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Dr. Bob is Robert Hsiung, MD,
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Posted by SLS on May 28, 2008, at 16:28:28
In reply to Re: C*A*F*F*E*I*N*E..as an antidepressant?, posted by SLS on May 28, 2008, at 16:22:19
> I was depressed in March 2009...a combo of Prozac, Lithium, and geodon is helping me.
By the way, how much lithium are you taking?
Thanks.
- Scott
Posted by IAMtheWalrus on May 28, 2008, at 17:15:35
In reply to Re: C*A*F*F*E*I*N*E..as an antidepressant?, posted by SLS on May 28, 2008, at 16:22:19
> > > > > If caffeine were a true antidepressant, I think we would see more people using it as such. It would certainly be in the media if it were. It would not remain the best kept secret in psychiatry - nor the rest of the world. I have strategically used coffee and caffeine pills as a psychic energy booster and a mood elevator since the early 1980s. It did more for me consistently than the failed antidepressants I was exposed to. It does for depressed people as it does for healthy people. No more. Perhaps less.
> > > > >
> > > > >
> > > > > - Scott
> > > >
> > > > I disagree. When i worked in retail sales many years ago i used to drink huge amounts of strong black coffee and it would most definitely elevate my mood. As with all drugs, everyone is different.
> > > >
> > > > -W
> > >
> > >
> > > Are you depressed right now? If not, when was the last time you were depressed?
> > >
> > >
> > > - Scott
> > >
> > > Not right now, Thank God! I was depressed in March 2009...a combo of Prozac, Lithium, and geodon is helping me.
>
> I'm sure your treatment is nothing less of a miracle that it should provide you with a remission. I am happy for you - really. However,
> your answer begs the question why you are not using caffeine as monotherapy.
>
>
> - Scott
>Ha..i knew you were going to ask that. I said it elevated my mood many years ago, after i developed tolerance to Caffeine, the affect abated. I never said i thought it would make a good long term AD. I said it can elevate your (my) mood. That being said, i don't believe in stimulants as monotherapy for 'most' people with clinical depression.
-W
Posted by IAMtheWalrus on May 28, 2008, at 17:18:07
In reply to Re: C*A*F*F*E*I*N*E..as an antidepressant? » SLS, posted by SLS on May 28, 2008, at 16:28:28
> > I was depressed in March 2009...a combo of Prozac, Lithium, and geodon is helping me.
>
> By the way, how much lithium are you taking?
>
> Thanks.
>
>
> - Scott300mgs of Lithium. I'm not bipolar, it's being used as an augmentation agent.
-W
Posted by SLS on May 28, 2008, at 17:34:02
In reply to Re: C*A*F*F*E*I*N*E..as an antidepressant? » SLS, posted by IAMtheWalrus on May 28, 2008, at 17:18:07
> > > I was depressed in March 2009...a combo of Prozac, Lithium, and geodon is helping me.
This is a pretty heady choice of drugs. Who chose the Geodon? Good call.
I was initially unimpressed with Geodon as a drug. I didn't feel it was right for any indication. In particular, I didn't like hearing the many accounts of its provoking psychosis and other activating side effects. I have since seen Geodon produce robust antidepressant responses, especially when added to an SSRI. A friend of mine derived substantial benefit when Geodon was added to Wellbutrin + Lexapro.
- Scott
Posted by IAMtheWalrus on May 28, 2008, at 17:52:40
In reply to Re: C*A*F*F*E*I*N*E..as an antidepressant?, posted by SLS on May 28, 2008, at 17:34:02
> > > > I was depressed in March 2009...a combo of Prozac, Lithium, and geodon is helping me.
>
> This is a pretty heady choice of drugs. Who chose the Geodon? Good call.
>
> I was initially unimpressed with Geodon as a drug. I didn't feel it was right for any indication. In particular, I didn't like hearing the many accounts of its provoking psychosis and other activating side effects. I have since seen Geodon produce robust antidepressant responses, especially when added to an SSRI. A friend of mine derived substantial benefit when Geodon was added to Wellbutrin + Lexapro.
>
>
> - Scott
>
> My Psychiatrist thought of it..just wish it would have been sooner as last winter was hell for me. Better late than never. :)-W
Posted by Phillipa on May 28, 2008, at 19:59:39
In reply to Re: C*A*F*F*E*I*N*E..as an antidepressant? » SLS, posted by IAMtheWalrus on May 28, 2008, at 17:52:40
Ummmm isn't the year now 2008? It went by all of you. That is funny to me. Phillipa
Posted by linkadge on May 28, 2008, at 21:21:34
In reply to Re: C*A*F*F*E*I*N*E..as an antidepressant?, posted by undopaminergic on May 28, 2008, at 13:00:22
>That is because caffeine is a poor stimulant of
>mesolimbic dopamine.True, but the beta carbolines may have some effect there. Regardless, a drug doesn't need to directly enhance mesolimbic dopamine to be an effective AD.
>but I have the impression that it subtly >enhances my memory, cognition and activity >level.
Caffiene inhances acetylcholine levels in the hippocampus.
>A prerequisite for my successful use of caffeine >is to take it in conjunction with more potent >dopaminergic agents.
Well, whatever does it for you.
I personally don't get over fixated on the suposed effects of dopaminergics. Dopamine is not the magic pleasure chemical.
Linkadge
Posted by linkadge on May 28, 2008, at 21:23:55
In reply to Re: C*A*F*F*E*I*N*E..as an antidepressant?, posted by SLS on May 28, 2008, at 15:11:45
>If caffeine were a true antidepressant, I think >we would see more people using it as such.
You don't get out much (?)
>It would certainly be in the media if it were. >It would not remain the best kept secret in >psychiatry - nor the rest of the world.
Again, not necessarily.
>It does for depressed people as it does for >healthy people. No more. Perhaps less.
Again, a bit of a generalization.
Linkadge
Posted by linkadge on May 28, 2008, at 21:41:33
In reply to Re: C*A*F*F*E*I*N*E..as an antidepressant?, posted by SLS on May 28, 2008, at 16:22:19
>However, your answer begs the question why you >are not using caffeine as monotherapy.
Just because caffine monotherapy does is insufficant for certain mood disorders does not mean that it cannot posess a notable AD effect in some individuals.
Like was mentioned previously, coffee drinkers have consistantly lower rates of depression, parkinson's disease, and alzheimers which are often highly comorbid with depression.
It is quite possible that the neuroprotective effect conferred by caffine or other consituents of coffee in these neurological disorders has some sort of protective effect against the development of depression.
I'm sure that we are well aware by now (unfortunately) that many mood disorder folks are not just walking around with low serotonin. Chronically depressed people have brain structure abnormalities, everything from structural atrophy to cellular pathologies. These features likely reduce the effectiveness of antidepressants and make the condition chronic and more refractive.
Caffiene for instance can protect dopaminergic cells from a variety of neurotoxins. If coffee drinkers can preserve their dopaminergic system into old age, this may have a favorable impact on mood disorders, especially on those whose depression is complicated by a parkinsonian interlace.
And again, seeing as we know so little about the true neurobiological origins of mood disorders, I would be hesitate to say what is and is not an antidepressant for any one individual.
Linkadge
Posted by linkadge on May 28, 2008, at 21:44:41
In reply to Re: C*A*F*F*E*I*N*E..as an antidepressant? » IAMtheWalrus, posted by Phillipa on May 28, 2008, at 19:59:39
I did just fine for 3/4 of a year on dark organic coffee twice per day with magnesium/tarine at bedtime.
And again, there is more to coffee than just caffiene. Ie coffee drinkers have a %50 reduction in MAO-A and MAO-B. Its not clear what kind of impact this may have on certain affective disorders.
Linkadge
Posted by linkadge on May 28, 2008, at 21:49:18
In reply to Re: C*A*F*F*E*I*N*E..as an antidepressant?, posted by linkadge on May 28, 2008, at 21:44:41
I even came across a study a while ago about how coffee drinking schizophrenics had less typical antipsychotic induced brain atrophy / abnormalities.
It suggested the caffiene attenuated some of the brain pathologies associated with long term typical AP useage.
Linkadge
Posted by Molybdenum on May 28, 2008, at 22:26:21
In reply to Re: C*A*F*F*E*I*N*E..as an antidepressant?, posted by linkadge on May 28, 2008, at 21:49:18
Caffeine certainly used to give me a little extra boost to get through the day, just like it does for millions of others. I think it's fair to have some distinction between ADs and stimulants though.
From the Wiki god: "An antidepressant is a psychiatric medication or other substance...used for alleviating depression or dysthymia... Most antidepressants have a delayed onset of action and are usually taken over the course of weeks, months, or years. They are generally considered distinct from stimulants, and drugs used for an immediate euphoric effect only are not generally considered antidepressants."
That definition sounds fair, don't you think?
I like the distinction between ADs & stims on the grounds of the sustainability of the effect. ADs typically work for years - some people never get poop-out. The stims are all "instant effect" machines in my experience. By design, they MUST stop working after 12 hrs or so otherwise they interfere with sleep.
Modafinil helps my mood a little and I think that feeling "a little brighter" every day on account of this might be a helpful addition to the traditional ADs in my "treatment spectrum". But I'd still class it as a stim, not an AD in itself, if for no other reason than to make discussions on this forum clear. Imagine the mess that would ensue if we used the term AD to refer both groups. Get my point?
I don't think we need to consider whether each group of drugs actually produces long term chemical or physiological brain changes to help us differentiate between the two groups. There's enough points of distinction in the Wiki definition to leave this aspect alone.
So I agree with your points about caffeine having a genuine "depression alleviating" effect, but I think we should not call it an AD as such. I say leave it as a "stimulant".
Thanks for reading.... ;)
- M.
Posted by undopaminergic on May 28, 2008, at 23:02:13
In reply to Re: C*A*F*F*E*I*N*E..as an antidepressant?, posted by linkadge on May 28, 2008, at 21:21:34
> >That is because caffeine is a poor stimulant of
> >mesolimbic dopamine.
>
> True, but the beta carbolines may have some effect there. Regardless, a drug doesn't need to directly enhance mesolimbic dopamine to be an effective AD.
>My comment addressed the issues of why caffeine is "not much of a euphoriant" and why "Animals do not self inject caffiene like they do cocaine". No-one has claimed that an antidepressant needs to enhance mesolimbic dopamine. Furthermore, you may wish to make up your mind as to whether we're discussing caffeine or beta-carbolines, as they are not equivalent.
> I personally don't get over fixated on the suposed effects of dopaminergics. Dopamine is not the magic pleasure chemical.
>You are wise not to get fixated on supposed effects, but I wonder how magic pleasure chemicals are relevant to the topic at hand.
Posted by IAMtheWalrus on May 28, 2008, at 23:03:38
In reply to Re: C*A*F*F*E*I*N*E..as an antidepressant? » IAMtheWalrus, posted by Phillipa on May 28, 2008, at 19:59:39
> Ummmm isn't the year now 2008? It went by all of you. That is funny to me. Phillipa
OOPS..too much caffeine, my thoughts were/are racing ahead of time. ;)
-W
Posted by Phillipa on May 28, 2008, at 23:56:13
In reply to Re: C*A*F*F*E*I*N*E..as an antidepressant? » Phillipa, posted by IAMtheWalrus on May 28, 2008, at 23:03:38
I can't afford to be any older now. Love Phillipa
Posted by undopaminergic on May 29, 2008, at 0:37:04
In reply to Re: C*A*F*F*E*I*N*E..as an antidepressant?, posted by Molybdenum on May 28, 2008, at 22:26:21
> I think it's fair to have some distinction between ADs and stimulants though.
>To some extent, yes, but it should be acknowledged that the distinction is often a matter of marketing and politics.
> From the Wiki god: "An antidepressant is a psychiatric medication or other substance...used for alleviating depression or dysthymia... Most antidepressants have a delayed onset of action and are usually taken over the course of weeks, months, or years.
>That definition seems tailor-made to suit the contemporary excuses for antidepressants that not only take weeks to show efficacy - in the unlikely case that they ever do - but also have to be taken practically for good, because they do nothing to rectify the underlying pathology, but merely mask some of the more disturbing and conspicuous manifestations thereof.
> They are generally considered distinct from stimulants,
>I agree on that, because a "stimulant" is a more limited and specific concept.
> and drugs used for an immediate euphoric effect only are not generally considered antidepressants."
>How long does the euphoric effect have to be delayed in order for the drug to qualify as an antidepressant? Six hours? A week? More?
>
> I like the distinction between ADs & stims on the grounds of the sustainability of the effect. ADs typically work for years - some people never get poop-out. The stims are all "instant effect" machines in my experience. By design, they MUST stop working after 12 hrs or so otherwise they interfere with sleep.
>It may be more useful to distinguish the different classes of drugs based on their areas of application. Antidepressants are intended to relieve depressive illness, or in other words, to effect the transition from a depressive state to one of normalcy. Stimulants, on the other hand, are primarily useful to enhance or maintain wakefulness, vigilance, concentration, and the capacity for mental or physical effort. Antidepressants are not generally useful in those who are not depressed, in contrast to stimulants, which are basically effective for the same purposes in both normal and depressed individuals.
Posted by linkadge on May 29, 2008, at 8:15:52
In reply to Re: C*A*F*F*E*I*N*E..as an antidepressant?, posted by Molybdenum on May 28, 2008, at 22:26:21
>From the Wiki god: "An antidepressant is a >psychiatric medication or other substance...used >for alleviating depression or dysthymia... Most >antidepressants have a delayed onset of action >and are usually taken over the course of weeks, >months, or years. They are generally considered >distinct from stimulants, and drugs used for an >immediate euphoric effect only are not generally >considered antidepressants."
But I am arguing that the stimulant effect of caffiene is independant of longer term effects that coffee may have on affective disorders. For instance, if you reduce dark chocolate to caffine, then it shouldn't have the health benifits that it does. It should raise BP which it doesn't. Also, most stimulants are *not* neuroprotective, yet caffine shows some effect in this regard.
>I like the distinction between ADs & stims on >the grounds of the sustainability of the effect. >ADs typically work for years - some people never >get poop-out. The stims are all "instant effect" >machines in my experience. By design, they MUST >stop working after 12 hrs or so otherwise they >interfere with sleep.
Again, you don't really know how sustainable the effect of coffee is. It is true that the caffiene may wear off first, but that doesn't mean that coffee may not have a favorable impact on affective disorders long term.
>Modafinil helps my mood a little and I think >that feeling "a little brighter" every day on >account of this might be a helpful addition to >the traditional ADs in my "treatment spectrum". >But I'd still class it as a stim, not an AD in >itself, if for no other reason than to make >discussions on this forum clear.
But many people do use it as an antidepressant. I know people who have failed trials with SSRIs and SNRIs only to have a sustained AD effect from modafanil. Again, when you reduce depression to the biochemical disorder of your choice, then only certain drugs are antidepressants.
>Imagine the mess that would ensue if we used the >term AD to refer both groups. Get my point?
But again, I am separating the effect of caffinie from the effects of coffee. Its just like you cannot reduce cigarrettes to nicotine. Nicotine does not inhibit MAO, but we do know that other compounds in tobacco smoke do.
>There's enough points of distinction in the Wiki >definition to leave this aspect alone.
Yes and no. I know many people who use coffee daily for mood improvement. When my father attempts to quit coffee, he becomes very depressed (far beyond the time lag for complete caffinee withdral). No its not the kind of anxious/neurotic/insomniac depression, he just becomes much less motivated, he reads less, sleeps more, is less interested in favorite TV shows, works less around the house etc.
>So I agree with your points about caffeine >having a genuine "depression alleviating" >effect, but I think we should not call it an AD >as such. I say leave it as a "stimulant".
Some people would like to leave wellbutrin as a "stimulant". Some people crash from wellbutrin. That doesn't mean it doesn't provide an AD effect for many people.
Linkadge
Posted by linkadge on May 29, 2008, at 8:17:23
In reply to Re: C*A*F*F*E*I*N*E..as an antidepressant?, posted by undopaminergic on May 28, 2008, at 23:02:13
I know this thead started with the idea that caffinie is an antidepressant. I am just arguing that coffee is an antidepressant.
Linkadge
Posted by linkadge on May 29, 2008, at 8:27:25
In reply to Re: C*A*F*F*E*I*N*E..as an antidepressant?, posted by undopaminergic on May 29, 2008, at 0:37:04
>That definition seems tailor-made to suit the >contemporary excuses for antidepressants that >not only take weeks to show efficacy - in the >unlikely case that they ever do - but also have >to be taken practically for good, because they >do nothing to rectify the underlying pathology, >but merely mask some of the more disturbing and >conspicuous manifestations thereof.
I agree. The 'definition' of antidepressant was really formuated to make them sound different from stimulants. In order for treatment of affective disorders to be more acceptable, people had to believe they were not taking "uppers".
Some drugs like amineptine were antidepressnats with some euphoric abilities. That does not make them any less of an antidepressant.
An antidepressant drug doesn't need to take weeks to work, and doesn't necessarily need to be taken consistently. Ketamine for instance, can alleviate depression in hours and the effect can last for weeks.
Relief from depression is all about turning off the bad brain regions and turning on the good brain regions in a somewhat sustainable way. If daily coffee does that for you, then who is anybody to argue?
Linkadge
Posted by Zyprexa on May 29, 2008, at 17:56:33
In reply to C*A*F*F*E*I*N*E..as an antidepressant?, posted by IAMtheWalrus on May 27, 2008, at 16:15:38
Yes it does me too!
Posted by Amigan on May 30, 2008, at 8:46:49
In reply to C*A*F*F*E*I*N*E..as an antidepressant?, posted by IAMtheWalrus on May 27, 2008, at 16:15:38
Caffeine should be considered a mood enhancer rather than an antidepressant, imho.
It lifts me up like you and makes me feel better instantly. For me, it is the most decent mood enhancer from the ones i have tried: Nicotine, Sulpiride, Selegiline.
Posted by IAMtheWalrus on May 31, 2008, at 13:09:35
In reply to Re: C*A*F*F*E*I*N*E..as an antidepressant? » IAMtheWalrus, posted by Amigan on May 30, 2008, at 8:46:49
> Caffeine should be considered a mood enhancer rather than an antidepressant, imho.
> It lifts me up like you and makes me feel better instantly. For me, it is the most decent mood enhancer from the ones i have tried: Nicotine, Sulpiride, Selegiline.
>I don't smoke anymore, but when i did nicotine used to relax me big time.
-W
Posted by maz81 on June 2, 2008, at 7:40:12
In reply to C*A*F*F*E*I*N*E..as an antidepressant?, posted by IAMtheWalrus on May 27, 2008, at 16:15:38
Caffeine doesn't really brighten my mood but it's the only thing that can temporarily relieve the back pain I get with my depression. It doesn't respond to analgesics. Probably because its more like a "painful fatigue". Normally Red Bull does the trick.
Posted by IAMtheWalrus on June 2, 2008, at 10:24:38
In reply to Re: C*A*F*F*E*I*N*E..as an antidepressant?, posted by maz81 on June 2, 2008, at 7:40:12
> Caffeine doesn't really brighten my mood but it's the only thing that can temporarily relieve the back pain I get with my depression. It doesn't respond to analgesics. Probably because its more like a "painful fatigue". Normally Red Bull does the trick.
An interesting fact, when i was in a mental Hospitol last winter for severe depression they would not allow us to have any caffeine at all.
-W
Posted by undopaminergic on June 3, 2008, at 4:50:07
In reply to Re: C*A*F*F*E*I*N*E..as an antidepressant?, posted by maz81 on June 2, 2008, at 7:40:12
> Caffeine doesn't really brighten my mood but it's the only thing that can temporarily relieve the back pain I get with my depression. It doesn't respond to analgesics. Probably because its more like a "painful fatigue". Normally Red Bull does the trick.
>Caffeine is known to potentiate analgesics. At least aspirin and paracetamol (acetaminophen)... I don't know about opiates.
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