![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 38 to 62 of 101. Go back in thread:
Posted by LAURA777 on February 6, 2003, at 7:33:39
In reply to Re: Mirapex/Selegiline/Parnate » jumpy, posted by not exactly on February 6, 2003, at 3:50:14
hi bob , can you read this post , i do not know if you saw it .. also my question to you is , did the stimulants like ritalin and dexadrine make you feel like you were coming down from cocaine , what i mean to say is was it similar to the uncomfortable feelings you get with cocaine ?? let me know , thanks laura
here is the post too
http://www.dr-bob.org/babble/20030204/msgs/139623.html
Posted by not exactly on February 6, 2003, at 16:32:20
In reply to Re: Mirapex/Selegiline/Parnate » not exactly, posted by LAURA777 on February 6, 2003, at 7:33:39
Laura,
Yes, I saw your other post about anhedonia & dopamine [http://www.dr-bob.org/babble/20030204/msgs/139623.html] and I've been thinking about what you said - more on that topic later.
> did the stimulants like ritalin and dexadrine make you feel like you were coming down from cocaine , what i mean to say is was it similar to the uncomfortable feelings you get with cocaine ??
I have generally responded quite well to Ritalin and amphetamines. But I'm very sensitive to them, and the optimal dose for me is extremely small - 1 or 2 mg (far less than the smallest pill made), once or twice a day. At this effective level, they give me mild mood-boosting effects, and help dramatically with motivation, focus, and, yes, anhedonia (which, after thinking about your previous post, I'm coming to believe may well be the root cause of the mood, motivation, and focus problems). Side effects are virtually absent. Anxiety is not worsened, and sometimes it's reduced. The let-down is gradual & gentle, with no significant rebound effect. If I take my daily dose(s) early in the day, by bedtime I feel a bit drowsy (in a normal, healthy way) and sleep well. I set the alarm 1/2 hr. early and keep the morning dose ready by the bedside. When the alarm goes off, I'm a zombie (but getting up in the morning has always been like this, with or without stimulants), so I take my stim dose and go back to sleep. 30 minutes later I awake refreshed and ready to face the day. Used in this very conservative style, I find the benefits to be sustainable for months with no significant tolerance or "poop-out" effect. By themselves, stimulants are no substitute for an antidepressant, but they are a valuable adjunct.
However, if I take the kind of dose that most folks do - 5, 10, or more mg at a time - it makes me manic, anxious, and "hyper" (almost as unpleasant as cocaine, but discernably different), and afterwards I crash like a rock. Repetions of this roller-coaster ride cause tolerance to build rapidly.
Of course, YMMV, but I wonder if the reason many folks say they can't tolerate stimulants (including anhedonic low-dopamine folks who theoretically should benefit from them) is because they are actually taking far too much.
BTW, MAOIs are very different from stimulants in terms of benefits, side effects, duration, and underlying mechanism. My exposure to MAOIs is limited to selegiline, both at low oral doses, when it inhibits only MAO-B, and as a patch, when it acts like a general MAOI AD. Selegiline helped, but my subjective experience was not at all like with the stims.
Hope this helps. I'd be happy to discuss any aspect of these topics in more depth if you (or anyone else) is interested.
- Bob
Posted by LAURA777 on February 6, 2003, at 19:21:52
In reply to Re: stimulants / anhedonia » LAURA777, posted by not exactly on February 6, 2003, at 16:32:20
Hey bob , i found out incredible things today ..first i have high norepinephrine . this is know because my metabolism is very fast . i remain skinny although i eat .. i have energy but the anhedonia makes me tired because of the boredom and the fact that there is no temperance with the pleasant emotions .. initially i was put on prozac because of my excess energy .. i am not add nor am i adhd .. it is just in my natural state i am revved up ..go go go gota go ..The ssris have done a good job with this , it has put my noreprinephrine in check .. but i am still very sensitive to stimulants , i can not take cold meds with psedoephedrine , i feel horrid both emotional like the coke thing smaller scale and physcally .. Provigil is way too much for me .. it gives me energy , but nervous useless energy.. physically i do not feel well either , and this is due to the norepinephrine i have already .. this neurotransmitter is responsible for energy , metabolisim .. people who have fast metabolisim have lots of norepinephrine .. another proof of this is at the dental office when they give you novicaine they add what is called epinephrine .. it prolongs the novicaine effect , when i get this my heart pounds in my chest i shake and i get halos in my vision similar to migraine auras ...it is a scary thing ... my mother is also reactive this way to epinephrine ... these substances are all related .. i looked it up .. ephedrine and psuedoehedrine act of norepinephrine in our brains ,, ehedrine being a natural substance in herbs can cause very bad effects in a normal person .. it speeds up heart rate because it acctivates norepinephrine as does psuedoephdrine ..epinephrine and norepi act in conjuction , that is why you hear on emergency room shows when someones heart stops they say give me a vial of epi .... i have never coralated this before in my life with such clarity as i surfed the net .. that is why when they gave me effexor i had a bad reaction same goes for the wellbutrin .... none of these meds touch the dopamine , and as far as effecting dopamine levels inadvertantly it is not enough , i do not think alot of people have a dopamine deficit , hence the 70 percent response to ssri and snris when treating depression soley .. here is an interesting read the link is below ..
http://www.acnp.org/g4/GN401000093/CH.html
this is a good read because in mania dopamine is at a high in the brain . same with schiz when they are in the wild end .. antipsychotics reverse this .. so much so with schiz that they get severe apathy and anhedonia .. what makes me laugh is that i read a study involving depressives and schiz depressives .. the depressives measured very low on the serotonin scale . they measure this by some by product produced from the sero .. any way the measured the schiz depressives and the had high levels of sero .. that thought this strange .. i had to laugh .. how could they not see !! if you take away dopamine because of adverse schiz states serotonin is going to increase .. but lack of dopamine causes this negitive state of schiz , i guess that is why afiliby is a better treatment for them ...the upshot of all this is that dopamine is essential and not to be discarded for study as was previously thought ... noro and sero are not the end all for the depressive . they have to develop a good dopaminergic that targets the area of the mesolimbic , and i also think they need to investigate the opiates and created better drugs like buprenorphine .. i mean we use snake venom for anti venom .. i know if they put some time into it they could do this , it is just that profits are important and when you are talking opiate there is a massive amount of buearocratical bullshit .. sorry about the spelling .. read alot but still can't spell ..
so what do you think bob ??? if you would like to read further on the net . put in a search with nucleus accumbens dopamine .. mesolimbic system dopamine .. give me your thoughts .. thanks much ..laura
Posted by LAURA777 on February 6, 2003, at 22:29:54
In reply to Re: stimulants / anhedonia » not exactly, posted by LAURA777 on February 6, 2003, at 19:21:52
hey bob i made an error in the above post about antipsycohtic meds , i still am learning , there is so so much to learn .. anyway anyone out there .. please educate me when i post wrong info .. i would appreciate it , thanks laura
Posted by jumpy on February 6, 2003, at 23:18:34
In reply to Re: Mirapex/Selegiline/Parnate » jumpy, posted by not exactly on February 6, 2003, at 3:50:14
> I couldn't get it right after the trial (about 7 years ago) because it hadn't been approved yet. I *was* able to get it a couple of years later. I explained all this in a previous post [http://www.dr-bob.org/babble/20030204/msgs/139600.html].
Sorry, I didn't have time to read every post
> I did. For about a year. But it never worked as well. When selegiline is taken orally, the metabolic pathways are somewhat different, and hence the plasma levels of active metabolites end up at different ratios. So the overall effect is not exactly the same. Also, you need to take such a large dose orally that the MAOI diet is mandatory (which I found to be a big disadvantage). Cheese-safe levels of oral selegiline aren't effective as an AD.
True, people end up takeing anywhere from 20 to 50 mg of selegiline in the oral preparation and one does have to adhere to the diet. I haven't heard of people having difficulties with the switch from the patch to the pill and problems with the metabolite "ratios". Sorry to hear you were one of the few with this reaction.
> Parnate is near the top of my "to be tried" list, but I'm not looking forward to the MAOI diet restrictions. How can I live without pepperoni pizza? :-(
Actually, the diet is pretty healthy and easy to follow. No sausage, cheese, certain wines and beers ... they all add to a slimmer waistline and healthier heart. I would for go 1,000,000 pepperoni pizzas *and* the pitcher of beer that follows to find some relief from my depression. But if pizza mean that much to you, I guess your stuck. :-(
Good Luck
Keep us posted
Jumpy
Posted by missinglynxx on February 6, 2003, at 23:43:15
In reply to bob not exactly made an error in above post, posted by LAURA777 on February 6, 2003, at 22:29:54
be fantastic Good Luck with it.. WHat exactly did they give you Laura?
Posted by LAURA777 on February 7, 2003, at 1:15:53
In reply to Crosses Fingers that Lauras new medication will , posted by missinglynxx on February 6, 2003, at 23:43:15
hey mike they gave me provigil and it is a no no for me .. very bad , i can not take stimulants . i explained it in this post ..
http://www.dr-bob.org/babble/20030204/msgs/139866.html
be well and you be happy too!!!
Posted by not exactly on February 7, 2003, at 16:30:40
In reply to Re: Mirapex/Selegiline/Parnate » not exactly, posted by jumpy on February 6, 2003, at 23:18:34
> I haven't heard of people having difficulties with the switch from the patch to the pill and problems with the metabolite "ratios". Sorry to hear you were one of the few with this reaction.
Orally-administered selegiline results in significant exposure to numerous active metabolites, including l-amphetamine and l-methamphetamine. At the dosages required to induce robust MAO inhibition (MAO-A as well as B), these metabolites can dramatically alter the side effects and overall experience of selegiline, especially for those individuals (such as myself) who are highly sensitive to sympathomimetics. The selegiline patch avoids most of these problems by circumventing first-pass gut metabolism.
see:
http://www.nimh.nih.gov/ncdeu/abstracts2001/ncdeu2011.cfm
http://www.parkinson.org/med25.htm> Actually, the diet is pretty healthy and easy to follow. No sausage, cheese, certain wines and beers ... they all add to a slimmer waistline and healthier heart.
The MAOI diet might be easy for some folks, but for me it would mean a radical change in lifestyle. I live on cheeseburgers, chocolate candy, and other junk food. I eat in ethnic restaurants where the menu items don't list all the ingredients and the servers don't speak much English. I go to potluck dinner parties. Cheese, soy sauce, aged meats, and other tasty tyramine tidbits could be lurking anywhere.
Before you try to tell me that I'd be much better off with a different diet, let me point out that I'm slim, fit, and quite healthy. I have low cholesterol and normal blood pressure. Even though I'm 56, most people think I'm in my 30's, especially if they've seen me dance non-stop for hours or trot up a steep mountain trail. I'm in fine physical shape despite (or perhaps because of) my "terrible" diet. My pcp is impressed - claims I have "good genes".
> if pizza mean that much to you, I guess your stuck. :-(
My comment about "How can I live without pepperoni pizza?" was mostly meant as a joke, but it is true that I really love pepperoni pizza - it's one of the few joys in my pleasure-starved anhedonic existence. Probably more than half of my favorite foods contain dangerous amounts of tyrosine. But my hesitancy to try MAOI meds is not because I'm reluctant to deprive myself, it's because I'm concerned about the irreversible side effect known as "accidental death".
I'm sure I'll try a "real" MAOI like Parnate eventually. My intellectual curiosity and my need to "leave no stone unturned" will ultimately be stronger motivating factors than my quest for better mental health (which is too often impeded by my pervasive "why bother" attitude). But it will be a daring and scary step.
- Bob
Posted by missinglynxx on February 7, 2003, at 17:36:27
In reply to Re: Mirapex/Selegiline/Parnate » jumpy, posted by not exactly on February 7, 2003, at 16:30:40
Bob.. would you be unable to Eat Szechwan FOOD on the Parnate, that would Really SUCK... ( I cant live with Szechwan)Cant you drink White wine tho
And cant you eat NON aged,,,Monterry Jack type cheese for those cravings you get. or Mozarella Cheese? Just curious.. GOOD Luck
How have you done on Nortriptyline?
Posted by LAURA777 on February 7, 2003, at 19:11:35
In reply to Re: Mirapex/Selegiline/Parnate » jumpy, posted by not exactly on February 7, 2003, at 16:30:40
Hi Bob , it sounds like you have a fast metabolism too ,, are you also sensitive to ephedrine products in cold meds ?? i do not know if you read my post but the provigil sent me flying .. yuk , the doc gave me 200 mg. i took one at 10.00 am and was up to 3.00 am , and the day before i took one at 8.00 am and stayed up till 3.00 am . i felt miserable physically and emotionally , nervous energy .. needless to say i will not take anymore .. also i could not eat at all .
i read somewhere that tyrosine converts to dopa then dopa converts to dopamine ,then dopamine to norepinephrine then to epinephrine . i have also read that if you have a fast metabolisim that you have plenty norepinephrine .. if that is the case . where is my dopamine ???
when you go to the dentist does epinephrine bother you in the novicaine , do you get a reaction ..
i do hope that i can find a solution because i am miserable .Bob what is responsible for motivation and interest , i get conflicting reports when i read , some say it is norepinephrine some say dopamine .
Also do you think the mesolimbic system is responsible for anhedonia ?? do you think a deficiency in opiods is responsible too ..??
What do people do ?? i can't bear to think i have to be like this till i die ..
bupenorphrine is something i would like to try . because of the positive feelings i had with percocet and vicodin ..
i think my energy level is fine , it is the boredom that sends me to sleep , and it is hard to wake in the mornings cause i know what is ahead of me . more boredom .. and the endless push .. and because i have to push i get tired.. this routine would sap anyones energy .
i see alot of links that link cocaine abuse to anhedonia . and i also see also of links about drug/alcohol abuse in general causing anhedonia , and they also say it is prexisting genetics .
i have also read that constant stress raises our level of norepinephrine fight or flight and if we get enough stress for too long are endorphins become no longer able to work .. hence blunted feelings like post tramatic stress disorder ..
do you think having constant high levels of norepinephrine all through the years of your life cause this also ??? please let me hear what you have to say on many of my questions , i do thank you for you time ,laura
Posted by LAURA777 on February 7, 2003, at 19:48:30
In reply to Re: Mirapex/Selegiline/Parnate » jumpy, posted by not exactly on February 7, 2003, at 16:30:40
do you think that all the sensitivity to the stimulants is because of lots of norepinephrine ? is that what highly sensitive to sympathomimetics means ?? being senstive to stimulants ,, because if that is what it means then i am this also with out a doubt .. please let me know , laura
Posted by not exactly on February 7, 2003, at 20:00:49
In reply to Re: Mirapex/Selegiline/Parnate » not exactly, posted by missinglynxx on February 7, 2003, at 17:36:27
> would you be unable to Eat Szechwan FOOD on the Parnate
Yes, I fear that Szechwan food would be risky because it often contains soy sauce. That's a common ingredient in most oriental cuisines. Worse yet, Thai food (my favorite) often contains fish sauce. I've never seen fish sauce on a list of MAOI taboos, but since it's made from fermented anchovies, I bet it's chock full of tyramine. Italian & Mexican are of course loaded with cheese. Indian food might be OK, but nobody knows what's in those curries.
> Cant you drink White wine
White wine is safer than red, but I MUCH prefer red. I'll just stick with water, which is my favorite beverage anyway.
> And cant you eat NON aged,,,Monterry Jack type cheese for those cravings you get. or Mozarella Cheese?
Non-aged cheeses are OK, but a poor substitute for the sharp-tasting (and highly fatal) varieties.
> How have you done on Nortriptyline?
Thanks for asking. I'm on desipramine, actually (I guess they're pretty similar). It's been a week, and so far the improvement has been subtle. My mood & concentration are somewhat improved, but so far it hasn't noticably helped with procrastination or anhedonia. At least the side effects haven't been a problem - very minimal and already abating. Each day it's a little better - encouraging.
- Bob
Posted by not exactly on February 7, 2003, at 21:57:48
In reply to hey bob can you give me some info !!! » not exactly, posted by LAURA777 on February 7, 2003, at 19:11:35
Laura,
> it sounds like you have a fast metabolism too
I guess I must. I can eat like a horse and still fit into size 30 jeans.
> are you also sensitive to ephedrine products in cold meds ?
Definitely. They work fine for me as long as I make sure I don't take any more than 1/4 the recommended dose.
> provigil sent me flying .. yuk , the doc gave me 200 mg
I've never dared to take 200mg at once. 50 mg b.i.d. worked well for me.
> i read somewhere that tyrosine converts to dopa then dopa converts to dopamine ,then dopamine to norepinephrine then to epinephrine
Sounds right. BTW, you left out the first step - phenylalanine (much more common in food than tyrosine) gets converted to tyrosine. Don't forget that enzymes and cofactors are needed to make each conversion happen, so if there's a deficiency anywhere, it's like closing a valve. Conversely, an overactive enzyme can deplete the precursors. This is an oversimplification, but you get the idea.
> i have also read that if you have a fast metabolisim that you have plenty norepinephrine
Perhaps. That's no doubt an oversimplification too.
> if that is the case . where is my dopamine ???
One possibility is an overzealous enzyme that's converting every bit of dopamine it can find into norepinephrine. But I'm sure there are numerous other possible explanations.
In some cases, there's enough dopamine, but a deficiency of neurons that respond to it. This happens in the later stages of Parkinson's Disease, for example.
> when you go to the dentist does epinephrine bother you in the novicaine , do you get a reaction ..
Hard to say. Epinephrine, as you may know, is just another word for adrenaline. When the dentist turns on the damn drill, I probably generate plenty of my own.
> what is responsible for motivation and interest , i get conflicting reports when i read , some say it is norepinephrine some say dopamine.
My simplistic understanding is that motivation/drive is mediated by norepinephrine, pleasure/reward is mediated by dopamine, and satisfaction/joy is mediated by serotonin. "Interest" is a more complex emotion that probably needs all 3 working together.
> Also do you think the mesolimbic system is responsible for anhedonia ?? do you think a deficiency in opiods is responsible too ..??
Can't say. Now you're moving away from my area of expertise. I understand the chemistry, but you've probably researched brain structure/function much more than I have.
> What do people do ?? i can't bear to think i have to be like this till i die ..
Unfortunately, "trial and error" seems to be the state of the art. You need to be persistent, reflective, insightful, and patient. Having a good pdoc and good health insurance helps too.
> i see alot of links that link cocaine abuse to anhedonia . and i also see also of links about drug/alcohol abuse in general causing anhedonia , and they also say it is prexisting genetics .
> i have also read that constant stress raises our level of norepinephrine fight or flight and if we get enough stress for too long are endorphins become no longer able to work .. hence blunted feelings like post tramatic stress disorder ..
> do you think having constant high levels of norepinephrine all through the years of your life cause this also ???Stress (of various types) can lead to depletion of certain neurotransmitters. This can diminish one's ability to cope with the stress, thereby amplifying the effect of the stress and causing a vicious cycle.
> do you think that all the sensitivity to the stimulants is because of lots of norepinephrine ? is that what highly sensitive to sympathomimetics means ?? being senstive to stimulants
Sympathomimetics are agents which act like the body's natural hormones (specifically epinephrine and norepinephrine) that stimulate the sympathetic nervous system. Sympathomimetics are therefore (directly or indirectly) stimulants, and most meds which are called "stimulants" are in fact sympathomimetics. But there are exceptions. Provigil and caffeine are certainly stimulants, but they are not true sympathomimetics.
However, hypersensitivity to stimulants is very different from "having too much norepinephrine". The sensitivity simply means that a small amount of a stimulant has a big effect. High norepinephrine levels wouldn't cause this sensitivity, but might possibly be a result of it.
I am extremely sensitive to stimulants, but I think my norepinephrine levels are if anything too low. I say this because meds which are known to increase norepinephrine, such as amphetamines, Wellbutrin, and desipramine, have a positive effect on me.
But I may be just as confused about what all this really means as the next guy. Like you, I read a lot, and try to put it all together in a way that makes sense. But we're all just groping around in the dark. When we find something that works (a drug, a belief, an activity), we stick with it until it fails us. Then we move on.
- Bob
PS: I really enjoy your questions and theories. It's given me a lot to think about and respond to.
Posted by fachad on February 7, 2003, at 22:22:34
In reply to Re: stimulants / anhedonia » not exactly, posted by LAURA777 on February 6, 2003, at 19:21:52
Laura777,
Have you or your pdoc ever considered that you might be bipolar, and that your primary symptoms are actually a manifestation of dysphoric hypomania?
I only ask because of your description of your state as both high energy and unpleasant. Also to me (a very lethargic low energy person) the style of your posts seem to be like descriptions I have read of bit pressured speech.
Here is the link:
http://bipolar.about.com/library/blmisc/bl-faq-presspeech.htm
I hope that my suggesting this possibility does not offend you. It's just an observation, and all I have to go on is your posts. I'm just throwing it out as a possibility to consider.
Posted by fachad on February 7, 2003, at 22:39:28
In reply to ADHEDONIA QUESTIONS ?? please read , posted by LAURA777 on February 2, 2003, at 16:53:01
I can't find the message where you said that you cannot tolerate pseudoephedrine, but I just wanted to throw in that I can't live without it. I can't breathe because of nasal congestion, and I consequently feel all around horrible.
I've been taking it regularly for as long as I can remember, long before any psych meds. I considered not trying Ritalin 10 years ago because my pdoc told me not to take Sudafed with it!
I ended up trying the Ritalin, and then cautiously adding back the Sudafed, monitoring my BP. My BP remained low, even on both.
It turns out that with Dextrostat and Sudafed combined, for the first time in my life I have enough sympathetic tone to be able to stand up quickly without passing out! woohoo!
Posted by LAURA777 on February 8, 2003, at 6:24:25
In reply to dysphoric hypomania? » LAURA777, posted by fachad on February 7, 2003, at 22:22:34
Hi fachad , no i am not at all offended , My sister has bipolor.. i have also looked up dysphoric bipolor , it is all very interesting ..
i do not think i have this for many reasons ..
i have never suffered from insomnia .. This for which i am very grateful .. i am very sensitive to stimulants , very , and the posts from feb. 5 and the 6th , i had taken provigil 200mg and i was flying .. so my writing may have been a little less ordered ..
all my life i have been discribed as hyper .. lots of energy .. prozac has changed this for me.. so the "push gota go gota go " has practically disappeared .. i used to think that i was adhd .. but i am able to sit and read for hours .. even prior to prozac ... plus i am not that irratible , no more that ordinary and i don't get pms ..
i have also been seeing a therapist for 3 years and i think he would have seen this in me if it were a diagnosis .... ( just in case i am in denial)
My theory is that my brain or body converts all my dopamine very quickly into norepinephrine .. this is very simplistic and i need to look into it .. i enjoy your posts by the way , and i see that you like philosophy , i do too .. can you tell me about the philosophy that you mentioned in previous posts ??? thanks , laura
Posted by LAURA777 on February 8, 2003, at 7:20:49
In reply to Re: hey bob can you give me some info » LAURA777, posted by not exactly on February 7, 2003, at 21:57:48
> I guess I must. I can eat like a horse and still fit into size 30 jeans.
hey Bob you have a fast metabolisim
I have a theory , First let me say that when i go to the dentist , i get a very bad reaction to the epinephrine , my heart starts to pound , i shake , tremors , and i get halos in my vision like migraine auras ...
Now to my theory , When i did cocaine , the pleasure or so called euphoria was very short acting for me .. i went straight to the crappy feeling faster than most people from what i can observe .. do you think that my brain converts dopamine right to norepinephrine .. i remeber in a previous post you had mentioned that cocaine has little to do with NE .. i disagree .. the stimulant effect is directly related to NE .. don't you think ..
Heres something else.. when most people do opiates they get sedated .. I do not . i am awake , but it is pleasant , not like on stimulants , the only reason i can account for this is the opiate (endorphin) property of this drug .. like a good balance .. to further this , when opiates are taken, they shut up the fight of flight chemicals . it lowers the Ne .. While on Heroin there is no stress .. to even go further .. When withdrawling from heroin the NE goes why up .. hence the leg twitches diarhea , cramps , elevated blood pressure , anxious , irritable, sort of like being on stimulants ..They know that the body acts as if in fight or flight ...as you may know they give people clonidine to help smooth these reactions ..As you know Ne regulates blood pressure ,metabolism , energy level ..what if someone has a dysfuction of Ne , meaning the dopamine is eaten up to NE and as a result the person may on a low level, but constant , expierience fight of flight anxiousness ....resulting in a dysfunction of the endorphins not workinng like they are supposed too . i correlate this with what they know about post tramatic stress syndrome .. please give me your thoughts on this .. it is my theory that i have a depleation in dopamine as well as endorphins .. thanks laura
Posted by JaneB on February 8, 2003, at 7:26:04
In reply to Psuedoephedrine is My Most Important Med » LAURA777, posted by fachad on February 7, 2003, at 22:39:28
> I can't find the message where you said that you cannot tolerate pseudoephedrine, but I just wanted to throw in that I can't live without it. I can't breathe because of nasal congestion, and I consequently feel all around horrible.
>
> I've been taking it regularly for as long as I can remember, long before any psych meds. I considered not trying Ritalin 10 years ago because my pdoc told me not to take Sudafed with it!Interesting! Have you tried other allergy meds? I tried 3 and they made me lethargic,etc.
>
> I ended up trying the Ritalin, and then cautiously adding back the Sudafed, monitoring my BP. My BP remained low, even on both.What brand/dosage of Sudafed do you take? Does it interfere with your sleep? I can't remember what other meds you are taking. Could you remind me. My BP remains low and without the Sudafed I get dizzy sometimes from just bending over. A little annoying when doing many work and pleasure activities!
If I don't take Sudafed I invariably wake up with a headache.
>
> It turns out that with Dextrostat and Sudafed combined, for the first time in my life I have enough sympathetic tone to be able to stand up quickly without passing out! woohoo!
>
Posted by LAURA777 on February 8, 2003, at 10:16:54
In reply to Re: hey bob can you give me some info » LAURA777, posted by not exactly on February 7, 2003, at 21:57:48
hey bob , check this article out , it correlates with what i have been saying
http://www.neurogenesis.cc/newinsights.htmalso cocaine is a NE agonist , and my suspicion is it quickly converts to epinephrine , hence the paranoia , because they say the epinephrine is in invovled in fight or flight .. what do you think ??? any addiction in your family ???
Posted by not exactly on February 8, 2003, at 13:00:09
In reply to Re: hey Bob heres a theory !! » not exactly, posted by LAURA777 on February 8, 2003, at 7:20:49
> I have a theory...
> do you think that my brain converts dopamine right to norepinephrineAn interesting theory. I wonder if the source of this theory is my recent post [http://www.dr-bob.org/babble/20030204/msgs/140070.html] when I suggested: "One possibility is an overzealous enzyme that's converting every bit of dopamine it can find into norepinephrine."
> i remeber in a previous post you had mentioned that cocaine has little to do with NE .. i disagree .. the stimulant effect is directly related to NE .. don't you think ..
I didn't say (or intend to imply) that. Cocaine is a potent dopamine reuptake inhibitor, and a somewhat less potent (tho nevertheless still fairly strong) norepinephrine reuptake inhibitor. Its stimulant effect results from both of these actions. The way I stated it in my previous post [http://www.dr-bob.org/babble/20030204/msgs/139371.html] was "...cocaine has no direct effect on serotonin (it is generally understood to be a reuptake inhibitor of dopamine, and to a lesser extent NE)..."
> also cocaine is a NE agonist , and my suspicion is it quickly converts to epinephrine , hence the paranoia , because they say the epinephrine is in invovled in fight or flight
Cocaine is not really an "NE agonist" in the strict sence of the term. An NE agonist would directly stimulate NE receptors instead of (even in the absence of) actual NE. This is not how cocaine affects NE receptors. It only blocks NE reuptake, resulting in higher NE levels. The receptors are then stimulated by this additional NE, not by the cocaine itself.
But this "excess" NE in the brain synapses would not be "convered" to systemic (outside the brain) epinephrine. Systemic epinephrine is synthesized and released by the adrenal gland (hence the name "adrenaline") [see http://arbl.cvmbs.colostate.edu/hbooks/pathphys/endocrine/adrenal/medhormones.html].
> any addiction in your family ???
Just me. I had an alcohol problem many years ago when I started drinking excessively in response to a very stressful job situation. Fortunately, my abusive boss got the axe and I was able to wean myself off. I don't drink at all now.
- Bob
Posted by LAURA777 on February 8, 2003, at 16:44:16
In reply to Re: hey Bob » LAURA777, posted by not exactly on February 8, 2003, at 13:00:09
hey , well i think there may be truth to your theory . and the only reason i stated that cocaine was an ne agonist is because i read it on a nuerotransmitter synthesis site . they used it as an example that it was a good ne agonist but not a good anti-depressant ..
did you read that article about the opioids and genetics .. ??
i read about the crf factor in depression ,, cortisol levels and all .. hyper hypothalmic pituitary ..
can you explain this to me better , and what roll anti-depressants play . ?? it seems that they say that snri , helps with this ,?? i don't know , it was all pretty complicated ..
does norepinephrine have any thing at all to do with the amount of epinephrine in our systems ??
could there be a screw up some where where too much of this gets produced??? or could it possible be that a person can be super sensitive to it ????
are parkinsons drugs effective in raising the dopamine in the nucleus accumbens ?? do parkinsons drugs raise dopa throughout the brain or just in certain areas ???
sorry if you told me already , but did you try any of these ???
why does maoi's taken on long term have a likelyhood of causing high blood pressure ??? or was that tca's ??? sorry can't remember..i know i read somewhere that taking maoi's and tca's long term can cause problems .. ???
do you think that having a fast metabolisim and being very sensitive to stims have anything to do with the anhedonia ?? or how the nuerotransmiters work ??
what do you think ??
sorry for all the numerous questions .. i promise next time i will keep it down to only 4 questions !!! thanks for your time .. laura
Posted by not exactly on February 8, 2003, at 18:36:55
In reply to Re: hey Bob i got a question???? » not exactly, posted by LAURA777 on February 8, 2003, at 16:44:16
Well, the desipramine is finally starting to kick in. Only trouble is, it seems more like an ANTI-antidepressant. I've been feeling irritable and annoyed, and the WHY BOTHER syndrome is in full gear. I had planned to go to a party tonite, but now the thought of showering, getting dressed, and driving to it seem like far too much trouble. And what could I possibly enjoy at the party anyway? I don't want to be with people, or eat, or drink, or hear music. I just want to crawl in a hole somewhere. But I don't even feel like resting or sleeping. I don't know WHAT I want, and if I knew, it wouldn't be worth the effort.
I barely had the energy/motivation to send this post out. But I thought there was a chance ("hoping" is too "up" a word for now) that somebody might have an idea why I feel this way and what I could do about it. Any feedback would be appreciated, although I can't promise I'll be motivated to respond.
thanks,
bummed-out Bob
Posted by LAURA777 on February 8, 2003, at 19:22:25
In reply to BUMMED OUT BIG TIME, posted by not exactly on February 8, 2003, at 18:36:55
hey , i am so sorry , it sucks .. i usually sit and read books , so this computer has been a distraction and i also hope i will find an answer ..hope is everything ,, but i have been in that place where hope is even illusive . so i sleep .. but that gets really depressing .. i do not know what to say .. except that i think you are extremely intellegent and articulate and i admire your tenacity .. did you know a trait of having high NE is vigilance ... lol !! i am sorry ... i will talk with you soon , laura
Posted by fachad on February 8, 2003, at 19:37:40
In reply to Re: dysphoric hypomania? » fachad, posted by LAURA777 on February 8, 2003, at 6:24:25
Luara777,
I'm glad you did not take offence at my suggestion.
> My theory is that my brain or body converts all my dopamine very quickly into norepinephrine .. this is very simplistic and i need to look into it ..
My original theory from the cocaine experience was that my MAOI was just "overactive". I thought it broke down catecholamines too fast.
I cooked that one up based on my experience of coke wearing off so much faster for me than anyone else, and the feeling that the coke induced good mood was "melting" or "dissolving" right before my inner eyes.
In retrospect that seems really simplistic, but it did help me get a handle on my experiences. And that is real the purpose of theories - to make sense of experiences.
>i enjoy your posts by the way , and i see that you like philosophy , i do too .. can you tell me about the philosophy that you mentioned in previous posts ???
Yes, I have been thinking philosophically as long as I can remember. When I discovered philosophy as a formal discipline in high school, I was hooked. I completed a B.S in philosophy, with full intent of going to graduate school, but alas, the need to be gainfully employed got in the way.
Most of the posts I have done that have waxed philosophical have been on Psycho-Babble Faith, and have been a (civil, per Dr. Bob) statement of my rationalism and skepticism toward religious dogma and revealed religion.
There have been a few probes into epistemology in service of that end. Epistemology has always seemed to me to be the core concern in philosophy.
I've also done a few posts on philosophy of mind. I think that while there is much validity in the biochemical theory of mental disorders, it is very easy to take the implicit reductionism to extremes and end up with a view of human beings as merely so chemicals and cells.
I also think that the biochemical perspective can detract from the genuine need to focus on the behavioral, characteriological, and existential issues that factor into the human experience of emotional misery.
The need for medication in psychiatry could be compared to the need for cholesterol lowering drugs in primary care. Yes, there are some folks who have a strong genetic predisposition to high cholesterol, but there are others who just need to lay off the cheeseburgers. And the existence of a drug to lower cholesterol removes the motivation for some to observe a healthy diet. I think you can see where that analogy is going.
In addition to biological vs. behavioral etiologies of mental/emotional distress, I think there are also characterological and existential considerations. I think that biological treatments can go so far and no further; behavioral techniques and good behavioral hygiene can go so far; and beyond that there is a certain amount of emotional suffering that is just part of the human condition...
Posted by LAURA777 on February 8, 2003, at 20:58:57
In reply to Simplified Theories and Philosophical Musings » LAURA777, posted by fachad on February 8, 2003, at 19:37:40
> Luara777,
>
> I'm glad you did not take offence at my suggestion.
>
> > My theory is that my brain or body converts all my dopamine very quickly into norepinephrine .. this is very simplistic and i need to look into it ..actually the above theory is Bobs ,,
>
> I also think that the biochemical perspective can detract from the genuine need to focus on the behavioral, characteriological, and existential issues that factor into the human experience of emotional misery.
But shouldn't the emotional misery be tempered with joy , fun , and just basic happiness once in awhile ??
i used to like to go trail hiking ,i love the trees nature ect ect ,, and i have done many things that i see others are enjoying and i do not see it .. it is like everything is DULL . i know that it is not me physchologically . i am very aware . i have been self examing and focusing for years , and as a result of that i am pretty healthy .. but still a work in progress just like everyone else .. but what is this Dull thing .. gotta be biological .. i remember going out in snowstorms and it being so enchanting . truly , now it is dull , i have no answers ...> In addition to biological vs. behavioral etiologies of mental/emotional distress, I think there are also characterological and existential considerations. I think that biological treatments can go so far and no further; behavioral techniques and good behavioral hygiene can go so far; and beyond that there is a certain amount of emotional suffering that is just part of the human condition...
hey i can get with that , but again i say i live a life where there is no temperance ,, everything feels like a push to do ..
I am no intellectual Giant in philosophy , i am just interested in it because i think alot.. about alot of things and i find this interests me ...but there has to be more .. i see people enjoying a smattering of things and i know i used to also , now it is dull , why is this ??be easy with me on the philosophy terms because i do not know them ,so explain some of these things to me ... i will try and find some of your posts in the religion section , thanks , laura
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