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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Mischief on August 7, 2002, at 0:02:01
Can someone tell me what ad's are dopamine ones as it seems that all the ad's I have been on are the other to chemical and they havn't worked so I was just wondering how a dopamine one might go.
Thanks.
Posted by BekkaH on August 7, 2002, at 0:35:10
In reply to DOPAMINE-AD's, posted by Mischief on August 7, 2002, at 0:02:01
Wellbutrin, which you said you tried, is supposed to have some slight effect on dopamine, but I think it affects norepinephrine much more.
Effexor, at very high doses, supposedly blocks the reuptake of dopamine, and at the lower doses it acts as a serotonin reuptake inhibitor, I believe.
Parnate, a monoamine oxidase inhibitor (MAOI), is one of the most dopaminergic medicines available. If you take an MAOI, you have to be careful not to eat aged or fermented foods, like cheese,etc. Another dopaminergic MAOI is Eldepryl/Selegiline.
Then, there are the psychostimulants, like dexedrine (dextroamphetamine), Adderall (a mixture of amphetamine salts) and Ritalin/Concerta (methylphenidate). Sometimes, in severe, difficult-to-treat depressions, doctors will use stimulants alone, but stimulants are usually more effective over the long term when they are used to "augment" another antidepressant.
In recent years, some doctors are prescribing dopamine agonists, like Mirapex (Pramipexole) to augment other antidepressants. Dopamine agonists like Mirapex are actually used for the treatment of Parkinson's disease, but they are also helpful in some antidepressant combinations.
How is your psychopharmacologist? Is he/she creative and willing to try out some medication combinations? It takes a certain amount of imagination, creativity, time and patience for a doctor to work closely with you to come up with a combo that works for you. Some doctors are too conservative or too scared to try augmentation with psychostimulants. Perhaps some of those meds you've tried are not lost causes. If you could find one that could be combined with something else, like a dopamine agonist or a psychostimulant, perhaps you'd feel better.
There are some other possibilities for antidepressant augmentation that do NOT involve the use of meds that affect dopamine. For example, many patients here have been helped by augmenting their antidepressants with lithium, lamictal/lamotrigine, topamax, thyroid supplementation, among others. Lamictal (lamotrigine) appears to be one of the best meds for antidepressant augmentation; however, the dose must be raised VERY gradually, over many weeks, to avoid some rare, but dangerous, side effects.
Perhaps you can discuss some medication combinations and augmentation strategies with your pdoc on Thursday. I hope your appointment goes well!
Posted by Mischief on August 7, 2002, at 0:35:33
In reply to DOPAMINE-AD's, posted by Mischief on August 7, 2002, at 0:02:01
> Can someone tell me what ad's are dopamine ones as it seems that all the ad's I have been on are the other to chemical and they havn't worked so I was just wondering how a dopamine one might go.
>
> Thanks.Could you also tell me the side-effects from these drugs.
Thanks.
Posted by BekkaH on August 7, 2002, at 0:44:09
In reply to Re: DOPAMINE-AD's, posted by Mischief on August 7, 2002, at 0:35:33
What time is it in Australia? How many hours difference between New York and Australia? I guess you're on the other side of the International Dateline, aren't you? So, it's already Thursday where you are, or am I confused?
I guess this belongs on Psycho-Social Babble, so I won't write too much more about time zones on PB.
Posted by Mischief on August 7, 2002, at 0:53:22
In reply to By the way . . . , posted by BekkaH on August 7, 2002, at 0:44:09
It's 4p.m Wednesday I think we are 16hrs in front of you.
Posted by turalizz on August 7, 2002, at 6:09:27
In reply to DOPAMINE-AD's, posted by Mischief on August 7, 2002, at 0:02:01
> Can someone tell me what ad's are dopamine ones as it seems that all the ad's I have been on are the other to chemical and they havn't worked so I was just wondering how a dopamine one might go.
>
> Thanks.You can try selegiline + phenylalanine or selegiline + 5-HTP
http://smart-drugs.com/Ward-Dean-deprenyl.htm
Posted by BekkaH on August 8, 2002, at 0:28:47
In reply to DOPAMINE-AD's, posted by Mischief on August 7, 2002, at 0:02:01
Hi Mischief,
Have you tried physical exercise like walking, swimming or some other regular physical activity that you enjoy? Physical exercise, by itself, may not get rid of severe depression, but it will certainly help and may even serve to augment the medications you are on.
When you are feeling awful, I know that the mere suggestion of exercise must seem like a cruel joke, but once you establish a routine, it really does help.
Bekka
Posted by Mischief on August 8, 2002, at 2:33:35
In reply to Question for Mischief, posted by BekkaH on August 8, 2002, at 0:28:47
At the moment I can't even walk six steps without sitting down. I have been in this severe depression for nearly two years this time. I saw Pdoc today and he wants me to have more ECT but I am not ready to do that (not yet anyway). He has changed my medication to Aurorix for two weeks until I get the reboxetine out of my system and start on a diet so he is then going to change it to Parnate. What do you think?
Thanks.
Posted by Iago Camboa on August 8, 2002, at 3:35:36
In reply to Re: DOPAMINE-AD's -Mischief, posted by BekkaH on August 7, 2002, at 0:35:10
Hi Bekka (and anyone),
Please allow me to kindly disagree with your 'classification' of Effexor (at lower doses!!??) as a serotonin reuptake inhibitor (i.e. another SSDD SSRI, to put things your very way...). As a matter of fact, both at lower & higher doses, both venlafaxine (= Effexor) and its metabolite O-desmethylvenlafaxine are POTENT inhibitors of neuronal serotonine AND NOREPINEPHRINE reuptake and weak inhibitors of dopamine reuptake...
I tried lately Prozac (a true SSRI) and then Effexor and they were to me like night and day. I tried both of them (in succession) to (partially at first) substitute clomipramine/Anafranil, not because the latter was pooping out (it worked just fine) but because I wanted to find other (alternative) effective ADs (to my system, of course...)[ My whole combo was 112.5mg/day clomipramine, 2mg/day Xanax and 300mg/day adrafinil ]
Famous Prozac (that 'stupor mundi'?) at 20mg/day felt to me like 'fog' (or 'noise') added into my brain: I had no single positive effect on that s**t and gave it up after 12 days (no s.e., no stimulation, no sedation, no withdrawal, only fog & fog...). Was it my fault because I had clomipramine and Xanax in my system? Were 12 days of fog just too short an interval for the benefits to kick in? Who knows? To speak the whole truth I should also tell I always have caffeine in my system too, but for me caffein and Xanax don't really matter anything: I just don't feel them anymore long since... No need either to augment or to diminish those two, though I feel they both are doing a positive role in the background and don't find any use or desire in abolishing (or lowering) them... Also adrafinil was not important at this time...
As for Effexor, I did feel its effects in less than two hours after I swallowed 37.5mg of it one beautiful day at 4 pm (a most welcome mild stimulation, a very gentle 'high', no jitters at all and no agitation/anxiety, but a very calm and 'focused' unforgettable positive effect...) Only negative side effect: I could not sleep at all that night (I had at hand almost two full boxes of Ambien/Stilnox (more than 50 pills) but that night I decided to take no hypnotic at all nor any extra amount of Xanax just to assert to myself WHO was in charge... (LOL)).Sorry to have disturbed (your) normal flow of ideas but I thought it could be useful for someone to hear an 'unconventional' way of speaking of two well-known and (for me) so very different ADs: Prozac, a SSRI, and Effexor, a SNRI. (Please forgive me but I just couldn't stand it to see Prozac in the same class of Effexor!!). Thank you for your kind attention,
Iago
> Wellbutrin, which you said you tried, is supposed to have some slight effect on dopamine, but I think it affects norepinephrine much more.
>
> Effexor, at very high doses, supposedly blocks the reuptake of dopamine, and at the lower doses it acts as a serotonin reuptake inhibitor, I believe.
>
> Parnate, a monoamine oxidase inhibitor (MAOI), is one of the most dopaminergic medicines available. If you take an MAOI, you have to be careful not to eat aged or fermented foods, like cheese,etc. Another dopaminergic MAOI is Eldepryl/Selegiline.
>
> Then, there are the psychostimulants, like dexedrine (dextroamphetamine), Adderall (a mixture of amphetamine salts) and Ritalin/Concerta (methylphenidate). Sometimes, in severe, difficult-to-treat depressions, doctors will use stimulants alone, but stimulants are usually more effective over the long term when they are used to "augment" another antidepressant.
>
> In recent years, some doctors are prescribing dopamine agonists, like Mirapex (Pramipexole) to augment other antidepressants. Dopamine agonists like Mirapex are actually used for the treatment of Parkinson's disease, but they are also helpful in some antidepressant combinations.
>
> How is your psychopharmacologist? Is he/she creative and willing to try out some medication combinations? It takes a certain amount of imagination, creativity, time and patience for a doctor to work closely with you to come up with a combo that works for you. Some doctors are too conservative or too scared to try augmentation with psychostimulants. Perhaps some of those meds you've tried are not lost causes. If you could find one that could be combined with something else, like a dopamine agonist or a psychostimulant, perhaps you'd feel better.
>
> There are some other possibilities for antidepressant augmentation that do NOT involve the use of meds that affect dopamine. For example, many patients here have been helped by augmenting their antidepressants with lithium, lamictal/lamotrigine, topamax, thyroid supplementation, among others. Lamictal (lamotrigine) appears to be one of the best meds for antidepressant augmentation; however, the dose must be raised VERY gradually, over many weeks, to avoid some rare, but dangerous, side effects.
>
> Perhaps you can discuss some medication combinations and augmentation strategies with your pdoc on Thursday. I hope your appointment goes well!
Posted by BekkaH on August 8, 2002, at 18:43:57
In reply to Re: DOPAMINE-AD's -Mischief » BekkaH, posted by Iago Camboa on August 8, 2002, at 3:35:36
Hi Iago,
Thank you for the clarification. I tried Effexor a long time ago and had a bad experience with it, so perhaps I blocked from my memory the information I read it about back then.
By the way, I like your name -- Iago.
Bekka
Posted by Iago Camboa on August 9, 2002, at 3:54:28
In reply to SNRI vs SSRI - Iago, posted by BekkaH on August 8, 2002, at 18:43:57
This is the end of the thread.
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