.g, Benign prostatic hyperplasia (BPH)) have that indicated feeling less motivation and drive in some instances.
I have taken a low dose of Nefazodone (generic Serzone) for years. It has wonderful effects as an anxiolytic, hypnotic and other properties that offset the SEs that come with taking Citalopram. The downside of Nefazodone (and Trazodone for that matter) is the mCPP metabolite that can have anxiogenic and other vexing side effects (this might include detrimental effects on motivation as well). But most of the time, the parent drug's effects override mCPP's deleterious effects. The other push-pull effect of Nefazodone is that besides it's main effect on 5-HT2 antagonisn (as well as mild SSRI and 5-HT1A modulation) is a lesser role as a alpha-1 blocker.
I'm convinced that the alpha-1 blockade adds to its effects as an anxiolytic and hypnotic. However, I think the minor trade-off might be that it could possibly add to a mild impact on drive and motivation, but certainly this mechanism of action as an "apathy-inducer" is not as blunting as serotonergic drugs. As an aside, drugs such as Provigil have strong alpha-1 agonism.
Can you describe your experience with Prazosin and what you see as the cost-benefit analysis in taking it?
Thanks,
JB
poster:jrbecker76
thread:1035977
URL: http://www.dr-bob.org/babble/20130112/msgs/1036099.html