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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 pablo1 on November 15, 2004, at 15:38:55
I'm trying this stuff & honestly don't know much about it. The thinking is that it's rated for OCD & I tend to be on the obsessive/overfocused side with my ADHD. Stimulants alone just make me hyperfocus worse so I thought I'd try ritalin with an SSRI. I've got some Prozac too if this doesn't help. I'm just a week into it & not noticing much except a bit queasy/dizzy/nervous in the morning after I take 50mg. I'm also adding 1mg of clonazepam to take the edge off the hyperfocusing. Effexor knocked out my emotions & messed with my sleep. So far I can still have feelings and pleasure... I was not taking stimulants with effexor though. Wellbutrin also messed with my sleep. The norepenephrine stuff seems to react badly for me, I think I already have too much adrenaline. I was taking some pure dopamine meds from overseas that really felt good & removed any trace of depression but I still overfocused and my big problem is procrastination, getting distracted & sucked into projects & not able to convince myself to take care of my chores. Zoloft is supposed to have a pretty decent amount of dopamine action.
Posted by JayDee on November 15, 2004, at 21:04:02
In reply to Zoloft for overfocused ADD, posted by pablo1 on November 15, 2004, at 15:38:55
Zoloft does work on DA more then NE, which is a contrast compared to other SSRI's. However Zoloft is VERY scewed toward 5htp, so it doesn't mean much.
Posted by pablo1 on November 16, 2004, at 13:38:58
In reply to Re: Zoloft for overfocused ADD, posted by JayDee on November 15, 2004, at 21:04:02
I don't understand this comment?
> However Zoloft is VERY scewed toward 5htp, so it doesn't mean much.
Posted by banga on November 16, 2004, at 14:33:08
In reply to Re: Zoloft for overfocused ADD, posted by JayDee on November 15, 2004, at 21:04:02
He means that even though technically Zoloft influences dopamine, it is so slightly that it doesn't mean anything. Zoloft works ALMOST exclusively on serotonin (5htp).
Posted by pablo1 on November 16, 2004, at 15:47:40
In reply to Re: Zoloft for overfocused ADD, posted by banga on November 16, 2004, at 14:33:08
I found this chart and was unable to verify the validity but it indicates that zoloft has a very significant effect on dopamine reuptake. The ritalin number was offered separately for comparison, not part of the original chart.
Chart Showing Reuptake Inhibition
--------------------------------------------------------
(the higher number is, the more the neurotransmitter stays active)
--------------------------------------------------------
__NAME__________SERATONIN_____NOREPENEPHRINE_____DOPAMINE_
--------------------------------------------------------
Zoloft _________ 0.2400 ________ 341.0000 _______ 0.3800
--------------------------------------------------------
Ritalin ____________ ___________ 004.0000
--------------------------------------------------------
Seroxat ________ 02.5000 _______ 798.0000 _______ 0.2000
--------------------------------------------------------
Wellbutrin _____ 00.0019 _______ 000.0110 _______ 0.1900
--------------------------------------------------------
Effexor_________ 00.0940 _______ 011.0000 _______ 0.0110
--------------------------------------------------------
Lexapro ________ 02.7000 _______ 086.0000 _______ 0.0036
--------------------------------------------------------
Deproxin _______ 00.4100 _______ 123.0000 _______ 0.0280
--------------------------------------------------------
Edronax ________ 14.0000 _______ 001.7000 _______ 0.0087
Posted by banga on November 16, 2004, at 16:40:38
In reply to Re: Zoloft for overfocused ADD, posted by pablo1 on November 16, 2004, at 15:47:40
Do you have a source for this graph?I'd be interested in seeing it for comparisons, I like comparing info from different sources. I must say it is quite different from a similar type of chart comparison I have around...I will provide the link later. And I'm not quite clear---you say the higher the number, the more effet there is? Then most of these drugs are most active on norepinephrine?? Something seems off...either I'm reading it wrong or it doesn't add up.
Posted by pablo1 on November 16, 2004, at 17:39:10
In reply to Re: Zoloft for overfocused ADD, posted by banga on November 16, 2004, at 16:40:38
I don't recall where it was posted, one of these psych forums. Here's the additional info I have with that.
Intro:
Here is a table with the relative values of blockade of NA, 5HT and DA
the greater the value,
the greater the affinity for blocking the re-uptake site.
A followup question:
Where did you get these numbers?
The potency stats I have are from A Primer of Drug Action by Robert M.
Julien, M.D., Ph.D.These numbers do not make any sense to me. (First off, did I get the
right numbers under the right neurotransmitters, the table was a little
messed up on my newsreader??) Second, I assume these neurotransmitter
columns and the values under them are ment to represent inhibition of
reuptake of that neurotransmitter (and not inhibition of one of the many
receptor subtypes for each type of receptor). But what really has me
confused is what the values represent numerically. They are presumably
IC50 values (a measure of drug affinity) given in maybe micromolar
concentrations?? If they are, then the lower the numerical value the
greater affinity the drug has for blocking the reuptake of that
neurotransmitter. Sometimes IC50 values are given in -log units, and when
that happens the larger the number the higher the affinity. But that
doesn't seem to be the case here. I am confused.
Posted by JayDee on November 16, 2004, at 17:50:15
In reply to Re: Zoloft for overfocused ADD, posted by pablo1 on November 16, 2004, at 15:47:40
I wouldn't trust that chart. Heck, they couldn't even spell Norepinephrine or Serotonin right!
I had a link with a much more accurate chart, which even compared the SSRI's affinity for other neuroamines such as histamine and acetylcholine. I can't find the link now, must have forgot to mark it. It was a great study too, stupid ADD.
IIRC Zoloft, Luvox and Celexa were the most selective for 5-HTP
Posted by banga on November 16, 2004, at 18:24:16
In reply to Re: Zoloft for overfocused ADD, posted by JayDee on November 16, 2004, at 17:50:15
I hope this link works--
http://www.preskorn.com/books/ssri_s3.html
That's where there are various charts re: reuptake inhibition of the 3 neurotransmitters. Regarding serotonin, it states: Although among the SSRIs and TCAs sertraline is the most potent dopamine uptake pump inhibitor, "it still is 100 times less potent in terms of inhibiting the dopamine versus the serotonin uptake pump. That means the physician would have to increase the dose of sertraline 100 times higher than that needed to inhibit serotonin uptake pump before a comparable effect would be achieved on the dopamine uptake pump."I love this article, frequently look at it to compare SSRIs and TCAs.
Posted by pablo1 on November 16, 2004, at 18:57:50
In reply to Re: Zoloft for overfocused ADD, posted by banga on November 16, 2004, at 18:24:16
Thanks, well they still don't give relative figures for ritalin or amphetamines but I guess this shows my chart is bogus and I suppose the dopamine action of SSRI's is trivial though that's not entirely clear without seeing a stimulant on that chart.
In any case I'm taking ritalin along with the zoloft. And zoloft is one that's recommended for OCD which seems it should be helpful for the overfocused type ADD in relaxing me. I'm taking clonazepam 1mg also for that purpose.
I got the idea that the dopamine & norepenephrine effects of ssris could be significant because effexor really messed with my sleep pattern & it is supposed to have a significant norepenephrine effect though supposedly not until you reach very high doses. But it did seem to mess with my sleep.
The zoloft in any case is not giving me bad side effects compared to effexor so whatever the reason it seems better for me.
Posted by JayDee on November 16, 2004, at 19:04:20
In reply to Re: Zoloft for overfocused ADD, posted by banga on November 16, 2004, at 18:24:16
Thats the link!
This is the end of the thread.
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