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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 ace on June 19, 2005, at 1:54:23
TRamadol, when combined with Nardil brings back that euphoria, extreme motivation etc do you guys attribute this to more 5HT activity?
But is their any antidepressant that works like Tramadol.and woul Tramadol and such an antidepressent would work as well without taking Nardil concurrently,,,,
sigh.....i think i should go to the BIGGEST 5HT agonist - Anafarnail....
help please kids!
Mr. Crazy Ace.....
....."I look at myself in a sober light,
I'm not Elvis, but I'm alright!"
Posted by rod on June 19, 2005, at 7:31:33
In reply to What AD most like Tramadol???, posted by ace on June 19, 2005, at 1:54:23
> TRamadol, when combined with Nardil brings back that euphoria, extreme motivation etc do you guys attribute this to more 5HT activity?
>
> But is their any antidepressant that works like Tramadol.and woul Tramadol and such an antidepressent would work as well without taking Nardil concurrently,,,,
>
> sigh.....i think i should go to the BIGGEST 5HT agonist - Anafarnail....
>
> help please kids!
>
> Mr. Crazy Ace.....
>
> ....."I look at myself in a sober light,
> I'm not Elvis, but I'm alright!"ehrmm huh?
I think the replys to your previous post answerd your qusetion.
http://www.dr-bob.org/babble/20050611/msgs/511404.html Chairman MAO got it right in my opinion.And about Anafranil. hmmm serious? You tried it before, without euphoria... so I guess it wont work now... for your purpose...
Posted by ed_uk on June 19, 2005, at 9:45:52
In reply to Re: What AD most like Tramadol???, posted by rod on June 19, 2005, at 7:31:33
Sorry to interrupt crazy Ace!!!
Hi Roli!
Did you get a prescription for trihexyphenidyl?
~Ed
Posted by rod on June 19, 2005, at 14:18:14
In reply to Re: What AD most like Tramadol??? » rod, posted by ed_uk on June 19, 2005, at 9:45:52
> Sorry to interrupt crazy Ace!!!
>
> Hi Roli!
>
> Did you get a prescription for trihexyphenidyl?
>
> ~Edhehe HiHo Ed!
Nope, didnt ask yet. I am trying something else. Cyproheptadine (Periactin). I hope my current strategy works on the long term.
For the last few days/weeks I was taking Concerta with DHEA (apart from many other things), but my incurance does not cover Concerta, so I had to switch to Ritalin. But hmmmmm this didnt work great at all. Much much more "stress like effect" from Ritalin than Concerta. I had to up the dose of DHEA but it somwhow didnt produce satisfying results.... anywaySo now I am on Periactin and its working like a little magic pill :-)))
Its not really stimulating, not really mood brightening, but its wiping out my apathy and numbness and mental slowness. wow. great. It really improved functionality. I am looking forward to start a part time job as an assistant at some kind of cancer research institute (no I do not study anything related to that.) And I feel mentally fit eenough to do the job YAY !! horray.I just hope that it will work on the long term. But I think it will.
And now my "thats how I pimped up my brain" list :Pnortriptyline 125mg
Periactin 12mg
Solian 50mg
Lyrica 300mg
Nicergoline 30mg
Pentoxifylline (or something like that :P ) 600mg
Rivotril 0,25 (im tapering off)
Diphenhydramine 50mg (also tapering)
oh wellbye
Roland
Posted by linkadge on June 19, 2005, at 15:06:24
In reply to Re: What AD most like Tramadol??? » ed_uk, posted by rod on June 19, 2005, at 14:18:14
I mean this in the kindest way Ace, but I would not consider it healthy to be in a state of:
"euphoria, extreme motivation"
If you're feeling good, count your blessings. Then there will be more chance they'll be there for you when you really just need to feel normal.
Tanke CareLinkadge
Posted by ed_uk on June 19, 2005, at 16:20:04
In reply to Re: What AD most like Tramadol??? » ed_uk, posted by rod on June 19, 2005, at 14:18:14
Hi Roli!
>So now I am on Periactin and its working like a little magic pill :-)))
That's great!!! Was it your idea to try cyproheptadine? I think cypro would knock me out, antihistamines always do.
>its wiping out my apathy and numbness and mental slowness........
That's really interesting. Did you decide to try it because it's a serotonin antagonist? Do you find it quite anticholinergic?
By the way, have you ever tried mirtazapine (Remeron)? I wonder whether you'd find that it had a similar effect to Periactin. Perhaps not, it's not anticholinergic - I know you like anticholinergics.
>It really improved functionality. I am looking forward to start a part time job as an assistant at some kind of cancer research institute (no I do not study anything related to that.) And I feel mentally fit eenough to do the job YAY !! horray.
Wow, the Periactin is really good! You sound so happy :-D
>nortriptyline 125mg.......for depression?
Periactin 12mg........for apathy?
Solian 50mg.........for depression/apathy/anxiety?
Lyrica 300mg...........for anxiety?
Nicergoline 30mg........to boost your brain power?!
Pentoxifylline (or something like that :P ) 600mg.............to boost your memory?
Rivotril 0,25 (im tapering off).......for anxiety?
Diphenhydramine 50mg (also tapering).......for sleep?What an interesting combination! You must have an innovative pdoc. Tell me more :-)
Bye!
~Ed
Posted by Phillipa on June 19, 2005, at 18:32:06
In reply to Re: What AD most like Tramadol??? » ed_uk, posted by rod on June 19, 2005, at 14:18:14
Sounds like Greek to me. Are there American names for these meds? Fondly, Phillipa
Posted by rod on June 20, 2005, at 7:12:20
In reply to Re: What AD most like Tramadol??? » rod, posted by ed_uk on June 19, 2005, at 16:20:04
>Sounds like Greek to me. Are there American names for these meds? Fondly, Phillipa
hehe no. not greek. Substance Names are the qite the same everywhere in the world. Somethinmes the only differ in the last "e" of the name... But some I have mentionend are trade names.
> Hi Roli!
>
> >So now I am on Periactin and its working like a little magic pill :-)))
>
> That's great!!! Was it your idea to try cyproheptadine? I think cypro would knock me out, antihistamines always do.
>
> >its wiping out my apathy and numbness and mental slowness........
>
> That's really interesting. Did you decide to try it because it's a serotonin antagonist? Do you find it quite anticholinergic?Exactly. I wanted to know what an serotonin antagonist does for me. And I dont find it anticholinergic at all. I wanted to add some more 5-ht(2A) antagonism. But I dont know the affinities of the different subreceptor families for it. Sometimes its even called an unspecific antiserotonergic agent? is it true? And what I dont understand is that it actually does not induce depression as aside effect...
> By the way, have you ever tried mirtazapine (Remeron)? I wonder whether you'd find that it had a similar effect to Periactin. Perhaps not, it's not anticholinergic - I know you like anticholinergics.
Like Scott, Remeron makes me much much worse after a short time. Dont really know why....
> >It really improved functionality. I am looking forward to start a part time job as an assistant at some kind of cancer research institute (no I do not study anything related to that.) And I feel mentally fit eenough to do the job YAY !! horray.
>
> Wow, the Periactin is really good! You sound so happy :-D
>
> >nortriptyline 125mg.......for depression?yes
> Periactin 12mg........for apathy?
just to make me generally better. also some anti stress effect(look at pubmed. it also decreases HPA axis activity)
> Solian 50mg.........for depression/apathy/anxiety?
anxiety, tensions, motivation, depression... (Subbtance name: Amisulpride)
> Lyrica 300mg...........for anxiety?
well, I would describe it as having an anti stress effect and makes me think more clearly.
> Nicergoline 30mg........to boost your brain power?!
yup :) It is acting as a mild psychostimulant for me.
Substance name. not available in US> Pentoxifylline (or something like that :P ) 600mg.............to boost your memory?
It has some anti stress effect for me. this might explain it:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14566072&query_hl=2
trade name "Trental", substance: "Pentoxifylline"> Rivotril 0,25 (im tapering off).......for anxiety?
anxiety, sleep.
Substance name: Clonazepam> Diphenhydramine 50mg (also tapering).......for sleep?
sleep, depression
Trade name: Benadryl> What an interesting combination! You must have an innovative pdoc. Tell me more :-)
hmmm actually this combination has "evolved" over time. I just tried some stuff and if it had an positive effect, I have kept it, as long it was beneficial...
And I would describe my doc as a consultant, because in the appointments we discuss things togehter. But most of the time I get what I want, if I have some good arguments... =)
But in the end its more like a "lets try and see" story...
> Bye!
>
> ~Edgood bye
Roland
Posted by rod on June 20, 2005, at 7:49:17
In reply to Re: What AD most like Tramadol???, posted by rod on June 20, 2005, at 7:12:20
Soemthing I forgot to clarify is that stress makes me depressed, apahtic and confused. And those drugs which seem to fight that almost feel like they are re-kindle a little flame in my forebrain, improving concentration, constructive thinking, defeat apathy.
but now I said enough about little me :P
I have already hi-jacked aces thread... sorry acebye
Roland> >Sounds like Greek to me. Are there American names for these meds? Fondly, Phillipa
>
> hehe no. not greek. Substance Names are the qite the same everywhere in the world. Somethinmes the only differ in the last "e" of the name... But some I have mentionend are trade names.
>
>
> > Hi Roli!
> >
> > >So now I am on Periactin and its working like a little magic pill :-)))
> >
> > That's great!!! Was it your idea to try cyproheptadine? I think cypro would knock me out, antihistamines always do.
> >
> > >its wiping out my apathy and numbness and mental slowness........
> >
> > That's really interesting. Did you decide to try it because it's a serotonin antagonist? Do you find it quite anticholinergic?
>
> Exactly. I wanted to know what an serotonin antagonist does for me. And I dont find it anticholinergic at all. I wanted to add some more 5-ht(2A) antagonism. But I dont know the affinities of the different subreceptor families for it. Sometimes its even called an unspecific antiserotonergic agent? is it true? And what I dont understand is that it actually does not induce depression as aside effect...
>
> > By the way, have you ever tried mirtazapine (Remeron)? I wonder whether you'd find that it had a similar effect to Periactin. Perhaps not, it's not anticholinergic - I know you like anticholinergics.
>
> Like Scott, Remeron makes me much much worse after a short time. Dont really know why....
>
> > >It really improved functionality. I am looking forward to start a part time job as an assistant at some kind of cancer research institute (no I do not study anything related to that.) And I feel mentally fit eenough to do the job YAY !! horray.
> >
> > Wow, the Periactin is really good! You sound so happy :-D
> >
> > >nortriptyline 125mg.......for depression?
>
> yes
>
> > Periactin 12mg........for apathy?
>
> just to make me generally better. also some anti stress effect(look at pubmed. it also decreases HPA axis activity)
>
> > Solian 50mg.........for depression/apathy/anxiety?
>
> anxiety, tensions, motivation, depression... (Subbtance name: Amisulpride)
>
> > Lyrica 300mg...........for anxiety?
>
> well, I would describe it as having an anti stress effect and makes me think more clearly.
>
> > Nicergoline 30mg........to boost your brain power?!
>
> yup :) It is acting as a mild psychostimulant for me.
> Substance name. not available in US
>
> > Pentoxifylline (or something like that :P ) 600mg.............to boost your memory?
>
> It has some anti stress effect for me. this might explain it:
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14566072&query_hl=2
> trade name "Trental", substance: "Pentoxifylline"
>
> > Rivotril 0,25 (im tapering off).......for anxiety?
>
> anxiety, sleep.
> Substance name: Clonazepam
>
> > Diphenhydramine 50mg (also tapering).......for sleep?
>
> sleep, depression
> Trade name: Benadryl
>
> > What an interesting combination! You must have an innovative pdoc. Tell me more :-)
>
> hmmm actually this combination has "evolved" over time. I just tried some stuff and if it had an positive effect, I have kept it, as long it was beneficial...
> And I would describe my doc as a consultant, because in the appointments we discuss things togehter. But most of the time I get what I want, if I have some good arguments... =)
> But in the end its more like a "lets try and see" story...
>
>
> > Bye!
> >
> > ~Ed
>
> good bye
> Roland
Posted by ed_uk on June 20, 2005, at 11:35:36
In reply to Re: What AD most like Tramadol???, posted by rod on June 20, 2005, at 7:12:20
Hi Roli!
>hijack...
I think it was me who hijacked the thread :-O
Sorry ACE <blush>>But I dont know the affinities of the different subreceptor families for it.
It mainly binds to 5-HT2 receptors.....and of course, it's a very potent antihistamine..........
>And what I dont understand is that it actually does not induce depression as aside effect...
Antagonism at certain serotonin receptors can be a good thing.
>Like Scott, Remeron makes me much much worse after a short time.
Does it make you irritable and restless?
>And I would describe my doc as a consultant, because in the appointments we discuss things togehter.
I want your doc! Can you send him to the UK please?
Bye Roli :-)
~Ed
Posted by Chairman_MAO on June 20, 2005, at 15:23:24
In reply to What AD most like Tramadol???, posted by ace on June 19, 2005, at 1:54:23
Drug-induced euprhoria ALWAYS fades to some degree. ALWAYS. You will NEVER be able to recapture the initial euphoria you felt on Nardil; this is simply the nature of the brain, mind, and LIFE. Moreover, increased 5-HT is NOT what you need for this euphoria. Indeed, unless you can convince me otherwise using a rational argument, I will maintain that your reasoning is based upon a dangerously flawed understanding of neuropsychopharm and the mechanism of action of the drugs in question here. DO NOT mix a potent serotonergic with an MAOI! ____*****YOU WILL NOT GET THE RESULTS YOU ARE SEEKING, AND WILL LIKELY END UP DELIRIOUS, IN THE E.R., OR EVEN DEAD!*****______ Try l-tryptophan if you wish to test out this hypothesis. However, even that combination can result in serotonin syndrome; it simply has SOME track record of safety, and was popular in the 70s and early 80s, AFAIK.
That said, there are ways to make your response to phenelzine more "robust", which is the closest thing you're going to get to eurphoria, IMO. Please believe me that what you liked about tramadol was the mu-opioid stimulation. Get on an opioid (buprenorphine, tramadol, morphine, etc)! Tramadol's effects on 5-ht are weak, and yet you report that it "brings back the Nardil euphoria". If that's so, then why do you draw the conclusion that a more potent serotonergic agent is what you need? That seems illogical to me.
If you cannot get on an opioid, you need something to enhance activity in the nucleus accumbens. Opioids inhibit GABAnergic activity in the NAc, thereby enhancing dopaminergic tone there, which gives a sense of well-being. Moreover, they inhibit NE release in the locus coeruleus, which gives a sense of serenity and calm (the "real" picture is way more complex, but this is the level that I understand). It is likely, however, that the Nardil is already fulfilling this function, so it is not as important.
Thus, you need an agent to increase DA tone in the NAc. You can go with a direct DA agonist: use either cabergoline up to ~8mg/day (one case study had success at 2.5mg), or pramipexole/ropinirole. Your pdoc should be able to go over the differences with you, and if you ask me I can go into it further. Tolerance will develop to the feeling of well-being you get from that, however, due to DA autoreceptor desensitization leading to decreased DA release. Thus, you need a DA autoreceptor antagonist (amisulpride, which may work alone in this application) or a DA releaser (amantadine, memantine). In fact, tramadol/buprenorphine + memantine would be an excellent combination, because memantine (ideal dose for this 60mg/day) is known to attenuate opioid tolerance.
For the biggest "punch", try Nardil + cabergoline 1-8mg/day + buprenorphine 0.3mg-0.6mg sublingual (or whatever dose works for you). Bupe is arguably the best antidepressant opioid because of kappa antagonism. Its limited abuse potential also makes it attractive to pdocs. On top of that, add memantine, 10-30mg bid, and you have a regimen that basically will give you as much "euphoria" as you reasonably can expect long-term.
Caveat emptor: euphoria is much more enjoyable when the drugs make it possible to get it from REAL-LIFE experiences as opposed to getting it from the drugs directly. Think about it this way: The weather on some islands in the South Pacific is beautiful. However, many of those islands are crappy places to live because there is no economy. The relation between mood (euphoria) and your life is the same: No matter how great your mood, if you don't have content in your life that matches it, no amount of euphoria will ever be satisfying enough.
PLEASE heed my warnings and do not add a potent serotonergic agent to Nardil! The fact that you keep contemplating this despite what we're saying here worries me. I empathize with your quest for well-being in more ways than you likely imagine, and what may seem like harsh criticism is actually my trying to bequeath to you wisdom that I learned the hard way--so you don't have to.
Please keep us posted on what you decide to do, and best of luck.
--cm
This is the end of the thread.
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