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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Marty on February 16, 2009, at 23:07:06
I have this problem with dopaminergics. I would think it's dopaminergic in nature since the common properties of the drugs that does that to me (Parnate, Wellbutrin and now Agomelatine) all have some pro-DA properties. (PS: Agomelatine by antagonizing 5-HT2c is pro-DA) If I need to stick with the pro-Dopamine drug: Any way to treat that 'side effect' without creating too much side effects ?
Clonazepam seems to help. My 100mg of Lamictal should help too, but I won't stop it and restart it just to make sure. Lyrica would also help, but there's no way I'll return on that. SRI's sucks the life out of me and I do my best to avoid them.
What could help ? I'd like to avoid cognitive and sexual side effects and weight gain.
Thanks for you ideas and for sharing your experiences !
/\/\arty
Posted by Phillipa on February 17, 2009, at 0:19:35
In reply to Dopaminergic jealousy/obsession/upsets boosting ??, posted by Marty on February 16, 2009, at 23:07:06
Marty how is it going? Love Phillipa
Posted by desolationrower on February 17, 2009, at 2:42:26
In reply to Re: Dopaminergic jealousy/obsession/upsets boosting ?? » Marty, posted by Phillipa on February 17, 2009, at 0:19:35
i'd try a neuroleptic, although i wouldn't rule out an sri either.
-d/r
Posted by West on February 17, 2009, at 8:28:22
In reply to Dopaminergic jealousy/obsession/upsets boosting ??, posted by Marty on February 16, 2009, at 23:07:06
Clonazepam would seem like a safe bet but you run the risk of cognitive dulling and poor memory. I wouldn't like to recommend it since i haven't tried it but mirtazapine could help - by quelling the activation through antihistaminic and potent 5ht-2 and 3 antagonism actions, the binding of serotonin to the latter will open up the channel and elicit an excitatory response in serotonin transmission.
West
Posted by SLS on February 17, 2009, at 9:19:52
In reply to Dopaminergic jealousy/obsession/upsets boosting ??, posted by Marty on February 16, 2009, at 23:07:06
Memantine
Trileptal
TopiramateA few anti-glutamatergics to look into.
- Scott
Posted by Marty on February 17, 2009, at 14:03:05
In reply to Re: Dopaminergic jealousy/obsession/upsets boosting ??, posted by desolationrower on February 17, 2009, at 2:42:26
> i'd try a neuroleptic, although i wouldn't rule out an sri either.
Thanks for your input D/r. I agree a neuroleptic could help, but it would defeat the purpose of taking a dopaminergic in the first place I fear. But maybe it depends on the neuroleptic... I could try some I didn't yet tried, but I fear another -ACUTE- Suicidal Akathesia crisis. Aripiprazole comes to mind, but it's long half life scares me: the crisis would be so long they would have to strap me to make sure I survive. :\
SRIs are, for now, out of question.. for many reasons.
Thanks for your input,
/\/\arty
Posted by Marty on February 17, 2009, at 14:06:50
In reply to Re: Dopaminergic jealousy/obsession/upsets boosting ?? » Marty, posted by Phillipa on February 17, 2009, at 0:19:35
> Marty how is it going? Love Phillipa
Not too bad... but lately I missed many doses of Agomelatine because of some financial problems and I also had an acute suicidal akathesia crisis (this is hell) .. so my state isn't that good right now and it will take time before I get better. Also it seems 25mg of Agomelatine doesn't do it anymore for me and so I'm on 50mg .. but at that dosage I'm having some issues.. the one I described in my in my first post in this thread.
Hope you're well Phillipa!
/\/\arty
Posted by Marty on February 17, 2009, at 14:10:01
In reply to Re: Dopaminergic jealousy/obsession/upsets boosting ??, posted by West on February 17, 2009, at 8:28:22
> mirtazapine could help - by quelling the activation through antihistaminic and potent 5ht-2 and 3 antagonism actions, the binding of serotonin to the latter will open up the channel and elicit an excitatory response in serotonin transmission.
I can't stand Mirtazepine... at minimum I have some Restless Legs Syndrome and after more than 3, 4 days I have some moderate akathesia.
Thanks for your input,
/\/\arty
Posted by Marty on February 17, 2009, at 14:36:22
In reply to Re: Dopaminergic jealousy/obsession/upsets boosting ?? » Marty, posted by SLS on February 17, 2009, at 9:19:52
> Memantine
> Trileptal
> Topiramate
>
> A few anti-glutamatergics to look into.Hmmm interesting!.. so you're saying what I'm experiencing is an glutaminergic overstimulation in some region ? Any papers discussing something relating to your rationale ? this is very interesting Scott!
/\/\arty
Posted by Sigismund on February 17, 2009, at 15:15:35
In reply to Re: Dopaminergic jealousy/obsession/upsets boostin » Phillipa, posted by Marty on February 17, 2009, at 14:06:50
>Any way to treat that 'side effect' without creating too much side effects ?
I'd be surprised.
What about 37.5? Would that be just enough?
Posted by Marty on February 17, 2009, at 15:57:25
In reply to Re: Dopaminergic jealousy/obsession/upsets boostin » Marty, posted by Sigismund on February 17, 2009, at 15:15:35
> >Any way to treat that 'side effect' without creating too much side effects ?
>
> I'd be surprised.Yes, I too would be surprised.
> What about 37.5? Would that be just enough?
It's possible. If I don't emotively adapt to 50mg, then I'll consider a downgrade to 37.5mg. I know the other way around, that is starting with 37.5mg , could be a better strategy... but I feel the need for some quick relief and I put my money on the 50mg for this. Note that 50mg could be a bad bet since it could induce some irritability/dysthimia/etc which would render it worst than 37.5mg if the goal is too feel good and feel good quickly.
Thanks for your input,
/\/\arty
Posted by SLS on February 17, 2009, at 16:24:24
In reply to Re: Dopaminergic jealousy/obsession/upsets boostin » SLS, posted by Marty on February 17, 2009, at 14:36:22
> > Memantine
> > Trileptal
> > Topiramate
> >
> > A few anti-glutamatergics to look into.
>
> Hmmm interesting!.. so you're saying what I'm experiencing is an glutaminergic overstimulation in some region ? Any papers discussing something relating to your rationale ? this is very interesting Scott!
>
> /\/\artyI was just using the old noodle in coming up with the idea. Your thoughts regarding Lamictal was a tip-off. However, the drugs I chose are more effective at suppressing glutamate hyperactivity globally.
A quick search on Google indicates the possibility that my guess was a pretty good one.
I can't wait for you to do your homework on this one! I would do it right now, except that I'm at school right now, and I have class in a few minutes.
More tomorrow...
:-)
- Scott
Posted by bleauberry on February 17, 2009, at 17:51:34
In reply to Dopaminergic jealousy/obsession/upsets boosting ??, posted by Marty on February 16, 2009, at 23:07:06
I know your problem real well. It haunts me from med to med and does seem related to the norepinephrine/dopamine circuitry.
Good ideas have already been suggested. I would reiterate...
Mood stabilizers (personal trial, mileage varies)
Antipsychotics (Zyprexa-fast, Abilify-slower, Seroquel-(maybe too sedating)
A tiny dose of Lexapro or Zoloft...not a therapeutic dose, just a counterbalance dose.
As low a dose as possible of lorazepam or klonopin, maybe xanax.Of the above things, what worked best for me and fast was 2.5mg Lexapro or 6.25mg Zoloft or 2.5mg Zyprexa or 500mg Depakote extended release. At times the 3 benzos also helped immensely and immediately, but I never did them more than an as-needed basis for emergencies only.
Posted by Phillipa on February 17, 2009, at 19:46:37
In reply to Dopaminergic jealousy/obsession/upsets boosting ??, posted by Marty on February 16, 2009, at 23:07:06
Marty I think private is the word. Love Phillipa
This is the end of the thread.
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