![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by KaraS on September 18, 2005, at 16:18:50
In reply to Re: Name change... » KaraS, posted by neuroman on September 15, 2005, at 20:24:45
> How are you? I've spent the last few months trying some things. I've been bouncing around cyberspace doing research of course. Also spent plenty of time laying in bed and staring at the ceiling and banging my head against the wall.
That's one of my favorite pasttimes as well. :(
> > I liked your old name - thought it was very clever.
>
> Well...when I first registered I couldn't think of a name. The TV happened to be on and the movie that was playing was "Force Ten From Navarrone" with the Italian actor Franco Nero. Since I am Italian and i'm also a neurosomatic mental case, I thought franco neuro would be a good fit. But i've done so much reading about the brain, the nervous system and neurotransmitters I feel like i've truly become...neuroman! Besides, my name is Paul. Maybe I should've been paolo neuro?
>
> Have you made any progress towards good health and happiness? I certainly hope so...
I don't feel much better yet but I've also gained more knowledge. I got that rEEG done. It said I was low dopamine (no sh*t!) but it also said that I don't need serotonin. I previously thought I needed both. The doctor also diagnosed me as having ADD which was a relief. I have suspected that for a while now. He prescribed beta blockers and Dexedrine for me. I've only taken the Dex a couple of times and it has made me calm and sedated - not the motivation I was looking for. I need to up the dosage now and experiment with it. How about you? Were you able to find a doctor who was willing to do the IV ketamine experiment?
Posted by neuroman on September 18, 2005, at 16:18:51
In reply to Re: Name change... » neuroman, posted by KaraS on September 16, 2005, at 1:57:26
> I don't feel much better yet but I've also gained more knowledge. I got that rEEG done. It said I was low dopamine (no sh*t!) but it also said that I don't need serotonin. I previously thought I needed both. The doctor also diagnosed me as having ADD which was a relief. I have suspected that for a while now. He prescribed beta blockers and Dexedrine for me. I've only taken the Dex a couple of times and it has made me calm and sedated - not the motivation I was looking for. I need to up the dosage now and experiment with it.
Sounds like we're in the same boat. I may need to try a stimulant too but I have the feeling it may just knock me out like the bupropion did. It's interesting that he prescribed beta blockers. How do they make you feel?
> How about you? Were you able to find a doctor who was willing to do the IV ketamine experiment?
Unfortunately no. But I'm still looking. Been shopping around for a psychiatrist that's willing to try some things. Can't make a decision. I did manage to give myself a rather sloppy lidocaine IV. (Don't ask me how I managed to pull that one off.) Didn't really do much. I've been taking a lot of tyrosine and DLPA. It's helped with pain but isn't a cure. Maybe 20 years ago it would have helped me avoid getting depleted, but I need the hard stuff now.
A few months ago a friend of mine gave me some of his lamical. I took 25mg for a week or so then went to 50mg for a few days. Didn't feel much except a slight jaw tightness for the first couple of days. I think it suppresses dopamine initially for a few days after a dose increase than it (the dopamine) moves back to baseline. Anyway, i didn't have too many pills so i came down off the 50mg over a couple of days. Holy cow! Wherever I originally had pain felt a whole lot worse. So i wondered, if stopping a certain med makes all your symptoms worse, than maybe it was working on the right areas. So I went back to Braverman and got a script. Also got some gabapentin to compare with the lamictal. I took 300mg gabapentin in the PM for about a month. Have you ever taken gabapentin? It helped me sleep, helped with nerve pain and for some reason it still makes me horny. I know it's working on dopamine somehow. I think because it antagonizes the NMDA receptor at the glycine site (i think). This is why i would really love to try the ketamine IV. I'll have to throw up a thread about this and get some thoughts from other people who've tried gabapentin. The problem is that it's too sedating for me to take during the day and the short half life caused a daily pain rebound that wasn't too pleasant. Had to taper off because the withdrawal rebound was similar to lamictal. Well now i'm on 50mg of lamictal and plan to go up to 100 or 200mg and see if it helps with pain. Than maybe add a dopamine agonist or maybe try bupropion again. Also gave reboxatine a test run. And yesterday popped one tianeptine. It gave me a slight boost in the feeling of well being and a very slight pain relief. Any way you look at it i won't feel better without a whole lot more dopamine. I saw a post by "Lunesta" last week having to do with glutamate and excitotoxicity. It was an interesting post. Would like to get some of his/her thoughts on some stuff. I guess i'll just keep trying things. But playing with the lamictal and gabapentin like i have been was no picnic. Set me back for a while but I think i'm starting to recover. Back to my usual familiar rotten state that is. Ok i'll stop now so i can give my fingers a rest...
Posted by wildcard on September 18, 2005, at 16:18:51
In reply to Re: Name change... » KaraS, posted by neuroman on September 16, 2005, at 10:35:47
hey! i skimmed over ur post re: dopamine and it interested me b/c only effexor and wellbutrin have given me *some* relief. i know this should be on the med board so i look fwd to seeing u there. take care ; )
Posted by neuroman on September 18, 2005, at 16:18:51
In reply to Re: Name change... » neuroman, posted by wildcard on September 16, 2005, at 10:54:58
Good point. I'll have to strart up a thread on the med board. As soon as I can muster up the motivation that is. (Damn low dopamine!) :-)
Posted by wildcard on September 18, 2005, at 16:18:51
In reply to Re: Name change... » wildcard, posted by neuroman on September 16, 2005, at 11:15:11
Posted by KaraS on September 18, 2005, at 16:18:51
In reply to Re: Name change... » KaraS, posted by neuroman on September 16, 2005, at 10:35:47
> Sounds like we're in the same boat. I may need to try a stimulant too but I have the feeling it may just knock me out like the bupropion did. It's interesting that he prescribed beta blockers. How do they make you feel?
I am hoping that eventually the autoreceptors will eventually downregulate in response to an increase in dopamine. When I took 5 mg. of selegiline it used to make me tired. After a few days of this it still made me tired but after several hours I started getting a stimulant response. It ended up keeping me up that night and since I was working at the time, I didn't experiment with it further but I do think there's a good chance that in time I would have ended up with stimulation after I took the selegiline.
The beta blockers are helpful. I don't have huge spikes in pulse rate. I like that. I only need a very small amount in order for them to keep my pulse rate in the 60's so I really don't have any bad side effects. The only thing I don't like about them is that I can no longer get a big kick from caffeine.
> > How about you? Were you able to find a doctor who was willing to do the IV ketamine experiment?
>
> Unfortunately no. But I'm still looking. Been shopping around for a psychiatrist that's willing to try some things. Can't make a decision. I did manage to give myself a rather sloppy lidocaine IV. (Don't ask me how I managed to pull that one off.) Didn't really do much. I've been taking a lot of tyrosine and DLPA. It's helped with pain but isn't a cure. Maybe 20 years ago it would have helped me avoid getting depleted, but I need the hard stuff now.
I don't have the additional problem of pain. That's got to be tough to handle. It's bad enough having depression and no motivation.
> A few months ago a friend of mine gave me some of his lamical. I took 25mg for a week or so then went to 50mg for a few days. Didn't feel much except a slight jaw tightness for the first couple of days. I think it suppresses dopamine initially for a few days after a dose increase than it (the dopamine) moves back to baseline. Anyway, i didn't have too many pills so i came down off the 50mg over a couple of days. Holy cow! Wherever I originally had pain felt a whole lot worse. So i wondered, if stopping a certain med makes all your symptoms worse, than maybe it was working on the right areas. So I went back to Braverman and got a script. Also got some gabapentin to compare with the lamictal. I took 300mg gabapentin in the PM for about a month. Have you ever taken gabapentin? It helped me sleep, helped with nerve pain and for some reason it still makes me horny. I know it's working on dopamine somehow. I think because it antagonizes the NMDA receptor at the glycine site (i think). This is why i would really love to try the ketamine IV. I'll have to throw up a thread about this and get some thoughts from other people who've tried gabapentin. The problem is that it's too sedating for me to take during the day and the short half life caused a daily pain rebound that wasn't too pleasant. Had to taper off because the withdrawal rebound was similar to lamictal. Well now i'm on 50mg of lamictal and plan to go up to 100 or 200mg and see if it helps with pain. Than maybe add a dopamine agonist or maybe try bupropion again. Also gave reboxatine a test run. And yesterday popped one tianeptine. It gave me a slight boost in the feeling of well being and a very slight pain relief. Any way you look at it i won't feel better without a whole lot more dopamine. I saw a post by "Lunesta" last week having to do with glutamate and excitotoxicity. It was an interesting post. Would like to get some of his/her thoughts on some stuff. I guess i'll just keep trying things. But playing with the lamictal and gabapentin like i have been was no picnic. Set me back for a while but I think i'm starting to recover. Back to my usual familiar rotten state that is. Ok i'll stop now so i can give my fingers a rest...
I haven't tried Lamictal yet but I have tried gabapentin. It really knocked me out and created a lot of nausea too. I didn't like it at all. At least you're trying the right things. Did you say you've tried nortriptyline yet? I think I remember that you have. Could you not take it because of the tachycardia? Am I remembering correctly? If so, maybe you could try it again with a beta blocker (preferably a cardio-selective one like atenolol). Tianeptine sounds interesting. I've wanted to try that one for a while now. Have you thought about amantadine at all?
Posted by neuroman on September 18, 2005, at 16:18:51
In reply to Re: Name change... » neuroman, posted by KaraS on September 17, 2005, at 22:51:56
> I haven't tried Lamictal yet but I have tried gabapentin. It really knocked me out and created a lot of nausea too. I didn't like it at all. At least you're trying the right things. Did you say you've tried nortriptyline yet? I think I remember that you have. Could you not take it because of the tachycardia? Am I remembering correctly? If so, maybe you could try it again with a beta blocker (preferably a cardio-selective one like atenolol). Tianeptine sounds interesting. I've wanted to try that one for a while now. Have you thought about amantadine at all?
Have to keep trying stuff. I'm pretty wary of TCA's. The one I took was elavil (amitriptyline) for 3 1/2 years. Besides the serotonin/norepinephrine effects TCA'S also block ion channels (like most anti-convulsants but in a somewhat different manner). By doing this they also suppress the release of glutamate. I didn't know any of this when i stopped it too quickly. I think the rebound secretion of glutamate and/or the influx of calcium may have caused excitotoxic damage which i still haven't recovered from. And of course the rebound anxiety and insomnia all added to the disaster. But what's done is done.
Since tyrosine/DLPA do help and bupropion also initially had an unexpected pain relieving effect, I think there is still hope of repairing some of the damage. I'm not sure lamictal is really a good choice for me. While my mood has been somewhat improved, my left side pain hasn't. It may be suppressing transmitter release a little too much. I'm also not sleeping. Here is a short list of some other meds i'd like to try:
amantadine - (definitely) dopamine agonist, NMDA antagonist
hydergine - dopamine and acetylcholine agonist
clonidine - alpha2 receptor agonist, has shown efficacy in treating ADD/ADHD (dopaminergic?), pain, muscle twitches, may be sedating, causes growth hormone release and is reputed to cause pleasant dreams! If clonidine helps then switch to guanfacine which is also an alpha2 agonist but has fewer side effects.
At some point a stimulant.
Maybe try your beta blocker. :-)
It all comes down to that darned overactive stress (fight or flight) response. Every time it's activated you get the dopamine-norepinephrine-epinephrine conversion. Over time this depletes dopamine and generally leaves you with chronically elevated levels of epinephrine. That's not good for the blood vessels. Or anything elso for that matter. I have it all figured out. Except how to fix it. Argh! >-[ By the way, how long have you been taking this combo? I have a good feeling about it. Boost dopamine and ease stress/anxiety. That's the way to go...
Posted by wildcard on September 18, 2005, at 16:18:51
In reply to Re: Name change... » KaraS, posted by neuroman on September 18, 2005, at 0:12:13
Posted by neuroman on September 18, 2005, at 18:47:40
In reply to PLEEEZ go to med board..i need ur knowledge ; ) (nm) » neuroman, posted by wildcard on September 18, 2005, at 0:22:19
OK...I was forcibly ejected from the admin. board...I hope your happy... :-)
Posted by Phillipa on September 18, 2005, at 19:02:28
In reply to Re: PLEEEZ go to med board..i need ur knowledge ; ) » wildcard, posted by neuroman on September 18, 2005, at 18:47:40
Willyee Welcome back! Fondly, Phillipa
Posted by KaraS on September 19, 2005, at 0:31:59
In reply to Re: Name change... » KaraS, posted by neuroman on September 18, 2005, at 0:12:13
> > I haven't tried Lamictal yet but I have tried gabapentin. It really knocked me out and created a lot of nausea too. I didn't like it at all. At least you're trying the right things. Did you say you've tried nortriptyline yet? I think I remember that you have. Could you not take it because of the tachycardia? Am I remembering correctly? If so, maybe you could try it again with a beta blocker (preferably a cardio-selective one like atenolol). Tianeptine sounds interesting. I've wanted to try that one for a while now. Have you thought about amantadine at all?
>
> Have to keep trying stuff. I'm pretty wary of TCA's. The one I took was elavil (amitriptyline) for 3 1/2 years. Besides the serotonin/norepinephrine effects TCA'S also block ion channels (like most anti-convulsants but in a somewhat different manner). By doing this they also suppress the release of glutamate. I didn't know any of this when i stopped it too quickly. I think the rebound secretion of glutamate and/or the influx of calcium may have caused excitotoxic damage which i still haven't recovered from. And of course the rebound anxiety and insomnia all added to the disaster. But what's done is done.
OK, scratch the TCA recommendation.
> Since tyrosine/DLPA do help and bupropion also initially had an unexpected pain relieving effect, I think there is still hope of repairing some of the damage. I'm not sure lamictal is really a good choice for me. While my mood has been somewhat improved, my left side pain hasn't. It may be suppressing transmitter release a little too much. I'm also not sleeping. Here is a short list of some other meds i'd like to try:
>
> amantadine - (definitely) dopamine agonist, NMDA antagonist
>
> hydergine - dopamine and acetylcholine agonist
>
> clonidine - alpha2 receptor agonist, has shown efficacy in treating ADD/ADHD (dopaminergic?), pain, muscle twitches, may be sedating, causes growth hormone release and is reputed to cause pleasant dreams! If clonidine helps then switch to guanfacine which is also an alpha2 agonist but has fewer side effects.
>
> At some point a stimulant.
>
> Maybe try your beta blocker. :-)
Sounds like a good list. Hydergine should be easy to get since it doesn't require a prescription. I've never heard of guanfacine but why start with clonidine if you're only going to switch over? Why not just try guanfacine to begin with?I'll keep you posted as to whether I ever get a stimulant response from the Dexedrine. My fingers are crossed. Even if I feel calm on it but have some motivation, I'd be very happy.
> It all comes down to that darned overactive stress (fight or flight) response. Every time it's activated you get the dopamine-norepinephrine-epinephrine conversion. Over time this depletes dopamine and generally leaves you with chronically elevated levels of epinephrine. That's not good for the blood vessels. Or anything elso for that matter. I have it all figured out. Except how to fix it. Argh! >-[ By the way, how long have you been taking this combo? I have a good feeling about it. Boost dopamine and ease stress/anxiety. That's the way to go...
I also wonder if the SSRIs are responsible for my low dopamine as well as the overactive fight or flight response. Heredity could be to blame as well since I've got an attention deficit issue, which I'm pretty sure I was born with.I wish you could find a doctor who would work with you on your level.
k
Posted by neuroman on September 20, 2005, at 12:45:14
In reply to Re: Name change... » neuroman, posted by KaraS on September 19, 2005, at 0:31:59
Hi,
> OK, scratch the TCA recommendation.Actually, I'm still keeping desiprimine as a possibility. I just won't take it for three years and then stop it in three weeks!
> I've never heard of guanfacine but why start with clonidine if you're only going to switch over? Why not just try guanfacine to begin with?
Good point. I think clonidine is stronger and will give a more certain indication that alpha2 agonism will help. But I guess one could try the guanfacine. Whatever I can get my hands on first will be the deciding factor. :-)
> I'll keep you posted as to whether I ever get a stimulant response from the Dexedrine. My fingers are crossed. Even if I feel calm on it but have some motivation, I'd be very happy.
Please do keep me posted. Hopefully we can learn from each others experiences. While no two brains are the same, some are more similar than others. Ours may be very similar... :-)
> I also wonder if the SSRIs are responsible for my low dopamine
While i doubt that they are responsible for your (or my) low dopamine, they certainly haven't helped the situation and probably made an underlying deficiency worse. I think Paxil is the worst offender. Prozac the least. IMHO that is. If you have high dopamine levels and are stressed they might be a good choice. But once dopamine levels are low they are a very bad choice.
> ...as well as the overactive fight or flight response.
Initially, one would think that this wouldn't be the case because they are often prescribed to have the exact opposite effect. (i.e. to suppress situational anxiety, social phobia, etc.) Paxil did seem to suppress my f/f response at first. Unfortunately, I was paying the price of further suppression of already low dopamine levels.
But putting dopamine aside for a moment there is also the matter of individual serotonin receptors. It has been shown in rats that 5-HT1a receptor agonists (such as buspirone) produce a marked enhancement of the acoustic startle response. Which is probably the last thing someone with an over the top f/f response or generalized anxiety or hypervigilance needs. This is probably because our 5-HT1a receptors are over-sensitized to begin with. Prozac desensitizes the 5-HT1a receptor with chronic treatment, whereas neither Paxil or Zoloft has this effect. They may make matters worse by increasing serotonin across the board without desensitizing the 5-HT1a receptor.
There may be problems with individual DA receptors also. You already know about sensitized autoreceptors, but there may be an imbalance of D1 (stimulatory) vs. D2 (inhibitory) receptors. In any event it all comes down to raising dopamine while suppressing the DA-NE-E stress response. It's not easy to do since most agents that supposedly suppress the stress response (serotonergic & gabaergic) also tend to suppress dopamine. This sucks...I just want to feel better...
> Heredity could be to blame as well since I've got an attention deficit issue, which I'm pretty sure I was born with.
I have no doubt that I was born predisposed toward anxiety.
> I wish you could find a doctor who would work with you on your level.
That has been my fervent and as of yet unanswered prayer. You know when a person desires something or expects a reward their dopamine goes up. When that desire is fulfilled or the expectation is met than their dopamine levels remain high. On the other hand, if those desires or expectations are not met than their dopamine levels plummet. In layman's terms this is called FRUSTRATION!!! Every time i made an appointment with a new doc i would feel good. ("Finally, i'll get some help and get to the bottom of this...") And every time i would end up being frustrated and bitterly disappointed. In this way, to someone whose life had already been filled with a disproportionate amount of frustration and disappointment, the medical community has done me great harm. I no longer have any desire or expecation of reward. I no longer feel much frustration. I no longer feel much of anything. In other words, complete catecholamine burnout.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15858403&query_hl=1
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16165291&query_hl=8Interesting how the areas dealing with frustration and emotional pain seem to overlap. Isn't our right brain supposed to be the emotional side? May explain why my physical pain is predominately on the left side of my body. Just speculation...
Paul
Posted by KaraS on September 23, 2005, at 16:01:47
In reply to I'm keeping my fingers crossed too... » KaraS, posted by neuroman on September 20, 2005, at 12:45:14
Hi,
I want to get back to this thread and a few others on the board but I don't have the time right now. I'll try to get back to it this weekend. For now, I'll just bring it back to the board.
Talk to you later.
k
Posted by KaraS on September 25, 2005, at 2:58:40
In reply to Re: I'm keeping my fingers crossed too... » neuroman, posted by KaraS on September 23, 2005, at 16:01:47
Hi,
> Actually, I'm still keeping desiprimine as a possibility. I just won't take it for three years and then stop it in three weeks!
Good idea. It's definitely the best of the TCAs.
> Good point. I think clonidine is stronger and will give a more certain indication that alpha2 agonism will help. But I guess one could try the guanfacine. Whatever I can get my hands on first will be the deciding factor. :-)
Another good plan.
> > I'll keep you posted as to whether I ever get a stimulant response from the Dexedrine. My fingers are crossed. Even if I feel calm on it but have some motivation, I'd be very happy.
>
> Please do keep me posted. Hopefully we can learn from each others experiences. While no two brains are the same, some are more similar than others. Ours may be very similar... :-)
It sound like it though I don't have neuropathy issues.
> > I also wonder if the SSRIs are responsible for my low dopamine
>
> While i doubt that they are responsible for your (or my) low dopamine, they certainly haven't helped the situation and probably made an underlying deficiency worse. I think Paxil is the worst offender. Prozac the least. IMHO that is. If you have high dopamine levels and are stressed they might be a good choice. But once dopamine levels are low they are a very bad choice.
I know this intellectually yet I find myself wanting to go back on Effexor low dose (75 mg). In the past that amount did raise my spirits while controlling the anxiety. It allowed me to be good company and feel some joy. I didn't have any motivation on it but I found once I went off of it that I didn't have any more motivation. I'm wondering if I went back on it and added in enough of a stimulant, whether this might be a good combination. What do you think?
Horrible idea?
> > ...as well as the overactive fight or flight response.
>
> Initially, one would think that this wouldn't be the case because they are often prescribed to have the exact opposite effect. (i.e. to suppress situational anxiety, social phobia, etc.) Paxil did seem to suppress my f/f response at first. Unfortunately, I was paying the price of further suppression of already low dopamine levels.
SSRIs alone or without dopaminergic meds can be damaging in my opinion. I see people who are doing well on them but I wonder how long it will be before the apathy and lack of motivation set in.
> But putting dopamine aside for a moment there is also the matter of individual serotonin receptors. It has been shown in rats that 5-HT1a receptor agonists (such as buspirone) produce a marked enhancement of the acoustic startle response. Which is probably the last thing someone with an over the top f/f response or generalized anxiety or hypervigilance needs. This is probably because our 5-HT1a receptors are over-sensitized to begin with. Prozac desensitizes the 5-HT1a receptor with chronic treatment, whereas neither Paxil or Zoloft has this effect. They may make matters worse by increasing serotonin across the board without desensitizing the 5-HT1a receptor.
That's really interesting. It might help to explain why I've had an exaggerated startle response over the years. I wonder if that would also pertain to the startle response when you're hit on the knee. Mine always makes the doctors think that I'm hyperthyroid ... even though I'm hypothyroid. How does Effexor fit in here? Does it desensitize the 5-HT1a receptor?
> There may be problems with individual DA receptors also. You already know about sensitized autoreceptors, but there may be an imbalance of D1 (stimulatory) vs. D2 (inhibitory) receptors. In any event it all comes down to raising dopamine while suppressing the DA-NE-E stress response. It's not easy to do since most agents that supposedly suppress the stress response (serotonergic & gabaergic) also tend to suppress dopamine. This sucks...I just want to feel better...
I hear you. My doctor thought that beta blockers might do that for me but it hasn't proved to be enough. A friend of mine just told me about another of the doctor's patients who is doing a lot better just from the beta blockers. But there are still other medications for us to try yet.
> > Heredity could be to blame as well since I've got an attention deficit issue, which I'm pretty sure I was born with.
>
> I have no doubt that I was born predisposed toward anxiety.
Same here.
> > I wish you could find a doctor who would work with you on your level.
>
> That has been my fervent and as of yet unanswered prayer. You know when a person desires something or expects a reward their dopamine goes up. When that desire is fulfilled or the expectation is met than their dopamine levels remain high. On the other hand, if those desires or expectations are not met than their dopamine levels plummet. In layman's terms this is called FRUSTRATION!!! Every time i made an appointment with a new doc i would feel good. ("Finally, i'll get some help and get to the bottom of this...") And every time i would end up being frustrated and bitterly disappointed. In this way, to someone whose life had already been filled with a disproportionate amount of frustration and disappointment, the medical community has done me great harm. I no longer have any desire or expecation of reward. I no longer feel much frustration. I no longer feel much of anything. In other words, complete catecholamine burnout.
>
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15858403&query_hl=1
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16165291&query_hl=8
I think this very phenomenom helped to make my EEG look better than it normally would. It's hard to keep hoping after many let downs though.
> Interesting how the areas dealing with frustration and emotional pain seem to overlap. Isn't our right brain supposed to be the emotional side? May explain why my physical pain is predominately on the left side of my body. Just speculation...
Dunno but I'm skeptical.
K
Posted by KaraS on September 25, 2005, at 3:02:25
In reply to I'm keeping my fingers crossed too... » KaraS, posted by neuroman on September 20, 2005, at 12:45:14
Can you turn your babble mail on for a short while? There are some details I wanted to mention to you that I don't want to post on the board.
k
Posted by neuroman on September 25, 2005, at 20:03:18
In reply to Re: I'm keeping my fingers crossed too... » KaraS, posted by KaraS on September 25, 2005, at 2:58:40
Hi Kara,
> I know this intellectually yet I find myself wanting to go back on Effexor low dose (75 mg). In the past that amount did raise my spirits while controlling the anxiety. It allowed me to be good company and feel some joy. I didn't have any motivation on it but I found once I went off of it that I didn't have any more motivation. I'm wondering if I went back on it and added in enough of a stimulant, whether this might be a good combination. What do you think?
Horrible idea?I understand completely. I've felt so rotten lately that I've even wondered if I should just start taking the Elavil again so that I can sleep and function again. Maybe half a life is better than no life. But I'm not there yet. I still say that a tiny amount of Paxil or tryptophan or 5htp (if they were available) way back when I was really excited (too excited) about life could have made a huge difference, but not now. I think you should stick with the dopaminergics for now. Are they still making you tired? Maybe you should consider starting with tiny amounts and building up slowly. I took a bupropion SR during the week and didn't feel much. I haven't been sleeping and got out of bed exhausted the next day but as the morning progressed I started feeling pretty good. I ended up having the best day that I've had in a long time. Almost felt normal. Had very little pain. Was listening to and enjoying music. I think I just may be a very slow metabolizer and may need to take it every other day. Maybe taking it every day it was building up in my system and triggering the autoreceptors to shut down dopamine secretion and knock me out. Maybe we need subclinical dosages initially so we can come in below the radar (autoreceptors) so to speak. Also Dr. Jay Goldstein would give all of his patients taking stimulants 500mg of niacinimide per day because he felt it protected the dopamine neurons. I don't know why or how but it might be a good idea.
> SSRIs alone or without dopaminergic meds can be damaging in my opinion. I see people who are doing well on them but I wonder how long it will be before the apathy and lack of motivation set in.I agree. My sister's been on zoloft for seven years. We're a lot alike. I think she's been getting some signs of low dopamine and want her to start supplementing with DLPA or tyrosine.
> I wonder if that would also pertain to the startle response when you're hit on the knee. Mine always makes the doctors think that I'm hyperthyroid ... even though I'm hypothyroid.
They may be related. I like the fact that my reflexes are over the top, because it allows me to kick my doctors and not be held responsible. :-)
> How does Effexor fit in here? Does it desensitize the 5-HT1a receptor?
Not sure i'll have to look into it.
> My doctor thought that beta blockers might do that for me but it hasn't proved to be enough. A friend of mine just told me about another of the doctor's patients who is doing a lot better just from the beta blockers. But there are still other medications for us to try yet.
I'm sorta trying to do this with the lamictal but i think it might be blocking a few too many ion channels.
> I think this very phenomenom helped to make my EEG look better than it normally would.
May have...
> It's hard to keep hoping after many let downs though.
Don't i know it...
Paul
Posted by neuroman on September 25, 2005, at 20:04:59
In reply to P.S. » neuroman, posted by KaraS on September 25, 2005, at 3:02:25
Darn i thought it was turned on...um..how do i go about turning it on?
Posted by KaraS on September 25, 2005, at 20:53:52
In reply to Re: P.S. » KaraS, posted by neuroman on September 25, 2005, at 20:04:59
> Darn i thought it was turned on...um..how do i go about turning it on?
It looks like you did it. It's on now. I'll try to send you a babblemail.
Posted by neuroman on September 25, 2005, at 21:00:48
In reply to Re: P.S. » neuroman, posted by KaraS on September 25, 2005, at 20:53:52
Did you send the babblemail?
Posted by KaraS on September 25, 2005, at 23:12:13
In reply to Re: P.S. » KaraS, posted by neuroman on September 25, 2005, at 21:00:48
> Did you send the babblemail?
Yes. Let me know if you didn't receive it.
Posted by KaraS on September 26, 2005, at 0:40:57
In reply to Re: I'm keeping my fingers crossed too... » KaraS, posted by neuroman on September 25, 2005, at 20:03:18
> Hi Kara,
>
> > I know this intellectually yet I find myself wanting to go back on Effexor low dose (75 mg). In the past that amount did raise my spirits while controlling the anxiety. It allowed me to be good company and feel some joy. I didn't have any motivation on it but I found once I went off of it that I didn't have any more motivation. I'm wondering if I went back on it and added in enough of a stimulant, whether this might be a good combination. What do you think?
> Horrible idea?
>
> I understand completely. I've felt so rotten lately that I've even wondered if I should just start taking the Elavil again so that I can sleep and function again. Maybe half a life is better than no life. But I'm not there yet. I still say that a tiny amount of Paxil or tryptophan or 5htp (if they were available) way back when I was really excited (too excited) about life could have made a huge difference, but not now. I think you should stick with the dopaminergics for now. Are they still making you tired? Maybe you should consider starting with tiny amounts and building up slowly. I took a bupropion SR during the week and didn't feel much. I haven't been sleeping and got out of bed exhausted the next day but as the morning progressed I started feeling pretty good. I ended up having the best day that I've had in a long time. Almost felt normal. Had very little pain. Was listening to and enjoying music. I think I just may be a very slow metabolizer and may need to take it every other day. Maybe taking it every day it was building up in my system and triggering the autoreceptors to shut down dopamine secretion and knock me out. Maybe we need subclinical dosages initially so we can come in below the radar (autoreceptors) so to speak. Also Dr. Jay Goldstein would give all of his patients taking stimulants 500mg of niacinimide per day because he felt it protected the dopamine neurons. I don't know why or how but it might be a good idea.
That would be great if every other day on the bupropion works for you. An easy solution and much cheaper! I had never heard that about niacinimide. I used to take about 500 mg. a day for anxiety instead of a benzo. Some people can easily take 1500 mg. a day (500 mg. at one time) but even 167 mg. at a time is VERY sedating for me. I have read that NAC is also good to take to counteract neurotoxicity. I don't have any side effects from that one.
> I agree. My sister's been on zoloft for seven years. We're a lot alike. I think she's been getting some signs of low dopamine and want her to start supplementing with DLPA or tyrosine.
I wonder if that is enough to help. I would be curious to hear how that turns out.
> > I wonder if that would also pertain to the startle response when you're hit on the knee. Mine always makes the doctors think that I'm hyperthyroid ... even though I'm hypothyroid.
>
> They may be related. I like the fact that my reflexes are over the top, because it allows me to kick my doctors and not be held responsible. :-)
LOL
> > How does Effexor fit in here? Does it desensitize the 5-HT1a receptor?
>
> Not sure i'll have to look into it.
>
> > My doctor thought that beta blockers might do that for me but it hasn't proved to be enough. A friend of mine just told me about another of the doctor's patients who is doing a lot better just from the beta blockers. But there are still other medications for us to try yet.
>
> I'm sorta trying to do this with the lamictal but i think it might be blocking a few too many ion channels.
That's probably my next trial. I'm a little afraid of THE rash particularly since I don't have health insurance. Maybe I'll try lithium orotate first though.k
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.