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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 rod on May 8, 2004, at 5:26:27
First, jippie, Abilify is coming to my place!
My question. Has anybody taken both and is able to compare their effect?
My concern about Mirapex is, the possible sleepiness after long term use, as reported by Ame sans vie. But on th other hand, this person also tried it at a huge doese, to achieve a psychedelic effect and saw patterns etc. Maybe after that, going back to a normal dose, the sleepiness occured, which wouldnt occur under noraml use. I dont know. It is also commonly reported for people treated for parkinson, but these people seem to take higher dosages and normally take additional dopaminergics like L-Dopa plus much much more.
My concern about Abilify. Its an antipsychotic and I already take Amisulpride and wont stop it. It will stay in my cocktail. Is it possible to experience numbness and cognitive problems with Abilify? At 150 mg of Amisulpride (now take 50mg) I indeed felt a little numb, simple minded...
My doctor wants to put me on Abilify first, if my recent trial of Buspar doesnt produce the desired effect. His concerns about Mirapex are, that it has according to him a very strong intrinsic activity at D Receptors. Maybe to strong he said.. He did some studies about pramipexole for psychiatric uses but entirely stopped when one of the participants jumped out of the window... He said Pramipexole can have a too strong stimulating effect. Hmm, but thats maybe what I need. So he wants to try Abilify, because its only a pratial agonist and thereby seems to be more predictable.
So, apart from safety issues, I would like to hear from people who can compare these two regarding motivation, stimulation, social withdrawness, dystymia etc.
I personally tend more to try Mirapex first. But I am not sure.Roland
Posted by harryp on May 8, 2004, at 8:57:04
In reply to Mirapex or Abilify? Anyone tried both?, posted by rod on May 8, 2004, at 5:26:27
I'm a little confused. You're taking an antipsychotic (amilsulpride) now that is a dopamine antagonist (blocks dopamine receptors), yet are considering a drug (Mirapex) that is a dopamine agonist (activates dopamine receptors)! You would be taking two drugs with opposite effect, and the results would be hard to predict.
Abilify is a "partial agonist" of Dopamine, and supposedly "normalizes" dopamine levels--although I suspect in most cases it acts as an antagonist. Taking it along with amilsulpride also seems contradictory and unwise.
What symptoms are you trying to control?
Posted by rod on May 8, 2004, at 9:46:02
In reply to Re: Mirapex or Abilify? Anyone tried both?, posted by harryp on May 8, 2004, at 8:57:04
> I'm a little confused. You're taking an antipsychotic (amilsulpride) now that is a dopamine antagonist (blocks dopamine receptors), yet are considering a drug (Mirapex) that is a dopamine agonist (activates dopamine receptors)! You would be taking two drugs with opposite effect, and the results would be hard to predict.
>Basically you are right, if I would take e.g. 2000mg of Amisulpride, which is used for positive schizophrenia. But I take a subeffective dose (50mg) which acts as a dopamine presynaptic *auto*receptor antagonist (= increased dopaminergic transmission). So Amisulpride is a indirect agonist at D receptors for me.
Adding Mirapex or Abilify would further increase dopaminergic neurotransmission, because I am almost sure there is no overstiulation that needs to be blocked by Abilify. I really think (aswell as my doc) Abilify will boost my dopamine instead of antagonising it.
> Abilify is a "partial agonist" of Dopamine, and supposedly "normalizes" dopamine levels--although I suspect in most cases it acts as an antagonist. Taking it along with amilsulpride also seems contradictory and unwise.
>
> What symptoms are you trying to control?Lack of motivation, increased need for sleep, flat emotions, social isolation, low self esteem, "poverty of speech" (I am a very quiet person) etc. the dystymic spectrum and the deficit syndrome spectrum. These things are related to dopamine. Dopaminergics work much better than serotonergics for dystymia for example.
Posted by SLS on May 8, 2004, at 10:06:22
In reply to Re: Mirapex or Abilify? Anyone tried both? » harryp, posted by rod on May 8, 2004, at 9:46:02
Hey there Rod.
> > What symptoms are you trying to control?
> Lack of motivation, increased need for sleep, flat emotions, social isolation, low self esteem, "poverty of speech" (I am a very quiet person) etc... ...and the deficit syndrome spectrum.
Me too.
How does your depression affect your abilities to read, learn, and remember?
- Scott
Posted by rod on May 8, 2004, at 20:25:24
In reply to Re: Mirapex or Abilify? Anyone tried both? » rod, posted by SLS on May 8, 2004, at 10:06:22
> Hey there Rod.
>
> > > What symptoms are you trying to control?
>
> > Lack of motivation, increased need for sleep, flat emotions, social isolation, low self esteem, "poverty of speech" (I am a very quiet person) etc... ...and the deficit syndrome spectrum.
>
> Me too.
>
> How does your depression affect your abilities to read, learn, and remember?Also impaired. My mental energy is very low compared to healthy individuals. Currently, I am able to learn for about an hour, thanks to nortriptyline. This is very fine, because most other drugs interfere with my productivity very much (e.g. SSRIs). hmmm, if I look back, the time amitriptyline worked, I was able to be productive for around 5 hours... I really achieved much that time... But Amitriptyline doesnt seem to work anymore, but nortriptyline does some good, not full response, but a greatly welcomed partial response. I just have to find the right augmentors...
the funny thing is, when I feel better its almost like old memories get unlocked in my head, and are available again.
Roland
>
>
> - Scott
>
Posted by SLS on May 8, 2004, at 21:55:43
In reply to Re: Mirapex or Abilify? Anyone tried both? » SLS, posted by rod on May 8, 2004, at 20:25:24
> the funny thing is, when I feel better its almost like old memories get unlocked in my head, and are available again.
EXACTLY!
- Scott
Posted by Questionmark on May 9, 2004, at 1:54:29
In reply to Re: Mirapex or Abilify? Anyone tried both?, posted by SLS on May 8, 2004, at 21:55:43
> > the funny thing is, when I feel better its almost like old memories get unlocked in my head, and are available again.
>
> EXACTLY!
>
> - Scott
i find this to be true for any stimulating or catecholaminergic substance that i take enough of or for long enough: caffeine, methylphenidate, amphetamines, yohimbine, and holy crap, Parnate. This makes me think that the catecholamines (esp DA and NE) must be integrally involved in "long-term" memory storage and/or retrieval. i find this interesting.What i also find really interesting, now that i think about it, is that serotonergic meds always seem to subtly (though maybe significantly) prevent the random emergence/reemergence of older memories as well as impede my ability to willfully recall them. Since the prolonged increase in serotonin transmission is said to be associated with inhibited dopamine and norepinephrine transmission, there must be some connection there. Also, what i PARTICularly find interesting is that one of the most emotionally painful things for me to think about is the past (my past) and all of my regrets and wasted hours, days, weeks, months, and years. And some of the most emotionally painful substances for me to take are those that are highly catecholaminergic, or at least/especially dopaminergic: e.g., psychostimulants (when taken too frequently for too long a duration) and, particularly, Parnate. And accordingly, those meds that are the most efficacious for me and for the emotional pain are those that are predominantly serotonergic: Paxil, other SSRIs, Effexor, and, in particular, in a class by itself-- Nardil.
Maybe i've just had too much caffeine today, but this is all very fascinating to me. It all ties together so well. And it is a splendid example, in my opinion, for why different drugs affect different people quite differently. Ah, dang it. i want to go somewhere further with this, but i cannot think of any way how. Well, i hope at least someone takes at least something from this.
Oh, Post Script: i also tend to find that cannabis is both inducive of older memories (to some extent) and often very emotionally painful for me (which is why i rarely use it anymore, sadly). i do not know which neurotransmitters (other than cannabinoid receptors, of course) and brain areas that THC primarily affects (directly or indirectly), however, so i do not know what this means.
Thoughts??
Posted by rod on May 9, 2004, at 5:31:48
In reply to Re: Mirapex or Abilify? Anyone tried both?, posted by SLS on May 8, 2004, at 21:55:43
Dear Scott,
You also take Abilify.
How would you describe its effect on you?
Stimulating, motivating etc.?Roland
Posted by cybercafe on May 9, 2004, at 5:55:26
In reply to Re: Mirapex or Abilify? Anyone tried both? » harryp, posted by rod on May 8, 2004, at 9:46:02
> > I'm a little confused. You're taking an antipsychotic (amilsulpride) now that is a dopamine antagonist (blocks dopamine receptors), yet are considering a drug (Mirapex) that is a dopamine agonist (activates dopamine receptors)! You would be taking two drugs with opposite effect, and the results would be hard to predict.
> >
>
> Basically you are right, if I would take e.g. 2000mg of Amisulpride, which is used for positive schizophrenia. But I take a subeffective dose (50mg) which acts as a dopamine presynaptic *auto*receptor antagonist (= increased dopaminergic transmission). So Amisulpride is a indirect agonist at D receptors for me.
>
> Adding Mirapex or Abilify would further increase dopaminergic neurotransmission, because I am almost sure there is no overstiulation that needs to be blocked by Abilify. I really think (aswell as my doc) Abilify will boost my dopamine instead of antagonising it.
>
> > Abilify is a "partial agonist" of Dopamine, and supposedly "normalizes" dopamine levels--although I suspect in most cases it acts as an antagonist. Taking it along with amilsulpride also seems contradictory and unwise.
> >
> > What symptoms are you trying to control?
>
> Lack of motivation, increased need for sleep, flat emotions, social isolation, low self esteem, "poverty of speech" (I am a very quiet person) etc. the dystymic spectrum and the deficit syndrome spectrum. These things are related to dopamine. Dopaminergics work much better than serotonergics for dystymia for example.
abilify definately helped me with motivation.
definately.
also caused some insonmnia, but then other meds were added so this effect is no longer seen.i'd say the motivation abilify gave me alone got me to do things that themselves helped improve my depression and all the things you mention..... though i did find that lowering the dose a bit helped rid me of flat emotions (abilify caused it, but then i am bipolar so i suppose it's supposed to)
Posted by SLS on May 9, 2004, at 6:43:25
In reply to Re: Mirapex or Abilify? Anyone tried both? » SLS, posted by rod on May 9, 2004, at 5:31:48
> You also take Abilify.
> How would you describe its effect on you?
> Stimulating, motivating etc.?
Hi Roland.Yes, Abilify afforded me an increase in motivation and sociability. It also takes the edge off anxiety which helps me stay away from suicidal ideation. The effect for me is at best mild, but I guess I have to do what I can. It did have an antidepressant effect in the beginning for me. Remember how resistant my depression is to treatment. If Abilify is minimally helpful for me, it is probably very effective for others.
I did experience a sort of anxiety and impatience in the beginning. I guess some might call it mild akathisia. It did pass within a few months, and I do not experience any vestige of it. It is pretty much transparent right now. No side effects.
- Scott
Posted by zeugma on May 9, 2004, at 13:29:48
In reply to Emergence Of Older Memories W/ Certain Drugs..., posted by Questionmark on May 9, 2004, at 1:54:29
> > > the funny thing is, when I feel better its almost like old memories get unlocked in my head, and are available again.
> >
> > EXACTLY!
> >
> > - Scott
>
>
> i find this to be true for any stimulating or catecholaminergic substance that i take enough of or for long enough: caffeine, methylphenidate, amphetamines, yohimbine, and holy crap, Parnate. This makes me think that the catecholamines (esp DA and NE) must be integrally involved in "long-term" memory storage and/or retrieval. i find this interesting.So do I. My ADD/depression makes me feel like my identity is a smashed mirror, parts that are disconnected from one another, or maybe more like living inside a kaleidoscope, so I feel like I have no control over the changes that are taking place and few memories to hang on to. I drank tons of caffeine (and still do) because it helps the inattention and mood and gives a little physical lift, but of all the meds I've tried, only NEergic meds made me feel coherent. I think there might be something to do with the interaction between norepinephrine and dopamine in the prefrontal cortex, which is the 'operating center' for the brain.
>
> What i also find really interesting, now that i think about it, is that serotonergic meds always seem to subtly (though maybe significantly) prevent the random emergence/reemergence of older memories as well as impede my ability to willfully recall them. Since the prolonged increase in serotonin transmission is said to be associated with inhibited dopamine and norepinephrine transmission, there must be some connection there. Also, what i PARTICularly find interesting is that one of the most emotionally painful things for me to think about is the past (my past) and all of my regrets and wasted hours, days, weeks, months, and years. And some of the most emotionally painful substances for me to take are those that are highly catecholaminergic, or at least/especially dopaminergic: e.g., psychostimulants (when taken too frequently for too long a duration) and, particularly, Parnate. And accordingly, those meds that are the most efficacious for me and for the emotional pain are those that are predominantly serotonergic: Paxil, other SSRIs, Effexor, and, in particular, in a class by itself-- Nardil.Yes, my current crisis is strongly related to activation of memories that in my unmedicated state just disappear into the fog. This is also why therapy and CBT can be dangerous for some people- there are many things in anyone's brain who has suffered prolonged depression that are going to be devastating if they break into consciousness. Unfortunately, if serotoninergic drugs will depress catecholamine levels, that will threaten to make me non-functional. Elevating catecholamine levels makes me able to pursue goals and have a coherent sense of self. the danger is that the emotional pain is in direct proportion to that coherence, if for any reason they are suddenly recalled.
>
> Maybe i've just had too much caffeine today, but this is all very fascinating to me. It all ties together so well. And it is a splendid example, in my opinion, for why different drugs affect different people quite differently. Ah, dang it. i want to go somewhere further with this, but i cannot think of any way how. Well, i hope at least someone takes at least something from this.Please continue in this vein. Are you involved in psychology or psychopharmacology? It also sounds like it relates to profound concerns regarding identity and memory that are central to philosophy.
>
> Oh, Post Script: i also tend to find that cannabis is both inducive of older memories (to some extent) and often very emotionally painful for me (which is why i rarely use it anymore, sadly). i do not know which neurotransmitters (other than cannabinoid receptors, of course) and brain areas that THC primarily affects (directly or indirectly), however, so i do not know what this means.
>
> Thoughts??I know nothing of cannabis, In the past it caused panic attacks, now it has no effect at all.
This is the end of the thread.
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