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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 metafunj on October 27, 2009, at 14:45:33
Has anyone noticed an increased ability concentration or short term memory while taking a Dopamine agonist like Mirapex or Requip or any of the atypical antipsychotics?
Posted by Zyprexa on October 27, 2009, at 16:16:33
In reply to Do DA agonist and APs increase cognition?, posted by metafunj on October 27, 2009, at 14:45:33
Yes with zyprexa.
Posted by delna on October 27, 2009, at 16:31:43
In reply to Do DA agonist and APs increase cognition?, posted by metafunj on October 27, 2009, at 14:45:33
> Has anyone noticed an increased ability concentration or short term memory while taking a Dopamine agonist like Mirapex or Requip or any of the atypical antipsychotics?
I was on Mirapex for 8 months and my concentration was amazing. Too amazing.
However, it made me really weird in that i would stare at the computer all day and work. I was totally focused on digital art at the time and I could concentrate on it all day. (I used to forget to eat.) But that's all I did. It made me very aloof and I had no interest in anything else whatsoever. It didn't improve my cognition or memory- only concentration. Granted, I learned everything I know about digital art in those 8 months but got off it because I was ONLY interested in working and cut off from everyone and everything else which is just not healthy. My pdoc thought this was a weird reaction, so it may just be me.Geodon, at a low dose, on the other hand, improved my cognition/ memory and concentration to pre-illness days (but then that is a DA antagonist, if I am right. Correct me if I am wrong) So are all the APs. I had no cognition improvement with zyprexia but it didn't make me dumber either.
What I have found helpful for cognition/ concentration are both Provigil and to some extent Wellbutrin.
Maybe others have had a better experience with Mirapex.....
Hope you find what you are looking for.
Take Care
D
Posted by cactus on October 27, 2009, at 17:12:08
In reply to Do DA agonist and APs increase cognition?, posted by metafunj on October 27, 2009, at 14:45:33
> Has anyone noticed an increased ability concentration or short term memory while taking a Dopamine agonist like Mirapex or Requip or any of the atypical antipsychotics?
For me a resounding YES for DA's, Requip/Repreve (Ropinirole) was fantastic for concentration, etc...., tick every box for me and it was amazing for depression too! I had the unfortunate side effect of vomiting though, which I put up with for 3 month because I felt so good, but I had to stop. I was losing too much weight. It was prescribed to me for RLS but it's properties went above and beyond the call of that.
Big no for AP's, they make me feel terrible, to the point where I have no idea what day it is sometimes. C
Posted by g_g_g_unit on October 27, 2009, at 19:49:17
In reply to Re: Do DA agonist and APs increase cognition? » metafunj, posted by delna on October 27, 2009, at 16:31:43
> > Has anyone noticed an increased ability concentration or short term memory while taking a Dopamine agonist like Mirapex or Requip or any of the atypical antipsychotics?
>
> I was on Mirapex for 8 months and my concentration was amazing. Too amazing.
> However, it made me really weird in that i would stare at the computer all day and work. I was totally focused on digital art at the time and I could concentrate on it all day. (I used to forget to eat.) But that's all I did. It made me very aloof and I had no interest in anything else whatsoever. It didn't improve my cognition or memory- only concentration. Granted, I learned everything I know about digital art in those 8 months but got off it because I was ONLY interested in working and cut off from everyone and everything else which is just not healthy. My pdoc thought this was a weird reaction, so it may just be me.
>
> Geodon, at a low dose, on the other hand, improved my cognition/ memory and concentration to pre-illness days (but then that is a DA antagonist, if I am right. Correct me if I am wrong) So are all the APs. I had no cognition improvement with zyprexia but it didn't make me dumber either.
>
> What I have found helpful for cognition/ concentration are both Provigil and to some extent Wellbutrin.
>
> Maybe others have had a better experience with Mirapex.....
>
> Hope you find what you are looking for.
> Take Care
> D
>
>
>so wellbutrin/provigil don't exacerbate your OCD? i believe it was shown that Mirapex actually *decreases* blood flow to the brain, so i don't think it would be all that useful for cognition.
that's really interesting about the Geodon. i know another poster psychobot also uses a really low dose (i believe it actually increases DA? at really low doses) and finds it helpful for cognition. i requested it from my pdoc but he turned me down in favour of Risperdal, which is way too dirty for my liking :/
Posted by metafunj on October 27, 2009, at 20:09:07
In reply to Re: Do DA agonist and APs increase cognition?, posted by g_g_g_unit on October 27, 2009, at 19:49:17
I appreciate the posts. It seems like any drug that can increase DA transmission may be able to improve at least concentration and maybe even memory.
Regarding Atypical APs. At a low dose they antagonize the D2 autoreceptor. This is the receptor that when activate inhibits the release of dopamine. So when its activated by DA it acts as a DA brake. When you antagonize it you disinhibit the release of DA. This is what low dose APs do. When you take an atypical at a higher dose it starts to block the post synaptic receptor which decreases dopamine transmission. This is presumabley when the antipsychotic part of the medication takes a effect.
Also atypical APs also antagonize certain serotonin receptors that cause the release of more dopamine.
Has Zyprexa or any one else noticed weight gain at these lower doses of APs?
Posted by Phillipa on October 27, 2009, at 21:30:25
In reply to Re: Do DA agonist and APs increase cognition?, posted by metafunj on October 27, 2009, at 20:09:07
A former poster is on 5mg of requip 2.5mg of abilify, one other extremly low dose of a med and is now a lawyer again. He was bad off. Phillipa
Posted by efishy on October 28, 2009, at 5:29:23
In reply to Do DA agonist and APs increase cognition?, posted by metafunj on October 27, 2009, at 14:45:33
I find that a low dose of abilify (1 mg) lets me concentrate a lot better on schoolwork (especially chemistry which takes a lot of concentration).
I also did a lot better on my practical drivers license test with serdolect, which made me think and perform very calmly. Before that i had failed twice , once with abilify and once without meds.
I didn't experience any cognitive benefits with zyprexa though, it just makes tired and introvert. Serdolect also makes me introvert, while abilify is the opposite.
Posted by delna on October 28, 2009, at 8:24:41
In reply to Re: Do DA agonist and APs increase cognition?, posted by g_g_g_unit on October 27, 2009, at 19:49:17
> so wellbutrin/provigil don't exacerbate your OCD?I'm assuming that's a question for me- so I'm answering it :)
No they don't. Not at all. I know maybe the drug action of both may increase OCD (so I was told) but with me that is not the case at all. A long as I am on an SSRI/SNRI (even low maintenance doses) I can take as much of these drugs with no OCD symptoms.> that's really interesting about the Geodon. i know another poster psychobot also uses a really low dose (i believe it actually increases DA? at really low doses) and finds it helpful for cognition. i requested it from my pdoc but he turned me down in favour of Risperdal, which is way too dirty for my liking :/
Yes, I don't like the thought of Risperidal either due to it's side effect profile -especially for women. Geodon is really good at doses of 40-60mg max. Why did your doc turn you down????
>
>
Posted by metafunj on October 28, 2009, at 11:32:10
In reply to Re: Do DA agonist and APs increase cognition? » g_g_g_unit, posted by delna on October 28, 2009, at 8:24:41
Thanks for the posts, I had no idea that these drugs could improve cognition so well. Looks like its another option instead of stimulants if the current combo doesn't kick in.
I read on wikipedia that DA agonists can cause compulsive gambling, hypersexuality, and even cross dressing?
I assume that didn't happen to anyone here or they would have mentioned it.
http://en.wikipedia.org/wiki/Pramipexole
"Several unusual adverse effects of pramipexole (and related D3-preferring dopamine agonist medications such as ropinirole) may include compulsive gambling, hypersexuality, and overeating,[10] even in patients without any prior history of these behaviours.[11] Other compulsive behaviors, such as excessive shopping and even cross-dressing, have been reported.[12] These side effects are thought to be linked to the D3 activity of pramipexole, as D3 receptors are heavily expressed in brain regions involved in mood, behavior, and reward."lol?
Posted by delna on October 28, 2009, at 11:46:25
In reply to Re: Do DA agonist and APs increase cognition? » delna, posted by metafunj on October 28, 2009, at 11:32:10
I'm sorry i didn't say, but was a bit embarrassed. The hypersexuality thing did happen to me.
But it was, how do I put it....manageable.
TC
D
Posted by metafunj on October 28, 2009, at 13:22:11
In reply to Re: Do DA agonist and APs increase cognition? » metafunj, posted by delna on October 28, 2009, at 11:46:25
Thank you for your candor. I was thinking about trying the brand wellbutrin. The generic seems to only increase norepinephrine in me and has no mood brightening or cognitive effects. I'm also interested in trying provigil since it is a stimulant but not scheduled and may be easier to get.
Posted by Zyprexa on October 29, 2009, at 20:46:45
In reply to Re: Do DA agonist and APs increase cognition?, posted by metafunj on October 27, 2009, at 20:09:07
When I stoped taking zyprexa I couldn't eat anything, it all made me sick and wouldn't go down. So I took 2.5mg zyprexa and in 45 min I could eat again. I think there would be weight gain at any dose.
Posted by metafunj on October 30, 2009, at 9:13:25
In reply to Re: Do DA agonist and APs increase cognition?, posted by Zyprexa on October 29, 2009, at 20:46:45
You know its funny when I started taking prozac at 5mgs I didn't feel hungry. Prozac antagonizes the 5 HT2C receptor so it should make one hungry, but it didn't do that. Zyprexa also antagonizes this receptor. I wonder if it would have a similar effect as prozac or make me want to eat more? Zyprexa also antagonizes the H1 receptor which is supposed to make one hungry also, maybe its the combo of antagonizing both of these receptors that causes weight gain.
Posted by g_g_g_unit on November 5, 2009, at 15:56:37
In reply to Re: Do DA agonist and APs increase cognition? » g_g_g_unit, posted by delna on October 28, 2009, at 8:24:41
>Geodon is really good at doses of 40-60mg max. Why did your doc turn you down????
> >
he had never heard of it :/i don't really trust him - he's always consulting the guidebook for dosing, etc. when i said nortriptyline helped my attention, he had to look up anafranil before he could reassure me it also had NRI properties.
maybe i expect too much?
Posted by delna on November 5, 2009, at 16:21:23
In reply to Re: Do DA agonist and APs increase cognition? » delna, posted by g_g_g_unit on November 5, 2009, at 15:56:37
> >Geodon is really good at doses of 40-60mg max. Why did your doc turn you down????
> > >
>
>
> he had never heard of it :/
>
> i don't really trust him - he's always consulting the guidebook for dosing, etc. when i said nortriptyline helped my attention, he had to look up anafranil before he could reassure me it also had NRI properties.
>
> maybe i expect too much?
>
>sorry, but your post made me laugh. Its not funny (only in a dark-humor sort of way) but the way you described him gave me this clear picture of a fumbling, idiotic and clueless doctor. It was more of a bitter laugh actually. It reminds me of my pdoc too, consulting his PDR for everything. And making up the rest.
They're all as bad, I am starting to think.No, you don't expect too much. But If that means wanting a pdoc with more knowledge than you have, then yes maybe, you do want too much. Because it seems like that is a rare animal. So here we all are doing the research, which is actually the pdocs job. This is their darn field- they should really know their stuff. Its just shameless.
I can't believe he hasn't heard of Geodon... scary! That's a good drug- it really is. I'm sorry he's so incompetent and is denying you the chance to try it.
:(
Take care
Love
D
Posted by g_g_g_unit on November 5, 2009, at 23:48:58
In reply to Re: Do DA agonist and APs increase cognition? » g_g_g_unit, posted by delna on November 5, 2009, at 16:21:23
>
> sorry, but your post made me laugh. Its not funny (only in a dark-humor sort of way) but the way you described him gave me this clear picture of a fumbling, idiotic and clueless doctor. It was more of a bitter laugh actually. It reminds me of my pdoc too, consulting his PDR for everything. And making up the rest.
> They're all as bad, I am starting to think.
>
> No, you don't expect too much. But If that means wanting a pdoc with more knowledge than you have, then yes maybe, you do want too much. Because it seems like that is a rare animal. So here we all are doing the research, which is actually the pdocs job. This is their darn field- they should really know their stuff. Its just shameless.
>
> I can't believe he hasn't heard of Geodon... scary! That's a good drug- it really is. I'm sorry he's so incompetent and is denying you the chance to try it.
> :(
> Take care
> Love
> Dno, the humor was intentional :) it's strange - he's probably the most overall compassionate pdoc i've had, but also the least competent... and when i say compassionate, i guess towards the fact that i suffer from OCD, which he seems to want to abolish at all costs. it's funny hearing them fumbling for explanations - one told me SSRI's should enhance my creativity, yada yada. the best pdoc i had was also the biggest ***hole, but i wish i'd stuck with him, because he was open to trying anything.
anyway, maybe Geodon is not really used where i live (outside of the US). i'm going for a second opinion with a psychiatrist who specialises in ADHD next week. my hope is that he might have more concern with executive function, etc. i've made up a detailed history of my med-use and reaction to each drug.
hope you're doing okay with Parnate withdrawal. i'm 4 days into the 2-week washout. i was using Seroquel to cover up the anxiety, which worked, but i didn't want additional withdrawal, so stopped, and it's really starting to hit me. i'm a teary, dysfunctional, foggy mess :(
Posted by delna on November 6, 2009, at 6:27:09
In reply to Re: Do DA agonist and APs increase cognition? » delna, posted by g_g_g_unit on November 5, 2009, at 23:48:58
>
> no, the humor was intentional :) it's strange - he's probably the most overall compassionate pdoc i've had, but also the least competentI know what you mean. I've had pdocs like one who used to call me to see how I'm doing post surgery. But him and the rest were dingbats and incompetent :) My neuro here is also really compassionate. He looked into my Geodon/TD case in detail, simply because he was concerned. He didn't even want to be paid for that! But I spoke with him yesterday and he just went round and round in circles till it was clear (to him and to me ) that he had no clue what he was talking about. :)
>and when i say compassionate, i guess towards the fact that i suffer from OCD, which he seems to want to abolish at all costs.That's good- it really is! One of my pdoc here actually burst out laughing when I told him about the obsessions that were haunting me. I said
'its not funny". He paused and then said 'actually, it is! Very funny' I failed to see the humor. Idiot!
So, I'm glad you have a pdoc that 'gets' how bad OCD can be and that it should be totally 'eradicated'. It can be crippling if not attacked aggressively.
>it's funny hearing them fumbling for explanations - one told me SSRI's should enhance my creativity, yada yada.SSRI's and creativity!? OMG that is hilarious. Unless he wanted to secretly switch you into hypomania...
>the best pdoc i had was also the biggest ***hole, but i wish i'd stuck with him, because he was open to trying anything.
Well, I did but when push came to shove his 'meanness' has come out.
I chose to go with this US pdoc even though I knew he was a jerk. Seriously cut and dry and no compassion. But extremely professional. He is the best pdoc I have seen and he listened and evaluated (and believed what I would say). The fact that he was uncaring never bothered me because I prefer a pdoc who knows what he is doing than a stupid one, who is nice.
Well now I really wish he was slightly more compassionate because he is just ignoring my emails because 'technically' I am no longer his patient (although he did start me on the Geodon and knew about the pain).
So I don't know .I wish there was an in between.
> anyway, maybe Geodon is not really used where i live (outside of the US). i'm going for a second opinion with a psychiatrist who specialises in ADHD next week. my hope is that he might have more concern with executive function, etc. i've made up a detailed history of my med-use and reaction to each drug.That's so important- a good summary. I really hope he has something positive to add. Finders crossed...
> hope you're doing okay with Parnate withdrawal. i'm 4 days into the 2-week washout. i was using Seroquel to cover up the anxiety, which worked, but i didn't want additional withdrawal, so stopped, and it's really starting to hit me. i'm a teary, dysfunctional, foggy mess :(
Oh, no! I'm sorry you are feeling so bad. It will pass as long as you hold on tight. (very esay to say, I know)
I have had no 'withdrawal' just a total return of symptoms and my ability to 'hang in there' is really weakening- rapidly.Take care
Love
D
Posted by g_g_g_unit on November 6, 2009, at 17:00:18
In reply to Re: Do DA agonist and APs increase cognition? » g_g_g_unit, posted by delna on November 6, 2009, at 6:27:09
> >and when i say compassionate, i guess towards the fact that i suffer from OCD, which he seems to want to abolish at all costs.
>
> That's good- it really is! One of my pdoc here actually burst out laughing when I told him about the obsessions that were haunting me. I said
> 'its not funny". He paused and then said 'actually, it is! Very funny' I failed to see the humor. Idiot!
> So, I'm glad you have a pdoc that 'gets' how bad OCD can be and that it should be totally 'eradicated'. It can be crippling if not attacked aggressively.he laughed?! was he misguidedly trying to help you by making light of the thoughts or something? anyway, the fact that my pdoc wants to abolish the OCD is a mixed blessing, i.e. he's breaking out the heavy-hitters (anafranil, risperdone) when i'd like a more subtle approach
>
>
> >it's funny hearing them fumbling for explanations - one told me SSRI's should enhance my creativity, yada yada.
>
> SSRI's and creativity!? OMG that is hilarious. Unless he wanted to secretly switch you into hypomania...
>
> >the best pdoc i had was also the biggest ***hole, but i wish i'd stuck with him, because he was open to trying anything.
>
> Well, I did but when push came to shove his 'meanness' has come out.
> I chose to go with this US pdoc even though I knew he was a jerk. Seriously cut and dry and no compassion. But extremely professional. He is the best pdoc I have seen and he listened and evaluated (and believed what I would say). The fact that he was uncaring never bothered me because I prefer a pdoc who knows what he is doing than a stupid one, who is nice.
> Well now I really wish he was slightly more compassionate because he is just ignoring my emails because 'technically' I am no longer his patient (although he did start me on the Geodon and knew about the pain).
>
> So I don't know .I wish there was an in between.
>hmm you're right, looking back his meanness did come out, twice, which was too much for me - once when he found out i wasn't using him as my concurrent therapist, and once when i asked to try methylphenidate.
>
> > anyway, maybe Geodon is not really used where i live (outside of the US). i'm going for a second opinion with a psychiatrist who specialises in ADHD next week. my hope is that he might have more concern with executive function, etc. i've made up a detailed history of my med-use and reaction to each drug.
>
> That's so important- a good summary. I really hope he has something positive to add. Finders crossed...
>
> > hope you're doing okay with Parnate withdrawal. i'm 4 days into the 2-week washout. i was using Seroquel to cover up the anxiety, which worked, but i didn't want additional withdrawal, so stopped, and it's really starting to hit me. i'm a teary, dysfunctional, foggy mess :(
>
> Oh, no! I'm sorry you are feeling so bad. It will pass as long as you hold on tight. (very esay to say, I know)
> I have had no 'withdrawal' just a total return of symptoms and my ability to 'hang in there' is really weakening- rapidly.
>
> Take care
> Love
> D
>
>i'm sorry to hear that. i'm amazed you are able to be so composed and compassionate towards me when you are suffering so badly yourself. i hope things turn out okay for you. i more get this sickening feeling in my stomach (and i don't want to just shrug it off as depression) that i've made a complete mess of myself by indulging in AD's, and there's no turning back now. i would love to just go back to work - i'm young and had a really promising career a year ago. your comment about Geodon returning you to status quo gave me so much hope
Posted by delna on November 7, 2009, at 6:09:31
In reply to Re: Do DA agonist and APs increase cognition?, posted by g_g_g_unit on November 6, 2009, at 17:00:18
> he laughed?! was he misguidedly trying to help you by making light of the thoughts or something?
Well, it was stupid because it didn't work and my thoughts were terrifying, not just bothersome.
>anyway, the fact that my pdoc wants to abolish the OCD is a mixed blessing, i.e. he's breaking out the heavy-hitters (anafranil, risperdone) when i'd like a more subtle approach
Maybe.... but if you are not responding to conventional drugs like SSRI/SNRI's and your OCD is crippling then there isn't too much choice.
This is a recent algorithm for OCD treatment. See if anything from that gives you an idea/ possibility.
http://focus.psychiatryonline.org/content/vol5/issue3/images/large/foc0030720760001.jpegThe full paper is also really interesting becasue it talks about all the diff. types of OCD and treatment possibilities. Maybe something strikes a cord???:
http://focus.psychiatryonline.org/cgi/content/full/5/3/299> i'm amazed you are able to be so composed and compassionate towards me when you are suffering so badly yourself.
LOL, you should tell that to my parents who think I am behaving like a horror-movie star...:)
> hope things turn out okay for you.
Thanks so much.
>i would love to just go back to work - i'm young and had a really promising career a year ago. your comment about Geodon returning you to status quo gave me so much hope
You know, I'm sure you will find something that helps. Geodon was my miracle- you may have your own just waiting to be discovered.
But I know frustrating it can be though..looking and looking :(
Take care
Love
D
Posted by g_g_g_unit on November 7, 2009, at 16:24:19
In reply to Re: Do DA agonist and APs increase cognition? » g_g_g_unit, posted by delna on November 7, 2009, at 6:09:31
> Well, it was stupid because it didn't work and my thoughts were terrifying, not just bothersome.
>yeah, i hate it when the thoughts are described as bothersome .. like an itch that needs to be scratched or something. just psych jargon that has no bearing on the actual experience.
> >anyway, the fact that my pdoc wants to abolish the OCD is a mixed blessing, i.e. he's breaking out the heavy-hitters (anafranil, risperdone) when i'd like a more subtle approach
>
> Maybe.... but if you are not responding to conventional drugs like SSRI/SNRI's and your OCD is crippling then there isn't too much choice.
> This is a recent algorithm for OCD treatment. See if anything from that gives you an idea/ possibility.
> http://focus.psychiatryonline.org/content/vol5/issue3/images/large/foc0030720760001.jpeg
>
> The full paper is also really interesting becasue it talks about all the diff. types of OCD and treatment possibilities. Maybe something strikes a cord???:
> http://focus.psychiatryonline.org/cgi/content/full/5/3/299i've seen that algorithm. i hate to sound like a know-it-all, but i think what i need is a decent multi-angle approach. i don't *not* respond to SSRI's, but they remove certain parts of my functioning (like drive, etc.) which i require. so it's more that i'm fussy, while doctors where i live are quite myopic and strictly focus on the OCD, which at the moment is less crippling than my loss of drive, attention difficulties, etc. in my present state, i don't experience much anxiety or OCD; i just feel kinda blank. at least i've done enough experimenting now that i have some idea of what does what in me - i.e. what helps functioning but resurrects the OCD and visa versa. i just need a doc who will listen.
> > i'm amazed you are able to be so composed and compassionate towards me when you are suffering so badly yourself.
>
> LOL, you should tell that to my parents who think I am behaving like a horror-movie star...:)ditto :)
>
> > hope things turn out okay for you.
>
> Thanks so much.
>
> >i would love to just go back to work - i'm young and had a really promising career a year ago. your comment about Geodon returning you to status quo gave me so much hope
>
> You know, I'm sure you will find something that helps. Geodon was my miracle- you may have your own just waiting to be discovered.thanks, i hope so
>
> Take care
> Love
> D
>
>you too
This is the end of the thread.
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